Prognostic Value of Adjuvant Chemotherapy Following Pancreaticoduodenectomy in Elderly Patients With Pancreatic Cancer

Background/Aim: The aim of this study was to investigate the relationship between age and long-term survival among patients who underwent pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). Patients and Methods: A total of 916 patients who underwent PD for curative resection of PDAC were included in this study. Patients were divided into younger (n=726, <70 years) and older (n=190, ≥70 years), and the overall survival (OS) between the two groups was compared. Results: Median OS was significantly longer in the younger group (p<0.001). However, the survival advantage among younger patients was not significant when analyzing only patients who received adjuvant chemotherapy (p=0.548). Among patients who did not receive adjuvant chemotherapy, OS was significantly longer in the younger group (p=0.003). Among patients who received neither adjuvant chemotherapy nor treatment for recurrence, survival was not significantly different between the groups (p=0.629). Conclusion: Adjuvant chemotherapy should be recommended, and additional treatment for recurrence is effective even among elderly who have not received adjuvant chemotherapy.

http://bit.ly/2MMl0bz

Radiation Therapy for Extrapelvic Lymph Node Recurrence After Curative Treatment for Cervical Cancer

Background/Aim: To investigate outcomes of patients with cervical cancer who received radiation therapy for extrapelvic lymph node recurrence after initial pelvic radiotherapy. Patients and Methods: The treatment charts of 20 patients were retrospectively reviewed, and factors influencing patient's prognosis were statistically analyzed. Results: The three-year in-field tumor control rate was 55% and overall survival (OS) at 2, 3, and 5 years was 55%, 45%, and 37.5%, respectively. The rate of the three-year OS in patients with recurrence within and after 9 months was 20% and 70%, respectively (p=0.016). None of the 4 patients who were diagnosed with supraclavicular lymph node recurrence alone at more than 9 months after initial treatment experienced further recurrence. Five-year survival of the remaining 16 patients was only 21% (p=0.021). Conclusion: Time to recurrence significantly influenced survival in patients with cervical cancer who received radiotherapy for extra-pelvic lymph node recurrence. Supraclavicular lymph node recurrence alone had a favorable impact on patient's prognosis.

http://bit.ly/2DPS0wB

The Role of KRAS in Endometrial Cancer: A Mini-Review

Endometrial cancer (EC) is the most common cancer of the female genital tract, resulting annually in 76,000 related deaths worldwide. EC originates either from oestrogen-related proliferative endometrium (type I, endometrioid), or from atrophic endometrium (type II, non-endometrioid). Each type of EC is characterized by different molecular profile alterations. The Kirsten rat sarcoma viral oncogene homolog (KRAS) gene encodes a signalling protein which moderates response to various extracellular signals via down-regulation of the mitogen-activated protein kinase (MAPK) or phosphoinositide-3-kinase/v-akt murine thymoma viral oncogene (PI3K/AKT) pathways. This article reviews the role of KRAS in predicting transition from hyperplastic endometrium to early-stage well-differentiated EC, as well as further invasive proliferation of the tumour to advanced-stage disease. KRAS seems to be directly associated with type I EC, and most studies support its early involvement in carcinogenesis. Current evidence correlates KRAS mutations with increased cell proliferation and apoptosis, as well as up-regulation of endometrial cell oestrogen receptors. Tumours positive for KRAS mutation can harbour hypermethylation-related changes in genome expression, and this can be the cause of concurrent loss of DNA repair proteins. Despite some evidence that KRAS mutation status affects cancer progression, a consensus is yet to be reached. Based on the available evidence, we suggest that screening for KRAS mutations in patients with hyperplastic endometrium or early-stage type I EC, may provide important information for prognosis stratification, and further provision of personalised treatment options.

http://bit.ly/2MNXR8u

Crypts With Corrupted Shapes in Non-polypoid Adenomas

Background: Colonic crypts with normal epithelial lining exhibiting corrupted shapes (NECS) have been previously found beneath the adenomatous tissue of polypoid conventional adenomas, in both rats and humans. Aim: To assess the frequency of NECS in non-polypoid colonic flat adenomas (FAs) and lateral-spreading adenomas (LSAs). Materials and Methods: Histological hematoxylin and eosin-stained sections from 51 non-polypoid colonic adenomas were scrutinized over a 10-mm field of vision (FOV). FAs were regarded lesions encompassed within the FOV and LSAs as those surpassing that limit. The NECS/mm ratio was calculated in individual lesions as the number of NECS beneath the adenomatous tissue, divided by the length (mm) of the FA and LSA. Results: Out of the 51 non-polypoid adenomas, 27 were FAs and the remaining 24 LSAs. All 51 non-polypoid lesions were tubular adenomas. The mean number of NECS in FAs was 6.29 (range=2-10) and in LSAs was 15.29 (range=7-41) (p<0.05). On the other hand, the mean NECS/mm ratio in FAs was 0.94 (range=0.50-2.00) and in LSAs was 0.92 (range=0.40-2.93). Thus, no essential differences in the number of NECS/mm was found between FA and LSA. Conclusion: The accretion of NECS below the neoplastic canopy of FA and LSA contrasts with the rare occurrence of NECS in normal colonic mucosa. This finding emerges as a previously unaddressed major event, an event that might play an important role in the histogenesis of non-polypoid adenomas of the colon.

http://bit.ly/2DRyrnU

Integrin as a Molecular Target for Anti-cancer Approaches in Lung Cancer

Integrins are cell-matrix adhesion molecules providing both mechanical engagement of cell to extracellular matrix, and generation of cellular signals that are implicated in cancer malignancies. The concept that integrins play important roles in cell survival, proliferation, motility, differentiation, and ensuring appropriate cell localization, leads to the hypothesis that inhibition of certain integrins would benefit cancer therapy. In lung cancer, integrins αv, α5, β1, β3, and β5 have been shown to augment survival and metastatic potential of cancer cells. This review presents data suggesting integrins as molecular targets for anti-cancer approaches, and the mechanisms through which integrins confer resistance of lung cancer to chemotherapeutics and metastasis. The better understanding of these key molecules may benefit the discovery of anti-cancer drugs and strategies.

http://bit.ly/2MJuMuW

County Median Family Income Is an Independent Prognostic Factor for Stage IV Anaplastic Thyroid Cancer

Background/Aim: Advanced anaplastic thyroid cancer (ATC) is a rare, but highly aggressive malignancy, and its prognostic factors need to be further explored. We examined socioeconomic factors' predictive effect for survival performance in stage IV ATC patients. Materials and Methods: Using the Surveillance, Epidemiology, and End Results database, we collected 1,048 cases with stage IV anaplastic thyroid cancer (ATC) from 2004 to 2015. Demographic, clinical, and socioeconomic factors were evaluated using univariate and multivariate analyses. Results: Median family income showed a significant effect on overall survival (OS) and cancer-specific survival (CSS) in univariate analysis. Median family income level was found to be an independent prognostic factor for OS after multivariate adjustment Multivariate analysis for CSS showed similar results. Conclusion: Family income level is an independent prognostic factor for stage IV ATC.

http://bit.ly/2DP76Tl

A Potent CD1d-binding Glycolipid for iNKT-Cell-based Therapy Against Human Breast Cancer

Background/Aim: Invariant natural killer T-cells (iNKT) stimulated by CD1d-binding glycolipids have been shown to exert antitumor effects by a number of studies in a mouse model. Breast cancer is a devastating disease, with different types of breast cancer recurring locally or distant as metastatic/advanced disease following initial treatment. The aim of this study was to examine the tumoricidal effect of a CD1d-binding glycolipid, called 7DW8-5, against a highly invasive human breast cancer cell line both in vitro and in vivo. Materials and Methods: Parental MDA-MB-231 cells and MDA-MB-231 cells transduced with human CD1d were labeled with carboxyfluorescein diacetate succinimidyl ester (CFSE), followed by loading with glycolipids. After co-culturing with human iNKT cells, the cells were permeabilized and stained with Alexa Flour 647-conjugated antibody to active caspase-3, and analyzed using a BD LSR II. For the in vivo tumoricidal effect, MDA-MB-231 cells transduced with human CD1d and luciferase genes were injected into the mammary fat pad of female NOD/SCID/IL2rnull (NSG) mice, followed by the injection of human iNKT cells with or without 7DW8-5, and the levels of luminescence were analyzed with whole-body imaging. Results: Human iNKT cells could kill CD1d-expressing human breast cancer cells in vitro in the presence of 7DW8-5, but not α-GalCer. As for in vivo, the adoptive transfer of human iNKT cells into tumor-challenged NSG mice significantly inhibited the growth of CD1d+ MDA-MB-231 human breast cancer cells in the presence of 7DW8-5. Conclusion: CD1d-binding, glycolipid-based iNKT-cell therapy is suggested as a potent and effective treatment against breast cancer in humans.

http://bit.ly/2ML4NDy

Clinical Outcomes of 42 Renal Cell Carcinoma Patients With Metastases Solely to the Lung Who Received Sorafenib as Second-line Systemic Therapy

