Histological changes of superficial esophageal squamous cell carcinoma after preoperative chemotherapy

Abstract

Introduction

We aimed to analyze the clinical and histological effects of chemotherapy in superficial esophageal squamous cell carcinoma (SESCC).

Methods

We analyzed tumor samples from five patients with cT1bN1M0 who underwent subtotal esophagectomy following two courses of a new triplet chemotherapy regimen including docetaxel, cisplatin, and 5-fluorouracil (DCF). To assess the histological effects of chemotherapy, resected specimens were analyzed by macroscopic examination, hematoxylin & eosin (HE) staining, immunohistochemical (IHC) staining (p53, Ki-67 and cytokeratin) and periodic acid-Schiff (PAS) staining.

Results

All five patients had a pathological T stage of T0/1a-LPM/1a-MM/1b (1/2/1/1) and histological grade of grade1a/1b/2/3 (1/1/2/1). Endoscopic examination revealed substantial shrinkage of lugol-voiding lesions (LVLs) in all cases. One case showed complete LVL disappearance, and resected specimen examination confirmed pathological complete response (pCR). IHC and PAS staining revealed that most initial LVLs were PAS-negative. Obvious viable cells were confirmed in two cases. The other three cases exhibited nuclear atypia and strong expression of p53 and Ki-67 in the basal layer of mucosa or lamina propria mucosae, even though the superficial layer of mucosa showed no obvious LVLs with PAS-positive. p53-positive lesions were also observed in Ki-67-positive. This indicated discordance between the endoscopic findings and histopathological evaluation.

Conclusion

DCF chemotherapy alone had a substantial therapeutic effect on SESCC in all cases. However, despite the normal appearance of the mucosal surface, viable cancer cells remained below the basal layer of mucosa. Careful attention should be paid when diagnosing clinical CR, or securing a resection margin of SESCC after DCF chemotherapy.

Monthly dynamics of atmospheric wet nitrogen deposition on different spatial scales in China

Abstract

China is one of three global hotspots for nitrogen (N) deposition, which has concerned scientists and the public. While previous studies on N deposition in China have focused on its composition, spatial pattern, and interannual dynamics, its monthly dynamics in different regions remain unclear, hindering our ability to evaluate its ecological effects. Therefore, we obtained monthly wet N deposition data from196 sites after continuous network observations and published data in China and analyzed the monthly dynamics of NH₄⁺–N, NO₃⁻–N, and dissolved inorganic N (DIN=NH₄⁺−N+NO₃⁻–N) deposition fluxes on site, regional, and national scales. We observed that the deposition fluxes of NH₄⁺–N, NO₃⁻–N, and DIN in China showed clear monthly patterns and regional differences. In Northern China, wet N deposition predominantly showed a unimodal trend, whereas in Southern China, it revealed a bimodal trend or irregular fluctuations. During 2000–2016, NH₄⁺–N, NO₃⁻–N, and DIN deposition fluxes were estimated as 9.09, 6.12, and 15.21 kg N ha⁻¹ year.⁻¹, respectively. Our findings enhance our understanding of atmospheric wet N deposition, and can serve as a reference for N deposition simulation experiments in different regions, and for generating long-term N deposition data for model optimization. Regional differences in the monthly dynamics of wet N deposition should be emphasized to accurately evaluate its ecological effects on terrestrial ecosystems in different regions.

Characterization of Mg-based bimetal treatment of insensitive munition 2,4-dinitroanisole

Abstract

The manufacturing of insensitive munition 2,4-dinitroanisole (DNAN) generates waste streams that require treatment. DNAN has been treated previously with zero-valent iron (ZVI) and Fe-based bimetals. Use of Mg-based bimetals offers certain advantages including potential higher reactivity and relative insensitivity to pH conditions. This work reports preliminary findings of DNAN degradation by three Mg-based bimetals: Mg/Cu, Mg/Ni, and Mg/Zn. Treatment of DNAN by all three bimetals is highly effective in aqueous solutions (> 89% removal) and wastewater (> 91% removal) in comparison with treatment solely with zero-valent magnesium (ZVMg; 35% removal). Investigation of reaction byproducts supports a partial degradation pathway involving reduction of the ortho or para nitro to amino group, leading to 2-amino-4-nitroanisole (2-ANAN) and 4-amino-2-nitroanisole (4-ANAN). Further reduction of the second nitro group leads to 2,4-diaminoanisole (DAAN). These byproducts are detected in small quantities in the aqueous phase. Carbon mass balance analysis suggests near-complete closure (91%) with 12.4 and 78.4% of the total organic carbon (TOC) distributed in the aqueous and mineral bimetal phases, respectively. Post-treatment surface mineral phase analysis indicates Mg(OH)₂ as the main oxidized species; oxide formation does not appear to impair treatment.

