Recurrence following hemithyroidectomy in patients with low- and intermediate-risk papillary thyroid carcinoma.

BACKGROUND: This study evaluated the incidence, patterns and risk factors for recurrence after hemithyroidectomy in patients with low- and intermediate-risk papillary thyroid carcinoma (PTC), and verified the predictive role of the risk staging systems in current use. METHODS: The clinicopathological characteristics and risk categories were analysed according to recurrence in patients who underwent hemithyroidectomy for low- and intermediate-risk conventional PTC, and were followed up for at least 24 months. Five risk staging systems were used to stratify risk: the 2015 American Thyroid Association (ATA) system; Age, Metastases, Extent and Size (AMES) system; Metastases, Age, Complete resection, Invasion and Size (MACIS) system; Grade, Age, Metastases, Extent and Size (GAMES) system; and the eighth AJCC system. RESULTS: The study included 561 patients; 93·9 per cent of the study population (527 of 561) had a papillary thyroid microcarcinoma 1 cm or smaller in size. At a mean follow-up of 83 months, 25 patients (4·5 per cent) had recurrence; among these patients, 23 (92%) presented with a remaining thyroid lobe. Multifocality was significantly associated with recurrence in univariable and multivariable analyses (adjusted hazard ratio 3·16, 95 per cent c.i. 1·25 to 7·98; P = 0·015). Disease-free survival (DFS) varied according to multifocality (P = 0·010). The five risk staging systems were not associated with recurrence, and their Harrell's C-index ranged from 0·500 to 0·531. DFS rates did not differ between the risk categories in each system. CONCLUSION: Although the recurrence rate after hemithyroidectomy in patients with low- and intermediate-risk PTC was low, meticulous follow-up focusing on the remaining thyroid lobe is needed for early detection and timely management of recurrence. The risk scoring systems in current use have no predictive role in these patients.

ANTECEDENTES: Este estudio evaluó la incidencia, patrones y factores de riesgo de recidiva tras hemitiroidectomía en pacientes con carcinoma papilar de tiroides (papillary thyroid carcinoma, PTC) de riesgo bajo e intermedio y verificó el papel predictivo de los sistemas de estadificación del riesgo utilizados en la actualidad (risk staging systems, RSSs). MÉTODOS: Se analizaron las características clinicopatológicas y las categorías de riesgo en base a la recidiva en 561 pacientes que fueron sometidos a hemitiroidectomía por PTC convencional de riesgo bajo e intermedio y seguidos durante ≥ 24 meses. Para estratificar el riesgo se utilizaron cinco RSSs, incluyendo el sistema de la American Thyroid Association (ATA) de 2015; la edad, las metástasis, la extensión y el tamaño del sistema AMES; las metástasis, la edad, la resección completa, la invasión y el tamaño del sistema GAMES; y la octava edición de la American Joint Committee on Cancer system (AJCC). RESULTADOS: La proporción de la población de estudio con microcarcinoma papilar de tiroides de tamaño ≤ 1 cm fue 93,9% (527/561). A los 83 meses de seguimiento, 25 pacientes (4,5%) presentaron recidiva y entre estos pacientes, 23 (92%) no habían sido sometidos a tiroidectomía total. La multifocalidad se asoció significativamente con la recidiva en los análisis univariado y multivariable con un cociente de riesgos instantáneos (hazard ratio, HR) ajustado de 3,163; i.c. del 95% 1,253-7,983; P = 0,015. La supervivencia libre de enfermedad (disease-free survival, DFS) varió según la multifocalidad (P = 0,010). Los cinco RSSs no se asociaron con la recidiva, y su índice C de Harrell fue 0,500-0,531. Las DFSs no fueron diferentes entre las categorías de riesgo de cada RSS. CONCLUSIÓN: La tasa de recidiva tras hemitiroidectomía en pacientes con PTC de riesgo bajo e intermedio fue baja. Sin embargo, es necesario efectuar un seguimiento meticuloso, centrándose en el lóbulo tiroideo restante, para la detección precoz y el tratamiento oportuno de la recidiva. Los RSSs que se utilizan en la actualidad no tienen valor predictivo en estos pacientes.

