Morphological Changes and Durability of Skin and Mucosal Flaps in Intraoral and Pharyngeal Reconstructions: Long-term Follow-up and Literature Review for Potential Second Carcinomas

The long-term changes in tissues implanted in the oral cavity and pharynx after head and neck reconstruction have not been fully evaluated. This study aimed to clarify the morphological changes, long-term durability, and potential for secondary carcinogenesis in such tissues. In our single-center study, the rough morphological changes in 54 cases of intraoral and pharyngeal skin and mucosal flaps were evaluated more than 10 years after flap transfer. In addition, the literature on the development of second carcinomas from skin flaps was reviewed. The mean follow-up period for transferred flaps was 148 months. The reconstruction areas and the probability of morphological changes were significantly correlated (p=0.006), especially in cases with tongue, lower gingiva, and buccal mucosal reconstruction. Free jejunal flap surfaces were well maintained, whereas tubed skin flaps showed severe morphological changes in cases with pharyngeal reconstruction. None of the flaps in our series developed second primary carcinomas. Skin flaps generally had good durability for > 10 years in intraoral environments, while mucosal flaps had better durability for pharyngeal reconstruction. Second squamous carcinomas arising from skin flaps are extremely rare; however, surgeons should take this possibility into consideration and conduct meticulous and long-term follow-up

Elastic properties of the Non-Fermi liquid metal CeRu4Sb12Ce Ru_4 Sb_{12} and the Dense Kondo semiconductor CeOs4Sb12Ce Os_4 Sb_{12}

We have investigated the elastic properties of the Ce-based filled skutterudite antimonides CeRu$_{4}$Sb$_{12}$ and CeOs$_{4}$Sb$_{12}$ by means of ultrasonic measurements. CeRu$_{4}$Sb$_{12}$ shows a slight increase around 130 K in the temperature dependence of the elastic constants $C$$_{11}$, ($C$$_{11}$-$C$$_{12}$)/2 and $C$$_{44}$. No apparent softening toward low temperature due to a quadrupolar response of the 4$f$-electronic ground state of the Ce ion was observed at low temperatures. In contrast CeOs$_{4}$Sb$_{12}$ shows a pronounced elastic softening toward low temperature in the longitudinal $C$$_{11}$ as a function of temperature ($T$) below about 15 K, while a slight elastic softening was observed in the transverse $C$$_{44}$ below about 1.5 K. Furthermore, CeOs$_{4}$Sb$_{12}$ shows a steep decrease around a phase transition temperature of 0.9 K in both $C$$_{11}$ and$C$$_{44}$. The elastic softening observed in $C$$_{11}$ below about 15 K cannot be explained reasonably only by the crystalline electric field effect. It is most likely to be responsible for the coupling between the elastic strain and the quasiparticle band with a small energy gap in the vicinity of Fermi level. The elastic properties and the 4$f$ ground state of Ce ions in CeRu$_{4}$Sb$_{12}$ and CeOs$_{4}$Sb$_{12}$ are discussed from the viewpoint of the crystalline electric field effect and the band structure in the vicinity of Fermi level.Comment: 9 pages, 11 figures, regular pape

Endolymphatic Hydrops After Sac Surgery

Meniere’s disease is a common disease, that presents with recurrent vertigo and cochlear symptoms. The pathology of Meniere’s disease was first reported to involve endolymphatic hydrops in 1938. The endolymphatic sac is thought to have a role to keep the hydrostatic pressure and endolymph homeostasis for the inner ear. As a surgery for intractable Meniere’s disease, endolymphatic sac drainage with intraendolymphatic sac application of large doses of steroids is performed to control the endolymphatic hydrops and preserve or improve inner ear function. In the present study, to observe the effect of this surgery, we calculated the endolymphatic space size using 3-Teslamagnetic resonance imaging (MRI) 4 h after intravenous injection of gadolinium enhancement at two time points: just before surgery and 2 years after. To reveal the condition of the endolymphatic space, we constructed three-dimensional MR images semi-automatically and fused the three-dimensional images of the total fluid space of inner ear and the endolymphatic space. After fusing the images, we calculated the volume of the total fluid space and endolymphatic space. Two years after surgery, 16 of 20 patients (80.0%) showed relief from vertigo/dizziness and reductions in the ratio of the volume of the endolymphatic size to the total fluid space of inner ear. Endolymphatic sac drainage with intraendolymphatic sac application of large doses of steroids could control vertigo/dizziness and decrease the endolymphatic hydrops. These results indicate that endolymphatic sac drainage is a good treatment option for patients with intractable Meniere’s disease. In addition, volumetric measurement of inner ear volume could be useful for confirming the effect of treatments on Meniere’s disease

Efficient anchoring of alien chromosome segments introgressed into bread wheat by new Leymus racemosus genome-based markers

Background: The tertiary gene pool of bread wheat, to which Leymus racemosus belongs, has remained underutilized due to the current limited genomic resources of the species that constitute it. Continuous enrichment of public databases with useful information regarding these species is, therefore, needed to provide insights on their genome structures and aid successful utilization of their genes to develop improved wheat cultivars for effective management of environmental stresses. Results: We generated de novo DNA and mRNA sequence information of L. racemosus and developed 110 polymorphic PCR-based markers from the data, and to complement the PCR markers, DArT-seq genotyping was applied to develop additional 9990 SNP markers. Approximately 52% of all the markers enabled us to clearly genotype 22 wheat-L. racemosus chromosome introgression lines, and L. racemosus chromosome-specific markers were highly efficient in detailed characterization of the translocation and recombination lines analyzed. A further analysis revealed remarkable transferability of the PCR markers to three other important Triticeae perennial species: L. mollis, Psathyrostachys huashanica and Elymus ciliaris, indicating their suitability for characterizing wheat-alien chromosome introgressions carrying chromosomes of these genomes. Conclusion: The efficiency of the markers in characterizing wheat-L. racemosus chromosome introgression lines proves their reliability, and their high transferability further broadens their scope of application. This is the first report on sequencing and development of markers from L. racemosus genome and the application of DArT-seq to develop markers from a perennial wild relative of wheat, marking a paradigm shift from the seeming concentration of the technology on cultivated species. Integration of these markers with appropriate cytogenetic methods would accelerate development and characterization of wheat-alien chromosome introgression lines

<CLINICAL REPORT>A case of inverted papilloma of the maxillary sinus

A case of inverted papilloma arising in the maxillary sinus is described. The first symptoms were rhinorroea and discomfort of the left infraorbital region. A biopsy obtained by penetration into the maxillary sinus resulted in a diagnosis of chronic sinusitis. However, the surgical specimen showed characteristic inverted epithelial proliferation. Two years after operation by the Caldwell-Luc method, there are no signs of recurrence. The diagnosis and treatment of inverted papilloma are discussed

Relationship between protein C and antithrombin III deficiencies in sepsis without disseminated intravascular coagulation status

Sepsis 2008 / Granada, Spain / 19-22 November 200