Cancers, Vol. 9, Pages 111: Translocation Renal Cell Carcinoma: An Update on Clinicopathological and Molecular Features

Cancers, Vol. 9, Pages 111: Translocation Renal Cell Carcinoma: An Update on Clinicopathological and Molecular Features

Cancers doi: 10.3390/cancers9090111

Authors: Kentaro Inamura

Microphthalmia-associated transcription (MiT) family translocation renal cell carcinoma (tRCC) comprises Xp11 tRCC and t(6;11) RCC. Due to the presence of fusion genes, Xp11 tRCC and t(6;11) RCC are also known as TFE3- and TFEB-rearranged RCC, respectively. TFE3 and TFEB belong to the MiT family, which regulates melanocyte and osteoclast differentiation, and TFE3- and TFEB-rearranged RCC show characteristic clinicopathological and immunohistochemical features. Recent studies identified the fusion partner-dependent clinicopathological and immunohistochemical features in TFE3-rearranged RCC. Furthermore, RCC with chromosome 6p amplification, including TFEB, was identified as a unique subtype of RCC, along with ALK-rearranged RCC. This review summarizes these recent advancements in our tRCC-related knowledge.

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The fate of radiology report recommendations at a pediatric medical center

Abstract

Background

The American College of Radiology (ACR) practice parameters for communication dictate that follow-up recommendations be suggested when appropriate. Radiologists assume that referring physicians read their reports and heed their advice. In reality, recommendations might not be carried out or even acknowledged.

Objective

We aimed to determine the proportion of imaging recommendations that are acknowledged and acted upon.

Materials and methods

We conducted a retrospective review of all consecutive radiology reports containing "recommend" in the impression at a single academic children's hospital over a 1-month period. We documented point of care (emergency department, inpatient, outpatient), study type, recommendation wording, and communication method (report only or direct verbal). We reviewed medical records to ascertain whether the recommendations were acknowledged or executed. We used chi-square tests to evaluate associations between variables. P<0.05 was considered significant.

Results

We reviewed 526 reports and excluded 73. We included the remaining 453 reports, from 370 unique patients (201 male, 169 female). Inpatients comprised most reports (n=223), followed by emergency department (ED) patients (n=118) and outpatients (n=112). Among these reports, 69% (n=313) of recommendations were executed. Of the 140 recommendations not carried out, 14% were acknowledged in clinical notes. Compliance correlated with point of care (ED>inpatient>outpatient; P=0.001) but not with additional verbal communication (P=0.33), study type (radiograph vs. other; P=0.35) or type of follow-up recommendation (follow-up imaging vs. other; P=0.99).

Conclusion

Nearly one-third of radiology report follow-up recommendations are not executed. Recommendations are most commonly neglected for outpatient imaging reports. The radiology community should take steps to improve recommendation adherence.

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Association of rs1057035polymorphism in microRNA biogenesis pathway gene ( DICER1 ) with azoospermia among Iranian population

Abstract

Since genes involved in microRNA biogenesis pathways have a main role in impaired spermatogenesis, in this research, we evaluated different genotypes frequency of seven single-nucleotide polymorphisms in DICER1 and DROSHA genes. Different genotypes frequency of DICER1 (rs12323635, rs1057035, rs13078 and rs3742330) and DROSHA (rs10719, rs642321 and rs2291102) were determined by sequencing method in 385 infertile men and 120 fertile controls. It was found that CC genotype (P = 0.000) and C allele (P = 0.0) of rs1057035 T > C polymorphism were associated with idiopathic male infertility (azoospermia). Gene expression study in blood and testis samples was done by real time PCR technique. Our results showed significant under expression of DICER1 gene in blood and testis tissues of azoospermic samples (P < 0.05), but we did not observed significant difference in expression ratio between infertile men with and without C allele of rs1057035 SNP (P > 0.05). The results of this study showed that among the studied variants, only one of them in DICER1 might be associated with azoospermia, but additional studies needs in different populations and ethnics.

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Epidemiological factors related to hospitalization due to influenza in children below 6 months of age

Abstract

The aim of this study was to address the epidemiological factors associated to hospital admissions due to influenza in infants younger than 6 months. A case-control study was performed in a tertiary hospital in Spain. Cases were infants under 6 months of age without comorbidities who were admitted due to influenza between October 2010 and March 2015. Controls were healthy infants younger than 6 months who were hospitalized due to non-respiratory illness or non-infectious diseases (urinary tract infection was included as controls). Data were retrospectively collected from medical records and phone interviews. A total of 88 cases and 122 controls we included. From univariate analysis, differences were found in relation to maternal age (43.1 ± 4.95 vs 32 ± 5.3), paternal age (37 ± 6.4 vs 34.5 ± 6.1), having siblings (79 vs 24%), siblings below 4 years old (54 vs 15%), and having vaccinated grandparents (18 vs 39%) (p < 0.05). After logistic regression, having vaccinated grandparents was an independent protective factor (OR 0.22 [CI95%; 0.05–0.91]), while having siblings was a risk factor (OR 15.8 [CI95% 3.15–79.5]). Vaccination during pregnancy was highly uncommon (3.5 vs 8.3%; p = 0.3).

Conclusion: This study underlines the importance of increasing influenza immunization among household contacts of infants below 6 months to prevent their influenza admission.

What is Known:

• Infants younger than 6 months old are considered a high-risk population.

• Vaccination against influenza is not licensed in infants below 6 months.

What is New:

• Increasing vaccination coverage in elderly people could reduce infants' hospitalization rates.

• Cocoon immunization strategy may reduce the admission of infants.

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The Impact of Volatile Anesthetic Choice on Postoperative Outcomes of Cardiac Surgery: A Meta-Analysis

Objectives. To evaluate the impact of volatile anesthetic choice on clinically relevant outcomes of patients undergoing cardiac surgery. Methods. Major databases were systematically searched for randomized controlled trials (RCTs) comparing volatile anesthetics (isoflurane versus sevoflurane) in cardiac surgery. Study-level characteristics, intraoperative events, and postoperative outcomes were extracted from the articles. Results. Sixteen RCTs involving 961 patients were included in this meta-analysis. There were no significant differences between both anesthetics in terms of intensive care unit length of stay (SMD −0.07, 95% CI −0.38 to 0.24, ), hospital length of stay (SMD 0.06, 95% CI −0.33 to 0.45, ), time to extubation (SMD 0.29, 95% CI −0.08 to 0.65, ), S100 (at the end of surgery: SMD 0.08, 95% CI −0.33 to 0.49, ; 24 hours after surgery: SMD 0.21, 95% CI −0.23 to 0.65, ), or troponin (at the end of surgery: SMD −1.13, 95% CI −2.39 to 0.13, ; 24 hours after surgery: SMD 0.74, 95% CI −0.15 to 1.62, ). CK-MB was shown to be significantly increased when using isoflurane instead of sevoflurane (SMD 2.16, 95% CI 0.57 to 3.74, ). Conclusions. The volatile anesthetic choice has no significant impact on postoperative outcomes of patients undergoing cardiac surgery.

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Maternal exposure to nanosized titanium dioxide suppresses embryonic development in mice

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The Trump Administration's Effect on National Parks

It's been a hard summer for our public lands.

-- Read more on ScientificAmerican.com

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Ganglioneuroblastoma in a newborn with multiple metastases: a case report

Ganglioneuroblastoma is a tumor of peripheral neuroblastic tissue which occurs predominantly in the pediatric age group; it is a rare occurrence in the newborn period with only one case reported at birth to date.

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Vinblastine and antihelmintic mebendazole potentiate temozolomide in resistant gliomas

Summary

Glioblastoma (GBM) is a very aggressive tumor that has not had substantial therapeutic improvement since the introduction of temozolomide (TMZ) in combination with radiotherapy. Combining TMZ with other chemotherapeutic agents is a strategy that could be further explored for GBM. To search for molecular predictors of TMZ resistance, the TCGA (The Cancer Genome Atlas) database was utilized to assess the impact of specific genes on TMZ response. Patients whose tumors expressed low levels of FGFR3 and AKT2 responded poorly to TMZ. Combination treatment of vinblastine (VBL) plus mebendazole (MBZ) with TMZ was more effective in reducing cell number in most cultures when compared to TMZ alone, especially in cells with low expression levels of FGFR3 and AKT2. Cell cycle distribution and nuclear morphometric analysis indicated that the triple combination of TMZ, VBL and MBZ (TVM) was able to induce polyploidy and senescence, in addition to increasing the Notch3 RNA level in patient-derived gliomas. Thus, this set of data suggests that the triple combination of TMZ, VBL and MBZ may be a considerable therapeutic alternative for the TMZ-tolerant gliomas that harbor low expression of FGFR3/AKT2.

