Cutaneous non-tuberculous mycobacteria in Western Sydney, Australia. Population study 1996–2013

The association between multiple pilomatrixomas and APC gene mutations

Melanoma of the Sinonasal Tract: Value of a Septate Pattern on Precontrast T1-Weighted MR Imaging [HEAD & NECK]

BACKGROUND AND PURPOSE:

Various tumors of the sinonasal tract can exhibit high signal intensity on T1WI. The purpose of this study was to determine the value of a septate pattern on precontrast T1WI for diagnosing sinonasal melanoma.

MATERIALS AND METHODS:

Retrospectively, 3 observers independently reviewed MR images of 31 histologically proved sinonasal melanomas with special attention to the presence or absence of a septate pattern on precontrast T1WI, defined as alternating hyperintense and hypointense striations on precontrast T1WI. For comparison, we evaluated the prevalence of a septate pattern on precontrast T1WI in 106 nonmelanomatous sinonasal malignant tumors with 16 different histologic types. We also tried to identify the histopathologic features responsible for the septate pattern on precontrast T1WI.

RESULTS:

Twenty-seven (87.1%) of 31 sinonasal melanomas showed hyperintense foci on T1WI, among which a septate pattern on precontrast T1WI was seen in 23 (74.2%), while 22 (20.8%) of 106 nonmelanomatous malignant tumors demonstrated hyperintense foci on T1WI, among which only 3 (2.8%) showed a septate pattern on precontrast T1WI. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of a septate pattern on precontrast T1WI for the diagnosis of sinonasal melanoma were 74%, 97%, 88%, 93%, and 92%, respectively. Although limited due to the retrospective nature, 4 of 23 histologically reviewed sinonasal melanomas revealed an uneven distribution of melanin with alternating melanin and fibrous bands within the tumors.

CONCLUSIONS:

A septate pattern on precontrast T1WI might be an adjunctive imaging finding for the diagnosis of sinonasal melanoma. This might be attributed histologically to an uneven distribution of melanin and hemorrhage within the tumors.

Nonsphericity Index and Size Ratio Identify Morphologic Differences between Growing and Stable Aneurysms in a Longitudinal Study of 93 Cases [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Recent studies have strongly associated intracranial aneurysm growth with increased risk of rupture. Identifying aneurysms that are likely to grow would be beneficial to plan more effective monitoring and intervention strategies. Our hypothesis is that for unruptured intracranial aneurysms of similar size, morphologic characteristics differ between aneurysms that continue to grow and those that do not.

MATERIALS AND METHODS:

From aneurysms in our medical center with follow-up imaging dates in 2015, ninety-three intracranial aneurysms (23 growing, 70 stable) were selected. All CTA images for the aneurysm diagnosis and follow-up were collected, a total of 348 3D imaging studies. Aneurysm 3D geometry for each imaging study was reconstructed, and morphologic characteristics, including volume, surface area, nonsphericity index, aspect ratio, and size ratio were calculated.

RESULTS:

Morphologic characteristics were found to differ between growing and stable groups. For aneurysms of <3 mm, nonsphericity index (P < .001); 3–5 mm, nonsphericity index (P < .001); 5–7 mm, size ratio (P = .003); >7 mm, volume (P < .001); surface area (P < .001); and nonsphericity index (P = .002) were significant. Within the anterior communicating artery, the nonsphericity index (P = .008) and, within the posterior communicating artery, size ratio (P = .004) were significant. The nonsphericity index receiver operating characteristic area under the curve was 0.721 for discriminating growing and stable cases on the basis of initial images.

CONCLUSIONS:

Among aneurysms with similar sizes, morphologic characteristics appear to differ between those that are growing and those that are stable. The nonsphericity index, in particular, was found to be higher among growing aneurysms. The size ratio was found to be the second most significant parameter associated with growth.

Early Hemodynamic Response Assessment of Stereotactic Radiosurgery for a Cerebral Arteriovenous Malformation Using 4D Flow MRI [INTERVENTIONAL]

SUMMARY:

Brain AVMs treated with stereotactic radiosurgery typically demonstrate a minimum latency period of 1–3 years between treatment and nidus obliteration. Assessment of treatment response is usually limited to evaluation of AVM nidus structural changes using conventional MR imaging and MRA techniques. This report describes the use of 4D Flow MRI to also measure radiation-induced hemodynamic changes in a Spetzler-Martin grade III AVM, which were detectable as early as 6 months after treatment.

Quantitative Susceptibility Mapping of the Thalamus: Relationships with Thalamic Volume, Total Gray Matter Volume, and T2 Lesion Burden [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Both thalamic iron deposition and atrophy have been reported in patients with multiple sclerosis compared with healthy controls, but how they are related is unclear. The purpose of this study was to understand the pathophysiologic basis for this iron deposition.

MATERIALS AND METHODS:

Ninety-five patients with relapsing-remitting multiple sclerosis underwent 3T MR imaging with a standardized protocol that included quantitative susceptibility mapping to measure iron concentration and a 3D T1 echo-spoiled gradient-echo sequence to obtain thalamic volumes. Volumes of interest were manually delineated on the quantitative susceptibility map to encompass both thalami. Multivariate regression analyses were performed to identify the association between thalamic susceptibility and volume. Associations between thalamic susceptibility and total gray matter volume, cortical thickness, and T2 lesion volume were also assessed.

RESULTS:

The relative susceptibility of the thalamus was associated with T2 lesion volume (P = .015) and was higher in the presence of enhancing lesions (P = .013). The relative susceptibility of the thalami was not associated with thalamic volumes, total gray matter volumes, or cortical thickness (P > .05).

CONCLUSIONS:

Iron levels in the thalami are associated with T2 lesion burden and the presence of enhancing lesions, but not with thalamic or gray matter volumes, suggesting that iron accumulation is associated with white matter inflammation rather than gray matter neurodegeneration.

Comparison of MR Imaging and Dual-Energy CT for the Evaluation of Cartilage Invasion by Laryngeal and Hypopharyngeal Squamous Cell Carcinoma [HEAD & NECK]

BACKGROUND AND PURPOSE:

Dual-energy CT can distinguish iodine-enhanced tumors from nonossified cartilage and has been investigated for evaluating cartilage invasion in patients with laryngeal and hypopharyngeal squamous cell carcinomas. In this study, we compared the diagnostic accuracy of MR imaging and of a combination of weighted-average and iodine overlay dual-energy CT images in detecting cartilage invasion by laryngeal and hypopharyngeal squamous cell carcinomas, in particular thyroid cartilage invasion.

MATERIALS AND METHODS:

Fifty-five consecutive patients who underwent 3T MR imaging and 128-slice dual-energy CT for preoperative initial staging of laryngeal or hypopharyngeal squamous cell carcinomas were included. Two blinded observers evaluated laryngeal cartilage invasion on MR imaging and dual-energy CT using a combination of weighted-average and iodine-overlay images. Pathologic findings of surgically resected specimens were used as the reference standard for evaluating sensitivity, specificity, and the areas under the receiver operating characteristic curve of both modalities for cartilage invasion by each type of cartilage and for all cartilages together. Sensitivity and specificity were compared using the McNemar test and generalized linear mixed models.

