Abstract
Enhancing the acid tolerance of the probiotic bacterial strain Lactobacillus acidophilus NCFM (L. acidophilus NCFM) is critical for improving its viability during transiting through gastrointestinal tract, which is the basis of eliciting beneficial effects as an intestinal probiotic. In this study, the role of trehalose and the glutamateγ-aminobutyric acid antiporter gene gadC in enhancing the acid tolerance of L. acidophilus NCFM was investigated. Trehalose at a concentration of 0.5% (w/v) was sufficient to significantly increase bacterial viability at pH 2.0, and trehalose of 2.0% can preserve more than 80% of bacterial viability both at pH 2.0 and 3.0. The inactivation of gadC gene in L. acidophilus NCFM significantly reduced bacterial viability at pH 2.0, and diminished the protective effect of trehalose against acid stress. In conclusion, exogeneous trehalose conferred L. acidophilus NCFM enhanced viability at extreme low pH values, an effect that appeared to depend on its endogenous glutamate-depenent acid resistance system.Δευτέρα 3 Σεπτεμβρίου 2018
Chlorothalonil Biotransformation by Cytochrome P450 Monooxygenases in Sclerotinia homoeocarpa
Abstract
Cytochrome P450s have been shown to play a vital role in the xenobiotic detoxification system of Sclerotinia homoeocarpa, the causal agent of the turfgrass disease dollar spot. A previous study indicated that three CYP450s were validated to play a functional role in resistance against different fungicide classes including propiconazole and plant growth regulator, flurprimidol. In this study, we present these CYP450s possess the capability to modify the multi-site mode of action fungicide chlorothalonil. Chlorothalonil is an extensively used contact fungicide and has been shown to persist in soils. High Performance Liquid Chromatography (HPLC) indicated faster rates of chlorothalonil biotransformation by CYP561 and CYP65 overexpression strains when compared to the wild-type and CYP68 overexpression strain. Our GC-MS results show that the primary transformation intermediate found in soils, 4-hydroxy-2,5,6 trichloro-isophthalonitrile is produced by CYP450s' metabolism. These findings suggest fungal CYP450s can biotransform chlorothalonil for biodegradation or detoxification.Recent advances in the microbial hydroxylation and reduction of soy isoflavones
Abstract
Soy isoflavones are naturally occurring phytochemicals, which are biotransformed into functional derivatives through oxidative and reductive metabolic pathways of diverse microorganisms. Such representative derivatives, ortho-dihydroxyisoflavones (ODIs) and equols, have attracted great attention for their versatile health benefits since they were found from soybean fermented foods and human intestinal fluids. Recently, scientists in food technology, nutrition, and microbiology began to understand their correct biosynthetic pathways and nutraceutical values, and have attempted to produce the valuable bioactive compounds using microbial fermentation and whole-cell/enzyme-based biotransformation. Furthermore, artificial design of microbial catalysts and/or protein engineering of oxidoreductases were also conducted to enhance production efficiency and regioselectivity of products. This minireview summarizes and introduces the past year's studies and recent advances in notable production of ODIs and equols, and provides information on available microbial species and their catalytic performance with perspectives on industrial application.Myo-inositol as an adjuvant to florfenicol against Aeromonas hydrophila infection in common carp Cyprinus carpio
Abstract
Florfenicol, a synthetic drug with chemical structure and spectrum of antibacterial activity similar to chloramphenicol, has been shown to be effective against a number of bacterial pathogens. However, there are increasing signs of florfenicol-resistant bacteria due to the misuse and overuse of florfenicol in aquaculture. In the present study, florfenicol had a higher bactericidal efficacy in the presence of myo-inositol, may be due to the ability of myo-inositol to increase susceptibility of Aeromonas hydrophila to florfenicol. Furthermore, in two different infected models, co-administration myo-inositol and florfenicol significantly reduced the bacterial load in the liver, kidney and spleen tissues of A. hydrophila-infected Cyprinus carpio, and greatly increased the survival rate of infected fish. Finally, it was also found that myo-inositol exhibited synergistic action with other antibiotic drugs including neomycin sulfate, ceftriaxone and enrofloxacin. The results obtained in this study suggest that myo-inositol as a efficient adjuvant to antibiotic drugs, could be useful in increasing the antimicrobial activity of antibiotic drugs against A. hydrophila infection, also be useful to help decrease the occurrence of antibiotic overuse in aquaculture.Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial
Abstract
Objectives
Diagnostic accuracy of conventional coronary CT angiography (CCTAconv) may be compromised by blooming artifacts from calcifications or stents. Blooming artifacts may be reduced by subtraction coronary CT angiography (CCTAsub) in which non-contrast and contrast CT data sets are subtracted digitally. We tested whether CCTAsub in patients with severe coronary calcification or stents reduces the number of false-positive stenosis evaluations compared with CCTAconv.
Methods
In this study, 180 symptomatic patients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and CT scanned (2013-2016) at three international centers. CCTAconv, and CCTAsub data sets were reconstructed. Target segments were defined as motion-free coronary segments with a suspected stenosis (> 50% of lumen) potentially due to blooming of either calcium or stents. Target segments were evaluated with respect to misregistration artifacts from the CCTAsub reconstruction process, in which case evaluation was omitted. CCTAsub and CCTAconv were compared with ICA. Primary outcome measure was the frequency of false positives by CCTAconv versus CCTAsub to identify > 50% coronary stenosis by ICA on a per-segment level.
Results
After exclusion of 76 patients, 104 (14% females) with mean age 67 years and median Agatston score 852 were included. There were 136 target segments with misregistration and 121 target segments without. Accuracy calculations in target segments without misregistration showed a reduction of the false positives from 72% [95% confidence interval (CI): 63-80%] in CCTAconv to 33% (CI:25-42%) in CCTAsub, at the expense of 7% (CI:3-14%) false negatives in CCTAsub.
Conclusions
In severely calcified coronary arteries or stents, CCTAsub reduces the false-positive rate in well-aligned, calcified or stent segments suspected of significant stenosis on CCTAconv. Nevertheless, misregistration artifacts are frequent in CCTAsub.
Key Points
• A high calcium-score reduces the diagnostic accuracy in patients scanned with cardiac CT.
• These patients would normally need an invasive angiogram for diagnosis.
• In this prospective, multicenter study, subtraction CT, when evaluable, reduces false-positive stenosis evaluations.
• Subtraction coronary CT angiography may, when evaluable, reduce excessive downstream testing.
Correction to: Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT
The original version of this article, published on 19 January 2018, unfortunately contained a mistake.
Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers
Abstract
Objectives
To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT.
Methods
Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers. Various dynamic parameters describing SLD were compared (maximal value, variation coefficient and range) in patients with and without scapholunate ligament ruptures confirmed by CT arthrography.
Results
SLD in CF varied from 3.17 ± 0.38 to 3.24 ± 0.80 mm in controls and from 4.11 ± 0.77 and 4.01 ± 0.85 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p < 0.009). SLD in RUD varied from 3.35 ± 0.51 and 3.01 ± 0.78 mm in controls and from 4.51 ± 1.26 to 4.42 ± 1.75 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p varied from 0.001 to 0.002). The inter-observer variability was better for RUD (ICC = 0.85 versus 0.6 for RUD and CF respectively).
Conclusion
Analysis of SLD using kinematic CT has shown significant measurement differences between the groups with or without scapholunate instability with good diagnostic performance.
Key Points
• Kinematic CT can quantitatively assess scapholunate dissociation.
• SLD analysis on kinematic CT has excellent reproducibility with radioulnar deviation maneuver.
• Scapholunate dissociation was significantly different in patients with and without instability.
• Diagnostic performance for scapholunate instability identification was better with radioulnar deviation.
Correction to: Anatomy of the retro-oesophageal major aortopulmonary collateral arteries in patients with pulmonary atresia with ventricular septal defect: results from preoperative CTA
The original version of this article, originally published online ahead of printing on January 05, 2018, unfortunately contained mistakes.
Optic radiations are thinner and show signs of iron deposition in patients with long-standing remitting-relapsing multiple sclerosis: an enhanced T 2 * -weighted angiography imaging study
Abstract
Objective
This study aimed to investigate iron deposition and thickness and signal changes in optic radiation (OR) by enhanced T2*-weighted angiography imaging (ESWAN) in patients with relapsing-remitting multiple sclerosis (RRMS) with unilateral and bilateral lesions or no lesions.
Methods
Fifty-one RRMS patients (42 patients with a disease duration [DD] ≥ 2 years [group Mor], nine patients with a DD < 2 years [group Les]) and 51 healthy controls (group Con) underwent conventional magnetic resonance imaging (MRI) and ESWAN at 3.0 T. The mean phase value (MPV) of the OR was measured on the phase image, and thickness and signal changes of the OR were observed on the magnitude image.
Results
The average MPVs for the OR were 1,981.55 ± 7.75 in group Mor, 1,998.45 ± 2.01 in group Les, and 2,000.48 ± 5.53 in group Con. In group Mor, 28 patients with bilateral OR lesions showed bilateral OR thinning with a heterogeneous signal, and 14 patients with unilateral OR lesions showed ipsilateral OR thinning with a heterogeneous signal. In the remaining nine patients without OR lesions and in group Con, the bilateral OR had a normal appearance. In the patients, a negative correlation was found between DD and OR thickness and a positive correlation was found between MPV and OR thickness.
Conclusions
We confirmed iron deposition in the OR in the RRMS patients, and the OR thickness was lower in the patients than in the controls.
Key Points
• Enhanced T 2 * -weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis (MS).
• Focal destruction of the optic radiation (OR) is detectable by ESWAN.
• Iron deposition in OR can be measured on ESWAN phase image in MS patients.
• OR thickness was lower in the patients than in the controls.
• Iron deposition and thickness changes of the OR are associated with disease duration.