Feasibility of a new V-shaped incision for parotidectomy: a preliminary report.

We report the design of a new V-shaped incision for parotidectomy that involves only preauricular and postauricular incisions and no hairline or upper cervical incision. It can be used to approach almost all the superficial parotid region, including the superior and anterior divisions, with minimal scarring. To evaluate its technical feasibility, safety, and cosmetic results, we prospectively enrolled 15 patients (between September 2015 and September 2016) who had partial parotidectomy as the primary treatment for benign parotid tumours. Operations were successfully completed through this approach alone in 14 (mean (range) operating time: 120 (105-142) minutes; drainage volume: 51 (23-70) ml; and duration of drainage: 2.6 (2-4) days). There were no serious complications such as paralysis of the facial nerve or necrosis of the wound. The mean (range) visual analogue scale (VAS) and Vancouver Scar Scale scores for the scars were 9 (8-10) and 0.9 (0-3), respectively. A V-shaped incision for partial parotidectomy is technically feasible and safe, and can produce good cosmetic results in selected patients with benign parotid tumours. Our results need to be confirmed in larger studies and case-control trials.

Efficacy of computed tomography for abdominal stab wounds: a single institutional analysis.

PURPOSE: There are several diagnostic tools to support the decision for abdominal stab wounds. The aim of this study is to evaluate the ability of computed tomography (CT) to facilitate decisions on the initial management in patients with anterior abdominal stab wounds. METHODS: The medical records of all 118 patients who sustained abdominal stab wounds from March 2004 to January 2012 were reviewed retrospectively. RESULTS: The average age of patients was 41 years, and 84 (71%) patients were male. Ten patients underwent an immediate laparotomy due to hemodynamic instability, peritonitis, or definite evisceration. The other 108 patients underwent CT scans, and 91 patients had positive CT findings, leading to performance of laparotomy in 82 patients. One patient underwent a non-therapeutic laparotomy. Seventeen patients had negative CT results; however, seven patients underwent early laparotomy according to the attending surgeon's decision using serial physical examination or other diagnostic tools. The sensitivity of the CT scan was 94.2%, and the positive-predictive value was 98.8%. CONCLUSIONS: CT can be used efficiently along with physical examination as an initial diagnostic tool in patients with abdominal stab wounds. However, there can be missed injuries, then surgeon should consider other diagnostic methods.

MicroRNA miR-8 regulates multiple growth factor hormones produced from Drosophila fat cells.

Metabolic organs such as the liver and adipose tissue produce several peptide hormones that influence metabolic homeostasis. Fat bodies, the Drosophila counterpart of liver and adipose tissues, have been thought to analogously secrete several hormones that affect organismal physiology, but their identity and regulation remain poorly understood. Previous studies have indicated that microRNA miR-8, functions in the fat body to non-autonomously regulate organismal growth, suggesting that fat body-derived humoral factors are regulated by miR-8. Here, we found that several putative peptide hormones known to have mitogenic effects are regulated by miR-8 in the fat body. Most members of the imaginal disc growth factors and two members of the adenosine deaminase-related growth factors are up-regulated in the absence of miR-8. Drosophila insulin-like peptide 6 (Dilp6) and imaginal morphogenesis protein-late 2 (Imp-L2), a binding partner of Dilp, are also up-regulated in the fat body of miR-8 null mutant larvae. The fat body-specific reintroduction of miR-8 into the miR-8 null mutants revealed six peptides that showed fat-body organ-autonomous regulation by miR-8. Amongst them, only Imp-L2 was found to be regulated by U-shaped, the miR-8 target for body growth. However, a rescue experiment by knockdown of Imp-L2 indicated that Imp-L2 alone does not account for miR-8's control over the insect's growth. Our findings suggest that multiple peptide hormones regulated by miR-8 in the fat body may collectively contribute to Drosophila growth.

Spontaneous Zone III rupture of the flexor tendons of the ulnar three digits in elderly Korean farmers.