Background/Aim: In renal cell carcinoma (RCC), sorafenib was the first targeted agent demonstrating a definitive benefit in a large phase III clinical trial. The objective of this study was to assess the clinical outcomes of 42 consecutive RCC patients with metastases solely to the lung who received sorafenib as a second-line systemic agent. Patients and Methods: Of the 42 patients, 14 (33.3%) and 28 (66.7%) received cytokine therapy and sunitinib, respectively, prior to treatment with sorafenib. In this series, all patients initially received 400 mg of sorafenib twice daily on a continuous dosing schedule. The efficacy and safety of second-line sorafenib in these 42 patients were retrospectively evaluated. Results: As the best response to sorafenib, 2 (4.8%), 14 (33.3%), 22 (52.4%) and 4 (9.5%) patients were judged to show a complete response, partial response, stable disease and progressive disease, respectively. The median progression-free survival (PFS) and overall survival (OS) after the introduction of sorafenib was 10.6 and 30.2 months, respectively. Multivariate analyses of several parameters identified the following independent prognostic predictors: C-reactive protein (CRP) level for PFS, and International Renal Cell Carcinoma Database Consortium classification and CRP level for OS. The common adverse events associated with sorafenib were hand-foot syndrome, hypertension and diarrhea, which developed in 22 (52.4%), 17 (40.5%) and 13 (31.0%), respectively; however, any AEs corresponding to ≥grade 3 occurred in only 16 (38.1%). Conclusion: Favorable disease control with acceptable tolerability might be expected by introducing sorafenib as second-line therapy for RCC patients with metastases solely to the lung; therefore, sorafenib could be the optimal option for this category of patients.

http://bit.ly/2DSe0Hv

High miR-3687 Expression Affects Migratory and Invasive Ability of Oesophageal Carcinoma

Background/Aim: Basaloid squamous cell carcinoma of the oesophagus (BSCCE) is a variant of oesophageal squamous cell carcinoma (ESCC), that has a more aggressive biological behaviour than that of typical ESCC. miR-3687 has been previously identified to be highly expressed in BSCCE. This study aimed to evaluate the prognostic impact of miR-3687 in ESCC and determine the role of miR-3687 in ESCC motility. Materials and Methods: miR-3687 expression in human ESCC cell lines and in primary tumour samples obtained from patients with ESCC who underwent esophagectomy were analyzed via real-time polymerase chain reaction (PCR). Knockdown and over-expression experiments were conducted with miR-3687 siRNA and miRNA mimic, and the effect on cell proliferation, migration, and invasion was analyzed. Results: A total of 92 samples were analyzed. High miR-3687 expression was correlated with poor prognosis. miR-3687 upregulation promoted cell migration and invasion. Conclusion: miR-3687 expression negatively impacts the prognosis of patients with ESCC.

http://bit.ly/2MKIZYB

Age Adjusted Charlson Comorbidity Index Strongly Influences Survival, Irrespective of Performance Status and Age, in Patients With Advanced Prostatic Cancer Treated With Enzalutamide

Background/Aim: Enzalutamide is prescribed for advanced prostatic cancer patients, regardless of physical comorbidity. We hypothesized that comorbidity negatively affects survival regardless of age, performance status and prostate-specific antigen (PSA) response. Patients and Methods: All patients (n=106) treated at the ADRZ Medical Center with enzalutamide in the period 2015-2018 and who had undergone at least one PSA response evaluation were included in a multivariate analysis to test which variables independently affected Time to PSA progression (TPSAP) and/or overall survival (OS). Results: A poorer performance status appeared to relate to a two times increased risk of dying (HR=2.032, 95%CI=1.078-3.830). An older age did not appear to influence OS, whereas an ACCI of more than 9 points appeared to relate to a more than three times increased risk of dying (HR=3.538, 95%CI=1.466-8.538). Conclusion: Survival appeared to be strongly affected by comorbidity, irrespective of age and performance status in patients treated with enzalutamide.

http://bit.ly/2DQfCBq

Association of CD31 and p53 With Survival of Ovarian Cancer Patients

Background/Aim: New markers for ovarian cancer are needed. This study aimed to examine the expression of tumour cell p53 and endothelial cell CD31 proteins and correlate them to clinicopathological factors. Patients and Methods: Expression of proteins was immunohistochemically assessed using tissue sections from 585-599 ovarian cancer patients from the Danish MALOVA study. Results: High CD31 expression was found in poorly differentiated tumours (p=0.0006), and high p53 expression was found in poorly differentiated cancers (p<0.0001), high clinical stage (p<0.0001), non-radical surgery (p<0.0001) and high serum CA-125 values (p<0.0001). CD31 expression showed no prognostic survival value, but high hazard ratios were found for patients with high p53 expression (HR=2.313, p<0.0001). An interaction was found between p53 and stage of cancer, suggesting a prognostic impact of p53 in low-stage, but not in advanced-stage cancer. Conclusion: More than 5% of p53 tissue expression may predict shorter survival of ovarian cancer patients and may be useful for predicting the risk of disease progression in low-stage patients following primary surgery. CD31 has no strong prognostic value.

http://bit.ly/2MQD84c

Diagnostic Utility of Third-Look, Contrast-Enhanced Sonography Followed by Needle Biopsy for MRI, But Not Ultrasonography Breast Lesions

Background/Aim: To clarify the diagnostic utility of third-look, contrast-enhanced ultrasonography (CEUS) for MRI-detected breast lesions undetectable by unenhanced, second-look ultrasonography (MRI+/US– lesions). Patients and Methods: Clinical stage 0–IIA breast cancer patients who underwent CEUS for incidental MRI+/US– lesions (n=27; cohort 1) and patients with breast lesions detected only by MRI, to be examined by CEUS (n=15; cohort 2), were retrospectively analyzed. Results: Of the 42 MRI+/US– lesions, 23 (55%) were detected by CEUS and then examined by needle biopsy. Pathological examination showed that 10 of these 23 lesions were malignant. None of the 19 lesions undetected by CEUS were found to be histologically malignant or developed malignancy with a median follow-up of 18.5 months. The accuracy, sensitivity, and specificity of CEUS plus needle biopsy were 98%, 91%, and 100%, respectively. Conclusion: Third-look CEUS followed by needle biopsy is useful in the initial diagnosis of MRI+/US– lesions.

http://bit.ly/2DSTSor

Oligodendrocytes Up-regulate the Invasive Activity of Glioblastoma Cells via the Angiopoietin-2 Signaling Pathway

Background/Aim: Glioblastoma (GBM) is one of the most lethal solid cancers due to its highly invasive nature. The malignant potential of GBM cells might be partially regulated by surrounding normal cells, such as oligodendrocytes or fibroblasts. The aim of this study was to examine the interaction between stromal cells and GBM cells. Materials and Methods: Two GBM cell lines were used. The effect of stromal cells, oligodendrocytes or fibroblasts, on the invasive ability of GBM cells was examined by wound-healing assay and invasion assay. Results: Oligodendrocytes, in contrast to fibroblasts, significantly increased the migration and invasive ability of GBM cells. Angiopoietin-2 levels were high in the conditioned medium obtained from oligodendrocytes. Angiopoietin-2 significantly increased the motility of GBM, and the motility-stimulating activity of the oligodendrocytes-derived conditioned medium was significantly decreased by anti-angiopoietin-2-neutralizing antibody. Conclusion: Glioma stromal cells, oligodendrocytes, might up-regulate the invasiveness of GBM cells via angiopoietin-2 signaling.

http://bit.ly/2MNUNt9

Postoperative Pneumonia After Esophagectomy and Systemic Inflammatory Response Syndrome

Background/Aim: The aim of this study was to determine the association between post-esophagectomy pneumonia and the presence of pathogenic organisms in the sputum or pharynx and postoperative systemic inflammatory response syndrome (SIRS). Materials and Methods: This retrospective study included 98 patients diagnosed with esophageal cancer who had undergone esophagectomy. Results: Postoperative pneumonia was observed in 24 patients (24.5%). Of the total 98 patients, 45 (45.9%) were tested positive for pathogenic organisms preoperatively, and 16 of those (35.6%) developed postoperative pneumonia; postoperative pneumonia occurred at a higher rate in these patients compared to pathogenic organism-negative patients (p=0.019). Postoperative SIRS was observed in 62 patients (63.3%), and 21 of these (33.9%) developed postoperative pneumonia, a significantly higher rate compared to patients without SIRS (p=0.007). Conclusion: Postoperative pneumonia was significantly associated with the presence of pathogenic organisms in the sputum or pharynx and postoperative SIRS.

http://bit.ly/2DQ3gZV

Cytoplasmic Keap1 Expression Is Associated With Poor Prognosis in Endometrial Cancer

Background/Aim: Oxidative stress is involved in several carcinogenic pathways. Nuclear factor erythroid 2-related factor (Nrf2), Kelch-like ECH-associated protein 1 (Keap1) and Park7 (DJ-1) are the main regulators of antioxidant enzymes eliminating reactive oxidative species (ROS). The roles of these proteins were studied as potential prognostic factors in endometrial cancer. Materials and Methods: Nrf2, Keap1 and DJ-1 expression in endometrial carcinomas was analyzed immunohistochemically. Correlations between staining patterns and clinical prognostic variables were evaluated. Results: Extensive cytoplasmic Keap1 staining correlated to several factors associated with poor prognosis of endometrial cancer including advanced stage, poor histological differentiation, lymphovascular invasion, pelvic lymph node metastasis and deep myometrial invasion. In multivariate analysis, cytoplasmic Keap1 was a stronger predictor of poor progression-free survival than grade. Nuclear Nrf2 staining was seen in all patients with lymph node metastasis while DJ-1 staining was associated with clinically favourable disease types. Conclusion: Cytoplasmic Keap1 expression indicates poor prognosis in endometrial cancer.

