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Τρίτη 25 Σεπτεμβρίου 2018

Processions, Seductions, Divine Battles: Aśvaghoṣa at the Foundations of Old Javanese Literature

Abstract

The influence of Aśvaghoṣa on the later tradition of kāvya was largely passed over in the South Asian tradition, even though the debt to his influence is clear in processional scenes developed by Kālidāsa and the attempted seduction of Arjuna developed by Bhāravi in his Kirātārjunīyam. We know from the testimony of the Chinese pilgrim Yijing that the Buddhacarita was a revered object of study in the Sumatran capital Śrībhoga near the close of the seventh century CE. It thus perhaps comes as no surprise that three tropes or themes developed by Aśvaghoṣa were developed by several important composers of kakawin, the Old Javanese literary genre comparable to the kāvya of South Asia. This paper looks at the development of the themes of processions, divine battles and attempted seductions in a long history beginning with Aśvaghoṣa and closing with the work of the Javanese author Mpu Tantular, who completed the Buddhist kakawin Sutasoma c. 1365–1389 CE. This paper is partly based on a revised perspective on the history of the Shailendra and Sañjaya dynasties of central Java developed by examining the role of the "Shailendra royal preceptors" in bringing Sanskrit learning to Central Java in the period 778–847 CE.



Evaluation of drug resistance mutations in patients with chronic hepatitis B

Abstract

Mutations occurring in viral polymerase gene of hepatitis B virus (HBV) due to the use of nucleos(t)id analogs reduce the activity of the drugs by causing antiviral resistance. In this study, it was aimed to evaluate mutations responsible for drug resistance and drug resistance mutation rates in patients followed up by the diagnosis of chronic hepatitis B (CHB). A total of 318 CHB patients were included in the study. HBV mutations were detected using the INNO-LiPA commercial kit based on the reverse hybridization principle. Drug resistance mutation was detected in 46.86% (149/318) of the patients. The rates of drug resistance were found 36.79% (117/318) for lamivudine resistance, 12.58% (40/318) for entecavir (ETV), and 7.86% (25/318) for adefovir. In 10 patients, the possible tenofovir (TDF) resistance (3.14%) was found. Single-drug and double-drug resistances were detected in 34.59% and in 11.01% of the patients, respectively. Triple drug resistance was detected in only 1.26% of the patients. Unlike various studies in Turkey and in other countries, remarkable resistance to ETV and TDF were found in this study. The high rate of the probable TDF resistance was striking, with 3.14%.



The surgical anatomy of the superficial and deep palmar arches: a Meta-analysis.

Related Articles

The surgical anatomy of the superficial and deep palmar arches: a Meta-analysis.

J Plast Reconstr Aesthet Surg. 2018 Aug 24;:

Authors: Zarzecki MP, Popieluszko P, Zayachkowski A, Pękala PA, Henry BM, Tomaszewski KA

Abstract
INTRODUCTION: The following study aimed to find the pooled prevalence estimate of anatomical variations in the palmar vasculature, namely the superficial palmar arch (SPA) and the deep palmar arch (DPA). The importance of understanding the vasculature of the hand has become critical with the increasing use of hand microsurgery.
METHODS: Major online medical databases (PubMed, EMBASE, ScienceDirect, and Web of Science) were extensively searched for terms pertaining to the SPA, the DPA, and their anatomy and variations. Articles reporting data on the SPA and/or the DPA were collected and their data extracted. Furthermore, a reference search was performed, allowing to pinpoint any articles that were not previously found. The collected data were analyzed using MetaXL 5.3.
RESULTS: The analysis included 36 studies (n = 4841 palmar arches). The SPA was found to be complete in 81.3% of cases, with the radioulnar anastomosis being the most common variant (72.0%). The incomplete SPA was present in 18.7% of cases, with the ulnar artery supplying the third finger from both radial and ulnar side as the most prevalent in 34.8%. The DPA was found to be complete in 95.2% of cases.
CONCLUSION: In this study, the SPA was predominantly complete, with the anastomosis between the radial and the ulnar artery being most prevalent. Furthermore, the DPA was also complete in the vast majority of cases. The palmar arches and their variations should be kept in mind when considering the use of palmar vasculature for cardiac catheterization and other medical procedures, due to the risk of iatrogenic ischemic hand complications.

PMID: 30245020 [PubMed - as supplied by publisher]



Zhu, Hanmin 朱漢民, Classics Hermeneutics and Reason(s) Embodiment–On the Historical Construction of Chinese Philosophy 經典詮釋與義理體認——中國哲學建構歷程片論



Association of extracellular heat shock protein 70 and insulin resistance in type 2 diabetes; independent of obesity and C-reactive protein

Abstract

Despite few studies on intracellular heat shock protein70, the clinical association between insulin resistance and extracellular heat shock protein70 (eHSP70) is not well studied. In the current study, we examined the association between homeostatic model assessment-insulin resistance (HOMA-IR) and eHSP70 in patients with type 2 diabetes (T2DM) and healthy controls. A total of 145 patients with T2DM and 41 matched healthy controls were selected. Patients and controls were divided based on waist circumference (WC) to two groups, and eHSP70 was compared between them. The association between HOMA-IR and eHSP70 was examined using regression models adjusted for age, high-sensitive C-reactive protein (hs-CRP), and central obesity as confounding factors. While eHSP70 and hs-CRP were significantly correlated with HOMA-IR in patients with T2DM (p = 0.032, 0.025, respectively), there was no correlation between eHSP70 and HOMA-IR in the control group. Extracellular HSP70 and hs-CRP were not correlated in healthy controls. But a significant association appeared between eHSP70 and hs-CRP in patients with T2DM (p = 0.05). Both BMI and WC were not correlated with eHSP70 in both groups. Extracellular HSP70 was positively associated with HOMA-IR in patients with T2DM, independent from hs-CRP and obesity. We also showed eHSP70 levels remained unchanged through increase in BMI or WC in patients with T2D and in healthy controls. Our findings suggest that eHSP70 may contribute to the pathogenesis of T2DM by increasing insulin resistance.