Spontaneous flexor tendon rupture is a rare condition and the aetiology is not clear. We report 12 elderly Korean farmers with spontaneous flexor tendon ruptures. We found the rupture in the dominant hand in ten patients. A rupture in the little finger was found in all 12 patients (seven with both flexor tendons ruptured and five with only the profundus ruptured), in the ring finger in four patients (the profundus ruptured in all and both flexor tendons in two patients), and in the middle finger a partial rupture of the profundus in one patient. The tendons were ruptured close to the hook of the hamate. Repetitive friction between the flexor tendons and the hamate hook may cause the ruptures. The hamate hook was excised and the ruptured profundus tendons were reconstructed with tendon transfers with quite favourable functional recovery at follow-up of 1 to 2 years. The ruptured superficialis tendons were not reconstructed. Level of Evidence IV.

Mid-long term effect of non-ablative high radiofrequency therapy on the rabbit dermal extracellular matrix.

This study quantitatively investigated the postoperative effects of radiofrequency (RF) application on the normal dermal extracellular matrix (ECM) of in vivo rabbits. Postoperative effects were evaluated by histology and atomic force microscopy analysis of dermal tissues treated using three RF energy levels (10 ~ 30 W) and either a single- or multiple-pass procedure. Progressive changes in the morphology of rabbit dermal ECMs were investigated over a 30-day postoperartive period. All RF-treated groups, except for the low energy group (10 W), displayed more prominent inflammatory responses compared to the control. This inflammatory reaction was more prominent a day after application. Dermal tissues 30 days after RF application exhibited prominent myofibroblast activity associated with ECM contractile activity during wound healing in addition to chronic inflammation. A decrease in the morphology of dermal ECMs after RF application continued until seven days postoperatively. The ECM diameter increased to near baseline at 30 days postoperatively. Low energy and multi-pass applications resulted in greater collagen fibril contraction and recovery at the ultra-structural level at 30 days postoperatively than did a single high energy application.

Synthesis of Pt doped Bi2O3/RuO2 photocatalysts for hydrogen production from water splitting using visible light.

This study was focused on the preparation of modified bismuth oxide photocatalysts, including Ru and Pt doped Bi2O3, using sonochemically assisted method to enhance their photocatalytic activity. The crystalline phase composition and surface structure of Bi2O3 photocatalysts were examined using SEM, XRD, UV-visible spectroscopy, and XPS. Optical characterizations have indicated that the Bi2O3 presents the photoabsorption properties shifting from UV light region into visible light which is approaching towards the edge of 470 nm. According to the experimental results, visible-light-driven photocatalysis for water splitting with the addition of 0.3 M Na2SO3 and 0.03 M H2C2O4 as sacrificing agents demonstrates that Pt/Bi2O3-RuO2 catalyst could increase the amount of hydrogen evolution, which is around 11.6 and 14.5 micromol g(-1) h(-1), respectively. Plausible formation mechanisms of modified bismuth oxide and reaction mechanisms of photocatalytic water splitting have been proposed.

QTL analysis of white blood cell, platelet and red blood cell-related traits in an F2 intercross between Landrace and Korean native pigs.

Haematological traits play important roles in disease resistance and defence functions. The objective of this study was to locate quantitative trait loci (QTL) and the associated positional candidate genes influencing haematological traits in an F(2) intercross between Landrace and Korean native pigs. Eight blood-related traits (six erythrocyte traits, one leucocyte trait and one platelet trait) were measured in 816 F(2) progeny. All experimental animals were genotyped with 173 informative microsatellite markers located throughout the pig genome. We report that nine chromosomes harboured QTL for the baseline blood parameters: genomic regions on SSC 1, 4, 5, 6, 8, 9, 11, 13 and 17. Eight of twenty identified QTL reached genome-wide significance. In addition, we evaluated the KIT locus, an obvious candidate gene locus affecting variation in blood-related traits. Using dense single nucleotide polymorphism marker data on SSC 8 and the marker-assisted association test, the strong association of the KIT locus with blood phenotypes was confirmed. In conclusion, our study identified both previously reported and novel QTL affecting baseline haematological parameters in pigs. Additionally, the positional candidate genes identified here could play an important role in elucidating the genetic architecture of haematological phenotype variation in swine and in humans.

Facile microwave-combustion synthesis of wurtzite CdS nanoparticles.