http://bit.ly/2MLdVrK

Leptomeningeal Gliomatosis: A Single Institution Study of 31 Patients

Background/Aim: Secondary leptomeningeal gliomatosis (LG) is a rare and severe progression pattern of glioma. Our objective was to evaluate the characteristics and outcome of patients with LG. Patients and Methods: We retrospectively reviewed 31 patients diagnosed with secondary LG. At the time of LG diagnosis, the median age of patients was 45 years. The histological grade was IV in 20 patients and II to III in 11 patients. As a first-line of therapy for LG, 22 patients received an oncological treatment: i) BCNU-temozolomide (TMZ) (n=15), ii) other type of chemotherapy (n=7), and iii) no treatment (supportive care) (n=9). Results: Following LG diagnosis, the median progression-free survival (PFS) and overall survival (OS) were 1.8 months [95% confidence interval (CI)=0.9-2.7] and 2.1 months (95%CI=1.3-3), respectively. The univariate analyses showed an improved OS with age of less than 45 years (p<0.001), a prolonged interval from the initial glioma diagnosis (IGD) to LG diagnosis (p=0.003), BCNU–TMZ as the preferred first-line treatment for LG out of the three options (p=0.008), and Karnofsky performance status (KPS) ≥70 (p=0.012). Prolonged interval from IGD to LG diagnosis (HR=5.839) and BCNU–TMZ as the chosen first-line treatment for LG (HR=6.635) remained significant in the multivariate analyses as well. Among the 22 treated patients, the median OS was significantly higher (p=0.008) with the BCNU–TMZ treatment (5.7 months; 95%CI=4.2-7.1), compared to other types of treatment offered (2 months; 95%CI=1.1-2.9). Conclusion: The time interval from the IGD to the LG diagnosis is a potential prognostic factor for LG. BCNU–TMZ may be a therapeutic option in the present setting.

http://bit.ly/2DQKbHi

Isothiocyanate-induced Cell Cycle Arrest in a Novel In Vitro Exposure Protocol of Human Malignant Melanoma (A375) Cells

Background/Aim: Several studies have documented the effects of isothiocyanates (ITCs) on cancer prevention by inducing oxidative stress, activating apoptosis, affecting cell-cycle regulation, etc. Previously, we have shown that ITCs, administered at low concentrations by the means of double-bolus are capable of potentiating cytotoxicity in human malignant melanoma (A375) cells by inducing apoptosis. The aim of the present study was to further investigate the effect of the treatment of A375 cells with ITCs on cell-cycle progression and the levels of various cell cycle regulators. Materials and Methods: Cell-cycle analysis was performed by means of flow cytometry whereas western immunoblotting was used to determine the expression levels of these protein regulators. Results: Our data showed an increase in the number of cells in the G₂/M phase accompanied by a decrease in the G₀/G₁ phase, while several cell-cycle regulators were shown to be differentially expressed upon exposure to ITCs. Conclusion: ITCs induced cell-cycle arrest in A375 cells.

http://bit.ly/2MK63qz

MicroRNA-based Targeted Therapeutics in Pancreatic Cancer

The discovery during the last decade of microRNAs (miRs, miRNA) and their role in regulating normal physiological processes as well as in the pathogenesis of human tumors has been a revolutionary development in molecular oncology. miRNAs activating or inhibiting oncogenic molecular pathways that are involved in tumorigenesis, cell progression, invasion, angiogenesis and metastasis are now considered of major impact in many cancer types. miRNA-based therapeutics that inhibit the levels of oncogenic miRNAs (oncomiRs) or elevate tumor suppressor miRs have enormous potential as molecular therapeutic targets. Thus, the development of new targeted cancer therapies based on miRNAs promise to revolutionize cancer treatment due to their increased efficacy compared to conventional chemoradiation-based therapies and hopefully to lower levels of adverse effects.

http://bit.ly/2DQW1ku

Basic Gene Expression Characteristics of Glioma Stem Cells and Human Glioblastoma

Background: Glioma stem cells (GSCs) play important roles in the tumorigenesis of glioblastoma multiforme (GBM). Using a novel cellular bioinformatics pipeline, we aimed to characterize the differences in gene-expression profiles among GSCs, U251 (glioma cell line), and a human GBM tissue sample. Materials and Methods: Total RNA was extracted from GSCs, U251 and GBM and microarray analysis was performed; the data were then applied to the bioinformatics pipeline consisting of a principal component analysis (PCA) with factor loadings, an intracellular pathway analysis, and an immunopathway analysis. Results: The PCA clearly distinguished the three groups. The factor loadings of the PCA suggested that v-myc avian myelocytomatosis viral oncogene neuroblastoma derived homolog (MYCN), dipeptidyl-peptidase 4 (DPP4), and macrophage migration-inhibitory factor (MIF) contribute to the stemness of GSCs. The intracellular pathway and immunopathway analyses provided relevant information about the functions of representative genes in GSCs. Conclusion: The newly-developed cellular bioinformatics pipeline was a useful method to clarify the similarities and differences among samples.

http://bit.ly/2MT8tmV

Genetic Analysis Using a Gene Panel in 87 Caucasian Patients With Colorectal Cancer: Own Results and Review of Literature

Background/Aim: Colorectal cancer (CRC) is the third most common cancer worldwide. The prognosis between left- and right-sided CRC differs, partly due to baseline differences as vascular supply. The purpose of the present study was to investigate whether there are genetic differences between left- and right-sided CRC. Patients and Methods: Eighty-seven patients with CRC (mean age: 61 years) were retrospectively included in the study. Blood samples were used for genetic analysis, by applying the sequencing research panel Ion AmpliSeq Colon and Lung Cancer Research Panel V2. Statistical analyses included Chi-square tests, Kaplan-Meier survival curves, and univariate/multivariate Cox-regression analyses. Results: By testing the sequence of 22 genes included in the panel, a significant difference was detected between left- and right-sided CRC regarding the expression of BRAF and DDR2 genes, with mutations occurring more often in the right-sided CRC. In the multivariate setting, left-sided CRC only turned out as a significant positive prognostic parameter regarding progression-free survival, irrespective of the type of chemotherapy or BRAF and NRAS mutations. Conclusion: Tumour location was the only parameter proven to be an independent prognostic factor for CRC in the present study.

http://bit.ly/2DPM8Ue

Evidence of non-DDD pathway in the anaerobic degradation of DDT in tropical soil

Abstract

DDT transformation to DDD in soil is the most commonly reported pathway under anaerobic conditions. A few instances of DDT conversion to products other than DDD/DDE have been reported under aerobic conditions and hardly any under anaerobic conditions. In particular, few reports exist on the anaerobic degradation of DDT in African tropical soils, despite DDT contamination arising from obsolete pesticide stockpiles in the continent as well as new contamination from DDT use for mosquito and tsetse fly control. Moreover, the development of possible remediation strategies for contaminated sites demands adequate understanding of different soil processes and their effect on DDT persistence, hence necessitating the study. The aim of this work was to study the effect of simulated anaerobic conditions and slow-release carbon sources (compost) on the dissipation of DDT in two tropical clay soils (paddy soil and field soil) amenable to periodic flooding. The results showed faster DDT dissipation in the field soil but higher metabolite formation in the paddy soil. To explain this paradox, the levels of dissolved organic carbon and carbon mineralization (CH₄ and CO₂) were correlated with p,p-DDT and p,p-DDD concentrations. It was concluded that DDT underwent reductive degradation (DDD pathway) in the paddy soil and both reductive (DDD pathway) and oxidative degradation (non-DDD pathway) in the field soil.

http://bit.ly/2S75Cwo

Socioeconomic status of the population – a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


http://bit.ly/2UDctuq

Physical growth and development characteristics of children with Williams syndrome aged 0–24 months in Zhejiang Province

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


http://bit.ly/2S3lUX4

Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


http://bit.ly/2UBpEvw

Recycling of crushed waste rock as backfilling material in coal mine: effects of particle size on compaction behaviours

Abstract

Crushed waste rocks can be used as materials for backfilling goafs, so as to achieve the simultaneous goals of processing solid waste and controlling surface subsidence; however, particle size distribution directly affects the compaction of crushed waste rocks. Therefore, by employing a self-designed bidirectional loading test system for granular materials, this study tested compaction characteristics of crushed waste rocks with four different particle size distributions. Moreover, this research tested the changes of parameters in lateral and axial loading of crushed waste rocks and analysed the influence of particle size distribution on lateral strain, axial strain, porosity, lateral stress, and lateral pressure coefficient during compaction. The test results show that (1) particle size distribution affects porosity, strain, and lateral pressure coefficient of crushed waste rocks under lateral and axial loading. (2) For the samples under particle size distribution ranging from 0 to 10 mm, the initial porosity is low and deformations are small under axial loading, so that particles can make contact and bear effective stress in grain-grain contact. Therefore, more stress is transferred to the lateral direction. (3) After compaction, the curves of the samples of crushed waste rocks under four particle size distributions all shift upwards in comparison with those before compaction, indicating that particles are crushed and the proportion of small particles constantly increases. (4) A reasonable particle size distribution can significantly improve stress characteristics, reduce crushing of particles in the samples, and increase the stiffness of the samples, so as to achieve better compaction effects.

http://bit.ly/2t3Ugu6

Sulfur dioxide induces apoptosis via reactive oxygen species generation in rat cardiomyocytes

Abstract

Epidemiological evidence suggests that the incidence and mortality of cardiovascular diseases are closely related to sulfur dioxide (SO₂). In the present study, H9C2 cells were incubated with 100 μM NaHSO₃ with or without pretreatment of an antioxidant, N-acetyl-l-cysteine (NAC). The changes of apoptosis rate, mitochondrial membrane potential (MMP), ATP content, caspase-3 activity, and reactive oxygen species (ROS) were detected. Rats were inhaled 7 mg/m³ SO₂ and/or intraperitoneal injected with 50 mg/kg (bw) of NAC for 30 days. RT-PCR and Western blot were used to detect the mRNA and protein levels of apoptosis-related genes. We found that the apoptosis of H9C2 cells was induced by NaHSO₃, which decreased the content of MMP and ATP, and induced the expression of caspase-3. NAC can inhibit the apoptosis induced by NaHSO₃ treatment. SO₂ and NaHSO₃ decreased the expression of Bcl-2 and the ratio of Bcl-2/Bax, increased the expression of Bax and P53 accumulation and phosphorylation, and activated caspase-9 and caspase-3. Whereas NAC can reduce the changes of apoptosis-related proteins in rat heart. Our results suggest that SO₂ induces ROS-mediated P53 and caspase-dependent mitochondrial signaling pathways in H9C2 cells and rat hearts. Antioxidant therapy can reduce the adverse reactions of SO₂ and lead to a decline in the cardiovascular disease induced by SO₂.

http://bit.ly/2TrjQEY

Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis

Abstract

Objective

The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery.