RESULTS:

Dual-energy CT showed higher specificity than MR imaging for diagnosing all cartilage together (84% for MR imaging versus 98% for dual-energy CT, P < .004) and for thyroid cartilage (64% versus 100%, P < .001), with a similar average area under the curve (0.94 versus 0.95, P = .70). The sensitivity did not differ significantly for all cartilages together (97% versus 81%, P = .16) and for thyroid cartilage (100% versus 89%, P = .50), though there was a trend toward increased sensitivity with MR imaging.

CONCLUSIONS:

Dual-energy CT showed higher specificity and acceptable sensitivity in diagnosing laryngeal cartilage invasion compared with MR imaging.

Local Glioma Cells Are Associated with Vascular Dysregulation [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Malignant glioma is a highly infiltrative malignancy that causes variable disruptions to the structure and function of the cerebrovasculature. While many of these structural disruptions have known correlative histopathologic alterations, the mechanisms underlying vascular dysfunction identified by resting-state blood oxygen level–dependent imaging are not yet known. The purpose of this study was to characterize the alterations that correlate with a blood oxygen level–dependent biomarker of vascular dysregulation.

Materials and Methods:

Thirty-two stereotactically localized biopsies were obtained from contrast-enhancing (n = 16) and nonenhancing (n = 16) regions during open surgical resection of malignant glioma in 17 patients. Preoperative resting-state blood oxygen level–dependent fMRI was used to evaluate the relationships between radiographic and histopathologic characteristics. Signal intensity for a blood oxygen level–dependent biomarker was compared with scores of tumor infiltration and microvascular proliferation as well as total cell and neuronal density.

Results:

Biopsies corresponded to a range of blood oxygen level–dependent signals, ranging from relatively normal (z = –4.79) to markedly abnormal (z = 8.84). Total cell density was directly related to blood oxygen level–dependent signal abnormality (P = .013, R² = 0.19), while the neuronal labeling index was inversely related to blood oxygen level–dependent signal abnormality (P = .016, R² = 0.21). The blood oxygen level–dependent signal abnormality was also related to tumor infiltration (P = .014) and microvascular proliferation (P = .045).

Conclusions:

The relationship between local, neoplastic characteristics and a blood oxygen level–dependent biomarker of vascular function suggests that local effects of glioma cell infiltration contribute to vascular dysregulation.

Comparison of Blood Oxygenation Level-Dependent fMRI and Provocative DSC Perfusion MR Imaging for Monitoring Cerebrovascular Reserve in Intracranial Chronic Cerebrovascular Disease [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Loss of hemodynamic reserve in intracranial cerebrovascular disease reduces blood oxygenation level–dependent activation by fMRI and increases asymmetry in MTT measured by provocative DSC perfusion MR imaging before and after vasodilation with intravenous acetazolamide. The concordance for detecting hemodynamic reserve integrity has been compared.

MATERIALS AND METHODS:

Patients (n = 40) with intracranial cerebrovascular disease and technically adequate DSA, fMRI and provocative DSC perfusion studies were retrospectively grouped into single vessels proximal to and distal from the circle of Willis, multiple vessels, and Moyamoya disease. The vascular territories were classified as having compromised hemodynamic reserve if the expected fMRI blood oxygenation level–dependent activation was absent or if MTT showed increased asymmetry following vasodilation. Concordance was examined in compromised and uncompromised vascular territories of each group with the Fischer exact test and proportions of agreement.

RESULTS:

Extensive leptomeningeal collateral circulation was present in all cases. Decreased concordance between the methods was found in vascular territories with stenosis distal to but not proximal to the circle of Willis. Multivessel and Moyamoya diseases also showed low concordance. A model of multiple temporally displaced arterial inputs from leptomeningeal collateral flow demonstrated that the resultant lengthening MTT mimicked compromised hemodynamic reserve despite being sufficient to support blood oxygenation level–dependent contrast.

CONCLUSIONS:

Decreased concordance between the 2 methods for assessment of hemodynamic reserve for vascular disease distal to the circle of Willis is posited to be due to well-developed leptomeningeal collateral circulation providing multiple temporally displaced arterial input functions that bias the perfusion analysis toward hemodynamic reserve compromise while blood oxygenation level–dependent activation remains detectable.

Looking Deep into the Eye-of-the-Tiger in Pantothenate Kinase-Associated Neurodegeneration [PEDIATRICS]

BACKGROUND AND PURPOSE:

A detailed delineation of the MR imaging changes in the globus pallidus in pantothenate kinase–associated neurodegeneration will be helpful for diagnosis and monitoring of patients. The aim of this study was to determine the morphologic spectrum of the "eye-of-the-tiger" sign and the topographic pattern of iron deposition in a group of patients with pantothenate kinase–associated neurodegeneration.

MATERIALS AND METHODS:

Seventy-four MR imaging scans from 54 individuals with PANK2 mutations were analyzed for signal patterns in the globus pallidus. Sixteen SWI data from 15 patients who underwent 1.5T (n = 7), 3T (n = 7), and 7T (n = 2) MR imaging were included to visualize the iron topography.

RESULTS:

The linear hyperintensity alongside the medial border of the globus pallidus was the earliest T2 signal change. This finding was evident before SWI changes from iron deposition became visible. T2WI performed in early childhood mostly showed isolated hyperintense signal. In adult patients, marked signal reduction within an earlier hyperintense center resulting from iron accumulation led to the loss of signal difference between the central and surrounding areas. Signal hypointensity on SWI progressed from the medial to the lateral portion of the globus pallidus with increasing age. The fiber connections between the medial globus pallidus and the anteromedial aspect of the substantia nigra and subthalamic nucleus were markedly hypointense on SWI.

CONCLUSIONS:

In pantothenate kinase–associated neurodegeneration, the globus pallidus MR imaging changes using SWI develop as region-specific and age-dependent phenomena. Signal inhomogeneity was observed across the globus pallidus in pantothenate kinase–associated neurodegeneration and should be considered when determining the concentration of iron.

Intravoxel Incoherent Motion MR Imaging in the Differentiation of Benign and Malignant Sinonasal Lesions: Comparison with Conventional Diffusion-Weighted MR Imaging [HEAD & NECK]

BACKGROUND AND PURPOSE:

Intravoxel incoherent motion is a promising method for the differentiation of sinonasal lesions. This study aimed to evaluate the value of intravoxel incoherent motion in the differentiation of benign and malignant sinonasal lesions and to compare the diagnostic performance of intravoxel incoherent motion with that of conventional DWI.