Comments for Mertens et al. (2018), Glyphosate, a chelating agent—relevant for ecological risk assessment?

The development of induced pluripotent stem cell-derived mesenchymal stem/stromal cells from normal human and RDEB epidermal keratinocytes

Epidermolysis bullosa (EB) is a group of hereditary skin diseases characterized by widespread blister formation from birth. The recessive dystrophic EB (RDEB) subtype is caused by mutations in the COL7A1 gene, which encodes type VII collagen, the main protein that forms anchoring fibrils beneath the dermal-epidermal junction (DEJ) [1–3]. There are no established therapies, only symptomatic treatments; therefore, extensive research has been conducted in search of effective treatments. Candidates for fundamental treatments are cell-based therapies, including allogeneic mesenchymal stem/stromal cell (MSC)-based therapies, as reported by several groups [4–6].

Ultrasonography for classifying lymphatic sclerosis types and deciding optimal sites of lymphatic-venous anastomosis in lymphoedema patients

We have previously categorised the degree of degeneration of the collecting lymphatic vessels into four types: normal, ectasis, contraction and sclerosis type (NECST classification). Here, we evaluated the collective lymphatic vessels in lymphoedema-affected limbs using ultrasonography. In step 1, we investigated 110 lymphatic vessels from 25 patients with lymphoedema, who underwent lymphatic-venous anastomosis (LVA) following preoperative ultrasonography. We classified the lymphatic vessels using the NECST classification via intraoperative microscopic observation.

Hydrochlorothiazide use and risk of Merkel cell carcinoma and malignant adnexal skin tumors: A nationwide case-control study

Hydrochlorothiazide use has been associated with markedly increased risk of squamous cell carcinoma. No previous studies have investigated the association between hydrochlorothiazide use and the risk of Merkel cell carcinoma (MCC) and malignant adnexal skin tumors (MAST).

Fibroproliferative Genes are Preferentially Expressed in Central Centrifugal Cicatricial Alopecia

CCCA and FPDs both commonly affect patients of African descent.Critical genes implicated in FPDs are upregulated in CCCA affected scalp tissue.Anti-fibrotic therapies may play a role in the treatment of CCCA.

Motorized 0.8 mm micro-punch grafting for refractory vitiligo: A retrospective study of 230 cases

Punch grafting for vitiligo has been time-consuming and may result in cobblestone-like appearances. We devised a motorized 0.8 mm micro-punch grafting procedure to overcome these limitations.

Lipofibromas are not related to diabetes mellitus or obesity

Reply to “Wound Management Strategies in Stevens-Johnson syndrome/Toxic Epidermal Necrolysis: An unmet need”

Wound Management Strategies in Stevens-Johnson syndrome/Toxic Epidermal Necrolysis: An unmet need

Myths of Exposure

Publication date: Available online 15 June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Karin A. Pacheco

Anaphylaxis After Vaccination in a Pediatric Patient: Further Implicating Alpha-Gal Allergy

Publication date: Available online 15 June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Cosby A. Stone, Scott P. Commins, Shailesh Choudhary, Chandra Vethody, Jill L. Heavrin, Jared Wingerter, Jonathan A. Hemler, Kenneth Babe, Elizabeth J. Phillips, Allison E. Norton

Deep dewatering process of sludge by chemical conditioning and its potential influence on wastewater treatment plants

