Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck.

OBJECTIVE:The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4-6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival. STUDY DESIGN:Retrospective database review. SETTING:All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California. SUBJECTS AND METHODS:The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances. RESULTS:Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034). CONCLUSION:The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients

Complement C3 variant and the risk of age-related macular degeneration

Background: Age-related macular degeneration is the most common cause of blindness in Western populations. Susceptibility is influenced by age and by genetic and environmental factors. Complement activation is implicated in the pathogenesis.Methods: We tested for an association between age-related macular degeneration and 13 single-nucleotide polymorphisms (SNPs) spanning the complement genes C3 and C5 in case subjects and control subjects from the southeastern region of England. All subjects were examined by an ophthalmologist and had independent grading of fundus photographs to confirm their disease status. To test for replication of the most significant findings, we genotyped a set of Scottish cases and controls.Results: The common functional polymorphism rs2230199 (Arg80Gly) in the C3 gene, corresponding to the electrophoretic variants C3S (slow) and C3F (fast), was strongly associated with age-related macular degeneration in both the English group (603 cases and 350 controls, P=5.9 x 10(sup -5)) and the Scottish group (244 cases and 351 controls, P=5.0 x 10(sup -5)). The odds ratio for age-related macular degeneration in C3 S/F heterozygotes as compared with S/S homozygotes was 1.7 (95% confidence interval [CI], 1.3 to 2.1); for F/F homozygotes, the odds ratio was 2.6 (95% CI, 1.6 to 4.1). The estimated population attributable risk for C3F was 22%.Conclusions: Complement C3 is important in the pathogenesis of age-related macular degeneration. This finding further underscores the influence of the complement pathway in the pathogenesis of this disease

Measuring hearing in wild beluga whales

Author Posting. © The Author(s), 2016. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in "The Effects of Noise on Aquatic Life II," edited by Arthur N. Popper, Anthony Hawkins, 729-735. New York, NY: Springer, 2016. doi: 10.1007/978-1-4939-2981-8_88.We measured the hearing abilities of seven wild beluga whales (Delphinapterus leucas) during a collection-and-release experiment in Bristol Bay, AK, USA. Here we summarize the methods and initial data from one animal, discussing the implications of this experiment. Audiograms were collected from 4-150 kHz. The animal with the lowest threshold heard best at 80 kHz and demonstrated overall good hearing from 22-110 kHz. The robustness of the methodology and data suggest AEP audiograms can be incorporated into future collection-and-release health assessments. Such methods may provide high-quality results for multiple animals facilitating population-level audiograms and hearing measures in new species.Project funding and field support provided by Georgia Aquarium and the National Marine Mammal Laboratory of the Alaska Fisheries Science Center (NMML/AFSC). Field work also supported by National Marine Fisheries Service Alaska Regional Office (NMFS AKR), WHOI Arctic Research Initiative, WHOI Ocean Life Institute, U.S. Fish and Wildlife Service, Bristol Bay Native Association, Alaska SeaLife Center, Shedd Aquarium and Mystic Aquarium. Audiogram analyses were funded by the Office of Naval Research award number N000141210203 (from Michael Weise)

Sperm design and variation in the New World blackbirds (Icteridae)

Post-copulatory sexual selection (PCSS) is thought to be one of the evolutionary forces responsible for the rapid and divergent evolution of sperm design. However, whereas in some taxa particular sperm traits are positively associated with PCSS, in other taxa, these relationships are negative, and the causes of these different patterns across taxa are poorly understood. In a comparative study using New World blackbirds (Icteridae), we tested whether sperm design was influenced by the level of PCSS and found significant positive associations with the level of PCSS for all sperm components but head length. Additionally, whereas the absolute length of sperm components increased, their variation declined with the intensity of PCSS, indicating stabilizing selection around an optimal sperm design. Given the diversity of, and strong selection on, sperm design, it seems likely that sperm phenotype may influence sperm velocity within species. However, in contrast to other recent studies of passerine birds, but consistent with several other studies, we found no significant link between sperm design and velocity, using four different species that vary both in sperm design and PCSS. Potential reasons for this discrepancy between studies are discussed

