Exercise on balance and function for knee osteoarthritis: A randomized controlled trial

Publication date: Available online 7 April 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Roberta de Matos Brunelli Braghin, Elisa Cavalheiro Libardi, Carina Junqueira, Marcello Henrique Nogueira – Barbosa, Daniela Cristina Carvalho de Abreu
ObjectivesTo assess balance and function of symptomatic and asymptomatic subjects with knee osteoarthritis (OA) and investigate the influence of physical exercise.DesignSubjects were divided into three groups: Group 1 (n = 15), symptomatic knee OA; Group 2 (n = 11), asymptomatic knee OA; and Group 3 (n = 16), knee OA and no intervention. History of falls, the WOMAC questionnaire, balance and functionality were assessed.ResultsAfter intervention, there was a significant difference in the total WOMAC score and in the pain and function domains only in Group 1. After intervention, Group 2 showed significant differences in decreased time on the Step Up/Over test and postural sway increased.ConclusionAfter the intervention, the symptomatic group reported improvement in pain and function on the WOMAC, while the asymptomatic group showed improvement in performance in the Step Up/Over test. There were no new episodes of falls in groups 1 and 2.



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Acute effects of self-myofascial release and stretching in overhead athletes with GIRD

Publication date: Available online 7 April 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Ryan R. Fairall, Lee Cabell, Richard J. Boergers, Fortunato Battaglia
Summary ObjectiveTo examine the acute effects of self-myofascial release (SMR), static stretching (SS), and the combination of self-myofascial release and static stretching (SMR+SS) on glenohumeral internal rotation range of motion (GH IR ROM) in overhead athletes with glenohumeral internal rotation deficit (GIRD).ParticipantsTwelve asymptomatic adult male amateur softball position players exhibiting GIRD.ResultsAll three methods significantly improved GH IR ROM. Post hoc testing revealed that SS alone and SMR+SS improved GH IR ROM significantly more than SMR alone. However, there were no significant differences in GH IR ROM between SS alone and SMR+SS.ConclusionsIf an athlete has a limited time to perform a warm-up (e.g., 3-4 minutes), SS alone is recommended to improve GH IR ROM. However, if the athlete has more time available to warm up (e.g., 7-8 minutes), combining SMR+SS may result in a greater increase in GH IR ROM.



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Intentional cannabis use to reduce crack cocaine use in a Canadian setting: A longitudinal analysis

Publication date: September 2017
Source:Addictive Behaviors, Volume 72
Author(s): M. Eugenia Socías, Thomas Kerr, Evan Wood, Huiru Dong, Stephanie Lake, Kanna Hayashi, Kora DeBeck, Didier Jutras-Aswad, Julio Montaner, M.-J. Milloy
BackgroundNo effective pharmacotherapies exist for the treatment of crack cocaine use disorders. Emerging data suggests that cannabinoids may play a role in reducing cocaine-related craving symptoms. This study investigated the intentional use of cannabis to reduce crack use among people who use illicit drugs (PWUD).MethodsData were drawn from three prospective cohorts of PWUD in Vancouver, Canada. Using data from participants reporting intentional cannabis use to control crack use, we used generalized linear mixed-effects modeling to estimate the independent effect of three pre-defined intentional cannabis use periods (i.e., before, during and after first reported intentional use to reduce crack use) on frequency of crack use.ResultsBetween 2012 and 2015, 122 participants reported using cannabis to reduce crack use, contributing a total of 620 observations. In adjusted analyses, compared to before periods, after periods were associated with reduced frequency of crack use (Adjusted Odds Ratio [AOR]=1.89, 95% Confidence Interval [CI]: 1.02–3.45), but not the intentional use periods (AOR=0.85, 95% CI: 0.51–1.41). Frequency of cannabis use in after periods was higher than in before periods (AOR=4.72, 95% CI: 2.47–8.99), and showed a tendency to lower frequency than in intentional cannabis use periods (AOR=0.56, 95% CI: 0.32–1.01).ConclusionsA period of intentional cannabis use to reduce crack use was associated with decreased frequency of crack use in subsequent periods among PWUD. Further clinical research to assess the potential of cannabinoids for the treatment of crack use disorders is warranted.



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Randomized, Controlled Trial of Fractional Carbon Dioxide Laser Resurfacing Followed by Ultrashort Incubation Aminolevulinic Acid Blue Light Photodynamic Therapy for Actinic Keratosis.

BACKGROUND: Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an established treatment option for actinic keratosis (AK), and recently fractional carbon dioxide (CO2) laser was shown to improve outcomes; but studies of short incubation photosensitizer are lacking. OBJECTIVE: Assess the efficacy of short incubation ALA followed by blue light PDT with and without previous fractional CO2 treatment for the treatment of AK. METHODS: Randomized, paired split-design, controlled trial of fractional CO2 followed by ultrashort 15-minute versus 30-minute incubation ALA and blue light PDT for the treatment of AK on the face. RESULTS: The complete clearance rates (CRs) at 8 weeks after ALA PDT with and without FxCO2 at 30- and 15-minute ALA incubation times were 89.78% (+FxCO2) versus 71.20% CR (-FxCO2) at 30', and 86.38% (+FxCO2) versus 69.23% (-FxCO2) at 15' ALA incubation. All lesion improvements were statistically significant. CONCLUSION: This randomized, comparative paired group controlled clinical study demonstrates that ultrashort 15- and 30-minute incubation ALA PDTs are of limited efficacy for the treatment of AK. Pretreatment with fractional ablative resurfacing yields statistically significant greater AK clearance with ALA-PDT at ultrashort ALA incubations followed by blue light. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Modified V-Y Advancement Flap With "Directed" Granulation and Leveling Sutures for Defects of the Lid-Cheek Junction.

No abstract available

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Differences in Hyaluronic Acid Filler Persistence Depending Upon Facial Site: A Consideration of Anatomical Factors.

No abstract available

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Endocrine Mucin-Producing Sweat Gland Carcinoma Treated With Mohs Micrographic Surgery.

No abstract available

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The Facial Platysma and Its Underappreciated Role in Lower Face Dynamics and Contour.

BACKGROUND: The platysma is a superficial muscle involved in important features of the aging neck. Vertical bands, horizontal lines, and loss of lower face contour are effectively treated with botulinum toxin A (BoNT-A). However, its pars facialis, mandibularis, and modiolaris have been underappreciated. OBJECTIVE: To demonstrate the role of BoNT-A treatment of the upper platysma and its impact on lower face dynamics and contour. MATERIAL AND METHODS: Retrospective analysis of cases treated by an injection pattern encompassing the facial platysma components, aiming to block the lower face as a whole complex. It consisted of 2 intramuscular injections into the mentalis muscle and 2 horizontal lines of BoNT-A injections superficially performed above and below the mandible (total dose, 16 onabotulinumtoxinA U/side). Photographs were taken at rest and during motion (frontal and oblique views), before and after treatment. RESULTS: A total of 161 patients have been treated in the last 2 years with the following results: frontal and lateral enhancement of lower facial contour, relaxation of high horizontal lines located just below the lateral mandibular border, and lower deep vertical smile lines present lateral to the oral commissures and melomental folds. CONCLUSION: The upper platysma muscle plays a relevant role in the functional anatomy of the lower face that can be modulated safely with neuromodulators. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Customized Assembly of Microneedling Device in the Clinic.

No abstract available

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Repeatable Tie-Over Dressing Technique Using "3-Way Stop-Cock".

No abstract available

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Safety of Cochlear Implants in Electrosurgery: A Systematic Review of the Literature.

BACKGROUND: The implications of electrosurgical instrument use in patients with cochlear implants (CIs) are becoming increasingly relevant for dermatologic surgeons as the number of implanted CI devices continues to grow. The literature, however, fails to provide clear recommendations for appropriate treatment of these patients. OBJECTIVE: To systematically consolidate and critique the current literature regarding electrosurgical instrument use in patients with CI, to determine implications of various electrosurgical devices and settings on CI function and health of cochlear tissues, and to devise recommendations for appropriate use. MATERIALS AND METHODS: The manuscript was created based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A broad search of PubMed, Access Medicine, Clinical Key, Ovid, Scopus, the Cochrane Library, and Web of Science was performed using key words such as CI, electrosurgery, and/or electrosurgical device. Criteria for inclusion included being written in English language and institutional access to manuscript. All years were included. Additional references were obtained from personal communication with CI manufacturers. Study biases were assessed through evaluation of funding and/or sponsoring agencies for included studies. RESULTS: The authors' search yielded a total of 8 studies, 5 of which were a level of evidence 5, 2 of which were level of evidence 4, and 1 of which was a level of evidence 3. The remaining study was relegated only to device testing. These studies were complicated by inaccurate terminology and inconsistent recommendations. CONCLUSION: The body of evidence evaluating electrosurgical instrument use in patients with CI is severely limited in number and quality. Thus, vague and inconsistent recommendations have emerged that place patients at risk of serious and costly adverse effects. In light of this, the authors suggest use of the most conservative recommendations available for electrosurgical instrument use in patients with CI. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Surgical Pearl: Adding Gentian Violet to Aluminum Chloride Aids in Differentiating Cotton-Tipped Applicators on Surgical Tray.

No abstract available

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Multiple Squamous Cell Carcinomas Arising in Hyperpigmented Patches: A Newly Recognized Feature of Incontinentia Pigmenti?.

No abstract available

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Masthead

Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1





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Editorial Board

Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1





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Table of Contents

Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1





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outside front cover

Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1





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Preparation, characterization, and dye removal study of activated carbon prepared from palm kernel shell

Abstract

Palm oil mill wastes (palm kernel shell (PKS)) were used to prepare activated carbons, which were tested in the removal of colorants from water. The adsorbents were prepared by 1-h impregnation of PKS with ZnCl₂ as the activating agent (PKS:ZnCl₂ mass ratios of 1:1 and 2:1), followed by carbonization in autogenous atmosphere at 500 and 550 °C during 1 h. The characterization of the activated carbons included textural properties (porosity), surface chemistry (functional groups), and surface morphology. The dye removal performance of the different activated carbons was investigated by means of the uptake of methylene blue (MB) in solutions with various initial concentrations (25–400 mg/L of MB) at 30 °C, using a 0.05-g carbon/50-mL solution relationship. The sample prepared with 1:1 PKS:ZnCl₂ and carbonized at 550 °C showed the highest MB adsorption capacity (maximum uptake at the equilibrium, q _max = 225.3 mg MB / g adsorbent), resulting from its elevated specific surface area (BET, 1058 m²/g) and microporosity (micropore surface area, 721 m²/g). The kinetic experiments showed that removals over 90% of the equilibrium adsorptions were achieved after 4-h contact time in all the cases. The study showed that palm oil mill waste biomass could be used in the preparation of adsorbents efficient in the removal of colorants in wastewaters.