Abstract

FeCl₃, quick lime, and cationic polyacrylamide (CPAM) were used for excess sludge conditioning from wastewater treatment plant (WWTP) and the dewatering performance by different chemical conditioners was investigated. Experimental results showed that FeCl₃ could make small and concentrated sludge particles. Furthermore, new mineral phase structures for building a dewatering framework were obtained by the addition of quick lime, and the coagulation capacity was enhanced by the formation of colloid hydroxyl polymer, which was induced due to the alkaline environment. In addition, the floc particle size significantly increased after the CPAM dosage. The bound water could be released with the stripping of tightly bound extracellular polymeric substance (EPS). Therefore, the dewatering performance and efficiencies were improved and subsequently the hypothetical sludge deep dewatering process was depicted in accordance with the variation of EPS. However, high-strength refractory organics in sludge filtrates caused by quick lime pyrolysis could lead to the unstable operation of the WWTP, because the relatively high concentrations of organic compounds with benzene were dominant in sludge dewatering filtrates.

Reply to the Letter to the Editor: "The hard road to patient-centered care: 3 or 6 months of adjuvant chemotherapy for patients with stage III colon cancer?" By P. Trendsz et al.

Impact of multiple extragenital warts on quality of life in immune-competent Egyptian adults: a comparative cross-sectional study

Which Fall Ascertainment Method Captures Most Falls in Pre-Frail and Frail Seniors?

Abstract

There is no consensus on most reliable falls ascertainment method. Therefore, we investigated which method captures most falls among pre-frail and frail seniors from two randomized controlled trials conducted in Zurich, Switzerland, a 18-month trial (2009–2010) including 200 community-dwelling pre-frail seniors with a prior fall and a 12-month trial (2005–2008) including 173 frail seniors with acute hip fracture. Both included the same fall ascertainment methods: monthly active-asking, daily self-report diary, and a call-in hotline. We compared number of falls reported and estimated overall and positive percent agreement between methods. Pre-frail seniors reported 499 falls (rate = 2.5/year) and frail seniors reported 205 falls (rate = 1.4/year). Most falls were reported by active-asking: 81% of falls in pre-frail, and 78% in frail seniors. Among pre-frail seniors, diaries captured additional 19% falls, while hotline added none. Among frail seniors, hotline added 16% falls, while diaries added 6%. The positive percent agreement between active-asking and diary was 100% among pre-frail and 88% among frail seniors. While monthly active-asking captures most falls in both groups, this method alone missed 19% of falls in pre-frail and 22% in frail seniors. Thus, a combination of active-asking and diaries for pre-frail, and active-asking and the hotline for frail seniors is warranted.

Determinants of Airborne Solvent Exposure in the Collision Repair Industry

Abstract

Objectives

To assess the determinants of airborne solvent exposures in contemporary vehicle collision repair workplaces.

Methods

Personal, full-shift airborne solvent exposures (n = 97) were assessed in 85 vehicle collision repair workers from 18 workshops. Peak exposures were assessed using a small number of video exposure monitoring measurements.

Results

Solvent exposures were highest in spray painters (geometric mean = 2.7 ppm) followed by panel beaters (0.5 ppm), but were well below workplace exposure standards. The lowest exposure levels were observed for mixing room extraction located away from the mixing bench [exposure ratio (ER) = 0.51, 95% confidence interval (CI) = 0.30–0.87]. Time spent mixing paint was associated with higher exposures (ER for every 10-min increase = 1.14, 95% CI = 1.05–1.24), as was time spent cleaning equipment with solvents (ER = 1.11, 95% CI = 0.88–1.39), spraying primer (ER = 1.10, 95% CI = 0.96–1.27), and spraying clear coat paint (ER = 1.07, 95% CI = 1.00–1.15). Overall, the combined non-spray painting tasks (mixing paint, degreasing, and cleaning equipment) were more strongly associated with exposure (ER = 1.10, 95% CI = 1.03–1.18) than the combined spray painting tasks (ER = 1.03, 95% CI = 1.00–1.05). Peak exposures ranged from 10 to 1100 ppm with the strongest and most frequent peaks occurring during paint mixing, decanting of solvents, cleaning of equipment, and painting in a cross-draft spray booth.

Conclusions

Airborne solvent exposures in the collision repair industry were associated with job title, the design and location of exhaust ventilation and emission sources, and time spent on specific tasks, with the highest average and peak exposures shown for non-spray painting tasks. These findings provide a contemporary basis for intervention programmes to reduce airborne solvent exposures in this industry.

