Mesenchymal Stem Cells and Extracellular Vesicles Derived from Canine Adipose Tissue Ameliorates Inflammation, Skin Barrier Function and Pruritus by Reducing JAK/STAT Signaling in Atopic Dermatitis.

Canine atopic dermatitis (AD) is a common chronic inflammatory skin disorder resulting from imbalance between T lymphocytes. Current canine AD treatments use immunomodulatory drugs, but some of the dogs have limitations that do not respond to standard treatment, or relapse after a period of time. Thus, the purpose of this study was to evaluate the immunomodulatory effect of mesenchymal stem cells derived from canine adipose tissue (cASCs) and cASCs-derived extracellular vesicles (cASC-EVs) on AD. First, we isolated and characterized cASCs and cASCs-EVs to use for the improvement of canine atopic dermatitis. Here, we investigated the effect of cASCs or cASC-EVs on DNCB-induced AD in mice, before using for canine AD. Interestingly, we found that cASCs and cASC-EVs improved AD-like dermatitis, and markedly decreased levels of serum IgE, (49.6%, p = 0.002 and 32.1%, p = 0.016 respectively) epidermal inflammatory cytokines and chemokines, such as IL-4 (32%, p = 0.197 and 44%, p = 0.094 respectively), IL-13 (47.4%, p = 0.163, and 50.0%, p = 0.039 respectively), IL-31 (64.3%, p = 0.030 and 76.2%, p = 0.016 respectively), RANTES (66.7%, p = 0.002 and 55.6%, p = 0.007) and TARC (64%, p = 0.016 and 86%, p = 0.010 respectively). In addition, cASCs or cASC-EVs promoted skin barrier repair by restoring transepidermal water loss, enhancing stratum corneum hydration and upregulating the expression levels of epidermal differentiation proteins. Moreover, cASCs or cASC-EVs reduced IL-31/TRPA1-mediated pruritus and activation of JAK/STAT signaling pathway. Taken together, these results suggest the potential of cASCs or cASC-EVs for the treatment of chronic inflammation and damaged skin barrier in AD or canine AD.

Thermodynamic patterns duringin-situheating of InAs nanowires encapsulated in Al2O3shells.

Understanding the dynamic thermal behavior of nanomaterials based on their unique physical and chemical properties is critical for their applications. In this study, the thermal behavior of single-crystalline InAs nanowires in an amorphous Al2O3shell was investigated by conductingin situheating experiments in a transmission electron microscope. Two different thermodynamic patterns were observed during thein situheating experiments: (1) continuous vaporization and condensation simultaneously at temperatures lower than 838.15 K, and (2) pure evaporation at temperatures higher than 878.15 K. During the simultaneous condensation and vaporization in closer areas in a single InAs nanowire, the front edge of the vaporization was flat, while that of the condensation actively changed with time and temperature. Pure vaporization was conducted via layer-by-layer evaporation followed by three-dimensional vaporization at the final stage. The thermal behaviors of the InAs nanowires were demonstrated from a thermodynamic point of view.

Comparison of the effectiveness and safety of bioactive glass ceramic to allograft bone for anterior cervical discectomy and fusion with anterior plate fixation.

Recently, a bioactive glass ceramic (BGC) has been developed for use as intervertebral cages for anterior cervical discectomy and fusion (ACDF). However, the effectiveness and safety of BGC cages remain to be evaluated. We completed a retrospective comparison of the radiological and clinical outcomes of 36 patients (52 levels) who underwent ACDF with a BGC cage and 35 patients (54 levels) using allograft bone. The following variables were compared between the two groups: the visual analog (VAS) neck and arm pain score and the neck disability index (NDI), measured before surgery and 1 year after; the change in Cobb's angle, between the C2 and C7 vertebrae, the global sagittal angle, and disc height compared from before surgery to 1 year after; and the rate of spinal fusion and cage subsidence at 1 and 2 years after surgery. The VAS and NDI scores were not different between the two groups. Similarly, the spinal fusion rate was not different between the BGC and allograft bone group at 1 year (73% and 87%, respectively; p = 0.07) and 2 years (94% and 91%, respectively; p = 0.54) after surgery. However, the rate of cage subsidence was higher in the allograft bone (43%) than the BGC (19%) group (p = 0.03), as was the rate of instrument-related failure (p = 0.028), with a specifically higher incidence of implant fracture or failure in the allograft bone group (p = 0.025). Overall, our findings indicate that BGC cages provide a feasible and safe alternative to allograft bone for ACDF.