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Takayasu arteritis presenting as embolic stroke

A 52-year-old Caucasian woman presented to the emergency department with symptoms of acute ischaemic stroke (right-side weakness, confusion and aphasia) that resolved completely after administration of tissue plasminogen activator. During stroke work-up, she was found to have an enhancing infiltrate of the aorta at the level of the take-off of the great vessels, most consistent with early Takayasu arteritis. After being discharged home on steroids and dual antiplatelet therapy, she returned 2 days later with re-presentation of weakness and aphasia. Further work-up revealed two intraluminal clots in the left common carotid and left internal carotid arteries that had not been discovered during previous testing. This case illustrates the need to screen for sources of embolic stroke in patients with Takayasu arteritis, especially those with recurring symptoms.

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Oesophageal mastocytosis: eosinophilic oesophagitis without eosinophils?

A 59-year-old male with a history of lifelong asthma, allergic rhinitis and hypercholesterolaemia presented to the emergency department for management of severe substernal chest pain with radiating pain to his left arm, nausea and diaphoresis. Physical examination was unrevealing and a cardiac workup including cardiac enzymes, ECG, chest radiographs were negative for an underlying ischaemic event. A subsequent gastrointestinal workup including oesophageal manometry and oesophagogastroduodenoscopy revealed elevated lower oesophageal pressures and histopathology suggestive of mast cell proliferation, respectively. These findings were suggestive of oesophageal mastocytosis. Treatment with omeprazole-sodium bicarbonate, cetirizine, montelukast and oral budesonide promptly ameliorated his symptoms which have not recurred.

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Continuous remission of renal cell carcinoma with tumour thrombus after severe adverse events following short-term treatment with sunitinib

A 64-year-old Japanese man with renal cell carcinoma (RCC) and tumour thrombus in the inferior vena cava was treated with sunitinib. Two weeks after treatment, he was hospitalised for disturbance of consciousness. Laboratory tests revealed high-grade hypoglycaemia, hyponatraemia, liver dysfunction and thrombocytopaenia with disseminated intravascular coagulation. Sunitinib was discontinued and the patient recovered after a protracted platelet transfusion. At 5 months after treatment, CT revealed that the tumour thrombus had disappeared and other lesions had regressed. MRI at 15 months revealed further regression and suggested the possibility of histological remission according to the signal intensity of fibrosis. A partial response persisted at 20 months after treatment, despite residual accumulation in the renal tumour evident on positron emission tomography. In summary, we present a case of locally advanced RCC accompanied by severe adverse events that showed a significant and durable response to treatment with sunitinib for just 2 weeks.

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Word onset phonetic properties and motor artifacts in speech production EEG recordings

Abstract

Electrophysiological research using verbal response paradigms faces the problem of muscle artifacts that occur during speech production or in the period preceding articulation. In this context, this paper has two related aims. The first is to show how the nature of the first phoneme influences the alignment of the ERPs. The second is to further characterize the EEG signal around the onset of articulation, both in temporal and frequency domains. Participants were asked to name aloud pictures of common objects. We applied microstate analyses and time-frequency transformations of ERPs locked to vocal onset to compare the EEG signal between voiced and unvoiced labial plosive word onset consonants. We found a delay of about 40 ms in the set of stable topographic patterns for /b/ relative to /p/ onset words. A similar shift was observed in the power increase of gamma oscillations (30–50 Hz), which had an earlier onset for /p/ trials (∼150 ms before vocal onset). This 40-ms shift is consistent with the length of the voiced proportion of the acoustic signal prior to the release of the closure in the vocal responses. These results demonstrate that phonetic features are an important parameter affecting response-locked ERPs, and hence that the onset of the acoustic energy may not be an optimal trigger for synchronizing the EEG activity to the response in vocal paradigms. The indexes explored in this study provide a step forward in the characterization of muscle-related artifacts in electrophysiological studies of speech and language production.

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Backbone cyclization of analgesic conotoxin GeXIVA facilitates direct folding of the ribbon isomer [Methods and Resources]

Conotoxin GeXIVA inhibits the α9α10 nicotinic acetylcholine receptor (nAChR) and is analgesic in animal models of pain. α-conotoxins have four cysteines, which can have three possible disulfide connectivities: globular (CysI-CysIII and CysII-CysIV); ribbon (CysI-CysIV and CysII-CysIII) or bead (CysI-CysII and CysIII-CysIV). Native α-conotoxins preferably adopt the globular connectivity, and previous studies of α-conotoxins have focused on the globular isomers as the ribbon and bead isomers typically have lower potency at nAChRs than the globular form. A recent report showed that the bead and ribbon isomers of GeXIVA are more potent than the globular isomer, with low nanomolar half maximal inhibitory concentrations (IC50s). Despite this high potency, the therapeutic potential of GeXIVA is limited because, like most peptides, it is susceptible to proteolytic degradation and is challenging to synthesize in high yield. Here we used backbone cyclization as a strategy to improve the folding yield as well as increase the serum stability of ribbon GeXIVA while preserving activity at the α9α10 nAChR. Specifically, cyclization of ribbon GeXIVA with a two-residue linker maintained the biological activity at the human α9α10 nAChR and improved stability in human serum. Short linkers led to selective formation of the ribbon disulfide isomer without requiring orthogonal protection. Overall, this study highlights the value of backbone cyclization in directing folding, improving yields and stabilizing conotoxins with therapeutic potential.

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A Preliminary Study Investigating the Association Between Hearing Acuity and a Screening Cognitive Tool

Annals of Otology, Rhinology &Laryngology, Ahead of Print.


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Celebrity gossip and the alarming rise of oral cancers in men - Philly.com (blog)

The Sun

Celebrity gossip and the alarming rise of oral cancers in men Philly.com (blog) Health insurance claims for the condition jumped 61 percent from 2011 to 2015, according to a report by FAIR Health, an independent nonprofit. The most dramatic increases were seen in throat and tongue cancer, which were three times more common in ... Batman and Top Gun star Val Kilmer is battling cancer, Michael Douglas claimsThe Sun Michael Douglas reveals Val Kilmer is battling cancerNEWS.com.au Michael Douglas says Val Kilmer has cancer and 'things don't look too good'Stuff.co.nz Huffington Post -Yahoo7 Be -PEOPLE.com -Facebook all 144 news articles »

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Can hypothermia save dying military trauma patients?

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Down syndrome

Down syndrome: A common birth defect that is usually due to an extra chromosome 21 (trisomy 21). Down syndrome causes mental retardation, a characteristic facial appearance, and multiple malformations. It occurs most frequently in children born to mothers over age 35. It is associated with a major risk for heart problems, a lesser risk of duodenal atresia (partially undeveloped intestines), and a minor but significant risk of acute leukemia. Treatment for Down syndrome includes early intervention to develop the mental and physical capacities to their utmost, speech therapy, and surgery, as needed, to repair malformations. About one-half of children with Down syndrome have heart defects, most often holes between the two sides of the heart (septal defects). With appropriate intervention, most children with Down syndrome live active, productive lives into at least middle age. Most are mildly to moderately retarded, although some have IQs in the low'normal range. Unfortunately, most adults with Down syndrome eventually develop Alzheimer's disease as they grow older. Down syndrome was also once called mongolism, a term now considered out of date, as the disorder has no relationship to Mongolian or Asian heritage. It can occur in any racial or ethnic group.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
We Bring Doctors' Knowledge To You

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Too much prosecco will rot your teeth

Prosecco lovers could end up with rotten teeth because of the alcoholic drink's high sugar content, dentists have warned. Experts are calling the problem 'prosecco smile' and think it could get worse due to the popularity of the beverage.

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A chemical compound inhibiting the Aha1-Hsp90 chaperone complex [Molecular Biophysics]

The eukaryotic Hsp90 chaperone machinery comprises many co-chaperones and regulates the conformation of hundreds of cytosolic client proteins. Therefore, it is not surprising that the Hsp90 machinery has become an attractive therapeutic target for diseases such as cancer. The compounds used so far to target this machinery affect the entire Hsp90 system. However, it would be desirable to achieve a more selective targeting of Hsp90-co-chaperone complexes. To test this concept, in this-proof-of-principle study, we screened for modulators of the interaction between Hsp90 and its co-chaperone Aha1, which accelerates Hsp90's ATPase activity. A FRET-based assay that monitored Aha1 binding to Hsp90 enabled identification of several chemical compounds modulating the effect of Aha1 on Hsp90 activity. We found that one of these inhibitors can abrogate the Aha1-induced ATPase stimulation of Hsp90 without significantly affecting Hsp90 ATPase activity in the absence of Aha1. NMR spectroscopy revealed that this inhibitory compound binds the N-terminal domain of Hsp90 close to its ATP-binding site and overlapping with a transient Aha1-interaction site. We also noted that this inhibitor does not dissociate the Aha1-Hsp90 complex but prevents the specific interaction with the N-terminal domain of Hsp90 required for catalysis. In consequence, the inhibitor affected the activation and processing of Hsp90-Aha1-dependent client proteins in vivo. We conclude that it is possible to abrogate a specific co-chaperone function of Hsp90 without inhibiting the entire Hsp90 machinery. This concept may also hold true for other co-chaperones of Hsp90.

