Lack of an association between alopecia areata and visceral or hematopoietic cancers

To the Editor: Alopecia areata (AA) is a polygenic, patchy nonscarring hair loss that presents on the scalp and body that drastically affects patients' quality of life.1 The pathogenesis of AA remains elusive, though T-lymphocyte–mediated inflammation and various environmental stressors play a role. The association between AA and various autoimmune diseases has been explored in several studies.1 Recently, studies found lower rates of nonmelanoma skin cancers and a trend toward decreased melanoma among AA patients.

Recurrence of genital aphthosis in girls: A retrospective analysis

To the Editor: Genital aphthosis in girls is a rare, underrecognized condition characterized by genital ulceration after an acute systemic illness.1,2 The aphthae often are associated with severe dysuria and emotional distress in this young, adolescent population. We sought to identify disease recurrence by reviewing clinical records from January 1997 through August 2015. Institutional review board approval was obtained (IRB# 15-008638, December 2015).

Prevalence of pediatric alopecia areata among 572,617 dermatology patients

To the Editor: The authors initiated this retrospective analysis to evaluate the prevalence, age, and sex of pediatric patients with alopecia areata (AA) and the impact that pediatric AA has on a typical dermatology practice. Billing data from Leavitt Medical Associates of Florida, doing business under the name Advanced Dermatology and Cosmetic Surgery, was collected from offices throughout Florida and Ohio, and 572,617 dermatology patients were identified. The study population included 71,951 pediatric patients (1-17 years of age): 33,800 boys and 37,791 girls.

Spectrum of orocutaneous disease associations

The oral cavity and cutaneous organ systems share a close embryologic origin. Therefore, there are numerous dermatologic conditions presenting with concomitant oral findings of which the dermatologist must be aware. The second article in this continuing medical education series reviews inflammatory orocutaneous conditions and a number of genodermatoses. It is essential for dermatologists to be familiar with oral cavity manifestations associated with dermatologic diseases for prompt diagnosis, management, and appropriate referral to stomatology and dentistry.

Onychophagia and onychotillomania can be effectively managed

To the Editor: We greatly appreciate the commentary by Lipner and Scher.1 We agree that our patients would benefit from prompt treatment to reduce shame and prevent irreversible nail damage. Herein, we present our clinical pearls using pharmacotherapy, stimulus control, habit-reversal training (HRT), and cognitive behavioral and aversion therapy. We often combine psychotherapies such as HRT and stimulus control. Six or more sessions are typically required. We have treated several cases of onychophagia and onychotillomania with N-acetylcysteine 1200-2400 mg/day.

October iotaderma (#284)

Comment on “Psychocutaneous disease: Clinical perspectives”

To the Editor: Kuhn et al1 are to be commended for writing this informative review on psychocutaneous disease. In this manuscript, they delineate common psychiatric conditions with skin manifestations including delusional, factitious, obsessive-compulsive, and eating disorders; psychogenic pruritus; cutaneous sensory (pain) syndromes; posttraumatic stress disorder; and sleep-wake disorders. They appropriately describe the important role fingernails play in removing organisms during delusional infestations and describe patients with factitious skin disorder creating well-demarcated geometric erosions.

Smoke-evacuating cautery pencils for dermatologic surgery

Potential health risks may exist related to particulates and volatile chemicals in electrosurgical smoke.1 Although particulate matter is effectively filtered by specialized masks such as N-95 masks, volatile chemicals are not.1 Standard surgical masks provide no protection. Further, handheld smoke evacuation with stand-alone units requires an assistant to carefully follow the motions of the surgeon while reliably holding the evacuation tube at the correct distance from the cautery tip (≤2 in)2 without compromising the visual field.

Recurrence, evolution, and re-excision of moderately dysplastic nevi

To the Editor: I read with great interest the fascinating and valuable article by Hiscox et al on recurrence of moderately dysplastic nevi (MDN).1 The authors argue that their findings "support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision." While the authors' study indeed adds to the literature, and supports the findings of another recent study2 assessing a similar clinical question, several important caveats should be noted.

CME examination

Approach to moderately dysplastic nevi with positive histologic margins

To the Editor: We are grateful to Dr Kantor for his thoughtful and detailed review of our paper.1 Our goal was to contribute to the literature regarding moderate dysplastic nevi (DN), and we showed that 147 such nevi with positive histologic margins showed a recurrence rate of only 4%.2 We agree that larger studies are needed and are grateful that they are underway. Dr Kantor is correct in pointing out that the majority of these moderate DNs were biopsied with the intent to excise, and we agree that our data are not applicable to partially sampled lesions because partial sampling was not the goal of our study.

Oral tofacitinib monotherapy in Korean patients with refractory moderate-to-severe alopecia areata: A case series

To the Editor: Recent reports document successful treatment of alopecia areata (AA) with tofacitinib.1-5 However, long-term data using tofacitinib monotherapy is still sparse, and we are unaware of the quality of treatment in persons of Asian decent. We report the results of extended tofacitinib monotherapy in adult Korean patients with moderate-to-severe AA.

Histopathologic features of melanoma in difficult-to-diagnose lesions: A case-control study; methodological issues

To the Editor: We read with great interest the article authored by Gonzalez et al that was published in the Journal of the American Academy of Dermatology in 2017.1 The authors aimed to measure the accuracy of histopathologic features in difficult-to diagnose melanocytic tumors and the interobserver agreement of those features. They constructed a prediction model and found that asymmetry, single-cell melanocytosis, solar elastosis, pagetoid melanocytosis, and broad surface diameter were the most predictive factors of outcome studied.

Iotaderma #285

Reply to: “Histopathologic features of melanoma in difficult-to-diagnose lesions: A case-control study; methodological issues”

To the Editor: I thank Drs Ayubi and Safiri1 for their comments regarding our recent article on the accuracy of different histopathologic features of melanoma in difficult-to-diagnose melanocytic neoplasms.2 I would like to emphasize that this was an exploratory hypothesis-generating research project designed to identify which histopathologic attributes were most likely to be of value in designing a diagnostic algorithm for the difficult melanocytic neoplasm. Ayubi and Safiri recommend (1) additional validation studies and (2) better demonstration of temporality between independent and dependent variables.

Frequent skin examinations in patients with actinic keratoses: Ethical, financial, and moral implications

In many disputes, the 2 parties in disagreement can "meet each other halfway" and reach a pragmatic solution that may not be perfect but is acceptable to both. When disagreements occur in the context of the physician-patient relationship, there are inevitably ethical issues or principles to be considered in arriving at a solution. In addition, the competing interests of others may need to be considered.

Mitigation or prevention of mild hair dye contact dermatitis after pretreatment with clobetasol foam

Nearly 40% of commercial hair dye users develop allergic contact dermatitis (ACD).1 Weak ACD reactions might be augmented with repeated exposure.2 Thus, stopping the cycle early might not only mitigate symptoms but also prevent progression.

CME examination

Editorial Board

Folate and phototherapy: What should we inform our patients?

Ultraviolet (UV) degradation of folate has been studied in vitro and in vivo, but comprehensive reviews of the subject and recommendations for supplementing folate are lacking, especially for women of childbearing age, in whom decreases in folate predisposes newborns to neural tube defects.

Effect of a high-cholesterol diet on lipoprotein metabolism and xanthoma formation in rabbits

Summary

Background

Xanthelasma is the most common type of cutaneous xanthoma and often occurs on the eyelids. Xanthoma has been reported to be highly correlated with abnormal lipoprotein metabolism.

Aims

In this study, we wanted to investigate the effects of a high-cholesterol diet on xanthoma formation and lipoprotein metabolism in rabbits.

Methods

In animals fed with high-cholesterol diet, deteced plasma lipid [ie, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (L-DLC)] levels and pathology of xanthoma.

Results

Plasma lipid levels were dramatically elevated within 8 weeks. In addition, high dietary cholesterol promoted xanthoma formation on the napex. Microscopic examination showed that foam cells laden with cholesterol deposits accumulated around the dermal capillaries and cutaneous appendages within the skin of the napex.

Conclusion

These findings indicate a critical role for a high-cholesterol diet in the dysregulation of lipoprotein metabolism and the development of xanthoma in rabbits. The results suggest that abnormal lipid metabolism may increase the occurrence of xanthoma.

The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy

Abstract

Background/Objectives

Acne, a common pediatric disease, tends to be more comedonal in preadolescents, whereas older individuals are more likely to have inflammatory lesions in addition to comedones. Thus the microbiome of preadolescents may be different. In this pilot study we aimed to characterize the preadolescent acne microbiome, compare the microbiome in preadolescents with and without acne, and investigate changes in the microbiome after topical treatment with benzoyl peroxide or a retinoid in a small cohort of preadolescents.

Methods

Participants were 7-10 years of age with (intervention group) or without (control group) acne and were recruited during routine outpatient dermatology visits. Baseline questionnaires, physical examination, and pore strip application were performed for all participants. Intervention group participants were randomized to receive topical therapy with benzoyl peroxide 5% gel or cream or tretinoin 0.025% cream. Participants with acne were followed up 8-10 weeks later and pore strip application was repeated.

Results

Preadolescents with acne were colonized with a greater diversity of cutaneous bacteria than controls and the most commonly identified bacterium was Streptococcus. The number of bacterial species and phylogenetic diversity decreased after treatment with benzoyl peroxide and tretinoin.

Conclusion

The predominant bacteria in microbiome studies of adult acne is Propionibacterium, whereas in this pediatric population we saw a lot of Streptococcus bacteria. After treatment, the microbiomes of intervention group participants more closely resembled those of control group participants.

Pediatric keloids: A 6-year retrospective review

Abstract

Background/Objectives

Keloids are reportedly rare at the extremes of life. We sought to describe the epidemiology of pediatric keloids seen at the plastic surgery outpatient department of the University College Hospital, Ibadan.

Methods

We retrospectively reviewed all children younger than 19 years who presented with nonburn keloids between 2008 and 2014. Data were obtained on age; duration, size, and location of the keloid; family history; mode of treatment; and outcome. Outcome variables were recurrence and wound complications. Data were analyzed using the Pearson chi-square test for discreet variables and the independent-sample t test for continuous variables. P < .05 was taken as statistically significant.

