The role of adjuvant radiotherapy in locally advanced T4 mandible squamous cell carcinoma in the N0 patient: a single centre experience.

In locally advanced oral squamous cell carcinoma (OSCC), namely that showing invasion of the mandible, demonstrating no high-risk (e.g. extranodal extension, positive margin) or intermediate-risk histopathological features (e.g. perineural invasion, lymphovascular invasion), the additional benefit of postoperative radiotherapy (PORT) currently remains uncertain. A retrospective review covering the period between January 1, 2010 and December 31, 2019 was conducted to identify patients from a single UK centre with locally advanced invasive mandibular OSCC defined as pT4a, with no nodal or distant metastasis (N0 M0). The primary outcome was to determine the disease-free survival and overall survival rates in the surgery + PORT group, in comparison to the surgery only group. Twenty-eight eligible patients were identified, with 13 patients in the surgery + PORT group and 15 patients in the surgery only group. A single patient in the surgery + PORT group developed disease recurrence and subsequently died (1/13) (median follow-up 5.24 years, range 2.13-10.71 years). No patient in the surgery only group developed disease recurrence or died (0/15) (median follow-up 5.13 years, range 1.37-10.93 years). It may be reasonable to consider omitting PORT in pT4a pN0 M0 OSCC of the mandible in patients who demonstrate no high- or intermediate-risk histopathological features, following multidisciplinary team discussion.

Isolation of a novel mycovirus OMIV in Pleurotus ostreatus and its detection using a triple antibody sandwich-ELISA.

A novel mycovirus was isolated from a diseased mushroom, Pleurotus ostreatus, using a purification procedure involving polyethylene glycol (PEG)-NaCl precipitation, differential centrifugation, and equilibrium centrifugation in a CsCl gradient. The virion was a 43 nm isometric virus encapsulating double-stranded RNA (dsRNA) genome of 2.1, 2.0, 1.9, and 1.7 kbp with a coat protein (CP) of 58 kDa. The new mycovirus was named Oyster Mushroom Isometric Virus (OMIV). A triple antibody sandwich-ELISA (TAS-ELISA) system was constructed to detect OMIV in the mushroom using an anti-OMIV mouse monoclonal antibody and an anti-OMIV rabbit polyclonal serum. The TAS-ELISA system was sensitive enough to allow detection of OMIV in the mushroom with the naked eye. It detected successfully virus particles from 0.6 mg of diseased tissue as well as 0.4 microg/ml purified virus preparation.

A system to impose prescribed homogenous strains on cultured cells.

There is presently significant interest in cellular responses to physical forces, and numerous devices have been developed to apply stretch to cultured cells. Many of the early devices were limited by the heterogeneity of deformation of cells in different locations and by the high degree of anisotropy at a particular location. We have therefore developed a system to impose cyclic, large-strain, homogeneous stretch on a multiwell surface-treated silicone elastomer substrate plated with pulmonary epithelial cells. The pneumatically driven mechanism consists of four plates each with a clamp to fix one edge of the cruciform elastomer substrate. Four linear bearings set at predetermined angles between the plates ensure a constant ratio of principal strains throughout the stretch cycle. We present the design of the device and membrane shape, the surface modifications of the membrane to promote cell adhesion, predicted and experimental measurements of the strain field, and new data using cultured airway epithelial cells. We present for the first time the relationship between the magnitude of cyclic mechanical strain and the extent of wound closure and cell spreading.

Estimation of respiratory impedance and source pressure using a Thévenin equivalent circuit model.

The objective of this paper is to present a new technique which can provide both active respiration source pressure and lung impedance in a single noninvasive test. The method is based upon a Thévenin equivalent circuit model of respiratory mechanics. Using this model, the equivalent source pressure and source impedance can be computed from the measured changes of respiratory pressures and flows in two consecutive cycles before and after addition of purely resistive loads to the mouth. In maximal breathing the source parameters were reproducible in six normal human subjects. The total respiratory resistance during maximal breathing had an average value of 3.46 cmH2O l-1 s-1, and the total dynamic compliance had an average value of 0.078 l cmH2O-1. The airway resistances measured using a plethysmographic method were within the range of 45-65% of the estimated total respiratory resistances. These two resistances were related with a correlation coefficient of 0.98. An average value of the magnitudes of the fundamental components of the source pressure was 6.73 cmH2O during maximal breathing and 2.09 cmH2O during spontaneous breathing.