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Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa?

Summary

Decades of research have reported only weak associations between the intakes of specific foods or drinks and weight gain and obesity. Randomized controlled dietary intervention trials have only shown very modest effects of changes in nutrient intake and diet composition on body weight in obese subjects. This review summarizes the scientific evidence on the role mental stress (either in or not in association with impaired sleep) may play in poor sleep, enhanced appetite, cravings and decreased motivation for physical activity. All these factors contribute to weight gain and obesity, possibly via decreasing the efficacy of weight loss interventions. We also review evidence for the role that lifestyle and stress management may play in achieving weight loss in stress-vulnerable individuals with overweight.

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Caloric restriction prevents carcinogen-initiated liver cancer in mice

Caloric restriction (CR) and endurance exercise elicit wide-ranging health benefits including reduced risk of select cancers. In addition, diet composition influences oncogenesis, although its interactions with exercise and CR are not well understood. Therefore, to investigate the potential interactions between diet and lifestyle interventions on liver tumorigenesis, the carcinogen diethylnitrosamine (DEN) was administered to 72 male C57Bl/6 mice that were subsequently fed diets enriched with lard (CTL) or olive oil (OO) and were further stratified to voluntary wheel running (Ex) or 30% CR for 49 weeks. While Ex and diet composition did not influence liver oncogenesis, CR prevented hepatic tumor formation. Additionally, CR reduced steatosis, hepatocyte ballooning, inflammation and immune cell infiltration, all of which are hallmarks in the progression of non-alcoholic fatty liver disease (NAFLD) to liver tumorigenesis. RNA sequencing of non-transformed liver tissues from CR mice revealed changes in metabolic pathways and reduced inflammation, cytokine production, stellate cell activation and migration, and genes associated with liver injury and oncogenesis. These data demonstrate that CR protects against steatosis, liver inflammation, and liver injury and is a robust deterrent of carcinogen-induced hepatic oncogenesis.

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Immune analysis of cry1Ab -genetically modified potato by in-silico analysis and animal mode l

Abstract

The safety of feeding transgenic potato (Solanum tuberosum), resistant to the potato tuber moth, to Wistar rats was examined from an immunological perspective. The genetically modified potato (GMP) was harbouring cry1Ab and nptII genes as target and selectable marker genes, respectively. In-silico analysis reconfirmed that Cry1Ab and NPTII protein sequences have no significant homology to known toxins or known allergens. The Wistar rats were fed a diet containing 20% GMP or its parental control, non-GMP (NGMP), for 90 days. The consumption of GMP food did not affect the growth rate, food intake, food efficiency, and general health status of the rats. There were no significant differences in the serum concentrations of immunoglobulin A (IgA), IgG, IgM, interleukin 6 (IL-6), and IFN-γ between GMP and NGMP-fed rats. Based on such data, it is concluded that the transgenic potato had no adverse effect on immunity functions of Wistar rats.

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Compositional analyses of diverse phytochemicals and polar metabolites from different-colored potato ( Solanum tubersum L.) tubers

Abstract

Lipophilic bioactive compounds and hydrophilic primary metabolites from potato (solanum tubersum L.) tubers with different-colored flesh (white-, yellow-, red-, and purple) were characterized. The carotenoid content was relatively higher in red-colored potatoes, in which lutein was most plentiful. Among the other lipophilic compounds analyzed, including policosanols, tocopherols, and phytosterols, octacosanol was measured in the largest amount, followed by β-sitosterol, irrespective of color variations. Forty-three hydrophilics consisting of amino acids, organic acids, sugars, and sugar alcohols and 18 lipophilics were subjected to data-mining processes. The results of multivariate statistical analyses clearly distincted the different varieties and separated red-fleshed potatoes from other color-fleshed potatoes according to abundance of amino acids, sugars, and carotenoids. This study confirmed the metabolic association-related biochemical pathway between metabolite characteristic and color differences in potato tubers. These results can facilitate understanding the metabolic differences among diverse colored potatoes and provide fruitful information for genetic engineering of potato cultivars.

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Dr. Siegel on Induction Therapy for Head and Neck Cancer - OncLive

OncLive

Dr. Siegel on Induction Therapy for Head and Neck Cancer OncLive Robert Siegel, MD, chair, professor of medicine, director, Division of Hematology/Oncology, George Washington University, discusses induction therapy for head and neck cancer. In head and neck cancer, when physicians are using induction therapy there ...

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Transparent Large-Area MoS2 Phototransistors with Inkjet-Printed Components on Flexible Platforms

ACS Nano

DOI: 10.1021/acsnano.7b04893

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Multiple correspondence analysis as a strategy to explore the association between categories of qualitative variables related to oral–maxillofacial trauma and violent crimes at the community level

The main objective of this study was to show the applicability of multiple correspondence analysis (MCA) in the detection and representation of underlying structures in large datasets used to investigate oral–maxillofacial lesions. A cross-sectional study was conducted involving the analysis of the medical–forensic and social records of 992 people who experienced oral–maxillofacial trauma resulting from non-fatal violent crimes that occurred in the community. Based on the MCA results, two distinct victim profiles were identified.

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Adjuvant radiation and survival following surgical resection of sinonasal melanoma

Surgery remains the mainstay of treatment for sinonasal melanoma, but it is often difficult to obtain clear, negative margins. Therefore, patients often receive adjuvant radiation therapy (RT), however its impact on overall survival (OS) is not well understood.

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Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life

Chronic hyperplasia of the inferior nasal concha is accompanied by a nasal obstruction; however, there is no standardised surgical treatment for this condition. Here, we compared the outcome of three surgical techniques frequently used to treat the hyperplasia of inferior turbinates: turbinectomy with lateralization, submucosal electrocautery and laser cautery additional to septoplasty.

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Adjuvant radiation and survival following surgical resection of sinonasal melanoma

Surgery remains the mainstay of treatment for sinonasal melanoma, but it is often difficult to obtain clear, negative margins. Therefore, patients often receive adjuvant radiation therapy (RT), however its impact on overall survival (OS) is not well understood.

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Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life

Chronic hyperplasia of the inferior nasal concha is accompanied by a nasal obstruction; however, there is no standardised surgical treatment for this condition. Here, we compared the outcome of three surgical techniques frequently used to treat the hyperplasia of inferior turbinates: turbinectomy with lateralization, submucosal electrocautery and laser cautery additional to septoplasty.

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Histamine and TLR ligands synergistically induce endothelial-cell gap-formation by the extrinsic coagulating pathway

Histamine and LPS synergistically induce the expression of TF by vascular endothelial cells, activating the extrinsic coagulation cascade followed by an increase of vascular permeability.

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Novel Stat1 Mutation Disrupts Small Ubiquitin-Related Modifier (Sumo) Conjugation Causing Gain Of Function

The E705V GOF STAT1 mutation in the consensus motif for sumoylation is associated with the occurrence of CMC, squamous cell carcinoma, and endocrinopathies. This is also the first described association of Rhodococcus equi in GOF STAT1 disease.

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Astrotactin 1-derived peptide (AP): a new skin-penetrating peptide against inflammatory skin diseases"

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Success rates and complications of autologous onlay bone grafts and sinus lifts in patients with congenital hypodontia and after trauma

Autogenous bone remains the gold standard for augmentation of the alveolar ridge in congenital hypodontia and appreciable post-traumatic deformity. This generally reflects the volume of material required for such defects and the osteogenic potential of the grafts. Morbidity at the donor site and success rates may lead to autogenous grafts being superseded by xenografts or alloplastic materials in the future, but we know of little evidence to confirm this. All patients having augmentation of the alveolar ridge or sinus lift to enable subsequent placement of implants between 01 January 2009 and 31 December 2016 were identified from a prospectively-gathered database held at the Queen Elizabeth Hospital, Birmingham.

