Midline versus paramedian mandibulotomy for tongue cancer surgery: analysis of complications.

Midline and paramedian mandibulotomies both have distinct anatomical and surgical strengths. A retrospective study was performed at Chang Gung Memorial Hospital, Linkou Branch between 2014 and 2019 to investigate how the osteotomy site (midline (n = 221) or paramedian (n = 44)) and type (straight, notched, or stair-stepped) affect postoperative and post-radiotherapy complications in patients undergoing wide excision of tongue cancer with flap reconstruction. Midline mandibulotomies were predominantly of the straight osteotomy type, while paramedian mandibulotomies were mostly notched type (P < 0.001). Comparably low elective tooth extraction rates were found in both approaches (P = 0.556). Paramedian mandibulotomy showed a higher osteoradionecrosis rate (P = 0.026), but there was no significance in the sub-analysis of individual types. Paramedian sites were associated with more early infection (P = 0.036) and plate exposure (P = 0.036) than midline sites with the straight osteotomy type, but complication rates did not differ significantly for the notched and stair-stepped types. Paramedian sites (P = 0.020) and notched types (P = 0.006) were associated with higher odds of osteoradionecrosis in the univariable logistic regression analysis, but only the notched type remained significant in the multivariable analysis (P = 0.048). In conclusion, paramedian sites increased the rate of osteoradionecrosis, and correlation with the osteotomy type resulted in more osteoradionecrosis in notched types and more complications in straight paramedian mandibulotomies.

Perceived usefulness and ease of use of fundoscopy by medical students: a randomised crossover trial of six technologies (eFOCUS 1).

BACKGROUND: Fundoscopy outside ophthalmology is in decline, and the technical demands of the traditional direct ophthalmoscope examination are likely contributing. Alternative fundoscopy technologies are increasingly available, yet valid comparisons between fundoscopy technologies are lacking. We aimed to assess medical students' perceptions of usefulness and ease of use of traditional and contemporary fundus-viewing technologies including smartphone fundoscopy. METHODS: One hundred forty-six second-year medical students participated in a cross-sectional, randomised, cross-over study of fundoscopy methods. Medical students completed small group training sessions using six current fundoscopy technologies including: a non-mydriatic fundus camera; two types of direct fundoscopy; and three types of smartphone fundoscopy. A novel survey of perceived usefulness and ease of use was then completed by students. RESULTS: Repeated-measures ANOVA found students rated both the perceived usefulness (p< 0.001) and ease of use (p< 0.001) of smartphone fundoscopy significantly higher than both the non-mydriatic camera and direct fundoscopy. CONCLUSIONS: Smartphone fundoscopy was found to be significantly more useful and easier to use than other modalities. Educators should optimise student access to novel fundoscopy technologies such as smartphone fundoscopy which may mitigate the technical challenges of fundoscopy and reinvigorate use of this valuable clinical examination.

IRF6 mutation screening in non-syndromic orofacial clefting: analysis of 1521 families.

Van der Woude syndrome (VWS) is an autosomal dominant malformation syndrome characterized by orofacial clefting (OFC) and lower lip pits. The clinical presentation of VWS is variable and can present as an isolated OFC, making it difficult to distinguish VWS cases from individuals with non-syndromic OFCs. About 70% of causal VWS mutations occur in IRF6, a gene that is also associated with non-syndromic OFCs. Screening for IRF6 mutations in apparently non-syndromic cases has been performed in several modestly sized cohorts with mixed results. In this study, we screened 1521 trios with presumed non-syndromic OFCs to determine the frequency of causal IRF6 mutations. We identified seven likely causal IRF6 mutations, although a posteriori review identified two misdiagnosed VWS families based on the presence of lip pits. We found no evidence for association between rare IRF6 polymorphisms and non-syndromic OFCs. We combined our results with other similar studies (totaling 2472 families) and conclude that causal IRF6 mutations are found in 0.24-0.44% of apparently non-syndromic OFC families. We suggest that clinical mutation screening for IRF6 be considered for certain family patterns such as families with mixed types of OFCs and/or autosomal dominant transmission.

Influence of Incorporated Pt-Fe2O3 Core-Shell Nanoparticles on the Resistive Switching Characteristics of ZnO Thin Film.