Beyond photoaging: additional factors involved in the process of skin aging



Identification and isolation of splenic tissue resident macrophage subpopulations by flow cytometry

Abstract
Tissue resident macrophages in the spleen, including red pulp and white pulp macrophages, marginal zone macrophages (MZMs), and marginal zone metallophilic macrophages (MMMs), are highly heterogeneous as a consequence of adaptation to tissue-specific environments. Each macrophage subpopulation in the spleen is usually identified based on the localization, morphology and membrane antigen expression by immunohistochemistry. However, their phenotypical and functional characteristics remain incompletely understood due to the difficulty of identification and isolation by flow cytometry. We used a cocktail of three enzymes (Collagenase D, Dispase I and DNase I), rather than traditional mechanical grinding, for isolation of each subpopulation, which resulted in significant improvement of isolation of these macrophage subpopulations, particularly MZMs and MMMs, as determined by CD11bhiF4/80medTim4hi and CD11bhiF4/80medTim4med, respectively. This method should be helpful for molecular and functional characterization of each splenic resident macrophage subpopulation.

Chemotherapy-induced metastasis: An unexpected foe?

Mena plasma membrane, cytosol and focal adhesion expression in human cell line U-2 OS ICC

By Yoskaly Lazo-Fernandez, PhD

Introduction

Evidence has accumulated recently indicating that common cancer therapies might stimulate metastasis in a significant number of cancer patients1. In fact, neoadjuvant chemotherapy (NAC) drugs, which are administered preoperatively as a first line of treatment, have been associated with increased infiltration of endothelial progenitor cells and macrophages in primary tumors, resulting in higher angiogenesis and tumor regrowth2. Mechanisms by which these cellular injury responses induce metastasis, both in preclinical in vivo models, and in human patients have been elucidated recently in two independent studies.

The tumor microenvironment of metastasis

In their excellent article, Karagiannis et al.3 relied heavily on the histological analysis and intravital-imaging functional assessment of a well-established marker for breast cancer metastasis, the tumor microenvironment of metastasis (TMEM)4. TMEMs are microanatomical assemblies of three different cell types inside tumors. These are: peritubular macrophages, tumor cells and endothelial cells. What is extraordinary about TMEMs is that their assembly seems to be indispensable for cancer cell intravasation and distant metastasis to occur5. Not surprisingly, the histopathological determination of TMEM scores in breast cancer patient biopsies has become a reliable prognosis marker associated with distant metastasis6.

VEGF expression in human breast cancer tissue IHCVEGF165 was detected in immersion fixed frozen sections of human breast cancer tissue using 5 µg/mL Human VEGF165 Polyclonal Antibody (Catalog# AB-293-NA) overnight at 4℃. Tissue was stained (red) and counterstained with hematoxylin (blue). View our protocol for Chromogenic IHC Staining of Frozen Tissue Sections.

Mechanisms by which NAC induces breast cancer metastasis

Administration of NAC drugs such as paclitaxel or the doxorubicin/cyclophosphamide combination induced significant increases in TMEM scores in all of the 4 in vivo preclinical models of breast cancer that were tested in the project3. Moreover, these effects where functionally very relevant, as the same treatments stimulated all the molecular and functional markers associated with TMEM activity including:

  1. The abundance of intra-tumoral perivascular macrophages, particularly those overexpressing the angiopoietin receptor TIE-2 and Vascular Endothelial Growth Factor (VEGF).
  2. The intra-tumoral vascular permeability, with observable intervals of vessel leaking or bursting followed by tumor cell intravasation.
  3. The plasmatic concentration of circulating tumor cells (CTC).
  4. The incidence of lung metastasis and the number of metastasis per animal.
  5. The expression of the mammalian enabled protein MENA, particularly of its tumor promoting isoform MENAINV. Moreover, some of these results were replicated in samples from human breast cancer patients right after they received extensive NAC treatments.

The second paper by Chang et al.7 reported similar increases of TMEM activity in a breast cancer model after paclitaxel in vivo administration. In addition, this study showed that the pro-metastatic effects of chemotherapy extend to the metastatic host, non-cancerous, tissue. For example, in the metastatic lung, paclitaxel reduced the cytotoxic responses of T and NK cells and increased the presence of inflammatory monocytes, all of which stimulated the distant seeding and proliferation of cancer cells.

Significance

Overall these results regarding the pro-metastatic effects of paclitaxel and other chemotherapeutic drugs, are concerning and highly controversial. On the one hand, the curative and/or life-extending effects of these drugs in a number of cancer types, including a high percentage of breast cancer patients, needs to be defended. On the other, it wouldn't be ethical to allow the subset of cancer patients that could be severely harmed by chemotherapy to go through the high costs and harsh side effects of these treatments. An open discussion on these issues has undoubtedly started, fueled by the very recent publication of several reviews in high impact journals1,8–10.