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The transcription factor Gbx2 induces expression of Kruppel-like factor 4 to maintain and induce naive pluripotency of embryonic stem cells [Developmental Biology]

The transcription factor gastrulation brain homeobox 2 (Gbx2) is a direct target of the LIF/STAT3 signaling pathway, maintains mouse embryonic stem cell (mESC) self-renewal, and facilitates mouse epiblast stem cell (mEpiSC) reprogramming to naive pluripotency. However, the mechanism by which Gbx2 mediates its effects on pluripotency remains unknown. Here, using an RNA-Seq approach, we identified Kruppel-like factor (Klf4) as a direct target of Gbx2. Functional studies indicated that Klf4 mediates the self-renewal-promoting effects of Gbx2, as knockdown of Klf4 expression abrogated the ability of Gbx2 to maintain the undifferentiated state of mESCs. We also found that Gbx2 largely depends on Klf4 to reprogram mEpiSCs to a mESC-like state. In summary, our study has uncovered a mechanism by which Gbx2 maintains and induces naive pluripotency. These findings expand our understanding of the pluripotency control network and may inform the development of culture conditions for improved ESC maintenance and differentiation.

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Hypoxia-inducible factor 2{alpha} (HIF-2{alpha}) promotes colon cancer growth by potentiating Yes-associated protein 1 (YAP1) activity [Molecular Bases of Disease]

Colorectal cancer (CRC) is the third-leading cause of cancer mortality in the United States and other industrialized countries. A hypoxic microenvironment is a hallmark for solid tumors. The hypoxia-induced signal transduction is transcriptionally mediated by hypoxia-inducible factor (HIF). Three major HIF isoforms HIF-1, HIF-2, and HIF-3 are present in the intestine. Our previous work demonstrates that HIF-2 is essential for CRC growth and progression. However, the mechanisms mediating cell proliferation following hypoxia or HIF-2 activation in CRC are unclear. Data mining of RNA-Seq experiments with mouse models of intestinal HIF-2 or Yes-associated protein 1 (YAP1) overexpression indicates a significant overlap of genes in these conditions. YAP1 is a transcriptional co-activator in the Hippo signaling pathway, and YAP1-induced transcriptional responses are essential in cancer cell proliferation. Here, we report that HIF-2 robustly increases YAP1 expression and activity in CRC-derived cell lines and in mouse models. The potentiation of YAP1 activity by HIF-2 was not via canonical signaling mechanisms such as Src (non-receptor tyrosine kinase), PI3K, ERK, or MAPK pathways. Moreover, we detected no direct interaction of HIF-2 with YAP1. Of note, YAP1 activation was critical for cancer cell growth under hypoxia. Our findings indicate that HIF-2 increases cancer cell growth by upregulating YAP1 activity, suggesting that this pathway might be targeted in potential anti-cancer approaches for treating CRC patients.

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Heartland virus NSs protein disrupts host defenses by blocking the TBK1 kinase-IRF3 transcription factor interaction and signaling required for interferon induction [Molecular Bases of Disease]

Heartland virus (HRTV) is a pathogenic phlebovirus related to the severe fever with thrombocytopenia syndrome virus (SFTSV), another phlebovirus causing life-threatening diseases in humans. Previous findings have suggested that SFTSV can antagonize the host interferon (IFN) system via viral nonstructural protein (NSs)-mediated sequestration of antiviral signaling proteins into NSs-induced inclusion bodies (IBs). However, whether and how HRTV counteracts the host innate immunity is unknown. Here, we report that HRTV NSs (HNSs) also antagonizes IFN and cytokine induction and bolsters viral replication, although no noticeable IB formation was observed in HNSs-expressing cells. Furthermore, HNSs inhibited the virus-triggered activation of IFN-β promoter by specifically targeting the IFN-stimulated response element (ISRE) but not the NF-κB response element. Consistently, HNSs blocked the phosphorylation and nuclear translocation of IFN regulatory factor 3 (IRF3, an ISRE-activating transcription factor). Reporter gene assays next showed that HNSs interrupts the antiviral signaling mediated by RIG-I-like receptors likely at the level of TANK-binding kinase 1 (TBK1). Indeed, HNSs strongly interacts with TBK1 as indicated by confocal microscopy and pulldown analyses, and we also noted that the scaffold dimerization domain of TBK1 is required for the TBK1-HNSs interaction. Finally, pulldown assays demonstrated that HNSs expression dose-dependently diminishes a TBK1-IRF3 interaction, further explaining the mechanism for HNSs function. Collectively, these data suggest that HNSs, an antagonist of host innate immunity, interacts with TBK1 and thereby hinders the association of TBK1 with its substrate IRF3, thus blocking IRF3 activation and transcriptional induction of the cellular antiviral responses.

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Evidence for a direct crosstalk between malic enzyme and the pentose phosphate pathway via structural interactions [Cell Biology]

Recent studies have revealed that the oxidative pentose phosphate pathway (PPP), malic enzyme (ME) and folate metabolism are the three major routes for generating cellular NADPH, a key cofactor involved in redox control and reductive biosynthesis. Many tumor cells exhibit altered NADPH metabolism to fuel their rapid proliferation. However, little is known about how NADPH metabolism is coordinated in tumor cells. Here we report that ME1 increases the PPP flux by forming physiological complexes with 6-Phosphogluconate dehydrogenase (6PGD). We found that ME1 and 6PGD form a hetero-oligomer that increases the capability of 6PGD to bind its substrate 6PG. Through activating 6PGD, ME1 enhances NADPH generation, PPP flux and tumor cell growth. Interestingly, although ME1 could bind either the dimer-defect mutant 6PGD (K294R) or the NADP+-binding defect 6PGD mutants, only 6PGD (K294R) activity was induced by ME1. Thus, ME1/6PGD hetero-complexes may mimic the active oligomer form of 6PGD. Together, these findings uncover a direct crosstalk mechanism between ME1 and PPP, may reveal an alternative model for signaling transduction via protein conformational simulation and pave the way for better understanding how metabolic pathways are coordinated in cancer.

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Dectin-1 intracellular domain determines species-specific ligand spectrum by modulating receptor sensitivity [Signal Transduction]

C-type lectin receptors (CLRs) comprise a large family of immunoreceptors that recognizes polysaccharide ligands exposed on pathogen surfaces and are conserved among mammals. However, interspecies differences in their ligand spectrums are not fully understood. Dectin-1 is a well-characterized CLR that recognizes β-glucan. We report here that seaweed-derived fucan activates cells expressing human Dectin-1 but not mouse Dectin-1. Low-valency β-glucan components within fucan appeared to be responsible for this activation, as the ligand activity was eliminated by β-glucanase treatment. The low-valency β-glucan laminarin also acted as an agonist for human Dectin-1 but not for mouse Dectin-1, whereas the high-valency β-glucan curdlan activated both human and mouse Dectin-1. Reciprocal mutagenesis analysis revealed that the ligand-binding domain of human Dectin-1 does not determine its unique sensitivity to low-valency β-glucan. Rather, we found that its intracellular domain renders human Dectin-1 reactive to low-valency β-glucan ligand. Substitution with two amino acids, Glu2 and Pro5, located in the human Dectin-1 intracellular domain was sufficient to confer sensitivity to low-valency β-glucan in mouse Dectin-1. Conversely, the introduction of mouse-specific amino acids, Lys2 and Ser5, to human Dectin-1 reduced the reactivity to low-valency β-glucan. Indeed, low-valency ligands induced a set of proinflammatory genes in human but not mouse primary dendritic cells. These results suggest that Dectin-1′s intracellular domain, but not its ligand-binding domain, determines the species-specific activation profile of Dectin-1 ligands.

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Palmitoylation of the ciliary GTPase Arl13b is necessary for its stability and its role in cilia formation [Cell Biology]

Primary cilia are hair-like extensions of the plasma membrane of most mammalian cells that serve specialized signaling functions. To traffic properly to cilia, multiple cilia proteins rely on palmitoylation, the post-translational attachment of a saturated 16-carbon lipid. However, details regarding the mechanism of how palmitoylation affects cilia protein localization and function are unknown. Herein, we investigated the protein ADP ribosylation factor like GTPase 13b (Arl13b) as a model palmitoylated ciliary protein. Using biochemical, cellular, and in vivo studies, we found that Arl13b palmitoylation occurs in vivo in mouse kidneys, and that it is required for trafficking to and function within cilia. Myristoylation, a 14-carbon lipid, is shown to largely substitute for palmitoylation with regard to cilia localization of Arl13b, but not with regard to its function within cilia. The functional importance of palmitoylation results in part from a dramatic increase in Arl13b stability, which is not observed with myristoylation. Additional results show that blockade of depalmitoylation slows the degradation of Arl13b that occurs during cilia resportion, raising the possibility that the sensitivity of Arl13b stability to palmitoylation may be exploited by the cell to accelerate degradation of Arl13b by depalmitoylating it. Together, the results show that palmitoylation plays a unique and critical role in controlling the localization, stability, abundance and thus function of Arl13b. Pharmacological manipulation of protein palmitoylation may be a strategy to alter cilia function.