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Estimation of heavy metal-contaminated soils’ mechanical characteristics using electrical resistivity

Abstract

Under the process of urbanization in China, more and more attention has been paid to the reuse of heavy metal-contaminated sites. The shear characteristics of heavy metal-contaminated soils are investigated by electrical detection in this paper. Three metal ions (Zn²⁺, Cd²⁺, and Pb²⁺) were used, the metal concentrations of which are 50, 166.67, 500, 1666.67, and 5000 mg/kg, respectively. Direct shear tests were used to investigate the influence of heavy metal ions on the shear characters of soil samples. It is found that with the addition of heavy metal ions, the shear strength, cohesion, and friction angle of contaminated soils are higher than the control samples. The higher concentration of heavy metal ions penetrated in soils, the higher these engineering characteristics of contaminated soils observed. In addition, an electrical resistivity detection machine is used to evaluate the shear characteristics of contaminated soils. The electrical resistivity test results show that there is a decreasing tendency of resistivity with the increase of heavy metal ion concentrations in soils. Compared with the electrical resistivity and the shear characteristics of metal-contaminated soils, it is found that, under fixed compactness and saturation, shear strength of metal-contaminated soils decreased with the increase of resistivity. A basic linear relationship between C/log(N + 10) and resistivity can be observed, and there is a basic linear relationship between φ/log(N + 10) and resistivity. Besides, a comparison of the measured and predicted shear characteristics shows a high accuracy, indicating that the resistivity can be used to evaluate the shear characteristics of heavy metal contaminated soils.

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Fishing for contaminants: identification of three mechanism specific transcriptome signatures using Danio rerio embryos

Abstract

In ecotoxicology, transcriptomics is an effective way to detect gene expression changes in response to environmental pollutants. Such changes can be used to identify contaminants or contaminant classes and can be applied as early warning signals for pollution. To do so, it is important to distinguish contaminant-specific transcriptomic changes from genetic alterations due to general stress. Here we present a first step in the identification of contaminant class-specific transcriptome signatures. Embryos of zebrafish (Danio rerio) were exposed to three substances (methylmercury, chlorpyrifos and Aroclor 1254, each from 24 to 48 hpf exposed) representing sediment typical contaminant classes. We analyzed the altered transcriptome to detect discriminative genes significantly regulated in reaction to the three applied contaminants. By comparison of the results of the three contaminants, we identified transcriptome signatures and biologically important pathways (using Cytoscape/ClueGO software) that react significantly to the contaminant classes. This approach increases the chance of finding genes that play an important role in contaminant class-specific pathways rather than more general processes.

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The significance of renewable energy use for economic output and environmental protection: evidence from the Next 11 developing economies

Abstract

Increasing economic activities in developing economies raise demand for energy mainly sourced from conventional sources. The consumption of more conventional energy will have a significant negative impact on the environment. Therefore, attention of policy makers has recently shifted towards the promotion of renewable energy generation and uses across economic activities to ensure low carbon economy. Given the recent scenario, in this paper, we aim to examine the role of renewable energy consumption on the economic output and CO₂ emissions of the next fastest developing economies of the world. The study employs several robust panel econometric models by using annual data from 1990 to 2012. Empirical findings confirm the significant long-run association among the variables. Similarly, results show that renewable energy consumption positively contributes to economic output and has an adverse effect on CO₂ emissions. Given our findings, we suggest policy makers of those economies to initiate further effective policies to promote more renewable energy generation and uses across economic activities to ensure sustainable economic development.

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The genus Achyranthes: A review on traditional uses, phytochemistry, and pharmacological activities

Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Xirui He, Xiaoxiao Wang, Jiacheng Fang, Yu Chang, Ning Ning, Hao Guo, Linhong Huang, Xiaoqiang Huang
Ethnopharmacological relevanceAchyranthes L. (Amaranthaceae), also known as Chaff Flower and Niuxi/牛膝, mainly includes two famous medicinal species namely A. bidentata and A. aspera. A. bidentata has been widely used as blood-activating and stasis-resolving medicine for the treatment of various diseases including amenorrhea, dysmenorrhea, lumbago, gonalgia, paraplegia, edema, stranguria, headache, dizziness, odontalgia, oral ulcer, hematemesis, and epistaxis. A. aspera has been widely used to treat various diseases, including gynecological disorder, asthma, ophthalmia, odontalgia, haemorrhoids, and abdominal tumor, and has been applied to difficult labour, wound healing, insect and snake bites.Aim of this reviewThis review aims to provide systematically reorganized information on distributions, botanical characteristics, ethnopharmacology, chemical constituents, qualitative and quantitative analysis, pharmacological activities, and toxicity of Achyranthes species to support their therapeutic potential.Materials and methodsThe relevant information on Achyranthes species was gathered from worldwide accepted scientific databases via electronic search (Google Scholar, Web of Science, ScienceDirect, ACS Publications, PubMed, Wiley Online Library, SciFinder, CNKI). Information was also obtained from International Plant Names Index, Chinese Pharmacopoeia, Chinese herbal classic books, PhD and MSc dissertations, etc.ResultsA comprehensive analysis of literatures obtained through the above- mentioned sources confirms that the ethnomedicinal uses of Achyranthes species are mainly recorded in China, India, Korea, Pakistan, Ethiopia, Kenya, Sri Lanka, Bangladesh, Philippines, etc. Phytochemical investigations revealed that the major bioactive substances of Achyranthes plants are polysaccharides, polypeptides, triterpenoid saponins, and ketosteroids. Achyranthes plants have been shown to not only act on immune system, nervous system, bone metabolism, and reproduction, but also possess a wide range of biological activities, including blood-activating, anti-tumor, anti-inflammation, anti-arthritis, anti-oxidation, anti-aging, wound healing, etc. Toxicity studies indicated that A. bidentata and A. aspera seem non-toxic at the common therapeutic doses.ConclusionsA. bidentata and A. aspera are very promising to be fully utilized in the development of nutraceutical and pharmaceutical products. There are, however, needs for further in-depth studies to confirm some ethnomedicinal uses of Achyranthes plants and to elucidate the scientific connotation of the widely documented property of conducting drug downward of A. bidentata. In addition, other widespread Achyranthes species like A. japonica and A. rubrofusca ought to be studied. Likewise, systematic comparative studies of the chemical constituents of medicinal Achyranthes plants resources with the same local name are also needed. Furthermore, not only should the investigations on the structure-activity relationship of the main bioactive compounds triterpenoid saponins and ketosteroids be carried out, but the pathways of absorption, distribution, metabolism, and excretion ought to be clarified. Last but not least, there is also a need to evaluate the long-term chronic toxicity and acute toxicity in vivo of the main bioactive compounds.

Graphical abstract

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Abietic acid isolated from pine resin (Resina Pini) enhances angiogenesis in HUVECs and accelerates cutaneous wound healing in mice

Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Jun Yeon Park, Yun Kyung Lee, Dong-Soo Lee, Jeong-Eun Yoo, Myoung-Sook Shin, Noriko Yamabe, Su-Nam Kim, Seulah Lee, Ki Hyun Kim, Hae-Jeung Lee, Seok Sun Roh, Ki Sung Kang
Ethnopharmacological relevanceResin known as Resina Pini is listed in the Korean and Japanese pharmacopoeias and has been used for treating skin wounds and inflammation. Resin is composed of more than 50% abietic acid and 10% neutral substances.ObjectiveIn the present study, the wound-healing effects of abietic acid and the possible underlying mechanism of action were investigated in various in vitro and in vivo models.Materials and methodsThe effects of abietic acid on tube formation and migration were measured in human umbilical vein vascular endothelial cells (HUVECs). Protein expression of mitogen-activated protein kinase (MAPK) activation was evaluated via Western blotting analysis. The wound-healing effects of abietic acid were assessed using a mouse model of cutaneous wounds.ResultsThe results showed that abietic acid enhanced cell migration and tube formation in HUVECs. Abietic acid induced significant angiogenic potential, which is associated with upregulation of extracellular signal-regulated kinase (ERK) and p38 expression. Additionally, 0.8μM abietic acid-treated groups showed accelerated wound closure compared to the controls in a mouse model of cutaneous wounds.ConclusionThe current data indicate that abietic acid treatment elevated cell migration and tube formation in HUVECs by the activation of ERK and p38 MAPKs. We suggest that abietic acid can be developed as a wound-healing agent.

Graphical abstract

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Protective effect of a phenolic extract containing indoline amides from Portulaca oleracea against cognitive impairment in senescent mice induced by large dose of D-galactose /NaNO2

Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Peipei Wang, Hongxiang Sun, Dianyu Liu, Zezhao Jiao, Su Yue, Xiuquan He, Wen Xia, Jianbo Ji, Lan Xiang
Ethnopharmacological relevance:Portulaca oleracea L. is a potherb and also a widely used traditional Chinese medicine. In accordance with its nickname "longevity vegetable", pharmacological study demonstrated that this plant possessed antioxidant, anti-aging, and cognition-improvement function. Active principles pertaining to these functions of P. oleracea need to be elucidated.Aim of the study:The present study evaluated the effect of a phenolic extract (PAAs) from P. oleracea which contained specific antioxidant indoline amides on cognitive impairment in senescent mice.Materials and methods:PAAs was prepared through AB-8 macroporous resin column chromatography. Total phenol content was determined using colorimetric method, and contents of indoline amides were determined using HPLC-UV method. Senescent Kunming mice with cognitive dysfunction were established by intraperitoneal injection of D-galactose (D-gal, 1250mg/kg/day) and NaNO2 (90mg/kg/day) for 8 weeks, L-PAAs (360mg/kg/day), H-PAAs (720mg/kg/day), and nootropic drug piracetam (PA, 400mg/kg/day) as the positive control were orally administered. Spatial learning and memory abilities were evaluated by Morris water maze experiment. Activities of AChE, SOD, CAT, and levels of GSH and MDA in the brain or plasma were measured. Hippocampal morphology was observed by HE staining.Results:Chronic treatment of large dose of D-gal/NaNO2 significantly reduced lifespan, elevated AChE activity, decreased CAT activity, compensatorily up-regulated SOD activity and GSH level, increased MDA level, induced neuronal damage in hippocampal CA1, CA3 and CA4 regions, and impaired cognitive function. Similar to PA, PAAs prolonged the lifespan and improved spatial memory ability. Moreover, PAAs improved learning ability. H-PAAs significantly reversed compensatory increase in SOD activity to the normal level, elevated serum CAT activity, and reduced MDA levels in brain and plasma, more potent than L-PAAs. Besides these, PAAs evidently inhibited hippocampal neuronal damage. However, it had no effect on brain AChE activity.Conclusion:PAAs as the bioactive principles of P. oleracea attenuated oxidative stress, improved survival rate, and enhanced cognitive function in D-gal/NaNO2-induced senile mice, similar to piracetam. This phenolic extract provides a promising candidate for prevention of aging and aging-related cognitive dysfunction in clinic.