The inhibitory effect of gadoxetate disodium on hepatic transporters: a study using indocyanine green
Abstract
Objectives
To assess the inhibitory effect of gadoxetate disodium on the transporter system using indocyanine green (ICG).
Materials and Methods
Groups of six female B6 Albino mice were injected with the test agent (0.62 mmol/kg gadoxetate disodium) or phosphate-buffered saline (control) 10 min before injection of ICG. Identical fluorescence images were subsequently obtained to create time-efficiency curves of liver parenchymal uptake. The study was performed on hypothermic and normothermic mice. The logarithms of the absorption rate constants (logKa values) and of the elimination rate constants (logKe values) were calculated for each experimental condition, and between-group differences were compared using Student's t-test.
Results
The logKe values of the test group were lower than those of the control group at both temperatures (-6.52 vs. -5.87 under hypothermic conditions and -4.54 vs. -4.14 under normothermic conditions), and both differences were statistically significant (p = 0.037, 0.015 respectively). In terms of the logKa values, although the difference did not reach statistical significance (p = 0.052), the test group had lower values than the control group under hypothermic conditions (-0.771 vs. -0.376). In normothermic mice, the logKa values for the test and control groups were 0.037 and 0.277 respectively, thus not significantly different (p = 0.404).
Conclusions
Gadoxetate disodium inhibited ICG excretion. Thus, gadoxetate disodium inhibited the ATP-binding cassette sub-family C member 2 transporter.
Key Points
• Gadoxetate disodium inhibited ICG excretion.
• Gadoxetate disodium tended to inhibit hepatic ICG uptake.
• Drug-drug interactions of gadoxetate disodium need further investigation.
Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas
Abstract
Objectives
ASL is useful in evaluating tumour blood flow and in detecting hypervascular tumours. The purpose of this study was to assess the additive value of ASL to non-contrast and contrast-enhanced (NC/CE)-T1WI for diagnosing residual or recurrent meningiomas.
Methods
This retrospective study included 25 postoperative patients (20 women, 5 men; median age, 65 [32–85] years) with and 25 gender- and age-matched postoperative patients without residual or recurrent meningiomas. ASL was performed using a pseudocontinuous method. Seven independent observers (two radiology residents, two general radiologists and three neuroradiologists) participated in two reading sessions consisting of only NC/CE-T1WI (first session) or NC/CE-T1WI with ASL (second session). We evaluated the sensitivity and diagnostic performance for the detection of residual or recurrent meningiomas. The diagnostic performance was assessed using a figure of merit (FOM) calculated via jackknife free-response receiver-operating characteristics. Statistical analysis was performed with paired t tests, with a significance level of p < .05.
Results
The sensitivities were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (62.1% vs. 70.7%), general radiologists (75.9% vs. 87.9%), neuroradiologists (97.7% vs. 100%) and all observers (81.3% vs. 88.2%). The FOMs were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (0.76 vs. 0.83), general radiologists (0.83 vs. 0.93), neuroradiologists (0.95 vs. 0.99) and all observers (0.86 vs. 0.93). The addition of ASL significantly improved the diagnostic parameters for all observers except neuroradiologists (p <. 05).
Conclusions
ASL improved the detection rate of residual or recurrent meningiomas on NC/CE-T1WI among both radiology residents and general radiologists.
Key Points
• ASL improved diagnostic performance for residual/recurrent meningioma compare to NC/CE-T1WI alone.
• Diagnostic sensitivity was increased after adding ASL compared with NC/CE-T1WI.
• FOM was increased after adding ASL compared with NC/CE-T1WI.
Clinical impact of preoperative liver MRI in the evaluation of synchronous liver metastasis of colon cancer
Abstract
Objectives
To investigate whether additional MRI including gadoxetic acid enhancement is associated with survival rate (SR) in patients with synchronous liver metastasis of colon cancer (sCLM), compared with patients assessed only with CT.
Methods
Fifty-two patients underwent only CT (CT group) and 65 underwent additional MRI (CT+MRI group) for preoperative work-up of sCLM. In the CT+MRI group, the discrepancy between CT and MRI was analyzed. The 5-year SR was compared between the groups, and affecting factors were investigated. The inverse probability treatment weighting analysis (IPTW) adjusted by propensity scores was performed.
Results
In the CT+MRI group, 44 (67.7%) showed a discrepancy in the number of sCLMs between CT and MRI. MRI detected 39 additional sCLMs initially missed on CT in 26 patients. The number of detected sCLMs was better correlated with the pathologic findings in the CT+MRI group than in the CT group (p = 0.008). The estimated 5-year SR in the CT+MRI group was 70.8%, while that in the CT group was 48.1%. On adjusted multivariate analyses after the IPTW, the CT+MRI group showed a significantly lower risk of overall mortality than the CT group.
Conclusion
Additional preoperative evaluation by MRI allowed us to more precisely detect sCLM and was associated with a better SR.
Key Points
• CT+MRI group showed significantly higher 5-year survival rates than CT group.
• CT+MRI group was an independent prognostic factor of overall mortality.
• MRI facilitates more accurate detection and better lesion characterization.
• MRI selected better candidates for curative treatment.
• The benefits of MRI were reflected by better survival.
Correction to: Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study
The original version of this article, published on 14 March 2018, unfortunately contained a mistake.
Interobserver and intermodality agreement of standardized algorithms for non-invasive diagnosis of hepatocellular carcinoma in high-risk patients: CEUS-LI-RADS versus MRI-LI-RADS
Abstract
Objectives
We compared the interobserver agreement for the recently introduced contrast-enhanced ultrasound (CEUS)-based algorithm CEUS-LI-RADS (Liver Imaging Reporting and Data System) versus the well-established magnetic resonance imaging (MRI)-LI-RADS for non-invasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.
Methods
Focal liver lesions in 50 high-risk patients (mean age 66.2 ± 11.8 years; 39 male) were assessed retrospectively with CEUS and MRI. Two independent observers reviewed CEUS and MRI examinations, separately, classifying observations according to CEUS-LI-RADSv.2016 and MRI-LI-RADSv.2014. Interobserver agreement was assessed with Cohen's kappa.
Results
Forty-three lesions were HCCs; two were intrahepatic cholangiocarcinomas; five were benign lesions. Arterial phase hyperenhancement was perceived less frequently with CEUS than with MRI (37/50 / 38/50 lesions = 74%/78% [CEUS; observer 1/observer 2] versus 46/50 / 44/50 lesions = 92%/88% [MRI; observer 1/observer 2]). Washout appearance was observed in 34/50 / 20/50 lesions = 68%/40% with CEUS and 31/50 / 31/50 lesions = 62%/62%) with MRI. Interobserver agreement was moderate for arterial hyperenhancement (ĸ = 0.511/0.565 [CEUS/MRI]) and "washout" (ĸ = 0.490/0.582 [CEUS/MRI]), fair for CEUS-LI-RADS category (ĸ = 0.309) and substantial for MRI-LI-RADS category (ĸ = 0.609). Intermodality agreement was fair for arterial hyperenhancement (ĸ = 0.329), slight to fair for "washout" (ĸ = 0.202) and LI-RADS category (ĸ = 0.218)
Conclusion
Interobserver agreement is substantial for MRI-LI-RADS and only fair for CEUS-LI-RADS. This is mostly because interobserver agreement in the perception of washout appearance is better in MRI than in CEUS. Further refinement of the LI-RADS algorithms and increasing education and practice may be necessary to improve the concordance between CEUS and MRI for the final LI-RADS categorization.
Key Points
• CEUS-LI-RADS and MRI-LIRADS enable standardized non-invasive diagnosis of HCC in high-risk patients.
• With CEUS, interobserver agreement is better for arterial hyperenhancement than for "washout".
• Interobserver agreement for major features is moderate for both CEUS and MRI.
• Interobserver agreement for LI-RADS category is substantial for MRI, and fair for CEUS.
• Interobserver-agreement for CEUS-LI-RADS will presumably improve with ongoing use of the algorithm.
Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis
Abstract
Purpose
To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard.
Materials and methods
330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists. Inter-observer agreement was analyzed. Transplant renal artery anatomy and complications were evaluated and compared with DSA. If possible, accuracy was calculated on a per-artery basis.
Results
Good or excellent image quality was found in 95.4 % (352/369) of examinations with good inter-observer agreement (K=0.760). Twenty-two patients with DSA had 28 non-contrast-enhanced MRA examinations within a 2-month period. Of these, 19 patients had TRAS, two patients had pseudoaneurysms, and one patient had a normal transplant renal artery but an occluded external iliac artery. Non-contrast-enhanced MRA correctly detected 19 TRAS and nine normal arteries, giving 96.6 % accuracy on a per-artery basis.
Conclusions
Non-contrast-enhanced MRA demonstrates a good depiction of the transplanted renal artery and shows good correlation with DSA in cases where there was TRAS.
Key Points
• Good or excellent image quality was found in 95.4 % of examinations.
• Non-contrast-enhanced MRA can clearly map transplant renal artery anatomy.
• Non-contrast-enhanced MRA is a reliable tool to detect TRAS.
Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow
Abstract
Purpose
To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.
Methods
Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.
Results
The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.
Conclusion
The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.
Key points
• Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals.
• A clinical cancer network provides opportunities to improve healthcare.
• Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality.
• Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.
Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years
Abstract
Objectives
To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations.
Methods
The institutional review board (IRB) of the Charité approved this retrospective, single-centre study. A total of 4376 cardiac MR imaging reports of 3553 patients (age 37.4 ± 20 years, 60.8 % male) examined from 2000 to 2014 were included. Findings with a recommendation for follow-up were considered "major ECF". To analyse the association of indication, age and gender with ECF, Poisson regression and computed incidence rate ratios (IRR) were evaluated.