An optimal cortical bone trajectory technique to prevent early surgical complications.

BACKGROUND: Cortical bone trajectory (CBT) technique has a theoretical benefit for patients with osteoporosis, and leads to reduce screw loosening. However, there are no reports of complications and outcomes of CBT. METHODS: Consecutive patients (n = 34) with degenerative lumbar spines who underwent PLIF between December 2013 and December 2015 and were followed up for at least six months were analyzed in this study. Bone mineral density, fusion rate, cage subsidence, C-arm, screw loosening, screw violation, trajectory angle of the screw, Hounsfield unit and extent of facetectomy were examined. Outcome assessments were obtained in all patients preoperatively and postoperatively. RESULTS: There were 34 patients and 73 screw levels. After the surgery with cortical screw fixation and PLIF, patients had good clinical outcomes. However, ten of the 34 patients had problems with cortical screw fixation such as screw loosening or cage migration. In the patients with screw loosening, two underwent revision surgery due to cage migration, and one had an infection. Incorrect trajectory angles of the screw were significantly related with screw loosening. Low BMD and HU at screw fixation level were associated with screw loosening. Cage subsidence was statistically related with clinical outcomes. CONCLUSION: The cortical screw offers improved clinical outcomes since it requires minimal muscle dissection. However, we have experienced some early complications using this technique. To reduce complications such as screw loosening, an exact insertion angle of the screw and osteoporotic bone quality should be considered carefully.

Anti-Melanogenic Effects of Korean Red Ginseng Oil in an Ultraviolet B-Induced Hairless Mouse Model.

A 'remedy for all' natural product widely known in the Korean Peninsula is called Panax Ginseng Meyer. Globalization represents a persistent risk to the ozone layer, leading to bountiful amounts of Ultra-Violet B beams (UVB). The variety in human skin hues is ascribed to the characteristic color called Melanin. However, Melanin overproduction due to UVB beams promotes skin staining and tumorigenesis, a process called photo aging, which damages skin quality. To assess the effects of Korean Red Ginseng Oil (KGO) on photo aging, the murine melanoma cell lines B16/F10 were used in vitro and HRM-2 hairless mice exposed to UVB were studied in vivo. Our results revealed that KGO reduced tyrosinase activity and melanin production in B16/F10 cells along with the suppression of upstream factors involved in the melanin production pathway, both transcriptionally and transitionally. In the in vivo studies, KGO suppressed the expression of Matrix Metalloproteinase (MMP) and Interleukins along with a reduction of depth in wrinkle formation and reduced collagen degradation. Moreover, the feed intake and feed efficiency ratio that decreased as a result of UVB exposure was also improved by KGO treatment. In light of our results, we conclude that KGO can have considerable benefits due to its various properties of natural skin enhancement.

Treatment outcomes of radiotherapy for primary spinal cord glioma.

PURPOSE: Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen. METHODS: We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82%) received postoperative RT, 6 (13%) underwent definitive RT without surgery, and 2 (5%) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy). RESULTS: In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2­year overall survival and progression-free survival rates were 74 and 54%, respectively. Overall, 13 (32%) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with diverse prognosis. In grade IV tumors, seeding developed in 45%. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50%, p < 0.001). CONCLUSION: To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.

Multicenter retrospective analysis of the clinicopathologic features of monomorphic epitheliotropic intestinal T-cell lymphoma.