Further research on this area is urgent, particularly on the identification of the molecular determinants of the curative vs. the pro-metastatic and potentially harmful response to chemotherapy in cancer patients. Such advances could allow the implementation of more personalized chemotherapeutic approaches. In the meantime, novel combination pharmacotherapies are being tested that could significantly alleviate this problem. For example, Karagiannis3 eliminated the pro-metastatic effects of paclitaxel by pretreating the mice with the TIE-2 inhibitor, currently undergoing clinical trials, rebastinib. Chang7 also attained encouraging results in the identification of the novel potential target, the transcription factor ATF3, whose potential pharmacological inhibition could also counteract the harmful pro-metastatic effects of chemo. It seems reasonable to predict that a much more personalized and effective set of treatment protocols for breast- and other types of cancer, is around the corner, we can hardly wait.


Explore Metastasis Products

Yoskaly FernandezYoskaly Lazo Fernandez, PhD
Research Assistant Professor, The University of Kansas Medical Center
Dr. Lazo-Fernandez is interested in the application of novel immunotherapies for the treatment of cancer, particularly ovarian cancer.


References

  1. Martin OA, Anderson RL, Narayan K, MacManus MP. Does the mobilization of circulating tumour cells during cancer therapy cause metastasis? Nature Reviews Clinical Oncology. 2017;14(1):32-44. doi:10.1038/nrclinonc.2016.128 .
  2. Daenen L, Houthuijzen J, Cirkel G, Roodhart J, Shaked Y, Voest E. Treatment-induced host-mediated mechanisms reducing the efficacy of antitumor therapies. Oncogene. 2014;33(11):1341. doi:10.1038/onc.2013.94 .
  3. Karagiannis GS, Pastoriza JM, Wang Y, Harney AS, Entenberg D, Pignatelli J, Sharma VP, Xue EA, Cheng E, Alfonso T, Jones JG, Anampa J, Rohan TE, Sparano JA, Condeelis JS, Oktay MH. Neoadjuvant chemotherapy induces breast cancer metastasis through a TMEM-mediated mechanism. Science Translational Medicine. 2017;9(397):eaan0026. doi:10.1126/scitranslmed.aan0026 .
  4. Oktay MH, Jones JG. TMEM: a novel breast cancer dissemination marker for the assessment of metastatic risk. Biomarkers in Medicine. 2015;9(2):81-84. doi:10.2217/bmm.14.104 .
  5. Roussos ET, Wang Y, Wyckoff JB, Sellers RS, Wang W, Li J, Pollard JW, Gertler FB, Condeelis JS. Mena deficiency delays tumor progression and decreases metastasis in polyoma middle-T transgenic mouse mammary tumors. Breast Cancer Research. 2010;12(6):1-16. doi:10.1186/bcr2784 .
  6. Robinson BD, Sica GL, Liu Y-F, Rohan TE, Gertler FB, Condeelis JS, Jones JG. Tumor Microenvironment of Metastasis in Human Breast Carcinoma: A Potential Prognostic Marker Linked to Hematogenous Dissemination. Clinical Cancer Research. 2009;15(7):2433-2441. doi:10.1158/1078-0432.CCR-08-2179 .
  7. Chang Y, Jalgaonkar SP, Middleton JD, Hai T. Stress-inducible gene Atf3 in the noncancer host cells contributes to chemotherapy-exacerbated breast cancer metastasis. Proceedings of the National Academy of Sciences. 2017;114(34):E7159-E7168. doi:10.1073/pnas.1700455114 .
  8. Martin OA, Anderson RL. Editorial: Therapy-induced metastasis. Clinical & Experimental Metastasis. 2018;35(4):219-221. doi:10.1007/s10585-018-9914-x .
  9. Karagiannis GS, Condeelis JS, Oktay MH. Chemotherapy-induced metastasis in breast cancer. Oncotarget. 2017;8(67):110733-110734. doi:10.18632/oncotarget.22717 .
  10. Karagiannis GS, Condeelis JS, Oktay MH. Chemotherapy-induced metastasis: mechanisms and translational opportunities. Clinical & experimental metastasis. 2018;35(4):269-284. doi:10.1007/s10585-017-9870-x .

 

 



Onkologie und Versorgung in Fach- und Publikumsmedien



Deep learning with convolutional neural network for objective skill evaluation in robot-assisted surgery

Abstract

Purpose

With the advent of robot-assisted surgery, the role of data-driven approaches to integrate statistics and machine learning is growing rapidly with prominent interests in objective surgical skill assessment. However, most existing work requires translating robot motion kinematics into intermediate features or gesture segments that are expensive to extract, lack efficiency, and require significant domain-specific knowledge.

Methods

We propose an analytical deep learning framework for skill assessment in surgical training. A deep convolutional neural network is implemented to map multivariate time series data of the motion kinematics to individual skill levels.

Results

We perform experiments on the public minimally invasive surgical robotic dataset, JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS). Our proposed learning model achieved competitive accuracies of 92.5%, 95.4%, and 91.3%, in the standard training tasks: Suturing, Needle-passing, and Knot-tying, respectively. Without the need of engineered features or carefully tuned gesture segmentation, our model can successfully decode skill information from raw motion profiles via end-to-end learning. Meanwhile, the proposed model is able to reliably interpret skills within a 1–3 second window, without needing an observation of entire training trial.

Conclusion

This study highlights the potential of deep architectures for efficient online skill assessment in modern surgical training.



A retrospective analysis of esophageal eosinophilia in patients with aspirin-exacerbated respiratory disease.

