Causes and management of sight threatening complications of dermal filler injections: A review.

Injectable dermal fillers continue to increase in popularity in aesthetic medicine. Although rare, vision loss secondary to filler injections is a devastating complication associated with a poor visual prognosis. The mechanism for vision loss is thought to be related to retrograde embolization of the dermal filler from peripheral vessels in the face into the ophthalmic arterial system. Early recognition and prompt management are essential if vision is to be salvaged. The use of retrobulbar hyaluronidase is still contentious, however when administered by a specialist, this treatment gives the best chance at visual recovery and should be considered for all cases.

Periorbital desmoplastic squamous cell carcinoma.

Desmoplasia is the formation of a dense collagenous stroma around a neoplasm. It occurs in a variety of malignancies including squamous cell carcinoma (SCC). While desmoplasia is uncommonly seen in cutaneous SCC, it is an independent risk factor for recurrence and metastasis. We report a case series of desmoplastic SCC in the periorbital region. Seven cases were identified: the median age was 68, four were men. The mean follow-up was 48 months. Two patients (29%) had aggressive local recurrence: one required salvage surgery including orbital exenteration, parotidectomy, and neck dissection to excise involved parotid and cervical lymph nodes; the other required repeat excision and adjuvant radiotherapy. Desmoplastic SCC is an uncommon but highly aggressive subtype. In the periorbital region, due to the high risk of orbital invasion, it is potentially sight and life-threatening.

Exercise modulates APOE expression in brain cortex of female APOE3 and APOE4 targeted replacement mice.

Apolipoprotein E (ApoE) is the main cholesterol carrier of the brain and the ε4 gene variant (APOE4) is the most prevalent genetic risk factor for Alzheimer's disease (AD), increasing risk up to 15-fold. Several studies indicate that APOE4 modulates critical factors for neuronal function, including brain-derived neurotrophic factor (BDNF) and peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α). Both proteins show exercise-induced upregulation, which is presumed to mediate many of the beneficial effects of physical activity including improved cognition; however, there is variability in results between individuals potentially in-part due to genetic variations including APOE isoform. This study aimed to determine if the two most prevalent human APOE isoforms influence adaptive responses to exercise-training. Targeted replacement mice, homozygous for either APOE3 or APOE4 were randomized into exercised and sedentary groups. Baseline locomotor function and voluntary wheel-running behavior was reduced in APOE4 mice. Exercised groups were subjected to daily treadmill running for 8 weeks. ApoE protein in brain cortex was significantly increased by exercise in both genotypes. PGC-1α mRNA levels in brain cortex were significantly lower in APOE4 mice, and only tended to increase with exercise in both genotypes. Hippocampal BDNF protein were similar between genotypes and was not significantly modulated by treadmill running. Behavioral and biochemical variations between APOE3 and APOE4 mice likely contribute to the differential risk for neurological and vascular diseases and the exercise-induced increase in ApoE levels suggests an added feature of the potential efficacy of physical activity as a preventative and therapeutic strategy for neurogenerative processes in both genotypes.

Evaluation Criteria for Chromosome Instability Detection by FISH to Predict Malignant Progression in Premalignant Glottic Laryngeal Lesions.

Background: The definition of objective, clinically applicable evaluation criteria for FISH 1c/7c in laryngeal precursor lesions for the detection of chromosome instability (CI). Copy Number Variations (CNV) for chromosomes 1 and 7 reflect the general ploidy status of premalignant head and neck lesions and can therefore be used as a marker for CI. Methods: We performed dual-target FISH for chromosomes 1 and 7 centromeres on 4 µm formalin-fixed, paraffin-embedded tissue sections of 87 laryngeal premalignancies to detect CNVs. Thirty-five normal head and neck squamous cell samples were used as a control. First, the chromosome 7:1 ratio (CR) was evaluated per lesion. The normal range of CRs (≥0.84 ≤ 1.16) was based on the mean CR +/− 3 x SD found in the normal population. Second, the percentage of aberrant nuclei, harboring > 2 chromosomes of chromosome 1 and/or 7 (PAN), was established (cut-off value for abnormal PAN ≥ 10%). Results: PAN showed a stronger correlation with malignant progression than CR (resp. OR 5.6, p = 0.001 and OR 3.8, p = 0.009). PAN combined with histopathology resulted in a prognostic model with an area under the ROC curve (AUC) of 0.75 (s.e. 0.061, sensitivity 71%, specificity 70%). Conclusions: evaluation criteria for FISH 1c/7c based on PAN ≥ 10% provide the best prognostic information on the risk of malignant progression of premalignant laryngeal lesions as compared with criteria based on the CR. FISH 1c/7c detection can be applied in combination with histopathological assessment.