Direct imaging of domains in the Lbeta' state of 1,2-dipalmitoylphosphatidylcholine bilayers.

A near-field scanning optical microscope was used to study domain formation and evolution in single-component supported lipid bilayers in the gel (L(beta') state. Results on 1,2-dipalmitoylphosphatidylcholine (DPPC) bilayers on glass substrates at room temperature are presented. The domain structure is determined by means of the optical anisotropy of the sample, which arises because DPPC molecules are tilted at theta approximately 32 degrees with respect to the bilayer normal [J. F. Nagle and S. Tristram-Nagle, Biochim. Biophys. Acta 1469, 159 (2000)]. From the measurements we obtain the difference in the index of refraction for the directions parallel and perpendicular to the acyl chains of the lipid molecules, Delta(n)=0.37+/-0.12, in good agreement with calculated and measured values. Direct evidence of the existence of domains in the L(beta') state is provided. These domains, defined as the correlation of the tilt angle theta, are found to be 1-2 microm across. Furthermore, it was found that they are robust under single-lipid-molecule diffusion, remaining unchanged over periods of hundreds of minutes.

Immediate and late clinical and angiographic outcomes after GFX coronary stenting: is high-pressure balloon dilatation necessary?

BACKGROUND: The GFX stent is a balloon-expandable stent made of sinusoidal element of stainless steel. The adjunct high-pressure balloon dilatations were usually recommended in routine stenting procedure. HYPOTHESIS: The aim of this study was to evaluate the immediate and long-term clinical and angiographic outcomes and to investigate the necessity of high-pressure balloon dilatation during GFX stenting. METHODS: In all, 172 consecutive patients underwent single 12 or 18 mm GFX stent implantation in 188 native coronary lesions. Two types of stenting technique were used: (1) stent size of a final stent-to-artery ratio of 1:1 (inflation pressure > 10 atm, high-pressure group), and (2) stent size of 0.5 mm bigger than reference vessel (inflation pressure < or = 10 atm, low-pressure group). The adjunct high-pressure balloon dilatations were performed only in cases of suboptimal results. RESULTS: The adjunct high-pressure balloon dilatation was required in 11 of 83 lesions (13%) in the high-pressure group and in 7 of 105 lesions (7%) in the low-pressure group (p = 0.203). Procedural success rate was 100%. There were no significant differences of in-hospital and long-term clinical events between the two groups. The overall angiographic restenosis rate was 17.7%; 18.4% in the high-pressure group and 17.1% in the low-pressure group (p = 0.991). CONCLUSIONS: The GFX stent is a safe and effective device with a high procedural success rate and favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials may be needed to compare stenting techniques in GFX stent implantation.

Treatment of osteochondral injuries. Genetic engineering.

Articular cartilage injuries are commonly encountered problems in sports medicine and orthopaedics. The treatment of chondral and osteochondral lesions, which possess only a very limited potential for healing, still represents a great challenge to clinicians and to scientists. Experimental investigations reported over the last 20 years have shown that a variety of methods, including implantation of periosteum, perichondrium, artificial matrices, growth factors, and transplanted cells, can stimulate formation of new cartilage. Genetic engineering--a combination of gene transfer techniques and tissue engineering--will facilitate new approaches to the treatment of articular cartilage injuries.

Pre-operative localization and embolization for jejunal arteriovenous malformation with massive haemorrhage.

Arteriovenous malformation of the gastrointestinal tract is relatively rare in adults. The most accurate diagnosis is by angiography and pre-operative localization has been reported, including by coil embolization, catheter or guidewire replacement, and intraoperative staining techniques. We report the case of a 20-year-old man with acute and massive small intestinal haemorrhage due to jejunal ateriovenous malformation, which was embolized immediately with N-butyl-2-cyanoacrylate. The technique is rapid and safe under fluoroscopy control and the method can help surgeons with mini-laparotomy or laparoscopic surgery because of the clear localization and stable condition of the patient.

Novel adhesion prevention membrane based on a bioresorbable copoly(ester-ether) comprised of poly-L-lactide and Pluronic: in vitro and in vivo evaluations.

