Thyroid surgery for elderly patients: Are they at increased operative risks?

published_or_final_versio

Prostate cancer stem cells

Despite the discovery over 60 years ago by Huggins and Hodges 1 that prostate cancers respond to androgen deprivation therapy, hormone-refractory prostate cancer remains a major clinical challenge. There is now mounting evidence that solid tumours originate from undifferentiated stem cell-like cells coexisting within a heterogeneous tumour mass that drive tumour formation, maintain tumour homeostasis and initiate metastases. This review focuses upon current evidence for prostate cancer stem cells, addressing the identification and properties of both normal and transformed prostate stem cells

Studying the effect of sonographic landmarks imaged on transcutaneous laryngeal ultrasonography on perioperative vocal cord assessment

Scientific Session 8INTRODUCTION: Transcutaneous laryngeal ultrasound (TLUSG) is a non-invasive way of assessing vocal cord (VC) function. During examination, the assessor often looks at 3 sonographic landmarks (namely, false VC (FC), true VC (TC) and arytenoids (AR)) to ascertain VC movement. However, it is unclear among these landmarks, which one provides the most reliable VC assessment as not all patients would have all three landmarks identified on the same examination. We postulated that perhaps finding all three sonographic landmarks may further improve diagnostic accuracy. To address these questions, we prospectively evaluated consecutive patients over two institutions …published_or_final_versio

A systematic review and meta-analysis of prophylactic central neck dissection on short-term locoregional recurrence in papillary thyroid carcinoma after total thyroidectomy

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A prospective, assessor-blind evaluation of surgeon-performed transcutaneous laryngeal ultrasonography in vocal cord examination before and after thyroidectomy

postprin

Is vocal cord asymmetry seen on transcutaneous laryngeal ultrasonography a significant predictor of voice quality changes after thyroidectomy?

Background: Vocal cord asymmetry (VCA) on laryngoscopic examination (LE) may suggest voice impairment after thyroidectomy, but LE may cause patient discomfort. We aimed to correlate the presence of postoperative VCA assessed by noninvasive transcutaneous laryngeal ultrasonography (TLUSG) with voice quality changes after thyroidectomy. Methods: A total of 169 patients scheduled for thyroidectomy completed two validated voice symptoms questionnaires - the GRBAS (grade, roughness, breathiness, asthenia, strain) scale and the voice impairment score (VIS) - and underwent TLUSG and LE at 1 day before and 7-10 days after thyroidectomy. Postoperative VCA was apparent in 51 patients on TLUSG (group I), whereas there was no VCA in the other 118 patients (group II, controls). The GRBAS scale and VIS results were compared between the groups. Results: Before operation, the two groups had comparable preoperative GRBAS and VIS status. After operation, the "grade" and "roughness" components on the GRBAS scale were significantly worse in group I than in group II: 0.24 versus 0.07 (p = 0.016) and 0.33 versus 0.14 (p = 0.022), respectively. "Grade" and "roughness" in the GRBAS scale significantly worsened after the operation in group I: from 0.04 to 0.24 (p = 0.008) and from 0.02 to 0.33 (p = 0.001), respectively. They did not change in group II. Also, the overall VIS was significantly worse after thyroidectomy in group I: 4.97 versus 12.97 (p < 0.001). Conclusions: VCA seen on TLUSG significantly correlated with "grade" and "roughness" components on the GRBAS scale and the overall VIS. Thus, VCA might be used as a surrogate of postoperative voice changes. © 2013 Société Internationale de Chirurgie.postprin

Advanced power routing framework for optimal economic operation and control of solar photovoltaic-based islanded microgrid

© 2019 Institution of Engineering and Technology. All rights reserved. Energy sharing through a microgrid (MG) is essential for islanded communities to maximise the use of distributed energy resources (DERs) and battery energy storage systems (BESSs). Proper energy management and control strategies of such MGs can offer revenue to prosumers (active consumers with DERs) by routing excess energy to their neighbours and maintaining grid constraints at the same time. This paper proposes an advanced power-routing framework for a solarphotovoltaic (PV)-based islanded MG with a central storage system (CSS). An optimisation-based economic operation for the MG is developed that determines the power routing and energy sharing in the MG in the day-ahead stage. A modified droop controller-based real-time control strategy has been established that maintains the voltage constraints of the MG. The proposed power-routing framework is verified via a case study for a typical islanded MG. The outcome of the optimal economic operation and a controller verification of the proposed framework are presented to demonstrate the effectiveness of the proposed powerrouting framework. Results reveal that the proposed framework performs a stable control operation and provides a profit of 57 AU$/day at optimal conditions

Quantum Graphs II: Some spectral properties of quantum and combinatorial graphs

The paper deals with some spectral properties of (mostly infinite) quantum and combinatorial graphs. Quantum graphs have been intensively studied lately due to their numerous applications to mesoscopic physics, nanotechnology, optics, and other areas. A Schnol type theorem is proven that allows one to detect that a point belongs to the spectrum when a generalized eigenfunction with an subexponential growth integral estimate is available. A theorem on spectral gap opening for ``decorated'' quantum graphs is established (its analog is known for the combinatorial case). It is also shown that if a periodic combinatorial or quantum graph has a point spectrum, it is generated by compactly supported eigenfunctions (``scars'').Comment: 4 eps figures, LATEX file, 21 pages Revised form: a cut-and-paste blooper fixe

Stroma Regulates Increased Epithelial Lateral Cell Adhesion in 3D Culture: A Role for Actin/Cadherin Dynamics

Cell shape and tissue architecture are controlled by changes to junctional proteins and the cytoskeleton. How tissues control the dynamics of adhesion and cytoskeletal tension is unclear. We have studied epithelial tissue architecture using 3D culture models and found that adult primary prostate epithelial cells grow into hollow acinus-like spheroids. Importantly, when co-cultured with stroma the epithelia show increased lateral cell adhesions. To investigate this mechanism further we aimed to: identify a cell line model to allow repeatable and robust experiments; determine whether or not epithelial adhesion molecules were affected by stromal culture; and determine which stromal signalling molecules may influence cell adhesion in 3D epithelial cell cultures.The prostate cell line, BPH-1, showed increased lateral cell adhesion in response to stroma, when grown as 3D spheroids. Electron microscopy showed that 9.4% of lateral membranes were within 20 nm of each other and that this increased to 54% in the presence of stroma, after 7 days in culture. Stromal signalling did not influence E-cadherin or desmosome RNA or protein expression, but increased E-cadherin/actin co-localisation on the basolateral membranes, and decreased paracellular permeability. Microarray analysis identified several growth factors and pathways that were differentially expressed in stroma in response to 3D epithelial culture. The upregulated growth factors TGFβ2, CXCL12 and FGF10 were selected for further analysis because of previous associations with morphology. Small molecule inhibition of TGFβ2 signalling but not of CXCL12 and FGF10 signalling led to a decrease in actin and E-cadherin co-localisation and increased paracellular permeability.In 3D culture models, paracrine stromal signals increase epithelial cell adhesion via adhesion/cytoskeleton interactions and TGFβ2-dependent mechanisms may play a key role. These findings indicate a role for stroma in maintaining adult epithelial tissue morphology and integrity