Graphical abstract

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Psychoactive Drugs in Plastic Surgery

Background: Psychoactive drug use is on the rise in the United States, with plastic surgery patients a potentially susceptible group. This study aimed to determine the incidence of cosmetic and reconstructive patients in our practice taking psychoactive drugs and to compare those values with the national average. Furthermore, we discuss the patient safety concerns when patients withhold their medical history information over the course of their treatment. Methods: Urban private plastic practice patients who underwent surgery in a closed practice from 2009 to 2016 were divided into cosmetic and reconstructive cohorts. Review for drug use was medical scripts, history, and Surescripts drug reporting. Extracted information includes age, race, procedure, psychoactive medications, and whether or not they stated a mental health diagnosis on their medical history forms. Only patients with complete records were included. Results: A total of 830 patients were included in statistical analysis. Due to minimal cohort number, 70 men were excluded, as there were no comparative national data. Our analysis found that 33.6% cosmetic patients and 46.3% reconstructive patients used at least one psychoactive drug. Conclusion: There is a statistically significant difference between psychoactive drug use at our practice compared with the general population and a significantly larger percentage of reconstructive patients taking drugs compared with the cosmetic cohort.

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Improved Outcomes with Pedicled Nipple-sparing Mastectomies Using a New Surgical Delay: Mastectomy through Wise Incisions

Summary: Nipple-sparing mastectomy (NSM) is challenging in patients with significant ptosis and skin excess. We previously described the first use of a surgical delay (a supraareolar incision with undermining off the breast mound) to facilitate a second-stage pedicled NSM and reconstruction. Here, we present an improvement in our surgical delay technique—a total skin and NSM through Wise incisions. This technique obviates concerns regarding delays in cancer care and more aggressively delays the nipple, allowing for more reliable and extreme NAC transpositions. This strategy also delays the Wise pattern flaps resulting in better wound healing, which is critical in implant-based reconstructions.

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The Aesthetic Items Scale: A Tool for the Evaluation of Aesthetic Outcome after Breast Reconstruction

Background: Valid tools to assess aesthetic outcomes after breast reconstructive surgery are scarce. Previously a professional aesthetic assessment scale was introduced, the Aesthetic Items Scale (AIS). We aim to determine if this method is a valid and reliable tool to assess aesthetic outcome after breast reconstructive surgery. Methods: The study population was consenting women who underwent prophylactic mastectomy with subsequent implant-based breast reconstruction. The aesthetic outcome with regard to breast volume, shape, symmetry, scars, and nipple areola complex was rated on a 5-point scale using standardized photographs to give a summed total score. Photographs were evaluated by the patient, 5 plastic surgeons, and 3 mammography nurses. An overall rating of aesthetic outcome on a 1–10 scale was given separately. We determined the intraclass correlation coefficient and assessed interobserver agreement. To assess validity, we calculated the correlation between total score and overall rating of aesthetic outcome. Results: Interobserver reliability was highest between plastic surgeons for the subitem and overall scores and ranged between 0.56 and 0.82. The summed score of the AIS correlates strongly with the overall rating in professionals but not in patients. Conclusions: The AIS is a valid and reliable method for evaluating aesthetic outcome of breast reconstruction by plastic surgeons. The results indicate that patients judge aesthetic outcome differently, taking into account factors that are not represented in the AIS. Professionals can use this method to evaluate surgical results, but other measurements are needed to map satisfaction of the patient with her breasts.

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Combinational effects of maxacalcitol and betamethasone butyrate propionate on imiquimod-induced psoriasis-like dermatitis in mice

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Kei Hashimoto, Hideya Uratsuji, Yoshihito Yamada, Takamichi Kitano, Yusuke Kumagai, Tatsumi Matsumoto




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Intravenous immunoglobulin suppresses disease activity in mouse models of bullous pemphigoid

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Hideyuki Ujiie, Tetsumasa Sasaoka, Wataru Nishie, Ken Natsuga, Satoru Shinkuma, Hiroshi Shimizu




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CD26/DPPIV-mediated regulation of pruritus in psoriasis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Eriko Komiya, Ryo Hatano, Haruna Otsuka, Takumi Itoh, Taketo Yamada, Mitsutoshi Tominaga, Kenji Takamori, Kei Ohnuma, Chikao Morimoto




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Decreased IL-10-producing B cell level in patients with pemphigus but not with pemphigoid

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Miho Kabuto, Noriki Fujimoto, Toshifumi Takahashi, Takeshi Nakanishi, Toshihiro Tanaka




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Editors Choice

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2





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Binding affinity and interaction of LL-37 with HLA-C*06:02 in psoriasis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Tomotaka Mabuchi, Noriaki Hirayama




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The ex vivo-induced regulatory B cells ameliorate tissue fibrosis and autoimmunity via an anti-oxidative effect in systemic sclerosis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Ayumi Yoshizaki, Takemichi Fukasawa, Satoshi Ebata, Shinichi Sato




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Single B cell analysis can reveal distinct cytokine profile of autoreactive B cells in systemic sclerosis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Takemichi Fukasawa, Ayumi Yoshizaki, Satoshi Toyama, Satoshi Ebata, Kouki Nakamura, Ryosuke Saigusa, Takashi Yamashita, Yohei Ichimura, Takehiro Takahashi, Takashi Taniguchi, Yoshihide Asano, Yutaka Kazoe, Kazuma Mawatari, Takehiko Kitamori, Shinichi Sato




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Editorial board

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2





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High fat diet exacerbates psoriasis-like skin lesion induced by imiquimod through inducing IL-17A and inflammasomes in mice

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Yuko Higashi, Munekazu Yamakuchi, Tomoko Fukushige, Teruto Hashiguchi, Takuro Kanekura




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Involvement of opioid systems in itch-related behavior of imiquimod-induced psoriasis-like dermatitis model

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Nobuaki Takahashi, Mitsutoshi Tominaga, Yayoi Kamata, Yoshie Umehara, Hironori Matsuda, Yasushi Suga, Hideoki Ogawa, Kenji Takamori




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Role of sulfated cholecystokinin 8 in spinal itch transmission

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Fumiya Kusube, Mitsutoshi Tominaga, Hiroaki Kawasaki, Fumiyuki Yamakura, Hisashi Naito, Hideki Ogawa, Yasuhiro Tomooka, Kenji Takamori




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α2AP regulates vascular alteration by inhibiting VEGF signaling in systemic sclerosis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Yosuke Kanno, En Shu, Hiroyuki Kanoh, Ayaka Matsuda, Mariko Seishima




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Comparative study of cutaneous adverse reactions induced by a proteasome inhibitor with skin eruptions in Nakajo-Nishimura syndrome

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Kayo Kunimoto, Nobuo Kanazawa, Fukumi Furukawa, Keiko Manabe, Kenji Asagoe, Osamu Yamasaki, Takeshi Kabahara, Miwa Kanaoka, Michiko Aihara, Yuichi Teraki, Seiichi Izaki, Ryuhei Okuyama, Toshiyuki Yamamoto, John Hanna




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Genetic prediction of the effectiveness of anti-TNF-α therapy for psoriasis patients

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Rika Nishikawa, Hiroshi Nagai, Toshinori Bito, Tetsuya Ikeda, Tatsuya Horikawa, Atsuko Adachi, Tsukasa Matsubara




http://ift.tt/2ocb0Mh

Self-genomic double-stranded DNA is a potential trigger of keratinocyte hyperproliferation in psoriasis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Yuqian Luo, Takeshi Hara, Yuko Ishido, Norihisa Ishii, Takeshi Kambara, Koichi Suzuki




http://ift.tt/2oRkUWw

The pathogenic ceramide metabolizing enzyme sphingomyelin deacylase in atopic dermatitis is identical to the beta-subunit of acid ceramidase

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Yasuhiro Teranishi, Hiroshi Kuwahara, Makoto Kawashima, Genji Imokawa, Mari Nogami-Itoh




http://ift.tt/2ocjCCZ

FcgRIIb is critical to establish clonal ignorance and suppress pemphigus phenotype in pathogenic anti-desmoglein 3 antibody knock-in mice

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Hisashi Nomura, Yuko Kase, Jun Yamagami, Naoko Wada, Shigeo Koyasu, Hayato Takahashi, Masayuki Amagai




http://ift.tt/2oRlGCW

Inhibitory regulation of MFG-E8 on fibrosis in systemic sclerosis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Chisako Fujiwara, Akihito Uehara, Yoko Yokoyama, Akihiko Uchiyama, Akiko Sekiguchi, Sachiko Ogino, Osamu Ishikawa, Sei-ichiro Motegi




http://ift.tt/2oc8CoS

Langerhans cells regulate autoimmune CD8 T cell-mediated interface dermatitis

Publication date: May 2017
Source:Journal of Dermatological Science, Volume 86, Issue 2
Author(s): Noriko Kubota, Naoko Okiyama, Akimasa Saito, Yosuke Ishitsuka, Rei Watanabe, Björn E. Clausen, Manabu Fujimoto




http://ift.tt/2oRi047

The role of interleukin-1β and extracellular signal-regulated kinase 1/2 in glucose-stimulated insulin secretion

Publication date: Available online 7 April 2017
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Ben Niu, Heng Su, Xue-Shan Xia, Qiu He, Yuan-Ming Xue, Xin-Ming Yan
Glucose-stimulated insulin secretion (GSIS) is one of the important physiological characteristics of islet β cells, and extracellular-regulated protein kinase 1/2 (ERK1/2) is an important member of the mitogen-activated protein kinase family that regulates this process. The inflammatory cytokine interleukin (IL)-1β can inhibit the insulin secretion of pancreatic β cells, but the exact mechanism is unclear. This study was designed to investigate the inhibitory effect of IL-1β on GSIS in βTC-6 cells and its relation with the ERK1/2 signal transduction pathway. β-TC6 cells were cultured and stimulated with 0mM, 1.38mM, or 5.5mM glucose. In addition, GSIS in β-TC6 cells was blocked by IL-1β at concentrations of 0.15 ng/mL, 1.5 ng/mL, and 15 ng/mL. After glucose stimulation and IL-1β intervention, the insulin level in the cell supernatant was detected by radioimmunoassay, and the phosphorylation level of ERK1/2 was detected by western blotting assay. The insulin level in the 1.38mM glucose group was 108.52 ± 5.94 uIU/mL, which was significantly higher than the 0mM and 5.5mM glucose groups (p < 0.05). Compared with the 0mM glucose group, the level of ERK1/2 phosphorylation was increased in the 1.38mM and 5.5mM glucose groups. After intervention by 0.15 ng/mL, 1.5 ng/mL, and 15 ng/mL IL-1β, the level of ERK1/2 phosphorylation induced by 1.38mM glucose stimulation decreased in a dose-dependent manner, and the insulin level correspondingly decreased. IL-1β can inhibit GSIS in βTC-6 cells, which is related to its inhibition of the phosphorylation of ERK1/2.



http://ift.tt/2oRhjYN

Digit-Color Synaesthesia Only Enhances Memory for Colors in a Specific Context: A New Method of Duration Thresholds to Measure Serial Recall.