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Regulation of mitochondrial protein import by the nucleotide exchange factors GrpEL1 and GrpEL2 in human cells [Protein Structure and Folding]

Mitochondria are organelles indispensable for maintenance of cellular energy homeostasis. Most mitochondrial proteins are nuclear encoded and are imported into the matrix compartment where they are properly folded. This process is facilitated by the mitochondrial heat shock protein 70 (mtHsp70), a chaperone contributing to mitochondrial protein quality control. The affinity of mtHsp70 for its protein clients and its chaperone function are regulated by binding of ATP/ADP to mtHsp70's nucleotide-binding domain (NBD). Nucleotide exchange factors (NEFs) play a crucial role in exchanging ADP for ATP at mtHsp70's NBD, thereby modulating mtHsp70's chaperone activity. A single NEF, Mge1, regulates mtHsp70's chaperone activity in lower eukaryotes, but the mammalian orthologs are unknown. Here, we report that two putative NEF orthologs GrpE like 1 (GrpEL1) and GrpEL2, modulate mtHsp70's function in human cells. We found that both GrpEL1 and GrpEL2 associate with mtHsp70 as heterooligomeric subcomplex and regulate mtHsp70 function. The formation of this subcomplex was critical for conferring stability to the NEFs, helped fine-tune mitochondrial protein quality control, and regulated crucial mtHsp70 functions, such as import of preproteins and biogenesis of Fe S clusters. Our results also suggested that GrpEL2 has evolved as a possible stress resistance protein in higher vertebrates to maintain chaperone activity under stress condition. In conclusion, our findings support the idea that GrpEL1 has a role as a stress modulator in mammalian cells and highlight that multiple NEFs are involved in controlling protein quality in mammalian mitochondria.

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Long-term voice outcome after thyroidectomy using energy based devices

Voice dysfunction is frequently reported after thyroidectomy even in absence of vocal fold paralysis. The energy-based devices such as Harmonic scalpel (HS) or LigaSure (LS) are commonly used in conventional thyroidectomy. The objective of this study was to investigate the long-term voice outcome after total thyroidectomy using energy based devices.

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Long-term voice outcome after thyroidectomy using energy based devices

Voice dysfunction is frequently reported after thyroidectomy even in absence of vocal fold paralysis. The energy-based devices such as Harmonic scalpel (HS) or LigaSure (LS) are commonly used in conventional thyroidectomy. The objective of this study was to investigate the long-term voice outcome after total thyroidectomy using energy based devices.

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Gastric Metastasis from Renal Cell Carcinoma, Clear Cell Type, Presenting with Gastrointestinal Bleeding

Renal cell carcinoma (RCC) accounts for 80–85% of all primary renal neoplasms. Although RCC can metastasize to any organ, gastric metastases from RCC are exceedingly rare. A 67-year-old male presented with melena and acute blood loss anemia. The patient had a history of RCC that had been treated with a radical nephrectomy. He had a recent myocardial infarction and was receiving double antiplatelet therapy. After hemodynamic stabilization, esophagogastroduodenoscopy showed a polypoid mass in the gastric fundus. The mass was excised. Histological and immunohistochemical evaluation were consistent with clear cell RCC. The polypoid lesion is consistent with a late solitary metastasis.

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Lycopene Inhibits Propagation of Chlamydia Infection

Chlamydiaceae is a family of obligate intracellular pathogenic bacteria with similar developmental cycles and cell biology responsible for a wide range of diseases in different hosts including genital and eye inflammatory diseases, arthritis, and inflammatory diseases of the respiratory and cardiovascular systems. In the present paper, we report that lycopene, one of the main dietary carotenoids, which is present in tomato and some other fruits, has a strong inhibitory effect on C. trachomatis and C. pneumoniae infections in alveolar macrophages. This finding was documented by both immunofluorescence analysis and electron microscopy. It was noted that lycopene treatment inhibited intracellular phase of the chlamydial developmental cycle and resulted in a significant loss of infectious progeny. The antichlamydial effect of lycopene was also confirmed in a clinical setting. There was a significant reduction of IgG antibodies against C. pneumoniae in the serum of volunteers treated for a month with oral ingestion of 7 mg of lycopene. Additional studies are needed to further explore the antichlamydial activity of lycopene and its possible effect on C. pneumoniae in relation to antichlamydial activity of lycopene to mechanisms of atherosclerosis.

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The Snap Tension Analysis of Taut-Slack Mooring Line with tanh Method

The continuous model is introduced, and the nonlinear partial differential equations of taut-slack mooring line system are transferred to nonlinear algebraic equations through tanh method, and four solitary solutions are obtained further. At the same time, to express the results clearly, the curve surfaces of strains, displacements, and tension are plotted. The results show that there are four different solutions in the system. With the pretension increasing, the tension changes from one solitary solution to snap tension, and when the pretension is increased further, the curve converts to continuous line, until straight line, which is corresponding to the taut mooring line. In the process of increasing of pretension, the mooring line transfers from slack to taut, accompanied with tension skipping, which is reduced by the system parameters, and different combination of parameters may introduce different tension in line, and the uncertainty may cause the breakage of mooring system. The results have an agreement with experiment, which shows that the calculating method in this paper may be believable and feasible. This work may provide reference for design of mooring system.

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A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression

Aim. To determine the prevalence of type of soft palate in targeted population. Materials and Methods. Using computer technology in dentistry, intraoral digital scanner, and 3D analysis software tool, study was conducted. 100 patients selected from the outpatient clinics were divided into two groups based on the ages of 20–40 years and 41–60 years with equal ratio of males and females. Each selected patient's maxillary arch was scanned with intraoral scanner; images so obtained were sectioned in anteroposterior cross section and with the 3D analysis software; the angulation between hard and soft palate was determined. Results. The prevalence of type II soft palate (angulation between hard and soft palate is between 10 and 45 degrees) was highest, 60% in group 1 and 44% in group 2. The difference between genders was statistically significant with value in both the groups, although females had higher angulation compared to the males in all classes of both groups. Conclusions. In targeted population of Aseer Province, Saudi Arabia, the prevalence of type II soft palate was more common, with higher soft palate angulation among females. The advanced age had no effect in the type of soft palate in the region.

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Interaction between an Eco-Spiral Bolt and Crushed Rock in a Borehole Evaluated by Pull-Out Testing

The interactions between an eco-spiral bolt and crushed rocks in a borehole were evaluated by pull-out testing in a laboratory and numerical analysis. The porosity of the crushed rock surrounding the bolt depended on the size of the eco-spiral bolt and affected the eco-spiral bolt's axial resistance force. The axial resistance force and the porosity of the crushed rocks in the borehole showed an inverse relationship. The porosity was also related to the size of the eco-spiral bolt. The maximum principal stress between the bolt and the rock was related to the porosity of the crushed rock and the size difference between the eco-spiral bolt and the borehole. At low porosity the experimental and numerical analyses show similar relationships between the axial resistance force and the displacement. However, at high porosity, the numerical results deviated greatly from the experimental observation. The initial agreement is attributed to the state of residual resistance after the maximum axial resistance force, and the latter divergence was due to the decreasing axial resistance force owing to slippage.

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Neutrophil-to-Lymphocyte Ratio Predicts Prognosis in Castration-Resistant Prostate Cancer Patients Who Received Cabazitaxel Chemotherapy

Introduction and Objectives. An elevated neutrophil-to-lymphocyte ratio (NLR) has been suggested to be associated with a poor prognosis in several cancers. We evaluated the utility of an elevated NLR as a biomarker to predict the prognosis of metastatic castration-resistant prostate cancer (mCRPC) patients treated with cabazitaxel (CBZ). Methods. We analyzed 47 patients who received CBZ chemotherapy for mCRPC in our institutions. The NLR was calculated using the neutrophil and lymphocyte counts before CBZ chemotherapy. We determined the NLR cut-off value based on the sensitivity and specificity levels derived from area under the receiver operator characteristic curves for death. A multivariate analysis was performed to investigate the association between the NLR and the prognosis. Results. The median overall survival (OS) after CBZ was 10.0 months (range: 6.3–13.2). The median OS was shorter in patients with a high NLR (≥3.83) than in those with a low NLR (

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Predictability of Urinary CD80 in the Relapse of Primary Nephrotic Syndrome

Purpose. The current study is aimed at investigating whether urinary CD80 is reliable to predict the recurrence of pediatric PNS. Materials and Methods. A total of 128 children, 105 males and 23 females, were enrolled in this study. Urinary samples were collected from SSNS and SRNS patients and 25 healthy children as controls. Urinary CD80 was measured by ELISA and adjusted for urinary creatinine excretion. Results. Urinary CD80 in relapse stage of SSNS was significantly higher, and the urinary CD80 of paired relapse and remission stages of each SSNS patient were also significantly different. No significant difference was found between the urinary CD80 in SRNS relapse group, SRNS remission group, and the control group. Similarly, there was no significant difference between frequent SSNS and not frequent SSNS in remission group, as well as the relapse group. There is no correlation between urinary CD80 and 24-hour urinary protein. Conclusion. The increase of urinary CD80 was closely associated with the relapse of SSNS but was not related to the frequency of relapse. The urinary CD80 changes of concentration were reliable to predict the recurrence of SSNS. However, it cannot be used to predicate the frequent recurrence of PNS.