Results

Within the review period, 304 patients presented with keloids, of whom 40 (13.1%) were younger than 19 years. There was a female preponderance (n = 23, 57.5%). The mean age at onset of the keloid was 9.3 years (range 3 months-18 years). Thirty (75%) patients had keloids in the head and neck region. Keloids were sporadic in 31 (77.5%) patients. Nineteen (47.5%) patients had multimodal treatment for keloid. The recurrence rate was 20%. Recurrence was significantly associated with the size of the lesion (P = .003).

Conclusion

Keloids during childhood are not rare. More attention should be paid to the management of keloids in this age group.

Agminated segmental plaque-type blue nevus associated with hypertrichosis and soft tissue hypertrophy: Report of a case and review of the literature

Abstract

Blue nevi are common skin neoplasms that typically present as asymptomatic solitary papules, although they may rarely occur in an agminated configuration. We describe a case of agminated blue nevus in a segmental facial distribution associated with soft tissue hypertrophy and hypertrichosis in a 16-year-old boy and present a review of the literature. Although they are generally considered to be benign, concurrent soft tissue changes occurring within an agminated blue nevus should be investigated thoroughly to exclude alternate diagnoses.

Perineal groove in female infants: A case series and literature review

Abstract

Background

Perineal groove is a rare congenital malformation that is unknown to many clinicians and is often misdiagnosed. Although it may be self-resolving during childhood, this nonepithelized mucous membrane can pose the risk of local irritation and infection, particularly urinary tract infection.

Methods

A retrospective study of female infants diagnosed with a perineal groove was performed, demographic characteristics and clinical features were analyzed, and a photographic review was conducted.

Results

Five patients with perineal groove were observed in our clinic in 2015-16. The mean age was 14 months. None had symptoms, and no treatment was required. During follow-up of 1 year, all remained asymptomatic.

Conclusions

Our retrospective review suggests that perineal groove may be an underdiagnosed condition. Most cases resolve spontaneously, but confusion in diagnosis may lead to misdiagnosis or misinterpretation of sexual abuse and unnecessary treatments.

Basophils are recruited and localized at the site of tick bites in humans

Reconsidering the H&E stain as the gold standard in assessing the depth of burn wounds

While histological examination is considered by most as the gold standard for burn depth assessment, it has no practical use in the clinical setting. It has, however, been used in the research setting, as a mean for evaluating emerging techniques of depth measurement. Due to the limitations of the H&E stain, other stains have also been explored, such as lactate dehydrogenase (LDH), as presented in this issue, in "Improving the Histologic Characterization of Burn Depth." As the determination of burn depth is not a typical subject in dermatopathology, a summary of selected techniques and the possible role for the LDH stain in future research, is described herein.

Comment on: The over-Wise mammoplasty: a modified Wise pattern for large superficial breast tumors

A new cordycepin-producing caterpillar fungus Ophiocordyceps xuefengensis with artificial infection to the host, cultivation of mycelia and stromata

Abstract

Caterpillar fungi have numerous pharmacological and therapeutic applications in traditional medicine, due to a variety of active chemical constituents, such as cordycepin and adenosine. It is imperative to discover new resource for artificial cultivation and biometabolite production since the traditional natural species are endangered. In this study, a new strain HACM 001 was isolated and identified as Ophiocordyceps xuefengensis by rDNA-ITS sequencing. This strain showed the potential of artificial infection to caterpillar larvae leading to mummification, as well as fermentation mycelia in liquid culture and cultivation stromata in solid medium. Eight nucleosides and nucleobases, especially cordycepin and adenosine, were determined and analyzed with HPLC-DAD–Q-TOF-MS/MS technology. Cordycepin was detected in all forms of present O. xuefengensis strain at different contents, among which the highest content (37.1 μg/g) appeared in the stromata cultivated on solid medium. The content of adenosine in mycelia and stromata, respectively, reached 1155 μg/g and 1470 μg/g. Therefore, O. xuefengensis might be an alternative source for obtaining artificial fungus–caterpillar–larvae complex and producing cordycepin and adenosine.

Involvement of formate dehydrogenases in stationary phase oxidative stress tolerance in Escherichia coli

Abstract

Previously, we constructed a series of reduced-genome strains of Escherichia coli by combining large-scale chromosome deletions and then tested the sensitivity of these strains to the redox-cycling drug menadione. In this study, we analyzed a deletion that increased menadione sensitivity and discovered that loss of selenocysteine synthase genes was responsible for the strain's reduced tolerance to oxidative stress. Mutants of formate dehydrogenases, which are selenocysteine-containing enzymes, were also sensitive to menadione, indicating that these enzymes are involved in oxidative stress during stationary phase, specifically under microaerobic conditions in the presence of glucose. Among three formate dehydrogenases encoded by the E. coli genome, two were responsible for the observed phenotypes: formate dehydrogenase-H and -O. In a mutant of fdhD, which encodes a sulfur transferase that is essential for formate dehydrogenase activity, formate dehydrogenase-O could still contribute to oxidative stress tolerance, revealing a novel role for this protein. Consistent with this, overproduction of the electron transfer subunits of this enzyme, FdoH and FdoI, increased menadione tolerance and supported survival in stationary phase. These results suggested that formate dehydrogenase-O serves as an electron transfer element in glucose metabolism to promote oxidative stress tolerance and survival in stationary phase.

Identification and characterization of a CI binding operator at a distant location in the temperate staphylococcal phage ф11

Abstract

Bacteriophage ф11 encodes repressors CI and Cro for executing its growth in Staphylococcus aureus, a human pathogen. There are three homologous operators O1, O2 and O3 between the repressor-expressing genes. While CI binds to O1 and O2, Cro interacts only with O3. To locate additional CI binding operators in ф11, we searched its genome using the O1/O2 sequence as a probe. The results show the presence of a putative CI binding operator (O4) at the 3^΄ end of the cro. O4 differs from O2 and O1 by one base and five bases, respectively. A specific interaction was noticed between O4 and rCI, a recombinant CI. However, O4 shows no interaction with rCro, a chimeric Cro. Additionally, six guanine bases, situated in and around O4, have interacted with rCI. Interestingly, the rCI binding affinity of O4 or O1 is about 15 times higher than that of O2. A comparative study indicates that some bases and structural alteration, unique to O1 and O4, may contribute to their enhanced rCI binding affinity. Collectively, the study has not only broadened the distinct gene regulatory circuit of ф11 but also suggested that it possibly employs a complex mechanism for its development in S. aureus.

Identification of a fabZ gene essential for flexirubin synthesis in Cytophaga hutchinsonii

Abstract

Cytophaga hutchinsonii, an aerobic soil bacterium which could degrade cellulose, produces yellow flexirubin pigments. In this study, fabZ, annotated as a putative β-hydroxyacyl-(acyl carrier protein) (ACP) dehydratase gene, was identified by insertional mutation and gene deletion as an essential gene for flexirubin pigment synthesis. The availability of a FabZ mutant that fails to produce flexirubin allowed us to investigate the biological role of the pigment in C. hutchinsonii. Loss of flexirubin made the FabZ mutant more sensitive to UV radiation, oxidative stress and alkaline stress than the wild type.

Valorisation of CO 2 -rich off-gases to biopolymers through biotechnological process

Abstract

As one of the key enabling technologies, industrial biotechnology has a high potential to tackle harmful CO₂ emissions and to turn CO₂ into a valuable commodity. So far, experimental work mainly focused on the bioconversion of pure CO₂ to chemicals and plastics and little is known about the tolerance of the bioprocesses to the presence of impurities. This work is the first to investigate the impact of real CO₂-rich off-gases on autotrophic production of polyhydroxybutyrate. To this end, two-phase heterotrophic-autotrophic fermentation experiments were set up, consisting of heterothrophic cell mass growth using glucose as substrate followed by autotrophic biopolymer production using either pure synthetic CO₂ or industrial off-gases sampled at two point sources. The use of real off-gases did not affect the bacterial performance. High biopolymer content (up to 73%) and productivities (up to 0.227 g/lh) were obtained. Characterisation of the polymers showed that all biopolymers had similar properties, independent of the CO₂ source. Moreover, the CO₂-derived biopolymers' properties were comparable to commercial ones and biopolymers reported in literature, which are all produced from organic carbon sources.

Occupational asthma from biological pest control in greenhouses

Publication date: Available online 10 October 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Irmeli Lindström, Heidi Karvonen, Katri Suuronen, Hille Suojalehto

Juvenile elastoma without germline mutations in LEMD3 gene: A case of Buschke-Ollendorff syndrome?

Abstract

We report the case of a 6-year-old Caucasian girl with clinical and histopathologic features of Buschke-Ollendorff syndrome. Histologic examination of skin lesions showed thick, curly, elastic fibers in the derma. Bone lesions compatible with Buschke-Ollendorff syndrome were found in the girl's mother. Mutations in LEMD3 are pathogenic for Buschke-Ollendorff syndrome. Analysis of all exons and exon-intron junctions of LEMD3 did not reveal any germline mutations.

Photochemistry and Photophysics of the 3-Styrylidenebenz[e]indanes

Abstract

The photochemical and photophysical properties of the extended conformers of trans- and cis-1-(2-naphthyl)-2-phenylethenes (t- and c-NPE_B) are strikingly different than those of their rigid analogues, trans- and cis-3-styrylidenebenz[e]indane (t- and c-BPE). The fluorescence quantum yield and lifetime at 25 °C in methylcyclohexane drop from 0.76 and 22.2 ns in t-NPE_B to 0.0051 and 0.25 ns in t-BPE and there are complementary changes in the photoisomerization quantum yields. In both cases photoisomerization occurs in S₂, a stilbenic excited state. The differences in behavior are traced to the diminished S₁/S₂ energy gap on the alkyl substitution afforded by the five-membered ring in BPE. The effect of viscosity on the torsional relaxation of t-BPE, evaluated in glycerol/methanol mixtures at 25 °C and in 95/5 and 99.9/0.1 glycerol/methanol (% v/v) as a function of T, is well accounted for by the medium enhanced barrier model. Absorption and fluorescence spectra of t-BPE in pure glycerol reveal aggregate formation. Quenching of t-BPE fluorescence in methylcyclohexane by tri-n-butylamine (TBA) leads to exciplex fluorescence. Comparison with analogous results for t-NPE_B suggests that charge transfer involves primarily the naphthalenic S₁ state in t-NPE_B and the stilbenic S₂ state in t-BPE.