Methods

A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured.

Results

The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm.

Conclusions

It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery.

Clinical relevance

The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

http://bit.ly/2Bh6p38

Endocrine disrupting pesticides in soil and their health risk through ingestion of vegetables grown in Pakistan

Abstract

A comprehensive study was conducted to appraise the concentrations of 30 endocrine disrupting pesticides (EDPs) in soil and vegetable samples collected from Khyber Pakhtunkhwa, Pakistan. The sum of 30 EDPs (Σ₃₀EDPs) ranged from 192 to 2148 μg kg⁻¹ in the collected soils. The selected EDP concentrations exceeded their respective limits in most of the tested soils and showed great variation from site to site. Similarly, high variations in Σ₃₀EDP concentrations were also observed in vegetables with the highest mean concentration in lettuce (28.9 μg kg⁻¹), followed by radish (26.6 μg kg⁻¹), spinach (25.7 μg kg⁻¹), onion (16.2 μg kg⁻¹), turnip (15.6 μg kg⁻¹), and garlic (14.7 μg kg⁻¹). However, EDP levels in all studied vegetables were within FAO/WHO limits. The mean bioconcentration factor values were observed < 1 for all the studied vegetables. The health risk assessment revealed that the incremental lifetime cancer risk (ILCR) of Σ₃₀EDPs associated with vegetable ingestion was below the acceptable risk level (1 × 10⁻⁶), showing no cancer risk to local inhabitants. However, exposure to endocrine disruptor and probable carcinogen heptachlor epoxide poses a potential non-cancer risk (hazard quotient (HQ > 1)) to children through vegetable consumption. The presence of banned EDPs in soils and vegetables of the study area indicates the stability of these legacy chemicals in the environment from over usage in the past or illegal current application for agricultural purposes.

Graphical abstract

http://bit.ly/2t2HMTy

Phytoextraction of heavy metals from contaminated soil, water and atmosphere using ornamental plants: mechanisms and efficiency improvement strategies

Abstract

Accumulation of heavy metals (HMs) in soil, water and air is one of the major environmental concerns worldwide, which mainly occurs due to anthropogenic activities such as industrialization, urbanization, and mining. Conventional remediation strategies involving physical or chemical techniques are not cost-effective and/or eco-friendly, reinforcing the necessity for development of novel approaches. Phytoextraction has attracted considerable attention over the past decades and generally refers to use of plants for cleaning up environmental pollutants such as HMs. Compared to other plant types such as edible crops and medicinal plants, ornamental plants (OPs) seem to be a more viable option as they offer several advantages including cleaning up the HMs pollution, beautification of the environment, by-product generation and related economic benefits, and not generally being involved in the food/feed chain or other direct human applications. Phytoextraction ability of OPs involve diverse detoxification pathways such as enzymatic and non-enzymatic (secondary metabolites) antioxidative responses, distribution and deposition of HMs in the cell walls, vacuoles and metabolically inactive tissues, and chelation of HMs by a ligand such as phytochelatins followed by the sequestration of the metal–ligand complex into the vacuoles. The phytoextraction efficiency of OPs can be improved through chemical, microbial, soil amending, and genetic approaches, which primarily target bioavailability, uptake, and sequestration of HMs. In this review, we explore the phytoextraction potential of OPs for remediation of HMs-polluted environments, underpinning mechanisms, efficiency improvement strategies, and highlight the potential future research directions.

Graphical Abstract

ᅟ

http://bit.ly/2HKcCu7

Relationship between arsenic accumulation in tissues and hematological parameters in mullet caught in Faro Lake: a preliminary study

Abstract

The authors investigated the arsenic (As) accumulation in different tissues (muscle, gill, liver, stomach, and intestine) and the possible correlation between tissue concentration and hematological parameters in mullet (Mugil cephalus Linnaeus, 1758) caught in Faro Lake (Messina, Sicily, Italy). On all fish, hematological analyses of blood samples, measurement of biometric indices, and the removal of the muscles, gills, liver, stomach, and intestine for the determination of arsenic concentration were performed. A hemogram was performed to find effects of arsenic concentration in tissues on hematological variables. One-way analysis of variance showed significant differences of arsenic concentration in different tissues, with higher values in the gill. The correlation between hematological parameters and tissue arsenic concentration showed a statistical significance for red blood cell (RBC), hemoglobin concentration (Hb), and hematocrit (Hct) with the liver As concentration. Biometric indices (weight, length, and fork length) showed a significant correlation with As concentration of the muscle and liver also. Our results indicate the role of some hematological parameters as biomarkers useful to monitoring anthropogenic load of arsenic in water and sediment, because variations of these parameters represent one of the effects that arsenic exposure can have on fish.

http://bit.ly/2MQlmOA

Synergistic effect and degradation mechanism on Fe-Ni/CNTs for removal of 2,4-dichlorophenol in aqueous solution

Abstract

Fe-Ni bimetallic nanoparticles supported on CNTs (Fe-Ni/CNTs) were synthesized, characterized, and applied for removal of 2,4-dichlorophenol (2,4-DCP) in aqueous solution. The removal performance was enhanced drastically on Fe-Ni/CNTs with respect to monometallic Fe/CNTs. The synergistic effect between Fe-Ni nanoparticles and CNTs has been studied in detail. The research results indicated that the doping of Ni played an important role in promoting the catalytic degradation of 2,4-DCP. And the presence of CNTs not only could effectively reduce the aggregation of nanoparticles but also facilitate the mass transfer of 2,4-DCP and the formation of active atomic hydrogen during the catalytic process. In addition, the removal kinetics of 2,4-DCP by Fe-Ni/CNTs were in agreement with a pseudo-first-order model, and the rate constants were dependent on a number of factors including the initial concentration of 2,4-DCP, the dosage of Fe-Ni/CNTs, pH value of the solution, and doping amount of Ni. The degradation mechanism involved the adsorption by CNTs and catalytic reduction by Fe under the stimulating of Ni, and the preferred dechlorination followed the order of para-Cl > ortho-Cl. The study confirmed that Fe-Ni/CNTs had a potential to be a promising catalytic material for removal of chlorophenol and had a great prospect for practical application.

http://bit.ly/2DOEf17

Antipsychotics Promote Metabolic Disorders Disrupting Cellular Lipid Metabolism and Trafficking

Publication date: Available online 1 February 2019

Source: Trends in Endocrinology & Metabolism

Author(s): Chiara Vantaggiato, Elena Panzeri, Andrea Citterio, Genny Orso, Marco Pozzi

Antipsychotics frequently cause obesity and related metabolic disorders that current psychopharmacological/endocrinological theories do not explain consistently. An integrative/alternative theory implies metabolic alterations happening at the cellular level. Many observations in vitro and in vivo, and pivotal observations in humans, point towards chemical properties of antipsychotics, independent of receptor binding characteristics. Being amphiphilic weak bases, antipsychotics can disrupt lysosomal function, affecting cholesterol trafficking; moreover, by chemical mimicry, antipsychotics can inhibit cholesterol biosynthesis. These two molecular adverse effects may trigger a cascade of transcriptional and biochemical events, ultimately reducing available cholesterol while increasing cholesterol precursors and fatty acids. The macroscopic manifestation of these molecular alterations includes decreased high-density lipoprotein and increased very low-density lipoprotein and triglycerides that may translate into obesity and related metabolic disorders.

http://bit.ly/2RBzhsB

Acquisition of L2 morphology by adult language learners

Publication date: Available online 2 February 2019

Source: Cortex

Author(s): Lilli Kimppa, Yury Shtyrov, Suzanne C.A. Hut, Laura Hedlund, Miika Leminen, Alina Leminen

Abstract

Learning a new language requires the acquisition of morphological units that enable the fluent use of words in different grammatical contexts. While accumulating research has elucidated the neural processing of native morphology, much less is known about how second-language (L2) learners acquire and process morphology in their L2. To address this question, we presented native speakers as well as beginning and advanced learners of Finnish with spoken (1) derived words, (2) inflected words, (3) novel derivations (novel combinations of existing stem + suffix), and (4) pseudo-suffixed words (existing stem + pseudo-suffix) in a passive listening EEG experiment. An early (60 ms after suffix deviation point) positive ERP response showed no difference between inflections and derivations, suggesting similar early parsing of these complex words. At 130 ms, derivations elicited a lexical ERP pattern of full-form memory-trace activation, present in the L2 beginners and advanced speakers to different degrees, implying a shift from lexical processing to more dual parsing and lexical activation of the complex forms with increasing proficiency. Pseudo-suffixed words produced a syntactic pattern in a later, 170-240 ms time-window, exhibiting enhanced ERPs compared to inflections, indicating second pass syntactic parsing. Overall, the L2 learners demonstrated a gradual effect of proficiency towards L1-like responses. Advanced L2 learners seem to have developed memory traces for derivations and use early parsing. This suggests that advanced learners have already developed sensitivity to morphological information, while such knowledge is weak in beginners. However, discrepancies in ERP dynamics and topographies indicate partially differing recruitment of the language network in L1 and L2. In beginners, response differences between existing and novel morphology were scarce, implying that representations for complex forms are not yet well-established. The results suggest successful development of brain mechanisms for automatic processing of L2 morphology, capable of gradually attaining L1-like functionality with increasing proficiency.