Publication date: Available online 25 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Ryan C. Eid, Marina Palumbo, Tanya M. Laidlaw, Kathleen M. Buchheit, Katherine N. Cahill



Basics of genome-scale metabolic modeling and applications on C1-utilization

Abstract
It is fundamental to understand the relationship between genotype and phenotype in biology. This requires comprehensive knowledge of metabolic pathways, genetic information and well-defined mathematic modeling. Integration of knowledge on metabolism with mathematical modeling results in genome-scale metabolic models which have proven useful to investigate bacterial metabolism and to engineer bacterial strains capable of producing value-added biochemical. Single carbon substrates such as methane and carbon monoxide have drawn interests and they assumed one of next-generation feedstocks because of their high abundance and low price. The methylotroph and acetogen-based biorefineries hold promises for bioconversion of C1 substrates into biofuels and high value compounds. As an effort on expanding our knowledge on C1 utilization approaches, in silico computational framework of C1-metabolism in methylotrophic and acetogenic bacteria have been developed. In this review, genome-scale metabolic models for C1-utilizing bacteria and well-established analysis tools are presented for potential uses for study of C1 metabolism at the genome-scale and its application in metabolic engineering.

The Colors of Biotechnology: general overview and developments of White, Green and Blue areas

Abstract
Biotechnology is responsible for the manipulation of living organisms or their components for the production of products that are of benefit to human kind. Due to the wide range of applications, colors have been used to differentiate the main areas of research, such as white (industrial), green (agricultural), and blue (marine and fresh-water), among others. Thus, this review outlines the impacts of these areas of biotechnology, emphasizing their impact and potential to replace carbon-based technologies with more sustainable technologies.

In This Issue

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Two decades of the impact of Tasmanian Devil Facial Tumour Disease (DFTD)

Abstract
The Tasmanian Devil, a marsupial carnivore, has been restricted to the island state of Tasmania since its extinction on the Australian mainland about three thousand years ago. In the past two decades, this species has experienced severe population decline due to the emergence of devil facial tumour disease (DFTD), a transmissible cancer. During these twenty years, scientists have puzzled over the immunological and evolutionary responses by the Tasmanian devil to this transmissible cancer. Targeted strategies in population management and disease control have been developed as well as comparative processes to identify variation in tumor and host genetics. A multi-disciplinary approach with multi-institutional teams has produced considerable advances over the last decade. This has led to a greater understanding of the molecular pathogenesis and genomic classification of this cancer. New and promising developments in the Tasmanian devil's story include evidence that most immunized, and some wild devils, can produce an immune response to DFTD. Furthermore, epidemiology combined with genomic studies suggest a rapid evolution to the disease and that DFTD will become an endemic disease. Since 1998 there have been more than 350 publications, distributed over 37 Web of Science categories. A unique endemic island species has become an international curiosity that is in the spotlight of integrative and comparative biology research.

A Systematic Review of Evidence-Based Treatments for Prurigo Nodularis

Publication date: Available online 25 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Azam A. Qureshi, Laura E. Abate, Gil Yosipovitch, Adam J. Friedman

Abstract

Prurigo nodularis is a chronic dermatologic condition involving the development of multiple cutaneous nodules in the setting of intractable pruritus. Given emerging treatment options for this difficult-to-treat condition, a current review of therapeutics is needed. A systematic review was performed for clinical studies investigating prurigo nodularis treatment published from 1990 to present including at least 5 subjects. A total of 35 articles were assigned a level of evidence according to the Oxford Center for Evidence-based Medicine. All five studies investigating topical agents, including corticosteroids, calcineurin inhibitors, calcipotriol, and capsaicin, conveyed some beneficial effect with level of evidence 2b or higher. Six of eight reports investigating photo- and photochemotherapy achieved levels of evidence 2b or greater and showed good partial response rates. Thalidomide was studied by six reports providing evidence of good symptom response, but only two of which were rated level 2b or greater. Cyclosporine and methotrexate have demonstrated benefit in four combined studies, albeit with level four evidence. Pregabalin, amitriptyline, paroxetine, fluvoxamine, and neurokinin-1 receptor antagonists have demonstrated promising evidence in five level 2b studies. Higher-powered studies and additional randomized controlled trials are needed for evaluation of safe and efficacious systemic treatment options for prurigo nodularis.



Mutational mechanisms of amplifications revealed by analysis of clustered rearrangements in breast cancers

Abstract
Background
Complex clusters of rearrangements in cancer genomes are a challenge to interpret. Some are clear amplifications of driver oncogenes but others are less well understood. Detailed analysis of rearrangements within these complex clusters could reveal new insights into selection, and underlying mutational mechanisms.
Results
Here, we systematically investigate rearrangements that are densely clustered in individual tumours in a cohort of 560 breast cancers. Applying an agnostic approach, we identify 21 hotspots where clustered rearrangements recur across cancers. Some hotspots coincide with known oncogene loci including CCND1, ERBB2, ZNF217, chr8:ZNF703/FGFR1, IGF1R, and MYC. Others contain cancer genes not typically associated with breast cancer: MCL1, PTP4A1 and MYB. Intriguingly, we identify clustered rearrangements that physically connect distant hotspots. In particular, we observe simultaneous amplification of chr8:ZNF703/FGFR1 and chr11:CCND1 where deep analysis reveals that a chr8-chr11 translocation is likely to be an early, critical, initiating event.
Conclusions
We present an overview of complex rearrangements in breast cancer, highlighting a potential new way for detecting drivers and revealing novel mechanistic insights into the formation of two common amplicons.

GTCreator: a flexible annotation tool for image-based datasets

Abstract

Purpose:

Methodology evaluation for decision support systems for health is a time-consuming task. To assess performance of polyp detection methods in colonoscopy videos, clinicians have to deal with the annotation of thousands of images. Current existing tools could be improved in terms of flexibility and ease of use.

