Need to restage Korean melanoma patients following publication of the 8th edition of the American Joint Committee on Cancer staging manual

Background: The tumor, nodes and metastasis (TNM) classification and stage grouping have been updated in the 8th edition of the American Joint Committee on Cancer (AJCC) melanoma staging manual. However, restaging all the previous cases are not recommended. Aims: The aims of the study were to investigate the necessity of restaging Korean melanoma patients staged by the previous edition of the AJCC manual. Methods: Differences in the staging criteria of the 7th and 8th editions of the AJCC manual were identified. The staging of 276 primary melanomas from January 2011 to December 2018 was classified by both 7th and 8th editions of the manual and their differences were compared. Results: Staging by 7th and 8th edition of the AJCC manual differed in 64 cases (23.2%). The pathological prognostic staging changed in 35 (12.7%), and 29 (10.5%) had changes in only TNM classification but not the pathological staging. None of the patients needed additional sentinel lymph node biopsy or systemic treatment as a result of restaging. Additional counseling was needed for the patients, because melanoma-specific survival was increased in the 8th edition. Limitations: This is a retrospective study with relatively small number of patients at a single tertiary center in Korea. Conclusion: Assessment of the need for additional sentinel lymph node biopsy or systemic treatment is recommended because of the latest changes in the AJCC melanoma staging manual. Although the restaging of previously staged melanomas is not significantly needed in our patients, still the differences in TNM classification and/or pathological prognostic staging suggest the need to separately recognize the patients previously staged by 7th edition and recently staged by 8th edition. Careful counseling about melanoma-specific survival is needed for Asian patients

Comparing outcomes of the ankle arthrodesis by using two different materials via a transfibular approach / Comparação dos resultados da artrodese do tornozelo usando dois diferentes materiais através de uma abordagem transfibular

ABSTRACT Objective: To compare clinical and radiologic results and complications of patients who underwent arthrodesis using a transfibular approach with either a cannulated screw or an anterior fusion plate. Methods: Patients who underwent ankle arthrodesis were divided into two groups according to the used materials: 6.5 mm cannulated screw (A) and anterior fusion plate (B). The clinical scores were compared between groups. The radiologic results were then assessed by union time. The results were statistically analyzed using SPSS 20. Results: There was no significant difference between both groups in the American Orthopedic Foot & Ankle Society (AOFAS) score (p = 0.75), and in the visual analog scale (p = 0.42). In group B, two cases included wound infection at the surgical site. In tt A, the mean union time was 10.5 ± 2.3 weeks. In group B, it was 7.8 ± 1.3. There was a statistically significant difference (p = 0.007) between union time in both groups. Conclusion: Anterior fusion plate is an effective method for shorter union time, but the surgeon should be careful with the surgical wound at the skin incision site in the lesion of the distal tibia. Level of Evidence III, Retrospective comparative study.

RESUMO Objetivo: Comparar os resultados clínicos e radiológicos assim como as complicações de pacientes sujeitos a artrodese de abordagem transfibular com o uso de parafuso canulado ou placa óssea anterior. Métodos: Pacientes sujeitos a artrodese do tornozelo foram divididos em dois grupos de acordo com os materiais usados: parafuso canulado de 6,5 mm (A) e placa óssea anterior (B). Os escores clínicos de ambos os grupos foram comparados e os resultados radiológicos foram avaliados de acordo com o tempo de união óssea. Os resultados foram analisados estatisticamente usando SPSS 20. Resultados: Não houve diferença significativa entre os grupos quanto ao escore American Orthopedic Foot & Ankle Society (AOFAS) (p = 0,75) e a escala visual analógica (p = 0,42). No grupo B, ocorreu infecção na área da cirurgia em dois casos. No grupo A, a média de tempo de união foi de 10,5 ± 2,3 semanas. No grupo B, este foi de 7,8 ± 1,3. Constatou-se diferença estatisticamente significante (p = 0,007) quanto ao tempo de união em ambos os grupos. Conclusão: Os autores concluíram que a placa óssea anterior é um método eficiente para tempos de união curtos, porém o cirurgião deve ficar atento à ferida cirúrgica na área de incisão da pele em casos de lesão na tíbia distal. Nível de Evidência III, Estudo retrospectivo comparativo.