http://bit.ly/2TnM1Vc

Correction to: In memory of Professor Domenico Andreani

Unfortunately, the author name and his affiliation were published in the original publication. They have now been removed.

http://bit.ly/2G4i5KJ

In vitro effect of low-level laser therapy on the proliferative, apoptosis modulation, and oxi-inflammatory markers of premature-senescent hydrogen peroxide-induced dermal fibroblasts

Abstract

Skin aging is a complex biological process induced by intrinsic and extrinsic factors which is characterized by clinical and cellular changes, especially dermal fibroblasts. It is possible that, some procedures, such as low-level laser therapy (LLLT), could decelerate this process. To test this hypothesis, this study evaluated the in vitro LLLT on dermal fibroblast cell line (HFF-1) with premature senescence H₂O₂-induced. HFF-1 cells were cultured in standardized conditions, and initially H₂O₂ exposed at different concentrations. Fibroblasts were also just exposed at different LLLT (660 nm) doses. From these curves, the lowest H₂O₂ concentration that induced indicators of premature senescence and the lowest LLLT doses that triggered fibroblast proliferation were used in all assays. Cellular mortality, proliferation, and the levels of oxidative, inflammatory cytokines, apoptotic markers, and of two growth signaling molecules (FGF-1 and KGF) were compared among treatments. The H₂O₂ at 50 μM concentration induced some fibroblast senescence markers and for LLLT, the best dose for treatment was 4 J (p < 0.001). The interaction between H₂O₂ at 50 μM and LLLT at 4 J showed partially reversion of the higher levels of DNA oxidation, CASP 3, CASP 8, IL-1B, IL-6, and INFy induced by H₂O₂ exposure. LLLT also trigger increase of IL-10 anti-inflammatory cytokine, FGF-1 and KGF levels. Cellular proliferation was also improved when fibroblasts treated with H₂O₂ were exposed to LLLT (p < 0.001). These results suggest that in fibroblast with some senescence characteristics H₂O₂-induced, the LLLT presented an important protective and proliferative action, reverting partially or totally negative effects triggering by H₂O₂.

http://bit.ly/2WCmQjG

Book Review: Biodynamic Excisional Skin Tension Lines for Cutaneous Surgery

Publication date: Available online 2 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Derek W. Nickerson

http://bit.ly/2S73CUX

REPLY to ‘Comment on “Anti-aging effects of ingenol mebutate for patients with actinic keratosis” and phenol-croton oil peelings’

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Miri Kim, Yujin Jung, Jongsic Kim, Seo-won Jeong, Yu Ri Woo, Hyun Jeong Park

http://bit.ly/2UEGhH3

Follicular mucinosis in patients with hematologic malignancies other than mycosis fungoides: A clinicopathologic study

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Shamir Geller, Christian J. Gomez, Patricia L. Myskowski, Melissa Pulitzer

Abstract

Background

Follicular mucinosis (FM), defined by mucin accumulation within follicular epithelium, may occur in mycosis fungoides (MF). FM without MF is occasionally reported in systemic hematologic malignancies, and may be diagnostically challenging.

Objective

To describe clinicopathological characteristics of FM in patients with hematologic malignancies other than MF.

Methods

Clinical data and histopathology were analyzed in patients with FM and hematologic malignancies diagnosed between 1994 and 2017.

Results

Eighteen patients with FM and systemic hematologic malignancies without cutaneous T-cell lymphoma (CTCL) were identified, nine of them were post hematopoietic stem cell transplantation (HSCT). No non-CTCL associated FM cases (n=46, 37 biopsies) developed CTCL during mean follow-up of 4.3 years. Of CTCL associated with FM (n=44, 31 biopsies) MF was the most common subtype (n=38), although other CTCLs were identified. FM in patients with non-CTCL hematologic malignancies differed clinically from MF-associated FM, presenting most frequently with erythematous papules (P < .0001), without plaques (P <.0001), without alopecia (P = .001), and without histopathologically identified epidermal exocytosis (P = .013).

Limitations

A retrospective study in a single cancer center.

Conclusions

FM can present in systemic hematologic malignancies, including post-HSCT. Papular lesional morphology and histopathology may help to distinguish these cases from MF.

http://bit.ly/2S150Iu

About “Anti-aging effects of ingenol mebutate for patients with actinic keratosis” and phenol-croton oil peelings

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Carlos Gustavo Wambier, Kachiu Cecilia Lee, Thomas Michael Bertolini, Peter P. Rullan, Flavio Luis Beltrame

http://bit.ly/2UBLuPO

Secukinumab for moderate to severe palmoplantar pustular psoriasis: Results of the 2PRECISE study

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Ulrich Mrowietz, Hervé Bachelez, A. David Burden, Michael Rissler, Christian Sieder, Roberto Orsenigo, Kamel Chaouche-Teyara

Abstract

Background

Palmoplantar pustular psoriasis (PPP) is a debilitating disease of the palms and/or soles that is resistant to treatment. Secukinumab, an anti-IL-17A monoclonal antibody, is highly efficacious in the treatment of moderate to severe psoriasis.

Objective

The primary objective was ppPASI75 response with secukinumab at Week 16 vs. placebo (2.5% significance level).

Methods

2PRECISE was a phase 3b multicenter, randomized, double-blind, placebo-controlled, parallel-group study comparing secukinumab 300 mg (n=79) and 150 mg (n=80) to placebo (n=78) in subjects with moderate to severe PPP over 52 Weeks.

Results

The primary endpoint was not met. At Week 16, 26.6% of subjects with secukinumab 300 mg achieved ppPASI75 vs.. 14.1% with placebo (P=0.0411) [OR: 2.62; 95% CI: 1.04, 6.60]. At Week 52, 41.8% of subjects with secukinumab 300mg had ppPASI75. More DLQI 0/1 responses were achieved with secukinumab 300 mg (13.0%) vs. placebo (4.3%) at Week 16. At Week 52, 43.1% of subjects receiving secukinumab 300 mg had DLQI 0/1. No unexpected adverse events were observed.

Limitations

Small sample size and characteristics of PPP disease course.

Conclusion

PPP patients treated with secukinumab 300 mg showed benefit in ppPASI75 responses over 52 weeks and improved quality of life.

http://bit.ly/2S3RLHe

Autoimmunity and the Oral Cavity

Abstract

Purpose of Review

This review aims to make the oral health practitioner and researcher aware of autoimmune diseases that present in the mouth and have implications for oral health. Specifically, the autoimmune pathophysiology, examples of treatments, sequelae, and impact on oral health will be discussed. The limitations of our current knowledge and understanding of these diseases will also be highlighted.

Recent Findings

Over the past decade, it has become clear that there is a bidirectional relationship between oral health and autoimmune disease at other body sites; including diabetes and rheumatoid arthritis. Improving the oral health of patients with autoimmune diseases may reduce morbidity associated with such diseases.

Summary

Autoimmune diseases impact the oral cavity both directly and indirectly and are increasing in prevalence. As such, there is a growing need for the oral health practitioners to be aware of how autoimmune disease impacts the oral cavity. Further research is necessary to improve our understanding of the bidirectional relationship between oral health and autoimmune disease.

http://bit.ly/2sYY8wp

Issue Information

http://bit.ly/2Biyya6

Tetra‐arsenic tetra‐sulfide Ameliorates Lupus Syndromes by Inhibiting IL‐17 producing Double Negative T cells

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease of uncertain etiology that affects multiple tissues and organs. Tetra‐arsenic tetra‐sulfide (As₄S₄), a traditional Chinese medicine, is effective on acute promyelocytic leukemia with mild side effects. In our previous study, BXSB lupus‐prone mice treated with As₄S₄ has showed improved monocytosis, decreased serum interleukin‐6 (IL‐6) and suppressed skin, liver and renal lesions with well‐tolerance. In this study, we explored the effect and mechanism of As₄S₄ on the MRL/lpr mice. MRL/lpr and wild MRL/MpJ mice were divided into control and As₄S₄ treatment groups and dosed with As₄S₄ or placebo for 8 weeks. We found that As₄S₄ prevented the skin, renal and lung lesions of MRL/lpr mice. As₄S₄ significantly decreased the double negative T (DN T) cells and reduced the serum levels of IL‐17, IL‐10, and antinuclear antibodies (ANA) titer. Further results revealed that the FasL was decreased, and activated caspases elevated in DN T cells in As₄S₄ treated MRL/lpr mice. Taken together, As₄S₄ could selectively suppresses DN T cells by inducing apoptosis. It also reduced inflammatory cytokines IL‐17, which may be produced by DN T cells. As₄S₄ may represent a new therapy for SLE.