Methods:

We introduce GTCreator, a flexible annotation tool for providing image and text annotations to image-based datasets. It keeps the main basic functionalities of other similar tools while extending other capabilities such as allowing multiple annotators to work simultaneously on the same task or enhanced dataset browsing and easy annotation transfer aiming to speed up annotation processes in large datasets.

Results:

The comparison with other similar tools shows that GTCreator allows to obtain fast and precise annotation of image datasets, being the only one which offers full annotation editing and browsing capabilites.

Conclusion:

Our proposed annotation tool has been proven to be efficient for large image dataset annotation, as well as showing potential of use in other stages of method evaluation such as experimental setup or results analysis.



The little story of the Journal de Mycologie Médicale/Journal of Medical Mycology

Publication date: Available online 24 September 2018

Source: Journal de Mycologie Médicale

Author(s): J.-M. Bastide



Sarcoma de Kaposi y angiosarcoma cutáneo: directrices para el diagnóstico y tratamiento

Publication date: Available online 24 September 2018

Source: Actas Dermo-Sifiliográficas

Author(s): C. Requena, M. Alsina, D. Morgado-Carrasco, J. Cruz, O. Sanmartín, C. Serra-Guillén, B. Llombart

Resumen

El sarcoma de Kaposi es un sarcoma vascular con cuatro variantes clínicas: el clásico, que asienta preferentemente en las extremidades de pacientes ancianos, de curso crónico y poco agresivo; el endémico de África central; el de pacientes inmunodeprimidos, y el asociado a SIDA. En todas las variedades se ha demostrado que el virus herpes tipo 8 es el agente etiológico. El angiosarcoma cutáneo es una de las neoplasias cutáneas de peor pronóstico, con gran tendencia a la recidiva local y una supervivencia a 5 años del 10-50%. Existen 3 grandes variedades de angiosarcomas cutáneos: los idiopáticos de cara y cuero cabelludo, los desarrollados sobre áreas de linfedema crónico y los que aparecen sobre áreas de piel irradiada. El único tratamiento potencialmente curativo es la cirugía asociada o no a radioterapia, pero su mala delimitación y su carácter multicéntrico obligan en muchos casos a emplear tratamientos paliativos con quimio y/o radioterapia.

Abstract

Kaposi sarcoma is a vascular sarcoma with 4 clinical variants: classic Kaposi sarcoma, which mainly affect the extremities of elderly patients and follows a chronic, generally indolent course; African Kaposi sarcoma; immunosuppression-associated Kaposi sarcoma; and AIDS-associated Kaposi sarcoma. Type 8 human herpesvirus is the etiologic agent in all 4 variants. Cutaneous angiosarcoma is a cutaneous neoplasm with a very poor prognosis. It carries a high probability of local relapse and has a 10% to 15% survival rate at 5 years. There are 3 main variants of cutaneous angiosarcoma: idiopathic angiosarcoma of the face and scalp; Stewart-Treves syndrome; and postradiation angiosarcoma. The only potentially curative treatment is surgery with or without radiotherapy. However, its indistinct borders and multicentric nature mean that treatment is often palliative with chemotherapy, radiotherapy, or both.

Graphical abstract

Graphical abstract for this article



Morphea/lokalisierte Sklerodermie und extragenitaler Lichen sclerosus

Zusammenfassung

Die lokalisierte Sklerodermie (LoS) ist eine sehr heterogene Bindegewebserkrankung, die durch eine progrediente Sklerosierung der Haut mit möglicher Beteiligung extrakutaner Strukturen gekennzeichnet ist. Sowohl Kinder als auch Erwachsene können betroffen sein, zeigen aber unterschiedliche Häufigkeiten in den einzelnen Subtypen der Erkrankung. Die Erkrankung kann sich klinisch an der Haut je nach Subtyp sehr unterschiedlich darstellen. Aus diesem Grund wurden bereits eine Reihe von Klassifikationen entwickelt und in der Literatur beschrieben. Im Wesentlichen werden 5 Subgruppen differenziert, die durch horizontale bzw. vertikale Ausdehnung der Gewebsschädigung definiert sind und die je nach Ausprägung der kutanen und der subkutanen Beteiligung die Lebensqualität der betroffenen Patienten massiv einschränken können. Eine kausale Therapie existiert bisher nicht, trotzdem sollten die zur Verfügung stehenden Medikamenten bei progressiven Subtypen früh eingesetzt werden, um schwerwiegende funktionelle und kosmetische Beeinträchtigungen zu verringern bzw. zu vermeiden. Lichen sclerosus (LS) tritt genital und extragenital, ebenfalls sowohl bei Kindern als auch bei Erwachsenen, auf. Die extragenitale Form, auf die der vorliegende Beitrag fokussiert, kommt häufiger bei Erwachsenen vor. Auch hier ist die Genese der Erkrankung noch nicht aufgedeckt, und kausale Therapieformen stehen ebenfalls noch nicht zur Verfügung. Die Therapie orientiert sich an LoS.



