Comparison of Promoter Hypermethylation Pattern in Salivary Rinses Collected with and without an Exfoliating Brush from Patients with HNSCC

Background: Salivary rinses have been recently proposed as a valuable resource for the development of epigenetic biomarkers for detection and monitoring of head and neck squamous cell carcinoma (HNSCC). Both salivary rinses collected with and without an exfoliating brush from patients with HNSCC are used in detection of promoter hypermethylation, yet their correlation of promoter hypermethylation has not been evaluated. This study was to evaluate the concordance of promoter hypermethylation between salivary rinses collected with and without an exfoliating brush from patients with HNSCC. Methodolgy: 57 paired salivary rinses collected with or without an exfoliating brush from identical HNSCC patients were evaluated for promoter hypermethylation status using Quantitative Methylation-Specific PCR. Target tumor suppressor gene promoter regions were selected based on our previous studies describing a panel for HNSCC screening an

Cranioplasty Using a Mixture of Biologic and Nonbiologic Agents

IMPORTANCE: A surgeon faces challenges with cranioplasty techniques to achieve a successful result with relatively few complications. OBJECTIVE: To describe a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty with favorable outcomes and low occurrence of complications. DESIGN, SETTING, AND PARTICIPANTS: A retrospective medical records review of all 26 patients who underwent primary cranioplasty procedure with a modified technique between January 2011 and December 2015 at a high-volume head and neck oncologic reconstructive practice was conducted; data analysis was also performed during that period. After several years of experience with traditional cranioplasty maneuvers, the modified technique has evolved to incorporate both autologous bone grafts and alloplastic materials in the formation of a shapeable on-lay material. Data were collected on demographics, need for cranioplasty, materials used, outcomes, and risk factors. MAIN OUTCOMES AND MEASURES: Rates of infection, hematoma, flap loss or resorption, cerebrospinal fluid leak, hardware exposure or malfunction, and repeated reconstruction. RESULTS: Of the 26 patients, 21 (81%) were men; mean (SD) age was 65.8 (14.3) years. Eight (31%) patients had a history of diabetes, 4 (15%) patients were receiving immunosuppressive drugs, and 5 (19%) patients were active smokers at the time of surgery. Neoplasia was the most common cause of the calvarial defect seen, responsible for 20 of 28 (71%) operative defects and necessitated procedures. All but 1 patient achieved successful mineralization following primary cranioplasty with the modified technique; this success was verified based on physical examination and follow-up imaging. Complications were rare and involved only 3 patients who developed postoperative infection; 1 (4%) of these patients lost the integrity of the cranioplasty. Thus, the rate of infection was 11% and loss rate was 4%. Preoperative and postoperative radiotherapy appeared to have no bearing on graft survival. CONCLUSIONS AND RELEVANCE: The results using a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty are favorable, with satisfactory aesthetic outcomes and limited postoperative complications. LEVEL OF EVIDENCE: 4

The Role of Subcutaneous Radiofrequency-Assisted Liposculpture in the Facial Plastic Surgeon\u27s Practice.

Importance: Percutaneous radiofrequency-based skin tightening procedures can offer patients an option to undergo a potential treatment for skin laxity and excess adipose of the face and neck with less downtime, lower cost, and decreased risk of complications compared with more aggressive open procedures such as neck lift, face and neck lift, and platysmaplasty. Observations: FaceTite and AccuTite can safely yet effectively deliver energy into the subdermal space, targeting the dermal collagen network and deeper fascial layer. Ideal candidates have early jowl formation, mild to moderate skin laxity, and submental adiposity. Relevance & Conclusions: From the perspective of facial plastic surgeons, these procedures can enhance the volume of an aesthetic practice by welcoming patients who may not otherwise present for face and neck rejuvenation out of fear from surgery. Furthermore, many of these minimally invasive patients will ultimately return for surgical rejuvenation later in life

Transcutaneous Radiofrequency Microneedling in the Facial Plastic Surgeon\u27s Practice: A Review.

Importance: Minimally invasive methods for skin rejuvenation are in high demand. A diverse array of minimally invasive devices has been developed for aesthetical purposes and should be considered to help patients achieve their goals. Observations: Radiofrequency (RF) microneedling is a safe and effective intervention for treatment of various aesthetical and dermatological conditions in all skin types. This review highlights Morpheus8 (InMode, Inc., Irvine, CA) and what differentiates it from other similar devices. Conclusions and Relevance: RF microneedling addresses aesthetical and dermatological concerns for a diverse variety of patients in whom surgical intervention may not be desired. Morpheus8 has unique technological properties and advances that make it the preferred device for many practices

Concordance between salivary rinses collected with or without an exfoliating brush from 57 HNSCC patients.

§<p>WB = salivary rinses collected with an exfoliating brush.</p>‡<p>WOB = salivary rinses collected without a brush.</p>§§<p>CI = Confidence Interval.</p

Frequency of promoter methylation of the seven genes analyzed in the salivary rinses collected with or without an exfoliating brush from 57 HNSCC patients, and Spearman correlation of promoter methylation levels.

§<p>WB = salivary rinses collected with an exfoliating brush.</p>‡<p>WOB = salivary rinses collected without a brush.</p

Aberrant promoter methylation in the DNAs from salivary rinses collected with or without an exfoliating brush from 57 HNSCC cancer patients.

<p>Each column represents a patient, and each row the methylation status of the given gene in salivary samples collected with brush or without brush. Black shading indicates promoter hypermethylation and white indicates lack of promoter methylation. WB, salivary rinses collected with an exfoliating brush; WOB, salivary rinses collected without brush.</p