MATERIALS AND METHODS:

One hundred thirty-one patients with histologically proved solid sinonasal lesions (56 benign and 75 malignant) who underwent conventional DWI and intravoxel incoherent motion were recruited in this study. The diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values derived from intravoxel incoherent motion and ADC values derived from conventional DWI were measured and compared between the 2 groups using the Student t test. Receiver operating characteristic curve analysis, logistic regression analysis, and 10-fold cross-validation were performed to evaluate the diagnostic performance of single-parametric and multiparametric models.

RESULTS:

The mean ADC and D values were significantly lower in malignant sinonasal lesions than in benign sinonasal lesions (both P < .001). The mean f value was higher in malignant lesions than in benign lesions (P = .003). Multiparametric models can significantly improve the cross-validated areas under the curve for the differentiation of sinonasal lesions compared with single-parametric models (all corrected P < .05 except the D value). The model of D+f provided a better diagnostic performance than the ADC value (corrected P < .001).

CONCLUSIONS:

Intravoxel incoherent motion appears to be a more effective MR imaging technique than conventional DWI in the differentiation of benign and malignant sinonasal lesions.

Preparation and characterization of Na 2 S-modified biochar for nickel removal

Abstract

Biochar has good adsorption ability to various contaminants. In this work, peanut shell, corncob, cotton stalks, and crayfish shell were pyrolyzed under three temperatures (300, 450, 600 °C) to obtain biochars for the removal of Ni²⁺. The biochars were further modified with 2 mol/L Na₂S solution. Characterization results showed that the specific surface area and total pore volume of the modified biochars increased substantially. Among all the adsorbents, the modified corncob biochar (450 °C) showed the best Ni²⁺ adsorption. The adsorption kinetics followed the Elovich model with an equilibrium time of 24 h. The maximum capacity of the modified biochar reached 15.40 mg/g. The adsorption process was affected by pH, temperature, and coexisting ions. Increasing pH (under 7) provided more adsorption sites which enhanced adsorption capacity. Experimental results also indicated that the main adsorption mechanism of Ni²⁺ was ion exchange. Findings from this work suggest that modified biochar can be used as an effective adsorbent for the removal of Ni²⁺ from wastewater.

Graphical abstract

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Highly efficient degradation of berberine chloride form wastewater by a novel three-dimensional electrode photoelectrocatalytic system

Abstract

Fe₂O₃/graphite (Fe₂O₃/C) and nano-TiO₂-coated glass bead were prepared by impregnation and sol–gel method respectively and employed as the catalyst of a novel three-dimensional electrode photoelectrocatalytic (3-D PEC) system. The photoexcited electrons can transfer from TiO₂, Fe₂O₃ to counter electrode. It improves the migration of photoexcited charges, retards the fast recombination of electron–hole, and increases the lifetime of photogenerated holes (h⁺). In addition, the cycle reaction of Fe³⁺/Fe²⁺ on Fe₂O₃/C surface enhanced the Fenton reaction which can produce more hydroxyl radicals (·OH) and promote the capacity of mineralization of the pollutants. This novel 3-D PEC system showed excellent performance for the degradation of berberine chloride form (BCF). At the pH value of 3, 93% BCF was removed within 60 min; besides, 98.64% COD removal rate, 78.96% mineralization, 21.47% mineralization current efficiency, and just 3.16 kW h g⁻¹TOC energy cost were obtained in 120 min. In this study, we proposed the 3-D PEC mechanism. Electron spin resonance (ESR) and scavenging experiments suggest that the major reactive oxygen species (ROS) are superoxide radicals (O₂^·−), ·OH, and h⁺, while the role of sulfate radical (SO₄^·−) is insignificant. This work provides a new dimension for the design of reactors for wastewater treatment and the construction of the 3-D PEC system can potentially be utilized in water purification.

Hydration of dicalcium silicate and diffusion through neo-formed calcium-silicate-hydrates at weathered surfaces control the long-term leaching behaviour of basic oxygen furnace (BOF) steelmaking slag

Abstract

Alkalinity generation and toxic trace metal (such as vanadium) leaching from basic oxygen furnace (BOF) steel slag particles must be properly understood and managed by pre-conditioning if beneficial reuse of slag is to be maximised. Water leaching under aerated conditions was investigated using fresh BOF slag at three different particle sizes (0.5–1.0, 2–5 and 10 × 10 × 20 mm blocks) and a 6-month pre-weathered block. There were several distinct leaching stages observed over time associated with different phases controlling the solution chemistry: (1) free-lime (CaO) dissolution (days 0–2); (2) dicalcium silicate (Ca₂SiO₄) dissolution (days 2–14) and (3) Ca–Si–H and CaCO₃ formation and subsequent dissolution (days 14–73). Experiments with the smallest size fraction resulted in the highest Ca, Si and V concentrations, highlighting the role of surface area in controlling initial leaching. After ~2 weeks, the solution Ca/Si ratio (0.7–0.9) evolved to equal those found within a Ca–Si–H phase that replaced dicalcium silicate and free-lime phases in a 30- to 150-μm altered surface region. V release was a two-stage process; initially, V was released by dicalcium silicate dissolution, but V also isomorphically substituted for Si into the neo-formed Ca–Si–H in the alteration zone. Therefore, on longer timescales, the release of V to solution was primarily controlled by considerably slower Ca–Si–H dissolution rates, which decreased the rate of V release by an order of magnitude. Overall, the results indicate that the BOF slag leaching mechanism evolves from a situation initially dominated by rapid hydration and dissolution of primary dicalcium silicate/free-lime phases, to a slow diffusion limited process controlled by the solubility of secondary Ca–Si–H and CaCO₃ phases that replace and cover more reactive primary slag phases at particle surfaces.

Impacts of urbanization on regional nonpoint source pollution: case study for Beijing, China

Abstract

Due to limits on available data, the effects of urban sprawl on regional nonpoint source pollution (NPS) have not been investigated over long time periods. In this paper, the characteristics of urban sprawl from 1999 to 2014 in Beijing were explored by analyzing historical land-use data. The Event Mean Concentration data have been collected from all available references, which were used to estimate the variation in urban NPSs. Moreover, the impacts of variation in urban sprawl on regional NPSs were qualified. The results indicated that the urbanization process showed different influences on pollutants, while COD and TN were identified as key NPS pollutants. Residential areas contributed more NPS pollutants than did roads, which played a tremendous role in the control of urban NPS. The results also suggested in part that the impact of urban sprawl on the variation of COD decreased while TN increased in Beijing during the study period. These results would provide insight into the impacts of urban sprawl on NPS variation over a long period, as well as the reference for reasonable urban planning directives.