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Classification of Hand Grasp Kinetics and Types Using Movement-Related Cortical Potentials and EEG Rhythms

Detection of single-trial movement intentions from EEG is paramount for brain-computer interfacing in neurorehabilitation. These movement intentions contain task-related information and if this is decoded, the neurorehabilitation could potentially be optimized. The aim of this study was to classify single-trial movement intentions associated with two levels of force and speed and three different grasp types using EEG rhythms and components of the movement-related cortical potential (MRCP) as features. The feature importance was used to estimate encoding of discriminative information. Two data sets were used. 29 healthy subjects executed and imagined different hand movements, while EEG was recorded over the contralateral sensorimotor cortex. The following features were extracted: delta, theta, mu/alpha, beta, and gamma rhythms, readiness potential, negative slope, and motor potential of the MRCP. Sequential forward selection was performed, and classification was performed using linear discriminant analysis and support vector machines. Limited classification accuracies were obtained from the EEG rhythms and MRCP-components: (grasp types), (kinetic profiles, motor execution), and (kinetic profiles, motor imagination). Delta activity contributed the most but all features provided discriminative information. These findings suggest that information from the entire EEG spectrum is needed to discriminate between task-related parameters from single-trial movement intentions.

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Impact of Pyrotechnics over the Architectonic Heritage

The use of pyrotechnics near to the historical heritage such as walls, facades, church, or fortifications of a city is nowadays a topic of discussion. There is not a clear legislation about the use of pyrotechnics near to these buildings and how they can be affected by the expansive wave generated by the use of harquebusiers, fireworks, and cannons during the simulation of a battle. For this reason, this paper presents some practical tests that measure the vibroacoustic effect when these types of pyrotechnics are used near to the architectonical heritage. In order to collect these data, we have used several sound level meters and accelerometers placed on two different scenarios. The first one was placed near to the beach and the other one was placed in a building of a narrow alley. The tests were carried out during the festival of Moors and Christians of Villajoyosa (Spain) which is a famous festival. Along these tests, we reproduce the worse cases that may affect the building, using harquebusiers shots, fireworks, and cannons shots. Results show that the house placed near to the beach does not suffer important vibroacoustic impacts. However, the old building placed in the alley is very affected.

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Laser-Induced Color Marking of Titanium: A Modeling Study of the Interference Effect and the Impact of Protective Coating

Laser-induced color marking of metals, due to numerous advantages, including inter alia the high quality, resolution, durability, and noncontact methodology of surface marking, seems to be attractive for use in various applications. In this method, the resulting color is mainly evident from the interference effect. Therefore, one of the still unsolved problems on titanium is the color change after imposition of an additional layer (fingerprints, grease, etc.). In this paper, a computer simulation based on the theoretical thin layers model was presented. The results of the modeling study revealed that theoretically a thin protective coating of a known refractive index can be applied while still maintaining the target color. In this case, as a protective layer, an amphiphobic coating has been taken into consideration with its ability to resist surface contamination. The study was performed for titanium (grade 2). The model utilizes the real data derived from the spectrophotometer, as well as from the ellipsometry measurements of laser-induced samples.

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The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (). Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

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Vibration Analysis of a Piecewise-Smooth System with Negative Stiffness under Delayed Feedback Control

The principal resonance of a delayed piecewise-smooth (DPWS) system with negative stiffness under narrow-band random excitation is investigated in aspects of multiscale analysis, design methodology of the controller, and response properties. The amplitude-frequency response and steady-state moments together with the corresponding stability conditions of the controlled stochastic system are derived, in which the degradation case is also under consideration. Then, from the perspective of the equivalent damping, the comparisons of the response characteristics of the controlled system to the uncontrolled system, such as the phenomenon of frequency island, are fulfilled. Furthermore, sensitivity of the system response to feedback gain and time delay is studied and interesting dynamic properties are found. Meanwhile, the classification of the steady-state solution is also discussed. To control the maximum amplitude, the feedback parameters are determined by the frequency response together with stability boundaries which must be utilized to exclude the combinations of the unstable parameters. For the case with small noise intensity, mean-square responses present the similar characteristics to what is discussed in the deterministic case.

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Designing Dynamic Delivery Parking Spots in Urban Areas to Reduce Traffic Disruptions

Pick-up and delivery services are essential for businesses in urban areas. However, due to the limited space in city centers, it might be unfeasible to provide sufficient loading/unloading spots. As a result, this type of operations often interferes with traffic by occupying road space (e.g., illegal parking). In this study, a potential solution is investigated: Dynamic Delivery Parking Spots (DDPS). With this concept, based on the time-varying traffic demand, the area allowed for delivery parking changes over time in order to maximize delivery opportunities while reducing traffic disruptions. Using the hydrodynamic theory of traffic flow, we analyze the traffic discharging rate on an urban link with DDPS. In comparison to the situation without delivery parking, the results show that although DDPS occupy some space on a driving lane, it is possible to keep the delay at a local level, that is, without spreading to the network. In this paper, we provide a methodology for the DDPS design, so that the delivery requests can be satisfied while their negative impacts on traffic are reduced. A simulation study is used to validate the model and to estimate delay compared to real situations with illegal parking, showing that DDPS can reduce system's delay.

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Chinese Medicine Treatment for Afatinib-Induced Paronychia

Afatinib (Gilotrif™) is widely used to treat patients with mutant activating epidermal growth factor receptor- (EGFR-) dependent lung adenocarcinoma; however, it has various adverse side effects. Here, we report a patient with afatinib-induced paronychia. After Chinese medicine treatment with the well-known anticancer Chinese herbs, Jen-Ren-Hwo-Minq-Saan, and decoction of Ban-Zhi-Lian (Scutellaria barbata) with Bai-Hua-She-She-Cao (Hedyotis diffusa Willd), patient's condition was significantly improved. This shows that these Chinese medicines can not only be used in cancer treatment but also be used in the afatinib-induced paronychia.

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Erratum: Terpenoids from the Oleo-Gum-Resin of Boswellia serrata and Their Antiplasmodial Effects In Vitro

Planta Med
DOI: 10.1055/s-0043-118649

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Metabolomic-Guided Isolation of Bioactive Natural Products from Curvularia sp., an Endophytic Fungus of Terminalia laxiflora

Planta Med
DOI: 10.1055/s-0043-118807

Endophytic fungi associated with medicinal plants are a potential source of novel chemistry and biology. Metabolomic tools were successfully employed to compare the metabolite fingerprints of solid and liquid culture extracts of endophyte Curvularia sp. isolated from the leaves of Terminalia laxiflora. Natural product databases were used to dereplicate metabolites in order to determine known compounds and the presence of new natural products. Multivariate analysis highlighted the putative metabolites responsible for the bioactivity of the fungal extract and its fractions on NF-κB and the myelogenous leukemia cell line K562. Metabolomic tools and dereplication studies using high-resolution electrospray ionization mass spectrometry directed the fractionation and isolation of the bioactive components from the fungal extracts. This resulted in the isolation of N-acetylphenylalanine (1) and two linear peptide congeners of 1: dipeptide N-acetylphenylalanyl-L-phenylalanine (2) and tripeptide N-acetylphenylalanyl-L-phenylalanyl-L-leucine (3).
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Age ‐related histologic and biochemical changes in auricular and septal cartilage

ConclusionsIn auricular and septal cartilage, glycosaminoglycans, elastin, cell density, and cell size decrease significantly with age in patients over 55 years of age. Glycosaminoglycan content declines faster with age in septal cartilage than auricular cartilage. These age‐related changes may affect biomechanical properties and tissue viability, and thereby have implications for graft choice in functional, aesthetic, and reconstructive nasal surgery. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)

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SELECT-3: a phase I study of selumetinib in combination with platinum-doublet chemotherapy for advanced NSCLC in the first-line setting

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Dihydropyrimidine dehydrogenase pharmacogenetics for predicting fluoropyrimidine-related toxicity in the randomised, phase III adjuvant TOSCA trial in high-risk colon cancer patients

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Predicting response and toxicity to immune checkpoint inhibitors using routinely available blood and clinical markers

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Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study

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Tenascin C in colorectal cancer stroma is a predictive marker for liver metastasis and is a potent target of miR-198 as identified by microRNA analysis

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Receptionist calls time on 30-year career at Witton Street Dental Practice

She said: "I loved the job, I loved the people I worked with. I made lots of friends and they will stay friends.

