Perioperative nasal and paranasal sinus considerations in transsphenoidal surgery for pituitary disease

Endoscopic endonasal skull base surgery has emerged as the treatment modality of choice for a range of skull base lesions, particularly pituitary adenomas. However, navigation and manipulation of the nasal corridor and paranasal sinuses requires that surgeons are aware of effective techniques to maximize patient outcomes and avoid sinonasal morbidity postoperatively. This paper is a narrative review aimed to provide an updated and consolidated report on the perioperative management of the nasal corridor and paranasal sinuses in the setting of endoscopic skull base surgery for pituitary disease. Anatomic variants and common surgical techniques are discussed. Post-operative complications are evaluated in detail. Understanding the structural implications of the endonasal approach to the sphenoid is crucial to opti

Growth Kinetics and Production of Glucose Oxidase Using Aspergillus niger NRRL 326

In this paper, we demonstrate the substrate inhibition phenomena for growth kinetics of Aspergillus niger NRRL 326 grown on sucrose during glucose oxidase production. The initial set of experiments were carried out using three different substrates, viz., glucose, sucrose and raffinose of which it was observed that sucrose serves better for higher production of glucose oxidase. Experiments involving sensitivity studies conveyed that substrate inhibition became predominant when sucrose mass concentration was above γ = 30 g L-1 in the cultivation medium. The later part of the work was dovetailed towards validation of substrate inhibited growth kinetics with established models such as Haldane, Andrews, Luong, Han-Levenspiel and Aiba. Finally, it was observed that none of the classical models explains the kinetics well

Growth Kinetics and Production of Glucose Oxidase Using Aspergillus niger NRRL 326

In this paper, we demonstrate the substrate inhibition phenomena for growth kinetics of Aspergillus niger NRRL 326 grown on sucrose during glucose oxidase production. The initial set of experiments were carried out using three different substrates, viz., glucose, sucrose and raffinose of which it was observed that sucrose serves better for higher production of glucose oxidase. Experiments involving sensitivity studies conveyed that substrate inhibition became predominant when sucrose mass concentration was above γ = 30 g L-1 in the cultivation medium. The later part of the work was dovetailed towards validation of substrate inhibited growth kinetics with established models such as Haldane, Andrews, Luong, Han-Levenspiel and Aiba. Finally, it was observed that none of the classical models explains the kinetics well

Periodic and Quasiperiodic Motion of an Elongated Microswimmer in Poiseuille Flow

We study the dynamics of a prolate spheroidal microswimmer in Poiseuille flow for different flow geometries. When moving between two parallel plates or in a cylindrical microchannel, the swimmer performs either periodic swinging or periodic tumbling motion. Although the trajectories of spherical and elongated swimmers are qualitatively similar, the swinging and tumbling frequency strongly depends on the aspect ratio of the swimmer. In channels with reduced symmetry the swimmers perform quasiperiodic motion which we demonstrate explicitely for swimming in a channel with elliptical cross section

The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of squamous cell carcinoma of the head and neck (HNSCC)

Head and neck cancers, including those of the lip and oral cavity, nasal cavity, paranasal sinuses, oropharynx, larynx and nasopharynx represent nearly 700,000 new cases and 380,000 deaths worldwide per annum, and account for over 10,000 annual deaths in the United States alone. Improvement in outcomes are needed for patients with recurrent and or metastatic squamous cell carcinoma of the head and neck (HNSCC). In 2016, the US Food and Drug Administration (FDA) granted the first immunotherapeutic approvals - the anti-PD-1 immune checkpoint inhibitors nivolumab and pembrolizumab - for the treatment of patients with recurrent squamous cell carcinoma of the head and neck (HNSCC) that is refractory to platinum-based regimens. The European Commission followed in 2017 with approval of nivolumab for treatment of the same patient population, and shortly thereafter with approval of pembrolizumab monotherapy for the treatment of recurrent or metastatic HNSCC in adults whose tumors express PD-L1 with a 65 50% tumor proportion score and have progressed on or after platinum-containing chemotherapy. Then in 2019, the FDA granted approval for PD-1 inhibition as first-line treatment for patients with metastatic or unresectable, recurrent HNSCC, approving pembrolizumab in combination with platinum and fluorouracil for all patients with HNSCC and pembrolizumab as a single agent for patients with HNSCC whose tumors express a PD-L1 combined positive score 65 1. These approvals marked the first new therapies for these patients since 2006, as well as the first immunotherapeutic approvals in this disease. In light of the introduction of these novel therapies for the treatment of patients with head and neck cancer, The Society for Immunotherapy of Cancer (SITC) formed an expert committee tasked with generating consensus recommendations for emerging immunotherapies, including appropriate patient selection, therapy sequence, response monitoring, adverse event management, and biomarker testing. These consensus guidelines serve as a foundation to assist clinicians' understanding of the role of immunotherapies in this disease setting, and to standardize utilization across the field for patient benefit. Due to country-specific variances in approvals, availability and regulations regarding the discussed agents, this panel focused solely on FDA-approved drugs for the treatment of patients in the U.S