Interobserver variability of laryngeal mucosal premalignant lesions: a histopathological evaluation.

The objective of this study is to measure interobserver variability in the classification of laryngeal mucosal premalignant lesions by reassessing the histopathology of previously diagnosed cases and to determine the possible therapeutic consequences of disagreement among observers. Histopathological assessment of 110 laryngeal mucosal premalignant lesions was done by three pathologists. Each slide had to be classified according to the World Health Organization, Squamous Intraepithelial Neoplasia, and the Ljubljana Squamous Intraepithelial Lesions systems. After the independent assessment, a joint meeting took place. To assess the relation between histopathological grading and subsequent clinical management, we created a two- and a three-grade system besides one comprising all options. For all analyses, the SAS/STAT statistical software was used. The highest unweighted κ-values concerning the all-options system are observed for the Squamous Intraepithelial Neoplasia classification (0.28, 95% confidence interval 0.23-0.33), followed by the World Health Organization and Ljubljana classifications. For the two-grade system the Ljubljana classification shows the highest unweighted κ-values (0.50, 95%, 0.39-0.61), followed by the World Health Organization and Squamous Intraepithelial Neoplasia classifications. For the three-grade system, the unweighted κ-values are similar. The implementation of weighted κ-values led to higher scores within all three classification systems, although these did not exceed 0.55 (moderate agreement). Given the high level of consensus, simultaneous pathological assessment may be said to provide added value in comparison with independent assessment. In the current study, no clear tendency is observed in favor of any one classification system. The proposed three-grade system could be an improved histopathological tool because it is easier to correlate with clinical decision making and because it yields better unweighted κ-values and proportions of concordance than the all-options system. Furthermore, clinical management could benefit from assessment by more than one pathologist in suspected cases of dysplasia or carcinoma.

Acoustic wave propagation along AlN on Bi12GeO20 structures.

Using Bi12GeO20 plate coated by AlN film, the main characteristics of the A0, S0, A1, and S1 Lamb waves are numerically calculated and compared with those of SAW in the same structure. It is shown that (i) there exist only one SAW mode for this material combination, (ii) the mode exist in a narrow range of AlN thickness, (iii) it can be excited using four different transducer configurations, (iv) the velocity and coupling constants of the mode are, respectively, higher and lower as compared with the values for the uncoated Bi12GeO20 substrate. On the other hand, for Lamb waves (i) there are several modes of different orders, (ii) the modes exist in a wide range of the AlN thickness, (iii) they may be excited using twelve IDT configurations, (iv) the velocities and coupling constants of the waves may be larger and smaller as compared with the values for the uncoated plate, (v) both characteristics of the modes depend on the mode order, film thickness, plate thickness, and transducer configuration, and (vi) the depth profiles of the modes are neither symmetrical nor anti-symmetrical. These properties make Lamb waves more attractive than SAW. Application of the waves and the structure for some applications are suggested.

Quasi longitudinal Lamb acoustic modes along ZnO/Si/ZnO structures.

