Short-term outcomes after Ivor Lewis oesophagectomy for cancer during the COVID-19 pandemic.

INTRODUCTION: Elective surgery in the UK came to a halt during the early part of the COVID-19 pandemic. As COVID-19-related infection and mortality rates in Devon and Cornwall were relatively low, however, urgent elective surgery continued in Plymouth, with the necessary precautions in place. This study aimed to assess outcomes following Ivor Lewis oesophagectomy (ILO) during the pandemic. METHODS: We prospectively analysed details of 20 consecutive patients who underwent ILO for cancer over a 3-month period between 17 March and 12 June 2020. All patients underwent COVID-19 swab testing 24-48 hours before surgery and during admission when clinically indicated. The primary outcome measure was COVID-19-related morbidity. Secondary outcome measures were non-COVID-19-related morbidity, mortality and length of hospital stay. RESULTS: Twenty patients underwent ILO during the study period. All patients identified as white British. No patients tested positive for COVID-19 pre- or postoperatively. There was no COVID-19-related morbidity. There was no in-hospital mortality. Seven patients developed pneumonia, which settled with antibiotics. One patient developed an anastomotic leak, which was treated conservatively. One patient returned to theatre for a para-conduit hernia repair. The median length of hospital stay was nine days. One patient required admission to the high dependency unit for inotropic support for two days. CONCLUSIONS: ILO can be performed safely during the COVID-19 pandemic with the necessary precautions in place.

Conformational dynamics of [Formula: see text]-conotoxin PnIB in complex solvent systems.

Cone snails are slow-moving animals that secure survival by injecting to their prey a concoction of highly potent and stable neurotoxic peptides called conotoxins. These small toxins (~ 10-30 AA) interact with ion channels and their diverse structures account for various variables such as the environment and the prey of preference. This study probed the conformational space of α-conotoxin PnIB from Conus pennaceus by performing all-atom molecular dynamics simulations on the conotoxin in complex solvent systems of water and octanol. Secondary structure analyses showed a uniform conformation for the pure (C100Oc, C100W) and minute (C95Oc, C5Oc) systems. In C50Oc, however, structural changes were observed. The original helices were converted to turns and were shown to happen simultaneously with the elongation of the helix and shortening of end-to-end distance. The transitions complement the orientation of the peptide at the interface. The shift to the broken helix conformation is marked by the rearrangement of solvent molecules to a framework that favors the accumulation of water molecules at residues 6-11 of the H2 region. This promotes specific protein-solvent interactions that facilitate secondary structure transitions. As PnIB has shown favorable binding toward neuronal nicotinic acetylcholine receptors, this study may provide insights on this conotoxin's therapeutic potential. Description: Structural changes in PnIB are accompanied by a simultaneous change in solvent density.

Predictive value and clinical significance of increased SSAT-1 activity in healthy adults.

AIM: Spermidine/spermine N1-acetyltransferase (SSAT-1) regulates cell growth, proliferation and death. Amantadine is converted by SSAT-1 to acetylamantadine (AA). In our earlier studies, although SSAT-1 was activated in patients with cancer, a number of ostensibly healthy adult volunteers had higher than expected AA concentration. This study was therefore undertaken to examine the outlier group. MATERIALS & METHODS: A follow up of urine analysis for AA by liquid chromatography-tandem mass spectrometry as well as clinical assessments and additional blood analyses were conducted. RESULTS: In some of the outlier controls, higher than expected AA concentration was linked to increased serum carcinoembryonic antigen. Clinical and radiographic assessments revealed underlying abnormalities in other cases that could represent premalignant conditions. Hematology tests revealed elevations in white blood cells and platelets, which are markers of inflammation. CONCLUSION: High urine concentration of AA could be used as a simple and useful test for screening of cancer in high-risk populations.

Decreased hemispheric connectivity and decreased intra- and inter- hemisphere asymmetry of resting state functional network connectivity in schizophrenia.