The resistance-switching characteristics of metal oxides have attracted great interest for the non-volatile memory applications such as resistive random access memory. A basic resistive random access memory device has a metal/insulator/metal structure, and its memory effect is achieved by applying voltage to change the resistance of the insulating layer. One of the promising candidates for explaining the resistance-switching mechanism is the formation and rupture of nanoscale conductive filaments. However, this model has an issue that needs to be addressed: the wide distribution of switching voltage due to randomly formed filaments. Therefore, some researchers have reported a decrease in switching voltage distribution and an increase in switching stability by incorporating nanoparticles into the insulating layer. In this study, we investigated influence of incorporated Pt-Fe2O3 core-shell nanoparticles on the resistive switching characteristics of ZnO thin films. Devices were fabricated on SiO2 wafers. A 100-nm-thick Cr layer was used as the bottom electrode. A 50-nm-thick ZnO layer was deposited using the sputtering method, and Pt-Fe2O3 nanoparticles were deposited on it by the dip coating method. A 50-nm-thick ZnO layer was then deposited again. A top Cr electrode (size: 100 µm x 100 µm) was deposited using a shadow mask and sputtering system. All the devices showed bipolar resistance-switching behavior that is observed in Cr/ZnO/Cr structures. However, the on/off voltage was dramatically lowered by incorporating nanoparticles into the insulating layer when compared with that of the devices without nanoparticles. In addition, the switching stability of the devices was improved upon the incorporation of nanoparticles. On the basis of these results, we can conclude that Pt-Fe2O3 nanoparticles may be used to enhance the resistance switching properties of ZnO thin films by incorporating them into the films.

Resistive switching characteristics of the Cr/ZnO/Cr structure.

Resistive random access memory (ReRAM) with conductor-dielectric-conductor structures has attracted extensive attention for next generation nonvolatile memory devices. The resistive switching effect has been observed in various materials, such as metal oxides and chalcogenide oxides. From our findings, we advocate the resistive switching characteristics of zinc oxide thin film, due to its simple composition and ease of manipulation. In this study, we investigated the current-voltage (I-V) characteristics of the Cr/ZnO/Cr capacitor structure. The Cr electrode and ZnO thin film were deposited by radio frequency magnetron sputtering at room temperature. The top electrode layers were patterned by 100 microm x 100 microm. The fabricated devices of the Cr/ZnO/Cr structures exhibited bipolar switching behavior. In addition, using the Cr-coated AFM tip replaced with the top electrode enabled us to map the local current image and measure the current flow at each point. This gave us more information to verify the resistive switching mechanism of ZnO thin film.

Direct observation of enhanced cathodoluminescence emissions from ZnO nanocones compared with ZnO nanowire arrays.

We report, for the first time, direct observation of enhanced cathodoluminescence (CL) emissions from ZnO nanocones (NCs) compared with ZnO nanowires (NWs). For direct and unambiguous comparison of CL emissions from NWs and nanocones, periodic arrays of ZnO NW were converted to nanocone arrays by our unique HCl [aq] etching technique, enabling us to compare the CL emissions from original NWs and final nanocones at the same location. CL measurements on NW and nanocone arrays reveal that emission intensity of the nanocone at ∼ 387 nm is over two times larger than that of NW arrays. The enhancement of CL emission from nanocones has been confirmed by finite-difference time-domain simulation of enhanced light extraction from ZnO nanocones compared to ZnO NWs. The enhanced CL from nanocones is attributed to its sharp morphology, resulting in more chances of photons to be extracted at the interface between ZnO and air.

Formation of ZnO nanocones using wet chemical etching of ZnO nanorods in an aqueous solution of HCl.

In this report, a simple wet chemical etching of ZnO nanorods to fabricate large area ZnO nanocones is demonstrated. The cone-like morphology formation utilizes anisotropic etching rate on the different crystal planes of ZnO nanorods in an aqueous solution of HCl (HCl [aq]). To form ZnO nanocones, single crystalline ZnO nanorods with a flat hexagonal shape are synthesized on p-Si(100) using hydrothermal method at 90 degrees C and then, are immersed in HCl [aq]. Electron microscopy reveals that the HCl [aq] treatment of ZnO nanorods significantly etched sidewalls of nanorods, resulting in the cone-like morphology formation. The nanocone formation is the most noticeable when the etching occurred in HCl [aq] with a pH of 2.5-3.0 for 5 min etching time. Geometrical analysis using the electron microscopy reveals that the sidewall of a ZnO nanocone have formed a plane indexed as (0-111) after the etching process.

Microfabricated in-channel structured polydimethylsiloxane microfluidic system for a lab-on-a-chip.