Author: Teichmann, A. Lina; Nieuwenstein, Mark R.; Rich, Anina N.

DOI: 10.1037/xhp0000402

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2oc3Esk

Words We Do Not Say-Context Effects on the Phonological Activation of Lexical Alternatives in Speech Production.

Author: Jescheniak, Jorg D.; Kurtz, Franziska; Schriefers, Herbert; Gunther, Josefine; Klaus, Jana; Madebach, Andreas

DOI: 10.1037/xhp0000352

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2nsMklO

On the Origin of Body-Related Influences on Visual Perception.

Author: Kirsch, Wladimir; Herbort, Oliver; Ullrich, Benjamin; Kunde, Wilfried

DOI: 10.1037/xhp0000358

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2odxjTO

Enhancement and Suppression of Tactile Signals During Reaching.

Author: Voudouris, Dimitris; Fiehler, Katja

DOI: 10.1037/xhp0000373

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2pfGbFQ

Adding Depth to Overlapping Displays Can Improve Visual Search Performance.

Author: Godwin, Hayward J.; Menneer, Tamaryn; Liversedge, Simon P.; Cave, Kyle R.; Holliman, Nick S.; Donnelly, Nick

DOI: 10.1037/xhp0000353

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2odvq9r

The Impact of Evidence Reliability on Sensitivity and Bias in Decision Confidence.

Author: Boldt, Annika; de Gardelle, Vincent; Yeung, Nick

DOI: 10.1037/xhp0000404

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2pfJr4e

Is Orthographic Information From Multiple Parafoveal Words Processed in Parallel: An Eye-Tracking Study.

Author: Cutter, Michael G.; Drieghe, Denis; Liversedge, Simon P.

DOI: 10.1037/xhp0000408

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2odxiPK

The Effect of Episodic Retrieval on Inhibition in Task Switching.

Author: Grange, James A.; Kowalczyk, Agnieszka W.; O'Loughlin, Rory

DOI: 10.1037/xhp0000411

Publication Date: POST AUTHOR CORRECTIONS, 6 April 2017

http://ift.tt/2pfMCsN

Simulum fly bites

Publication date: Available online 8 April 2017
Source:Medical Journal Armed Forces India
Author(s): Rupesh Prasad, A.S. Kushwaha




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An Indurated Plaque in a Toddler.

No abstract available

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An Indurated Plaque in a Toddler.

No abstract available

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Myxoid Spitz Nevi: Report of 6 Cases.

Mucin deposition in Spitz nevus seems to be a very rare phenomenon, as there have only been 3 cases previously published. We report 6 additional cases, half of them in women, and half in men. The ages of the patients varied from 5 to 47 years (mean = 30.17). Sizes of the nevi varied from 3 to 6 mm. Four lesions were located on the extremities, whereas one was located on the trunk (there was no clinical information about the other). A vascular lesion was suspected in 2 cases. Excision with clear margins was achieved in all cases but one. So far, there have been no recurrences after follow-ups varying from 1 to 5 years. The biopsy showed a symmetrical melanocytic Spitz nevus in all cases. Three cases were compound, and 3 cases were junctional nevi. The epidermis was either acanthotic or hyperplastic in all cases, with no epidermal consumption. Kamino bodies were found in 4 cases. The deposit of mucin was moderate in 5 cases and mild in one case. Mucin was found in the stroma between the dermal melanocytes in cases of compound nevi and in the melanocytic nests of the junctional component. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2obNZcH

Sox10 and DOG1 Expression in Primary Adnexal Tumors of the Skin.

Primary skin adnexal tumors can be challenging to classify and must be discerned from cutaneous adenocarcinoma metastases from various sites. We evaluated expression of Sox10 and DOG1 in normal cutaneous adnexa and in 194 primary skin adnexal tumors, and compared their performance in discriminating primary skin adnexal tumors from cutaneous metastatic adenocarcinomas with that of p40 and p63. In normal skin adnexa, we noted Sox10 expression in both the secretory and myoepithelial cells in eccrine glands, but only in myoepithelial cells in apocrine glands. DOG1 demonstrated canalicular expression in eccrine glands, and weak expression in myoepithelial cells of apocrine glands, germinative cells of sebaceous glands, and outer root sheath of follicular infundibulum. Sox10 was expressed in 100% of cylindromas and spiradenomas, and in variable frequency in other benign and malignant tumors of sweat glands. DOG1 was positive in most cylindromas (87.5%), in only 10.5% of spiradenomas, and was variably expressed in other benign and malignant tumors of sweat glands. All syringomas (n = 20) were negative for Sox10 and DOG1. One out of the 33 follicular neoplasms was positive for Sox10 and DOG1 (3%). All sebaceous neoplasms were negative for Sox10, and 28.1% of them were positive for DOG1. Sox10 was specific (91.9%) but not sensitive (28.4%) for primary skin origin, and was far less accurate (38.5%) than p63 or p40 (95.5% accuracy). Combining Sox10 with p63 or p40 showed only very minimal gain in accuracy (96%). DOG1 expression in tumors showed low sensitivity and specificity for skin adnexal origin. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nsXBm0

Chromoblastomycosis caused by Rhinocladiella similis: case report

Publication date: Available online 7 April 2017
Source:Medical Mycology Case Reports
Author(s): Daiane Heidrich, Gloria M. Gonzalez, Danielle M. Pagani, Mauricio Ramírez-Castrillón, Maria Lucia Scroferneker
We report a case of chromoblastomycosis in lesions on the chest and foot. Itraconazole was chosen as the initial treatment for this patient, who was followed up for 8 months before becoming noncompliant. The pathogenic fungal species was identified as Rhinocladiella similis by ITS region sequencing. In vitro analyses indicate that the fungus was sensitive to posaconazole and itraconazole. This report presents R. similis as a new agent of chromoblastomycosis and raises the hypothesis that this species could be more resistant to some antifungals than R. aquaspersa.



http://ift.tt/2oRexTg

Characterization of Gnrh/Gnih elements in the olfacto-retinal system and ovary during zebrafish ovarian maturation

Publication date: Available online 8 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Sheryll Corchuelo, Emanuel R.M. Martinez, Arno J. Butzge, Lucas B. Doretto, Tanda N. Valentin, Laura S.O. Nakaghi, Gustavo M. Somoza, Rafael H. Nóbrega
Gonadotropin releasing hormone (GnRH) is one of the key players of brain-pituitary-gonad axis, exerting overall control over vertebrate reproduction. In zebrafish, two variants were characterized and name as Gnrh2 and Gnrh3. In this species, Gnrh3, the hypohysiotropic form, is expressed by neurons of the olfactory-retinal system, where it is related with food detection, intra/interspecific recognition, visual acuity and retinal processing modulation. Previous studies have reported the presence of Gnrh receptors in the zebrafish retina, but not yet in the zebrafish olfactory epithelium. The current study analyzed the presence of gnrh2 and gnrh3, their receptors (gnrhr 1,2,3 and 4) and gnih (gonadotropin inhibitory hormone) transcripts, as well as the Gnrh3 protein in the olfactory epithelium (OE), olfactory bulb (OB), retina and ovary during zebrafish ovarian maturation. We found an increase of gnrh receptors transcripts in the OE at the final stages of ovarian maturation. In the OE, Gnrh3 protein was detected in the olfactory receptor neurons cilia and in the olfactory nerve fibers. Interestingly, in the OB, we found an inverse expression pattern between gnih and gnrh3. In the retina, gnrhr4 mRNA was found in the nuclei of amacrine, bipolar, and ganglion cells next to Gnrh3 positive fibers. In the ovary, gnrh3, gnrhr2 and gnrhr4 transcripts were found in perinucleolar oocytes, while gnih in oocytes at the cortical alveolus stage. Our results suggested that Gnrh/Gnih elements are involved in the neuromodulation of the sensorial system particularly at the final stages of maturation, playing also a paracrine role in the ovary.

Graphical abstract

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Epigenetic processes in sporadic parathyroid neoplasms

Publication date: Available online 8 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Angelica M. Silva-Figueroa, Nancy D. Perrier
Parathyroid tumors (PTs) are highly variable in their genetic background. Increasing evidence demonstrates that endocrine diseases can be caused by epigenetic alterations. The present review is focused on epigenetic aberrations related to PTs. DNA methylation, posttranslational histone modification, and noncoding RNAs are epigenetic mechanisms involved in parathyroid tumorigenesis. The information in this review has the potential to define epigenetic signatures associated with PTs for future use as diagnostic markers and lead to the development of new epigenetic drugs with therapeutic applications for these tumors. However, several epigenetic aspects regarding the biomarkers involved and their interactions in tumorigenesis on PTs are still unknown. Key to future epigenetic research would be a focus on global epigenetic identification of biomarkers in the different types of PTs, especially in parathyroid carcinoma. Better understanding may be useful for diagnostic and therapeutic uncertainty.



http://ift.tt/2nWFzF7

Copyright

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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CME Accreditation Page

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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Forthcoming Issues

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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Contributors

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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Contents

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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Advances in Imaging of Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Àlex Rovira




http://ift.tt/2nsK6Ti

Advances in the Diagnosis, Characterization, and Monitoring of Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Àlex Rovira




http://ift.tt/2pfywrb

Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Angela Vidal-Jordana, Xavier Montalban

Teaser

Multiple sclerosis (MS) is a chronic autoimmune and degenerative disease of the central nervous system that affects young people. MS develops in genetically susceptible individuals exposed to different unknown triggering factors. Different phenotypes are described. About 15% of patients present with a primary progressive course and 85% with a relapsing-remitting course. An increasing number of disease-modifying treatments has emerged. Although encouraging, the number of drugs challenges the neurologist because each treatment has its own risk–benefit profile. Patients should be involved in the decision-making process to ensure good treatment and safety monitoring adherence.


http://ift.tt/2nsw4RH

Brain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Iris Dekker, Mike P. Wattjes

Teaser

Multiple sclerosis (MS) is a disabling disease, with the first symptoms mostly appearing early in life. In addition to the clinical and laboratory findings, imaging has become increasingly important for diagnosis, prognosis, and monitoring. Because of its importance for these purposes, a high level of knowledge of imaging MS pathology and a standardization of the imaging acquisition, interpretation, and reporting is necessary. Here we will describe the MR imaging characteristics of MS pathology, the current imaging protocols, diagnostic criteria, and the differential diagnosis of MS.


http://ift.tt/2pfkkhQ

Pediatric Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Silvia N. Tenembaum

Teaser

This article presents an overview of evolving diagnostic criteria of pediatric multiple sclerosis and related disorders, emphasizing distinguishing clinical and neuroimaging features that should be considered for differential diagnosis in childhood and adolescence. New data on the integrity of brain tissue in children with MS provided by advanced MR imaging techniques are addressed as well.


http://ift.tt/2nsRXjN

Microstructural MR Imaging Techniques in Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Massimo Filippi, Paolo Preziosa, Maria A. Rocca

Teaser

Due to its sensitivity in the detection of focal white matter (WM) lesions, MR imaging has become a paraclinical tool central to diagnosing multiple sclerosis (MS) and monitoring its evolution. Despite this, the correlation between patients' clinical status and conventional MR imaging measures is weak to moderate. Quantitative MR imaging–based techniques, such as magnetization transfer and diffusion tensor imaging, have a higher specificity toward the heterogeneous pathologic substrates of MS than MR imaging. This article discusses the main insights derived from the application of such MR imaging–based techniques to define MS pathophysiology and to quantify the progressive accumulation of structural damage in the central nervous system.