Block copolymers consisting of poly(L-lactide) (PLLA) and poly(oxyethylene-co-oxypropylene), with various compositions, were synthesized and characterized in vitro and in vivo for their application as postoperative adhesion prevention membranes. It was found that the flexibility and degradability of the cast films of the block copolymers grew with increasing Pluronic F68 [PN; poly(oxyethylene-co-oxypropylene] composition. The receding contact angle of the copolymer films against water became lower than that of the PLLA film, because the surface was predominantly covered with more hydrophilic PN segments in a wet state. This surface property significantly affects the cell attachment property of the copolymer films, and the fibroblasts cultured on the films exhibit a spheroid-like morphology. The copolymer films subcutaneously implanted in the back of rats induced milder tissue responses compared with PLLA homopolymers, because of the increased surface hydrophilicity in the former. In vivo evaluation using a uterus horn model in rats revealed that the performance of these copolymer films as an adhesion-prevention membrane is comparable to that of a conventionally utilized membrane of oxidized regenerated cellulose. These results indicate that the copolymer films are biocompatible materials with controllable mechanical properties and biodegradability as adhesion-prevention membranes.

Chemical degradation of composite restoratives.

The chemical environment is one aspect of the oral environment, which could have an appreciable influence on the in vivo degradation of composite restoratives. The effects of chemical media on surface hardness of four composite restoratives (Silux [SX], Z100 [ZO], Ariston [AR] and Surefil [SF]) were investigated. The relationship between hardness and the thickness of the degradation layer was also studied. Thirty six specimens (3 x 4 x 2 mm) were made for each material. Following polymerization, the specimens were stored in artificial saliva at 37 degrees C for 24 h. The specimens were then randomly divided into six groups of six, subjected to microhardness testing (load = 500 gf, dwell time = 15 s) and stored in the following chemicals for 1 week at 37 degrees C: artificial saliva (S), distilled water (W), 0.02 N citric acid (C), 0.02 N lactic acid (L), heptane (H) and 75-25% ethanol-water solution (E). After conditioning, the specimens were again subjected to hardness testing and sectioned. Change in hardness (DH) was computed and the thickness of the degradation layer (DL) was measured using a computerized image analysis system at 600x magnification. Results of statistical analysis (ANOVA/Scheffe's [P < 0.05]) of DH based on materials were as follows: SX - E > all other mediums; ZO - W > C; and AR - S, W, E > H (> indicates significantly greater hardness change). No significant difference in DH was observed between the different chemicals for SF. The effects of chemical media on DH were found to be material dependent. A significant but weak positive correlation (Pearson's correlation [P < 0.05]) exists between change in hardness and thickness of the degradation layer.

Safety, tolerability and pharmacokinetics of the new long-acting quinolone DW-116 after single and multiple dosing in healthy subjects.

The safety, tolerability and pharmacokinetics of DW-116, a new fluoroquinolone with a broad antibacterial spectrum, were evaluated in healthy male subjects after administration of single oral doses of 100, 200, 300 and 800 mg and after administration of multiple oral doses of 300 or 400 mg, respectively, for 7 days. DW-116 was well tolerated. Gastrointestinal symptoms and skin reactions were noted and considered to be possibly related to DW-116. The geometric means of the maximum plasma concentrations (Cmax) linearly increased with the dose administered from 1.19 mg/L to 8.73 mg/L after single dose administration. At steady state, the geometric mean minimum and maximum plasma concentrations were 2.14 and 5.65 mg/L, respectively, after the multiple 300 mg dose and 2.73 and 8.00 mg/L, respectively, for the multiple 400 mg dose. Tmax varied between 1 and 5 h. The terminal half-life ranged from 11.37 to 24.89 h. The geometric mean renal clearance was approximately 30 mL/min. Approximately 45% of the dose was excreted unchanged in urine within 60 h. There was no clinically relevant deviation from dose proportionality. The changes in steady-state pharmacokinetic parameters when DW-116 was taken before a high-fat breakfast were not clinically relevant. In conclusion, DW-116 was safe in this study, the first administration to human subjects. Its pharmacokinetics indicate that once-daily dosing may be possible.