Solar energy harvesting by magnetic-semiconductor nanoheterostructure in water treatment technology

Abstract

Photocatalytic degradation of toxic organic pollutants in the wastewater using dispersed semiconductor nanophotocatalysts has a number of advantages such as high activity, cost effectiveness, and utilization of free solar energy. However, it is difficult to recover and recycle nanophotocatalysts since the fine dispersed nanoparticles are easily suspended in waters. Furthermore, a large amount of photocatalysts will lead to color contamination. Thus, it is necessary to prepare photocatalysts with easy separation for the reusable application. To take advantage of high photocatalysis activity and reusability, magnetic photocatalysts with separation function were utilized. In this review, the photocatalytic principle, structure, and application of the magnetic-semiconductor nanoheterostructure photocatalysts under solar light are evaluated.

Graphical abstract

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Discussion: Management of Tuberous Breast Deformities: Review of Long-Term Outcomes and Patient Satisfaction with BREAST-Q

Outcomes of Fat-Augmented Latissimus Dorsi (FALD) Flap Versus Implant-Based Latissimus Dorsi Flap for Delayed Post-radiation Breast Reconstruction

Abstract

Background

Although free abdominal flaps constitute the gold standard in post-radiation delayed breast reconstruction, latissimus dorsi-based methods offer alternative reconstructive options. This retrospective study aims to compare outcomes of delayed breast reconstruction using the fat-augmented latissimus dorsi (FALD) autologous reconstruction and the latissimus dorsi-plus-implant reconstruction in irradiated women.

Methods

We reviewed the files of 47 post-mastectomy irradiated patients (aged 29–73 years), who underwent delayed latissimus dorsi-based breast reconstruction between 2010 and 2016. Twenty-three patients (Group A) had an extended FALD flap and twenty-four patients (Group B) an implant-based latissimus dorsi reconstruction. Patients' age, BMI, pregnancies, volume of injected fat, implant size, postoperative complications, and secondary surgical procedures were recorded and analyzed.

Results

Age, BMI, pregnancies, and donor-site complications were similar in both groups (p > 0.05). Mean fat volume injected initially was 254 cc (ranged 130–380 cc/session); mean implant volume was 323 cc (ranged 225–420 cc). Breast complications were significantly fewer in Group A (one wound dehiscence, two oily cysts) compared to Group B (three cases with wound dehiscence, two extrusions, thirteen severe capsular contractions). Non-statistically significant difference was documented for secondary procedures between groups; although the mean number of additional surgeries/patient was higher in Group A, they referred to secondary lipofilling, whereas in Group B they were revision surgeries for complications.

Conclusions

The FALD flap constitutes an alternative method for delayed autologous reconstruction after post-mastectomy irradiation, avoiding implant-related complications. Although additional fat graft sessions might be required, it provides an ideal autogenous reconstructive option for thin nulliparous women, with a small opposite breast and adequate fat donor sites.

Level of Evidence IV

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In type 2 diabetes induced by cigarette smoking, activation of p38 MAPK is involved in pancreatic β-cell apoptosis

Abstract

Type 2 diabetes (T2D) is a chronic disease caused by pancreatic β-cell dysfunction and insulin resistance. Exposure to smoke is a risk factor for diabetes; however, its mechanisms are unclear. In an epidemiological study, we determined the relationship between cigarette smoking and β-cell function. T2D patients had a history of heavier smoking than people without T2D, and heavy smokers had more abnormal glucose metabolism. For various smoking populations, there was a dose-effect relationship between decreases of homeostatic model assessment (HOMA)-β levels or the increases of HOMA-insulin resistance (IR) levels and amount of smoking (pack-years), which indicated that smoking induced β-cell dysfunction. For MIN6 cells, cigarette smoke extract (CSE) decreased insulin secretion and content; enhanced apoptosis, as illustrated by decreases of BCL-2 levels, increases of BAX and cleaved caspase-3 levels, and an increased apoptotic index; and activated the p38 MAPK pathway. For MIN6 cells, inhibition of p-p38 MAPK by SB203580 prevented enhanced apoptosis and the dysfunction of insulin secretion induced by CSE. In sum, activation of p38 MAPK is involved in the apoptosis of pancreatic β-cells induced by cigarette smoking, which is a possible mechanism for induction of T2D by cigarette smoke.

Development of porosity and surface chemistry of textile waste jute-based activated carbon by physical activation

Abstract

Two-step physical activation was used to prepare activated carbon from textile waste jute. Raw material was first carbonized under nitrogen and then activated by CO₂. Based on yield and pore structure, the optimal carbonization temperature and time were 500 °C and 60 min, respectively. Carbonized sample was next activated. The development of porosity and surface chemistry was highly dependent on activation temperature and time. Activated carbon produced at 800 °C was predominantly microporous while that produced at 900 °C was more mesoporous and macroporous. The shift from microporosity to mesoporosity could be used to produce either microporous or mesoporous carbon just by changing the activation temperature. Activation also changed the surface chemistry and created a more carbonaceous structure. The jute-based activated carbon was mostly powdered in form, slightly acidic and effective in adsorbing both heavy metals and organics.

Temporal-spatial variation and partitioning of dissolved and particulate heavy metal(loid)s in a river affected by mining activities in Southern China

Abstract

The physicochemical properties and heavy metal(loid) concentrations of the river water both fluctuate greatly along the river affected by mining activities, and the transportation of heavy metal(loid)s is therefore more complicated than unpolluted river. Dissolved and particulate heavy metal(loid)s in a river polluted by mining activities were measured to study their temporal-spatial variation and partitioning. The concentrations of dissolved arsenic (As), cadmium (Cd), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn) were considerably high at the sites near the mine area. Notably, dissolved As at most sites were higher than the Chinese quality criterion of class II for surface water indicating high environmental risk. Mn and Pb at most sites and Ni at a part of the sites mainly existed in the particulate phase. For other heavy metal(loid)s, i.e., As, Cd, chromium (Cr), and Zn, the particulate phase was extremely high at the sites near the mine area and responsible for heavy metal(loid) transport. Significant correlations between particulate heavy metal(loid)s and temperature and electrical conductivity (EC) were found. However, the partitioning of heavy metal(loid)s did not significantly relate to the river water properties, due to most heavy metal(loid)s in suspended particulate matter (SPM) are stable and affected less by water properties. Except for Cr and Ni, other heavy metal(loid)s showed high concentrations in sediments, and considerable Cd, Mn, and Zn existed in exchangeable and carbonate fraction indicating high environmental risk. The environmental assessment of SPM showed that Cd, Zn, and As, as the main pollutants in SPM, all reached extremely polluted level at the sites near the mine area, and the environmental risk of heavy metal(loid)s in SPM was higher during dry season than that during wet season. The results can contribute to understanding the partitioning and transportation of heavy metal(loid)s in the river affected by mining activities.

Development of a Stiffness-Angle Law for Simplifying the Measurement of Human Hair Stiffness

Abstract

Objective

This research examines the benefits of caffeine absorption on hair stiffness. In order to test hair stiffness, we have developed an evaluation method that is not only accurate, but also inexpensive. Our evaluation method for measuring hair stiffness culminated in a model, called the Stiffness-Angle Law, which describes the elastic properties of hair and can be widely applied to the development of hair care products.

