The difference in congenital cholesteatoma CT findings based on the type of mass.

OBJECTIVE: A retrospective assessment of differences in congenital cholesteatoma CT findings with a focus on type of cholesteatoma mass. MATERIALS AND METHODS: The medical records and CT images of 14 patients with congenital cholesteatomas in the middle ear who underwent surgery at our institution between January 2009 and July 2014 were reviewed. Cholesteatomas were classified as closed type, open type, or mixed type based on intraoperative findings. The CT findings including cholesteatoma size, location, and shape were retrospectively reviewed. RESULTS: Eight patients had closed type cholesteatomas, four had mixed type, and two had open type. The mean size of all cholesteatomas was 5.1mm. None of the cholesteatoma types indicated a tendency towards a certain location. The round shape was observed more frequently in closed type cholesteatomas than in other types (closed: 5/8; mixed: 1/4; open: 0/2). Two large closed type cholseteatomas and two mixed type cholesteatomas exhibited a constricted shape. Both of the open type cholesteatomas displayed an irregular shape. CONCLUSION: Small closed type congenital cholesteatomas were typically observed as round shaped lesions, but large closed type cholesteatomas and other type cholesteatomas tended to display shapes other than round.

Prevalence and clinical significance of supra- or infraclavicular drainage on preoperative lymphoscintigraphy in women with breast cancer.

OBJECTIVE: Preoperative sentinel lymph node (SLN) mapping by lymphoscintigraphy is helpful to evaluate extra-axillary SLNs over a wider range than the blue dye method. However, the clinical value of extra-axillary SLNs remains uncertain. The goal of this study was to determine the prevalence and clinical significance of supra- or infraclavicular drainage on preoperative lymphoscintigraphy in women with breast cancer. MATERIALS AND METHODS: We retrospectively reviewed the files of 942 consecutive breast cancer women who underwent preoperative lymphoscintigraphy for SLN biopsy at our institution between April 2004 and March 2015. RESULTS: Supra- or infraclavicular drainage was detected in 5/942 women (0.5%) on preoperative lymphoscintigraphy. An axillary hot spot was detected in all five women, and a positive axillary SLN was detected in four women. Breast tumor locations were the upper inner or outer quadrants in four women and the lower outer quadrant in one woman. The median follow-up period was 75 months (mean: 92; range: 26-111 months). Recurrence outside the axilla was found in three (60%) women. The woman with a negative SLN status did not undergo adjuvant chemotherapy, but developed extra-axillary lymph node recurrence 3 years after primary surgery. No patient died of metastatic breast cancer at the last follow-up. CONCLUSIONS: The detection of the supra- or infraclavicular SLNs on lymphoscintigraphy may provide additional staging information to tailor individual treatment regimens with regard to the potential risk of recurrence or metastasis of breast cancer.

Aligned biodegradable nanofibrous structure: a potential scaffold for blood vessel engineering.

A unique biodegradable nanofibrous structure, aligned poly(L-lactid-co-epsilon-caprolactone) [P(LLA-CL)] (75:25) copolymer nanofibrous scaffold was produced by electrospinning. The diameter of the generated fibers was around 500 nm with an aligned topography which mimics the circumferential orientation of cells and fibrils found in the medial layer of a native artery. A favorable interaction between this scaffold with human coronary artery smooth muscle cells (SMCs) was demonstrated via MTS assay, phase contrast light microscopy, scanning electron microscopy, immunohistology assay and laser scanning confocal microscopy separately. Tissue culture polystyrene and plane solvent-cast P(LLA-CL) film were used as controls. The results showed that, the SMCs attached and migrated along the axis of the aligned nanofibers and expressed a spindle-like contractile phenotype; the distribution and organization of smooth muscle cytoskeleton proteins inside SMCs were parallel to the direction of the nanofibers; the adhesion and proliferation rate of SMCs on the aligned nanofibrous scaffold was significantly improved than on the plane polymer films. The above results strongly suggest that this synthetic aligned matrix combines with the advantages of synthetic biodegradable polymers, nanometer-scale dimension mimicking the natural ECM and a defined architecture replicating the in vivo-like vascular structure, may represent an ideal tissue engineering scaffold, especially for blood vessel engineering.

Physical activity and immune senescence in men.

A cross-sectional survey examined whether habitual endurance exercisers retained a higher level of T cell function than sedentary individuals in old age. Subjects, all male, comprised 17 elderly runners, 16 young, and 19 elderly controls (mean ages +/- SD: 63.8 +/- 3.3, 23.6 +/- 1.6, and 65.8 +/- 3.5 yr, respectively), whose resting blood samples served for the immunological tests. Compared with the young subjects, both elderly groups had lower circulating CD3+ and CD8+ cell-counts (P = 0.029, P = 0.001, respectively), with a trend to a higher CD4/CD8 ratio, but higher percentages of activated CD3+, and "memory" CD4+ and CD8+ cells (all, P < 0.0001). Proliferative responses to phytohemagglutinin, pokeweed mitogen, and alloantigens were markedly reduced in the elderly (P < 0.001, and P = 0.024, respectively). IL-2 production tended to be decreased in the elderly sedentary subjects. However, natural killer cell activity and other cytokine production remained unchanged in the elderly sedentary subjects. Comparison between the active and sedentary elderly groups showed no differences in circulating counts of immunocompetent cells. However, the active elderly subjects demonstrated significantly greater proliferative responses to phytohemagglutinin ( P = 0.016) and to pokeweed mitogen (P = 0.011), and higher rates of IL-2 (P = 0.021), IFN-gamma (P = 0.015) and IL-4 production (P = 0.012). These results suggest that endurance training in later life is associated with a lesser age-related decline in certain aspects of circulating T cell function and related cytokine production.