Deep Learning Prediction of Ovarian Malignancy at US Compared with O-RADS and Expert Assessment.

Background Deep learning (DL) algorithms could improve the classification of ovarian tumors assessed with multimodal US. Purpose To develop DL algorithms for the automated classification of benign versus malignant ovarian tumors assessed with US and to compare algorithm performance to Ovarian-Adnexal Reporting and Data System (O-RADS) and subjective expert assessment for malignancy. Materials and Methods This retrospective study included consecutive women with ovarian tumors undergoing gray scale and color Doppler US from January 2019 to November 2019. Histopathologic analysis was the reference standard. The data set was divided into training (70%), validation (10%), and test (20%) sets. Algorithms modified from residual network (ResNet) with two fusion strategies (feature fusion [hereafter, DLfeature] or decision fusion [hereafter, DLdecision]) were developed. DL prediction of malignancy was compared with O-RADS risk categorization and expert assessment by area under the receiver operating characteristic curve (AUC) analysis in the test set. Results A total of 422 women (mean age, 46.4 years ± 14.8 [SD]) with 304 benign and 118 malignant tumors were included; there were 337 women in the training and validation data set and 85 women in the test data set. DLfeature had an AUC of 0.93 (95% CI: 0.85, 0.97) for classifying malignant from benign ovarian tumors, comparable with O-RADS (AUC, 0.92; 95% CI: 0.85, 0.97; P = .88) and expert assessment (AUC, 0.97; 95% CI: 0.91, 0.99; P = .07), and similar to DLdecision (AUC, 0.90; 95% CI: 0.82, 0.96; P = .29). DLdecision, DLfeature, O-RADS, and expert assessment achieved sensitivities of 92%, 92%, 92%, and 96%, respectively, and specificities of 80%, 85%, 89%, and 87%, respectively, for malignancy. Conclusion Deep learning algorithms developed by using multimodal US images may distinguish malignant from benign ovarian tumors with diagnostic performance comparable to expert subjective and Ovarian-Adnexal Reporting and Data System assessment. © RSNA, 2022 Online supplemental material is available for this article.

PTEN gene polymorphisms and susceptibility to oral squamous cell carcinoma in a Chinese Han population.

The tumor suppressor gene phosphatase and tensin homologue (PTEN) plays a significant role in regulating cell growth, proliferation, and apoptosis. However, there are no data regarding the role of PTEN polymorphisms in the development of oral squamous cell carcinoma (OSCC). A hospital-based case-control study was conducted to investigate the potential association between PTEN polymorphisms and the risk of OSCC in a Chinese Han population. The study population comprised 201 patients with OSCC and 199 healthy controls. Seventeen single-nucleotide polymorphisms (SNPs) of PTEN were investigated and genotyped using Sequenom Mass ARRAY and iPLEX-MALDI-TOF technology. The observed genotype frequencies of these polymorphisms were in agreement with Hardy-Weinberg equilibrium in the control group (P > 0.05 for all). The heterozygous CT genotype was not associated with significantly increased risk for OSCC (OR = 0.89, 95 % CI = (0.55-1.42), P = 0.83), the TT genotype was not associated with increased risk for OSCC (OR = 1.01, 95 % CI = (0.58-1.74), P = 0.74) compared to the PTEN SNP rs1234224 homozygous CC genotype. Meanwhile, CT/TT variants were not associated with increased risk for OSCC compared with the CC genotype (OR = 0.93, 95 % CI = 0.60-1.44, P = 0.73). The T allele was not associated with significantly increased risk compared to the C allele (OR = 0.99, 95 % CI = 0.72-1.58, P = 0.69). Similar associations with the risk of OSCC were observed for the other genotypes of PTEN gene polymorphisms. There were no significant differences in the distribution of the genotype and allele frequencies of polymorphisms of the PTEN gene between the OSCC patients and controls in a Chinese Han population. Further studies are needed to clarify the specific roles of PTEN polymorphisms in the etiology of OSCC.

Gelsolin rs1078305 and rs10818524 polymorphisms were associated with risk of oral squamous cell carcinoma in a Chinese Han population.

BACKGROUND: Gelsolin (GSN) is one of the most abundant actin-binding proteins, and is involved in cancer development and progression. PATIENTS AND METHODS: A hospital-based case-control study including 201 patients with OSCC and 199 healthy controls was conducted. Seventeen single-nucleotide polymorphisms (SNPs) of GSN were investigated by Sequenom Mass ARRAY and iPLEX-MALDI-TOF technology. RESULTS: Through comparison of the 17 SNPs on GSN gene between the two groups, SNP rs1078305 and rs10818524 were verified to be significantly associated with an increased risk of OSCC. For GSN rs1078305, the TT genotype was associated with increased risk for OSCC (OR = 1.92, 95% CI = 1.11-3.32, p = 0.028). CT/TT variants were also associated with increased risk for OSCC compared to the CC genotype (OR = 1.83, 95% CI = 1.25-3.84, p = 0.032). CONCLUSION: The rs1078305 and rs10818524 SNPs of GSN were associated with increased risk for OSCC development in a Chinese Han population.