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Molecular and Metabolic Imaging in Multiple Sclerosis

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2
Author(s): Marcello Moccia, Olga Ciccarelli

Teaser

Multiple sclerosis is a multifactorial disease with heterogeneous pathogenetic mechanisms, which deserve to be studied to evaluate new possible targets for treatments and improve patient management. MR spectroscopy and PET allow assessing in vivo the molecular and metabolic mechanisms underlying the pathogenesis of multiple sclerosis. This article focuses on the relationship between these imaging techniques and the biologic and chemical pathways leading to multiple sclerosis pathology and its clinical features. Future directions of research are also presented.


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Index

Publication date: May 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 2





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Predicting and planning for SIEA flap utilisation in breast reconstruction; an algorithm combining pre-operative computed tomography analysis and intraoperative angiosome assessment

Low flap complication rates and excellent aesthetic outcomes are now commonplace in breast reconstruction. As a result, attention is now being focused on minimising donor site morbidity. Despite its potential donor site advantages, the SIEA flap is often discounted given concerns about the high flap failure rates. In this study we present out experience of using the SIEA flap in breast reconstruction and provide an algorithm based upon the pre-operative computed tomography angiogram (CTA) to aid pre-operative planning.

http://ift.tt/2pfz68a

Long-Term Outcome of Paediatric Flexor Tendon Injuries of the Hand

The ideal rehabilitation regimen of paediatric flexor tendon injuries of the hand is discussed controversially. In this study the clinical outcome of paediatric patients with flexor tendon injuries treated with a dynamic postoperative protocol was assessed. All children treated with flexor tendon injuries of the hand and a dynamic postoperative protocol between 1999 and 2011 were included. Patients were invited for a follow-up examination consisting of clinical examination and the TAM and Buck-Gramcko scores and the linear measurement system.

http://ift.tt/2oddHyT

An analysis of facial morphology of UK and US general election candidates: Does the ‘power face’ exist?

To determine the frequency of recognised morphologic facial phenotypes amongst UK and US election candidates and to assess whether there is a relationship between facial morphology and success in general elections.

http://ift.tt/2od78w8

A Cohort Study of Immediate Implant Exchange During Acute Infection in the Setting of Breast Reconstruction

Implant infections in the setting of breast reconstruction present a significant setback for breast cancer patients. Traditional management of implant infections is predicated on operative removal of the implant and delayed replacement. Another option for implant infection management has emerged in which the soft tissue infection is neutralized, the implant is removed and the surgical site washed out, and a new implant replaced immediately. Here we present our findings with the implementation of this technique and an algorithm for choosing which patients are the most appropriate candidates based on retrospective review.

http://ift.tt/2pflolL

Reply to: A Systematic Review of Complications Associated with Direct Implants vs. Tissue Expanders Following Wise Pattern Skin-Sparing Mastectomy

The authors have no financial interest to declare in relation to the content of this communication.

http://ift.tt/2odfZ1b

Reassessment of the clinical significance of portal-superior mesenteric vein invasion in borderline resectable pancreatic cancer

Publication date: Available online 8 April 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Sojun Hoshimoto, Shoichi Hishinuma, Hirofumi Shirakawa, Moriaki Tomikawa, Iwao Ozawa, Saho Wakamatsu, Sayuri Hoshi, Nobuo Hoshi, Kaoru Hirabayashi, Yoshiro Ogata
ObjectiveThe principal objective of this study is to clarify the prognostic significance of borderline resectable pancreatic cancer (BRPC). The second objective is to evaluate the prognostic impact of the depth of pathological venous invasion.MethodsThe study included 122 pancreatic cancer patients who underwent curative surgery. All computed tomography scans of the patients were retrospectively interpreted and classified according to the NCCN guidelines, version 1.2016, as resectable (-) or borderline resectable (+) in each arterial (BR-A) and venous (BR-PV) involvement.ResultsThe overall survival (OS) rate was significantly higher in BR-A(-) patients (n=94) than in BR-A(+) patients (n=28) (P=0.001), whereas there was no difference between BR-PV(-) (n=101) and BR-PV(+) patients (n=21) (P=0.257). In a multivariate analysis, the independent predictors of OS included BR-A(+) (P=0.002), lymph node metastasis (P=0.008), pathological venous invasion (P=0.003), and adjuvant chemotherapy (P=0.001). Of 39 patients who underwent venous resection, no significant difference was observed between BR-PV(-) (n=20) and BR-PV(+) patients (n=19) in resection rate, lymph node metastasis, the presence of extrapancreatic nerve invasion, recurrence rate, frequency of initial recurrence at a liver or local site, and OS. Pathological venous invasion was significantly deeper in BR-PV(+) patients. However, the depth of invasion was not associated with OS.ConclusionThe definition of venous involvement in the current guidelines predicted the depth of pathological venous invasion but not OS in BRPC patients. Further prospective, randomized studies are needed to establish treatment strategies for BRPC patients with isolated venous involvement.



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Pressurized IntraPeritoneal Aerosol Chemotherapy – Practical Aspects

Publication date: Available online 8 April 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Martin Hübner, Fabian Grass, Hugo Teixeira-Farinha, Basile Pache, Patrice Mathevet, Nicolas Demartines
IntroductionPressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has been introduced as novel treatment for peritoneal carcinomatosis. Only proper patient selection, stringent safety protocol and careful surgery allow for a secure procedure. We hereby report the essentials for safe implementation.MethodsAll consecutive procedures within 20 months after PIPAC implementation were analyzed with regards to practical and surgical aspects. Special emphasis was laid on modifications of technique and safety measures during the implementation process with systematic use of a dedicated checklist. Further, surgical difficulty was documented by use of a visual analogue scale (VAS).Results127 PIPAC procedures were performed in 58 patients from January 2015 until October 2016. 81% of patients had at least one previous laparotomy. Median operation time was 91 min (87-103) for the first 20 cases, 93 min (IQR 88-107) for PIPAC21-50, and 103 min (IQR 91-121) for the following 77 procedures. Primary and secondary non-access occurred in 3 patients (2%), all of them having prior hyperthermic intraperitoneal chemotherapy (HIPEC). Using open Hasson technique, one single bowel lesion occurred, which was the only intraoperative complication. One 5mm and another 10/12mm trocar were used in 88% of procedures while additional trocars were needed in 12%. No leak of cytostatics was observed and no procedure needed to be stopped. VAS for overall difficulty of the procedure was 3±2.4, and 3±2.9 and 3±2.5, respectively, for abdominal access and intraoperative staging.ConclusionsWith standardized surgical approach and dedicated safety checklist, PIPAC can be safely introduced in clinical routine with minimal learning curve.



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Surgical treatment for periacetabular metastatic lesions

Publication date: Available online 8 April 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Tatiana Charles, Lieveke Ameye, Michael Gebhart
IntroductionPeriacetabular bone metastasis present with severe pain and functional loss leading to a poor quality of life. Surgical treatment remains challenging.Material and methodsWe reviewed all cases operated at our institution. We analyzed pain scores and functional status as well as complications and their risk factors.ResultsThirty-five patients underwent curettage and cemented reconstruction. Mean surgical time was 168 minutes. Mean surgical blood losses were 3 150ml. Major complications were encountered in 23% and minor complications in 29% of cases. We found a significant pain relief (p < 0.0001) and improvement in functional status in the postoperative period (p < 0.0001). A Harrington grade 4 lesion was correlated with a higher complication rate (p-value= 0.002).ConclusionsIn this series we were able to show that surgical management is an effective option in the treatment of metastatic bone disease to the pelvis. However, this treatment is very complex and associated with very high complication rates. Therefore, adequate patient selection and preoperative management is advocated.



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PEG-PE/Clay Composite Carriers for Doxorubicin: Effect of Composite Structure on Release, Cell Interaction and Cytotoxicity

Publication date: Available online 8 April 2017
Source:Acta Biomaterialia
Author(s): Hagay Kohay, Can Sarisozen, Rupa Sawant, Aditi Jhaveri, Vladimir P Torchilin, Yael G. Mishael
A novel drug delivery system for doxorubicin (DOX), based on organic-inorganic composites was developed. DOX was incorporated in micelles (M-DOX) of polyethylene glycol-phosphatidylethanolamine (PEG-PE) which in turn were adsorbed by the clay, montmorillonite (MMT). The nano-structures of the PEG-PE/MMT composites of LOW and HIGH polymer loadings were characterized by XRD, TGA, FTIR, size (DLS) and zeta measurements. These measurements suggest that for the LOW composite a single layer of polymer intercalates in the clay platelets and the polymer only partially covers the external surface, while for the HIGH composite two layers of polymer intercalate and a bilayer may form on the external surface. These nanostructures have a direct effect on formulation stability and on the rate of DOX release. The release rate was reversely correlated with the degree of DOX interaction with the clay and followed the sequence: M-DOX>HIGH formulation>LOW formulation>DOX/MMT. Despite the slower release from the HIGH formulation, its cytotoxicity effect on sensitive cells was as high as the "free" DOX. Surprisingly, the LOW formulation, with the slowest release, demonstrated the highest cytotoxicity in the case of Adriamycin (ADR) resistant cells. Confocal microscopy images and association tests provided an insight into the contribution of formulation-cell interactions vs. the contribution of DOX release rate. Internalization of the formulations was suggested as a mechanism that increases DOX efficiency, particularly in the ADR resistant cell line. The employment of organic-inorganic hybrid materials as drug delivery systems, has not reached its full potential, however, its functionality as an efficient tunable release system was demonstrated.Statement of significanceDOX PEG-PE/clay formulations were design as an efficient drug delivery system. The main aim was to develop PEG-PE/clay formulations of different structures based on various PEG-PE/clay ratios in order to achieve tunable release rates, to control the external surface characteristics and formulation stability. The formulations showed significantly higher toxicity in comparison to "free" DOX, explained by formulation internalization. For each cell line tested, sensitive and ADR resistant, a different formulation structure was found most efficient. The potential of PEG-PE/clay-DOX formulations to improve DOX administration efficacy was demonstrated and should be further explored and implemented for other cancer drugs and cells.