Methods

Small molecules (≤ 500 g/mol) such as caffeine can be absorbed into hair. A common shampoo containing 4% caffeine was formulated and applied to hair 10 times, after which the hair stiffness was measured. The caffeine absorption of the treated hair was observed using Fourier Transform Infrared Spectroscopy (FTIR) with a Focal Plane Array (FPA) detector. Our evaluation method for measuring hair stiffness consists of a regular camera and a support for single strands of hair. After attaching the hair to the support, the bending angle of the hair was observed with a camera and measured. Then the hair strand was weighed. The stiffness of the hair was calculated based on our proposed Stiffness-Angle law using three variables: angle, weight of hair, and the distance the hair was pulled across the support.

Results

The caffeine absorption was confirmed by FTIR analysis. The concentration of amide bond in the hair certainly increased due to caffeine absorption. After caffeine was absorbed into the hair, the bending angle and weight of the hair changed. Applying these measured changes to the Stiffness-Angle law, it was confirmed that the hair stiffness increased by 13.2% due to caffeine absorption.

Conclusion

The theoretical results using the Stiffness-Angle law agree with the visual examinations of hair exposed to caffeine, and also the known results of hair stiffness from a previous report. Our evaluation method combined with our proposed Stiffness-Angle Law effectively provides an accurate and inexpensive evaluation technique for measuring bending stiffness of human hair.

This article is protected by copyright. All rights reserved.

Data-Driven Surgical Decision Making in Nasal Airway Surgery

What are the factors that influence our surgical decision making in functional nasal airway surgery? Certainly, we rely on individual patient symptoms, medical history, and physical examination to help us determine the specific interventions that we believe will most benefit our patients. However, there is undoubtedly a great deal of variability in the specific approaches or techniques that we use. Our surgical decision making is based on our prior training, personal experiences, and in many cases, surgical dogma that has been passed down to us from mentors or conferences that we have attended. Unfortunately, surgical dogma is often pervasive but lacking in evidence or data to support it. With the emphasis on evidence-based medicine and patient outcomes over the past few decades, there is an increasing importance on data-driven surgical decision making.

Evaluating Inferior Turbinate Reduction Techniques

This study uses computational fluid dynamics analysis to assess the effects of inferior turbinate resection techniques on nasal airflow in 5 patients.

Terbinafine-induced liver injury may be asymptomatic: need for regular monitoring: reply from the authors

‘Not-being-at-home’: Subject, Freedom and Transcending in Heideggerian Educational Philosophy

Abstract

In my paper, by drawing on the writings Heidegger developed in the late 1920s, I wish to display what we may refer to as the thorough educational nature of Heideggerian reflection. It is my argument that the analysis of Dasein we find in the early Heidegger displays an extraordinary deep and dense reflection on selfhood and subjectivity, a reflection that is rooted in subject's freedom and transcending. By paying attention to the interplay between these two features, I argue that in the late 1920s, while challenging the notion of an all-encompassing consciousness as the place where everything should be understood and managed, Heidegger built a conception of selfhood and subjectivity in terms of freedom, responsibility, and ongoing transformation. Such a conception, I argue, is in and of itself educational.

Descriptive Analysis of the Arterial Supply to the Auricle in Patients with Unilateral Microtia

Background: Microtia is a congenital auricular deformity that occurs in 1:5,000–10,000 births. It can cause severe impairment to the patient's self-esteem and problems regarding social integration. Multiple measures have been described in attempt to better operative outcomes of these patients. We used computed tomography (CT) angiography to analyze the vascular pattern of the auricular region before surgery. Methods: Fourteen patients with unilateral microtia were included. All underwent CT angiogram plus tridimensional reconstruction. Both healthy and microtic auricles were analyzed descriptively in terms of main arterial supply, pattern, diameter of subbranches, and angulation. The sample was divided in 2 age groups for better understanding of the data. Results: Blood supply to the auricle was found to depend on 2 main vessels: temporal superficial artery (TSA) and its subbranches (superior, middle, and lower branch) and posterior auricular (PA) artery. In the microtic group, TSA was the dominant artery in 13 of 14 cases (92%). Superior, middle, and inferior branches were present in 4, 3, and 0 cases, respectively. Three of the microtic auricles presented supply from PA artery, from which in 1 case, it represented the only supply to the region. Conclusions: There is wide variability in the blood supply of both healthy and microtic auricles; however, we were able to identify some tendencies in our sample. Further research is needed to prove the benefit of a preoperative imaging study in these patients. Still, in our experience, we found it useful as a complement for surgical planning.

Monitoring key organic indoor pollutants and their elimination in a biotrickling biofilter

Abstract

A biotrickling filter was evaluated to treat the air of the interior of a bioprocess research laboratory. Initially, various solid-phase microextraction (SPME) fibers were used to identify and quantify the volatile organic pollutants and hexane, methyl isobutyl ketone, benzene, toluene, and xylene were further selected as indicators due to their prevalence and relative abundance. The system treated organic loading rates between 0.16 mg_carbon m⁻³ h⁻¹ and close to 30 mg_carbon m⁻³ h⁻¹ achieving removal efficiencies (RE) over 85% during 136 operational days. Respirometry experiments demonstrated that moderate acidification (below 5.0), due to microbial activity, adversely affected biofilter performance and consequently pH control was necessary to maintain performance.

CDX2 and LEF-1 expression in pilomatrical tumors and their utility in the diagnosis of pilomatrical carcinoma

Abstract

Background

The Wnt signaling pathway has been implicated in the pathogenesis of pilomatrical tumors. LEF-1 is a downstream component of this pathway, and CDX2 has been postulated to regulate it, but little is known about expression of these transcription factors in pilomatrical tumors.

Methods

Immunohistochemistry for CDX2, β-catenin, LEF-1, CK19, CK5, SATB2, Cadherin 17, and Androgen receptor was performed on pilomatricomas (PMs) (N=12), pilomatrical carcinomas (PMCAs) (N=12), and non-pilomatrical cutaneous tumors (N=18).

Results

PMs and PMCAs were positive for CDX2 (9/12 PMs, sens=75%,spec=100%;11/12 PMCAs, sens=92%,spec=100%;p<0.01), β-catenin (12/12 PMs, sens=100%, spec=94%;10/12 PMCAs, sens=83%, spec=94%;p<0.01), and LEF-1 (12/12 PMs, sens=100%, spec=56%;12/12 PMCAs, sens=100%, spec=56%;p<0.01 ). CDX2 expression was commonly focal, within a discrete subpopulation of squamoid cells. The LEF-1 expression pattern was different and discernable between pilomatrical tumors (strong, diffuse) and non-pilomatrical tumors (weak, patchy).