Results
The overall prevalence of ECF was 34% (95% confidence interval [CI] 32.5–35.6%). Major ECF were present in 3.4% (95% CI 2.9–4.1%) while findings that changed patient management were found in 0.9% (95% CI 0.7–1.3%). In the cases of congenital heart disease, ECF prevalence was higher compared to myocarditis (IRR, 6.0; 95% CI 5.1–7.1%; p < 0.001), while the prevalence of major ECF was lower (IRR, 0.2; 95% CI 0.02–0.51%; p < 0.05). Older patient age was associated with more nonvascular ECF (p < 0.001). Female patients had the same probability of having an ECF as male patients (IRR, 1.04; 95% CI 0.95–1.1%; p = 0.43).
Conclusion
ECF in cardiac MR imaging are present in about every third patient while relevant ECF that change patient management can be found in about one out of 100 patients. Our data suggest that it is important to involve well-trained radiologists in reading cardiac MR images, which often reveal ECF if congenital heart disease is the clinical indication.
Key Points
• Extracardiac findings are present in about every third patient.
• Relevant ECF changing patient management are found in one out of 100 findings.
• Chance of ECF is high in patients with CHD and vascular indications.
Surgery after FOLFIRINOX treatment for locally advanced and borderline resectable pancreatic cancer: increase in tumour attenuation on CT correlates with R0 resection
Abstract
Objectives
To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX.
Methods
Patients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared.
Results
Of 59 patients included, 19 were defined as unresectable (32%), 33 borderline resectable (56%) and 7 resectable (12%) during the blind radiological evaluation after FOLFIRINOX. Once in a surgical setting, 27% were non-resectable, whereas 73% received surgical resection with a 70% R0 rate. Consequent sensitivity and specificity were 86% and 29%. At imaging review, significant decreases in longest tumour dimension were observed in both groups: from 32 mm (95% CI 15–55) to 21 (10–44) in group A and from 34 (18–70) to 26 (7–60) in group B, p < 0.05. However, a significant increase in tumour attenuation in all phases was only observed for R0 resected, from 52 HU (26–75) to 65 (35–92) in arterial phase (p < 0.001) and from 62 (36–96) to 78 (40–120) in the venous (p = 0.001).
Conclusion
After neoadjuvant FOLFIRINOX, CT predicted resectability with acceptable sensitivity but low specificity. The observation of increased tumour attenuation at CT scan after FOLFIRINOX treatment might represent a reliable predictor of R0 resection.
Key Points
• CT drives the assessment of PDAC resectability after FOLFIRINOX
• CT predicts resectability with acceptable sensitivity but low specificity
• Significant increase in tumour attenuation was only observed for R0 resected PDAC
• Tumour attenuation after FOLFIRINOX represents a reliable predictor of R0 resection
Cardiac implanted electronic devices and MRI safety in 2018—the state of play
Abstract
Traditionally, the presence of cardiac implanted electronic devices (CIEDs) was a contra-indication to magnetic resonance (MR) imaging. Professional groups from around the world are releasing updated guidelines for the imaging of MR-conditional and legacy CIEDs, reflecting increasing evidence that this can be performed safely when strict protocols are followed.
Key Points
• The presence of a pacemaker or automatic implanted cardioverter defibrillator is no longer an absolute contraindication to magnetic resonance imaging.
• Strict protocols enable diagnostic quality images to be obtained with minimal risk.
• Close collaboration among radiologists, cardiologists and device manufacturer representatives is required.
Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest
Abstract
Aims and objectives
We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT.
Methods and materials
Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51.8 years) with non-traumatic, out-of-hospital SCA and ROSC and evaluation with dedicated SCA-WBCT over a 10-month period.
Results
In-hospital mortality was 54%. CPR-related injuries were detected in 85% (33/39).
Chest injuries were most common on WBCT: 85% (33) subjects had rib fractures (mean of 8.5 fractures/subject); 31% (12) sternal fractures; 13% (5) mediastinal haematoma; 10% (4) pneumothorax; 8% (3) pneumomediastinum and 3% (1) haemothorax. Three subjects (8%) had abdominal injuries on WBCT, including one hepatic haematoma with active haemorrhage.
Conclusion
CPR-related injuries on WBCT after ROSC are common, with serial rib fractures detected most commonly. An unexpectedly high rate of abdominal injuries was detected on SCA-WBCT. Radiologists need to be attuned to the spectrum of CPR-related injuries in WBCT, including abdominal injuries and subtle rib fractures.
Key Points
• CPR frequently causes injuries.
• Radiologists should be aware of the spectrum of CPR related injuries.
• Rib fractures are frequent and radiologic findings often subtle.
• Clinically unexpected abdominal injuries may be present.
Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy in prostate cancer – phase 1 trial
Abstract
Objectives
To evaluate the feasibility and safety of focal therapy for low–intermediate risk prostate cancer (PCa) with magnetic resonance-guided high frequency focused ultrasound (MRgFUS)
Methods
This IRB-approved phase 1 prospective study enrolled eight patients with prostate specific antigen (PSA) ≤ 10 ng/ml, ≤ cT2a and Gleason score ≤ 7 (4 + 3) disease following informed consent. Under MRI guidance, focused high frequency ultrasound energy was delivered to ablate the target tissue. Treatment-related adverse events were recorded. Oncologic outcomes were evaluated with multiparametric MRI, PSA and TRUS biopsy at 6 months following treatment.
Results
Ten target lesions [six Gleason 6 lesions, two Gleason 7 (3 + 4) and two Gleason 7 (4 + 3)] were treated in eight men (prostate volume range, 25–50 cc; mean MRI time, 248 min per patient; mean sonication duration, 65 min). Mean target volume was 2.7 cc and mean post-treatment non-perfused volume was 4.3 cc. Quality of life parameters were similar between baseline and 6 months in 6/8 patients. All treated regions were negative on MRI; 4/8 patients and 6/10 target lesions (60%) were clear of disease on biopsy. One patient with 2-mm Gleason 8 disease in one of five cores from treatment site (4 + 3 disease at baseline) subsequently underwent prostatectomy with negative surgical margins. Three patients with low volume (5–15%) Gleason 6 residual disease were offered active surveillance. Mean PSA decreased from 5.06 at baseline to 3.4 ng/ml at 6 months.
Conclusion
MRgFUS is a feasible and safe method of noninvasively ablating low–intermediate risk PCa with acceptable short-term oncologic outcomes.
Key Points
• Focal therapy selectively ablates locally confined, clinically significant index lesion with a margin while sparing rest of gland and adjacent vital structures.
• Magnetic resonance-guided focused high frequency ultrasound surgery (MRgFUS) combines MRI with HIFU.
• MRgFUS provides ability to monitor treatments in real time and allows a targeted approach for focal ablation.
• MRgFUS is a feasible, safe method of noninvasively ablating low–intermediate risk PCa.
• MRgFUS provides acceptable oncologic outcomes at 6 months.
Experience of neuroprotective air injection during radiofrequency ablation (RFA) of spinal osteoid osteoma
Abstract
Purpose
To assess the usefulness of epidural air injection during the RFA treatment of spinal osteoid osteoma.
Methods
A retrospective review of 17 patients who underwent RFA for spinal osteoid osteoma between September 2006 and May 2017 was performed. All the procedures were performed by a single radiologist. We reviewed the perioperative CT studies to assess the distribution of air relative to the osteoid osteoma. The clinical outcome of each patient group was evaluated during routine follow-up.
Results
Seventeen patients were treated for spinal OO (male:female 13:4; mean age was 16, ranging from 4 to 42). The nidus size ranged from 5.8 to 17.2 mm (mean 11.2). In nine cases epidural air injection was performed. In three cases the neuroprotective air was deemed satisfactory with a clear layer of air between the osteoid osteoma and the dural sac being visualised. In six patients adherence between the cortical bone immediately adjacent to the osteoid osteoma and the dural sac in contact was observed.
In 15 patients the procedure was successful in terms of pain relief. No neural damage or other complication was reported in either group.
Conclusion
RFA is a safe treatment for spinal osteoid osteoma. Neuroprotective air injection does not appear to be necessary when performing the treatment in the spine.
Key Points
• Seventeen patients with spinal OO were treated with RFA, nine with air injection and eight without. Clinically successful treatment was achieved in 15 patients, with 2 subsequently undergoing surgery
• In 6/9 cases the injected air failed to achieve separation between the osteoid osteoma and the thecal sac because of inflammatory adhesion
• No complications were observed, regardless of whether neuroprotective air was instilled. Neuroprotective air injection appears unnecessary when treating spinal OO
Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases
Abstract
Objectives
To explore the relationship between osteosclerotic changes and chemotherapy response in non-small-cell lung cancer (NSCLC) patients with bone metastases (BM).
Methods
Fifty-two NSCLC patients with BM were enrolled from 1 January 2010–31 June 2015 and divided into two groups based on their CT features: an osteosclerotic change (OC) group and a no-osteosclerotic change (NOC) group. The disease control rate (DCR) was evaluated, and progression-free survival (PFS) was analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse the factors that could affect PFS.
Results
Osteosclerotic changes were observed in 35/52 patients. The median interval when osteosclerotic changes occurred was 2 months (range 1–3 months) after chemotherapy. The OC group had a significantly higher 3-month DCR than the NOC group (p < 0.001). The OC group had a higher 1-year PFS rate than the NOC group (1-year PFS: 74.9% vs. 30.2%, p < 0.001). Univariate Cox regression analysis indicated that pathological subtype (HR = 4.419; 95% CI = 1.635–11.941, p = 0.003) and osteosclerotic changes (HR = 0.199; 95% CI = 0.083–0.477, p < 0.001) were significant predictors of PFS.
Conclusion
Early osteosclerotic changes predict chemotherapy response in NSCLC patients with BM.
Key Points
• Osteosclerotic changes were prevalent CT features after chemotherapy in NSCLC patients.