In this study we first report microwave-combustion synthesis of faceted CdS nanoparticles by using cadmium thiocyanate complex as a single source precursor. This is the first example of a metal-thiocyanate (M-SCN) complex being used as a source for metal sulfides (M-S) preparation in a microwave-combustion process. The synthesized CdS was characterized using X-ray diffraction (XRD), field mission scanning electron microscopy (FE-SEM), and high-resolution transmission electron microscopy (HR-TEM). The by-product assisted combustion synthesis yields CdS nanoparticles with the mixtures of octahedral geometries, hexagonal, and triangle plate morphologies and the sizes were found to be 100 nm to 5 microm. The XRD patterns imply the formation of well crystallized wurtzite CdS. The influence of cadmium and sulfur precursors and microwave irradiation time on the morphology of CdS nanoparticle was also investigated. The cadmium and sulfur precursors strongly influenced the CdS morphology and increasing the microwave irradiation time and intensity has no effect on the CdS morphology. In addition, a plausible mechanism of CdS nanoparticle formation has been proposed in this research.

Quantitative trait loci for production traits in pigs: a combined analysis of two Meishan x Large White populations.

Combined analysis of data from two or more resource populations can improve the power and accuracy of QTL mapping and allow some cross-validation of results. In this study, we performed a genome-wide scan using combined data from two F(2) populations derived from a cross between Large White and Chinese Meishan pigs. A total of 739 pigs were included in the analysis. In total 187 markers were genotyped in the two populations, including 115 markers genotyped in both populations, and these markers covered 2282 cM of the pig genome with an average of 13.58 cM between markers. Seven traits (teat number, birth weight, weaning weight, test-end weight, fat depth at shoulder, fat depth at mid back and fat depth at loin) were analysed for both individual populations and the combined population. There were 9 (2, 10), 1 (4, 4) and 14 (5, 18) QTL that achieved 1% genome-wide, 5% genome-wide and suggestive significance levels respectively in population 1 (population 2, combined population). Additive effects of QTL detected in the two populations at all significance levels were largely consistent suggesting that the QTL represent real genetic effects, but this was not the case for dominance or imprinting effects. There were also a number of significant interactions between detected QTL effects and population.

Magneto-optical enhancement through gyrotropic gratings.

Diffracted magneto-optical (MO) effects are numerically investigated for one-dimensional lossy gyrotropic gratings in the zeroth and the first orders for the polar magnetization by utilizing the rigorous coupled-wave approach implemented as an Airy-like internal-reflection series. The simulated Kerr spectra agree well with the experimental ones. The dependence of the MO Kerr enhancement on the grating depth in the first-order diffraction, compared with that in the zeroth one, is illustrated, and the diffracted MO Faraday effect is theoretically investigated as well. Such a MO enhancement through the gyrotropic gratings is superior to the conventional MO devices and magneto-photonic crystals. The potential applications are also suggested.

Salvage of the lower extremity free flap using cross-leg venous repair.

This retrospective study was designed to evaluate a salvage technique for free flaps suffering venous congestion by using a cross-leg vein repair in patients with venous-impaired lower extremities. Four free flap reconstructions were performed using the latissimus dorsi muscle to reconstruct soft tissue defects in the lower extremity. The recipient artery was confined to the ipsilateral leg and the venous anastomosis was performed with a long saphenous vein from the contralateral side. The legs were immobilised together by means of an external fixator. All patients were males with a mean age of 31 years. The mean time of pedicle division was 8.8 days (7-10). The mean size of the free flap was 186.5 cm(2). All flaps survived after pedicle division without venous congestion. There were no complications such as joint stiffness or donor site morbidity except for a linear scar. The cross-leg venous repair is a refinement of a salvage procedure for compromised free flaps used in the reconstruction of severe soft tissue defects in vascularly compromised lower extremities.

Varying Ti-6Al-4V surface roughness induces different early morphologic and molecular responses in MG63 osteoblast-like cells.