This article is protected by copyright. All rights reserved.

http://bit.ly/2t0qI0f

Immunostimulating effects of Ginkgo biloba extract against toxicity induced by organophosphate pesticide, diazinon in rainbow trout, Oncorhynchus mykiss : innate immunity components and immune-related genes

Abstract

The immunostimulating and therapeutic properties of Ginkgo biloba (GB) have always been the focus of traditional medicine over thousands of years. During last decade, special attentions were paid to use of GB in aquaculture to enhance fish health and survival. In the present study, we investigated for the first time the immunogenic effects of dietary GB against oxidative and toxicity induced by organophosphate pesticide, diazinon. In non-diazinon-exposed fish, the plasma total immunoglobulin, lysozyme activity, and peroxidase activity significantly elevated after 60-day experiment in fish supplemented with 1 and 2 g GB/kg diet (p < 0.05). The respiratory burst activity and complement activity significantly increased only in groups supplemented with 0.5 g GB/kg diet (p < 0.05). Furthermore, the peroxidase activity, total immunoglobulin, and lysozyme activity significantly declined in groups supplemented with 4 g GB/kg diet during feeding trial (p < 0.05). There were no significant differences in expression of interleukin 1 beta (IL-1β) and transforming growth factor beta 1 (TGF-β1) genes in kidney between control group (non-GB-supplemented fish) and GB-supplemented fish (p > 0.05). In diazinon-exposed fish, all immunity components significantly decreased during exposure in control and those fed 0.5 and 4 g GB/kg diet (p < 0.05). In fish fed 1 and 2 g GB/kg diet, no alternations were found in immunity components during exposure period (p > 0.05). In addition, diazinon induced the expression of IL-1β and TGF-β1 genes in control and fish fed 0.5 and 4 g GB/kg diet (p < 0.05). No significant changes were observed in expression of IL-1β and TGF-β1 genes in fish supplemented with 1 and 2 g GB/kg (p > 0.05). In conclusion, the results of the present study suggest an immunogenic role for dietary GB at optimum dietary levels (1–2 g GB/kg diet) against toxicity induced by diazinon. Nevertheless, GB at high dietary levels (4 g GB/kg diet) showed immunosuppressive effects, which makes it necessary to optimize its levels in diet.

http://bit.ly/2SmrR0x

Optimization of physical parameters for enhanced production of lipase from Staphylococcus hominis using response surface methodology

Abstract

Lipase, a versatile hydrolytic enzyme, is gaining more importance in environmental applications such as treatment of oil and grease containing wastewater, pretreatment of solid waste/industrial wastewater for anaerobic treatment. In the present study, the attempts have been made to improve the production of lipase from Staphylococcus hominis MTCC 8980 by optimization of pH, temperature, and agitation speed in lab scale shake flasks culture. The experiments were designed using the full factorial central composite design of experiment. A total of 20 experiments were conducted, and the optimized pH, temperature, and agitation speed were found to be 7.9, 33.1 °C, and 178.4 rpm, respectively. The results of the analysis of variance (ANOVA) test revealed that the linear terms for temperature and agitation were significant (p value < 0.05). Interaction for pH and agitation speed was found to have a significant effect on lipase production from S. hominis MTCC 8980. A 150% increase in enzyme activity was observed under the optimized conditions with the maximum lipase activity of 1.82 U/ml. Further enhancement of enzyme activity can be expected from the optimization of medium components.

http://bit.ly/2HLDAl7

A regional data assimilation system for estimating CO surface flux from atmospheric mixing ratio observations—a case study of Xuzhou, China

Abstract

Carbon monoxide (CO) emission inventory data are crucial for air quality control. However, the emission inventories are labor-intensive and time-consuming and generally have large uncertainties. In this study, we developed a new regional data assimilation system (TracersTracker) for estimating the surface CO emission flux from continuous mixing ratio observations using the proper orthogonal decomposition (POD)-based four-dimensional variational (4D-VAR) data assimilation method (POD-4DVar) and a coupled regional model (Weather Research and Forecasting model (WRF) with the Models-3 Community Multi-scale Air Quality (CMAQ) model). This system was applied to estimate CO emissions in Xuzhou city, China. An experiment was conducted with the continuous hourly surface CO mixing ratio observations from 21 monitoring towers in January and July of 2016. The experimental results of the system were examined and compared with the continuous surface CO observations (a priori emission). We found that the retrieved CO emission fluxes were higher than the a priori emission and were mainly distributed in urban and industrial areas, which were 104% higher in January (winter) and 44% higher in July (summer).

http://bit.ly/2SkIrOo

A mini review of bisphenol A (BPA) effects on cancer-related cellular signaling pathways

Abstract

Bisphenol A (BPA) is a plasticizer used widely in many industrial products and is now well established as an endocrine-disrupting chemical (EDC). BPA readily leaches out from these products into the environment and into foodstuffs (from packaging materials) and human exposure can be considerable. Many studies have shown that BPA exposure is associated with a range of chronic human health conditions, including diabetes, cardiovascular disorders, polycystic ovarian disease, hepatotoxicity, and various types of cancer. BPA exerts its effects through deregulating cell signaling pathways associated with cell growth, proliferation, migration, invasion, and apoptosis. Previous studies on the molecular mechanisms of BPA have illustrated a variety of pathways impaired at very low exposure concentrations and that stimulate cellular responses relating to tumorigenesis both in cancer onset and progression. In this mini review, the recent advancements made through in vitro analyses are reported on for the effect of BPA on various cellular signaling pathways focusing on the signaling pathways that play a major role in carcinogenesis.

http://bit.ly/2HN6Zvs

Soil amendments for cadmium phytostabilization by five marigold cultivars

Abstract

In recent years, ornamental plants have come under investigation as phytoremediation agents. In addition to reducing contaminant concentrations in soil, such plants support local economies by serving social (e.g., religious) and decorative purposes. Greenhouse studies investigated the phytostabilization potential of soil cadmium (Cd) by five cultivars of marigold (Tagetes erecta), a common ornamental flower in Asia. The effects of organic (cattle manure and pig manure) and inorganic (leonardite and Osmocote®) amendments in supporting plant growth and enhancing Cd uptake were also examined. Marigold cultivars Babuda and Sunshine grown in soil supplemented with pig manure produced the greatest biomass and experienced greatest Cd accumulation and flower production. In all treatments, plant parts accumulated Cd in the following order: root > shoot ≈ flower. Furthermore, Babuda and Sunshine cultivars had a high phytostabilization potential as evidenced by translocation factors < 1 and bioconcentration factors > 1 for roots. It is proposed that Babuda and Sunshine marigold cultivars be applied toward Cd phytostabilization while enhancing local economies as an ornamental species.

http://bit.ly/2SnhdGO

Nitrogen transfer from one plant to another depends on plant biomass production between conspecific and heterospecific species via a common arbuscular mycorrhizal network

Abstract

The formation of a common mycorrhizal network (CMN) between roots of different plant species enables nutrient transfers from one plant to another and their coexistence. However, almost all studies on nutrient transfers between CMN-connected plants have separately, but not simultaneously, been demonstrated under the same experimentation. Both conspecific and heterospecific seedlings of Cinnamomum camphora, Bidens pilosa, and Broussonetia papyrifera native to a karst habitat in southwest China were concurrently grown in a growth microcosm that had seven hollowed compartments (six around one in the center) being covered by 35.0-μm and/or 0.45-μm nylon mesh. The Ci. camphora in the central compartment was supplied with or without Glomus etunicatum and ¹⁵N to track N transfers between CMN-connected conspecific and heterospecific seedlings. The results showed as follows: significant greater nitrogen accumulations, biomass productions, ¹⁵N content, % N_transfer, and the N_transfer amount between receiver plant species ranked as Br. papyrifera≈Bi. pilosa > Ci. camphora under both M⁺ and M⁻, and as under M⁺ than under M⁻ for Ci. camphora but not for both Bi. Pilosa and Br. papyrifera; the CMN transferred more nitrogen (¹⁵N content, % N_transfer, and N_transfer amount) from the donor Ci. camphora to the heterospecific Br. papyrifera and Bi. pilosa, with a lower percentage of nitrogen derived from transfer (%NDFT). These findings suggest that the CMN may potentially regulate the nitrogen transfer from a donor plant to individual heterospecific receiver plants, where the ratio of nitrogen derived from transfer depends on the biomass strength of the individual plants.

http://bit.ly/2HNAygf

Microneedle fractional radiofrequency treatment of facial photoageing as assessed in a split‐face model

Summary

Background

A new therapeutic device passes radiofrequency energy through microneedles to targeted tissue. Three‐dimensional photography may be useful for evaluating the clinical efficacy of microneedle fractional radiofrequency (MFR) used on the appearance of rhytids and to improve facial laxity.

Aim

To evaluate the efficacy and safety of MFR in the treatment of facial photoageing.

Methods

In total, participants with facial photoageing were enrolled in the study. All volunteers were randomized to receive split‐face treatments with MFR 2 months apart. The participants self‐evaluated at baseline, Days 1–7, and Months 1 and 3 after the final treatment. Objective evaluation was provided by a three‐dimensional in vivo imaging system. In addition, skin melanin index, erythema index, immediate reactions, healing times and other adverse effects were evaluated.

Results

Compared with the untreated side, the treated side of most participants improved, based on clinical assessments at the 1‐ and 3‐month follow‐up visits after treatment. Both objective and participative assessments were satisfactory. The participants demonstrated a decrease of roughness parameter (Sa) value at each follow‐up visit. Compared with pretreatment value, Sa decreased significantly at Months 1 and 3 on the treated side (P < 0.05). Minimal and reversible adverse effects and rapid healing were recorded.