• Osteosclerotic changes were positively related to increased 3-month DCR.
• Osteosclerotic changes were positively related to increased 1-year PFS rate.
The use of etanercept for treatment of toxic epidermal necrolysis when toxic shock syndrome is in the differential
Dermatologic Therapy, EarlyView.
“SENECA” Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series
Dermatologic Therapy, EarlyView.
Parasitoids of the eucalyptus gall wasp Leptocybe spp.: a global review
Abstract
The genus Leptocybe Fisher & La Salle (Hymenoptera: Eulophidae) and its type species L. invasa were first described in 2004. Leptocybe spp. are global pests of eucalyptus plantations, and parasitoids play an important role in their control. In this review, we describe the species, distribution, biology, ecology and parasitism levels of Leptocybe spp. parasitoids and the problems associated with biological control programmes against Leptocybe spp. Additionally, prospects for the use of conservation or augmentative biological control programmes against Leptocybe spp. are discussed. Worldwide, approximately 23 species of parasitoids of Leptocybe spp. in 7 families and 10 genera have been found to date. Comparing the parasitism levels of the parasitoids showed that Quadrastichus mendeli, Selitrichodes neseri and several (approximately 4) native Megastigmus spp. could be exploited to manage Leptocybe spp. Available information on the Leptocybe spp. parasitoids is expected to improve our understanding related to ongoing studies of biological control programmes against Leptocybe spp.
Ultrashort time-to-echo quantitative magnetic resonance imaging of the triangular fibrocartilage: differences in position
Abstract
Purpose
To compare T2* values of the triangular fibrocartilage (TFC) obtained by ultrashort time-to-echo (UTE) techniques at the neutral position, ulnar flexion of the wrist, and pronation of the forearm.
Materials and methods
MR imaging was performed in ten healthy volunteers with a 3-T MR system by using an eight-channel knee coil. Coronal wrist T2* maps from three-dimensional cone UTE pulse sequences were obtained at the neutral, ulnar flexion, and pronation positions (TR: 19 ms, TE: 0.032 ms/4 ms/8 ms/12 ms, FOV: 18 cm, matrix: 430 × 430, section thickness: 1.5 mm, scan time: 8 min 31 s). UTE-T2* maps were calculated on a pixel-by-pixel basis for all structures of the wrist visualized in the coronal planes. The entire region of interest (ROI) for TFC was manually delineated, and the average T2* value was calculated for each ROI by three radiologists. The Kruskal-Wallis test, Wilcoxon signed-rank test, or intraclass correlation coefficients (ICC) were used for statistics.
Results
The difference in the average T2* value among the three groups according to the forearm/wrist position was significant (p < 0.001). The T2* value of the TFC at pronation (mean ± 2 SD: 7.92 ± 1.37 ms) was significantly lower than those at the neutral (10.08 ± 1.90 ms) and ulnar flexion positions (9.15 ± 1.03 ms) (p < 0.017). The ICC showed a substantial interobserver agreement in the T2* value measurements of the TFC (ICC = 0.986).
Conclusion
T2* relaxation time measurement of the TFC using UTE may be useful for assessing the loading effect by the forearm/wrist position.
Key Points
• The T2* value of the TFC may reflect the biomechanics of the wrist joint.
• Acute loading at pronation results in a decrease in the T2* value of the TFC.
• Quantitative wrist UTE MRI was successfully performed in vivo.
Multiparametric ultrasomics of significant liver fibrosis: A machine learning-based analysis
Abstract
Objective
To assess significant liver fibrosis by multiparametric ultrasomics data using machine learning.
Materials and Methods
This prospective study consisted of 144 patients with chronic hepatitis B. Ultrasomics—high-throughput quantitative data from ultrasound imaging of liver fibrosis—were generated using conventional radiomics, original radiofrequency (ORF) and contrast-enhanced micro-flow (CEMF) features. Three categories of features were explored using pairwise correlation and hierarchical clustering. Features were selected using diagnostic tests for fibrosis, activity and steatosis stage, with the histopathological results as the reference. The fibrosis staging performance of ultrasomics models with combinations of the selected features was evaluated with machine-learning algorithms by calculating the area under the receiver-operator characteristic curve (AUC).
Results
ORF and CEMF features had better predictive power than conventional radiomics for liver fibrosis stage (both p < 0.01). CEMF features exhibited the highest diagnostic value for activity stage (both p < 0.05), and ORF had the best diagnostic value for steatosis stage (both p < 0.01). The machine-learning classifiers of adaptive boosting, random forest and support vector machine were found to be optimal algorithms with better (all mean AUCs = 0.85) and more stable performance (coefficient of variation = 0.01–0.02) for fibrosis staging than decision tree, logistic regression and neural network (mean AUC = 0.61–0.72, CV = 0.07–0.08). The multiparametric ultrasomics model achieved much better performance (mean AUC values of 0.78–0.85) than the features from a single modality in discriminating significant fibrosis (≥ F2).
Conclusion
Machine-learning-based analysis of multiparametric ultrasomics can help improve the discrimination of significant fibrosis compared with mono or dual modalities.
Key Points
• Multiparametric ultrasomics has achieved much better performance in the discrimination of significant fibrosis (≥ F2) than the single modality of conventional radiomics, original radiofrequency and contrast-enhanced micro-flow.
• Adaptive boosting, random forest and support vector machine are the optimal algorithms for machine learning.
Toxicity potential of particles caused by particle-bound polycyclic aromatic hydrocarbons (PPAHs) at two roadside locations and relationship with traffic
Abstract
This study assessed exposure by the roadside to highly toxic particle-bound polycyclic aromatic hydrocarbons (PPAHs) that are known to adsorb preferentially on fine particles, aerodynamic diameter (dp ≤ 1 μm). The real-time air quality measurements were conducted in March, April, and May 2015 in Kanpur at two busy roadside locations: one outside IIT Kanpur main gate, IG, and another by a residential area, M3. The locations show varying land use type and traffic density. Higher averaged daily concentrations of PM10, PM2.5, and PM1 were observed at IG (PM10 700–800 μg/m3) owing to nature and high density of traffic, and occurrence of biomass burning nearby. Statistically significant relation (R2 > 90%, p < 0.05) between PM1 and PM2.5 highlights the influence of mobile sources on particle load at IG. IG, the busier location, had higher daily averaged concentration of aggregate PPAHs (104 ng/m3) than M3 which is located near a residential area (38 ng/m3). In contrast, the higher average daily value of PC/DC ratio (mass per unit surface area of PPAHs on nanoparticles) at M3 (4.87 ng/mm2) than at IG (4.08 ng/mm2) suggests that PAHs of greater mass occur on particles at M3. Finer particles are known to adsorb pollutants of a larger mass that are likely to be more toxic in case of PAHs suggest that ambient air at M3 has more toxicity potential. However, this inference is not based on chemical analyses, and chemical characteristics must also be taken into account for the detailed assessment of health risk. The multiple path dosimetry model (MPPD-v3.04) reveals that the 99.02% of PM10 inhaled, 77.01% of PM2.5 and 34.54% of PM1 are deposited in the outermost (head) region of the human respiratory tract.
Economic valuation of noise pollution control policy: does the type of noise matter?
Abstract
As the average noise level and number of noise sources have increased, governments have taken various measures to make soundscapes sustainable. Wise policy decisions require information about the monetary value of noise-control policies. This study elicited people's willingness to pay (WTP) for noise policies, separating traffic noise from residential noise to compare the value of controlling different types of noise. The contingent valuation method was used for the empirical analysis, with data from South Korea. The results show that the monthly mean WTP of respondents was KRW 3392.3 for residential noise reduction and KRW 3507.1 for transport noise reduction; thus, the WTP for the latter is slightly higher than that for the former. Moreover, about 80% of people are unwilling to pay for a noise policy at all, and that high ratio of people with zero WTP must be taken into consideration in the process of policy formulation and implementation. Respondents' experiential and psychological factors were found to be more important than their demographics in explaining their WTP for a noise policy. Potential policy implications based on the analysis results are provided.
Empirics on linkages among industrialization, urbanization, energy consumption, CO2 emissions and economic growth: a heterogeneous panel study of China
Abstract
This is the first attempt to explore linkages among industrialization, urbanization, energy consumption, CO2 emissions, and economic growth based on estimations in simultaneous equations framework. An economic growth model is extended to incorporate industrialization as shift factor and pollutant emissions as determinant of total factor productivity. A country panel of 30 Chinese provinces/cities and three regional panels, for periods 2000–2016, are estimated employing Augmented Mean Group (AMG) estimator as well as Common Correlated Effects Mean Group (CCEMG) estimator that are robust to both cross-sectional dependence and cointegration. The empirical findings are as follows: (i) the impact of urbanization on economic growth varied from negative to neutral to positive for western-, intermediate-, and eastern-economic zone, respectively, and is known as "urbanization ladder effect," (ii) moving from western to eastern economic zone, as regions develop, industry expansion has more powerful impact on economic growth, and thus, we define it as "industry expansion effect," (iii) industrialization promotes rapid urbanization in less developed and less employment saturated regions; hence, we name it as "employment saturation effect," (iv) economic growth in more developed regions pulled the CO2 emissions downward, while pushed it upward in case of less developed regions; therefore, we call it "growth pull/push effect," and (v) in bidirectional causality between energy consumption and economic growth, the "feedback effect" of economic growth remained dominant for all four panels. Based on empirical findings, policies are suggested for Chinese economy. Further, these policies have potential to extract implications for the rest of the world.
Correction to: Nematicidal potential of Taraxacum officinale
The original publication of this paper contains a mistake. Data on Table 1 under TR and TL column have been interchanged: that is compounds 1-12 and their amounts refer to TL; compounds 1-8 and related amounts refer to TR (see Fig. 1).