In this paper, the fabrication of microfluidic system integrated with micropump and microvalve on the same substrate and its high performance are described. The microfabricated microfluidic system has been optimized for application in capillary electrophoresis-electrochemical detector (CE-ECD), polymerase chain reaction (PCR) and microcantilever. The system is realized by means of a polydimethylsiloxane (PDMS)-glass chip and indium tin oxide heater. The pumping rates of the proposed micropump are measured as functions of the frequency and the duty-ratio of applied voltage. The performances of the microvalves are characterized under the on/off alternation with the applied power of the indium tin oxide (ITO) heater. The flow rate gradually decreases as the applied heater power increase. The optimized membrane thickness for microfluidic system is 350 microm. At this condition, the power of the cut-off flow in microvalve is 400 mW and the 70 nl/min of maximum pumping rate is observed at a duty ratio of 4% and a frequency of 4 Hz for the applied pulse power.

Fabrication of thin film titania with nanopores, nanopoles, and nanopipes by nanoporous alumina template.

We demonstrate the formation of thin film titania (TiO2) with a dense array of nanopores, nanopoles, and nanopipes. The heights of pores, poles, and pipes were approximately 130 nm, 180 nm, and 200 nm, respectively. The aspect ratios of these three structures were approximated between 2 and 3. In order to obtain titania thin films, a nanoporous alumina (Al2O3) template was fabricated by performing a two-step anodization process. The spin-coated titania films were uniformly patterned by a nanoimprinting lithography technique with a textured poly(methyl methacrylate) (PMMA) mold or nanoporous alumina template. The titania films are very useful for solar cells, photocatalytic and sensing applications, in which nano-structuring of surfaces with controlled dimensions is vital.

Development of a microfabricated disposable microchip with a capillary electrophoresis and integrated three-electrode electrochemical detection.

We have developed microsystems with a capillary electrophoresis and an electrochemical detector. The microfabricated CE-ECD systems are adequate for a disposable type and the characteristics are optimized for application in electrochemical detection. The system was realized by means of a polydimethylsiloxane (PDMS)-glass chip and an indium tin oxide electrode. The injection and separation channels were produced by relatively simple and inexpensive methods. A capillary electrophoresis and a three-electrode electrochemical detector were fabricated on the same substrate with the same fabrication procedure. We measured electropherograms for the testing analytes consisting of catechol and dopamine with different concentrations of 1mM and 0.1mM, respectively. The results showed an efficient and rapid separation and detection of all compounds within a very short time of around 80s using a separate electric field 60 V/cm. We could also successfully achieve an electropherogram of the separation of the 1 kb DNA ladder (8.4 ng/mul) from the 500 bp to 10 kb DNA fragments within just 150 s.

Molecular cloning and expression patterns of the molt-regulating transcription factor HHR3 from Helicoverpa armigera.

Molt-regulating transcription factors, hormone receptor 3 (HR3), play important roles in regulating expression of tissue-specific genes involved in insect molting and metamorphosis. A 1668 bp cDNA encoding a molt-regulating transcription factor (HHR3) was cloned from Helicoverpa armigera, which encodes a protein made up of 556 amino acids. This 62 kDa protein was found to have an isoelectric point (pI) of 6.52. There was no signal peptide or N-glycosylation site found in this cDNA. A DNA-binding region signature of nuclear hormone receptor was found from amino acids 107-133. A possible outside to inside transmembrane helice was found from amino acids 72-90. Northern blots of the larvae revealed five bands of HHR3 named as band 0, 1, 2, 3 and 4 with molecular masses determined as 2.1, 2.6, 3.6, 4.5 and 5.5 kb, respectively. The expression patterns of HHR3 in vivo were variable with developmental stages and tissues. Results showed that band 1-4 of HHR3 was only briefly expressed during molting, which suggested these bands are involved in the regulation of molting cascade, whereas band 0 was expressed in both molting and feeding larvae. Band 1 and 2 of HHR3 could be induced from epidermis of newly molted 6th instar larvae by non-steroidal ecdysone agonist, RH-2485.

Enhanced IL-18 expression in common skin tumors.