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a provisional entity in the 2017 World Health Organization classifications. To further elucidate the clinicopathologic features of this new disease, we carried out a retrospective, multicenter analysis of 42 patients with MEITL. The median age of the patients was 59 years (range, 20-84 years), and 27 patients (64 %) were male. Thirty-two patients (76 %) were Ann-Arbor stages I-II and 28 (67 %) were Lugano stages I-II1&2. The most frequent site of involvement was the jejunum (N = 21). Most cases expressed CD8 (79 %) and CD56 (95 %) and did not express CD30 (5 %) or EBER (0 %). The median progression-free survival was 6.9 months (95 % CI 4.3-9.6); the median OS was 14.8 months (2.4-27.2). Thirty-two patients (76 %) underwent surgery and 37 (88 %) received chemotherapy. A complete response (CR) rate was 38 %. Sixteen patients had undergone autologous stem cell transplantation (ASCT). Relapse or progression was documented in 24 cases, most frequently in the primary site (N = 23). Four cases showed central nervous system relapse. Age over 55 years, poor performance scale, advanced Lugano stage (IIE-IV), not achieving CR, and not receiving ASCT were associated with inferior OS. While the optimal management of MEITL remains undetermined, achieving CR and consolidative ASCT seem essential. As CHOP might be insufficient for achieving CR, more efficient combinations should be investigated. Additionally, considering the frequent local failure and CNS relapse, novel therapeutic approaches are required to improve survival.

Differentiation between spinal cord diffuse midline glioma with histone H3 K27M mutation and wild type: comparative magnetic resonance imaging.

PURPOSE: Diffuse midline glioma with histone H3 K27M mutation is a new entity described in the 2016 update of the World Health Organization Classification of Tumors of the Central Nervous System. The purpose of this study was to evaluate the clinical and imaging characteristics to predict the presence of H3 K27M mutation in spinal cord glioma using a machine learning-based classification model. METHODS: A total of 41 spinal cord glioma patients consisting of 24 H3 K27M mutants and 17 wild types were enrolled in this retrospective study. A total of 17 clinical and radiological features were evaluated. The random forest (RF) model was trained with the clinical and radiological features to predict the presence of H3 K27M mutation. The diagnostic ability of the RF model was evaluated using receiver operating characteristic (ROC) analysis. Area under the ROC curves (AUC) was calculated. RESULTS: MR imaging features of spinal cord diffuse midline gliomas were heterogeneous. Hemorrhage was the only variable that was able to differentiate H3 K27M mutated tumors from wild-type tumors in univariate analysis (p = 0.033). RF classifier yielded 0.632 classification AUC (95% CI, 0.456-0.808), 63.4% accuracy, 45.8% sensitivity, and 88.2% specificity. CONCLUSION: Our findings indicate that clinical and radiological features are associated with H3 K27M mutation status in spinal cord glioma.

Patterns of short-term and long-term surgical outcomes and prognostic factors for cervical ossification of the posterior longitudinal ligament between anterior cervical corpectomy and fusion and posterior laminoplasty.

To compare short-term and long-term surgical outcome patterns between anterior cervical corpectomy and fusion (ACCF) and laminoplasty (LP) in patients diagnosed with cervical ossification of the posterior longitudinal ligament (OPLL) and identify factors affecting surgical outcomes based on follow-up duration. During short-term follow-up period, surgical outcomes between ACCF and LP were similar. However, there were several reports that long-term surgical outcomes were superior in the ACCF compared with LP. Surgical outcomes between ACCF and LP according to follow-up period changed. This study enrolled 70 patients who underwent ACCF and 63 patients who underwent LP between 2005 and 2012. Patterns of surgical outcomes were analyzed in accordance with surgical procedures. Furthermore, these patients were divided into two subgroups in respect of follow-up duration: the short-term group (less than 48 months) and the long-term group (more than 48 months) group. Occupying ratio, type of OPLL, shape of ossified lesion, cervical sagittal alignment, grade of signal intensity on MRI, and Japanese Orthopedic Association (JOA) score were examined. Surgical outcomes of ACCF went into reverse at 48-month follow-up period. In the short-term group, JOA recovery rate had no difference between ACCF and LP. In the long-term group, the ACCF recovery rate (78.5 ± 31.0) was significantly higher than the LP recovery rate (48.4 ± 54.9) (P = 0.008). In the short-term group, old age (p = 0.011), hill shape (p = 0.013), and high grade of MRI signal intensity (p = 0.040) had negative effects on recovery rate. On the other hand, in the long-term group, LP (p = 0.021) and a high grade of MR signal intensity (p = 0.017) independently and negatively affected recovery rate. Long-term surgical outcomes of ACCF became better than those of LP at more than 48-month follow-up period. High-grade MRI signal changes and the LP surgical procedure were independent negative factors for long-term surgical outcomes in patients with OPLL. Direct decompression of the spinal cord with ACCF provides better long-term stable neurologic outcomes than LP.