A risk model for the prediction of skin tears in aged care residents: A prospective cohort study
International Wound Journal, EarlyView.
Novel prognostic score of postoperative complications after transthoracic minimally invasive esophagectomy for esophageal cancer: a retrospective cohort study of 90 consecutive patients
Abstract
Background
Esophagectomy is the standard treatment for esophageal cancer, but has a high rate of postoperative complications. Some studies reported the various scoring system to estimate the postoperative complications. However, there were according to various surgical methods and included intra- and post-operative factors. Recently, minimally invasive esophagectomy (MIE) is becoming the first-line treatment for esophageal cancer. The aim of this study was to investigate the risk factors of postoperative complications and to establish a useful system for predicting postoperative complications after transthoracic MIE.
Methods
From 2007 to 2015, 90 patients who underwent transthoracic MIE at our department were enrolled. Patients were divided into two groups according to postoperative complication: patients with major complications (n = 32) and without major complications (n = 58). Major complication was defined as ≥ IIIa in the Clavien–Dindo classification.
Results
Multivariate analysis identified four independent risk factors for predicting postoperative complications: age [≥ 70 years; odd ratio (OR) 6.88; p = 0.001]; sex (male; OR 5.24; p = 0.031); total protein level (< 6.7 mg/dl; OR 6.51; p = 0.002), and C-reactive protein level (≥ 0.15; OR, 6.58; p = 0.001). These four factors were used to establish a score. The complication rate for scores 0–4 were 0, 11, 36, 71, 100%, respectively. The frequency of major complications was significantly associated with the score (p < 0.001). Receiver operator characteristic curves to predict the score with regard to major complications showed an area under the curve value of 0.798 (95% confidence interval: 0.696–0.871, P < 0.001).
Conclusions
Our novel score may help to decide surgical intervention for esophagectomy and provide appropriate resources for perioperative management.
DFT/TDDFT insights into effects of dissociation and metal complexation on photochemical behavior of enrofloxacin in water
Abstract
Elucidation of the mechanisms underlying the effects of different dissociated forms and metal ion complexation on the photochemical behavior of antibiotics in aqueous media is a key problem and requires further research. We examined the mechanism of the direct photolysis of enrofloxacin (ENRO) in different dissociated forms in water and the impact of metal ions (Mg2+) on the photolysis of ENRO using density functional theory and time-dependent density functional theory. The results showed that different dissociated forms of ENRO exhibited diverse maximum electronic absorbance wavelengths (ENRO3+ (264 nm) < ENRO− (278 nm) < ENRO0 (280 nm) < ENRO2+ (282 nm) < ENRO+ (306 nm)). The calculations of the reaction pathways and activation energies (Ea) in the photolysis of ENRO0/ENRO+/ENRO− showed that defluorination was the main reaction pathway. The removal of cyclopropane was the main reaction pathway for the direct photolysis of ENRO2+/ENRO3+. Furthermore, the presence of Mg2+ was observed to change the order of the maximum electronic absorbance wavelengths and increases the intensities of the ENRO absorbance peaks. Calculations of the photolysis reaction pathways showed that the presence of Mg2+ increased the Ea for the most direct photolysis pathways of ENRO, while its presence decreased the Ea for several partial direct photolysis pathways such as the pathway in which the piperazine ring moiety of ENRO0/ENRO3+ is damaged and the pathway in which cyclopropane is released from ENRO3+. The findings on the photolysis behavior of ENRO in water system have provided useful information on the risk assessment of antibiotics.
Κυριακή 2 Σεπτεμβρίου 2018
A novel case of an aggressive superficial spindle cell sarcoma in an adult resembling fibrosarcomatous dermatofibrosarcoma protuberans and harboring an EML4‐NTRK3 fusion
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Mycobacterium abscessus infection following penetrations through wetsuits
Australasian Journal of Dermatology, EarlyView.
Sudanese Association of Dermatologists Special Meeting, Khartoum, Sudan
Dermatologic Therapy, EarlyView.
Demethylation and epigenetic modification with 5-Azacytidine reduces IDH1 mutant glioma growth in combination with Temozolomide
Abstract
Background
Isocitrate Deyhydrogenase (IDH) mutant gliomas are comprised of the majority of grade II-III gliomas and nearly all secondary glioblastomas. These progressive gliomas arise from mutations in IDH1 or IDH2 that pathologically produces D-2-hydroxyglutarate (2HG). 2-HG interferes with cell reactions using alpha ketoglutarate leading to a hypermethylated genome and epigenetic dysregulation of gene expression initiating tumorigenesis. Methods
Human IDH1 WT and IDH1R132H cell lines and patient derived xenografts (PDX) were used to evaluate the FDA-approved DNA demethylating agent 5-Azacytidine (5-Aza). Cell growth, protein and gene expression, chromatin immunoprecipitation, and nucleosome position assays were performed in 5-Aza treated cells. To evaluate antitumor activity in vivo, 5-Aza was administered alone and in combination with Temozolomide (TMZ) in a patient-derived xenograft (PDX) glioma models harboring IDH1R132H mutation. Results
5-Aza treatment has been found to reduce cell growth and increase Glial Fibrillary Acid Protein expression. Chromatin immunoprecipitation and nucleosome position assay showed that the mechanism of increased GFAP expression induction is associated with histone modification and nucleosome repositioning of the GFAP promoter, respectively. In vivo, 5-Aza treatment extended survival in IDH1R132H mutant, but not in an IDH1 WT glioma model. Additionally, 5-Aza enhances the therapeutic effect of DNA damaging agent TMZ in both subcutaneous and orthotopic PDX models of IDH1R132H mutant glioma. Conclusion
5-Aza provides a survival benefit as a single agent but worked best in combination with TMZ in two different IDH1R132H mutant glioma models.Possible contribution of autophagy in pyogenic granuloma
The Journal of Dermatology, Volume 45, Issue 9, Page 1145-1146, September 2018.
Issue Information
The Journal of Dermatology, Volume 45, Issue 9, Page i, 1029-1030, September 2018.
Kératodermie acrale symétrique : responsabilité de mutations d’un facteur de transcription
Publication date: Available online 1 September 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): O. Dereure
Consensus research priorities for facial palsy: a Delphi survey of patients, carers, clinicians and researchers
Publication date: Available online 1 September 2018
Source: Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): C Hamlet, N Rumsey, H Williamson, K Johnson, C Nduka
Abstract
Despite the potential negative impact of facial palsy, major gaps in understanding persist surrounding the treatment and care of those affected. This collaborative three-round Delphi process aimed to identify priorities for future facial palsy research, from the perspective of clinicians, researchers, patients and carers. It also determined whether the research priorities of patients and carers aligned with those of health professionals and researchers.
In Round one participants (n=85) were asked to generate research questions via focus groups or an online or postal survey. In Rounds two (n=72) and three (n=78) participants were asked to rate the priorities identified on a 5 point ordinal scale.
36 questions reached the definition of "high priority" consensus. Seven of each groups' top ten research priorities were shared. Prioritised questions included the provision and pathways of care, the psychosocial impact of living with facial palsy and the effective management of side-effects.
Establishing the research priorities in the field of facial palsy is a significant first step in ensuring the future research agenda is focussed on topics that are considered important by both patients and health professionals.
Granuloma Annulare’s Triangular Association with Malignancy
Publication date: Available online 1 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Warren R. Heymann
Protective effect of Thai silk extracts on drug-induced phototoxicity in human epidermal A431 cells and a reconstructed human epidermis model
Publication date: Available online 1 September 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Apiwan Rosena, Thongchai Koobkokkruad, Waleewan Eaknai, Phichaporn Bunwatcharaphansakun, Rawiwan Maniratanachote, Sasitorn Aueviriyavit
Abstract
Bombyx mori silk extracts, derived from the cocoon degumming process of draw and dye silk in the textile industry, are mainly composed of sericin protein. To add value to the Thai silk extracts, and hence the silk industry, a simple enrichment process was recently developed and the enriched silk extracts were then applied in nano-cosmeceutical products and nano-delivery systems. In this study, the protective effect of Thai silk extracts from three different strains of Bombyx mori on the drug-induced phototoxicity was evaluated in vitro using chlorpromazine (CPZ), a commonly used antipsychotic drug, as a representative phototoxic drug. The human epidermal A431 cell line and reconstructed human epidermis (RhE) model were used as the in vitro skin model. The silk extracts significantly improved the viability of A431 cells after CPZ exposure and ultraviolet A (UVA) irradiation, as shown by the significantly increased CPZ and UVA IC50 values and the decreased proportion of apoptotic cells. The protective effect of these silk extracts against the CPZ-induced UVA-phototoxicity in A431 cells was associated with the attenuation of intracellular oxidative stress via an increased intracellular glutathione level. Likewise, the silk extracts exhibited a protective effect on the CPZ-induced UVA-phototoxicity in the RhE model, in terms of an improved tissue viability and attenuation of the released inflammatory cytokine, interleukin-1α. These findings support the potential usefulness of silk extracts in novel applications, especially in the protection of drug-induced phototoxicity.
