Anterior referencing versus posterior referencing in total knee arthroplasty: a prospective observational study

Background: Femoral component rotation in total knee arthroplasty (TKA) is essential for patella-femoral tracking, flexion gap balance and normal kinematic function of the knee. The two referencing techniques used for sizing and adjudging the femoral rotation are anterior referencing (AR) and posterior referencing (PR).The current study was designed so as to identify which referencing system determines the femoral rotation more accurately.Methods: This study involved 34 consecutive patients (22 females and 12 males) with 60 osteoarthritic knees (bilateral=26; unilateral =8) who satisfied the inclusion criteria. The trans-epicondylar axis, was taken as gold standard to adjudge the correct femoral rotation and was marked as E. The axis of rotation as per anterior instrumentation (A), and as per posterior instrumentation (P) were marked and compared as to which of the axis (A or P) was parallel to E.Results: A was always parallel to E, however P was parallel to E in 42 knees. In 18 knees (6 with valgoid deformity, 12 with hypertrophic osteoarthritis involving the medial femoral condyle), P and E tend to converge laterally, suggestive of excessive internal rotation. Conclusions: Anterior referencing determines femoral rotation more accurately than posterior referencing for knees with severe valgoid deformity or those with hypertrophic osteoarthritis involving the overgrowth of medial femoral condyle

Neoadjuvant chemotherapy or chemoradiotherapy in head and neck cancer

The multidisciplinary approach to treating squamous cell carcinoma of the head and neck is complex and evolving. Chemotherapy is increasingly being incorporated into the treatment of squamous cell carcinoma of the head and neck. Previously, radiotherapy following surgery was the standard approach to the treatment of loco regionally advanced resectable disease. Data from randomized trials have confirmed the benefits of concurrent chemo radiotherapy in the adjuvant setting. Chemo radiotherapy is also the recommended approach for unresectable disease. Advanced loco regional disease is the most frequent clinical situation in Head and Neck cancer. The standard of care for most clinicians is a multidisciplinary treatment with concomitant chemotherapy plus radiotherapy (CRT). However, retrospective studies have shown that in patients treated with CRT there was a relative increase in systemic relapse due to a lack of systemic control. For this reason a renewed interest has appeared for the incorporation of induction chemotherapy in the treatment of locally advanced Head and Neck Cancer. Furthermore new combination regimens with taxanes have shown to be more active than the classical cisplatin and 5-fluorouracil induction regimen. Novel targeted agents, such as epidermal growth factor receptor antagonists, are showing promise in the treatment of patients with both loco regionally advanced and recurrent/metastatic squamous cell carcinoma of the head and neck

Neoadjuvant chemotherapy or chemoradiotherapy in head and neck cancer

The multidisciplinary approach to treating squamous cell carcinoma of the head and neck is complex and evolving. Chemotherapy is increasingly being incorporated into the treatment of squamous cell carcinoma of the head and neck. Previously, radiotherapy following surgery was the standard approach to the treatment of loco regionally advanced resectable disease. Data from randomized trials have confirmed the benefits of concurrent chemo radiotherapy in the adjuvant setting. Chemo radiotherapy is also the recommended approach for unresectable disease. Advanced loco regional disease is the most frequent clinical situation in Head and Neck cancer. The standard of care for most clinicians is a multidisciplinary treatment with concomitant chemotherapy plus radiotherapy (CRT). However, retrospective studies have shown that in patients treated with CRT there was a relative increase in systemic relapse due to a lack of systemic control. For this reason a renewed interest has appeared for the incorporation of induction chemotherapy in the treatment of locally advanced Head and Neck Cancer. Furthermore new combination regimens with taxanes have shown to be more active than the classical cisplatin and 5-fluorouracil induction regimen. Novel targeted agents, such as epidermal growth factor receptor antagonists, are showing promise in the treatment of patients with both loco regionally advanced and recurrent/metastatic squamous cell carcinoma of the head and neck

14-3-3epsilon contributes to tumour suppression in laryngeal carcinoma by affecting apoptosis and invasion

<p>Abstract</p> <p>Background</p> <p>14-3-3epsilon regulates a wide range of biological processes, including cell cycle control, proliferation, and apoptosis, and plays a significant role in neurogenesis and the formation of malignant tumours. However, the exact function and regulatory mechanism of 14-3-3epsilon in carcinogenesis have not been elucidated.</p> <p>Methods</p> <p>The expression of <it>14-3-3epsilon </it>was assessed by RT-PCR and western blotting. The invasiveness and viability of Hep-2 cells were determined by the transwell migration assay and MTT assay, respectively. Cell cycle and apoptosis of Hep-2 cells were detected by flow cytometry.</p> <p>Results</p> <p>The mRNA and protein expression of <it>14-3-3epsilon </it>in larynx squamous cell carcinoma (LSCC) tissues were significantly lower than those in clear surgical margin tissues. Statistical analysis showed that the 14-3-3epsilon protein level in metastatic lymph nodes was lower than that in paired tumour tissues. In addition, the protein level of 14-3-3epsilon in stage III or IV tumours was significantly lower than that in stage I or II tumours. Compared with control Hep-2 cells, the percentages of viable cells in the 14-3-3epsilon-GFP and negative control GFP groups were 36.68 ± 14.09% and 71.68 ± 12.10%, respectively. The proportions of S phase were 22.47 ± 3.36%, 28.17 ± 3.97% and 46.15 ± 6.82%, and the apoptotic sub-G1 populations were 1.23 ± 1.02%, 2.92 ± 1.59% and 13.72 ± 3.89% in the control, negative control GFP and 14-3-3epsilon-GFP groups, respectively. The percentages of the apoptotic cells were 0.84 ± 0.25%, 1.08 ± 0.24% and 2.93 ± 0.13% in the control, negative control GFP and 14-3-3epsilon-GFP groups, respectively. The numbers of cells that penetrated the filter membrane in the control, negative control GFP and 14-3-3epsilon-GFP groups were 20.65 ± 1.94, 17.63 ± 1.04 and 9.1 ± 0.24, respectively, indicating significant differences among the different groups.</p> <p>Conclusions</p> <p>Decreased expression of <it>14-3-3epsilon </it>in LSCC tissues contributes to the initiation and progression of LSCC. <it>14-3-3epsilon </it>can promote apoptosis and inhibit the invasiveness of LSCC.</p

Durable response with single-agent acalabrutinib in patients with relapsed or refractory mantle cell lymphoma

Bruton tyrosine kinase (BTK) inhibitors have greatly improved the spectrum of treatment options in mantle cell lymphoma (MCL) [1–4]. Acalabrutinib is a highly selective, orally administered, and potent BTK inhibitor with limited off-target activity [5]. Acalabrutinib was approved in 2017 by the US Food and Drug Administration for the treatment of relapsed/refractory MCL based on clinical data from the open-label, multicenter, phase 2 ACE-LY-004 study of acalabrutinib 100 mg twice daily [1]. Here, we present updated results from the ACE-LY-004 study after a median 26-month follow-up. Eligibility criteria and study design were published previously (Supplementary methods) [1]. Analysis of minimal residual disease (MRD) was conducted after complete response (CR) or partial response (PR) was achieved using the quantitative ClonoSEQ next-generation sequencing (5 × 10−6 ) assay (Adpative Biotechnologies, Seattle, WA, USA) in consenting patients with available paired archival tumor and whole blood samples. Data are updated as of February 12, 2018