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Could Your Next Doctor Be Your Dentist?

Allowing dentists to disrupt primary care may provide affordable preventive care for patients living in areas with problems of health care access and affordability. Tooth enamel is the strongest substance in the human body.

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Risk Factor Analysis for Capsular Contracture, Malposition, and Late Seroma in Subjects Receiving Natrelle 410 Form-Stable Silicone Breast Implants

No abstract available

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Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy

Background: Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage. Methods: A single surgeon's experience with immediate prosthetic reconstruction following nipple-sparing mastectomy from 2012 to 2016 was reviewed. Patient demographics, adjuvant treatment, length and characteristics of the expansion, and incidence of complications during the tissue expander stage were compared between the partial submuscular/partial acellular dermal matrix (dual-plane) cohort and the prepectoral cohort. Results: Fifty-one patients (84 breasts) underwent immediate prepectoral tissue expander placement, compared with 115 patients (186 breasts) undergoing immediate partial submuscular expander placement. The groups had similar comorbidities and postoperative radiation exposure. There was no significant difference in overall complication rate between the two groups (17.9 percent versus 18.8 percent; p = 0.49). Conclusions: Prepectoral breast reconstruction provides a safe and effective alternative to partial submuscular reconstruction, that yields comparable aesthetic results with less operative morbidity. In the authors' experience, the incidence of acute and chronic postoperative pain and animation deformity is significantly lower following prepectoral breast reconstruction. This technique is now considered for all patients who are safe oncologic candidates and are undergoing nipple-sparing mastectomy and prosthetic reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Disclosure of Financial Conflicts of Interest in Plastic and Reconstructive Surgery

Background: Recent articles in the scientific literature have expressed concerns about financial conflicts of interest in the profession of medicine in general and the specialty of plastic surgery in particular. Disclosure of financial ties to industry has been regarded as an address of a possible bias. The policies of medical journals places responsibility on authors for self-reporting of financial conflicts of interest, yet underreporting of conflicts of interest has occurred. The investigative hypothesis was that authors in the plastic surgery literature, in particular, Plastic and Reconstructive Surgery, underreported financial conflicts of interest. Methods: A review of articles published in Plastic and Reconstructive Surgery from July of 2015 through April of 2016 for author disclosures was accomplished. The disclosure statements were compared to the information available in the Open Payments database for 2015. The lack of disclosure on the part of an author, when present, was individually examined for relevance of the corporate conflicts of interest to the subject matter of the involved article. Results: A total of 302 articles authored by 1262 individuals were reviewed. One hundred thirty-nine (45.5 percent) had neither a disclosed nor an actual conflict of interest. In 61 articles (20.2 percent), one or more authors disclosed; 105 articles (34.8 percent) did not provide disclosure of a financial conflict of interest. In assessment of relevance, 10 undisclosed conflicts of interest (9.5 percent) were determined relevant, and one-third of that total were non–plastic surgeons. Conclusion: Nondisclosure of financial conflicts of interest is common, but only a small minority pose a potential for harm from bias.

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Discussion: Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy

No abstract available

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Psychological Outcomes of Labiaplasty: A Prospective Study

No abstract available

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Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants

Background: Bacteria/biofilm on breast implant surfaces has been implicated in capsular contracture and breast implant–associated anaplastic large-cell lymphoma (ALCL). Macrotextured breast implants have been shown to harbor more bacteria than smooth or microtextured implants. Recent reports also suggest that macrotextured implants are associated with a significantly higher incidence of breast implant–associated ALCL. Using techniques to reduce the number of bacteria around implants, specifically, the 14-point plan, has successfully minimized the occurrence of capsular contracture. The authors hypothesize that a similar effect may be seen in reducing the risk of breast implant–associated ALCL. Methods: Pooled data from eight plastic surgeons assessed the use of macrotextured breast implants (Biocell and polyurethane) and known cases of breast implant–associated ALCL. Surgeon adherence to the 14-point plan was also analyzed. Results: A total of 42,035 Biocell implants were placed in 21,650 patients; mean follow-up was 11.7 years (range, 1 to 14 years). A total of 704 polyurethane implants were used, with a mean follow-up of 8.0 years (range, 1 to 20 years). The overall capsular contracture rate was 2.2 percent. There were no cases of implant–associated ALCL. All surgeons routinely performed all 13 perioperative components of the 14-point plan; two surgeons do not routinely prescribe prophylaxis for subsequent unrelated procedures. Conclusions: Mounting evidence implicates the role of a sustained T-cell response to implant bacteria/biofilm in the development of breast implant–associated ALCL. Using the principles of the 14-point plan to minimize bacterial load at the time of surgery, the development and subsequent sequelae of capsular contracture and breast implant–associated ALCL may be reduced, especially with higher-risk macrotextured implants. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Determining the Oncologic Safety of Autologous Fat Grafting as a Reconstructive Modality: An Institutional Review of Breast Cancer Recurrence Rates and Surgical Outcomes

Background: The increasing use of autologous fat grafting in breast cancer patients has raised concerns regarding its oncologic safety. This study evaluated patient outcomes and tumor recurrence following mastectomy reconstruction and autologous fat grafting. Methods: Retrospective chart review identified patients who underwent mastectomy followed by breast reconstruction from 2010 to 2015. Eight hundred twenty-nine breasts met inclusion criteria: 248 (30.0 percent) underwent autologous fat grafting, whereas 581 (70.0 percent) breasts did not. Patient demographics, cancer characteristics, oncologic treatment, surgical treatment, surgical complications, local recurrence, and distant metastases were analyzed. Results: Autologous fat grafting patients and control patients were of similar body mass index, smoking status, and BRCA status. Patients who underwent fat grafting were significantly younger than control patients and were less likely to have diabetes, hypertension, or hyperlipidemia. The two groups represented similar distributions of BRCA status, Oncotype scores, and hormone receptor status. Patients underwent one to four grafting procedures: one procedure in 83.1 percent, two procedures in 13.7 percent, three in 2.8 percent, and four in 0.4 percent. Mean follow-up time from initial surgery was 45.6 months in the fat grafting group and 38.8 months in controls. The overall complication rate following fat grafting was 9.4 percent. Among breasts undergoing surgery for therapeutic indications, there were similar rates of local recurrence (fat grafting group, 2.5 percent; controls, 1.9 percent; p = 0.747). Interestingly, mean time to recurrence was significantly longer in the fat grafting group (52.3 months versus 22.8 months from initial surgery; p = 0.016). Conclusions: Autologous fat grafting is a powerful tool in breast reconstruction. This large, single-institution study provides valuable evidence-based support for its oncologic safety. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

Background: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Methods: Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Results: Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m2 (range, 22 to 44 kg/m2). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. Conclusions: The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Revision Buttock Implantation: Indications, Procedures, and Recommendations

No abstract available

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Comparison of Endothelial Differentiation Capacities of Human and Rat Adipose-Derived Stem Cells

No abstract available

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Free Diced Cartilage: A New Application of Diced Cartilage Grafts in Primary and Secondary Rhinoplasty

Background: Irregularities or deformities of the nasal dorsum after hump reduction account for a significant number of revision rhinoplasties. The authors therefore developed a technique of meticulously dicing and exactly placing free diced cartilage grafts, harvested from septum, rib, or ear cartilage. The cartilage paste is used for smoothening, augmentation, or camouflaging of the nasal dorsum in primary or revision rhinoplasties. Methods: A retrospective analysis of multisurgeon consecutive open approach rhinoplasties from January to December of 2014 was conducted at a single center. The authors compared the outcome of three different techniques to augment or cover the nasal dorsum after an observation period of 7 months. In group I, 325 patients with free diced cartilage grafts as the only onlay were included. In group II, consisting of 73 patients, the dorsal onlay was either fascia alone or in combination with free diced cartilage grafts. Forty-eight patients in group III received a dorsal augmentation with the classic diced cartilage in fascia technique. Results: Four hundred forty-six patients undergoing primary and secondary rhinoplasties in which one of the above-mentioned diced cartilage techniques was used were included in the study. The authors found revision rates for dorsal irregularities within the 7-month postoperative observation period of 5.2, 8.2, and 25 percent for groups I, II, and III, respectively. Conclusion: The authors' findings strongly support their clinical experience that the free diced cartilage graft technique presents an effective and easily reproducible method for camouflage and augmentation in aesthetic and reconstructive rhinoplasty.