Effects of meteorological factor and air pollution on sudden sensorineural hearing loss using the health claims data in Busan, Republic of Korea.

PURPOSE: Specific meteorological factors, including air pollution in the form of particulate matter (PM), affect the development of otologic disease and have adverse effects on the cardiovascular and respiratory systems. This study investigated relationships between the development of sudden sensorineural hearing loss(SSNHL) and meteorological factor with air pollution including PM. MATERIALS AND METHODS: The daily patient number in 2015 admitted to the hospital with SSNHL were extracted from the Health Insurance Review and Assessment Service Bigdata in Busan. The meteorological factors and air pollution data of Busan area were obtained from meteorological stations in Busan. The relationship between the number of hospitalizations and the climatic factors was checked. RESULTS: SSNHL patient group showed more common in women, and the highest rates were observed in patients in their 50s. The daily mean patient numbers were 2.27. The number of SSNHL patients in spring was statistically significantly higher than that in summer. The mean daily PM10 and PM2.5 concentrations were 48.0 and 29.4 µg/m3, respectively. The mean wind speed, maximum wind speed and daily atmospheric pressure range was weakly positively associated with SSNHL patient number. There were weak negative correlations between maximum PM2.5 and SSNHL admissions. The mean temperature and wind chill index showed non-significantly negative relationships with SSNHL admissions. CONCLUSIONS: In Busan area, statistically significant weak relationships were detected between the daily numbers of patients admitted to the hospital with SSNHL and meteorological data, including PM level. Further investigation of these associations is required.

Sonographic diagnosis of thyroid metastasis from hepatocellular carcinoma.

Metastasis to the thyroid is very rare in hepatocellular carcinoma (HCC) and only a few cases have been reported. Herein, we report a rare case of metastatic HCC to the thyroid in a 63-year-old man and discuss the various radiologic findings. Computed tomography (CT) revealed a heterogeneous enhancing mass that had invaded the thyroid cartilage in the left upper thyroid, compressing the airway. Ultrasonography (US) showed a heterogeneous hypoechoic mass with increased vascularity in the peripheral portion. The mass showed focal intense uptake on positron emission tomography-computed tomography (PET-CT). The patient underwent US-guided core needle biopsy and the final diagnosis was metastatic HCC.

Pazopanib maintenance after first-line etoposide and platinum chemotherapy in patients with extensive disease small-cell lung cancer: a multicentre, randomised, placebo-controlled Phase II study (KCSG-LU12-07).

BACKGROUND: We investigated whether pazopanib maintenance following first-line chemotherapy would improve survival in patients with extensive disease small-cell lung cancer (ED-SCLC). METHODS: This study is a randomised, placebo-controlled, phase II study that enroled ED-SCLC patients who had not progressed after four cycles of etoposide plus platinum therapy. Eligible patients were randomly assigned (1 : 1 ratio) to either placebo or pazopanib 800 mg per day until progression or unacceptable toxicity. The primary end point was progression-free survival (PFS). RESULTS: 97 patients were enroled and randomly assigned; 2 patients did not receive study drugs. In total, 95 patients received maintenance therapy (pazopanib, n=48; placebo, n=47) and were included in the analyses. Grade 3 toxicities for pazopanib maintenance were thrombocytopenia (10.4%, including one case with grade 4 toxicity), liver enzyme elevation (10.4%), fatigue (6.3%), and hypertension (6.3%). Median PFS was 3.7 months for pazopanib maintenance and 1.8 months for placebo (hazard ratio 0.44, 95% confidence interval: 0.29-0.69, P<0.0001). CONCLUSIONS: Pazopanib maintenance significantly prolonged PFS in patients with ED-SCLC. Given the toxicity profiles, however, relevant biomarkers to select patients for benefit from pazopanib should be further investigated.

Clinical outcomes of radiotherapy for spinal cord ependymoma with adverse prognostic features: a single-center study.