This article is protected by copyright. All rights reserved.

Optimization of culture conditions for rapid clinical-scale expansion of human umbilical cord blood-derived mesenchymal stem cells

Mesenchymal stem cells (MSCs) have broad-spectrum therapeutic effects in various diseases, and thus have many clinical applications. However, it is difficult to produce sufficient numbers of MSCs for clinical ...

Erythrokeratoderma - a manifestation associated with multiple types of ichthyoses with different gene defects

Erythrokeratoderma (OMIM #133200) refers to a group of closely related disorders of cornification manifesting with hyperkeratotic, often transient and migratory, erythematous figurate plaques with sharply demarcated borders that typically develop in early childhood with or without palmoplantar involvement.¹ Erythrokeratodermas have been historically classified into the two main categories: (a) erythrokeratodermia variabilis et progressiva (EKVP, also known as erythrokeratoderma figurata variabilis and Mendes da Costa disease), and (b) progressive symmetric erythrokeratoderma (PSEK, also known as Gottron syndrome).

This article is protected by copyright. All rights reserved.

The optimal regimen of brentuximab vedotin for CD30+ cutaneous lymphoma: Are we there yet?

Brentuximab vedotin (BV) is an anti-CD30 antibody–drug conjugate that is approved for refractory Hodgkin lymphoma and systemic anaplastic large-cell lymphoma. In the ALCANZA trial, the proportion of CD30+ cutaneous T-cell lymphoma (CTCL) patients achieving an objective response lasting at least 4 months was 56.3% with BV versus 12.5% with conventional therapy (oral methotrexate or bexarotene), and progression-free survival, complete response rate and improvement in symptom burden were significantly improved.¹ As in previous studies, 1.8 mg/kg dose was administered every 3 weeks in this study.^1,2 We routinely use this regimen that has been well studied in clinical trials, starting with 1.8 mg/kg and decrease to 1.2 mg/kg if needed. The safety profile for BV is similar to conventional therapies and although peripheral neuropathy occurs in 67%, it usually resolves or improves after cessation or completion of treatment.¹

This article is protected by copyright. All rights reserved.

Light-emitting diode 585nm photomodulation inhibiting melanin synthesis and inducing autophagy in human melanocytes

Normal human skin color is the result of the balance between melanin synthesis and melanin degradation [1]. When microenvironment changes, skin depigmentation or hyperpigmentation eventually occurs. It is commonly accepted that hyperpigmentation is mainly caused by two mechanisms: the overactivity and increased numbers of normal melanocytes or the increased production and decreased destruction of melanosomes. Melanocytes, which contain melanosomes, a distinctive lysosome-related organelle, are in charge of melanin biosynthesis.

Thromboprophylaxis in autologous breast reconstruction

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There's an autophagy for that!

By Christina Towers, PhD

A critical mechanism that cells use to generate nutrients and fuel metabolism is through a process called autophagy.  This process is complex and involves over 20 different proteins, most of which are highly conserved across species.  It involves the formation of a double membrane structure known as an autophagasome that fuses with the lysosome to facilitate the degradation of cytoplasmic material.  While bulk autophagy is thought to be largely non-specific, clearing damaged proteins from the cytoplasm, recent studies have begun to highlight more selective forms of autophagy.  Selective autophagy, also coined organellophagy, facilitates the degradation of specific organelles that are damaged or targeted for recycling.  Thus far, researchers have begun to investigate the selective degradation of mitochondria, peroxisomes, endoplasmic reticulum (ER), nuclei, and chloroplasts in plants, all mediated through variant forms of autophagy¹. 

Autophagy Process	Degraded Material
Mitophagy	Mitochondria
Pexophagy	Peroxisomes
Reticulophagy	ER
Nucleophagy	Nuclei
Chlorophagy	Chlorplasts

The most well studied of these processes is undoubtedly mitophagy, involving the turnover of mitochondria.  Mitochondria are the power houses of the cell generating ATP that fuels metabolism.  They also play crucial signaling roles during cell death, and clearance of damaged mitochondria is critical to maintain cellular and tissue homeostasis.  Mitophagy can be induced by several stimuli and cellular stressors including hypoxia, chemical uncouplers, ROS, and of course damaged mitochondria.

 

While all organelle selective forms of autophagy utilize the basic autophagy machinery, each has a set of specific machinery proteins and receptors. In the case of mitophagy that would include the proteins, PINK1 and PARKIN².  The serine/threonine phosphatase, PINK1, is usually imported into the inner mitochondrial membrane, however, when the mitochondrial membrane potential is compromised, PINK1 accumulates on the outside of the membrane where it signals the recruitment of the E3 ubiquitin ligase PARKIN to the mitochondrial membrane. Together these proteins generate a mitophagy signal by ubiquitinating proteins that are recognized by autophagy receptors.  There are PARKIN independent forms of mitophagy, and likewise, PARKIN can have mitophagy independent roles in the mitochondria as well¹. Although slightly different across species, in mammals, the critical mitophagy receptors include p62, BNIP3L, BNIP3, FUNDC1, NDP52, TAX1BP1 and OPTN³.

The relevance of mitophagy to human disease is apparent by the strong link between both the PINK1 and PARKIN genes in familiar Parkinson's disease, a progressive disorder stemming from the death of dopaminergic neurons in the brain⁴.  While there has been a recent focus in the field on different forms of selective autophagy, beyond mitochondrial degradation, there is still much to be learned about the specific proteins, receptors, and autophagic machinery important for each of the organelle specific processes and most importantly their role in disease. 

Learn more about selective autophagy

 

1. Anding, A. L. & Baehrecke, E. H. Cleaning House: Selective Autophagy of Organelles. Dev Cell 41, 10-22, doi:10.1016/j.devcel.2017.02.016 (2017).
2. Matsuda, N. et al. PINK1 stabilized by mitochondrial depolarization recruits Parkin to damaged mitochondria and activates latent Parkin for mitophagy. J Cell Biol 189, 211-221, doi:10.1083/jcb.200910140 (2010).
3. Lazarou, M. et al. The ubiquitin kinase PINK1 recruits autophagy receptors to induce mitophagy. Nature 524, 309-314, doi:10.1038/nature14893 (2015).
4. Valente, E. M. et al. Hereditary early-onset Parkinson's disease caused by mutations in PINK1. Science 304, 1158-1160, doi:10.1126/science.1096284 (2004).

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Triptans and CGRP blockade – impact on the cranial vasculature

The trigeminovascular system plays a key role in the pathophysiology of migraine. The activation of the trigeminovascular system causes release of various neurotransmitters and neuropeptides, including seroton...

Cutaneous protothecosis reminiscent of unilateral solar elastotic bands of forearm in an immunocompromised patient

Publication date: Available online 9 October 2017
Source:Dermatologica Sinica
Author(s): Yi-Hsin Ho, Yun-Wen Chiu, Chen-Yi Wu, Han-Nan Liu
We report a case of cutaneous protothecosis due to Prototheca wickerhamii in an elderly male with hepatocellular carcinoma (HCC), decompensated liver cirrhosis, diabetes mellitus, hypertension and coronary artery disease, who presented with a large dull erythematous plaque over right upper limb stretching from the lower third of the distal upper arm to near the wrist. A biopsy revealed marked, band-like solar elastosis in the upper dermis, a pathologic pattern that resembles solar elastotic bands of forearm. However, the following Periodic acid–Schiff stain and fungal culture confirmed the diagnosis of protothecosis. Our finding added a new pattern to the list of the highly variable cutaneous manifestations of protothecosis.

Prevalence of Actinic Keratosis in Different Regions of Spain: The EPIQA Study

Publication date: Available online 10 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): C. Ferrándiz-Pulido, M. Lera-Imbuluzqueta, C. Ferrándiz, M.J. Plazas-Fernandez

Morfea y liquen escleroatrófico extragenital generalizados tras vacuna antigripal

Publication date: Available online 10 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): S. Requena López, Y. Hidalgo García, S. Gómez Díez, B. Vivanco Allende

Extensive hyperpigmentation of the face in a Filipina

Der Praxismietvertrag

Zusammenfassung

Der Praxismietvertrag hat für den Arzt existenzielle Bedeutung. Eine vorausschauende Gestaltung lohnt sich wirtschaftlich und beugt Konflikten vor. Da es sich um einen Gewerberaummietvertrag handelt, sind nahezu sämtliche Vertragselemente frei verhandelbar. Gegebenenfalls lohnt es sich, als Praxisgesellschaft zu mieten. Üblich ist die Vereinbarung einer Festlaufzeit von mehreren Jahren mit einseitiger Verlängerungsoption. Bei einem Verstoß gegen Formvorgaben ist der Vertrag allerdings trotzdem kurzfristig kündbar. Die Miete wird in der Regel durch eine Wertsicherungsklausel bestimmt. Vorsicht ist im Zusammenhang mit der Optierung zur Umsatzsteuererhebung geboten. Sozietäts‑, Nachfolge- und Konkurrenzschutzklauseln dienen der Absicherung des Arztes, der sich im Übrigen Sonderkündigungsrechte und Todesfallschutz einräumen lassen sollte. Für den Zustand der Mieträume ist grundsätzlich der Vermieter verantwortlich. Bei Mängeln ist der Mieter zur Minderung berechtigt.