Graphical abstract
Cadmium selenide quantum dot-zinc oxide composite: Synthesis, characterization, dye removal ability with UV irradiation, and antibacterial activity as a safe and high-performance photocatalyst
Publication date: Available online 1 September 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Niyaz Mohammad Mahmoodi, Behzad Karimi, Mahmoud Mazarji, Hassan Moghtaderi
Abstract
In this paper, cadmium selenide quantum dot (CdSe QD)-zinc oxide (ZnO) nanocomposite (CdSe QD-ZnO) was synthesized and characterized and its photocatalytic dye degradation ability was investigated. The XRD, FTIR, UV–Vis, AFM and SEM were used to characterize the synthesized nanomaterials. The correlation coefficient of pseudo-first-order kinetic reaction is 0.98. The rate constants from 20 to 30 mg/L of pollutant concentrations was reduced by the order of 0.9. The temporal change in dye concentration reduces as the photocatalyst dosage increase up to optimum value of 0.04 g/L, then beyond that value the increase in the dosage becomes detrimental. Antibacterial activity of the synthesized nanocomposite as a safe photocatalyst was studied in details. Antibacterial activity of as prepared samples was also examined against Escherichia coli (E. coli). For in vitro study, Human umbilical vein endothelial cells (HUVEC) was utilized for the modeling of toxicity of each as prepared samples as representative of human normal cell line. In vivo study was conducted using leeches (Hirudo orientalis). In the presence of ethanol as hydroxyl radical (OH) scavenger, the removal efficiency significantly depresses compared to the di methyl sulfoxide as electron scavengers suggesting OH
possesses a major role in photocatalytic BR18 decolorization. By coupling with CdSe QD, the zone of inhibition was greatly increased suggesting the size dependent inactivation of E. coli. The results present that the composite had no significant effect on the proliferation of HUVEC normal cells. In addition, the treatment of cells with ZnO and the composite do not impact on the cell morphology.
Graphical Abstract
Diagnostic heuristics in dermatology, Part 2: Metacognition and other fixes
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Topical resiquimod dosing regimens in patients with multiple actinic keratosis: a multi‐centre, partly placebo‐controlled, double‐blind, clinical trial
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Assessing the Severity of Pyoderma Gangrenosum – A Need for Validated Measurement Tools
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Lack of Confidence Interval Reporting in Dermatology: A Call to Action
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Protection of glucotoxicity by a tripeptide derivative of α‐melanocyte‐stimulating hormone in human epidermal keratinocytes
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in Hidradenitis Suppurativa
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Autoantibodies undetectable by chemiluminescent enzyme immunoassay require extended antigen‐antibody reaction time for detection
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Σάββατο 1 Σεπτεμβρίου 2018
Facial Fat Grafting: Why, Where, How, and How Much
Abstract
Although the importance of volume loss in the aging face is now well recognized and fat grafting has increasingly become an integral part of contemporary facelift procedures, general acceptance of the fat grafting technique is a relatively recent occurrence and many surgeons reluctance to adopt the technique can be traced back in part to questions they have as to how loss of volume contributes to how the face ages, how to specifically recognize those changes, and questions they have about how to perform the fat grafting procedure to correct them. In this article we attempt to answer the questions "why perform facial fat grafting during facelift procedures?", "where should fat be placed in the face?", "how should fat be injected?", and "how much should be injected in each area?".
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Incisional Ptosis Correction with Hidden Double Fold in Asian Patients
Abstract
Background
Korean males and a few females desire to have larger eyes; however, they often wish to enlarge their eyes and conceal their double eyelids. This paper attempts to describe how to make the eyes bigger and brighter without showing double-fold eyelids.
Methods
The authors performed cosmetic ptosis correction in 121 cases from April 2013 to December 2017. All patients enrolled in this retrospective study underwent surgical procedures at the author's institutions. Patients were included that had mild-to-moderate degrees of ptosis and levator function greater than 5 mm, ages greater than 16 years, and no prior ptosis surgery.
Results
A successful outcome was achieved with this surgical approach in 113 (93.4%) patients. Complications potentially associated with ptosis surgery were not observed.
Discussion
A refined method of preoperative evaluation for incisional ptosis correction to conceal a double fold with no visible signs of surgery is described. Ptosis correction without the formation of double eyelids will result in skin hooding and visible scarring, and thus, it is recommended to lower the height of the double eyelids. The lower height of double eyelids can cover the incisional scar and make it appear there are no double eyelids.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
A Modified Double Eyelid Plastic Surgery Method: Continuous Buried Suture Method Accompanied by Simultaneous Correction of Mild Blepharoptosis
Abstract
Background
Double eyelid surgery with a buried suture is a popular plastic surgery procedure in Asia owing to the relatively minor scarring and quick recovery associated with it. In this article, we present a new approach involving a continuous single-loop buried suture method, which expands the operating site to the conjunctiva and the aponeurosis–Müller's muscle complex.
Methods
The medical records of 42 patients (80 eyes) who underwent double-eyelid blepharoplasty were retrospectively reviewed. We performed double-eyelid blepharoplasty with a single-knot continuous buried suture method, along with the resection of a small piece of the orbicularis oculi muscle. The formation of a double eyelid was achieved through traction of the aponeurosis–Müller's muscle complex from the medial conjunctiva and penetration of the upper eyelid.
Results
The majority of patients achieved the expected cosmetic effect of double eyelid formation after the procedure. In the subsequent follow-up period of 2–30 months, no complications, such as loosing or sagging of the double eyelid or granuloma formation, occurred. The mean recovery time ranged between one and 6 weeks. The pre-operative margin reflex distance (MRD1) was 2.36 ± 0.61 mm, and the post-operative MRD1 was 3.72 ± 0.63 mm, (p < 0.001). The Wilcoxon signed rank test was used for nonparametric, paired comparisons.
Conclusions
We proposed a modified technique involving a continuous buried suture method to create a better cosmetic effect through the formation of a double eyelid and simultaneous correction of mild blepharoptosis. This modified procedure is simple, fast, and effective, with limited adverse effects.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Comparison of the Scar Prevention Effect Between a Carbon Dioxide Fractional Laser and a Continuous Ablative Carbon Dioxide Laser with a 595-nm Nd:YAG Laser
Abstract
Purpose
A linear surgical scar, when located in the head and neck region, can be a significant cosmetic concern. Laser skin resurfacing with a fractional laser and a pulsed dye laser has been proven to be useful for treating such scars. As alternatives, we used a classic ablative CO2 laser in continuous mode with a 1-mm spot size and a 595-nm Nd:YAG laser. We investigated the effect of the combination of the continuous CO2 laser and 595-nm Nd:YAG laser and compared it to the effect of fractional CO2 laser monotherapy on linear scars.
Methods
This was a retrospective, case-controlled study designed to compare the efficacy between fractional CO2 laser therapy and combination therapy with a conventional CO2 laser in continuous mode and a 595-nm Nd:YAG laser. Treatment efficacy was evaluated by two different scar scales: the Stony Brook Scar Evaluation Scale (SBSES) and the modified Vancouver Scar Scale (mVSS). Laser treatments were performed every month until the 6th month after surgery.
Results
The SBSES and mVSS scores improved over time in both the monotherapy and the combination therapy (P < 0.001). No significant differences were found between the therapies for all the subcategories of the SBSES. However, among all the subcategories of the mVSS, pigmentation showed a better prognosis with combination therapy (P = 0.04).
Conclusion
Monotherapy and combination therapy can provide similar positive effects on linear scar improvement after repeated treatment, whereas combination therapy exerts more favorable anti-pigmentation effects than monotherapy. The combination of a continuous ablative CO2 laser with a 595-nm Nd:YAG laser can be used as a favorable alternative to a fractional CO2 laser. The 1-mm spot size of the CO2 laser beam may mimic the fractional laser form and offer more effective results for linear incision scars.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Fat Necrosis After Autologous Fat Transfer (AFT) to Breast: Comparison of Low-Speed Centrifugation with Sedimentation
Abstract
Background
Despite the advantages of autologous fat transfer to the breast, there are many complications after the surgery, such as oil cysts, calcification and palpable breast nodules. The fat purification process is a key step to reduce those complications, but there is currently no standard processing method. This study was designed to compare the incidence of fat necrosis after autologous fat grafting to the breast with low-speed centrifugation and sedimentation.
Methods
This study analyzed 100 patients (167 breasts) who underwent autologous fat grafts to the breasts from January, 2015 to March, 2017. Patients were divided into two groups randomly, low-speed centrifugation (800 r/min) and sedimentation (15 min). Postoperative fat necrosis such as oil cysts and palpable breast nodules was measured using physical examination and breast ultrasound 3 months after the surgery. The number and the diameter of the fat necroses were detected.
Results
A total of 100 patients (167 breasts) were included this research. There were 21 breasts with clinically palpable nodules (12.57%); fifteen (19.48%) were in the low-speed centrifugation group and six (6.67%) were in the sedimentation group (p < 0.05). According to postoperative breast ultrasounds, there were 83 breasts with hypoechoic cyst formations (49.7%); forty-five (58.44%) in the low-speed centrifugation group and 38 (42.22%) in the sedimentation group (p < 0.05). A positive correlation between the number of operative sessions and fat necrosis was found out.
Conclusion
Although low-speed centrifugation could achieve higher fat purification efficacy when compared with sedimentation, it causes more fat necrosis than sedimentation, such as clinically palpable nodules and subclinical nodules, especially in patients who had a history of breast surgery and those who needed more than one fat grafting session.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
The Use of a Retromammary Adipofascial Flap in Breast Augmentation for Patients with Thin Soft Tissue
Abstract
Background
In patients with a thin soft tissue breast envelope, lower pole implant palpability is a postoperative sequela that concerns patients. Anatomically, the lower aspect of the breast near the inframammary fold lacks sufficient soft tissue to cover the breast implant after augmentation.
Methods
A transareolar incision was made, and subcutaneous dissection was performed. The dissection first proceeded caudally to the lower aspect to the breast parenchyma. The dissection then changed direction and moved cephalad to the mid breast or nipple region. The fatty tissue and pectoralis muscle fascia were cut transversely at this level, and the dissection was reversed caudally in a subfascial plane to the new inframammary fold region. This maneuver created a retromammary adipofascial flap.
Results
A total of 368 breast augmentations were performed in 184 patients. Breast implants were inserted in the subfascial plane in 40 patients (21.7%) and in the subpectoral–subfascial plane in 144 patients (78.3%). A total of 368 breast implants were inserted, including 140 smooth cohesive silicone implants (38.0%), 2 textured round implants (0.5%), and 226 anatomic-type implants (61.5%). A cadaveric dissection revealed that a retromammary adipofascial flap measuring 3–4 mm in thickness can be acquired. Capsular contracture occurred in six breasts (1.7%).