Primary clear cell sarcoma of the tongue and surgical reconstruction: About a rare case report

Publication date: Available online 24 September 2018

Source: Annales de Chirurgie Plastique Esthétique

Author(s): A. Baus, D. Culie, L.T. Duong, A. Ben Lakhdar, J.-B. Schaaf, F. Janot, F. Kolb

Summary

Clear cell sarcomas (SCC), also called "soft-tissue melanoma", are rare and aggressive tumors that preferentially affect the lower limbs (tendons and fasciae) and which have also been described in head and neck localizations. Their clinical and immunohistochemical mimicry with melanoma makes it difficult to diagnose sarcomas. SCC treatment is mainly focused on large-scale resection surgery with adjuvant radiotherapy because of their low chemo-sensitivity and extreme lymphophilia. In case of head and neck localization, these treatments may lead to function and aesthetic sequelae thus requiring the use of modern techniques of reconstructive surgery. The authors describe the diagnosis, treatment and follow-up of large lingual SCC case using a DIEP free flap reconstruction according to an original technique developed in the department. Given the characteristics of patients with SCC (a high proportion of women between 20 and 40 years old) and its inherent qualities (low morbidity of the donor site, volume delivered and excellent plasticity), the fascio-cutaneous free flap type "DIEP" "taken according to the design of the" Cathedral triptych seems to be a viable choice among the range of reconstruction solutions.

Résumé

Les sarcomes à cellules claires (SCC), également baptisées « mélanomes des parties molles » sont des tumeurs rares et agressives affectant préférentiellement les membres inférieurs (tendons et aponévroses), mais pouvant s'observer dans des localisations ORL. De part leur mimétisme clinique et immunohistochimique avec le mélanome, les sarcomes restent encore aujourd'hui de diagnostic difficile. Compte tenu de leur faible chimiosensibilité et de leur extrême lymphophilie, le traitement des SCC est essentiellement axé sur la chirurgie d'exérèse large associé à de la radiothérapie adjuvante. En cas de localisation ORL, ces traitements peuvent être responsable de pertes de substances délabrantes sur le plan fonctionnel et esthétique, nécessitant l'utilisation de techniques modernes de chirurgie réparatrice. Les auteurs décrivent le diagnostic, le traitement et le suivi d'un cas de volumineux SSC lingual ayant fait appel à une reconstruction par lambeau libre DIEP selon une technique originale développée dans le service. Compte tenu des caractéristiques des patients atteints de SCC (proportion importante de femmes entre 20 et 40 ans), et de ses qualités propres (faible morbidité du site donneur, volume apporté et excellente plasticité), le lambeau libre fascio-cutané de type « DIEP » prélevé selon le dessin du « tryptique de la cathédrale » semble tenir une place de choix parmi l'éventail des solutions de reconstruction.



Morphea/lokalisierte Sklerodermie und extragenitaler Lichen sclerosus

Zusammenfassung

Die lokalisierte Sklerodermie (LoS) ist eine sehr heterogene Bindegewebserkrankung, die durch eine progrediente Sklerosierung der Haut mit möglicher Beteiligung extrakutaner Strukturen gekennzeichnet ist. Sowohl Kinder als auch Erwachsene können betroffen sein, zeigen aber unterschiedliche Häufigkeiten in den einzelnen Subtypen der Erkrankung. Die Erkrankung kann sich klinisch an der Haut je nach Subtyp sehr unterschiedlich darstellen. Aus diesem Grund wurden bereits eine Reihe von Klassifikationen entwickelt und in der Literatur beschrieben. Im Wesentlichen werden 5 Subgruppen differenziert, die durch horizontale bzw. vertikale Ausdehnung der Gewebsschädigung definiert sind und die je nach Ausprägung der kutanen und der subkutanen Beteiligung die Lebensqualität der betroffenen Patienten massiv einschränken können. Eine kausale Therapie existiert bisher nicht, trotzdem sollten die zur Verfügung stehenden Medikamenten bei progressiven Subtypen früh eingesetzt werden, um schwerwiegende funktionelle und kosmetische Beeinträchtigungen zu verringern bzw. zu vermeiden. Lichen sclerosus (LS) tritt genital und extragenital, ebenfalls sowohl bei Kindern als auch bei Erwachsenen, auf. Die extragenitale Form, auf die der vorliegende Beitrag fokussiert, kommt häufiger bei Erwachsenen vor. Auch hier ist die Genese der Erkrankung noch nicht aufgedeckt, und kausale Therapieformen stehen ebenfalls noch nicht zur Verfügung. Die Therapie orientiert sich an LoS.



Ointment vehicles regulate the wound‐healing process by modifying the hyaluronan‐rich matrix

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


DNA-methylation profiling is a method of choice for molecular verification of pediatric WNT activated medulloblastomas.

Abstract
Background
WNT activated medulloblastoma (WNT MB) represent a well-characterized molecular variant accounting for 10–15% of all MB and is associated with a favorable clinical outcome. Patients with localized WNT MBs could benefit from de-intensification of combined treatment, which would require an accurate diagnosis of these tumors. However, despite the presence of molecular features related with a WNT MB signature (nuclear ß-catenin immunoexpression, CTNNB1 mutation and monosomy 6), a prompt and reliable diagnostic verification of these tumors is not yet feasible.
Methods
In the current study, we analyzed 78 samples of WNT MB treated in a single institute through genome-wide DNA methylation and targeted next generation sequencing to elaborate an optimal method for WNT MB molecular verification.
Results
We found that DNA-methylation profiling discloses significant advantages for molecular diagnostic of WNT MB. All other "routine" methods applied such as ß-catenin immunohistochemistry, CTNNB1 mutation analysis, and detection of monosomy 6 failed to identify all WNT MB cases. Survival analysis revealed that application of a reduced radiotherapy protocol for WNT MB treatment had no influence on patients' survival. Only one patient died due to local relapse but recurrent tumor was pathologically and molecularly diagnosed as a secondary glioblastoma.
Conclusions
1. DNA methylation analysis should be considered as a method of choice for further clinically relevant stratification of WNT MB and for correct diagnosis of the recurrent tumors. 2. WNT MB patients with localized disease could benefit from treatment de-intensification.

Relationship between depression scores and degree of skin perspiration: A novel cross‐sectional study

International Wound Journal, EarlyView.