Assessing value in breast reconstruction - a systematic review of cost-effectiveness studies

Publication date: Available online 9 October 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Clifford C. Sheckter, Evan Matros, Arash Momeni
IntroductionBreast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high value care models.MethodsA systematic review of PubMed, Web of Science, and the Cost-Effectiveness Analysis Registry was conducted. Two reviewers independently evaluated all publications up until December 12, 2016.ResultsAfter removal of duplicates, 1910 records were screened, from which 53 studies underwent full text review. The 13 studies included for final analysis all included an incremental cost-effectiveness ratio (ICER). Five studies evaluated the cost-effectiveness of technology including: acellular dermal matrix (ADM) in staged prosthetic reconstruction, ADM in direct-to-implant (DTI) reconstruction, preoperative computed tomography angiography (CTA) in autologous reconstruction, indocyanine green dye angiography in evaluating anastomotic patency, and abdominal mesh reinforcement in abdominal tissue transfer. The remaining eight studies evaluated the cost-effectiveness of different reconstruction methods. Cost-effective strategies included: free vs. pedicled abdominal tissue transfer, DTI vs. staged prosthetic reconstruction, and fascia-sparing variants of free abdominal tissue transfer.ConclusionsCurrent evidence demonstrates multiple cost-effective technologies and methods in accomplishing successful breast reconstruction. Plastic surgeons should be well informed of such economic models when engaging payers and policy makers in discussions regarding high value breast reconstruction.

A (salicylaldiminato)Pt(II) complex with dimethylpropylene linkage: Synthesis, structural characterization and antineoplastic activity

Publication date: November 2017
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 176
Author(s): Mohammad Azam, Saud I. Al-Resayes, Saied M. Soliman, Agata Trzesowska-Kruszynska, Rafal Kruszynski, Zahid Khan
A novel (salicylaldiminato)Pt(II) complex with two different molecular structures, one solventless ((salicylaldiminato)Pt(II)) 1 and another one solvated ((salicylaldiminato)Pt(II). C2H5OH), 1·C2H5OH, has been obtained by the reaction of a salen ligand with [PtCl2(DMSO)2] in ethanol at room temperature. The asymmetric unit of solventless 1 contains 9 such complex molecules whereas 1·C2H5OH contains 2 complex molecules and one ethanol molecule. To get insights into the structure and bonding, DFT and TDFT calculation have been carried out. The electronic transition band at 408.0nm (calc. 424.3nm) is assigned to HOMO→LUMO (96%) excitation. The calculated NMR chemical shifts are interrelated with the experimental results, and a very slight effect of solvent was noticed on NMR chemical shifts. A MTT assay and the real-time cell monitoring xCELLigence system revealed that the 1 has significant potential to suppress cell viability and cell proliferation in human HT-29 and SW620 colorectal cancer cell lines.

Photodynamic damage predominates on different targets depending on cell growth phase of Candida albicans

Publication date: Available online 10 October 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Alessandra Baptista, Caetano P. Sabino, Silvia C. Núñez, Walter Miyakawa, Airton A. Martin, Martha S. Ribeiro
Photodynamic inactivation (PDI) has been reported to be effective to eradicate a wide variety of pathogens, including antimicrobial-resistant microorganisms. The aim of this study was to identify the potential molecular targets of PDI depending on growth phase of Candida albicans. Fungal cells in lag (6h) and stationary (48h) phases were submitted to PDI mediated by methylene blue (MB) combined with a (662±21) nm-LED, at 360mW of optical power. Pre-irradiation time was 10min and exposure times were 12min, 15min and 18min delivering radiant exposures of 129.6J/cm², 162J/cm² and 194.4J/cm², respectively, on a 24-well plate of about 2cm² at an irradiance of 180mW/cm². Scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force spectroscopy (AFS) and Fourier transform infrared spectroscopy (FT-IR) were employed to evaluate the photodynamic effect in young and old fungal cells following 15min of irradiation. Morphological analysis revealed wrinkled and shrunk fungal cell membrane for both growth phases while extracellular polymeric substance (EPS) removal was only observed for old fungal cells. Damaged intracellular structures were more pronounced in young fungal cells. The surface nanostiffness of young fungal cells decreased after PDI but increased for old fungal cells. Cellular adhesion force was reduced for both growth phases. Fungal cells in lag phase predominantly showed degradation of nucleic acids and proteins, while fungal cells in stationary phase showed more pronounced degradation of polysaccharides and lipids. Taken together, our results indicate different molecular targets for fungal cells in lag and stationary growth phase following PDI.

Water assessment using ultra-weak bioluminescence

Publication date: Available online 10 October 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): A.C. Cordeiro, J.L. Fabris, G.H. Couto, H.J. Kalinowski, E. Bertogna
In this paper a method to evaluate the presence of microorganisms of the coliform group in water samples using the ultra-weak bioluminescence (UWB) is proposed. A series of UWB measurements and optical density measurements from cultures of both a set of standard E. coli strain samples, and a set of water samples from a river near Curitiba City in Brazil were performed. All samples were previously incubated at 37°C for 11h in nutritive medium before the temporal UWB emission profiles data were acquired for a period of 24h inside a dark chamber of an especially implemented instrumentation capable of doing photon counting measurements. For the optical density measurements, a spectrophotometer was used to acquire the growth kinetics of those cultures for a period of 13h, and the results compared to the UWB profiles. Periodic time-components analysis of the UWB data from both the set of standard E. coli samples and the set of the river's water samples were performed and compared to each other. The results have shown that the UWB temporal profiles resemble in some way the growth kinetics curve and the periodic time-components analysis is an effective way to discriminate between contaminated and non-contaminated samples, therefore the method may be viable for detecting coliforms in water samples in less time than usual methods.

Baseline lab parameters predicting clinical outcome in melanoma patients treated with ipilimumab - a single center analysis

Abstract

Background

Overall response rates (ORR) for ipilimumab in advanced melanoma are only about 10%. Hence, it is important to explore biomarkers predicting ipilimumab responders.

Objective

We aimed to explore biomarkers in order to predict therapy outcome in melanoma patients who have undergone standard ipilimumab therapy in a real-world setting.

Methods

Databases of cutaneous melanoma patients (n = 52) who had received ipilimumab were reviewed and data collected on patient characteristics and diverse lab parameters. We performed univariate and multivariate statistics including logistic regression analysis and Cox proportional-hazards regression.

Results

Baseline leukocytes, lymphocytes, eosinophils, thrombocytes, neutrophil/lymphocyte ratio, thrombocytes/lymphocyte ratio, eosinophil/lymphocyte ratio, and serum vitamin D levels were not significantly associated with ORR, progression-free survival (PFS) and melanoma-specific survival (MSS). Multivariate analysis confirmed anti PD-1 pre-treatment as significant predictor for ORR following ipilimumab therapy. Low LDH levels and more than 2 ipilimumab cycles turned out to be significant independent predictors for prolonged PFS. Low S100B levels and anti-PD-1 treatment before or after ipilimumab were significant independent predictors for improved MSS. All aforementioned parameters and fecal calprotectin did not turn out to be predictors for ipilimumab-induced autoimmune-related adverse events and autoimmune colitis, respectively.

Conclusions

Low serum LDH before ipilimumab treatment is an independent predictor for improved PFS. Furthermore, low serum S100B is an independent predictor for MSS. The number of ipilimumab cycles (> 2) is significantly associated with prolonged PFS. Pre-treatment calprotectin does not predict the occurrence of autoimmune colitis under ipilimumab therapy.

This article is protected by copyright. All rights reserved.

Most Common Dermatology Diagnoses to the Emergency Department in the Pediatric population

Abstract

Skin related complaints are a top 10 reason for pediatric presentation to the ED. Older studies and those conducted outside of the US demonstrate wide variability in the frequency of pediatric presentations to the ED for skin complaints, ranging from 4-40% of visits.¹ One study found urticaria to be the most frequent PED dermatological diagnosis, while others found viral exanthema and contact dermatitis to be the most common diagnoses.

This article is protected by copyright. All rights reserved.

State-of-the-art immunogenicity evaluation in phase 3 confirmatory study (EGALITY) with etanercept biosimilar GP2015

Abstract

Immunogenicity is an important aspect of all biologics. Switching between biological products has triggered intensive discussion on the interchangeability of a biosimilar with its reference medicine, with the main focus being immunogenicity and different perspectives within Europe¹ and the United States.² Given that immunogenicity assay validation and performance characteristics differ from assay to assay, the immunogenicity assay parameters discussed here enable the interpretation of the immunogenicity results.

This article is protected by copyright. All rights reserved.

More about Molluscum pendulum/acrochordons in Tuberous Sclerosis Complex

Abstract

I thank Dr Baykal for his interest in our recent work about the clinical relevance of molluscum pendulum/acrochordons in patients with tuberous sclerosis complex (TSC) (1).He confirms and expands our own findings (2). He correctly insists that MP are not only located on the (posterior) neck, as was also the case in 2 of the 4 patients with TSC and MP that we reported. More widespread involvement, especially of the lateral and anterior aspect of the neck and the upper back, were frequent in the patients he reports.

This article is protected by copyright. All rights reserved.

A cross-sectional study of the perceptions about triggering factors in acne patients

Abstract

Acne is a common, inflammatory skin disease of the pilosebaceous unit.¹ Patients often have misconceptions about factors exacerbating acne that may influence their treatment seeking behavior. We conducted a cross-sectional study to investigate the perceptions of patients with acne about triggering factors, and how they may differ among adults and adolescents.

This article is protected by copyright. All rights reserved.

Effects of different soil remediation methods on inhibition of lead absorption and growth and quality of Dianthus superbus L.

Abstract

Heavy metal pollution in soil poses a serious threat to the growth of plants used in traditional Chinese medicine. Therefore, a pot experiment was conducted to study the effects of various soil remediation methods on the performance of Herba Dianthi (Dianthus superbus L.) grown on Pb-contaminated soil. The results show that inoculation of Herba Dianthi with arbuscular mycorrhizal fungi (AMF) led to a significant reduction in Pb uptake (P< 0.05), and increased root development and root-to-shoot ratio compared to untreated control plants, along with the highest content of active components. When planting with Trifolium repens, the reduction effect of Pb absorption was insignificant. Herba Dianthi showed improved growth and active ingredients, and the lowest Pb content, with AMF inoculation. The addition of EDTA decreased the growth of Herba Dianthi, but promoted the absorption of Pb. The inhibition of tumor cells was highest in E2. In conclusion, inoculation with AMF can ensure that plant lead content meets testing standards, helping to improve the quality of medicinal herbs.