Conclusions

This study reaffirms the importance of the Wnt signaling pathway in the tumorigenesis of pilomatrical tumors, and introduces CDX2 as a possible regulator and marker of pilomatrical tumorigenesis. LEF-1 and CDX2 performed at least as well as β-catenin, if not better when taking into account expression pattern, as a diagnostic marker for pilomatrical carcinoma, and should be considered in the workup of ambiguous primitive-appearing cutaneous tumors.

Cutaneous Intravascular CD30+ T-cell Pseudolymphoma Occurring in a Regressing Keratoacanthoma

Abstract

Cutaneous intravascular CD30+ pseudolymphoma is an uncommon incidental finding that may mimic intravascular or angiotropic lymphoma. We describe a 78-year-old female with a traumatized regressing keratoacanthoma on her left cheek. A shave biopsy was performed which revealed intravascular staining of atypical lymphocytes positive for CD45, CD3 and CD30. Clinical exam revealed no other evidence of lymphoma, the patient denied constitutional symptoms, and routine blood work was normal. The patient is healthy and doing well 28 months after her first visit. CD30+ pseudolymphoma should be distinguished from malignant intravascular lymphoproliferative disorders.

#dermpathJC: The First Online Dermatopathology Twitter Journal Club

Twitter, an online social media platform created in the spring of 2006, has now reached approximately 328 million active monthly users¹. It allows for rapid exchange of ideas in 140 character tweets.

Lichen planopilaris and frontal fibrosing alopecia cannot be differentiated by histopathology

Abstract

Background

Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) represent two entities that cause primary cicatricial alopecia. These entities are clinically different; nevertheless the literature suggests that FFA represents a form of LPP. The main argument in support of this hypothesis is that previous studies comparing the histologic findings have not found obvious differences between these diseases.

Methods

Our objective was to more critically compare and contrast 20 histologic findings of these diseases in a large number of patients in order to determine any significant histologic differences between LPP and FFA.

Results

We found three parameters that were statistically different, namely the presence of terminal catagen-telogen hairs (50% FFA versus 23.5% LPP; p = 0.020); a severe perifollicular inflammatory infiltrate (29.4% LPP versus 4.6% FFA; p = 0.010); and a zone of concentric lamellar fibroplasia (85.3% LPP versus 63.6% FFA; p = 0.041).

Conclusions

Although a few histologic features differ between FFA and LPP, we believe these differences are too subtle or non-specific to distinguish between them with confidence. Therefore, clinical correlation is essential to establish the diagnosis.

The impact of pre and perinatal lifestyle factors on child long term health and social outcomes: a systematic review

To understand the full extent of the impact of a trial, it is important to consider the long-term consequences of outcomes beyond the trial follow-up period, especially for early year's interventions. A system...

Anti-inflammatory and antinociceptive properties of the hydroalcoholic fractions from the leaves of Annona crassiflora Mart. in mice

Abstract

Background

Annona crassiflora Mart., popularly known as "Araticum", is a native tree of the Brazilian Cerrado used in folk medicine for treatment of pain and inflammatory diseases. We proposed to analyze analgesic and anti-inflammatory properties of the filtrate (F1) and the precipitate (F2) of the hydroalcoholic fraction from the leaves of Annona crassiflora Mart. in mice.

Materials and methods

Swiss mice were submitted to formalin-induced nociception test and tail-flick reflex test, to assess antinociceptive properties, and to the rota-rod test, for motor performance analyses. To evaluate anti-inflammatory properties, F1 and F2 were orally administered 1 h prior to the intrathoracic injection of carrageenan, zymosan, LPS, CXCL8, or vehicle in Balb/c mice and neutrophil infiltration was evaluated 4 h after injection.

Results

F1 and F2 reduced the licking time in the second phase of formalin-induced nociception test, but only F2 showed a dose-dependent response. Neither F1 nor F2 reduced the latency time in the tail-flick reflex test. In addition, motor performance alteration was not observed in F1- or F2-treated mice. F2 treatment significantly inhibited the neutrophilia induced by carrageenan, LPS, or CXCL8, but not zymosan.

Conclusions

The experimental data demonstrated that hydroalcoholic fractions of Annona crassiflora Mart. leaves have remarkable anti-inflammatory and antinociceptive activities.

Photocatalytic removal of SO 2 using natural zeolite modified by TiO 2 and polyoxypropylene surfactant

Abstract

Air pollution due to emission of various hazardous gases such as SO₂ into the atmosphere and its control is an important environmental issue. Application of photocatalysts is considered as a suitable process to control the gaseous pollutants. In this study, the efficiency of clinoptilolite as a natural zeolite (Ze) modified by TiO₂ (Ze-Ti) and a polymeric surfactant polyoxypropylene (Ze-Ti-POP) for removal of SO₂ was investigated. The nanocomposites were characterized by SEM, EDX, and BET analyses. The photocatalytic oxidation experiments of SO₂ by the nanocomposites and natural zeolite were done under UV irradiation with initial SO₂ concentration of 500 ppm in a photoreactor. The effects of different factors including reaction time, catalyst dose, UV irradiation intensity, humidity content, and calcination temperature and dose of TiO₂ were studied. The modification of clinoptilolite by TiO₂ and POP increased considerably the BET specific surface area of the nanocomposites. The results showed that maximum removal efficiencies of SO₂ by Ze-Ti and Ze-Ti-POP under the optimum experimental conditions were 82.1 and 87.4%, respectively. Adsorption kinetics data well fitted with the Langmuir–Hinshelwood model. Moreover, reusing of nanocomposites after three regeneration cycles indicated that application of Ze-Ti and Ze-Ti-POP nanocomposites could be a promising approach for SO₂ removal.

Graphical abstract

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MiR-760 suppresses non-small cell lung cancer proliferation and metastasis by targeting ROS1

Abstract

MicroRNAs (miRNAs) have been shown to be critical regulators in many types of tumors. The aim of our study was to investigate the role of miR-760 in non-small cell lung cancer (NSCLC). We demonstrated that the expression of miR-760 was downregulated in NSCLC tissues compared with the adjacent normal tissues. We also demonstrated that the expression of miR-760 was downregulated in the NSCLC cell lines. Overexpression of miR-760 suppressed the NSCLC cell proliferation, cell cycle, and migration. Moreover, we identified that ROS1 was a direct target of miR-760 in the NSCLC cell. Elevated expression of miR-760 suppressed ROS1 expression in the NSCLC cell. We also demonstrated that the expression of ROS1 was higher in the NSCLC tissues than in the adjacent lung tissues. MiR-760 expression level was reversely associated with the expression level of ROS1 in the NSCLC tissues. In summary, we showed that miR-760 suppressed the NSCLC cell proliferation, cell cycle, and migration through regulating the ROS1 expression. These data suggested that miR-760 may act as a tumor suppressor gene in the NSCLC partly through regulating ROS1 expression.