Interleukin-18 (IL-18) has been found to have multiple effects upon various cells involved in inflammatory response. Recently we reported that B16 murine melanoma cells are able to produce IL-18, which is involved in the regulation of intracellular reactive oxygen intermediates (ROI) and Fas-ligand expression, indicating that IL-18 plays key role in the tumor activity of melanoma. In this study, we investigated the pattern of IL-18 expression in the human system. IL-18 production was tested by enzyme linked immunosorbent assay (ELISA) assay in various tumor cell lines, including Raji (Burkitt's lymphoma), IM-9 (B lymphoblast), Jurkat (acute T cell leukemia), SK-MES-1 (squamous cell carcinoma (SCC) cell line), SK-MEL-2, G-361, DM-4, and DX-3 (melanoma cell lines). ELISA tests showed that IL-18 was highly expressed in malignant skin tumors such as SK-MES-1, SK-MEL-2, G-361, DM-4, and DX-3 cell lines, thus suggesting that IL-18 production may be associated with the malignancy of skin tumors. Here, we report that enhanced IL-18 expression is positively correlated with malignant skin tumors such as SCC and melanoma, suggesting the importance role of IL-18 in malignancy of skin tumors. Taken together, expression of IL-18 by tumor cells in human skin tissue may provide an important clue to understand the pathogenesis of malignant skin tumors.

In vitro analysis of transcriptional repression of the mouse mammary tumor virus promoter.

Transcription of the proviral DNA of mouse mammary tumor virus (MMTV) is induced by several classes of hormone-activated steroid receptor proteins. Basal promoter activity in the absence of receptor-mediated activation is selectively repressed by a distal negative regulatory element (dNRE) centered approximately 400 bp upstream of the transcription initiation site. An in vitro transcription system based on synthetic T-free cassette templates was developed to assess MMTV promoter activity, and dNRE-mediated repression was partially reconstituted with this system. Repression was observed with templates in which the dNRE was present in several sequence contexts. The activity of transcription preinitiation complexes formed in vitro in the presence of the dNRE could not be distinguished from that of complexes formed in its absence as assessed by the kinetics of transcript accumulation after addition of nucleoside triphosphates to preformed preinitiation complexes. dNRE-mediated repression in vitro appeared to be the result of decreased efficiency of assembly of functional transcription complexes on the MMTV promoter. However, repression could not be explained by inhibition of assembly of TATA-binding protein or transcription factor IIB into transcription complexes, as neither protein decreased the extent of repression when supplied in excess as a purified recombinant protein.

Characterization of geranium (Pelargonium graveolens) chloroplast EF-Tu cDNA.

A geranium (Pelargonium graveolens) chloroplast translational elongation factor EF-Tu (tufA) cDNA was isolated. The geranium tufA cDNA is 1,584 bp long with 20 bp of 5' untranslated region (UTR) and 139 bp of 3' UTR. It encodes 474 amino acids including a putative chloroplast transit peptide of 65 amino acids. The deduced polypeptides of the geranium tufA cDNA contains four GTP binding sequences in its N-terminal region and two chloroplast EF-Tu signature regions in the C-terminal region. The predicted molecular weight of the mature geranium chloroplast EF-Tu protein was about 45,000 and its amino acid sequence identity with the chloroplast EF-Tu proteins of tobacco, pea, Arabidopsis, rice, and soybean ranges from 85% to 91%. The geranium tufA appears to exist as a single copy gene like Arabidopsis and rice, whereas other known dicot plants have more than one copy in their nuclear genomes.

Direct activation of capsaicin receptors by products of lipoxygenases: endogenous capsaicin-like substances.

Capsaicin, a pungent ingredient of hot peppers, causes excitation of small sensory neurons, and thereby produces severe pain. A nonselective cation channel activated by capsaicin has been identified in sensory neurons and a cDNA encoding the channel has been cloned recently. However, an endogenous activator of the receptor has not yet been found. In this study, we show that several products of lipoxygenases directly activate the capsaicin-activated channel in isolated membrane patches of sensory neurons. Among them, 12- and 15-(S)-hydroperoxyeicosatetraenoic acids, 5- and 15-(S)-hydroxyeicosatetraenoic acids, and leukotriene B(4) possessed the highest potency. The eicosanoids also activated the cloned capsaicin receptor (VR1) expressed in HEK cells. Prostaglandins and unsaturated fatty acids failed to activate the channel. These results suggest a novel signaling mechanism underlying the pain sensory transduction.

Dynamic chromatin remodeling in the vicinity of J chain gene for the regulation of two stage-specific genes during B cell differentiation.

Dynamic chromatin remodeling during B cell differentiation was identified in the vicinity of J chain gene. In pre-B cells, the enhancer-containing DNase I hypersensitive sites (HSSs) 3-4 were open. However, these HSSs 3-4 turned out to be unassociated with J chain gene expression, as the J chain promoter-containing HSS1 remained in a closed state. The open enhancer HSSs 3-4 in the pre-B cells might be related to the expression of a pre-B cell-specific gene upstream of the HSSs 3-4, which was identified in our Northern blot analyses. The HSSs 3-4 are then closed in the next immature and mature B cell stages until the IL-2 opens the HSSs 3-4 again as well as HSS1 to express J chain gene in the primary immune responses. The dynamic regulation of chromatin structure during B cell differentiation for the expression of two stage-specific genes will provide a good model system for the study of B cell differentiation and gene expression.