Selenocysteine modulates resistance to environmental stress and confers anti-aging effects in C. elegans

OBJECTIVE: The free radical theory of aging suggests that cellular oxidative damage caused by free radicals is a leading cause of aging. In the present study, we examined the effects of a well-known anti-oxidant amino acid derivative, selenocysteine, in response to environmental stress and aging using Caenorhabditis elegans as a model system. METHOD: The response to oxidative stress induced by H2O2 or ultraviolet irradiation was compared between the untreated control and selenocysteine-treated groups. The effect of selenocysteine on lifespan and fertility was then determined. To examine the effect of selenocysteine on muscle aging, we monitored the change in motility with aging in both the untreated control and selenocysteine-treated groups. RESULTS: Dietary supplementation with selenocysteine significantly increased resistance to oxidative stress. Survival after ultraviolet irradiation was also increased by supplementation with selenocysteine. Treatment with selenocysteine confers a longevity phenotype without an accompanying reduction in fertility, which is frequently observed in lifespan-extending interventions as a trade-off in C. elegans. In addition, the age-related decline in motility was significantly delayed by supplementation of selenocysteine. CONCLUSION: These findings suggest that dietary supplementation of selenocysteine can modulate response to stressors and lead to lifespan extension, thus supporting the free radical theory of aging.

Supplementation of S-allyl cysteine improves health span in Caenorhabditis elegans / A suplementação de S-alil cisteína melhora a duração da saúde em Caenorhabditis elegans

Previous studies show that nutritional interventions with anti-oxidants have various healthpromoting effects in several model organisms. Here, we examine the effects of S-allyl cysteine on resistance to environmental stressors and age-related physiological changes using C. elegans as a model system. S-allyl cysteine is a modified amino acid found in aged garlic extracts and known to have strong anti-oxidant activity. The survival of worms under oxidative-stress conditions significantly increased with supplementation of S-allyl cysteine. In addition, pretreatment of S-allyl cysteine significantly increased resistance to both heat stress and ultraviolet irradiation. However, lifespan was not affected by S-allyl cysteine treatment. We also examined the effect of S-allyl cysteine on motility of C. elegans and found that S-allyl cysteine can retard the age-related decline of muscle tissue locomotive activity. S-allyl cysteine also significantly suppressed amyloid -induced paralysis in Alzheimer's disease model animals. Taken together, our study indicates that dietary supplementation of S-allyl cysteine can improve health span and suggests that S-allyl cysteine can be used to develop novel health-promoting pharmaceuticals.

Estudos anteriores mostram que intervenções nutricionais com antioxidantes têm vários efeitos promotores da saúde em vários organismos-modelo. Aqui, examinamos os efeitos da S-alil cisteína sobre a resistência a estressores ambientais e alterações fisiológicas relacionadas com a idade usando C. elegans como um sistema modelo. Salil cisteína é um aminoácido modificado encontrado em extratos de alho envelhecido e conhecido por ter forte atividade antioxidante. A sobrevivência de vermes sob condições de estresse oxidativo aumentou significativamente com a suplementação de S-alil cisteína. Além disso, o pré-tratamento com S-alil cisteína aumentou significativamente a resistência tanto ao estresse térmico como à irradiação ultravioleta. No entanto, o tempo de vida não foi afetado pelo tratamento com S-alil cisteína. Nós também examinamos o efeito da S-alil cisteína na motilidade de C. elegans e descobrimos que a S-alil cisteína pode retardar o declínio relacionado à idade da atividade locomotora do tecido muscular. A S-alil cisteína também suprimiu significativamente a paralisia induzida por amilóide em animais-modelo da doença de Alzheimer. Tomados em conjunto, o nosso estudo indica que a suplementação dietética de S-alil cisteína pode melhorar a duração da saúde e sugere que S-alil cisteína pode ser usada para desenvolver novos produtos farmacêuticos de promoção da saúde.

Patch tests with commercial hair dye products in patients with allergic contact dermatitis to para‑phenylenediamine.