Conclusions
During breast augmentation, an inferiorly based retromammary adipofascial flap can be created to help cover the lower pole of the breast from implant palpability. This is helpful especially in patients with thin skin, hypoplastic breasts, or constricted breasts.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
“Impact of Chronic Steroid Use on Plastic Surgery Outcomes: Analysis of 94,140 Cases”
Background: Steroids, commonly used to treat many chronic conditions, have been proven to suppress inflammation, edema, autoimmunity, and delay wound healing. Using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), this study aims to characterize the risk of perioperative chronic steroid use for complications in plastic surgery cases. Methods: A retrospective study was performed on 94,140 plastic surgery cases from the ACS NSQIP database for the years 2006-2015. Current procedural terminology codes were used to categorize the operations. Patients were separated into two cohorts based on chronic steroid use status. Univariate analysis was performed using χ2, Fisher's exact tests, or Wilcoxon rank sum tests. Logistic regression models were fitted to evaluate the association between chronic steroid use and postoperative complications. Total hospital length of stay was compared for cohorts. Odds ratios were computed at the 95% confidence interval. Results: Chronic steroid users were more likely to develop surgical complications (OR 1.3; p=0.0452) and medical complications (OR 1.8; p=0.0002) compared to non-steroid users. Among the ten most frequent procedures performed on chronic steroid users, steroid use was a significant risk factor for postoperative complications after reduction mammoplasty (OR 2.2; p=0.001); delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction (OR 2.2; p=0.049); and in trunk muscle, myocutaneous or fasciocutaneus flap (7.2; p=0.0029). Conclusion: With this information in hand, plastic surgeons will be better equipped to counsel patients and adequately design perioperative protocols for chronic steroid users. Financial Disclosure: Nothing to disclose. Presented at: None applicable Acknowledgement: We would like to thank Dr. Ari Rubenfeld and Julie Moore for their assistance and guidance with access to the ACS NSQIP database and their guidance with this project. DISCLAIMER: American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Matthew J Ranzer, MD, Assistant Professor of Surgery, University of Illinois at Chicago, Division of Plastic, Reconstructive, and Cosmetic Surgery, 820 S Wood St, Suite 515 CSN, Chicago, IL 60612 USA. Office: 312-996-9313 Fax: 312-413-0495, E-mail: ranzerm@uic.edu ©2018American Society of Plastic Surgeons
Preclinical experience using a new robotic system created for microsurgery
Background: Completing microsurgical anastomosis requires great technical skills. Robotic assistance in microsurgery can exceed the maximum human level of precision and manual dexterity to improve clinical outcomes. Since no robotic device has been designed primarily for microsurgery the authors developed a dedicated microsurgical robotic system (MSR). This preclinical study investigates whether microsurgical anastomosis can be successfully completed on silicone vessels using a prototype of this newly developed robotic system, and compares outcomes of robotic-assisted versus conventional anastomotic microsurgery. Methods: Three participants at different levels of microsurgical training completed ten anastomoses by hand and ten anastomoses with robotic assistance. Four blinded experienced microsurgeons evaluated the quality of the microsurgical skills using a modified version of the Structured Assessment of Microsurgical Skills (SAMS). Time to perform the anastomosis and adverse events were recorded. Results: The total time to perform the anastomoses with and without robotic assistance decreased to 35.1 minutes and 12.5 minutes respectively during the study. The overall performance and indicative skill of the SAMS improved during the conventional method (from respectively 2.8 to 3.6 and 2.6 to 3.7) and the robotic-assisted method (from respectively 2.3 to 3.0 and 2.3 to 3.1). Conclusions: It is feasible to complete anastomotic microsurgery on silicone vessels using the MSR. In comparison to the conventional method, time to perform the anastomosis was longer and quality of the microsurgical skills were lower in the robotic-assisted group. However, the robotic-assisted performance showed steeper learning curves (faster improvement) compared to the conventional performance for both surgical time and domains of microsurgical skills. The encouraging results indicate further development of the MSR and additional preclinical trials as step up towards clinical validation. FINANCIAL DISCLOSURE STATEMENT: Tom van Mulken has a financial disclosure, as he is Chief Medical Officer of the spin off company MicroSure: costs of travel and share in company. Rene van der Hulst has a financial disclosure as shareholder of MicroSure. Raimondo Cau has a financial disclosure, as he is Chief Technical Officer and shareholder of MicroSure. Ferry Schoenmakers is a software developer for MicroSure. The other authors have no financial disclosures. ACKNOWLEDGEMENTS: The four microsurgeons, forming the assessment panel, are gratefully acknowledged for their efforts. CORRESPONDING AUTHOR: Tom J.M. van Mulken, MD, Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands, Tel: (+31) 043-3875474; Fax: (+31) 043-3875473, Email: tom.van.mulken@mumc.nl ©2018American Society of Plastic Surgeons
Donor Site Morbidity and Functional Status Following Medial Femoral Condyle Flap Harvest
Background: The medial femoral condyle (MFC) free vascularized bone flap is a valuable alternative to other types of vascularized bone grafts. The donor site morbidity and functional outcomes after flap harvest have not been fully appreciated. Herein, we report the postoperative outcomes and analyze the impact of increasing the size of the flap on the knee donor site morbidity. Methods: A retrospective chart review of patients who underwent MFC flap between 2001 and 2012 at our institution was done. The size of the flap was stratified, based on the largest dimension, into 3 groups. Demographics, outcomes, and complications related to the flap donor site were recorded and analyzed. Subsequently, functional status was assessed by administering a validated condition-specific measure: the Lower Extremity Functional Scale (LEFS) questionnaire. A univariate logistic regression analysis was done, and results were analyzed. Results: A total of 75 patients were identified. Average age was 29.5 ± 15.2 years (range: 14-72). Average follow-up time was 13 months postoperatively. Overall Complication rate was 18.6%. Donor site paresthesia in the saphenous nerve distribution was the most common complication. Increasing size of the flap did result in a significant elevation in complication risk (p<.05 a total of patients completed the lefs questionnaire. average score was scored points indicating normal level function on average. conclusions: mfc flap has overall acceptable donor site morbidity with good post-operatively. larger flaps are associated greater number complications. meetings at which paper partially presented: none financial disclosures: authors interest in any products devices or drugs mentioned this manuscript. corresponding author: brian t. carlsen md division plastic surgery department mayo clinic first street sw rochester minnesota usa. phone: fax: email: carlsen.brian society surgeons>
Introducing Knowledge Translation to Plastic Surgery: Turning Evidence into Practice
Best evidence has no bearing on quality of life if it is not implemented in clinical practice. We introduce knowledge translation as a theoretical framework for closing the gap between evidence and practice in plastic surgery. The current state of published evidence in plastic surgery is reviewed and evaluated, with the recommendation to utilize the EQUATOR network's guidelines for reporting clinical research findings. Tools and strategies are offered for the reader to understand and integrate evidence at the bedside. Systemic solutions are also proposed for the dissemination of best evidence to facilitate its translation into practice. Financial Disclosure: The authors have no financial conflicts of interest or sources of funding to declare. Correspondence: Dr. Achilleas Thoma, 101-206 James Street South Hamilton, ON, L8P 3A9,, Phone (905) 523-0019, Fax (905) 523-0229, Email: drathoma@cogeco.net ©2018American Society of Plastic Surgeons
Melatonin ameliorates TNBS-induced colitis in rats through the melatonin receptors: involvement of TLR4/MyD88/NF-κB signalling pathway
Abstract
Aim
The aim of the present study is to investigate the anti-inflammatory effect of melatonin in trinitrobenzene sulfonic acid (TNBS)-induced rat colitis through the inhibition of Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signalling pathway and activation of melatonin receptor.
Methods
Colitis was induced in Wistar rats by administration of 100 mg/kg TNBS dissolved in 0.25 ml of 50% ethanol solution using a flexible plastic rubber catheter into the colon via the anus. This resulted in incidence of colitis on the first day, and all treatments were conducted for 10 days after induction of colitis. Melatonin was administered intraperitoneally (i.p.) at doses of 1, 5, and 10 mg/kg/day. Luzindole (non-selective MT1/MT2 receptor antagonist) was administered i.p. at dose of 5 mg/kg/day 15 min prior to melatonin injection. During the experiment, animals were monitored for the appearance of diarrhoea, body weight loss, and rectal bleeding. Myeloid peroxidase enzyme and tumour necrosis factor-α (TNF-α) activities were detected by immunohistochemistry. The protein expression level of TLR4, myeloid differentiation factor 88 (MyD88), NF-κB p65, and inhibitor of kappa B (I-κB) were detected by western blotting analysis.
Results
Treatment with melatonin improved weight loss, mucosal, and histological damage compared with TNBS group. In addition, melatonin decreased TNBS-induced up-regulation of TLR4, MyD88, and NF-κB p65, and increased down-regulation of I-κB proteins. On the other hand, the administration of luzindole resulted in the inhibition of melatonin effects.
Conclusions
It seems that the inhibition of TLR4/NF-κB signalling pathway may mediate the anti-inflammatory effects of melatonin in TNBS-induced rat colitis.