Identification of a protein that recognizes a distal negative regulatory element within the mouse mammary tumor virus long terminal repeat.

The mouse mammary tumor virus (MMTV) long terminal repeat contains a distal negative regulatory element (dNRE) that selectively represses activity of the proviral promoter in the absence of steroid hormone receptor-mediated activation. A protein, termed MMTV NRE-binding protein 1 (MNBP-1), that recognizes long terminal repeat sequences between -433 and -418 was identified by gel electrophoresis mobility shift assays and methylation interference footprinting in nuclear extracts of HeLa and Ltk(-) cells. Mutations within the defined binding site affect dNRE-mediated promoter repression in vivo. MNBP-1 has an apparent molecular mass of approximately 100 kDa as determined by gel filtration chromatography.

Capsaicin binds to the intracellular domain of the capsaicin-activated ion channel.

Capsaicin (CAP) excites small sensory neurons, causing pain, neurogenic inflammation, and other visceral reflexes. These effects have been proposed to be the result of CAP activation of a nonselective cation current. It is generally assumed that CAP binds to an extracellular domain of the membrane receptor. However, the exact binding site is not known because of the lipophilic nature of CAP. To determine whether the binding domain is extracellular or intracellular, we tested the effect of a synthetic water-soluble CAP analog, DA-5018.HCl, on current activation. CAP activated the 45 pS (at -60 mV) nonselective cation channel from either side of the membrane. However, DA-5018.HCl, which had a greater potency and efficacy than CAP, activated the channels only from the cytosolic side of the patch membrane in a capsazepine, a CAP receptor antagonist, reversible manner. When applied extracellularly, DA-5018. HCl did not, but CAP did, activate whole-cell currents in sensory neurons, as well as in oocytes expressing vanilloid receptor 1, a recently cloned CAP receptor. Hydrogen ions, reported as a possible endogenous activator of cation current, failed to elicit any current when acidic medium (pH 5.0-6.0) was applied intracellularly, indicating that H+ does not mediate the CAP effect. These results indicate that CAP and its analog bind to the cytosolic domain of the CAP receptor and suggest that an endogenous CAP-like substance other than H+ may be present in the cell.

RNA polymerase II transcription complex assembly in nuclear extracts.

In vitro transcription systems based on nuclear extracts of eukaryotic cells continue to be valuable experimental systems for assessing function of promoter sequences and defining new activities involved in transcription complex assembly and activity, but many aspects of such systems have not been experimentally examined. Here, transcription complex assembly on the promoter from the long terminal repeat of mouse mammary tumor virus was assessed in vitro with a transcription system derived from nuclear extracts of cultured HeLa cells. The extent of preinitiation complex assembly on the promoter was limited by the availability of template, even though only a small fraction of the template present in the assays participated in transcription. These results support a model for transcription complex assembly in which template DNA has two alternative fates, one leading to assembly of a functional transcription complex, and another that leads to irreversible template inactivation. The observed kinetics of assembly reflects loss of template by both pathways and is dominated by a relatively rapid rate of template inactivation. Supplementing nuclear extracts with purified TATA binding protein increased the extent as well as the apparent rate of assembly. Both effects can be explained by a TATA binding protein-dependent increase in the rate of assembly that leads to altered partitioning of template between competing pathways.

A stage-specific enhancer of immunoglobulin J chain gene is induced by interleukin-2 in a presecretor B cell stage.

Interleukin-2 (IL-2)-induced transcription of the J chain gene was used as a model for analyzing cytokine regulation during B cell development. To determine whether IL-2 signals are targeted to a J chain gene enhancer as well as to its promoter, the sequences flanking the J chain gene were first examined for DNase I hypersensitivity. Of six sites identified, two strong ones, 7.5 kb upstream of the J chain gene, were found to be associated with an enhancer that is active only during the antigen-driven stages of B cell development. Further analyses of the enhancer in the IL-2-responsive presecretor BCL1 cells showed that the enhancer is activated at this stage by an IL-2 signal that functions by opening the enhancer chromatin and stimulating STAT5 to bind to a STAT5 element critical for the enhancer induction. Moreover, after this early induction stage, the enhancer was shown to be constitutively open and active in terminally differentiated plasma cells.