A novel structure consisting of a Si plate sandwiched between two ZnO layers is suggested as propagation medium for Quasi Longitudinal (QL) acoustic Lamb waves. Considering a low-dispersive quasi-longitudinal mode as an example, the phase velocity v, electromechanical coupling constant k2 and mechanical displacements U1, U3 versus plate and ZnO layers thicknesses have been calculated starting from uncoated plate through the same plate with one layer to the plate with two layers onto opposite faces. A remarkable increase in the electromechanical coupling, together with an essential decrease in the vertical displacement U3, at the ZnO surface, have been theoretically demonstrated and experimentally verified for definite combinations of the films/plate thicknesses. This property of the structure is attractive for applications to microwave liquid sensors.

Gasoline sensor based on piezoelectric lateral electric field excited resonator.

It has been shown that by using piezoelectric lateral electric field excited resonators based on X - cut LiNbO3, one can determine the octane number of gasoline. The measured dependence of gasoline permittivity on its octane number has shown that there is an ambiguous connection between pointed parameters. We have demonstrated both theoretically and experimentally that the value of the real part of the electrical impedance on the frequency of parallel resonance uniquely associates with the octane number of gasoline contacting the free side of the resonator. At that the frequency of parallel resonance does not depend on permittivity/octane number of gasoline. An example of determination of the octane number of a mixture of two different samples of gasoline is given.

Acoustic Plate Mode sensing in liquids based on free and electrically shorted plate surfaces.

The sensing behavior to liquids for Acoustic Plate Modes (APMs) propagating along 64°Y, 90°X LiNbO3 plate was investigated vs. two electric boundary conditions. The changes in the APMs phase velocity and attenuation were measured upon exposure to different liquids wetting one of the surfaces of the plate, either free or electrically shorted by a thin conductive Al layer. The experimental data confirm that the presence of a metallic layer covering one of the plate surfaces affects the viscosity and temperature sensitivity of the device. The differences between the sensor response for various liquids, with free or metalized faces, are interpreted in terms of the APM polarization.

Improving accessibility to intravitreal anti-vascular endothelial growth factor treatment for ophthalmic patients in a peripheral centre.

AIM: An exponential rise in patients requiring intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment has occurred over recent years. We addressed this in Palmerston North by establishing a senior nurse-led macular review clinic. We aimed to determine the current intravitreal service accessibility and compared it to results from 2012. METHODS: Chart analysis. RESULTS: Planned follow-up was aimed for 42 days, near the end of the anti-VEGF therapeutic effect. It occurred on average at 45.05 (12 to 127) days after initial treatment induction and 40.7 (14 to 77) days for subsequent follow-ups. Treatment was started on average 29.8 (0 to 139) days after the decision was made. Further injections occurred on average 25.7 (0 to 104) days after the retreatment decision. These findings were similar to 2012 where initial follow-up occurred on average 42 (29 to 89) days following treatment, initial treatment 30 (0 to 78) days after treatment decision and retreatment at 34 (6 to 89) days. CONCLUSION: Instituting the senior nurse-led macular review clinic has enabled timely review of patients despite significant increases in those requiring treatment and surveillance. The average follow-up appointment delay is within the four week guideline set by NICE.

A surface acoustic wave bio-electronic nose for detection of volatile odorant molecules.

In this work, a "bio-electronic nose" for vapour phase detection of odorant molecules based on surface acoustic wave (SAW) resonators is presented. The biosensor system is composed of an array of five SAW resonators coated with three types of odorant-binding proteins (OBPs): the wild-type OBP from bovine (wtbOBP), a double-mutant of the OBP from bovine (dmbOBP), and the wild-type OBP from pig (wtpOBP). High resolution deposition of OBPs onto the active area of SAW resonators was implemented through laser-induced forward transfer (LIFT). The resonant frequency shifts of the SAW resonators after the deposition of the biomolecules confirmed the immobilisation of the proteins onto the Al/Au inter-digital transducers (IDTs). In addition, a low increase of insertion losses with a limited degradation of Q-factors is reported. The "bio-electronic nose" fabricated by LIFT is tested in nitrogen upon exposure to separated concentrations of R-(-)-1-octen-3-ol (octenol) and R-(-)-carvone (carvone) vapours. The "bio-electronic nose" showed low detection limits for the tested compounds (i.e. 0.48 ppm for the detection of octenol, and 0.74 ppm for the detection of carvone). In addition, the bio-sensing system was able to discriminate the octenol molecules from the carvone molecules, making it pertinent for the assessment of food contamination by moulds, or for the evaluation of indoor air quality in buildings.