Long-term laboratory culture causes contrasting shifts in tolerance to two marine pollutants in copepods of the genus Tigriopus

Abstract

Organismal chemical tolerance is often used to assess ecological risk and monitor water quality, yet tolerance can differ between field- and lab-raised organisms. In this study, we examined how tolerance to copper (Cu) and tributyltin oxide (TBTO) in two species of marine copepods, Tigriopus japonicus and T. californicus, changed across generations under benign laboratory culture (in the absence of pre-exposure to chemicals). Both copepod species exhibited similar chemical-specific changes in tolerance, with laboratory maintenance resulting in increased Cu tolerance and decreased TBTO tolerance. To assess potential factors underlying these patterns, chemical tolerance was measured in conjunction with candidate environmental variables (temperature, UV radiation, diet type, and starvation). The largest chemical-specific effect was found for starvation, which decreased TBTO tolerance but had no effect on Cu tolerance. Understanding how chemical-specific tolerance can change in the laboratory will be critical in strengthening bioassays and their applications for environmental protection and chemical management.

Forehead Lift Using Botulinum Toxin

Abstract

Background

The principle of dynamic muscular activity affecting eyebrow height and shape is well known. We postulate that similarly, dynamics of the fronto-galea-occipital muscles affect forehead height.

Objectives

To present a forehead lift technique using Botulinum toxin injection and evaluate its clinical efficacy and safety.

Methods

Twenty-nine female patients comprised the study group. Forty units of prepared abobutolinumtoxinA (Dysport, 10 U/0.05 mL) were injected into 4 points in the hair-bearing scalp, simulating the points of frontalis origin. The glabella and forehead regions were treated with 50 U each. Standard photographs and measurements were taken before and at 2 weeks following treatment. Forehead height was measured bilaterally drawing a vertical line from mid-pupil to frontal hairline (MPFH) and from medial canthus to frontal hairline (MCFH). We assessed outcome differences in patients with low vs high forehead (cutoff value 5.5 cm forehead height).

Results

Mean age was 48 years (range, 29-66 years). Two weeks following treatment, mean frontal height had increased significantly in all measurement points (MCFH right: 4.1 ± 1.8 mm, MCFH left 4.4 ± 1.8 mm, MPFH right 4.4 ± 2.0 mm, MPFH left 4.7 ± 2.3 mm; P <0.001). Low forehead subgroup achieved significantly higher forehead lift compared with high forehead subgroup both in MCFH (6.9% ± 2.0% vs 5.3% ± 2.2%, P = 0.043) and MPFH (8.6% ± 2.5% vs 5.7% ± 2.6%, P = 0.008). No adverse events were documented in any participant.

Conclusions

Botulinum toxin type A injection into frontalis origin can effectively and safely extend forehead height in selected patients. The effect of this technique is greater on patients with low foreheads.

Level of Evidence: 4

Clinical and dermoscopic characterization of pediatric and childhood melanomas. Multicenter study of 52 cases

Publication date: Available online 9 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Cristina Carrera, Alon Scope, Stephen W. Dusza, Giuseppe Argenziano, Gianluca Nazzaro, Alice Phan, Isabelle Tromme, Pietro Rubegni, Josep Malvehy, Susana Puig, Ashfaq A. Marghoob
BackgroundKnowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse and this may in part contribute to delay in detection and thicker tumors.Objectiveto analyze the clinical-dermoscopic characteristics of PM.Methodsretrospective study of 52 melanomas diagnosed before age of 20.ResultsBased on clinical, dermoscopic and histopathological characteristics, PM can be classified as Spitzoid and Non-Spitzoid Non-Spitzoid (37, 72.3%) melanomas presented at a mean age of 16.3 (8-20) and were associated with a high-risk phenotype and a preexisting nevus (62.2%). Spitzoid melanomas (15, 27.7%) were diagnosed at a mean age of 12.5 (2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). While less than 25% of PM fulfilled the modified clinical ABCD criteria, 40% of spitzoid melanomas did. Non-Spitzoid tended to be multicomponent (58.3%) or nevus-like patterns (25%). Dermoscopic melanoma criteria were found in all cases. Spitzoid melanomas revealed atypical vascular patterns with shiny-white lines (46.2%) or atypical pigmented spitzoid pattern (30.8%). There was good correlation between Spitzoid subtype histopathologically and dermoscopically (kappa 0.66).LimitationsRetrospective study without re-review of pathology.ConclusionDermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating Spitzoid from non-Spitzoid melanomas.

Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016

Publication date: Available online 9 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Kishore L. Jayakumar, Sara S. Samimi

The 'Y' technique: An attempt to standardize nail dressing

Publication date: Available online 9 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Karalikkattil T. Ashique, Chander Grover

The tenting technique: A novel filler technique in the danger zones

Publication date: Available online 10 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Adrian Pona, Martin N. Zaiac

Cost-effectiveness of nurse-delivered cognitive behavioural therapy (CBT) compared to supportive listening (SL) for adjustment to multiple sclerosis

Cognitive Behavioural Therapy (CBT) reduces distress in multiple sclerosis, and helps manage adjustment, but cost-effectiveness evidence is lacking.

Group Living and Male Dispersal Predict the Core Gut Microbiome in Wild Baboons

Synopsis

The mammalian gut microbiome plays a profound role in the physiology, metabolism, and overall health of its host. However, biologists have only a nascent understanding of the forces that drive inter-individual heterogeneity in gut microbial composition, especially the role of host social environment. Here we used 178 samples from 78 wild yellow baboons (Papio cynocephalus) living in two social groups to test how host social context, including group living, social interactions within groups, and transfer between social groups (e.g., dispersal) predict inter-individual variation in gut microbial alpha and beta diversity. We also tested whether social effects differed for prevalent "core" gut microbial taxa, which are thought to provide primary functions to hosts, versus rare "non-core" microbes, which may represent relatively transient environmental acquisitions. Confirming prior studies, we found that each social group harbored a distinct gut microbial community. These differences included both non-core and core gut microbial taxa, suggesting that these effects are not solely driven by recent gut microbial exposures. Within social groups, close grooming partners had more similar core microbiomes, but not non-core microbiomes, than individuals who rarely groomed each other, even controlling for kinship and diet similarity between grooming partners. Finally, in support of the idea that the gut microbiome can be altered by current social context, we found that the longer an immigrant male had lived in a given social group, the more closely his gut microbiome resembled the gut microbiomes of the group's long-term residents. Together, these results reveal the importance of a host's social context in shaping the gut microbiome and shed new light onto the microbiome-related consequences of male dispersal.

Neurobiology of Female Mate Choice in Frogs: Auditory Filtering and Valuation

Synopsis

Mate choice is a decision making process with profound implication for the reproductive success of both the sender and the chooser. Preferences for conspecific over heterospecific males and for some conspecifics over others are typically mediated by a female's response to signals produced by males. And although one can experimentally describe a female's preference function, there is relatively little understood about the neural mechanisms mediating these preferences. In anurans, mating preferences have often been explained in terms of sensory biases. Indeed, in the túngara frog (Physalaemus pustulosus), the auditory system appears to act as a filter for conspecific calls. However, auditory responses are not good predictors of intraspecific mating preferences in túngara frogs. Rather, neural activity in the preoptic area, which can be gated by estradiol, is a better predictor of mating preferences. A similar pattern holds in spadefoot toads (Spea bombifrons): the preoptic area, but not the auditory midbrain, integrates physiological cues in its response to mating calls in a pattern that predicts preferences. Neuroanatomically, the anuran preoptic area is poised to mediate forebrain influences on auditory response of the midbrain and it has descending projections to the medulla and spinal cord that could directly influence motor responses. Indeed, lesions of the preoptic area abolish phonotaxis. A role for the preoptic area in mating preferences is supported by studies in mammals that show the preoptic area is required for the expression of preferences. Further, activity of the preoptic area correlates with mating preference in fish. This leads to a model for the neurobiological mechanisms of mate choice, in which sensory systems filter relevant signals from irrelevant ones, but the preoptic area assigns value to the range of relevant signals.

Symposium Overview: Integrating Cognitive, Motivational, and Sensory Biases Underlying Acoustic- and Multimodal-Based Mate Choice

Synopsis

The goal of this symposium "Integrating Cognitive, Motivational and Sensory Biases Underlying Acoustic and Multimodal-Based Mate Choice" was to build a more complete framework in which to understand the mate choice brain. The presentations and papers within this symposium incorporate studies of motivational, cognitive, sensory and salience components of mate choice and highlight future directions that are needed to understand the biological basis of mate choice decision-making.

Neural Circuitry for Target Selection and Action Selection in Animal Behavior

Synopsis

Animal behaviorists have long strived for a comprehensive understanding of the proximate and ultimate causes of complex behavior, and we propose that recent advances in neurobiology can help reshape or clarify this behavior-oriented understanding. We begin with an overview of current views of neural circuit mechanisms that mediate target selection and action selection. In target selection, different stimuli compete for priority in sensory-motor processing. Action selection is the process by which multiple possible motor actions compete for priority in a manner which balances the needs of the animal with opportunities or threats in the environment. We next discuss spatial and temporal aspects of target and action selection, highlighting how neurophysiological responses to complex displays depend on spatial and temporal components of multisensory stimuli. We use two examples—(1) spatial attention as an example of target selection in the vertebrate midbrain and (2) goal-directed locomotion as an example of action selection in the insect central complex—to further clarify neural circuit dynamics as they relate to target and action selection, and their interaction. We suggest that a deeper understanding of neural circuit properties will introduce new hypotheses into behavioral studies, especially those aimed at understanding the evolution of complex displays based on receiver sensory biases. Additionally, knowledge of neural circuit properties can elucidate ways in which current context and previous experience can together modify neural circuit dynamics to produce complex context-dependent behavioral responses that often characterize animal behavior.