Conclusions

MFR appears to be an excellent treatment for photodamaged facial skin in Chinese patients.

http://bit.ly/2HKJ7IY

Oropharyngeal histoplasmosis: a report of 10 cases

Summary

A wide differential diagnosis must be entertained in patients with unusual oral and pharyngeal ulcerations. A mucosal biopsy is essential. We retrospectively reviewed 10 cases from the Infectious Diseases Division at Mayo Clinic Rochester (MN, USA), in which the diagnosis proved to be Histoplasma capsulatum infection. Between 1995 and 2016, 10 patients were diagnosed with oropharyngeal histoplasmosis. Common presenting symptoms included weight loss, weakness and oropharyngeal pain with ulcerations. Despite specialty evaluation at other facilities, diagnostic delay occurred in six patients due to lack of biopsy or fungal staining. Yeast forms consistent with H. capsulatum were identified in the biopsy specimens of all our patients. Treatment included intravenous amphotericin B and prolonged courses of azoles. Oral histoplasmosis occurred in both immunocompetent and immunosuppressed patients, and was a manifestation of disseminated infection. Severe pain involving all areas of the mouth was typical. Diagnostic delay may be avoided by early biopsy using fungal stains.

http://bit.ly/2BimnKv

Clear fluids fasting for elective paediatric anaesthesia: The European Society of Anaesthesiology consensus statement

No abstract available

http://bit.ly/2SpJBYQ

Maternal anaesthesia in open and fetoscopic surgery of foetal open spinal neural tube defects: A retrospective cohort study

BACKGROUND Prenatal myelomeningocele repair by open surgery can improve the neurological prognosis of children with this condition. A shift towards a fetoscopic approach seems to reduce maternal risks and improve obstetric outcomes. OBJECTIVE The aim of this study was to report on the anaesthetic management of women undergoing prenatal open or fetoscopic surgery for neural tube defects. DESIGN A retrospective cohort study. SETTING Prenatal myelomeningocele repair research group, Vall d'Hebron University Hospital, Spain. INTERVENTION Intra-uterine foetal repairs of spina bifida between 2011 and 2016 were reviewed. Anaesthetic and vasoconstrictor drugs, fluid therapy, maternal haemodynamic changes during surgery, blood gas changes during CO2 insufflation for fetoscopic surgery, and maternal and foetal complications were noted. RESULTS Twenty-nine foetuses with a neural tube defect underwent surgery, seven (24.1%) with open and 22 (75.9%) with fetoscopic surgery. There were no significant differences in maternal doses of opioids or neuromuscular blocking agents. Open surgery was associated with higher dose of halogenated anaesthetic agents [maximum medium alveolar concentration (MAC) sevoflurane 1.90 vs. 1.50%, P = 0.01], higher need for intra-operative tocolytic drugs [five of seven (71.4%) and two of 22 (9.1%) required nitroglycerine, P = 0.001], higher volume of colloids (500 vs. 300 ml, P = 0.036) and more postoperative tocolytic drugs (three drugs in all seven cases (100%) of open and in one of 21 (4.76%) of fetoscopic surgery, P 

http://bit.ly/2GiAJOv

Use of the Totaltrack VLM as a rescue device following failed tracheal intubation

No abstract available

http://bit.ly/2SeJ9Nh

Epidemiology and incidence of severe respiratory critical events in ear, nose and throat surgery in children in Europe: A prospective multicentre observational study

BACKGROUND Ear, nose and throat (ENT) surgery, the most frequently performed surgical procedure in children, is a strong predictor for peri-operative respiratory complications. However, there is no clear information about peri-operative respiratory severe critical events (SCEs) associated with anaesthesia management of ENT children in Europe. OBJECTIVE To characterise the epidemiology and incidence of respiratory SCEs during and following ENT surgery in Europe and to identify the risk factors for their occurrence. DESIGN A secondary analysis of the Anaesthesia PRactice In Children Observational Trial, a prospective observational multicentre cohort trial. SETTING The study included 261 centres across 33 European countries and took place over a consecutive 2-week recruitment period between April 2014 and January 2015. PATIENTS We extracted data from 5592 ENT surgical procedures that were performed on 5572 children aged 6.0 (3.6) years (mean (SD)) from the surgical database and compared these with data from 15 952 non-ENT surgical children aged 6.7 (4.8) years. MAIN OUTCOME MEASURES The primary outcome was the incidence of respiratory SCEs (laryngospasm, bronchospasm and new onset of postoperative stridor). Secondary outcomes were the differences in epidemiology between ENT children and non-ENT surgical children and the risk factors for the occurrence of respiratory SCEs. RESULTS The incidence (95% confidence interval) of any respiratory SCE (laryngospasm, bronchospasm and postoperative stridor) was 3.93% (3.46 to 4.48) and was significantly higher than that observed in non-ENT surgical children [2.61% (2.37 to 2.87)], with a relative risk of 1.51 (1.28 to 1.77), P less than 0.0001. Younger age (14% decrease in critical events by increasing year, P 

http://bit.ly/2Givf6e

Laryngotracheal stenosis in children following cardiac surgery: A retrospective review

No abstract available

http://bit.ly/2SpJqNa

Comparison of rocuronium requirement in children with continuous infusion versus intermittent bolus: A randomised controlled trial

BACKGROUND Minimising rocuronium administration during paediatric surgery helps to reduce the incidence of residual muscular blockade. OBJECTIVE To determine whether intermittent bolus injection (Bolus group) or continuous infusion (group) requires the lesser amount of rocuronium. DESIGN A randomised, single-blind controlled trial. SETTING A single university hospital from March to June 2017. PATIENTS Sixty-six children undergoing general anaesthesia. INTERVENTIONS Dose of rocuronium for maintenance of muscle relaxation in either Bolus or continuous infusion group. Train-of-four (TOF) count of two was maintained during surgery. When TOF count reached three, 0.1 mg kg−1 of rocuronium was administered in Bolus group or infused at an increased rate of 0.1 mg kg−1 h−1 in continuous infusion group. MAIN OUTCOME MEASURES Primary outcome was the dose of rocuronium given (μg kg−1 min−1). The recovery time from the TOF count four to TOF 0.7 (RT0.7), and 0.9 (RT0.9) were recorded. All adverse events were recorded up to 30 min after extubation. RESULTS Mean (SD) rocuronium dose in the Bolus group was 6.1 (0.9), [95% confidence interval (95% CI) 5.7 to 6.4] μg kg−1 min−1 and 4.9 (1.0), (95% CI 4.6 to 5.3) μg kg−1 min−1 in the continuous infusion group (P = 0.001). RT0.7 was 24.0 (13.7), 95% CI 19.3 to 28.7) min in the Bolus group, and 25.7 (16.0), (95% CI 20.2 to 31.2) min in the continuous infusion group (P = 0.73). RT0.9 was 30.7 (17.1), (95% CI 24.9 to 36.5) min in the Bolus group, and 30.0 (17.6), (95% CI 24.0 to 36.0) min in the continuous infusion group (P  = 0.91). The incidence of adverse events was not significantly different between two groups. CONCLUSION In children undergoing general anaesthesia, the dose of rocuronium given by continuous administration was less than that with intermittent bolus. TRIAL REGISTRATION ClinicalTrials.gov (identifier: NCT03060707).

http://bit.ly/2GjzXAS

Use of palonosetron and ondansetron in the prophylaxis of postoperative nausea and vomiting in women 60 years of age or older undergoing laparoscopic cholecystectomy: A randomised double-blind study

No abstract available

http://bit.ly/2SkgbeN

Ultrasound-guided vs. palpation-guided techniques for radial arterial catheterisation in infants: A randomised controlled trial

BACKGROUND The usefulness of ultrasound-guided techniques for radial arterial catheterisation has been well identified; however, its usefulness has not been completely evaluated in infants under 12 months of age, who are generally considered the most difficult group for arterial catheterisation. OBJECTIVE We evaluated whether ultrasound guidance would improve success rates and reduce the number of attempts at radial arterial catheterisation in infants. DESIGN A randomised, controlled and patient-blinded study. SETTING Single-centre trial, study period from June 2016 to February 2017. PATIENTS Seventy-four infants undergoing elective cardiac surgery. INTERVENTION Patients were allocated randomly into either ultrasound-guided group (group US) or palpation-guided group (group P) (each n=37) according to the technique applied for radial arterial catheterisation. All arterial catheterisations were performed by one of two experienced anaesthesiologists based on group assignment and were recorded on video. MAIN OUTCOME MEASURES The primary endpoint was the first-pass success. The number of attempts and total duration of the procedure until successful catheterisation were also analysed. RESULTS The first-pass success rate was significantly higher in the group US than in the group P (68 vs. 38%, P = 0.019). In addition, fewer attempts were needed for successful catheterisation in the group US than in the group P (median 1 [IQR 1 to 2] vs. 2 [1 to 4], P = 0.023). However, the median [IQR] procedural time (s) until successful catheterisation in the two groups was not significantly different (102 [49 to 394] vs. 218 [73 to 600], P = 0.054). CONCLUSION The current study demonstrated that the ultrasound-guided technique for radial arterial catheterisation in infants effectively improved first-pass success rate and also reduced the number of attempts required. TRIAL REGISTRATION ClinicalTrials.gov NCT02795468.

http://bit.ly/2Gjp6a4

The effect of virtual reality bronchoscopy simulator training on performance of bronchoscopic-guided intubation in patients: A randomised controlled trial