Graphical abstract

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Crack driving force in twisted plywood structures

Publication date: Available online 8 April 2017
Source:Acta Biomaterialia
Author(s): F.D. Fischer, O. Kolednik, J. Predan, H. Razi, P. Fratzl
Twisted plywood architectures can be observed in many biological materials with high fracture toughness, such as in arthropod cuticles or in lamellar bone. Main purpose of this paper is to analyze the influence of the progressive rotation of the fiber direction on the spatial variation of the crack driving force and, thus, on the fracture toughness of plywood-like structures. The theory of fiber composites is used to describe the stiffness matrix of a twisted plywood structure in a specimen-fixed coordinate system. The driving force acting on a crack propagating orthogonally to the fiber-rotation plane is studied by methods of computational mechanics, coupled with the concept of configurational forces. The analysis unfolds a spatial variation of the crack driving force with minima that are beneficial for the fracture toughness of the material. It is shown that the estimation of the crack driving force can be simplified by replacing the complicated anisotropic twisted plywood structure by an isotropic material with appropriate periodic variations of Young's modulus, which can be constructed based either on the local stiffness or local strain energy density variations. As practical example, the concepts are discussed for a specimen with a stiffness anisotropy similar to lamellar bone.Statement of SignificanceTwisted plywood-like structures exist in many natural fibre composites, such as bone or insect carapaces, and are known to be very fracture resistant. The crack driving force in such materials is analyzed quantitatively for the first time, using the concept of configurational forces. This tool, well established in the mechanics of materials, is introduced to the modeling of biological material systems with inhomogeneous and anisotropic material behavior. Based on this analysis, it is shown that the system can be approximated by an appropriately chosen inhomogeneous but isotropic material for the calculation of the crack driving force. The spatial variation of the crack driving force and, especially, its local minima are essential to describe the fracture properties of twisted plywood structures.

Graphical abstract

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Inter-joint coordination of posture on a seesaw device

Publication date: Available online 8 April 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Frédéric Noé, Xavier García-Massó, Thierry Paillard
Even though specific adjustments of the multi-joint control of posture have been observed when posture is challenged, multi-joint coordination on a seesaw device has never been accurately assessed. The current study was conducted in order to investigate the multi-joint coordination when subjects were standing on either a seesaw device or on a stable surface, with the eyes open or closed. Eighteen healthy active subjects were recruited. A principal component analysis and a Self-Organizing Maps analysis were performed on the joint angles in order to detect and characterize dominant coordination patterns. Intermuscular EMG coherence was analysed in order to assess the neurophysiological mechanisms associated with these coordination patterns. The results illustrated a multi-joint organization of posture on both stable ground and on the seesaw, with a higher variability among the individual postural responses observed when standing on the seesaw. These findings challenge the classical assumption of ankle mechanisms as dominating control on seesaw devices and confirm that inter-joint coordination in postural control is strongly modulated by stance conditions. When standing on the seesaw without vision, a decrease in intermuscular coherence was observed without any impact on the joint coordination patterns, likely due to an increase dependence on proprioceptive information.



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Muscular Echovariation: A New Biomarker in Amyotrophic Lateral Sclerosis

Publication date: Available online 8 April 2017
Source:Ultrasound in Medicine & Biology
Author(s): Jacinto J. Martínez-Payá, María Elena del Baño-Aledo, José Ríos-Díaz, José I. Tembl-Ferrairó, Juan F. Vázquez-Costa, Francesc Medina-Mirapeix
The purpose of the work described here was to assess the characteristics of echovariation in amyotrophic lateral sclerosis (ALS) compared with other muscle ultrasonography parameters. Twenty-six ALS patients (8 women, mean age 58.9 y, standard deviation 12.02 y) and 26 healthy controls (17 women, mean age 59.6 y, standard deviation 6.41 y) were included in this observational study. They underwent bilateral and transverse ultrasound of the biceps/brachialis, forearm flexor group, quadriceps femoris and tibialis anterior. Muscular thickness, echo-intensity and echovariation were analyzed. Muscles affected by ALS had increased echo-intensity, decreased thickness and decreased echovariation. Echovariation in all muscles except the quadriceps femoris strongly correlated with muscle strength (explained variance between 21.8% in the biceps/brachialis and 37.5% in the tibialis anterior) and the ALS Functional Rating Scale Revised score (explained variance between 26% in the biceps/brachialis and 36.7% in the forearm flexor group). Echovariation is an easy-to-obtain quantitative muscle ultrasonography parameter that could distinguish ALS patients from healthy controls more accurately than previous described biomarkers.



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Inertial Cavitation Ultrasound with Microbubbles Improves Reperfusion Efficacy When Combined with Tissue Plasminogen Activator in an In Vitro Model of Microvascular Obstruction

Publication date: Available online 7 April 2017
Source:Ultrasound in Medicine & Biology
Author(s): Akash Goyal, Francois T.H. Yu, Mathea G. Tenwalde, Xucai Chen, Andrew Althouse, Flordeliza S. Villanueva, John J. Pacella
We have previously reported that long-tone-burst, high-mechanical-index ultrasound (US) and microbubble (MB) therapy can restore perfusion in both in vitro and in vivo models of microvascular obstruction (MVO). Addition of MBs to US has been found to potentiate the efficacy of thrombolytics on large venous thrombi; however, the optimal US parameters for achieving microvascular reperfusion of MVO caused by microthrombi, when combined with tissue plasminogen activator (tPA), are unknown. We sought to elucidate the specific effects of US, with and without tPA, for effective reperfusion of MVO in an in vitro model using both venous and arterial microthrombi. Venous- and arterial-type microthrombi were infused onto a mesh with 40-μm pores to simulate MVO. Pulsed US (1 MHz) was delivered with inertial cavitation (IC) (1.0 MPa, 1000 cycles, 0.33 Hz) and stable cavitation (SC) US (0.23 MPa, 20% duty cycle, 0.33 Hz) regimes while MB suspension (2 × 10⁶ MBs/mL) was infused. The efficacy of sonoreperfusion with these parameters was tested with and without tPA. Sonoreperfusion efficacy was significantly greater for IC + tPA compared with tPA alone, IC, SC and SC + tPA, suggesting lytic synergism between tPA and US for both venous- and arterial-type microthrombi. In contrast to our previous in vitro studies using 1.5 MPa at 5000 US cycles without tPA, the IC regime employed herein used 90% less US energy. These findings suggest an IC regime can be used with tPA synergistically to achieve a high degree of fibrinolysis for both thrombus types.



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Carotid–Femoral Pulse Wave Velocity Assessed by Ultrasound: A Study with Echotracking Technology

Publication date: Available online 8 April 2017
Source:Ultrasound in Medicine & Biology
Author(s): Mathieu Collette, Carlo Palombo, Carmela Morizzo, Sara Sbragi, Michaela Kozakova, Georges Leftheriotis
Described here is a new method for determination of carotid–femoral pulse wave velocity (PWV) based on arterial diameter waveform recording by an ultrasound system. The study was carried out on 120 consecutive patients. Carotid–femoral PWV was determined using a tonometric technique (PWVpp, PulsePen, DiaTecne, Milan, Italy) and an echotracking ultrasound system (PWVet, E-Track, Aloka, Tokyo, Japan). The relationship between PWVpp and PWVet was evaluated by linear regression and Bland–Altman analysis. There was excellent agreement between PWVet and PWVpp (Pearson's r = 0.94, 95% confidence interval: 0.91–0.96, p < 0.0001; PWVet = 0.88 × PWVpp + 0.57). The Bland–Altman plot revealed an offset of −0.33 m/s with limits of agreement from −2.21 to 1.54 m/s. The coefficients of variation for within-subject repeatability between PWVet and PWVpp had were 5.79% and 8.47%, respectively, without significant differences in the Bland–Altman analysis. The results suggest that echotracking technology can provide a reliable estimate of aortic stiffness comparable to that of the tonometric techniques.



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Measurement of Median Nerve Strain and Applied Pressure for the Diagnosis of Carpal Tunnel Syndrome

Publication date: Available online 7 April 2017
Source:Ultrasound in Medicine & Biology
Author(s): Yuichi Yoshii, Wen-Lin Tung, Tomoo Ishii
The objective of this study was to evaluate the diagnostic utility of strain and applied-pressure measurements of the median nerve in carpal tunnel syndrome (CTS). Thirty-five wrists of 23 idiopathic CTS patients and 30 wrists of 15 normal patients were examined. Median nerve strain, pressure to the skin and the pressure/strain ratio were measured at the proximal carpal tunnel level. Parameters were compared between CTS patients and controls. The areas under the receiver operating characteristic curves (AUCs) were compared for the parameters. Median nerve strain was significantly lower in the patients than in the controls (p < 0.01). Pressure and pressure/strain ratio were significantly higher in the patients than in the controls (p < 0.05: pressure, p < 0.01: ratio). The AUCs were 0.926, 0.681 and 0.937 for strain, pressure and pressure/strain ratio, respectively. Pressure/strain ratio is useful for evaluating the condition of the median nerve with respect to the hardness of the surrounding structures in CTS.



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Neuroendocrine Tumors of the Breast

Abstract

A small but increasingly recognized and studied subset of breast carcinomas are characterized by neuroendocrine (NE) differentiation. As with nearly all forms of breast neoplasia, NE tumors are characterized by considerable heterogeneity in microscopic appearance and clinical aggressiveness. About half of NE breast carcinomas recapitulate the histological spectrum typical of their counterparts in other organ systems, varying from "carcinoid-like" to small cell carcinoma, with most representing intermediate grade tumors. Despite NE morphology, these tumors have a high frequency of estrogen receptor expression. Clinical outcomes of women with NE breast carcinomas are reliably grade and stage dependent. Tumors associated with "solid papillary" differentiation comprise the remaining cases of NE breast neoplasia. Solid papillary carcinoma is an intrinsically low grade/favorable prognosis class of breast neoplasia that usually presents in post-menopausal age groups. About half of solid papillary carcinoma present as a distinctive pattern of ductal carcinoma in situ that may be difficult to recognize owing to its close resemblance to florid proliferative lesions. Invasive solid papillary carcinomas are characterized by a variety of histological patterns and often show mucinous differentiation. Future studies are necessary to better define the histogenesis, optimal classification, and improved directed therapies for NE breast neoplasia.