Osteoblast response to Ti implants depends not only on the chemistry of the implant but also on the physical properties of the implant surface, such as microtopography and roughness. This study was undertaken to examine early changes in cell morphology and gene expression during the early phase of osteoblast interaction with titanium alloy (Ti-6Al-4V) surfaces of two different roughnesses. MG63 osteoblast-like cells were cultured for 2, 6, 24, and 72 h on smooth (Ra=0.18+/-0.03 microm) and rough (Ra=2.95+/-0.23 microm) Ti-6Al-4V surfaces. Changes in cell proliferation were assessed by measuring cell number after 72 h in culture. Morphological characteristics were observed by scanning electron microscopy after 2, 6, and 24 h of culture. Changes in gene expression for extracellular signal-regulated kinase 2 (Erk2), type I collagen (alpha2[I] collagen), phospholipase C-gamma2 (Plc-gamma2), and beta-actin were measured by RT-PCR after 6 and 24 h in culture. Cell number was significantly higher on the smooth surface. In scanning electron micrographs, cells on smooth Ti-6Al-4V were spherical and raised up from the surface after 2 h in culture. In contrast, cells on the rough surface adopted an irregular, elongated shape that spanned across pits in the surface. At 24 h, cells on the smooth surface had flattened, become elongate, and covered the surface. In contrast, cells on the rough surface appeared more differentiated in shape and the margins of the cells were irregular, with many processes extending out, following the contour of the surface. Of the genes examined, only Erk2 and beta-actin showed a change in expression with surface roughness. Both genes were upregulated (p<0.05) on the rough surface at 6 h. These results indicate that Ti-6Al-4V surface roughness affects osteoblast proliferation, morphology, and gene expression, and that these effects can be measured after periods as short as 2-6 h.

Detection of quantitative trait loci for androstenone, skatole and boar taint in a cross between Large White and Meishan pigs.

'Boar taint' is a strong perspiration-like, urine-like unpleasant odour given off upon heating or cooking of meat from some intact (uncastrated) male pigs. Data from the F(2) generation of a Large White (LW) x Meishan (MS) crossbred population were analysed to detect quantitative trait loci (QTL) for traits associated with boar taint. Fat samples from 178 intact male pigs slaughtered at 85 +/- 5 kg were analysed for the major contributors to boar taint (androstenone, indole and skatole). Fat and lean samples from cooked meat were scored for boar, abnormal and pork flavour and odour by a trained sensory panel (SP). A scan with 117 markers covering the whole genome was performed in the F(2) individuals, together with their F(1) parents and purebred grandparents. At the 5% chromosomal significance threshold (approximately equal to the genome-wide suggestive significance threshold), QTL were detected for the laboratory estimate of androstenone on chromosomes 2, 4, 6, 7 and 9. However, only on chromosome 6 were there QTL for boar flavour (BF) traits in the same or adjacent marker intervals as a QTL for the laboratory estimate of androstenone. On chromosome 14, QTL were detected for the laboratory estimates of indole and skatole, the SP score for skatole and the scores for BF in lean and BF in fat. In all five cases, the MS allele generally increased the estimate or score, compared with the LW allele, but it appeared that desirable and undesirable alleles were present in both breeds. This locus on chromosome 14 has considerable potential for use to reduce the incidence of boar taint, especially if further research can identify the causative polymorphism or strongly associated markers.

A major QTL conditioning salt tolerance in S-100 soybean and descendent cultivars.

Deployment of salt tolerant cultivars is an effective approach to minimize yield loss in a saline soil. In soybean, Glycine max (L.) Merr., substantial genetic variation exists for salt response. However, breeding for salt tolerance is hampered because no economically viable screening method has been developed for practical breeding. To facilitate the development of an effective screening method for salt tolerance in soybean, the present study was conducted to determine the heritability of salt tolerance and to identify associated quantitative trait loci (QTL). F2:5 lines from the cross of 'S-100' (salt tolerant) x 'Tokyo' (salt sensitive) were evaluated in a saline field in Hyde County, N.C., USA, in 1999 and in a greenhouse located in Raleigh, N.C., USA, in 2001. S-100 and Tokyo are ancestors of popular soybean cultivars released for the southern USA. The visual salt tolerance ratings of the F2:5 lines ranged from 0 (complete death) to 5 (normal healthy appearance). The entry-mean heritability for salt tolerance was 0.85, 0.48, and 0.57 in the field (four replications), greenhouse (two replications), and combined environments, respectively. The genotypic correlation between field and greenhouse ratings was 0.55, indicating reasonably good agreement between the two screening environments. To identify QTL associated with salt tolerance, each line was characterized with RFLP markers and an initial QTL single-factor analysis was completed. These results were used to identify genomic regions associated with the trait and to saturate the selected genomic regions with SSR markers to improve mapping precision. Subsequently, a major QTL for salt tolerance was discovered near the Sat_091 SSR marker on linkage group (LG) N, accounting for 41, 60, and 79% of the total genetic variation for salt tolerance in the field, greenhouse, and combined environments, respectively. The QTL allele associated with tolerance was derived from S-100. Pedigree tracking was used to examine the association between the salt tolerance QTL and flanking SSR marker alleles in U.S. cultivars descended from S-100 or Tokyo through 60 years of breeding. The presence of alleles from S-100 at the Sat_091 and Satt237 marker loci was always associated with salt tolerance in descendants. Alleles from Tokyo for these same markers were generally associated with salt sensitivity in descendent cultivars. The strong relationship between the SSR marker alleles and salt tolerance suggests that these markers could be used for marker-assisted selection in commercial breeding.