Development of a Coding and Crosswalk Tool for Occupations and Industries

Abstract

Introduction

Job coding into a standard occupation or industry classification is commonly performed in occupational epidemiology and occupational health. Sometimes, it is necessary to code jobs into multiple classifications or to convert job codes from one classification to another. We developed a generic tool, called CAPS-Canada (http://www.caps-canada.ca/), that combines a computer-assisted coding tool covering seven International, Canadian and US occupation and industry classifications and an assistant facilitating crosswalks from one classification to another. The objectives of this paper are to present the different functions of the CAPS-Canada tool and to assess their contribution through an inter-rater reliability study.

Method

The crosswalk assistant was built based on a database of >30,000 jobs coded during a previous project. We evaluated to what extent it would allow automatic translation between pairs of classifications. The influence of CAPS-Canada on agreement between coders was assessed through an inter-rater reliability study comparing three approaches: manual coding, coding with CAPS-Canada without the crosswalk assistant, and coding with the complete tool. The material for this trial consisted of a random sample of 1000 jobs extracted from a case–control study and divided into three subgroups of equivalent size.

Results

Across the classification systems, the crosswalk assistant would provide useful information for 83–99% of jobs (median 95%) in a population similar to ours. Eighteen to eighty-one percent of jobs (median 56%) could be entirely automatically recoded. Based on our sample of 1000 jobs, inter-rater reliability in occupation coding ranged from 35.7 to 66.5% (median 53.7%) depending on the combination of classification/resolution. Compared with manual coding, the use of CAPS-Canada substantially improved inter-rater reliability.

Conclusion

CAPS-Canada is an attractive alternative to manual coding and is particularly relevant for coding a job into multiple classifications or for recoding jobs into other classifications.

Determining the Impact of Sarcopenia on Postoperative Complications after Ventral Hernia Repair

Publication date: Available online 15 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Leandra A. Barnes, Alexander Y. Li, Derrick C. Wan, Arash Momeni
BackgroundPostoperative complication following ventral hernia repair (VHR) is a major clinical and financial burden. Preoperative risk assessment is necessary to minimize adverse outcomes following VHR. This study examines the ability of an independent parameter to predict postoperative morbidity following VHR.MethodsA retrospective analysis of 58 patients who underwent VHR via component separation between January 2009 and December 2013 was performed. Preoperative abdominal CT scans were analyzed to assess sarcopenia. Sarcopenia was determined using the Hounsfield unit average calculation (HUAC), a measure of psoas muscle size and density. Sarcopenia was defined as a HUAC score of less than 19.6 using receiver-operating characteristic (ROC) analysis and the Youden index. Multivariate analysis was performed to analyze the association of sarcopenia and postoperative complications.ResultsPreoperative sarcopenia was associated with an increased risk for postoperative complications (odds ratio [OR] 5.3; p=0.04). Preexisting gastrointestinal conditions, such as ulcerative colitis or colon cancer, were associated with an increased risk for postoperative complications (OR 5.7; p=0.05). A significantly higher rate of hernia recurrence (33.3% vs 10.8% [p=0.04]) and renal failure (19% vs 2.7% [p=0.03]) was noted in patients with sarcopenia when compared to patients without sarcopenia.ConclusionsSarcopenia is an independent risk factor for postoperative complications in VHR patients. Assessing sarcopenia using the HUAC score provides an opportunity for the adjustment of perioperative care plans to minimize postoperative complication rates.

Disability, Dialogue, and the Posthuman

Abstract

This article is the result of a mutual interest in the radical philosophical dialogue discussed by Martin Buber. The radical dialogue is rooted in western European values of humanism, values that are challenged because they exclude women, people with disabilities, non-western, indigenous people and sexual minorities. With our basis in radical dialogue we are discussing flaws within the very concept of dialogue, how dialogue is challenged in encounters between people with severe disabilities and their helpers, and we are proposing a new interpretation of dialogue in a posthuman area. To illuminate what might be at stake in relations where power is clearly imbalanced we use Pierre Bourdieus theory of the gift when asking ourselves: "How can we understand dialogue when there apparently is one dominant giver and one receiver unable to return the gift?" Discussing this question, we draw on Rosi Braidotti and her Posthuman Critical Theory to see if we can find new grounds to build dialogue on.