PURPOSE: This study evaluated the outcomes of radiotherapy (RT) for spinal ependymoma with adverse features, such as incomplete resection or disseminated disease. METHODS: Twenty-five patients underwent RT for spinal cord ependymoma during 1991-2016. Twenty-four patients had gross disease on the pre-RT spinal magnetic resonance images. Six patients (24%) had disseminated disease. The World Health Organization grades were I (12 patients), II (12 patients), and III (1 patient). The RT fields were the tumor bed plus margin in 19 patients (76%), the entire craniospinal axis in 5 patients (20%), and the entire spinal canal with posterior cranial fossa in 1 patient (4%). The median RT dose was 50.4 Gy (range 44.0-59.4 Gy). RESULTS: The median follow-up was 49 months (range 9-321 months), with 5-year overall and progression-free survival rates of 83.7% and 70.8%, respectively. Relative to patients with grade II/III ependymoma, patients with grade I ependymoma had higher 5-year rates of overall survival (100% vs. 69.4%, P = .088) and progression-free survival (100% vs. 42.3%, P = .02). Disease progression was observed in 4 patients who had grade II ependymoma, including 2 of 6 patients with disseminated disease and 2 of 19 patients with localized disease. Twelve patients (48%) exhibited improved neurological function. One patient who underwent craniospinal irradiation developed late hypopituitarism. No other RT-related late toxicities were observed. CONCLUSIONS: Favorable survival outcomes were achieved using RT for spinal ependymoma with adverse prognostic features. Thus, RT may be an effective treatment option when complete tumor removal cannot be achieved.

Antiemetic Corticosteroid Rotation from Dexamethasone to Methylprednisolone to Prevent Dexamethasone-Induced Hiccup in Cancer Patients Treated with Chemotherapy: A Randomized, Single-Blind, Crossover Phase III Trial.

BACKGROUND: To assess whether the rotation of dexamethasone to methylprednisolone decreases the intensity of dexamethasone-induced hiccup (DIH) in cancer patients treated with chemotherapy. MATERIALS AND METHODS: Adult patients who experienced DIH within 3 days after the administration of dexamethasone as an antiemetic were screened. Eligible patients were randomly assigned to receive dexamethasone (n = 33) or methylprednisolone (n = 32) as an antiemetic (randomization phase). In the next cycle of chemotherapy, the dexamethasone group received methylprednisolone and vice versa in the methylprednisolone group (crossover phase). The primary endpoint was the difference in hiccup intensity as measured using the numeric rating scale (NRS) between two groups. RESULTS: No female patients were enrolled, although the study did not exclude them. At the randomization phase, hiccup frequency was 28/33 (84.8%) in the dexamethasone group versus 20/32 (62.5%) in the methylprednisolone group (p = .04). Intensity of hiccup was significantly higher in the dexamethasone group than that in the methylprednisolone group (mean NRS, 3.5 vs. 1.4, p < .001). At the crossover phase, hiccup intensity was further decreased after the rotation of dexamethasone to methylprednisolone in the dexamethasone group (mean NRS, 3.5 to 0.9, p < .001), while it was increased by rotating methylprednisolone to dexamethasone in the methylprednisolone group (mean NRS, 1.4 to 3.3, p = .025). There were no differences in emesis intensity between the two groups at either the randomization or crossover phases. Clinicaltrials.gov identifier: NCT01974024. CONCLUSION: Dexamethasone-induced hiccup is a male-predominant phenomenon that can be ameliorated by rotating dexamethasone to methylprednisolone without compromising the antiemetic efficacy. IMPLICATIONS FOR PRACTICE: In this randomized, multicenter, phase III trial, hiccup intensity was significantly lower when the antiemetic corticosteroid was rotated from dexamethasone to methylprednisolone without a change in emesis intensity than that when dexamethasone was maintained. At the crossover phase, hiccup intensity was increased again if dexamethasone was readministered instead of methylprednisolone. The present study demonstrated that dexamethasone-induced hiccup can be improved by rotating from dexamethasone to methylprednisolone without compromising its antiemetic efficacy.

Torilin Inhibits Inflammation by Limiting TAK1-Mediated MAP Kinase and NF-κB Activation.