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Discussion: Free Diced Cartilage: A New Application of Diced Cartilage Grafts in Primary and Secondary Rhinoplasty

No abstract available

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Introducing the International Confederation of Plastic Surgery Societies: ICOPLAST

Summary: This article describes the formation of the International Confederation of Plastic Surgery Societies (ICOPLAST) as a novel, transparent, dynamic, and proactive confederation of national plastic surgery societies. ICOPLAST aspires to provide a voice for the entire international community of plastic surgeons. ICOPLAST has been designed to benefit the patient, plastic surgery as a profession, and each individual plastic surgeon. Its principal objective is to enhance international communication, education, and advocacy processes to ultimately improve patient outcomes for plastic surgery patients globally. The new ICOPLAST's focus is to add true value for patients. ICOPLAST's evolution, philosophy, governance, and bylaws are explained and all societies worldwide are encouraged and cordially invited to join. An open and warm invitation is provided. Additional information is found at www.ICOPLAST.org .

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Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers: Focus on the Lower Face

Summary: This third article of a three-part series addresses techniques and recommendations for aesthetic treatment of the lower face. The lower face is considered an advanced area for facial aesthetic treatment. In this region, soft-tissue fillers play a more important role than neuromodulators and should be used first to provide structure and support before neuromodulators are considered for treatment of dynamic lines. Treatment of the lip, perioral region, and chin, in addition to maintaining balance of the lower face with the face overall, is challenging. Procedures on the lip should avoid overcorrection while respecting the projection of the lips on the profile view and the ratio of lip size to chin. The chin is often neglected, but reshaping the jawline can provide dramatic improvement in facial aesthetics. Both profile and anterior views are critical in assessment and treatment of the lower face. Finally, rejuvenation of the neck region requires fillers for structural support of the chin and jawline and neuromodulators for treatment of the masseter and platysma.

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Aesthetic Facial Reconstruction after Mohs Surgery

No abstract available

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Artificial Synapses with Short- and Long-Term Memory for Spiking Neural Networks Based on Renewable Materials

ACS Nano

DOI: 10.1021/acsnano.7b03347

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Accelerating Palladium Nanowire H2 Sensors Using Engineered Nanofiltration

ACS Nano

DOI: 10.1021/acsnano.7b04529

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High Performance Poly(viologen)–Graphene Nanocomposite Battery Materials with Puff Paste Architecture

ACS Nano

DOI: 10.1021/acsnano.7b02310

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Size Controllable, Transparent, and Flexible 2D Silver Meshes Using Recrystallized Ice Crystals as Templates

ACS Nano

DOI: 10.1021/acsnano.7b03821

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Transient and Local Expression of Chemokine and Immune Checkpoint Traps To Treat Pancreatic Cancer

ACS Nano

DOI: 10.1021/acsnano.7b01786

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Correction to Probing Evolution of Twist-Angle-Dependent Interlayer Excitons in MoSe2/WSe2 van der Waals Heterostructures

ACS Nano

DOI: 10.1021/acsnano.7b05320

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Two-Dimensional Graphene Augments Nanosonosensitized Sonocatalytic Tumor Eradication

ACS Nano

DOI: 10.1021/acsnano.7b05215

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The Role of the Level of Interleukin-33 in the Therapeutic Outcomes of Immunotherapy in Patients with Allergic Rhinitis

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1605596

Introduction Allergic rhinitis (AR) affects up to 40% of the population and results in nasal itching, congestion, sneezing, and clear rhinorrhea. Objectives This study aimed to evaluate the changes in the clinical symptoms and in the level of serum interleukin (IL)-33 before and after pollen immunotherapy (IT) in patients with AR. Methods The total symptom score and the levels of total immunoglobulin E (IgE) and IL-33 were determined in the serum of 10 non-allergic healthy controls and 45 patients with AR who were equally divided into 3 groups: GI (patients did not receive IT), GII (patients had received IT for 6 months) and GIII (patients had received IT for 2 years). Results There was a significantly higher concentration of IgE and IL-33 in the serum of patients with AR than in that of non-allergic patients. Furthermore, serum level of IL-33 decreased significantly after pollen IT. But, there was no significant reduction in the serum level of IL-33 between GII and GIII patients. Conclusion Our results show a clinical improvement associated with a decrease in serum level of IL-33 after pollen IT.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Physical Therapy for Posterior and Horizontal Canal Benign Paroxysmal Positional Vertigo: Long-term Effect and Recurrence: A Systematic Review

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1604345

Introduction Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, and it is characterized by episodes of vertigo roundabout when the head is moved. A systematic review was performed using the most important scientific databases. This review included studies published in English in the last ten years, performed in adults, with emphasis on the diagnosis and treatment of BPPV. Objective To investigate the long-term effectiveness of vestibular rehabilitation (VR) in patients with BPPV and the rate of recurrence of symptoms. Data Synthesis A total of 38 studies were identified, of which only 12 met the inclusion criteria. The majority of the studies stated that VR is effective in decreasing the symptoms, with a short-term efficacy of 84.7%, and 89.2% in the long term in the reviewed studies. Conclusion Valuable studies show the beneficial effects of the maneuvers for the treatment of BPPV and their long-term effectiveness. This strengthens the conclusion that this treatment is effective in resolving symptoms and decreasing recurrences.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Efficacy of Myofunctional Therapy Associated with Voice Therapy in the Rehabilitation of Neurogenic Oropharyngeal Dysphagia: a pilot study

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1605597

Introduction Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments (p = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone (p = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy (p = 0.126). Conclusion This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
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Parameters for Applying the Brainstem Auditory Evoked Potential with Speech Stimulus: Systematic Review

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1605598

Introduction Studies using the Brainstem Auditory Evoked Potential with speech stimulus are increasing in Brazil, and there are divergences between the methodologies used for testing. Objectives To analyze the parameters used in the study of the Brainstem Auditory Evoked Potentials with speech stimulus. Data Synthesis The survey was performed using electronic databases. The search strategy was as follows: "Evoked potentials, auditory" OR "Brain stem" OR "Evoked potentials, auditory, brain stem" AND "Speech." The survey was performed from June to July of 2016. The criteria used for including articles in this study were: being written in Portuguese, English or Spanish; presenting the description of the testing parameters and the description of the sample. In the databases selected, 2,384 articles were found, and 43 articles met all of the inclusion criteria. The predominance of the following parameters was observed to achieve the potential during study: stimulation with the syllable /da/; monaural presentation with greater use of the right ear; intensity of 80 dB SPL; vertical placement of electrodes; use of in-ear headphones; patient seated, distracted in awake state; alternating polarity; use of speech synthesizer software for the elaboration of stimuli; presentation rate of 10.9/s; and sampling rate of 20 kHz. Conclusions The theme addressed in this systematic review is relatively recent. However, the results are significant enough to encourage the use of the procedure in clinical practice and advise clinicians about the most used procedures in each parameter.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Anatomical Variations in Patients with Ménière Disease: A Tomography Study

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1604463

Introduction The etiology of Ménière disease (MD), a difficult-to-treat condition with great morbidity, remains controversial in the literature. The possible clinical and diagnostic impact of anatomical variations of the temporal bone among patients with MD has been recently studied. Objective To identify anatomical variations of the temporal bone associated with the diagnosis of MD. Methods Thirty-seven patients were included, although each ear was considered separately (n = 74). A case group (nA = 33) was composed of the affected ears of patients with definite MD and a control group (nB = 41) was used consisting of the ears of individuals who did not meet the criteria for MD and of the contralateral ears from patients with unilateral disease. Tomographic images from the individuals included in the study were submitted to a blinded and systematic evaluation regarding a broad variety of anatomical variations of the temporal bone. Obtained data were compared statistically between the groups and after stratifying the study sample. Significance level was set at 0.05. Results Among the affected ears, it was observed an increased number of tomographic scans in which the vestibular aqueduct could not be identified (p = 0.01, Fisher exact test). No statistically significant differences were observed when comparing the affected and contralateral ears from patients with unilateral MD, between affected ears from patients with unilateral and bilateral disease or between contralateral ears of patients with unilateral affection and patients without the disease. Conclusion Some anatomical variations might be more frequent in the affected ears of patients with MD, such as the lower rates of individualization of the vestibular aqueduct.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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