High efficacy of ( Z )- γ -bisabolene from the essential oil of Galinsoga parviflora (Asteraceae) as larvicide and oviposition deterrent against six mosquito vectors

Abstract

The eco-friendly management of mosquitoes with novel and effective larvicides and oviposition deterrents is a crucial challenge to prevent outbreaks of mosquito-borne diseases. However, most of the herbal formulations tested in these years showed LC₅₀ values higher of 40 ppm, and significant oviposition deterrent activity only when tested at relatively higher doses (> 50 μg/ml). Herein, we studied the chemical composition of the Galinsoga parviflora essential oil (EO). This plant is an annual herb native to South America naturalized all over the world. We tested the EO larvicidal and oviposition deterrent action on 6 mosquito species. Totally 37 compounds were identified in the EO of G. parviflora by GC and GC-MS analyses. The major constituent was (Z)-γ-bisabolene (38.9%). The G. parviflora EO and (Z)-γ-bisabolene showed acute toxicity on An. stephensi (LC₅₀ = 31.04 and 2.04 μg/ml, respectively), Ae. aegypti (LC₅₀ = 34.22 and 2.26 μg/ml, respectively), Cx. quinquefasciatus (LC₅₀ = 37.10 and 2.47 μg/ml, respectively), An. subpictus (LC₅₀ = 40.97 and 4.09 μg/ml, respectively), Ae. albopictus (LC₅₀ = 45.55 and 4.50 μg/ml, respectively) and Cx. tritaeniorhynchus (LC₅₀ = 49.56 and 4.87 μg/ml, respectively) larvae. Furthermore, the oviposition deterrent potential of the G. parviflora EO and (Z)-γ-bisabolene was studied on six mosquito vectors, showing that 25 μg/ml of (Z)-γ-bisabolene led to an Oviposition Activity Index lower of − 0.79 in all tested mosquito vectors. Overall, all larvicidal LC₅₀ values estimated for (Z)-γ-bisabolene were lower than 5 μg/ml. This result far encompasses current evidences of toxicity reported for the large majority of botanical products currently tested against mosquito young instars, allowing us to propose this compound as an highly effective mosquito larvicide and oviposition deterrent.

Proposal for MSW contaminant classification applied to a tropical aquifer

Abstract

Groundwater is a natural resource exploited worldwide causing danger due to the lixiviation of waste deposited, which presents high potential degradation. Internationally, regulation aims for the maintenance of the quality of this resource. But the local lithology, mainly in countries with tropical weather, was not considered. This paper has an objective to propose two methodologies of contaminant identification of municipal solid waste (MSW) considering the Brazilian regulation, the local lithology and the temporal aspect. The study site is located in the midwest of São Paulo, at the Marília Formation, Bauru Aquifer, which presents sandstone rich in calcite. At first, the historic monitoring data accumulated between 2002 and 2015 were statistically organized. Then, methodologies of classification of major constituents and contamination method were developed. After these analyses, the compounds that possibly cause anomaly in the local environment are Al, As, Ba, Ca, Cd, Co, Cr, Cu, phosphatic, nitrogenous, and sulfated compounds, Fe, K, Mn, Ni, and Pb. Some of these have lithogenic genesis typical of tropical environment, and others come from the disposed waste. Despite different approaches, both methods demonstrate efficiency in identifying the pollutants presenting distinctions among themselves in conjunction with actual local regulation and the lithogenic source of certain compounds.

Estimation of oxygen effective diffusion coefficient in a non-steady-state biofilm based on response time

Abstract

In wastewater treatment, oxygen effective diffusion coefficient (D_eff ) is a key parameter in the study of oxygen diffusion-reaction process and mechanism in biofilms. Almost all the reported methods for estimating the D_eff rely on other biokinetic parameters, such as substrate consumption rate and reaction rate constant. Then, the estimation was complex. In this study, a method independent of other biokinetic parameters was proposed for estimating the dissolved oxygen (DO) D_eff in biofilms. It was based on the dynamic DO microdistribution in a non-steady-state inactive biofilm, which was measured by the oxygen transfer modeling device (OTMD) combining with an oxygen microelectrode system. A pure DO diffusion model was employed, and the expression of the DO D_eff was obtained by applying the analytical solution of the model to a selected critical DO concentration. DO D_eff in the biofilm from the bioreactor was calculated as (1.054 ± 0.041) × 10⁻⁹ m²/s, and it was in the same order of magnitude with the reported results. Therefore, the method proposed in this study was effective and feasible. Without measurement of any other biokinetic parameters, this method was convenient and will benefit the study of oxygen transport-reaction process in biofilms and other biofouling deposits.

Graphical abstract

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On how (not) to define modality in terms of essence

Abstract

In his influential article 'Essence and Modality', Fine proposes a definition of (conceptual, logical and metaphysical) necessity in terms of the primitive essentialist notion 'true in virtue of the nature of'. Fine's proposal is suggestive, but it admits of different interpretations, leaving it unsettled what the precise formulation of an Essentialist definition of necessity should be. In this paper, four different versions of the definition are discussed: a singular, a plural reading, and an existential variant of Fine's original suggestion and an alternative version proposed by Correia which is not based on Fine's primitive essentialist notion. The first main point of the paper is that the singular reading is untenable. The second that given plausible background assumptions, the remaining three definitions are extensionally equivalent. The third is that, this equivalence notwithstanding, Essentialists should adopt Correia's version of the definition, since both the existential variant, which has de facto been adopted as the standard version of the definition in the literature, and the plural reading suffer from problems connected to Fine's primitive essentialist notion.

Filaggrin gene mutations may influence the persistence of food allergies in Japanese primary school children

Abstract

Mutations in FLG are the underlying cause of ichthyosis vulgaris and are an important predisposing factor for atopic dermatitis (AD).¹ In 2011, FLG mutations were reported to increase the risk of peanut allergy², and they have been proven to increase the risk of other food sensitizations and allergies.^3,4 In this study, we comprehensively screened 411 children in Japan for 10 Japanese-population-specific FLG mutations and suggested that FLG mutations influence the persistence of food allergies (FAs).

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Confocal microscopy in adult women with acne

Abstract

Background

Acne is an inflammatory disease of the pilosebaceous follicle, affecting 41–54% of adult women, with a particular form that involves the mandible.

Methods

We characterized infundibulum morphology in two groups of adult women using reflectance confocal microscopy. First, we investigated acne visually "healthy zones" on the forehead in 15 adult women with diffuse acne and compared with acne-free controls. We then compared healthy forehead and affected mandibular zone in 15 acne patients with mandibular involvement. Exposed results had a P < 0.05.