Editorial Board

Publication date: June 2018
Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 3

Élaboration d’un questionnaire de satisfaction encadrant la chirurgie de féminisation faciale chez les patientes transsexuelles male to female (QESFF1) : Phase qualitative

Publication date: June 2018
Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 3
Author(s): C. Verbruggen, R. Weigert, P. Corre, V. Casoli, M. Bondaz
ObjectifLa chirurgie de féminisation faciale fait partie intégrante du processus de transformation des patientes transsexuelles male to female. Une évaluation globale de la satisfaction de ces patientes par un questionnaire spécifique est fondamentale afin de confirmer le bénéfice de cette chirurgie et d'optimiser les pratiques cliniques. L'objectif de cette étude est de développer un outil fiable et valide permettant de mesurer la satisfaction de ces patientes.MéthodesUne revue de la littérature, l'avis d'une commission d'experts et des entretiens avec des patientes issues de la population cible ont permis de mettre en place le Conceptual Framework du questionnaire. Il regroupe l'ensemble des domaines majeurs du questionnaire et a permis la création des différents items.RésultatsAucun questionnaire n'existe à ce jour pour mesurer de manière spécifique la satisfaction de ces patientes. Dix experts et 18 patientes ont participé à l'étude. Le Conceptual Framework se compose des domaines suivants : satisfaction concernant l'apparence féminine du visage ; les séquelles postopératoires ; qualité de vie. Le questionnaire comprend quatorze échelles de Likert indépendantes entre elles, utilisables en préopératoire et postopératoire. La fiabilité du questionnaire est excellente avec un score Alpha de Cronbach moyen de 0,85. La satisfaction mesurée après chirurgie de féminisation faciale dans cet étude est très bonne avec une moyenne de 83,7±7,41.ConclusionLe QESFF1 est un questionnaire fiable dont la création respecte les étapes du patients reported outcomes process. La démonstration de sa validité nécessite une étude pluricentrique ultérieure. Il permet aux praticiens de mesurer objectivement l'impact de la chirurgie de féminisation faciale chez les patientes transsexuelles male to female et peut également être utilisé en recherche clinique.ObjectiveFacial feminization surgery is becoming a more frequently requested procedure in transsexual male to female patients transformation. A global way of reporting outcomes data and showing the beneficial impact of this specific procedure is necessary. The objective of this study is to develop a reliable and valid tool to report patients' outcomes after facial feminization surgery.MethodsA systematic literature review, input from experts working with transsexual patients and patient interviews were used to develop the conceptual framework of the questionnaire. It includes the outcomes deemed important to facial feminization surgery and it was used to construct items of the questionnaire.ResultsThere is no specific tool for measuring patients outcomes after facial feminization surgery. Ten experts and 18 patients participated to this study. The conceptual framework includes the following themes: satisfaction with facial feminine appearance; adverse effects; quality of life. The questionnaire includes fourteen separate Likert scales, with preoperative and postoperative versions. The reliability of the questionnaire is excellent with a medium Alpha score of 0.85. Facial feminization surgery is associated with high patient satisfaction in this sample (83.7±7.41).ConclusionQESFF1 is a reliable questionnaire and its development follows the steps recommended by the patient-reported outcomes process. A large sample pilot test is needed to demonstrate its validity. The QESFF1 can provide physicians with the necessary tools to measure the impact of facial feminization surgery on male to female transsexual patients and also has the potential to support clinical trials.

Multiple diversity concepts and their ethical-epistemic implications

Abstract

A concept of diversity is an understanding of what makes a group diverse that may be applicable in a variety of contexts. We distinguish three diversity concepts, show that each can be found in discussions of diversity in science, and explain how they tend to be associated with distinct epistemic and ethical rationales. Yet philosophical literature on diversity among scientists has given little attention to distinct concepts of diversity. This is significant because the unappreciated existence of multiple diversity concepts can generate unclarity about the meaning of "diversity," lead to problematic inferences from empirical research, and obscure complex ethical-epistemic questions about how to define diversity in specific cases. We illustrate some ethical-epistemic implications of our proposal by reference to an example of deliberative mini-publics on human tissue biobanking.