Effectiveness of the Fibrinogen-Thrombin-Impregnated Collagen Patch in the Prevention of Postoperative Complications after Parotidectomy: A Single-Blinded, Randomized Controlled Study

We investigated whether a fibrinogen-thrombin collagen sponge patch reduces postoperative complications of parotid gland surgery. This single-blinded, randomized controlled study included 165 patients who underwent parotid surgery for benign tumors (2018–2019) at a tertiary center. Primary outcomes were postoperative drain amount, days until drain removal, and discharge. Patients were scheduled for follow-up at 1 and 4 weeks, and 3 months after surgery. Complications including surgical site infection, pain, seroma, sialocele, salivary fistula, facial nerve palsy, Frey’s syndrome with subjective symptoms, and facial asymmetry were analyzed. After identifying confounding variables, multivariate approaches were used. Histologic analysis was performed in a mouse model of salivary gland surgery. In total, 162 patients (77, fibrinogen-thrombin collagen patch group; 85, controls) were included, with no significant between-group differences other than resected tissue. Among postoperative total drain amount and days until drain removal and discharge, the only postoperative total drain was significantly lower in the patch group than in the control group in the adjusted model. Additionally, although validation through robust trials with longer follow-up is needed, we found the potential benefit of the fibrinogen patch on Frey’s syndrome and facial asymmetry. In conclusion, fibrinogen-thrombin-impregnated collagen patches in parotidectomy can reduce postoperative drainage and improve outcomes

Cost-Based Vertical Handover Decision Algorithm for WWAN/WLAN Integrated Networks

Next generation wireless communications are expected to rely on integrated networks consisting of multiple wireless technologies. Heterogeneous networks based on Wireless Local Area Networks (WLANs) and Wireless Wide Area Networks (WWANs) can combine their respective advantages on coverage and data rates, offering a high Quality of Service (QoS) to mobile users. In such environment, multi-interface terminals should seamlessly switch from one network to another in order to obtain improved performance or at least to maintain a continuous wireless connection. Therefore, network selection algorithm is important in providing better performance to the multi-interface terminals in the integrated networks. In this paper, we propose a cost-based vertical handover decision algorithm that triggers the Vertical Handover (VHO) based on a cost function for WWAN/WLAN integrated networks. For the cost function, we focus on developing an analytical model of the expected cost of WLAN for the mobile users that enter the double-coverage area while having a connection in the WWAN. Our simulation results show that the proposed scheme achieves better performance in terms of power consumption and throughput than typical approach where WLANs are always preferred whenever the WLAN access is available

Clinical Characteristics of Temporal Bone Metastases

Objectives The purposes of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy. Methods We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups. Results The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively). Conclusion If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do

Effectiveness of the Fibrinogen-Thrombin-Impregnated Collagen Patch in the Prevention of Postoperative Complications after Parotidectomy: A Single-Blinded, Randomized Controlled Study

We investigated whether a fibrinogen-thrombin collagen sponge patch reduces postoperative complications of parotid gland surgery. This single-blinded, randomized controlled study included 165 patients who underwent parotid surgery for benign tumors (2018–2019) at a tertiary center. Primary outcomes were postoperative drain amount, days until drain removal, and discharge. Patients were scheduled for follow-up at 1 and 4 weeks, and 3 months after surgery. Complications including surgical site infection, pain, seroma, sialocele, salivary fistula, facial nerve palsy, Frey’s syndrome with subjective symptoms, and facial asymmetry were analyzed. After identifying confounding variables, multivariate approaches were used. Histologic analysis was performed in a mouse model of salivary gland surgery. In total, 162 patients (77, fibrinogen-thrombin collagen patch group; 85, controls) were included, with no significant between-group differences other than resected tissue. Among postoperative total drain amount and days until drain removal and discharge, the only postoperative total drain was significantly lower in the patch group than in the control group in the adjusted model. Additionally, although validation through robust trials with longer follow-up is needed, we found the potential benefit of the fibrinogen patch on Frey’s syndrome and facial asymmetry. In conclusion, fibrinogen-thrombin-impregnated collagen patches in parotidectomy can reduce postoperative drainage and improve outcomes

Is Maintaining Thyroid-Stimulating Hormone Effective in Patients Undergoing Thyroid Lobectomy for Low-Risk Differentiated Thyroid Cancer? A Systematic Review and Meta-Analysis

There is no clear evidence that post-operative maintenance of thyroid-stimulating hormone (TSH) in the mid to lower reference range (0.5–2 mU/L) improves prognosis in patients undergoing thyroid lobectomy for low-risk differentiated thyroid cancer (DTC). The purpose of this systematic review and meta-analysis was to compare and analyze the recurrence rate according to whether the serum TSH level was maintained below 2 mU/L in patients who underwent thyroid lobectomy for low-risk DTC. Clinical data and outcomes were collected from MEDLINE, Embase, and the Cochrane Database of Systematic Reviews. The inclusion criteria were related studies on TSH maintenance or serum TSH concentration after surgery for DTC. Seven observational studies with a total of 3974 patients were included in this study. In the patients who received TSH maintenance less than 2 mU/L, the recurrence rate during the follow-up period was 2.3%. A subgroup analysis of five studies showed that the odds ratio for recurrence in patients who received TSH maintenance was 1.45 (p-value = 0.45) compared to patients who did not receive TSH maintenance. In conclusion, the evidence for the effectiveness of post-operative TSH maintenance less than 2 mU/L in patients undergoing thyroid lobectomy for low-risk DTC is insufficient

Analysis of expressions of deglutamylases (<i>CCP1</i>, <i>Ccp4</i>, <i>CCP5</i>, <i>and CCP6</i>) in testes and ovaries of <i>pcd</i>^<i>3J+/+</i> and <i>pcd^3J-/-</i> mice using semi-quantitative RT-PCR.

<p>The double bands for <i>Ccp4</i> indicate two alternatively spliced forms of <i>Ccp4</i>. <i>Gapdh</i> was used as a quantitative control.</p

Representative images of ovulated oocytes at the MII stage from <i>pcd</i>^<i>3J+/+</i>, <i>pcd</i>^<i>3J+/-</i>, and <i>pcd</i>^<i>3J-/-</i>females, showing normal chromosomal distribution and spindle formation.

<p>Oocytes were stained with anti-α-tubulin primary and Alexa Fluor^® 568 anti-mouse IgG secondary antibodies. The nucleus was stained with DAPI. The results from 33, 35, and 30 oocytes from 4 <i>pcd</i>^<i>3J+/+</i>, 3 <i>pcd</i>^<i>3J+/-</i>, and 3 <i>pcd</i>^<i>3J-/-</i> females, respectively, were analyzed. For <i>pcd</i>^<i>3J+/+</i><i>and pcd^3J+/-</i>, only a portion of the oocytes were used for immunocytochemical analysis.</p

Analysis of <i>CCP1</i> expression in GV oocytes and granulosa cells using semi-quantitative RT-PCR.

<p>Negative controls did not produce any products and are not shown.</p

Comparison of the population size of different follicular types between wild <i>pcd</i>^<i>3J+/+</i> and <i>pcd</i>^<i>3J-/-</i> females.

<p>The average numbers of primordial, primary, secondary, antral, and atretic follicles from a single ovary were determined using three each of 4- and 8-week-old ovaries. Ovaries were serially sectioned, every 10^th section was counted, and the total follicle numbers were determined. An increase in secondary follicles and a decrease in antral follicles were observed in <i>pcd</i>^<i>3J-/-</i> mice compared to the wild type, regardless of age. An asterisk indicates a significant difference (<i>P</i> < 0.05).</p