An angiographic lesion mimicking pseudo-aneurysm in cerebral arteriovenous malformation.

In cerebral arteriovenous malformations (AVMs), a pseudo-aneurysm represents rupture site, and its presence is known as a factor for rebleeding. We report a case of cerebral AVM presenting with intracerebral haemorrhage in which cerebral angiography showed a lesion mimicking pseudo-aneurysm. Although the patient needed urgent surgical decompression, it was delayed because early haematoma evacuation would induce rebleeding from the rupture site. The authors attempted to occlude the pseudoaneurysm interventionally before surgery. After surgical excision, the lesion that was believed to be a pseudo-aneurysm was revealed as a partially thrombosed venous sac having a thick fibrous wall. In this report, the authors discuss the pitfalls in the interpretation of pseudo-aneurysms in angiographic AVM architecture.

Induction of a pepper cDNA encoding SAR8.2 protein during the resistance response to tobacco mosaic virus.

A cDNA library was constructed with mRNA extracted from TMV resistant hot pepper plants 24 and 48 h after inoculation by TMV. The library was screened differentially with radio-labeled cDNA synthesized with mRNA from the leaves of either TMV-inoculated or mock-inoculated hot pepper plants. CaSAR8.2 clone was one of the clones isolated by this differential screening. The predicted amino acid sequence of CaSAR8.2 has a homology of 52% similarity to that of tobacco SAR8.2 genes. Southern blot analysis showed that a multigene family of CaSAR8.2 was present in the hot pepper genome. Transcripts homologous to CaSAR8.2 accumulated abundantly in the leaves and the flowers, but little in other tissues. CaSAR8.2 gene expression was induced by avirulent pathotype TMV-P0 inoculation but not by virulent TMV-P1.2 inoculation. Effects of exogenously applied abiotic elicitors on CaSAR8.2 expression were also examined. Salicylic acid and ethephon treatments caused a rapid accumulation of CaSAR8.2 transcripts in pepper leaves and methyl jasmonate treatment slightly induced the expression of CaSAR8.2. A strain of Xanthomonas campestris pv. vesicatoria (Xcv) that contains an avirulence gene avrBs2, was infiltrated into the leaves of a pepper cultivar containing the Bs2 resistance gene. A marked induction of CaSAR8.2 gene expression was observed in Xcv-infiltrated leaves. These results suggest possible roles of CaSAR8.2 as pathogenesis-related protein against varieties of pathogens including virus and bacteria.

Enantioselective binding of ofloxacin to B form DNA.

The binding affinity and binding mode of S- and R-ofloxacin, one of the quinolone antibiotics, to B form calf thymus DNA were studied in this work. The binding affinity of S-ofloxacin measured by both Stern-Volmer and Benesi-Hilderbrand methods was greater by a factor of 5 compared to R-enantiomer and the CD spectrum of the former is largely altered while that of the latter remained the same in the presence of DNA, indicating the enantiospecific binding of this drug to DNA. The binding geometry of both S- and R-ofloxacin calculated from the reduced linear dichroism was similar to norfloxacin, which is partially intercalated from the minor groove.