How Song Experience Affects Female Mate-Choice, Male Song, and Monoaminergic Activity in the Auditory Telencephalon in Lincoln's Sparrows

Synopsis

A sexual signal can indicate not only the signaler's attractiveness as a potential mate but also the signaler's competitiveness relative to rivals. As the attractiveness or competitiveness of the prevailing signaling environment increases, individuals prospecting for mates should change their choice threshold, whereas competing individuals should shift resources toward elevating their own competitiveness. Previous studies show that experimental elevations of song competition increase male competitive behavior in Lincoln's sparrows (Melospiza lincolnii) and European starlings (Sturnus vulgaris). Through a series of experimental manipulations using laboratory-housed Lincoln's sparrows, we have also discovered that females change the strength of their song preferences depending on the attractiveness of the song environment to which they have recently been exposed; compared to a less-attractive environment, a highly-attractive environment elevates the threshold for releasing phonotaxis behavior toward male song. These behavioral adjustments are associated with changes in forebrain monoaminergic activity that are triggered by experimental manipulations of the quality of the song environment. Findings from these studies suggest possible neural mechanisms for the regulation of adaptive behavioral plasticity associated with dynamic sexual signaling environments.

Understanding Female Receiver Psychology in Reproductive Contexts

Synopsis

Mate choice decision-making requires four components: sensory, cognitive, motivation, and salience. During the breeding season, the neural mechanisms underlying these components act in concert to radically transform the way a female perceives the social cues around her as well as the way in which cognitive and motivational processes influence her decision to respond to courting males. The role of each of these four components in mate choice responses will be discussed here as well as the brain regions involved in regulating each component. These components are not independent, modular systems. Instead, they are dependent on one another. This review will discuss the many ways in which these components interact and affect one another. The interaction of these components, however, ultimately leads back to a few key neuromodulators that thread motivation, sensory, salience, and cognitive components into a set of inter-dependent processes. These neuromodulators are estrogens and catecholamines. This review will highlight the need to understand estrogens in reproductive contexts not just as simply a 'sexual motivation modulator' or catecholamines as 'cognitive regulators' but as neuromodulators that work together to fully transform a non-breeding female into a completely reproductive female displaying: heightened sexual interest in courting males, greater arousal and selective attention toward courtship signals, improved signal detection and discrimination abilities, enhanced contextual signal memory, and increased motivation to respond to signals assigned incentive salience. The aim of this review is to build a foundation in which to understand the brain regions associated with cognitive, sensory, motivational, and signal salience not as independently acting systems but as a set of interacting processes that function together in a context-appropriate manner.

Associations Between Environmental Resources and the “Wanting” and “Liking” of Male Song in Female Songbirds

Synopsis

Reproductive success requires animals to adjust social and sexual behaviors in response to changes in environmental resources. In many species, males produce courtship signals to attract females; however, not all females are attracted by these signals. One possible explanation for this is that environmental resources alter neural mechanisms underlying motivation and reward in females so that male courtship is attractive when conditions are most favorable for an individual to breed. Here, we first introduce resource-dependent breeding behaviors of female songbirds. We then review studies that show associations between neural systems underlying motivation and reward, female responses to male courtship stimuli, and environmental resources necessary for breeding success (e.g., in female starlings, a nest cavity). Overall, we review evidence supporting the working hypotheses that (1) dopamine underlies sexually-motivated female responses to male courtship stimuli (i.e., song), (2) opioids underlie reward induced in females by hearing male courtship song, and (3) these systems are possibly modified by resources such that male courtship song is only attractive and rewarding to females with access to limited environmental resources essential for breeding success.

The Effects of Captivity on the Mammalian Gut Microbiome

Synopsis

Recent studies increasingly note the effect of captivity or the built environment on the microbiome of humans and other animals. As symbiotic microbes are essential to many aspects of biology (e.g., digestive and immune functions), it is important to understand how lifestyle differences can impact the microbiome, and, consequently, the health of hosts. Animals living in captivity experience a range of changes that may influence the gut bacteria, such as diet changes, treatments, and reduced contact with other individuals, species and variable environmental substrates that act as sources of bacterial diversity. Thus far, initial results from previous studies point to a pattern of decreased bacterial diversity in captive animals. However, these studies are relatively limited in the scope of species that have been examined. Here we present a dataset that includes paired wild and captive samples from mammalian taxa across six Orders to investigate generalizable patterns of the effects captivity on mammalian gut bacteria. In comparing the wild to the captive condition, our results indicate that alpha diversity of the gut bacteria remains consistent in some mammalian hosts (bovids, giraffes, anteaters, and aardvarks), declines in the captive condition in some hosts (canids, primates, and equids), and increases in the captive condition in one host taxon (rhinoceros). Differences in gut bacterial beta diversity between the captive and wild state were observed for most of the taxa surveyed, except the even-toed ungulates (bovids and giraffes). Additionally, beta diversity variation was also strongly influenced by host taxonomic group, diet type, and gut fermentation physiology. Bacterial taxa that demonstrated larger shifts in relative abundance between the captive and wild states included members of the Firmicutes and Bacteroidetes. Overall, the patterns that we observe will inform a range of disciplines from veterinary practice to captive breeding efforts for biological conservation. Furthermore, bacterial taxa that persist in the captive state provide unique insight into symbiotic relationships with the host.

To Become Senders, Songbirds Must be Receivers First

Synopsis

Courtship signals are attractive; in other words, receivers are motivated to approach courtship signals. Though the concept of a receiver is commonly associated in the literature with that of a mate seeker, young songbirds that are learning to sing by imitating conspecifics are also receivers. Juvenile songbirds are attracted to conspecific songs, which has been shown by juveniles working to hear song in operant chambers. The mechanisms explaining this attraction are poorly understood. Here, I review studies that hint at the mechanisms by which conspecific song becomes attractive. In at least some species, juveniles imitate individuals with which they have a strong social bond, such as the father. Such cases suggest that social reward plays a role in the process of song becoming attractive. In addition, experiments using birds reared in isolation from conspecific song have shown that juveniles imitate songs that have acoustic features that are typically found in conspecific song. Those studies suggest that such features are attractive to juveniles regardless of their social experience. The relative contributions of social reward and species-typical acoustic features to the attractiveness of a song can be determined using methods such as operant conditioning. For example, juvenile songbirds can be given control over the playback of songs that differ in a given attribute, such as acoustic similarity to the song of the father. The juveniles will frequently elicit playback of the songs that are attractive to them. Investigating the mechanisms that contribute to the attractiveness of conspecific song to learners will broaden our understanding of the evolution of song as a courtship signal, because the preferences of learners may ultimately determine what will be sung to potential mates.

Dramatic Differences in Gut Bacterial Densities Correlate with Diet and Habitat in Rainforest Ants

Synopsis

Abundance is a key parameter in microbial ecology, and important to estimates of potential metabolite flux, impacts of dispersal, and sensitivity of samples to technical biases such as laboratory contamination. However, modern amplicon-based sequencing techniques by themselves typically provide no information about the absolute abundance of microbes. Here, we use fluorescence microscopy and quantitative polymerase chain reaction as independent estimates of microbial abundance to test the hypothesis that microbial symbionts have enabled ants to dominate tropical rainforest canopies by facilitating herbivorous diets, and compare these methods to microbial diversity profiles from 16S rRNA amplicon sequencing. Through a systematic survey of ants from a lowland tropical forest, we show that the density of gut microbiota varies across several orders of magnitude among ant lineages, with median individuals from many genera only marginally above detection limits. Supporting the hypothesis that microbial symbiosis is important to dominance in the canopy, we find that the abundance of gut bacteria is positively correlated with stable isotope proxies of herbivory among canopy-dwelling ants, but not among ground-dwelling ants. Notably, these broad findings are much more evident in the quantitative data than in the 16S rRNA sequencing data. Our results provide quantitative context to the potential role of bacteria in facilitating the ants' dominance of the tropical rainforest canopy, and have broad implications for the interpretation of sequence-based surveys of microbial diversity.

Putting it in Context: Linking Auditory Processing with Social Behavior Circuits in the Vertebrate Brain

Synopsis

Context is critical to the adaptive value of communication. Sensory systems such as the auditory system represent an important juncture at which information on physiological state or social valence can be added to communicative information. However, the neural pathways that convey context to the auditory system are not well understood. The serotonergic system offers an excellent model to address these types of questions. Serotonin fluctuates in the mouse inferior colliculus (IC), an auditory midbrain region important for species-specific vocalizations, during specific social and non-social contexts. Furthermore, serotonin is an indicator of the valence of event-based changes within individual social interactions. We propose a model in which the brain's social behavior network serves as an afferent effector of the serotonergic dorsal raphe nucleus in order to gate contextual release of serotonin in the IC. Specifically, discrete vasopressinergic nuclei within the hypothalamus and extended amygdala that project to the dorsal raphe are functionally engaged during contexts in which serotonin fluctuates in the IC. Since serotonin strongly influences the responses of IC neurons to social vocalizations, this pathway could serve as a feedback loop whereby integrative social centers modulate their own sources of input. The end result of this feedback would be to produce a process that is geared, from sensory input to motor output, toward responding appropriately to a dynamic external world.

Manipulation of Gut Microbiota Reveals Shifting Community Structure Shaped by Host Developmental Windows in Amphibian Larvae

Synopsis

Exploration of the importance of developmental windows for microbial colonization in diverse animal taxa, and tests of how these shape both animal microbiomes as well as host phenotypes promise to shed needed light on host-microbe interactions. The aims of this study were to explore how gut microbiota diversity of larval amphibians varies among species and across ontogeny, and to test if manipulation of gut colonization can reveal how microbiomes develop. We found that gut microbiomes differ among species and change across larval ontogeny, with distinctive differences between larvae, metamorphic animals, and juvenile frogs. Through applying a gnotobiotic protocol to eggs and cross-inoculating gut microbiomes between species, we demonstrated that microbiota can be transplanted among species and developmental stages. These results also demonstrated that microbial colonization at hatching is potentially formative for long term composition and function of amphibian gut microbiomes, suggesting that hatching may be a critical developmental window for colonization, similar to the effects of birth mode on human microbiomes. Specifically, our results suggest that either the egg jelly and/or capsules surrounding amphibian eggs are likely important sources for initial microbiome inoculation. Furthermore, we speculate these results suggest that vertical transmission may be important to amphibian microbiome establishment and development, as is common among many animal taxa. Taken together, our results suggest that explicit tests of how host developmental windows influence microbial colonization, and shape amphibian microbiomes across life stages promise to provide insight into the ecological and evolutionary dynamics of host-microbe interactions.