Torilin, a sesquiterpene isolated from the fruits of Torilis japonica, has shown antimicrobial, anticancer, and anti-inflammatory properties. However, data on the mechanism of torilin action against inflammation is limited. This study aimed at determining the anti-inflammatory property of torilin in LPS-induced inflammation using in vitro model of inflammation. We examined torilin's effect on expression levels of inflammatory mediators and cytokines in LPS-stimulated RAW 264.7 macrophages. The involvement of NF-kB and AP-1, MAP kinases, and adaptor proteins were assessed. Torilin strongly inhibited LPS-induced NO release, iNOS, PGE2, COX-2, NF-α, IL-1ß, IL-6, and GM-CSF gene and protein expressions. In addition, MAPKs were also suppressed by torilin pretreatment. Involvement of ERK1/2, P38MAPK, and JNK1/2 was further confirmed by PD98059, SB203580, and SP600125 mediated suppression of iNOS and COX-2 proteins. Furthermore, torilin attenuated NF-kB and AP-1 translocation, DNA binding, and reporter gene transcription. Interestingly, torilin inhibited TAK1 kinase activation with the subsequent suppression of MAPK-mediated JNK, p38, ERK1/2, and AP-1 (ATF-2 and c-jun) activation and IKK-mediated I-κBα degradation, p65/p50 activation, and translocation. Together, the results revealed the suppression of NF-κB and AP-1 regulated inflammatory mediator and cytokine expressions, suggesting the test compound's potential as a candidate anti-inflammatory agent.

Electromechanical Properties and Spontaneous Response of the Current in InAsP Nanowires.

The electromechanical properties of ternary InAsP nanowires (NWs) were investigated by applying a uniaxial tensile strain in a transmission electron microscope (TEM). The electromechanical properties in our examined InAsP NWs were governed by the piezoresistive effect. We found that the electronic transport of the InAsP NWs is dominated by space-charge-limited transport, with a I ∞ V2 relation. Upon increasing the tensile strain, the electrical current in the NWs increases linearly, and the piezoresistance gradually decreases nonlinearly. By analyzing the space-charge-limited I-V curves, we show that the electromechanical response is due to a mobility that increases with strain. Finally, we use dynamical measurements to establish an upper limit on the time scale for the electromechanical response.

Phase II trial of epidermal growth factor ointment for patients with Erlotinib-related skin effects.

PURPOSE: The efficacy of erlotinib, the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, has been demonstrated in patients with non-small cell lung cancer (NSCLC) and pancreatic cancer (PC). In the present study, we evaluated the effect of epidermal growth factor (EGF) ointment on erlotinib-related skin effects (ERSEs). METHODS: This was an open-label, non-comparative, multicenter, phase II trial. The patients included those diagnosed with NSCLC or PC who were treated with erlotinib. The effectiveness of the ointment was defined as follows: (1) grade 2, 3, or 4 ERSEs downgraded to ≤ grade 1 or (2) grade 3 or 4 ERSEs downgraded to grade 2 and persisted for at least 2 weeks. RESULTS: Fifty-two patients from seven institutes in Korea were enrolled with informed consent. The final assessment included 46 patients (30 males, 16 females). According to the definition of effectiveness, the EGF ointment was effective in 36 (69.2%) intention to treat patients. There were no statistically significant differences in the effectiveness of the EGF ointment by gender (p = 0.465), age (p = 0.547), tumor type (p = 0.085), erlotinib dosage (p = 0.117), and number of prior chemotherapy sessions (p = 0.547). The grading for the average National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE) rating of rash/acne and itching improved from 2.02 ± 0.83 to 1.13 ± 0.89 and 1.52 ± 0.84 to 0.67 ± 0.90, respectively (p < 0.001). The most common reason for discontinuing the study was progression of cancer (37%). CONCLUSIONS: Based on the results, the EGF ointment is effective for ERSEs, regardless of gender, age, type of tumor, and dosage of erlotinib. The EGF ointment evenly improved all kinds of symptoms of ERSEs. CLINICAL TRIAL REGISTRATION NO: ClinicalTrials.gov identifier: NCT01593995.

Efficacy of Transforaminal Endoscopic Spine System (TESSYS) Technique in Treating Lumbar Disc Herniation.