BACKGROUND The use of a flexible optical bronchoscopic (FOB) for intubation is an essential airway management skill. OBJECTIVE(S) Our primary objective was to compare the effects of simulator training (ORSIM high-fidelity simulator) with no simulation training on the performance of FOB intubation in anaesthetised patients. DESIGN Randomised controlled trial. SETTING Single-centre tertiary hospital; trial conducted between April 2015 to May 2016. PARTICIPANTS Medical students, anaesthesia assistants and anaesthesia residents with experience of less than five FOB intubations from whom informed consent was obtained. INTERVENTION Students, anaesthesia assistants and anaesthesia residents viewed a didactic presentation before performing an initial FOB intubation in an anaesthetised patient. Intubations were recorded and evaluated using the Global Rating Scale (GRS) and checklist scores. Subsequently, participants were randomised to control group (Group CON) and had no simulation training, or to a simulation group (Group SIM) and underwent 60 min of simulation practice. Within a week, participants performed a second FOB intubation and were similarly evaluated. MAIN OUTCOME MEASURES Pretraining and posttraining intubation time, GRS and checklist scores. RESULTS Baseline characteristics were similar between groups. In Group SIM, there was significant improvement between pre and posttraining GRS [22.9 ± 8.1 vs. 28.2 ± 7.3, mean difference (95% CI) 5.3 (0.3 to 10.3), P = 0.04], and intubation time [177.6 ± 77.6 vs. 119.3 ± 52.2 s, mean difference (95% CI) −58.4 (−100.3 to −16.5) s, P = 0.01]. There was no difference in Group CON, between pre and posttraining intubation time, GRS or checklist. CONCLUSION We conclude, posttraining performance of FOB intubation, as measured by intubation time and GRS, improved in Group SIM, while it was unchanged in the Group CON. The ORSIM simulator may be a useful adjunct in acquiring FOB intubation skills. CLINICAL TRIAL NUMBER AND REGISTRY ClinicalTrials.gov ID: NCT02699242.

http://bit.ly/2SpJexq

Bupivacaine infiltration in children for postoperative analgesia after tonsillectomy: A randomised controlled trial

BACKGROUND Adenotonsillectomy is a frequently performed procedure in paediatric day-case surgery. Postoperative pain can be significant and standard analgesia protocols are often insufficient. OBJECTIVE Our primary objective was to investigate if infiltration of the peritonsillar space with bupivacaine would reduce the need for postoperative opioids compared with pre-emptive intravenous tramadol. DESIGN A double-blind, randomised controlled trial. SETTING Ambulatory surgical day care centre, University Hospitals of Leuven, Belgium, from January 2012 to September 2016. PATIENTS Two hundred children, between 4 and 10 years old, undergoing elective adenotonsillectomy were included in the study. INTERVENTION Children were randomly allocated to receive either a bolus of 3 mg kg−1 intravenous tramadol or infiltration of the tonsillar lodge with 5-ml bupivacaine 0.25%. Reasons for exclusion were American Society of Anesthesiologists classification greater than 2, allergies to the investigated products, psychomotor retardation, bleeding disorders and lack of proficiency in Flemish. MAIN OUTCOME MEASURES The primary endpoint was the number of children in need of piritramide postoperatively. Secondary outcomes included the cumulative dose of postoperative piritramide, pain scores and the incidence of postoperative nausea and vomiting during the first 24 postoperative hours, time to discharge and adverse effects. RESULTS The proportion of children in need of postoperative piritramide was significantly lower in the tramadol group than in children with peritonsillar infiltration (57 vs. 81%, P 

http://bit.ly/2Gkg2S7

Calculation improves the estimation of needle depth from skin to thoracic epidural space in infants

No abstract available

http://bit.ly/2SpJ9K8

Use of tracheal ultrasound combined with clinical parameters to select left double-lumen tube size: A prospective observational study

BACKGROUND Left double-lumen tubes (LDLTs) are used in thoracic surgery to allow one-lung ventilation. Their size is usually chosen on the basis of clinical parameters (height, sex). Double-lumen endobronchial tubes are frequently undersized/oversized, risking tube displacement or tracheal trauma. A correlation between ultrasound tracheal diameter and left main bronchus dimension has been demonstrated. OBJECTIVES We hypothesised that the insertion of undersized/oversized double-lumen tubes is frequent when the size is selected using standard criteria, and that the use of ultrasound to estimate tracheal diameter may help to reduce the frequency of insertion of oversized tubes. DESIGN Two-step prospective observational study. SETTING The operating room of a French University hospital from January 2016 to February 2017. PATIENTS We enrolled 102 and 50 consecutive patients undergoing elective thoracic surgery in Steps 1 and 2 (males 63.7 and 60.0%, age 63 (13) and 63 (11) years, height 170 (13) and 169 (9) cm, respectively). INTERVENTION In Step 1, the size of the LDLT inserted was selected on the basis of clinical parameters. Ultrasound data about tracheal diameter were collected to determine cut-off points associating height and tracheal diameter. Cut-off values for ultrasound tracheal diameter were applied retrospectively to test their capability to reduce the insertion rate of oversized tube. In Step 2, the LDLT size was chosen according to the determined combined cut-off values. MAIN OUTCOME MEASURE LDLT size was considered adequate if the bronchial cuff volume required for isolation of the lung (i.e. no difference between inspiratory and expiratory lung volumes) was 0.5 to 2.5 ml of air; undersized and oversized tubes required more than 2.5 ml and less than 0.5 ml, respectively. RESULTS In Step 1, LDLT size was appropriate/undersized/oversized in 40 (39.2%)/23 (22.6%)/39 (38.6%) of patients. Cut-off values derived from ultrasound measurements would have reduced the use of oversized tubes by 20.6% (P 

http://bit.ly/2GmODyO

Intra-operative difficult airway identification and critical airway communication: how effective are we?: A retrospective review of 6318 cases

No abstract available

http://bit.ly/2t4z7je

Measurement of forces applied using a Macintosh direct laryngoscope compared with a Glidescope video laryngoscope in patients with predictors of difficult laryngoscopy: A randomised controlled trial

BACKGROUND In patients with predictive features associated with easy direct laryngoscopy, videolaryngoscoy with the GlideScope has been shown to require less force when compared with Macintosh direct laryngoscopy. OBJECTIVE The aim of this study was to compare forces applied with Glidescope vs. Macintosh laryngoscopes in patients with predictive features associated with difficult direct laryngoscopy. DESIGN A randomised study. SETTING Toronto General Hospital, a university tertiary centre in Canada. PATIENTS Forty-four patients aged over 18 years, with one or more features of difficult intubation, undergoing elective surgery requiring single-lumen tracheal intubation. INTERVENTION We measured the force applied to oropharyngeal tissues by attaching three FlexiForce Sensors (A201-25) to the concave surface of Macintosh and GlideScope laryngoscope blades. Anaesthetists or experienced anaesthesia residents performed laryngoscopies with both devices in a randomised sequence. MAIN OUTCOME MEASURES The primary outcome was peak force. The secondary outcomes were average force and impulse force. The latter is the integral of the force over the time during which the force acted. RESULTS Complete data were available for 40 individuals. Peak and average forces decreased with GlideScope (17 vs. 21 N, P = 0.03, and 6 vs. 11 N, P 

http://bit.ly/2HLAKwt

Levobupivacaine scalp nerve block: haemodynamics and anaesthesia requirements in supratentorial craniotomy P 096: Erratum

No abstract available

http://bit.ly/2t3oBZU

Utility of Pediatric Allergic Disease Quality of Life Questionnaire for childhood eczema

Abstract

Aim

It is important to objectively evaluate quality of life (QoL) impairment in atopic diseases in children. This study aims to investigate the utility of a Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) in children with eczema.

Methods

PADQLQ, Patient‐Oriented Eczema Measure (POEM, a short‐term subjective‐symptom score), Nottingham Eczema Severity Score (NESS, a long‐term subjective‐symptom score), Children Dermatology Life Quality Index (CDLQI, a short‐term subjective‐symptom score) were compared and correlations evaluated.

Results

PADQLQ, POEM, NESS, CDLQI correlated well with each other (n=132 sets; spearman's correlations rho =0·48‐0·70, p<0·001). Bland Altman Plot showed a reasonably good agreement between CDLQI and PADQLQ. PADQLQ showed symptoms of asthma, allergic conjunctivitis and allergic rhinitis were present in 20‐30%, 45‐71%, and 58‐67%, respectively. Nevertheless, there was no association of eczema symptomatology by POEM or NESS with the severity of other allergic diseases.

Conclusion

PADQLQ correlates well with AD‐specific severity and QoL scores and reflects all allergic symptoms that holistically influence QoL in children with AD. PADQLQ is hence a composite severity score in terms of clinical symptomatology and QoL impairment for AD.

This article is protected by copyright. All rights reserved.

http://bit.ly/2UC0lKa

Serum cell‐free DNA levels are useful marker for extramammary Paget's disease

Abstract

Although carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) are useful marker for extramammary Paget's disease (EMPD), the serum CEA and CYFRA levels are not elevated in most EMPD patients without metastasis. Therefore, further useful biomarkers are needed for the detection of EMPD including early lesions. Cell‐free DNA (cfDNA) has attracted attention as an indicator of clinical conditions in several cancers, and we studied the clinical implications of cfDNA for EMPD. The serum cfDNA levels were significantly elevated in EMPD patients with or without metastasis compared to those in healthy controls. And serum cfDNA was a better diagnostic marker for the presence of EMPD compared to serum CYFRA. Moreover, the post‐operative serum cfDNA levels were significantly lower than those from the pre‐operative samples, and the change in serum cfDNA levels reflected the clinical courses of EMPD patients treated with chemotherapy. Taken together, serum cfDNA levels may be useful marker for the diagnosis and disease progression in EMPD.

This article is protected by copyright. All rights reserved.

http://bit.ly/2S5Ynou