With a Little Help from My Friends: Microbial Partners in Integrative and Comparative Biology—An Introduction to the Symposium

Synopsis

The role that host-associated microbes play in animal biology is gaining attention in comparative biology. Numerous research groups study the roles that microbes play in human health and nutrition, or in enhancing the production of agricultural animals. However, inclusion of host-associated microbes into research questions of integrative and comparative biology has lagged behind. We hosted a symposium to bring together top researchers in the field of host-associated microbes who also incorporate aspects of integrative and comparative biology. In this introduction, we highlight recent research demonstrating the profound roles that host-associated microbes play in many aspects of animal biology, such as immune function, endocrinology, and even behavior. It is our hope that integrative and comparative biologists will begin to include aspects of host-associated microbes into their research programs, enhancing both the fields of comparative biology and host–microbe interactions.

An Introductory “How-to” Guide for Incorporating Microbiome Research into Integrative and Comparative Biology

Synopsis

Research on host-associated microbial communities has grown rapidly. Despite the great body of work, inclusion of microbiota-related questions into integrative and comparative biology is still lagging behind other disciplines. The purpose of this paper is to offer an introduction into the basic tools and techniques of host-microbe research. Specifically, what considerations should be made before embarking on such projects (types of samples, types of controls)? How is microbiome data analyzed and integrated with data measured from the hosts? How can researchers experimentally manipulate the microbiome? With this information, integrative and comparative biologists should be able to include host-microbe studies into their research and push the boundaries of both fields.

Links between Natural Variation in the Microbiome and Host Fitness in Wild Mammals

Synopsis

Recent studies in model organisms have shown that compositional variation in the microbiome can affect a variety of host phenotypes including those related to digestion, development, immunity, and behavior. Natural variation in the microbiome within and between natural populations and species may also affect host phenotypes and thus fitness in the wild. Here, I review recent evidence that compositional variation in the microbiome may affect host phenotypes and fitness in wild mammals. Studies over the last decade indicate that natural variation in the mammalian microbiome may be important in the assistance of energy uptake from different diet types, detoxification of plant secondary compounds, protection from pathogens, chemical communication, and behavior. I discuss the importance of combining both field observations and manipulative experiments in a single system to fully characterize the functions and fitness effects of the microbiome. Finally, I discuss the evolutionary consequences of mammal–microbiome associations by proposing a framework to test how natural selection on hosts is mediated by the microbiome.

Attention and Motivated Response to Simulated Male Advertisement Call Activates Forebrain Dopaminergic and Social Decision-Making Network Nuclei in Female Midshipman Fish

Synopsis

Little is known regarding the coordination of audition with decision-making and subsequent motor responses that initiate social behavior including mate localization during courtship. Using the midshipman fish model, we tested the hypothesis that the time spent by females attending and responding to the advertisement call is correlated with the activation of a specific subset of catecholaminergic (CA) and social decision-making network (SDM) nuclei underlying auditory- driven sexual motivation. In addition, we quantified the relationship of neural activation between CA and SDM nuclei in all responders with the goal of providing a map of functional connectivity of the circuitry underlying a motivated state responsive to acoustic cues during mate localization. In order to make a baseline qualitative comparison of this functional brain map to unmotivated females, we made a similar correlative comparison of brain activation in females who were unresponsive to the advertisement call playback. Our results support an important role for dopaminergic neurons in the periventricular posterior tuberculum and ventral thalamus, putative A11 and A13 tetrapod homologues, respectively, as well as the posterior parvocellular preoptic area and dorsomedial telencephalon, (laterobasal amygdala homologue) in auditory attention and appetitive sexual behavior in fishes. These findings may also offer insights into the function of these highly conserved nuclei in the context of auditory-driven reproductive social behavior across vertebrates.

Social Cognition and the Neurobiology of Rodent Mate Choice

Synopsis

Various aspects of sociality, including mate choice, are dependent on social information. Mate choice is a social cognitive process that encompasses mechanisms for acquiring, processing, retaining and acting on social information. Social cognition includes the acquisition of social information about others (i.e., social recognition) and social information from others (i.e., social learning). Social cognition involves both assessing other individuals and their condition (e.g., health, infection status) and deciding about when and how to interact with them, thus, providing a frame-work for examining mate choice and its associated neurobiological mechanisms. In vertebrates, and in particular rodents, odors are an essential source of direct and indirect social information not only from others but also for others. Here, we briefly consider the relations between social cognition and olfactory-mediated mate choice in rodents. We briefly discuss aspects of: (1) social recognition of potential mates and the impact of infection threat on mate choice; (2) social learning and the utilization of the mate choices of others ("mate-choice copying") including in the context of infection; and (3) the neurobiological mechanisms, with particular focus on particular the roles of the nonapeptide, oxytocin and the steroid hormones, estrogens, associated with social cognition and mate choice.

Pairing Increases Activation of V1aR, but not OTR, in Auditory Regions of Zebra Finches: The Importance of Signal Modality in Nonapeptide-Social Behavior Relationships

Synopsis

Social relationships are complex, involving the production and comprehension of signals, individual recognition, and close coordination of behavior between two or more individuals. The nonapeptides oxytocin and vasopressin are widely believed to regulate social relationships. These findings come largely from prairie voles, in which nonapeptide receptors in olfactory neural circuits drive pair bonding. This research is assumed to apply to all species. Previous reviews have offered two competing hypotheses. The work of Sarah Newman has implicated a common neural network across species, the Social Behavior Network. In contrast, others have suggested that there are signal modality-specific networks that regulate social behavior. Our research focuses on evaluating these two competing hypotheses in the zebra finch, a species that relies heavily on vocal/auditory signals for communication, specifically the neural circuits underlying singing in males and song perception in females. We have demonstrated that the quality of vocal interactions is highly important for the formation of long-term monogamous bonds in zebra finches. Qualitative evidence at first suggests that nonapeptide receptor distributions are very different between monogamous rodents (olfactory species) and monogamous birds (vocal/auditory species). However, we have demonstrated that social bonding behaviors are not only correlated with activation of nonapeptide receptors in vocal and auditory circuits, but also involve regions of the common Social Behavior Network. Here, we show increased Vasopressin 1a receptor, but not oxytocin receptor, activation in two auditory regions following formation of a pair bond. To our knowledge, this is the first study to suggest a role of nonapeptides in the auditory circuit in pair bonding. Thus, we highlight converging mechanisms of social relationships and also point to the importance of studying multiple species to understand mechanisms of behavior.

Beyond Fermentation: Other Important Services Provided to Endothermic Herbivores by their Gut Microbiota

Synopsis

For decades, comparative biologists have recognized the importance of microbial partners in facilitating herbivory as a successful feeding strategy. Most of this success is attributed to the ability of gut microbes to digest recalcitrant dietary fiber and provides usable nutrients to their hosts. Gut microbes can also provide numerous other functions, such as vitamin synthesis, nitrogen recycling, and the detoxification of plant secondary compounds. Here, we review these microbial functions in herbivorous mammals and birds, highlighting studies that utilize recently developed metagenomic techniques. Several of these studies emphasize that microbial services are the product of interactions and exchanges within a complex microbial community, rather than the product of an individual member. Additionally, a number of these microbial functions are interdependent. For example, levels of dietary nitrogen or plant toxins can influence fiber digestibility. Further studies into the variety of microbial services provided to herbivorous hosts, and how these services might interact will broaden our understanding of host–microbe interactions.

Virtuelle Welt in der Mund‑, Kiefer- und Gesichtschirurgie

Characteristics of the Metabolic Syndrome in the Patients of IBERICAN Study (Identification of the Spanish Population at Cardiovascular and Renal Risk)

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.

An exploratory, prospective, open-label trial of ingenol mebutate gel 0.05% for the treatment of external anogenital warts

Abstract

Background

Anogenital warts (AGW) can cause physical discomfort and decreased quality of life. Recent case reports suggest that ingenol mebutate gel might be an effective treatment of AGW.

Objective

To explore primarily the safety, and secondarily the efficacy of ingenol mebutate gel 0.05% in patients with AGW.

Methods

This was an exploratory, open-label, 1-arm trial of ingenol mebutate gel 0.05% administered up to 3 times to patients with AGW. Safety was assessed by occurrence and severity of local skin reactions (LSRs) and treatment-related adverse events (AEs). Efficacy was assessed by complete clearance and reduction in AGW count 14 days after last treatment, and recurrence 12 weeks after clearance.

Results

Of 41 patients enrolled, 40 received treatment and 26 completed the trial. Patients had a median AGW count of 11.0 and AGW duration of 3.0 years at baseline. All patients experienced transient LSRs following treatment with a maximum composite LSR score of 7.5 (on a scale from 0–18). 93% of patients reported treatment-related AEs, most frequently pain (85%) and procedural complications (35%) due to smearing of the gel. 78% of patients took mild analgesics for the pain, typically for 1-2 days following treatment. The majority of AEs were of moderate to severe intensity.

17/39 patients (43.6%) had complete clearance 14 days after last treatment, and AGW count was reduced by 90.9%. There was a tendency towards lower clearance rate in patients with longer duration of AGW. 14/8 patients (57.1%) had AGW recurrence 12 weeks after clearance.

Conclusion

Ingenol mebutate gel was associated with a high number of AEs and withdrawals due to painful local and adjacent skin reactions. Furthermore, it showed promising efficacy in reducing AGW despite a difficult-to-treat population. Optimisation of the formulation is warranted to improve the safety profile of the treatment.

This article is protected by copyright. All rights reserved.

Time required for a standard sunscreen to become effective following application: a UV photography study

Abstract

Sunscreens are recommended that it should be applied generously (2 mg cm⁻²) half an hour before exposure and reapplied every 2 hours^1,2. It is not, however, always easy to apply in normal life (e.g., children doing outdoor activities at school or beachgoers who have to travel some distance to get to the sea) and in addition, sunscreen can be rubbed off or displaced by friction from clothing during the wait time and lose efficacy.The aim of this study was to determine the time needed for a sunscreen to offer optimal protection from the moment of application.