Many studies have shown that schizophrenia patients have aberrant functional network connectivity (FNC) among brain regions, suggesting schizophrenia manifests with significantly diminished (in majority of the cases) connectivity. Schizophrenia is also associated with a lack of hemispheric lateralization. Hoptman et al. (2012) reported lower inter-hemispheric connectivity in schizophrenia patients compared to controls using voxel-mirrored homotopic connectivity. In this study, we merge these two points of views together using a group independent component analysis (gICA)-based approach to generate hemisphere-specific timecourses and calculate intra-hemisphere and inter-hemisphere FNC on a resting state fMRI dataset consisting of age- and gender-balanced 151 schizophrenia patients and 163 healthy controls. We analyzed the group differences between patients and healthy controls in each type of FNC measures along with age and gender effects. The results reveal that FNC in schizophrenia patients shows less hemispheric asymmetry compared to that of the healthy controls. We also found a decrease in connectivity in all FNC types such as intra-left (L_FNC), intra-right (R_FNC) and inter-hemisphere (Inter_FNC) in the schizophrenia patients relative to healthy controls, but general patterns of connectivity were preserved in patients. Analyses of age and gender effects yielded results similar to those reported in whole brain FNC studies.

Hip-Knee-Ankle Radiographs Are More Appropriate for Assessment of Post-Operative Mechanical Alignment of Total Knee Arthroplasties than Standard AP Knee Radiographs.

Weight-bearing hip-knee-ankle (HKA) radiographs are the gold standard for measuring lower limb alignment after total knee arthroplasty (TKA), however the majority of UK units use standardised anteroposterior (AP) knee radiographs. This study aimed to determine whether standardised AP knee radiographs adequately assess lower limb alignment after TKA. HKA radiographs from 50 post-operative TKAs were cropped to the size of a standardised AP knee radiograph allowing comparison of mechanical and anatomical alignment measurements between the two views. Repeatability of alignment measurements was significantly better for HKA radiographs, however, there was poor agreement of the mechanical alignment measured between the two views. Standardised AP knee radiographs are insufficient to assess the mechanical alignment of post-operative TKA and we recommend routinely using HKA radiographs.

Spatial patterns of heavy metals in soil under different geological structures and land uses for assessing metal enrichments.

One hundred and thirty composite soil samples were collected from Hamedan county, Iran to characterize the spatial distribution and trace the sources of heavy metals including As, Cd, Co, Cr, Cu, Ni, Pb, V, Zn, and Fe. The multivariate gap statistical analysis was used; for interrelation of spatial patterns of pollution, the disjunctive kriging and geoenrichment factor (EF(G)) techniques were applied. Heavy metals and soil properties were grouped using agglomerative hierarchical clustering and gap statistic. Principal component analysis was used for identification of the source of metals in a set of data. Geostatistics was used for the geospatial data processing. Based on the comparison between the original data and background values of the ten metals, the disjunctive kriging and EF(G) techniques were used to quantify their geospatial patterns and assess the contamination levels of the heavy metals. The spatial distribution map combined with the statistical analysis showed that the main source of Cr, Co, Ni, Zn, Pb, and V in group A land use (agriculture, rocky, and urban) was geogenic; the origin of As, Cd, and Cu was industrial and agricultural activities (anthropogenic sources). In group B land use (rangeland and orchards), the origin of metals (Cr, Co, Ni, Zn, and V) was mainly controlled by natural factors and As, Cd, Cu, and Pb had been added by organic factors. In group C land use (water), the origin of most heavy metals is natural without anthropogenic sources. The Cd and As pollution was relatively more serious in different land use. The EF(G) technique used confirmed the anthropogenic influence of heavy metal pollution. All metals showed concentrations substantially higher than their background values, suggesting anthropogenic pollution.

[Identification and expression of six drought responsive transcripts through differential display in desi cottion (Gossypium aroreum)].

There is not enough information available on drought-modulated gene(s) in Gossypium arboreum, which can be a valuable gene pool for improving modern cotton cultivars. In the present work differential display reverse transcriptase PCR (DDRT) was used to compare overall differences in gene expression between water stressed and control plants. By screening 93 primer-pair combinations DDRT technique resulted in up-regulation of 30 cDNA transcripts. Through reamplification and quality control assay 10 cDNA transcripts appeared false positive. The remaining 20-cDNA transcripts were extracted from the gel, reamplified, cloned and sequenced. Homology search revealed that 6 transcripts showed significant homology with known genes. Real-time RT-PCR showed that among 6 transcripts 5 showed significant over expression in water stressed leaves as compared to control. This is an important finding since there are only few reports of universal stress protein and transposable elements are available in plants but none in cotton under drought condition.