Psychopathy, antisocial personality, and suicide risk.

H. Cleckley (1976) maintained that psychopaths are relatively immune to suicide, but substantial evidence exists for a relationship between antisocial deviance and suicidal acts. This study was the first to explicitly examine suicidal history among psychopathic individuals as defined by R. D. Hare's (1991) Psychopathy Checklist--Revised (PCL-R). Male prison inmates (N = 313) were assessed using the PCL-R and DSM-III-R and DSM-IV criteria (American Psychiatric Association, 1987, 1994) for antisocial personality disorder (APD), and they completed A. Tellegen's (1982) Multidimensional Personality Questionnaire (MPQ). Presence or absence of prior suicide attempts was coded from structured interview and prison file records. Suicide history was significantly related to PCL-R Factor 2 (which reflects chronic antisocial deviance) and to APD diagnosis but was unrelated to PCL-R Factor 1, which encompasses affective and interpersonal features of psychopathy. Higher order MPQ dimensions of Negative Emotionality and low Constraint were found to account for the relationship between history of suicidal attempts and antisocial deviance, indicating that temperament traits may represent a common vulnerability for both.

New properties of SAW gas sensing.

Novel attractive properties of SAW gas sensing are theoretically predicted and experimentally verified. The response upon gas exposure of SAW-based gas sensors can be increased, decreased, reversed, cancelled, speeded up, aged down, and selected for a given sensitive layer, simply by changing the substrate material and orientation. When utilized as a tool for analytical chemistry, the steady-state and kinetic properties of adsorption, desorption, and diffusion, together with other related processes, can be simply deduced from pure acoustic measurements. These new properties are shown to be produced by the change of the components of the elliptic polarization of the wave, varying with the propagation direction and the substrate material. Experimental results, obtained for quartz substrates coated with polycrystalline palladium and palladium-nickel films exposed to H(2), CO, N(2)O, and different concentrations of relative humidity in air are presented as an example.

New capabilities for optimizing SAW gas sensors.

It is shown how the performances of SAW gas sensors can be optimized based on pure acoustic peculiarities of SAW propagation in anisotropic single crystals. For a given gas and sensitive membrane, the calibration curve (dependence of the response R versus gas concentration n), the sensitivity S (slope of the calibration curve: S = dR/dn), the detection limit nth, (cut-off of the curve at the threshold Pthr), and the resolution deltan of the sensor (recognition of two close concentrations) can be controlled by a proper choice of the substrate material and its crystallographic orientation (cut and direction of the SAW propagation). An experimental test of this property is performed on SAW devices implemented on different substrate materials and crystallographic orientations, both uncoated or coated, with a sorbent membrane of polycrystalline Pd or Pd:Ni film, upon exposure to humid air as a test analyte.

Brillouin scattering by surface acoustic modes for elastic characterization of ZnO films.

Brillouin scattering from surface phonons was used for determining the dispersion curves of guided acoustic modes propagating along piezoelectric ZnO films. Measurements were performed on films of different thicknesses in the range between 20 and 320 nm, deposited by RF magnetron sputtering on Si and SiO(2) substrates. Brillouin spectra from Rayleigh acoustic modes are taken in the backscattering geometry at different incidence angles between 30 degrees and 70 degrees . The experimental data for the ZnO/Si films fit the expected theoretical dispersion curves fairly well for film thicknesses greater than 150 nm, while they appreciably depart from the same curves for smaller thicknesses. This behavior is interpreted in terms of a reduction of the effective elastic constants of the film in a layer near the interface, due to the lattice misfit between the film and the substrate. This effect was not observed in the case of ZnO films deposited on fused quartz substrates.