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Editorial Board/Aims and Scope

Publication date: 25 April 2017
Source:Vaccine, Volume 35, Issue 18





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Semiconductor diode laser device adjuvanting intradermal vaccine

Publication date: 25 April 2017
Source:Vaccine, Volume 35, Issue 18
Author(s): Yoshifumi Kimizuka, John J. Callahan, Zilong Huang, Kaitlyn Morse, Wataru Katagiri, Ayako Shigeta, Roderick Bronson, Shu Takeuchi, Yusuke Shimaoka, Megan P.K. Chan, Yang Zeng, Binghao Li, Huabiao Chen, Rhea Y.Y. Tan, Conor Dwyer, Tyler Mulley, Pierre Leblanc, Calum Goudie, Jeffrey Gelfand, Kosuke Tsukada, Timothy Brauns, Mark C. Poznansky, David Bean, Satoshi Kashiwagi
A brief exposure of skin to a low-power, non-tissue damaging laser light has been demonstrated to augment immune responses to intradermal vaccination. Both preclinical and clinical studies show that this approach is simple, effective, safe and well tolerated compared to standard chemical or biological adjuvants. Until now, these laser exposures have been performed using a diode-pumped solid-state laser (DPSSL) devices, which are expensive and require labor-intensive maintenance and special training. Development of an inexpensive, easy-to-use and small device would form an important step in translating this technology toward clinical application.Here we report that we have established a handheld, near-infrared (NIR) laser device using semiconductor diodes emitting either 1061, 1258, or 1301nm light that costs less than $4000, and that this device replicates the adjuvant effect of a DPSSL system in a mouse model of influenza vaccination. Our results also indicate that a broader range of NIR laser wavelengths possess the ability to enhance vaccine immune responses, allowing engineering options for the device design.This small, low-cost device establishes the feasibility of using a laser adjuvant approach for mass-vaccination programs in a clinical setting, opens the door for broader testing of this technology with a variety of vaccines and forms the foundation for development of devices ready for use in the clinic.



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Pregnancy-Related Spontaneous Coronary Artery Dissection: A Case Series and Literature Review

Publication date: Available online 7 April 2017
Source:The Journal of Emergency Medicine
Author(s): Emily Rose, Maheedhar Gedela, Nathan Miller, Paul L. Carpenter
BackgroundCardiac emergencies during pregnancy are rare but have significant associated morbidity and mortality when they do occur. The emergency physician must not only be aware of potentially life-threatening conditions in the pregnant woman, but also know the emergent management and treatment of these conditions to avoid worsening of the underlying condition. Pregnancy-related spontaneous coronary artery dissection has been described in the cardiology literature, but is not well-known in emergency medicine literature.Case SeriesWe present a case series of six previously healthy women ages 27 to 39 years who presented 1 to 75 days after delivery with spontaneous coronary artery dissection. The left main coronary was involved in 5 of 6 cases. One patient died, 5 survived. Two survivors maintained significant long-term disability. The patient that died had the diagnosis made on autopsy, the others were diagnosed with coronary angiography. Two patients were treated with stents, 2 with coronary artery bypass surgery, and 2 with medical management.Why Should an Emergency Physician Be Aware of This?Emergent coronary catheterization is indicated if this diagnosis is suspected. However, emergency care teams must also understand how and why management including coronary artery catheterization can exacerbate the underlying condition. The role of coronary artery computed tomography remains unknown, although it exposes the fetus to significant radiation if the woman is still pregnant at presentation. Medical management is indicated with diffuse or distal disease as pregnancy-related coronary artery dissections often resolve with time. Localized discrete lesions may be stented. Coronary artery bypass graft surgery may be considered if the left main artery is involved or there are multiple proximal lesions. Cardiac transplantation is indicated rarely.



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ECG Patterns Indicate Severity of Acute Pulmonary Embolism: Insights from Serial ECG Changes in a Patient Treated with Thrombolysis

Publication date: Available online 7 April 2017
Source:The Journal of Emergency Medicine
Author(s): Fu-qiang Sheng, Rong Xu, Jin-dong Xia, Mao-rong He




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Comparison between hypersensitivity reactions to cycles of modified FOLFOX6 and XELOX therapies in patients with colorectal cancer

Abstract

Purpose

Although hypersensitivity reactions (HSRs) to oxaliplatin (L-OHP) therapy are well-documented, few reports have compared different therapies in terms of HSR occurrence. In this study, we compared the frequency and pattern of HSRs to modified FOLFOX6 (mFOLFOX6; 5-fluorouracil, levofolinate calcium and L-OHP infusions) and XELOX (capecitabine and L-OHP) therapies, and sought to identify risk factors associated with HSRs.

Methods

Patients who had received mFOLFOX6 or XELOX chemotherapeutic regimens for unresectable colon or rectal cancer or as adjuvant chemotherapy following colon cancer surgery between April 2012 and August 2015 were included. Potential correlation between treatment modalities (regimen, dosage and route of administration of L-OHP, and injection timing for dexamethasone administration) and HSRs was assessed.

Results

Among the 240 patients included in the study, 136 had received mFOLFOX6 therapy and 104 had received XELOX therapy. Although the frequency of HSRs did not differ between the two groups, incidence of HSRs in the first cycle was higher in the XELOX therapy group. Treatment method or cumulative dosage was not identified as a risk factor for HSR; however, the incidence of ≥grade-2 HSR was higher in cases where the cumulative L-OHP dosage was ≥600 mg/m² and in patients in whom dexamethasone was not co-infused with L-OHP.

Conclusion

Although HSR rates were comparable among patients treated with mFOLFOX6 and XELOX, HSRs tended to occur more frequently during the first cycle of XELOX therapy as compared to that with mFOLFOX6 therapy. Our findings warrant careful assessment of ≥grade-2 HSRs in patients who are prescribed cumulative L-OHP dosages of ≥600 mg/m².

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Cone-beam computed tomography investigation of crucial mandibular canal variations in Thais

Abstract

Objective

The physiology of the mandibular nerve is an important factor relevant to successful implant planning and surgical procedures in the mandible. Variability among ethnicities may influence the particular safety guidelines for each population. In this study, we retrospectively examined the incidences of canal orientations and variations in Thais using cone-beam computed tomography (CBCT) radiography.

Methods

CBCT images of 441 mandibular sides of 248 patients aged 20 to 82 years (mean age, 43.7 years) were examined. The incidences of canal courses and variations were assessed by two calibrated observers (Cohen's kappa coefficient >0.8). Descriptive and bivariate statistics were analysed for categorical findings. A p value of <0.05 was considered statistically significant.

Results

Two common canal courses were identified: linear curve (Type 1, 39.9%) and elliptic-arc curve (Type 3, 48.1%). In addition, one-fifth of the patients had bifid canals (20.6%). There was a short supplemental canal extending to the second or third molar (Type 2, 53.8%) and a supplemental canal arising in the retromolar pad region (Type 4, 46.2%). An anterior loop was identified in 74.2% of the cases and was frequently bilateral (78.3%).

Conclusions

Effective examination of the canal anatomy should be considered prior to surgical procedures because of the shallow curve of the mandibular canal with a high incidence of an anterior loop. In addition, the position of bifid canals was associated with an increased risk of neurovascular alteration in implant placement, sagittal split ramus osteotomy, and retromolar bone harvesting.

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Tackling endocrine resistance in ER-positive HER2-negative advanced breast cancer: a tale of imprecision medicine

Publication date: Available online 7 April 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Alexios Matikas, Theodoros Foukakis, Jonas Bergh
The selection of patients with advanced breast cancer as appropriate for endocrine manipulation according to hormone receptor status is a successful strategy. Unfortunately, the emergence of resistance is inevitable and subsequent treatment is not well defined. Numerous mechanisms have been implicated in the development of resistance; central among them is the activation of compensatory signaling pathways. Despite the rationale that supports combining agents targeting these pathways with hormonal therapies in an attempt to delay or even reverse endocrine resistance, most clinical trials have failed to demonstrate improved outcomes. Although the inhibition of the PI3K/mTOR pathway and of CDK 4/6 function has led to meaningful prolongations of progression free survival, no overall survival gains have been reported yet. Considering the associated toxicity and costs, genomic-driven trials are eagerly needed in order to refine management strategies and achieve a truly personalized approach for this patient subgroup.



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Recovery of orthographic processing after stroke: A longitudinal fMRI study

Publication date: Available online 8 April 2017
Source:Cortex
Author(s): Jeremy Purcell, Rajani Sebastian, Richard Leigh, Samson Jarso, Cameron Davis, Joseph Posner, Amy Wright, Argye E. Hillis
An intact orthographic processing system is critical for normal reading and spelling. Here we investigate the neural changes associated with impairment and subsequent recovery of the orthographic lexical processing system in an individual with an ischemic left posterior cerebral artery (PCA) stroke. This work describes a longitudinal case study of a patient, known as MMY, with impairments in orthographic lexical processing for reading and spelling at stroke onset, and who recovered these skills within 1 year post stroke. We tested the hypothesis that this acute impairment to reading and spelling would be associated with a selective loss of neural activation in the left fusiform gyrus, and that subsequent recovery would be associated with a gain of neural activation in this region. MMY's case provided a unique opportunity to assess the selectivity of neural changes because she demonstrated a behavioral recovery of naming as well; i.e. if there is neural recovery for reading and spelling, but not naming, then these neural changes are selective to the recovery of orthographic processing. To test our hypothesis, we examined longitudinal behavioral and fMRI data of reading, spelling, and visual object naming acquired acutely, 3 weeks, 5 months, and one year post stroke. In confirmation of our hypothesis, the loss and subsequent gain of orthographic lexical processing was associated with up-regulation of neural activation in areas previously associated with orthographic lexical processing: i.e., the left mid-fusiform gyrus and inferior frontal junction. Furthermore, these neural changes were found to be selective to orthographic processing, as they were observed for reading and spelling, but not for visual object naming within the left mid-fusiform gyrus. This work shows that left PCA stroke can temporarily and selectively disrupt the orthographic lexical processing system, not only in the posterior region adjacent to the stroke, but also in relatively distant frontal orthographic processing regions.



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Resting-state functional reorganization in Parkinson’s disease: an activation likelihood estimation meta-analysis

Publication date: Available online 8 April 2017
Source:Cortex
Author(s): Masoud Tahmasian, Simon B. Eickhoff, Kathrin Giehl, Frank Schwartz, Damian M. Herz, Alexander Drzezga, Thilo van Eimeren, Angela R. Laird, Peter T. Fox, Habibolah Khazaie, Mojtaba Zarei, Carsten Eggers, Claudia R. Eickhoff
Parkinson's disease (PD) is a common progressive neurodegenerative disorder. Studies using resting-state functional MRI to investigate underlying pathophysiology of motor and non-motor symptoms in PD yielded largely inconsistent results. This quantitative neuroimaging meta-analysis aims to identify consistent abnormal intrinsic functional patterns in PD across studies. We used PubMed to retrieve suitable resting-state studies and stereotactic data were extracted from 28 individual between-group comparisons. Convergence across their findings was tested using the activation likelihood estimation approach. We found convergent evidence for intrinsic functional disturbances in bilateral inferior parietal lobule and the supramarginal gyrus in PD patients compared to healthy subjects. In follow-up task-based and task-independent functional connectivity analyses using two independent healthy subject data sets, we found that the regions showing convergent aberrations in PD formed an interconnected network mainly with the default mode network. Behavioral characterization of these regions using the BrainMap database suggested associated dysfunction of perception and executive processes. Taken together, our findings highlight the role of parietal cortex in the pathophysiology of PD.