Pressure ulcers in cardiac surgery: Few clinical studies, difficult risk assessment, and profound clinical implications

International Wound Journal, EarlyView.


The neurosurgical wound and factors that can affect cosmetic, functional, and neurological outcomes

International Wound Journal, EarlyView.


Lymphocytes are a major source of circulating soluble dipeptidyl peptidase 4

Clinical &Experimental Immunology, EarlyView.


Blood immune cell biomarkers in lung cancer

Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.


Prenatal Exposure to Cadmium and Child Growth, Obesity and Cardiometabolic Traits

Abstract
Prenatal cadmium exposure has been associated with impaired fetal growth, much less is known about the impact during later childhood on growth and cardiometabolic traits. To elucidate the impact of prenatal cadmium exposure on child growth, adiposity and cardiometabolic traits in 515 mother-child pairs in the "Rhea" cohort (Heraklion-Greece, 2007–2012), we measured urinary cadmium concentrations during early pregnancy, and assessed associations with repeated weight and height measurements from birth through childhood, and waist circumference, skinfold thicknesses, blood pressure, serum levels of lipids, leptin, and C-reactive protein at 4-years. Adjusted regression and mixed models were used, with interactions term for child sex and maternal smoking added. Elevated prenatal cadmium levels [third vs. first and second tertile of urinary cadmium (μg/L)] were significantly associated with slower weight trajectory (per standard deviation score) in all children (β; 95% confidence interval: −0.17; −0.32, −0.02), and slower height trajectory in girls (−0.30; −0.5,−0.09, Pinteraction = 0.025) and in children born to mothers who smoked during pregnancy (−0.48; −0.83, −1.13, Pinteraction = 0.027). To conclude, prenatal cadmium exposure was associated with delayed growth in early childhood. Further research is needed to understand cadmium-related sex differences and the role of co-exposure to maternal smoking during early pregnancy.

Spatio-Temporal Patterns and Diffusion of the 1918 Influenza Pandemic in British India

Abstract
The factors that drive spatial heterogeneity and diffusion of pandemic influenza remain debated. Here, we characterize the spatio-temporal mortality patterns of the 1918 influenza pandemic in British India and study the role of demographic factors, environmental variables, and mobility processes on the observed patterns of spread. We analyze fever and all-cause excess mortality across 206 districts in India during the period of January 1916 to December 1920, and control for variation in seasonality particular to India. Our analysis reveals that the 1918 autumn wave in India matches signature features of influenza pandemics with high disease burden among young adults, (moderate) spatial heterogeneity in burden, and highly synchronized outbreaks across the country deviating from annual seasonality. Importantly, we also find that population density and rainfall explain the spatial variation in excess mortality, and that long-distance travel via railroad is predictive of the observed spatial diffusion of disease. Our work integrates a spatio-temporal analysis of mortality patterns during the 1918 influenza pandemic in India with data on underlying factors and processes to reveal transmission mechanisms in a large, intensely connected setting with significant climatic variability. The characterization of such heterogeneity during historical pandemics is crucial to our ability to prepare for future pandemics.

Association Between Age and Plasmodium falciparum Infection Dynamics

Abstract
Few data exist on the incidence or duration of natural Plasmodium falciparum infections in high transmission settings. School-aged children (SAC) carry a disproportionate burden of infections, suggesting either increased incidence or duration. We estimated the incidence and duration of unique infections by age groups. The Mfera Cohort Study (2012–2017) had two years of follow-up with 120 participants tested monthly and during sick visits. Blood samples were collected to detect P. falciparum by microscopy and polymerase chain reaction. Positive samples underwent genotyping. Simulation was used to account for high non-detection of infection among low parasitemia infections, which increase in frequency with age. Adults had significantly fewer unique infections per person per year (median, 2.5) compared to SAC and under-five children (6.3 and 6.6, respectively). Over half of all genotypes were persistent. Infections lasted significantly longer in adults (median, 180 days) and SAC (median, 163 days) compared to under-five children (median, 97 days), after accounting for age-dependent, non-detection of infection. SAC acquired new infections at the same rate as under-five children, but maintained these infections for longer periods of time, similar to adults. This study provides new insights into P. falciparum infection dynamics that should be considered when designing malaria control strategies.

Successful treatment of dermatomyositis with low‐dose naltrexone

Dermatologic Therapy, EarlyView.


Anti‐desmoglein‐1 levels as predictor of prednisolone tapering in pemphigus vulgaris patients treated with rituximab

Dermatologic Therapy, EarlyView.


Circumcision is still the gold standard in management of plasma cell balanitis

Dermatologic Therapy, EarlyView.


Is skin microneedling a good alternative method of various skin defects removal

Dermatologic Therapy, EarlyView.


The therapeutic effect of tanshinone IIA on Propionibacterium acnes‐induced inflammation in vitro

Dermatologic Therapy, EarlyView.


A case series of dupilumab‐treated allergic contact dermatitis patients

Dermatologic Therapy, EarlyView.


Short‐ and long‐term effects of two emollients on itching and skin restoration in xerotic eczema

Dermatologic Therapy, EarlyView.


A case of necrotizing infundibular crystalline folliculitis

International Journal of Dermatology, EarlyView.


Serum carcinoembryonic antigen as a clinical marker in hypohidrosis

International Journal of Dermatology, EarlyView.


Infectious skin disorders encountered in a pediatric emergency department of a tertiary care hospital in Argentina: a descriptive study

International Journal of Dermatology, EarlyView.