Proximal femoral resection-interposition arthroplasty in cerebral palsy.

Hip dislocation is common in children with total body cerebral palsy. It is associated with pain, difficulty in seating and problems with perineal hygiene. We present a retrospective study of 15 patients who had undergone 21 proximal femoral resection-interposition arthroplasties between 1990 and 2005. The mean age at the time of surgery was 16.2 years (range 11-26 years). Mean follow-up was 3.4 years (range 1-7 years). Ninety percent of patients had pain relief. Perineal hygiene and sitting was improved in all cases. A lateral femoral head defect was noted in 90% of hips and was associated with pain, and significant degenerative changes. Twelve hips had heterotopic ossification (11 type-1, one type-2 and 0 type-3). No major complications were seen. We would submit that proximal femoral resection is a good salvage procedure for the painful, dislocated hip, with an excellent chance of resolving symptoms. The finding of a lateral femoral head defect on the radiograph is associated with significant degenerative changes.

The epidemiology of lip, oral cavity and pharyngeal cancers in Kuwait 1979-1988.

Of the 10 539 cases of cancer recorded in the Kuwait Cancer Registry in the 10 years 1979-1988, 784 (7.4%) involved the lip, oral cavity or pharynx. Nearly half of these were of the nasopharynx or salivary glands, and the incidence of salivary gland cancer appears to be increasing. The aetiology may be related to poor oral hygiene and tobacco-smoking.

Solid phase extraction of clenbuterol from plasma using immunoaffinity followed by HPLC.

An immuno-extraction column for clenbuterol has been prepared. Optimum conditions for the selective retention and elution of clenbuterol have been developed, based on a modification of our earlier work on morphine, chlortoluron and isoproturon. Clenbuterol could be retained on the immuno-column then eluted in one x one ml fraction using 50% methanol in phosphate buffered saline pH 2. On columns containing antisera (but not to clenbuterol) the clenbuterol was removed in the washing step. HPLC-UV determination gave clean traces. Day-to-day reproducibility was improved by precipitating the plasma proteins with acetonitrile.

Determination of morphine in urine by solid-phase immunoextraction and high-performance liquid chromatography with electrochemical detection.

The analysis of morphine in biological fluids is of vital interest in monitoring opiate abuse and in drug abuse research. Although methods for analysis of morphine and its metabolites are well established, studies are still being carried out to improve sample preparation procedures as well as detection levels of morphine in biological samples. In this study, morphine-specific immunosorbents were developed to concentrate morphine prior to HPLC analysis. Urine (0.1 ml) was diluted 10-fold with phosphate-buffered saline, pH 7.4 (PBS), loaded onto a solid-phase immunoextraction column and washed with 15 ml PBS followed by elution with 2 ml of elution buffer (40% ethanol in PBS, pH 4). The eluted fraction was analysed for morphine by HPLC-electrochemical detection using a cyanopropyl (CN) analytical column with 25% acetonitrile in phosphate buffer-sodium lauryl sulphate, pH 2.4 as the mobile phase. Duration of the extraction procedure was approximately 40 min. Calibration graphs were linear from 100 ng ml-1 to 500 ng ml-1 in urine. The inter-assay R.S.D. was < 10% and the recovery of morphine from urine was > 98%. Immunocolumns demonstrated remarkably high specificity towards morphine showing minimal binding with other opiate metabolites such as codeine, normorphine, norcodeine, morphine-3-glucuronide, morphine-6-glucuronide.

Therapy for hormone-resistant prostate cancer: no longer a myth.

In conclusion, there have been impressive efforts to identify new cellular targets for the treatment of hormone-refractory disease. It appears that in some cases, survival may be extended; however, further prospective trials are necessary to confirm these observations.