Relocation of inadequate resection margins in the wound bed during oral cavity oncological surgery: A feasibility study

Background: Specimen-driven intraoperative assessment of the resection margins provides immediate feedback if an additional excision is needed. However, relocation of an inadequate margin in the wound bed has shown to be difficult. The objective of this study is to assess a reliable method for accurate relocation of inadequate tumor resection margins in the wound bed after intraoperative assessment of the specimen. Methods: During oral cavity cancer surgery, the surgeon placed numbered tags on both sides of the resection line in a pair-wise manner. After resection, one tag of each pair remained on the specimen and the other tag in the wound bed. Upon detection of an inadequate margin in the specimen, the tags were used to relocate this margin in the wound bed. Results: The method was applied during 80 resections for oral cavity cancer. In 31 resections an inadequate margin was detected, and based on the paired tagging an accurate additional resection was achieved. Conclusion: Paired tagging facilitates a reliable relocation of inadequate margins, enabling an accurate additional resection during the initial surgery

Raman spectroscopy for cancer detection and cancer surgery guidance: translation to the clinics

Dermatology-oncolog

Interactions Among Fire, Insects and Pathogens in Coniferous Forests of the Interior Western United States and Canada

1 Natural and recurring disturbances caused by fire, native forest insects and pathogens have interacted for millennia to create and maintain forests dominated by seral or pioneering species of conifers in the interior regions of the western United States and Canada. 2 Changes in fire suppression and other factors in the last century have altered the species composition and increased the density of trees in many western forests, leading to concomitant changes in how these three disturbance agents interact. 3 Two- and three-way interactions are reviewed that involve fire, insects and pathogens in these forests, including fire-induced pathogen infection and insect attack, the effects of tree mortality from insects and diseases on fuel accumulation, and efforts to model these interactions. 4 The emerging concern is highlighted regarding how the amount and distribution of bark beetle-caused tree mortality will be affected by large-scale restoration of these fire-adapted forest ecosystems via prescribed fire. 5 The effects of fire on soil insects and pathogens, and on biodiversity of ground-dwelling arthropods, are examined. 6 The effects of fire suppression on forest susceptibility to insects and pathogens, are discussed, as is the use of prescribed fire to control forest pests

Characteristics, management, and outcomes of patients with left‐sided infective endocarditis complicated by heart failure: a substudy of the ESC‐EORP EURO‐ENDO (European infective endocarditis) registry

International audienc