The Combination of D-dimer and Glasgow Prognostic Score Can Be Useful in Predicting VTE in Patients with Stage IIIC and IVA Ovarian Cancer

Cancer patients have increased risk of venous thromboembolism (VTE) that must be assessed before treatment. This study aimed to determine effective VTE biomarkers in gynecologic cancer (GC). We investigated the correlation between D-dimer levels, Khorana risk score (KRS), Glasgow prognostic score (GPS), and VTE in 1499 GC patients (583 cervical cancer (CC), 621 endometrial cancer (EC), and 295 ovarian cancer (OC) patients) treated at our institution between January 2008 and December 2019. χ2 and Mann–Whitney U-tests were used to determine statistical significance. We used receiver operating characteristic-curve analysis to evaluate the discriminatory ability of each parameter. D-dimer levels were significantly correlated with KRS and GPS in patients with GC. VTE was diagnosed in 11 CC (1.9%), 27 EC (4.3%), and 39 OC patients (13.2%). Optimal D-dimer cut-off values for VTE were 3.1, 3.2, and 3.9 μg/ml in CC, EC and OC patients, respectively. D-dimer could significantly predict VTE in all GC patients. Furthermore, D-dimer combined with GPS was more accurate in predicting VTE than other VTE biomarkers in stage IIIC and IVA OC (AUC: 0.846; p<0.001). This study demonstrates that combined D-dimer and GPS are useful in predicting VTE in patients with OC

Tumor size before image-guided brachytherapy is an important factor of local control after radiotherapy for cervical squamous cell carcinoma: analysis in cases using central shielding

We analyzed the local control (LC) of cervical squamous cell carcinoma treated by computed tomography (CT)-based image-guided brachytherapy (IGBT) using central shielding (CS). We also examined the value of tumor diameter before brachytherapy (BT) as a factor of LC. In total, 97 patients were analyzed between April 2016 and March 2020. Whole-pelvic (WP) radiotherapy (RT) with CS was performed, and the total pelvic sidewall dose was 50 or 50.4 Gy; IGBT was delivered in 3-4 fractions. The total dose was calculated as the biologically equivalent dose in 2 Gy fractions, and distribution was modified manually by graphical optimization. The median follow-up period was 31.8 months (6.3-63.2 months). The 1- and 2-year LC rates were 89% and 87%, respectively. The hazard ratio was 10.11 (95% confidence interval: 1.48-68.99) for local recurrence in those with a horizontal tumor diameter >= 4 cm compared to those with = 4 cm, different treatment strategies such as employing interstitial-BT for dose escalation may be necessary

Healing of two‐wall intra‐bony defects treated with a novel EMD‐liquid—A pre‐clinical study in monkeys

AimTo investigate the effect of a novel enamel matrix derivative formulation (EMD‐liquid or Osteogain) combined with an absorbable collagen sponge (ACS) on periodontal wound healing in intra‐bony defects in monkeys.Materials and MethodsChronic two‐wall intra‐bony defects were created at the distal aspect of eight teeth in three monkeys (Macaca fascicularis). The 24 defects were randomly assigned to one of the following treatments: (i) open flap debridement (OFD) + ACS alone, (ii) OFD + Emdogain + ACS (Emdogain/ACS), (iii) OFD + Osteogain + ACS (Osteogain/ACS) or (iv) OFD alone. At 4 months, the animals were euthanized for histologic evaluation.ResultsOsteogain/ACS resulted in more consistent formation of cementum, periodontal ligament and bone with limited epithelial proliferation compared to OFD alone, Emdogain/ACS and OFD + ACS. Among the four treatment groups, the Osteogain/ACS group demonstrated the highest amount of regenerated tissues. However, complete periodontal regeneration was not observed in any of the defects in the four groups.ConclusionsThe present findings indicate that in two‐wall intra‐bony defects, reconstructive surgery with Osteogain/ACS appears to be a promising novel approach for facilitating periodontal wound healing/regeneration, thus warranting further clinical testing.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141785/1/jcpe12825.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141785/2/jcpe12825_am.pd

Effects of EMD liquid (Osteogain) on periodontal healing in class III furcation defects in monkeys

AimTo evaluate the effect of a novel liquid carrier system of enamel matrix derivative (Osteogain) soaked on an absorbable collagen sponge (ACS) upon periodontal wound healing/regeneration in furcation defects in monkeys.Materials and MethodsThe stability of the conventional enamel matrix derivative (Emdogain) and Osteogain adsorbed onto ACS was evaluated by ELISA. Chronic class III furcation defects were created at teeth 36, 37, 46, 47 in three monkeys (Macaca fascicularis). The 12 defects were assigned to one of the following treatments: (1) open flap debridement (OFD) + ACS, (2) OFD+Emdogain/ACS, (3) OFD+Osteogain/ACS, and (4) OFD alone. At 16 weeks following reconstructive surgery, the animals were killed for histological evaluation.ResultsA 20–60% significantly higher amount of total adsorbed amelogenin was found for ACS‐loaded Osteogain when compared to Emdogain. The histomorphometric analysis revealed that both approaches (OFD + Emdogain/ACS and OFD + Osteogain/ACS) resulted in higher amounts of connective tissue attachment and bone formation compared to treatment with OFD + ACS and OFD alone. Furthermore, OFD + Osteogain/ACS group showed higher new attachment formation, cementum, and new bone area.ConclusionsWithin their limits, the present data indicate that Osteogain possesses favourable physicochemical properties facilitating adsorption of amelogenin on ACS and may additionally enhance periodontal wound healing/regeneration when compared to Emdogain.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136308/1/jcpe12663.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136308/2/jcpe12663_am.pd

Parabolic Jets from the Spinning Black Hole in M87

The M87 jet is extensively examined by utilizing general relativistic magnetohydrodynamic (GRMHD) simulations as well as the steady axisymmetric force-free electrodynamic (FFE) solution. Quasi-steady funnel jets are obtained in GRMHD simulations up to the scale of $\sim 100$ gravitational radius ($r_{\rm g}$) for various black hole (BH) spins. As is known, the funnel edge is approximately determined by the following equipartitions; i) the magnetic and rest-mass energy densities and ii) the gas and magnetic pressures. Our numerical results give an additional factor that they follow the outermost parabolic streamline of the FFE solution, which is anchored to the event horizon on the equatorial plane. We also identify the matter dominated, non-relativistic corona/wind play a dynamical role in shaping the funnel jet into the parabolic geometry. We confirm a quantitative overlap between the outermost parabolic streamline of the FFE jet and the edge of jet sheath in VLBI observations at $\sim 10^{1}$-$10^{5} \, r_{\rm g}$, suggesting that the M87 jet is likely powered by the spinning BH. Our GRMHD simulations also indicate a lateral stratification of the bulk acceleration (i.e., the spine-sheath structure) as well as an emergence of knotty superluminal features. The spin characterizes the location of the jet stagnation surface inside the funnel. We suggest that the limb-brightened feature could be associated with the nature of the BH-driven jet, if the Doppler beaming is a dominant factor. Our findings can be examined with (sub-)mm VLBI observations, giving a clue for the origin of the M87 jet.Comment: 29 pages, 23 figures, accepted for publication in Ap