Results

Seven hundred and ninety-one follicles were observed on apparently healthy skin of 15 adult women with acne, with a larger diameter, thicker (68%), and hyper keratinized (65%) follicle border, and more keratin plugs (44%) than in controls. In the second group of 15 adult women with mandibular acne, we compared 569 follicles in the mandibular zone and 475 on forehead. In the mandibular area, follicles were significantly larger, thicker (76%), more hyper keratinized (72%), with more keratin plugs (47%) and increased inflammation (23%) compared with the forehead area. In the mandibular area, 0.2% of follicles showed isolated inflammation without hyper keratinization, and 15.3% had both thickened borders with an onion-like appearance and keratin plugs associated with inflammation.

Conclusions

Hyper keratinization was higher in healthy skin of adult women with acne compared with controls, confirming that microcomedo is crucial in the development of acne lesions. We also demonstrate that the repartition of comedones and microcomedones is inhomogeneous with a great number in the mandibular area where acne lesions are located.

Prevalence and predictors of depressive symptoms among attendees of a tertiary care dermatology clinic in Muscat, Oman

Abstract

Background

Various studies have suggested that depression is more prevalent among patients with skin disorders than in the general population. Most of the studies addressing this subject involve Euro-American populations.

Objectives

The present study aimed to estimate the prevalence of depressive symptoms among patients with dermatological disorders and, then, to decipher the clinical–demographic factors associated with depressive symptoms.

Methods

A cross-sectional analytical study was conducted among a random sample of patients attending a dermatology clinic in Muscat. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to find the adjusted and unadjusted odds ratios (ORs).

Results

A total of 260 patients participated in this study, with a response rate of 81%. The prevalence of depression symptoms was 24%. According to regression analysis, family history of depression, comorbid medical disorders, and treatment with topicals or isotretinoin were significant predictors of depression (OR = 9.41, 95% confidence interval [CI]: 2.27–39.05, P = 0.002; OR = 2.0, 95% CI: 1.2–3.21, P = 0.05; OR = 2.28, 95% CI: 1.09–4.76, P = 0.028; and OR = 2.78; 95% CI: 1.08–7.19, P = 0.035, respectively).

Conclusion

This study indicates that depressive symptoms are common among patients with dermatological disorders in Oman, particularly in those with a family history of depression and medical comorbidities, and those who use a specific dermatological medication. Screening for depression in patients attending dermatology clinics is essential in order to detect and promptly treat patients suffering from depression.

Monocle tumor as tonsillar squamous cell carcinoma metastasis: resolution after chemotherapy treatment

Long-term pediatric skin eruption-related hospitalizations in offspring conceived via fertility treatment

Abstract

Background

Although concerns have been raised regarding the long-term health risks of offspring conceived following fertility treatments, limited information is available regarding their health status beyond the neonatal period. We aimed to evaluate the risk of long-term eruptive dermatological morbidity among children born following fertility treatments as compared to those conceived spontaneously.

Methods

A population-based cohort study was conducted, including all singleton deliveries occurring between the years 1991 and 2014 at a single tertiary medical center. Fetuses with congenital malformations and multiple gestations were excluded. Children delivered following fertility treatment pregnancies and spontaneous pregnancies were compared. Hospitalizations of the offspring up to the age of 18 years involving cutaneous eruptions were evaluated. A Kaplan–Meier survival curve was used to compare cumulative morbidity incidence and a Cox regression model to control for confounders.

Results

During the study period, 242,187 singleton deliveries met the inclusion criteria, 1.8% of which were following fertility treatments (n = 4324). Eruptive dermatological morbidity of the offspring up to the age of 18 years was significantly more common in the fertility treatment group (1.5%) as compared to spontaneous pregnancies (1.1%; P = 0.023). The Kaplan–Meier survival curve demonstrated a significantly higher cumulative incidence of eruptive dermatological morbidity following fertility treatments (log-rank P = 0.007). Using the Cox regression model, while controlling for multiple confounders, fertility treatment was noted as an independent risk factor for long-term pediatric eruptive dermatological morbidity (adjusted HR = 1.43, CI 1.12–1.83, P = 0.004).

Conclusion

Singletons conceived via fertility treatments appear to be at an increased risk for long-term eruptive dermatological morbidity.

Case of psoriatic arthritis mutilans whose finger dysfunction was successfully ameliorated by surgical intervention during infliximab treatment

Impact of a new simplified disability scoring system for adult patients with localized scleroderma

Abstract

Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment.

Current developments in phototherapy for psoriasis

Abstract

Phototherapy utilizes the beneficial effects of ultraviolet (UV) wavelengths to affect immunoregulatory functions. UV light phototherapy using narrowband UV-B (NB-UVB) and bath-psoralen UV-A (bath-PUVA) therapy are well-established treatments for psoriasis. Dual-action mechanisms of UV phototherapy have been identified: apoptosis and immune suppression. NB-UVB depletes pathogenic T cells by inducing apoptosis and regulatory T cells. Other wavelengths are also utilized for phototherapy, namely 308-nm excimer light and 312-nm flat-typed NB-UVB. Excimer light (308-nm) therapy effectively targets the affected skin without unduly exposing other areas and increases the levels of regulatory T cells. Phototherapy improves impaired resting regulatory T cells and increases activated regulatory T cells in patients with psoriasis. Intensive studies of phototherapy effects have led to several improvements in the design, protocols, and light sources, such as UV light-emitting diodes, thereby providing several options for patients with refractory skin disease, such as psoriasis.

Case with anaphylactic shock induced by heparin-lock flush injection

In vivo skin reactions from pulsed-type, bipolar, alternating current radiofrequency treatment using invasive noninsulated electrodes

Abstract

Background

Bipolar, alternating current radiofrequency (RF) conduction using invasive noninsulated electrodes consecutively generates independent tissue coagulation around each electrode and then, the converged coagulation columns.

Methods

Two pulsed-type RF models at the on-time pulse width/pulse pack of 30 and 40 milliseconds were designed to amplify the early stage of RF-induced tissue reaction using hairless mouse skin in vivo. Then, structural and ultrastructural changes were evaluated in hairless mouse skin samples at baseline and immediately 1 day, 3 days, 7 days, and 14 days after treatment.

Results

Immediately after pulsed-RF treatment, a few chrysanthemum-like zones of electrothermal coagulation and hypereosinophilic collagen fibers were found in the dermis and dermo-subcutaneous fat junction. Histochemical staining for periodic acid-Schiff and immunohistochemical staining for type IV collagen revealed marked thickening of basement membranes. Transmission electron microscopy demonstrated that pulsed-RF treatment resulted in higher electron-dense and remarkably thicker lamina densa, as well as increases in anchoring fibrils, compared with untreated control specimens. Furthermore, CD31-positive blood vessels were smaller in size with a slit-like luminal appearance, without excessive damage to endothelial cells.

Conclusion

Our data indicated that pulse-type, bipolar RF energy induces structural and ultrastructural changes in basement membranes and vascular components in hairless mouse skin.

Non-invasive assessment of cellulitis from snapshot hyperspectral imaging – A primary study

Optical coherence tomography image processing for in vivo 3-dimensional visualization of basal cell carcinoma