Use of Extended Lateral Upper Arm Free Flap for Tongue Reconstruction After Radical Glossectomy for Tongue Cancer.

BACKGROUND: This study evaluated the safety and effectiveness of the extended lateral arm free flap (ELAFF) for repair of partial tongue defects after radical resection of tongue cancer. METHODS: The study included nine consecutive patients who underwent repair of a partial tongue defect with an ELAFF after radical resection of tongue cancer from November 2010 to December 2013. Lesions were at the tip or margin of the tongue. Details of the reconstructive surgery, donor-site and recipient-site morbidity, and functional and esthetic outcomes were evaluated during a minimum of 12 months follow-up. Patient-reported Visual Analog Scale (VAS) scores on a scale of 0 (minimum satisfaction) to 10 (maximum satisfaction) were used to evaluate esthetic outcomes. RESULTS: All patients were followed up for 12 months (median 24 months). The overall survival rate was 88 % (8/9). The donor site was closed primarily in all patients. The most frequent donor-site morbidity was a broad scar. Poor functional outcomes were associated with postoperative adjuvant radiotherapy. The shape and function of the reconstructed tongue were satisfactory. VAS scores (mean ± SD) for patient satisfaction with recipient-site and donor-site esthetics were 6.92 ± 1.70 and 7.33 ± 2.01, respectively. CONCLUSION: The ELAFF is a safe and effective option for repair of partial tongue defects after radical resection of tongue cancer. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Asymmetric Synthesis of 1,3-Oxazolidine Derivatives with Multi-Component Reaction and Research of Kinetic Resolution.

An efficient multi-component reaction to synthesize multi-substituted 1,3-oxazolidine compounds of high optical purity was described. All the products were well-characterized and the absolute configuration of one chiral center was determined. The plausible mechanism was proposed and a kinetic resolution of epoxides process was confirmed.

4-(4-Bromo-phen-yl)-2,6-diphenyl-pyridine.

In the title compound, C(23)H(16)BrN, the three benzene rings show a disrotatory counter-rotating arrangement around the central pyridine ring and are twisted with respect to the pyridine ring with dihedral angles of 19.56 (13), 27.54 (13) and 30.51 (13)°.

Use of modified lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer.

BACKGROUND: To evaluate the suitability of a modified lateral upper arm free flap (LAFF) for reconstruction of soft tissue defects after resection of oral cancer. METHODS: Eighteen cases of soft tissue defect repair performed between January 2011 and December 2013 using a modified LAFF after resection of oral cancer were reviewed. The design and harvest of the LAFF, the reconstruction procedure, and postoperative morbidity were reviewed and evaluated over a follow-up period of at least 12 months. RESULTS: The overall flap survival was 94.4 % (17/18 patients). A broad scar at the donor site was the most common morbidity, but patients did not report dissatisfaction with the scar because they could easily cover it. All wounds at the donor site achieved primary recovery. One case of flap loss was repaired with a radial forearm free flap. One case complicated by diabetes mellitus involved infection of the flap with one-third of the flap becoming necrotic. This flap survived after removal of the necrotic tissue. In one other case, fat liquefactive necrosis (1.5 × 1.0 cm) occurred in the flap on the tip of the tongue, and this flap survived after debridement. Overall, the shape and function of the reconstructed tissues were well restored, and there was no severe morbidity at the donor site in any case. CONCLUSION: The modified LAFF was safe and reliable for the reconstruction of soft tissue defects after resection of oral cancer.

[Use of extend lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer].

PURPOSE: To investigate the clinical outcomes of composite lateral arm free flap to reconstruct soft tissue defect after oral cancer ablation. METHODS: Fifteen cases of soft-tissue defects were reconstructed using composite lateral arm free flap from January 2011 to December 2013. Color Doppler ultrasound blood flow detector was used to avoid variation of posterior radial collateral artery (PRCA). Composite flaps were designed according to the direction of PRCA, shape and area of the soft-tissue defect, which were over condylus lateralis humeri, with areas ranged from 4 cｍ×5 cm-11 cm×5 cm and an average vascular pedicle length of 10cm. Primary closure was achieved on all donor sites. RESULTS: Fourteen flaps survived while vascular crisis was found in one flap 1 day post operation. The flap was replaced after an invalid salvation. All patients were followed up over 12 months, no recurrence was found. All patients achieved good recovery of morphology and functions with only 2 reporting local numbness of donor sites, which were relieved after 6 months. CONCLUSIONS: Composite lateral arm free flap, with consistent anatomy, suitable thickness and reliable blood supply, is a proper method to reconstruct postoperative soft tissue defect of patients with oral carcinoma.

Stable acyclic aliphatic solid enols: synthesis, characterization, X-ray structure analysis and calculations.

A synthetic approach to stable enols was introduced and series of acyclic aliphatic solid enols were obtained and characterized. Relationship between the structure and the stability of these enols was discussed. Gaussian 09 calculations had been carried out to rationalize the stability of the enols. These enol structures were confirmed by (1)H NMR, (13)C NMR, MS, IR, partly by single crystal X-ray structure analysis and the protons exchange experiments. This work showed that very stable acyclic aliphatic enols can be synthesized efficiently without any purification.