Flap reconstruction of the hypopharynx: a defect orientated approach

The present retrospective analysis evaluated the outcomes of different flap reconstructions for several hypopharyngeal defects in 136 patients who underwent hypopharyngeal reconstruction with a free or pedicled flap after excision of pharyngeal or laryngeal carcinoma.Functional and oncological outcome were the main measures. Nine patients had a type I-a hypopharyngeal defect (partial with larynx preserved), 33 type I-b (partial without larynx preserved), 85 type II (circumferential), 5 type III (extensive superior) and 4 vertical hemipharyngolaryngectomy. The flaps used to reconstruct these defects were pectoralis major (n = 34), free radial forearm (n = 25), jejunum (n = 72), pedicled latissimus dorsi (n = 2), sternocleidomastoid (n = 1), lateral thigh (n = 1) and deltopectoral (n = 1). Twelve defects (9%) needed a secondary flap reconstruction. Surgical and medical complications were seen in 29% and 8% of patients, respectively; 18% of patients developed a fistula. No difference in complication rate or admission days was found for pre-operative versus no previous radiotherapy, type of defect or free versus pedicled flap. After 12 months follow-up, 38% of patients had a tracheo-oesophageal voice prosthesis, in 82% a fully oral diet was obtained and the average body weight gain was 0.9 kg. Five-year overall and disease-specific survival rates were 35% and 49%, respectively, while local and regional control rates were 65% and 91%, respectively. Considering these results, a defect orientated approach may be helpful for deciding which flap should be used for reconstruction of the hypopharynx. An algorithm is proposed with similar functional and oncological outcomes for the different groups. The choice of flap should be based on expected morbidity and functional outcome

In-gas-cell laser ionization spectroscopy in the vicinity of 100Sn: Magnetic moments and mean-square charge radii of N=50-54 Ag

In-gas-cell laser ionization spectroscopy studies on the neutron deficient 97-101Ag isotopes have been performed with the LISOL setup. Magnetic dipole moments and mean-square charge radii have been determined for the first time with the exception of 101Ag, which was found in good agreement with previous experimental values. The reported results allow tentatively assigning the spin of 97,99Ag to 9/2 and confirming the presence of an isomeric state in these two isotopes, whose collapsed hyperfine structure suggests a spin of 1/2 . The effect of the N=50 shell closure is not only manifested in the magnetic moments but also in the evolution of the mean-square charge radii of the isotopes investigated, in accordance with the spherical droplet model predictions

Genetic diversity of Streptococcus suis isolates as determined by comparative genome hybridization

<p>Abstract</p> <p>Background</p> <p><it>Streptococcus suis </it>is a zoonotic pathogen that causes infections in young piglets. <it>S. suis </it>is a heterogeneous species. Thirty-three different capsular serotypes have been described, that differ in virulence between as well as within serotypes.</p> <p>Results</p> <p>In this study, the correlation between gene content, serotype, phenotype and virulence among 55 <it>S. suis </it>strains was studied using Comparative Genome Hybridization (CGH). Clustering of CGH data divided <it>S. suis </it>isolates into two clusters, A and B. Cluster A isolates could be discriminated from cluster B isolates based on the protein expression of extracellular factor (EF). Cluster A contained serotype 1 and 2 isolates that were correlated with virulence. Cluster B mainly contained serotype 7 and 9 isolates. Genetic similarity was observed between serotype 7 and serotype 2 isolates that do not express muramidase released protein (MRP) and EF (MRP^-EF^-), suggesting these isolates originated from a common founder. Profiles of 25 putative virulence-associated genes of <it>S. suis </it>were determined among the 55 isolates. Presence of all 25 genes was shown for cluster A isolates, whereas cluster B isolates lacked one or more putative virulence genes. Divergence of <it>S. suis </it>isolates was further studied based on the presence of 39 regions of difference. Conservation of genes was evaluated by the definition of a core genome that contained 78% of all ORFs in P1/7.</p> <p>Conclusions</p> <p>In conclusion, we show that CGH is a valuable method to study distribution of genes or gene clusters among isolates in detail, yielding information on genetic similarity, and virulence traits of <it>S. suis </it>isolates.</p

Correction to: Pattern recognition and pharmacokinetic methods on DCE-MRI data for tumor hypoxia mapping in sarcoma

The article Pattern recognition and pharmacokinetic methods on DCE-MRI data for tumor hypoxia mapping in sarcoma, written by M. Venianaki, O. Salvetti, E. de Bree, T. Maris, A. Karantanas, E. Kontopodis, K. Nikiforaki, K. Marias, was originally published electronically without open access

Pattern recognition and pharmacokinetic methods on DCE-MRI data for tumor hypoxia mapping in sarcoma

The main purpose of this study is to analyze the intrinsic tumor physiologic characteristics in patients with sarcoma through model-free analysis of dynamic contrast enhanced MR imaging data (DCE-MRI). Clinical data were collected from three patients with two different types of histologically proven sarcomas who underwent conventional and advanced MRI examination prior to excision. An advanced matrix factorization algorithm has been applied to the data, resulting in the identification of the principal time-signal uptake curves of DCE-MRI data, which were used to characterize the physiology of the tumor area, described by three different perfusion patterns i.e. hypoxic, well-perfused and necrotic one. The performance of the algorithm was tested by applying different initialization approaches with subsequent comparison of their results. The algorithm was proven to be robust and led to the consistent segmentation of the tumor area in three regions of different perfusion, i.e. well- perfused, hypoxic and necrotic. Results from the model-free approach were compared with a widely used pharmacokinetic (PK) model revealing significant correlations