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Competitive interactions in visual working memory drive access to awareness

Publication date: Available online 8 April 2017
Source:Cortex
Author(s): Dirk van Moorselaar, Surya Gayet, Chris L.E. Paffen, Jan Theeuwes, Stefan Van der Stigchel, Christian N.L. Olivers
Models of biased competition assume that pre-activating a visual representation in visual working memory (VWM) biases perception towards memory-matching objects. Consistent with this, it has been shown that targets suppressed by interocular competition gain prioritized access to awareness when they match VWM content. Thus far, these VWM biases during interocular suppression have been investigated with minimal levels of competition, as there was always only one target stimulus and observers only held a single item in VWM. In the current study we investigated how VWM-based modulation of access to awareness is influenced by a) multiple-item competition within the stimulus display and b) multiple-item competition within VWM. Using the method of breaking continuous flash suppression (b-CFS), we replicated the finding that information matching the content of VWM is released from interocular suppression faster than non-matching information. This VWM-based facilitation was significantly reduced, though still present, when VWM load increased from one to two items, demonstrating a clear competitive constraint on the top-down modulation by VWM. Furthermore, we manipulated inter-stimulus competition by varying the presence of distractors. When distractors were present, VWM-based facilitation was no longer specific to interocular suppression, but also occurred for monocular displays. The results demonstrate that VWM-based visual biases occur in response to competition, whether between or within the eyes, and reconcile findings from different paradigms.



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The Attribution of Animacy and Agency in Frontotemporal Dementia versus Alzheimer’s Disease

Publication date: Available online 8 April 2017
Source:Cortex
Author(s): Sylvia S. Fong, Pongsatorn Paholpak, Madelaine Daianu, Mariel B. Deutsch, Brandalyn C. Riedel, Andrew R. Carr, Elvira E. Jimenez, Michelle M. Mather, Paul M. Thompson, Mario F. Mendez
Impaired attribution of animacy (state of living or being sentient) and of agency (capability of intrinsically-driven action) may underlie social behavior disturbances in behavioral variant frontotemporal dementia (bvFTD). We presented the Heider and Simmel film of moving geometric shapes to 11 bvFTD patients, 11 Alzheimer's disease (AD) patients, and 12 healthy controls (HCs) and rated their recorded verbal responses for animacy attribution and agency attribution. All participants had skin conductance (SC) continuously recorded while viewing the film, and all dementia participants underwent magnetic resonance imaging (MRI) for regions of interest. The bvFTD patients, but not the AD patients, were impaired in animacy attribution, compared to the HCs. In contrast, both bvFTD and AD groups were impaired in agency attribution, compared to the HCs, and only the HCs had increasing SC responsiveness during viewing of the film. On MRI analysis of cortical thicknesses, animacy scores significantly correlated across groups with the right pars orbitalis and opercularis; agency scores with the left inferior and superior parietal cortices and the supramarginal gyrus; and both scores with the left cingulate isthmus involved in visuospatial context. These findings suggest that bvFTD is specifically associated with impaired animacy attribution from right inferior frontal atrophy. In contrast, both dementias may have impaired agency attribution from left parietal cortical atrophy and absent SC increases during the film, a sympathetic indicator of attribution of a social "story" to the moving shapes. These findings clarify disease-related changes in social attribution and corroborate the neuroanatomical origins of animacy and agency.



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Optic ataxia and the dorsal visual steam re-visited: impairment in bimanual haptic matching performed without vision

Publication date: Available online 8 April 2017
Source:Cortex
Author(s): Stephen R. Jackson, Laura A. Condon, Roger W. Newport, Sally Pears, Masud Husain, Nin Bajaj, Michael O'Donoghue
The 'two visual systems' account proposed by Milner and Goodale (1992) argued that visual perception and the visual control of action depend upon functionally distinct and anatomically separable brain systems: a ventral stream of visual processing that mediates visual perception (object identification and recognition) and a dorsal stream of visual processing mediating visually guided action. Compelling evidence for this proposal was provided by the neuropsychological studies of brain injured patients, in particular the contrasting pattern of impaired and preserved visual processing abilities of the visual object agnostic patient (DF) and optic ataxic patients who it was argued presented with impaired dorsal stream function. Optic ataxia has thus become a cornerstone of this 'two visual system' account (Pisella, Sergio, Blangero, Torchin, Vighetto, Rossetti, 2009). In the current study we re-examine this assumption by investigating how several individuals presenting with optic ataxia performed on a bimanual haptic matching task performed without vision, when the bar to be matched was presented haptically or visually. We demonstrate that, unlike neurologically healthy controls who perform the task with high levels of accuracy, all of the optic ataxic patients were unable to perform the task. We interpret this finding as further evidence that the key difficulty experienced by optic ataxic patients across a range of behavioural tasks may be an inability to simultaneously and directly compare two spatial representations so as to compute the difference between them.



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Darwin revisited: The vagus nerve is a causal element in controlling recognition of other’s emotions

Publication date: Available online 7 April 2017
Source:Cortex
Author(s): Lorenza S. Colzato, Roberta Sellaro, Christian Beste
Charles Darwin proposed that via the vagus nerve, the tenth cranial nerve, emotional facial expressions are evolved, adaptive and serve a crucial communicative function. In line with this idea, the later-developed polyvagal theory assumes that the vagus nerve is the key phylogenetic substrate that regulates emotional and social behavior. The polyvagal theory assumes that optimal social interaction, which includes the recognition of emotion in faces, is modulated by the vagus nerve. So far, in humans, it has not yet been demonstrated that the vagus plays a causal role in emotion recognition. To investigate this we employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that modulates brain activity via bottom-up mechanisms. A sham/placebo-controlled, randomized cross-over within-subjects design was used to infer a causal relation between the stimulated vagus nerve and the related ability to recognize emotions as indexed by the Reading the Mind in the Eyes Test in 38 healthy young volunteers. Active tVNS, compared to sham stimulation, enhanced emotion recognition for easy items, suggesting that it promoted the ability to decode salient social cues. Our results confirm that the vagus nerve is causally involved in emotion recognition, supporting Darwin's argumentation.



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Objective analysis of the topological organization of the human cortical visual connectome suggests three visual pathways

Publication date: Available online 7 April 2017
Source:Cortex
Author(s): Koen V. Haak, Christian F. Beckmann
The cortical visual system is composed of many areas serving various visual functions. In non-human primates, these are broadly organised into two distinct processing pathways: a ventral pathway for object recognition, and a dorsal pathway for action. In humans, recent theoretical proposals suggest the possible existence of additional pathways, but direct empirical evidence has yet to be presented. Here, we estimated the connectivity patterns between 22 human visual areas using resting-state functional MRI data of 470 individuals, leveraging the unprecedented data quantity and quality of the Human Connectome Project and a novel probabilistic atlas. An objective, data-driven analysis into the topological organisation of connectivity and subsequent quantitative confirmation revealed a highly significant triple dissociation between the retinotopic areas on the dorsal, ventral and lateral surfaces of the human occipital lobe. This suggests that the functional organisation of the human visual system involves not two but three cortical pathways.



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A Unique Clinicopathological Manifestation of Fungal Infection: A Case Series of Deep Dermatophytosis in Immunosuppressed Patients

Abstract

Background

Dermatophytes are the most common cause of superficial fungal infections in humans. Deep dermatophytosis, however, is rare, described to date only in isolated case reports, usually in the setting of systemic immunosuppression.

Objective

To present the 15-year experience of a tertiary dermato-mycology clinic with the diagnosis and treatment of deep dermatophytosis.

Methods

Patients were identified by database search. Clinical, mycological, histological, and treatment data were collected from the medical files.

Results

Ten patients were identified: nine after solid-organ transplantation and one undergoing chemotherapy, all diagnosed within 3 years after beginning immunosuppression (average 7.5 months). The infective agent in nine cases was Trichophyton rubrum. All patients presented with concurrent superficial fungal infections. Complete resolution was noted in response to systemic antifungal agents. There was no histological evidence of hair-follicle involvement.

Limitations

The limitations of the study were the retrospective design and the small cohort size.

Conclusion

This case-series study suggests that deep dermatophytosis is a separate entity, distinct from Majocchi's granuloma. It occurs only in immunocompromised patients and is characterized by discrete nodules, an indolent course, the absence of follicular invasion, and proximity to a superficial dermatophyte infection. Systemic antifungal treatment leads to complete resolution. The urgent need for the treatment of superficial fungal infections in immunocompromised patients is emphasized.

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The effect of PPARγ agonist on SGLT2 and glucagon expressions in alpha cells under hyperglycemia

Abstract

Background

Although sodium glucose cotransporter 2 (SGLT2) inhibitors have many beneficial effects for type 2 diabetes, including decreased cardiovascular death, recent reports that they increased glucagon through SGLT2 inhibition raised some concern. Troglitazone, Peroxisome proliferator-activated receptor γ (PPAR-γ) agonist, was reported to increase SGLT2 in renal proximal tubule cells, but its role on pancreatic alpha cells have not been reported. We investigated the effect of troglitazone on SGLT2 expression in alpha cells and subsequent glucagon regulation in hyperglycemia.

Methods

An Alpha TC1-6 cell line was cultured in control (5 mM) or hyperglycemia (HG, 15 mM) for 72 h. We applied troglitazone with or without PPARγ antagonist (GW9662 10 μM). To investigate the involvement of PI3K/Akt pathway, we applied troglitazone with or without Wortmanin. We measured sodium glucose transporter 2 (SGLT2) and glucagon (GCG) mRNA and protein expression. PPAR gamma, PI3K and Akt protein were also measured.

Results

Exposure of alpha TC cells to HG for 72 h increased glucagon mRNA and protein expression. HG decreased SGLT2 mRNA and protein expression. Troglitazone significantly reversed HG-induced reduction of SGLT2 expression and increase of glucagon secretion. PPARγ antagonist (GW9662 10 μM) decreased the expression of SGLT2 and increased glucagon as HG did. Hyperglycemia increased PI3K and pAkt expression in alpha cells. Wortmanin (PI3K inhibitor, 1 μM) reversed HG-induced SGLT2 decrease and glucagon increase. Troglitazone treatment decreased PI3K and pAkt expression in HG.

Conclusion

In conclusion, PPARγ agonist, troglitazone improved glucose transport SGLT2 dysfunction and subsequent glucagon dysregulation in alpha cell under hyperglycemia. Those effects were through the involvement of PI3K/pAkt signaling pathway. This study may add one more reason for the ideal combination of PPARγ agonist and SGLT2 inhibitor in clinical practice.

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