Dabrafenib plus trametinib in BRAF K601E‐mutant melanoma

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Cloning and expression of a transcription factor activator protein-1 member identified from the swimming crab Portunus trituberculatus

Abstract

Transcription activator proteins are regulatory proteins that bind to the promoter regions of target genes. Transcription activator protein-1 (AP-1) regulates numerous genes related to the immune system, apoptosis, and proliferation. In this study, the full-length cDNA of AP-1 from Portunus trituberculatus (PtAP-1) was identified by expressed sequence tag analysis and cDNA-end rapid amplification. The gene is 1183 bp and encodes a 256-amino acid protein with a predicted molecular mass and isoelectric point of 28.96 kDa and 8.90, respectively. PtAP-1 showed the highest expression level in the gonad tissue and the lowest expression level in blood, hemocyte, muscle, hepatopancreas, and gill, during the first 6 h of low-salinity stimulation (10%). Additionally, we observed steady decreases in PtAP-1 mRNA expression in the gill, but at 12 h, expression was initially upregulated, followed by a significant decrease until restoration to baseline levels at 48 h. Additionally, Vibrio alginolyticus challenge resulted in significant upregulation of PtAP-1 expression in the first 6 h, which was maintained at high levels for 48 h. From 48 to 72 h, we observed decreases in PtAP-1 levels, although they remained significantly higher than those detected at baseline. These results suggested that PtAP-1 is involved in the immune response and osmoregulation of crustaceans.



A Case of Nail Psoriasis Successfully Treated with Intralesional Methotrexate

Abstract

Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Treatment options available for nail psoriasis including topical therapy, intralesional injections, and systemic and biologic agents have various side effects and some benefits. Management is currently inconclusive. Intralesional injection of methotrexate in nail psoriasis was previously documented in few cases. We present a case of nail psoriasis successfully treated with low-dose intralesional methotrexate with no significant side effects in a 48-year-old psoriatic patient. Given the various side effects of conventional topical and systemic therapies limiting their use, we conclude that intralesional methotrexate injection seems to be a safe and effective treatment option for nail psoriasis. However, large controlled studies are needed.



A Case of Nail Psoriasis Successfully Treated with Intralesional Methotrexate

Abstract

Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Treatment options available for nail psoriasis including topical therapy, intralesional injections, and systemic and biologic agents have various side effects and some benefits. Management is currently inconclusive. Intralesional injection of methotrexate in nail psoriasis was previously documented in few cases. We present a case of nail psoriasis successfully treated with low-dose intralesional methotrexate with no significant side effects in a 48-year-old psoriatic patient. Given the various side effects of conventional topical and systemic therapies limiting their use, we conclude that intralesional methotrexate injection seems to be a safe and effective treatment option for nail psoriasis. However, large controlled studies are needed.



Multinucleate Cell Angiohistiocytoma: Case Report and Literature Review

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


Post‐Radiation Vascular Lesions of the Breast

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


Co‐existence of Langerhans cell histiocytosis and reticulohistiocytosis with initial presentation of skull lesions: A case report

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


One‐year follow‐up results of hair removal using an 810 nm diode laser

Journal of Cosmetic Dermatology, EarlyView.


Cosmeceutical potential of geranium and calendula essential oil: Determination of antioxidant activity and in vitro sun protection factor

Journal of Cosmetic Dermatology, EarlyView.


Morbihan Disease Treatment: Two Case Reports and a Systematic Literature Review

Purpose: To assess the effectiveness of treatments for Morbihan disease. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the literature was performed on April 1, 2018, using PubMed, Google Scholar, and Excerpta Medica dataBASE with terms used to describe Morbihan disease, including "Morbihan Disease," "Morbihan Syndrome," "lymphedema rosacea," and "lymphedematous rosacea". Case reports or case series were included if they fulfilled the following criteria: published in English, peer-reviewed, and reported Morbihan disease. Results: A total of 89 patients—87 patients from 49 articles and 2 cases from the authors' institution—were included in the final analysis. The median age of patients was 51 years (range: 14–79), and 66 of 89 (74%) patients were men. Male gender correlated with lack of complete response to treatment (odds ratio: 0.25; 95% confidence interval: 0.06–0.97; p = 0.02), while presence of papules or pustules correlated with complete response to treatment (odds ratio: 4.07; 95% confidence interval: 1.04–17.68; p = 0.03). Longer antibiotic duration correlated with response to treatment (p = 0.03), favoring complete over partial response (p= 0.02). Mean antibiotic duration in patients who responded was 4.43 months (standard deviation: 3.49), with complete responders requiring 6.50 months (standard deviation: 4.57). Oral corticosteroids, isotretinoins, and combination therapies did not correlate with treatment response. Conclusions: The presence of papules and pustules correlates with a complete response to treatment, while male gender correlates with a partial response. Patients may benefit from 4- to 6-month duration of tetracycline-based antibiotics. Prospective studies are needed to assess the impact of antibiotic and isotretinoin dose and duration on treatment response. Accepted for publication July 31, 2018. This work was partially supported by an unrestricted departmental grant from Research to Prevent Blindness. The authors have no conflicts of interest to disclose. Address correspondence and reprint requests to Gary J. Lelli, Jr, M.D. Department of Ophthalmology, Weill Cornell Medical College, 1305 York Avenue, New York, NY 10021. E-mail: gjl9003@med.cornell.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Increased risk of severe course of pemphigus in patients with pemphigus‐associated alopecia: a prospective observational study

Clinical and Experimental Dermatology, EarlyView.


Silver nanoparticles induce Egr‐1‐dependent psoriasin expression via the ERK and p38 pathways

Clinical and Experimental Dermatology, EarlyView.