Rutin protects against lipopolysaccharide-induced mastitis by inhibiting the activation of the NF-κB signaling pathway and attenuating endoplasmic reticulum stress
Abstract
Rutin, found widely in traditional Chinese medicine materials, is used to treat eye swelling and pain, hypertension, and hyperlipidemia. In the present study, a mouse mastitis model induced by lipopolysaccharide (LPS) was established to explore rutin's inhibitory mechanism on mastitis via nuclear factor kappa B (NF-κB) inflammatory signaling and the relationship between NF-κB signaling and endoplasmic reticulum (ER) stress. Mice were divided into six groups: Control group, LPS model group, LPS + rutin (25, 50, and 100 mg/kg) and LPS + dexamethasone (DEX) group. DEX, rutin, and PBS (control and LPS groups) were administered 1 h before and 12 h after perfusion of LPS. After LPS stimulation for 24 h, to evaluate rutin's therapeutic effect on mastitis, the mammary tissues of each group were collected to detect histopathological injury, tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6 mRNA and protein levels; and glucose-regulated protein, 78 kDa (GRP78) protein levels. The protein and mRNA levels of TNF-α, IL-1β, and IL-6 in the LPS + rutin group were significantly lower than those in the LPS model group. Similarly, p50/p105, phosphorylated (p)-p65/p65 and p-inhibitor of nuclear factor kappa b kinase subunit beta (p-IKKβ)/IKKβ ratios in the LPS + rutin group (50 mg/kg) and LPS + rutin group (100 mg/kg) decreased significantly. GRP78 protein expression was significantly higher in LPS + rutin group (100 mg/kg). The structure of mammary tissue became gradually more intact and vacuolization of acini decreased as the rutin concentration increased. The nuclear quantity of p65 in the LPS + rutin group decreased significantly in a rutin dose-dependent manner. Rutin had an anti-inflammatory effect in the LPS-induced mouse mastitis model, manifested by inhibition of NF-κB pathway activation and attenuation of ER stress.
SB203580 attenuates acute lung injury and inflammation in rats with acute pancreatitis in pregnancy
Abstract
Acute pancreatitis in pregnancy (APIP) can lead to multiple maternal and fetal organ injury and mitogen-activated protein kinase (MAPK) signaling pathway may be involved in it; however, whether APIP can result in acute lung injury and P38MAPK signaling pathway is involved in the pathogenesis has not been elucidated. The present study was undertaken to investigate the participation of P38MAPK signaling pathway and the protective effect of SB203580, an inhibitor of P38MAPK on acute lung injury induced by APIP. Twenty-four late-gestation SD rats were randomly assigned to four groups: Sham operation (SO) group, SB302580 (SB) group, APIP group, and SB + APIP group. All the rats were killed 6 h after modeling. The severity of pancreatitis was evaluated by serum amylase (AMY) and lipase (LIPA) and histopathological changes. Histological assessment of the lung and inflammatory cell infiltration was performed by H&E and immunofluorescence assay. The lung wet/dry (W/D) weight ratio was determined, and the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA). Western blot analysis was used to detect the protein expression of phosphorylated and total P38, tumor necrosis factor (TNF)-α, and intercellular adhesion molecules 1 (ICAM-1) in lung tissues. Obvious pathological changes existed in pancreas and lung after the induction of APIP, and their pathological scores were significantly higher than that of control group. The results showed that the phosphorylation of P38MAPK was elevated in the lung of APIP rats. Compared with APIP group, the intervention of SB203580 alleviated the pathological injury of the pancreas and lungs, decreased serum AMY and LIPA, attenuated the secretion of TNF-α, IL-1β, and IL-6 in lung, reduced the inflammatory cells' infiltration and lung W/D ratio and inhibited the activation of P38MAPK signaling pathway. These results suggest that APIP can lead to acute lung injury and inflammation and SB203580 can inhibit the lung injury by inhibiting the P38MAPK signaling pathway and blocking the inflammatory responses.
Troubling Hope: Performing Inventive Connections in Discomforting Times
Abstract
In what follows, we revisit the most promising conceptions of "hope" while following Haraway's admonition to "stay with the trouble." Thirty-five years after Haraway's (1991) opening to the Manifesto for Cyborgs where she states that "irony is about contradictions that do not resolve into larger wholes" (p. 149), we move with her ceaseless task to eschew resolution and certainty, urging instead a radical contingency that is fundamental to thought itself. The radical contingency recognizes the limits of what any one individual or one species is capable of unto itself. Any such exceptionalism is spurned. The possibilities of thinking-with, and making-with, are the necessary path of the troubled present. And there is no escaping the present, a present that is thick with affliction but is still unfinished and ongoing. We enter into the thick presence of our ongoing conversation around hope by revisiting the concepts that help us to think our thoughts, exploring how these conceptions worked and did not work for our collective thinking. We then build on the concepts' appendages, their attachments and detachments to our conversation around hope, by sketching Haraway's materialist challenge to hope (and despair), and her refusal of futurism and contingency that raise some questions about the potentialities of "critical hope." Finally, we situate our work within an understanding of the "pedagogical work of the concept," drawing a line from Haraway to Stengers to Deleuze, which allows us to explore resonance between concepts and posit a "pedadogy of the concept" to situate the limits of hope and potentialities of "staying with the trouble." To work towards a pedagogy that "stays with the trouble," we extend Haraway's critique that it matters "what thoughts think thoughts" by suggesting that it also matters which feelings we feel with, highlighting the vital necessity of feeling to the project of staying with the trouble.
Reinforcement of barrier function – skin repair formulations to deliver physiological lipids into skin
International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.
Consensus research priorities for facial palsy: a Delphi survey of patients, carers, clinicians and researchers
Despite the potential negative impact of facial palsy, major gaps in understanding persist surrounding the treatment and care of those affected. This collaborative three-round Delphi process aimed to identify priorities for future facial palsy research, from the perspective of clinicians, researchers, patients and carers. It also determined whether the research priorities of patients and carers aligned with those of health professionals and researchers.In Round one participants (n=85) were asked to generate research questions via focus groups or an online or postal survey.
Effect of iron plaque and selenium on mercury uptake and translocation in rice seedlings grown in solution culture
Abstract
A hydroponics experiment was conducted to investigate the effect of iron plaque on root surfaces and selenium (Se) on the uptake and transfer of mercury (Hg) in rice seedlings by adding in the EDTA-Fe (0, 10, 30, 50, 70 mg Fe l−1) into the solution to produce a different amount of iron plaque outside rice root. After 24 h, the red-brown iron plaque was formed on the root surface, and the amount of iron plaques was positively correlated with the amount of Fe in the solution. The iron plaque deposited on the root surface has a strong adsorption effect on the inorganic Hg. The addition of Se could promote the adsorption of Hg2+ on the iron plaque of rice, and the introduction of Se could increase the adsorption capacity of Hg on iron plaque on average by 1.42 times. The Hg was extracted by DCB (Dithionite-citrate-bicarbonate) up to between 66.2 and 67.8% of the total Hg when the roots with iron plaque (Fe70) were incubated with the combination of 5 μmol L−1 of HgCl2 and 5 μmol L−1 of Na2SeO3 for an hour. After 3 days, the content of Hg in the iron plaque decreased to 6.3–33.9%, indicating that part of the inorganic Hg adsorbed by the iron plaque could be reabsorbed and used. Besides that, the iron plaque allowed the Hg to stay longer in the iron plaque, which hindered the transfer of Hg to the shoot significantly. Hg adsorbed in the iron plaque can be desorbed by low-molecular-weight organic acids, which was equivalent to desorption of Hg from ferric hydroxide oxides. Hg adsorbed on the iron plaque can be moved back to the rest of the plant. These results suggest that the iron plaque and Se in the root surface might play a role as "physical buffer" in the absorption and transfer of Hg.
Defending stance voluntarism
Abstract
In this paper, I argue that stance voluntarism is a coherent and useful view for understanding debates about the ontological commitments warranted by science. To do so, I first engage in a defensive move: I rescue stance voluntarism from what I take to be the most pressing objection to have emerged in recent literature, which I call the 'irrationality objection'. According to this objection, an agent courts irrationality by simultaneously holding an epistemic stance and believing that stance voluntarism is true. I argue that this objection is based on a misunderstanding of stance voluntarism and the kinds of reasons that agents take themselves to have for their adopted stances. I then make the positive contention that we can expect the idea of stance voluntarism, thus saved, to not only be a defensible, but also a useful framework for understanding ontological disputes within science. I do this by presenting a case study from contemporary cosmology in which it is so. Combining these two claims, I argue that stance voluntarism is a coherent and useful view for understanding some ongoing disputes about ontology within scientific contexts.
Construction of a risk model for the development of metachronous squamous cell carcinoma after endoscopic resection of esopahageal squamous cell carcinoma
Abstract
Background
Previously, we identified that rs1229984 in ADH1B, rs671 in ALDH2, and smoking status were independently associated with the risk of developing metachronous squamous cell carcinoma (SCC) after endoscopic resection (ER) for esophageal SCC (ESCC). However, this analysis included cases with short-term follow-up. In the present study, we investigated the environmental and genetic factors associated with developing metachronous SCC using long-term follow-up observation after ER for ESCC.
Methods
One hundred and thirty ESCC patients who underwent treatment with ER were followed up using endoscopy for ≥ 30 months. We investigated the incidence of, and genetic/environmental factors associated with, metachronous SCC development after ER for ESCC. We also analyzed the potential risk factors for multiple metachronous SCC development using Cox's proportional hazards model. Moreover, we constructed a risk model for the development of metachronous SCC after ER for ESCC.
Results
Male, rs1229984, rs671, alcohol consumption (> 20 g/day), smoking, and multiple Lugol-voiding lesions (LVLs) significantly affected the incidence of multiple metachronous SCCs. Multiple Cox proportional analysis revealed that rs1229984, rs671, alcohol consumption, smoking, and multiple LVLs were independently associated with the risk of developing metachronous SCC. Patients who had ≤ 2 risk factors did not develop metachronous SCC, and the risk of developing metachronous SCC in patients with ≥ 3 risk factors was significantly higher than in patients with ≤ 2 risk factors.
Conclusion
The risk model using these 5 genetic and environmental factors is useful as an indication for multiple metachronous development in ESCC patients.
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