BACKGROUND To compare efficacy and safety of percutaneous transforaminal endoscopic spine system (TESSYS) and traditional fenestration discectomy (FD) in treatment of lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 106 LDH patients were divided into TESSYS group (n=48) and FD group (n=58). Visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and modified MacNab criteria were used for efficacy evaluation. Post-operative responses were compared by enzyme-linked immunosorbent assay (ELISA) based on detection of serum IL-6, CRP, and CPK levels. RESULTS In the TESSYS group, compared with the FD group, we observed, shorter incision length, less blood loss, shorter hospital stay, lower hospitalization cost, shorter recovery time, lower complication rate (all P<0.001), and lower VAS scores of lumbago and skelalgia at 3 days and 1, 3, and 6 months postoperatively (all P<0.05). At 24 and 48 h postoperatively, CRP level was remarkably higher in the FD group compared to the TESSYS group (P<0.001). Further, comparison of IL-6 levels at 6, 12, 24, and 48 h postoperatively revealed significantly higher levels in the FD group than in the FESSYS group (all P<0.001). CONCLUSIONS TESSYS had clinical advantages over FD and entails less trauma and quicker postoperative recovery, suggesting that TESSYS is well tolerated by patients and is a better approach than FD in surgical treatment of LDH.

Enhanced Neurite Outgrowth by Intracellular Stimulation.

Electrical stimulation through direct electrical activation has been widely used to recover the function of neurons, primarily through the extracellular application of thin film electrodes. However, studies using extracellular methods show limited ability to reveal correlations between the cells and the electrical stimulation due to interference from external sources such as membrane capacitance and culture medium. Here, we demonstrate long-term intracellular electrical stimulation of undamaged pheochromocytoma (PC-12) cells by utilizing a vertical nanowire electrode array (VNEA). The VNEA was prepared by synthesizing silicon nanowires on a Si substrate through a vapor-liquid-solid (VLS) mechanism and then fabricating them into electrodes with semiconductor nanodevice processing. PC-12 cells were cultured on the VNEA for 4 days with intracellular electrical stimulation and then a 2-day stabilization period. Periodic scanning via two-photon microscopy confirmed that the electrodes pierced the cells without inducing damage. Electrical stimulation through the VNEA enhances cellular differentiation and neurite outgrowth by about 50% relative to extracellular stimulation under the same conditions. VNEA-mediated stimulation also revealed that cellular differentiation and growth in the cultures were dependent on the potential used to stimulate them. Intracellular stimulation using nanowires could pave the way for controlled cellular differentiation and outgrowth studies in living cells.

Breast-specific gamma imaging: correlations with mammographic and clinicopathologic characteristics of breast cancer.

OBJECTIVE: The purpose of this article is to evaluate the correlations between breast-specific gamma imaging (BSGI) findings and mammographic and clinicopathologic characteristics of breast cancer. MATERIALS AND METHODS: Our study included 56 breast cancers that had undergone BSGI between August 2010 and December 2012. We reviewed imaging findings (BSGI and mammography) with histopathologic findings, including tumor size, histologic type, nuclear grade, presence of ductal carcinoma in situ (DCIS), and presence of extensive intraductal component (EIC); and immunochemical features, including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (ERBB2, formerly HER2), Ki67, and p53. We classified cancers into positive or negative groups on the basis of BSGI visibility and investigated the statistical differences in mammographic and histopathologic characteristics between the BSGI-positive and -negative groups. RESULTS: Among 56 malignancies, 48 (85.7%) were shown to be BSGI positive. Patients in the BSGI-positive group were statistically significantly older than those in the BSGI-negative group (p = 0.027). BSGI-positive cancers were statistically significantly larger than BSGI-negative cancers (p = 0.002). Cancers 1.0 cm or larger, unlike those of subcentimeter size, were statistically significantly more visible on BSGI (p = 0.004). The mammographic findings and mammographic densities did not statistically significantly differ between the BSGI-positive and -negative groups. Invasiveness of cancer showed no statistically significant difference on BSGI finding. Cancers with a DCIS component tended to be BSGI positive, but without statistical significance (p = 0.051). Visibility on BSGI was not statistically significantly associated with EIC, nuclear grade, ER, PR, ERBB2, Ki67, and p53. CONCLUSION: The sensitivity of BSGI for breast cancer was 85.7%. Breast cancers in older patients, cancers larger than 1.0 cm, and cancers with the DCIS component tended to be visible on BSGI. BSGI was an equally sensitive tool to detect the breast cancer in women with fatty and dense breast.