Hospitalization for heart disease, stroke, and diabetes mellitus among Indian-born persons: a small area analysis

BACKGROUND: We set out to describe the risk of hospitalization from heart disease, stroke, and diabetes among persons born in India, all foreign-born persons, and U.S.-born persons residing in New York City. METHODS: We examined billing records of 1,083,817 persons hospitalized in New York City during the year 2000. The zip code of each patient's residence was linked to corresponding data from the 2000 U.S. Census to obtain covariates not present in the billing records. Using logistic models, we evaluated the risk of hospitalization for heart disease, stroke and diabetes by country of origin. RESULTS: After controlling for covariates, Indian-born persons are at similar risk of hospitalization for heart disease (RR = 1.02, 95% confidence interval 1.02, 1.03), stroke (RR = 1.00, 95% confidence interval, 0.99, 1.01), and diabetes mellitus (RR = 0.96 95% confidence interval 0.94, 0.97) as native-born persons. However, Indian-born persons are more likely to be hospitalized for these diseases than other foreign-born persons. For instance, the risk of hospitalization for heart disease among foreign-born persons is 0.70 (95% confidence interval 0.67, 0.72) and the risk of hospitalization for diabetes is 0.39 (95% confidence interval 0.37, 0.42) relative to native-born persons. CONCLUSIONS: South Asians have considerably lower rates of hospitalization in New York than reported in countries with national health systems. Access may play a role. Clinicians working in immigrant settings should nonetheless maintain a higher vigilance for these conditions among Indian-born persons than among other foreign-born populations

Testing the theory of immune selection in cancers that break the rules of transplantation

Modification of cancer cells likely to reduce their immunogenicity, including loss or down-regulation of MHC molecules, is now well documented and has become the main support for the concept of immune surveillance. The evidence that these modifications, in fact, result from selection by the immune system is less clear, since the possibility that they may result from reorganized metabolism associated with proliferation or from cell de-differentiation remains. Here, we (a) survey old and new transplantation experiments that test the possibility of selection and (b) survey how transmissible tumours of dogs and Tasmanian devils provide naturally evolved tests of immune surveillance

Press hardening of alternative materials: conventional high- strength steels

he increase in strength of new high strength steels(HHS) and advanced high strength steels (AHHS) has led toforming issues, such as high springback, low formability, increase of forming forces and tool wear. These problems increase thecosts of manufacturing and maintainingstamping tools in the automotive industry. The aim of this research was to analyse the advantages of applyingthe press-hardening process toconventional HSS and AHSS steel to increase their formability and therefore reduce thenumber of forming steps and productioncosts. With this aimin mind, the press-hardening process was used to manufacturean industrialcomponent using four different automotive steelgrades: dual phase (DP),complex phase (CP), transformation-induced plasticity (TRIP) and martensitic (MS) grade.Springback measurements werecarried out, together with ananalysis of the obtained final mechanical properties and microstructures. The results showed that the formability of all thematerials increased. The mechanical properties of theCP800and TRIP700 materials were maintained or even improved, whereas those of the MS1200 and HCT980Xmaterials were significantly reduced. Weconclude thatpress hardening is a suitable manufacturing processforCP800 and TRIP700components