This article is protected by copyright. All rights reserved.

Role of sulfate, chloride, and nitrate anions on the degradation of fluoroquinolone antibiotics by photoelectro-Fenton

Abstract

Taking ciprofloxacin (CIP) as a fluoroquinolone antibiotic model, this work explores the role of common anions (sulfate, nitrate, and chloride) during the application of photoelectro-Fenton (PEF) at natural pH to degrade this type of compound in water. The system was composed of an IrO₂ anode, Ti, or gas diffusion electrode (GDE) as cathode, Fe²⁺, and UV (254 nm). To determine the implications of these anions, the degradation pathway and efficiency of the PEF sub-processes (UV photolysis, anodic oxidation, and electro-Fenton at natural pH) were studied in the individual presence of the anions. The results highlight that degradation routes and kinetics are strongly dependent on electrolytes. When chloride and nitrate ions were present, indirect electro-chemical oxidation was identified by electro-generated HOCl and nitrogenated oxidative species, respectively. Additionally, direct photolysis and direct oxidation at the anode surface were identified as degradation routes. As a consequence of the different pathways, six primary CIP by-products were identified. Therefore, a scheme was proposed representing the pathways involved in the degradation of CIP when submitted to PEF in water with chloride, nitrate, and sulfate ions, showing the complexity of this process. Promoted by individual and synergistic actions of this process, the PEF system leads to a complete elimination of CIP with total removal of antibiotic activity against Staphylococcus aureus and Escherichia coli, and significant mineralization. Finally, the role of the anions was tested in seawater containing CIP, in which the positive contributions of the anions were partially suppressed by its OH radical scavenger action. The findings are of interest for the understanding of the degradation of antibiotics via the PEF process in different matrices containing sulfate, nitrate, and chloride ions.

An evaluation of patient experience during percutaneous breast biopsy

Abstract

Objective

Percutaneous breast biopsy in a tertiary referral high volume breast centre: can we improve the patient experience?

Purpose

The study was performed to evaluate patient experience during ultrasound-guided (UGB) and vacuum-assisted stereotactic breast biopsy (SBB) and determine what factors could improve the patient experience.

Methods

Consecutive patients who underwent image guided breast biopsy from 01- 05/30, 2015 were approached in a structured telephone interview to evaluate pain and bruising from the procedure. Three hundred and fifty-one patients were interviewed (116 SBB and 235 UGB). Information about the radiologist performing the biopsy, biopsy type, needle gauge, and number of cores was collected from the biopsy reports. Correlation was done using Spearman rank test.

Results

Average patient scores of pain with UGB and SBB were 2.3 and 3.1 (out of 10). There was a significant correlation between pain during SBB and physician experience (p = 0.013), and no correlation with pain during UGB (p > 0.05). No correlation was found between needle gauge and pain experienced during breast biopsy or between numbers of cores and pain (p > 0.05). Body position during SBB was mentioned to cause discomfort and pain in 28% of patients while during UGB was mentioned by 0.4% of patients.

Conclusion

SBB was inferior to UGB for patient experience, but years of radiologists' experience correlated with improved patient scores of pain for SBB.

Key Points

• To achieve high quality, an institution must emphasise patient-centred care.

• Increased radiologist training with stereotactic biopsy may contribute to improved patient experience.

• Stereotactic breast biopsy was inferior to ultrasound biopsy for patient experience.

• Radiologists' experience correlated with improved patient scores of pain for stereotactic biopsy.

Applying protein-based amide proton transfer MR imaging to distinguish solitary brain metastases from glioblastoma

Abstract

Objectives

To determine the utility of amide proton transfer-weighted (APTw) MR imaging in distinguishing solitary brain metastases (SBMs) from glioblastomas (GBMs).

Methods

Forty-five patients with SBMs and 43 patients with GBMs underwent conventional and APT-weighted sequences before clinical intervention. The APTw parameters and relative APTw (rAPTw) parameters in the tumour core and the peritumoral brain zone (PBZ) were obtained and compared between SBMs and GBMs. The receiver-operating characteristic (ROC) curve was used to assess the best parameter for distinguishing between the two groups.

Results

The APTw_max, APTw_min, APTw_mean, rAPTw_max, rAPTw_min or rAPTw_mean values in the tumour core were not significantly different between the SBM and GBM groups (P = 0.141, 0.361, 0.221, 0.305, 0.578 and 0.448, respectively). However, the APTw_max, APTw_min, APTw_mean, rAPTw_max, rAPTw_min or rAPTw_mean values in the PBZ were significantly lower in the SBM group than in the GBM group (P < 0.001). The APTw_min values had the highest area under the ROC curve 0.905 and accuracy 85.2% in discriminating between the two neoplasms.

Conclusion

As a noninvasive imaging method, APT-weighted MR imaging can be used to distinguish SBMs from GBMs.

Key Points

• APTw values in the tumour core were not different between SBMs and GBMs.

• APTw values in peritumoral brain zone were lower in SBMs than in GBMs.

• The APTw _minwas the best parameter to distinguish SBMs from GBMs.

Cardiovascular magnetic resonance myocardial T1 mapping to detect and quantify cardiac involvement in familial amyloid polyneuropathy

Abstract

Objectives

This study sought to explore the potential role of non-contrast T1 mapping for the detection and quantification of cardiac involvement in familial amyloid polyneuropathy (FAP).

Methods

Japanese patients with FAP [n = 41, age 53.2 ± 13.9 years, genotype Val30Met (n = 25), non-Val30Met (n = 16)] underwent cardiac magnetic resonance imaging that included T1 mapping (saturation-recovery method) and late gadolinium-enhanced (LGE) imaging on a 3.0-T MR scanner. Their native T1 was measured on mid-ventricular short-axis images and compared with 30 controls.

Results

Of the 41 FAP patients 29 were LGE positive. The native T1 was significantly higher in FAP patients than in the controls (1,634.1 ± 126.3 ms vs. 1,432.4 ± 69.0 ms, p < 0.01), significantly higher in LGE-positive- than LGE-negative FAP patients (1,687.1 ± 104.4 ms vs. 1,505.4 ± 68.5 ms, p < 0.01), and significantly higher in LGE-negative FAP patients than the controls (p < 0.01). A native T1 cutoff value of 1,610 ms yielded 85.4% accuracy for identifying LGE-positive FAP. The native T1 significantly correlated with the interventricular septum wall thickness, the left ventricular mass, the LGE volume, the plasma B-type natriuretic peptide level, and the E/e' ratio (all p < 0.01).

Conclusion

T1 mapping is of high diagnostic accuracy for the detection of LGE-positive FAP. The native myocardial T1 may be correlated with the severity of cardiac amyloid deposition.

Key points

• The native T1 was higher in FAP patients than the controls.

• The native T1 was higher in LGE-positive- than LGE-negative FAP patients.

• The native T1 was higher in LGE-negative FAP patients than the controls.

• The native T1 correlated with clinical markers of systolic and diastolic dysfunction.

• Myocardial T1 mapping is of high diagnostic accuracy for detecting LGE-positive FAP.

Influence of acquired obesity on coronary vessel wall late gadolinium enhancement in discordant monozygote twins

Abstract

Objectives

The aim of this study was to investigate the impact of BMI on late gadolinium enhancement (LGE) of the coronary artery wall in identical monozygous twins discordant for BMI. Coronary LGE represents a useful parameter for the detection and quantification of atherosclerotic coronary vessel wall disease.

Methods

Thirteen monozygote female twin pairs (n = 26) with significantly different BMIs (>1.6 kg/m2) were recruited out of >10,000 twin pairs (TwinsUK Registry). A coronary 3D-T2prep-TFE MR angiogram and 3D-IR-TFE vessel wall scan were performed prior to and following the administration of 0.2 mmol/kg of Gd-DTPA on a 1.5 T MR scanner. The number of enhancing coronary segments and contrast to noise ratios (CNRs) of the coronary wall were quantified.

Results

An increase in BMI was associated with an increased number of enhancing coronary segments (5.3 ± 1.5 vs. 3.5 ± 1.6, p < 0.0001) and increased coronary wall enhancement (6.1 ± 1.1 vs. 4.8 ± 0.9, p = 0.0027) compared to matched twins with lower BMI.

Conclusions

This study in monozygous twins indicates that acquired factors predisposing to obesity, including lifestyle and environmental factors, result in increased LGE of the coronary arteries, potentially reflecting an increase in coronary atherosclerosis in this female study population.

Key points

• BMI-discordant twins allow the investigation of the influence of lifestyle factors independent from genetic confounders.

• Only thirteen obesity-discordant twins were identified underlining the strong genetic component of BMI.

• In female twins, a BMI increase is associated with increased coronary late gadolinium enhancement.

• Increased late gadolinium enhancement in the coronary vessel wall potentially reflects increased atherosclerosis.

Comparison of polyvinyl alcohol copolymer with detachable balloons for the embolisation of direct carotid cavernous fistula: a single-centre experience

Abstract

Objectives

To characterise the safety, efficacy and cost of direct carotid-cavernous fistula (CCF) treatment using polyvinyl alcohol copolymer or detachable balloons.

Methods

We reviewed retrospectively patients with direct CCFs treated with either a detachable balloon or polyvinyl alcohol copolymer at our hospital from 2005 to 2015 and identified 94 patients with 105 CCFs. All patients had follow-up angiograms. The CCF occlusion rate, procedure complication rate, treatment expense and operation time were recorded.

Results

With a mean of 5.4 months of angiographic follow-up, the complete occlusion rate and recanalisation rate of the polyvinyl alcohol copolymer group was not significantly different from that of the detachable balloon group. The treatment expense was much higher and the operation time was much longer in the polyvinyl alcohol copolymer group than the detachable balloon group (P < 0.001).

Conclusions

Embolisation of CCF with polyvinyl alcohol copolymer is as safe and effective as detachable balloon but has a much higher cost and longer operation time.

Key Points

• Carotid-cavernous fistula results from a damaged carotid artery.

• Detachable balloons have been used with success for many years.

• Some reported excellent outcomes after embolisation with polyvinyl alcohol copolymer.

• Treatment expense is much higher in the polyvinyl alcohol copolymer group.