Clusters of circulating tumor cells traverse capillary-sized vessels

Multicellular aggregates of circulating tumor cells (CTC clusters) are potent initiators of distant organ metastasis. However, it is currently assumed that CTC clusters are too large to pass through narrow vessels to reach these organs. Here, we present evidence that challenges this assumption through the use of microfluidic devices designed to mimic human capillary constrictions and CTC clusters obtained from patient and cancer cell origins. Over 90% of clusters containing up to 20 cells successfully traversed 5- to 10-μm constrictions even in whole blood. Clusters rapidly and reversibly reorganized into single-file chain-like geometries that substantially reduced their hydrodynamic resistances. Xenotransplantation of human CTC clusters into zebrafish showed similar reorganization and transit through capillary-sized vessels in vivo. Preliminary experiments demonstrated that clusters could be disrupted during transit using drugs that affected cellular interaction energies. These findings suggest that CTC clusters may contribute a greater role to tumor dissemination than previously believed and may point to strategies for combating CTC cluster-initiated metastasis

Catheter Balloon Adjustment of the Pulmonary Artery Band: Feasibility and Safety

The study aimed to assess the feasibility and safety of increasing pulmonary artery band (PAB) diameter by catheter-based PAB balloon dilation (PABBD). Eight dilations were performed between October 2006 and December 2008. Hemoclips were used to fix PABs surgically in a procedure designed to permit progressive clip dislodgment in a controlled manner. The PABBD resulted in gradual band loosening until the desired physiologic state was achieved. At time of PABBD, the patients had a mean age of 6 months (range 3–14 months) and a mean weight of 5 kg (range 2.6–7.3 kg). The median time from PAB placement until PABBD was 4.5 months (range 1–9 months). The single-balloon technique was used in seven cases (serial dilations in 5 cases) and the double-balloon technique in one case. The PABBDs were successful for all the patients, who experienced a mean saturation increase of 75–89% (P = 0.01) (mean increase of 20%), a mean PAB gradient decrease from 69 to 36 mmHg (P = 0.002) (mean decrease of 49%), and a mean band site diameter increase from 4.1 to 6.1 mm (P = 0.01) (mean increase of 45%). The only complication was transient pulmonary edema in one patient. The PABBD procedure is a feasible and safe method for increasing pulmonary blood flow in a staged manner and may eliminate the need for surgical band removal in some cases

Carotid axillary bypass in a patient with blocked subclavian stents: a case report

<p>Abstract</p> <p>Introduction</p> <p>Surgical treatment of symptomatic occlusive lesions of the proximal subclavian artery is infrequently necessary. Carotid subclavian bypass has gained popularity and is now considered standard treatment when stenting is not possible. Exposure of the subclavian artery and bypass grafting onto it is difficult, as the vessel is delicate, thin-walled and located deep in the supraclavicular fossa. The thoracic duct and brachial plexus are in close proximity to the left subclavian artery and are therefore susceptible to damage. Distal grafting to the axillary artery instead of the subclavian artery has the potential of avoiding some of these risks. Infraclavicular exposure of the axillary artery is more straightforward. The vessel wall is thicker and is easier to handle. In this case report, we describe a patient with a left proximal subclavian occlusion which was stented twice and blocked on both occasions. The patient underwent a carotid axillary bypass, as grafting onto the subclavian artery was impossible because of the two occluded metal stents.</p> <p>Case presentation</p> <p>A 56-year-old Caucasian woman, a heavy smoker, presented acutely with left arm numbness and pain and blood pressure discrepancies in both arms. A diagnosis of subclavian stenosis was confirmed on the basis of a computed tomographic scan and a magnetic resonance angiogram. The patient had undergone subclavian artery stenting twice, and unfortunately the stents blocked on both occasions. The patient underwent carotid axillary bypass surgery. She had an uneventful recovery and was able to return to a full, normal life.</p> <p>Conclusion</p> <p>Carotid axillary bypass appears to be a good alternative to carotid subclavian bypass in the treatment of symptomatic proximal stenosis or occlusion of the subclavian artery.</p