Background: Hair dye is one of the most common causes of allergic contact dermatitis. The main allergen has been identified as para‑phenylenediamine. To prevent the recurrence of contact dermatitis to para‑phenylenediamine, patients should discontinue the use of para‑phenylenediamine‑containing hair dye products. However, many patients are unable to discontinue their use for cosmetic or social reasons. Sometimes, they continue to have symptoms even after switching to so‑called “less allergenic” hair dyes. Objectives: To evaluate the safety of 15 commercially available hair dye products in patients with allergic contact dermatitis due to para‑phenylenediamine. Methods: We performed patch tests using 15 hair dyes that were advertised as “hypoallergenic,” “no para‑phenylenediamine” and “non‑allergenic” products in the market. Results: Twenty three patients completed the study and 20 (87.0%) patients had a positive patch test reaction to at least one product. While four (26.7%) hair dye products contained para‑phenylenediamine, 10 (66.7%) out of 15 contained m‑aminophenol and 7 (46.7%) contained toluene‑2,5‑diamine sulfate. Only one product did not elicit a positive reaction in any patient. Limitations: Small sample size and possibility of false‑positive reactions. Conclusions: Dermatologists should educate patients with allergic contact dermatitis to para‑phenylenediamine about the importance of performing sensitivity testing prior to the actual use of any hair dye product, irrespective of how it is advertised or labelled.

Prostate-Specific Antigen fluctuation: what does it mean in diagnosis of prostate cancer?

Objective To investigate whether prostate-specific antigen (PSA) fluctuation correlates with a prostate cancer and to assess whether PSA fluctuation could be used for diagnosis of prostate cancer. Materials and Methods Our study included 229 patients who were performed a prostate biopsy (non-cancer group, 177; prostate cancer group, 52). Enrolled patients were provided twice PSA tests within 6 months. PSA fluctuation (%/month) was defined as a change rate of PSA per a month. Independent t test was used to compare between two groups. Receiver operator characteristic curve was used to assess the availability as a differential diagnostic tool and the correlation. Simple linear regression was performed to analyze a correlation between PSA fluctuation and other factors such as age, PSA, PSA density, and prostate volume. Results There were significant differences in PSA, PSA density, percentage of free PSA, and PSA fluctuation between two groups. PSA fluctuation was significantly greater in non-cancer group than prostate cancer group (19.95±23.34%/month vs 9.63±8.57%/month, P=0.004). The most optimal cut-off value of PSA fluctuation was defined as 8.48%/month (sensitivity, 61.6%; specificity, 59.6%; AUC, 0.633; P=0.004). In a simple linear regression model, only PSA level was significantly correlated with PSA fluctuation. Conclusion Patients with wide PSA fluctuations, although baseline PSA levels are high, might have a low risk of diagnosis with prostate cancer. Thus, serial PSA measurements could be an option in patients with an elevated PSA level. .

Hypothermic cardiac arrest.

After being lost for 16 hr, a 7-yr-old boy was admitted to the emergency Department (ED) in a severe hypothermic condition of 23.3 degrees C with cardiac arrest. Active rewarming was conducted with cardiopulmonary resuscitation (CPR). Sixty minutes after admission, return of spontaneous circulation was confirmed. Fever developed 14 hr after admission and continued for 9 days due to frostbite wound of both feet. This case report demonstrates successful resuscitation in severe hypothermic cardiac arrest with complete neurologic recovery in a 7-yr-old boy.

The role of somatostatin in nociceptive processing of the spinal cord in anesthetized cats

Somatostatin (SOM) is one of the major neuropeptides in dorsal root ganglion cells, but its role in spinal nociceptive process has not been well known. In present study we aimed to investigate the effect of SOM on the response of dorsal horn neurons to the various types of peripheral nociceptive stimuli in anesthetized cats. Using carbon-filament microelectrode, the single cell activities of wide dynamic range neurons were recorded from the lumbosacral enlargement after noxious mechanical (squeeze), thermal (radiant heat lamp) and cold (dry ice) stimulation to the receptive field. Sciatic nerve was stimulated electrically to evoke A delta- and C-nociceptive responses SOM analogue, octreotide (10 mug/kg), was applied intravenously and the results were compared with those of morphine (2 mg/kg, MOR) Systemic SOM decreased the cellular responses to the noxious heat and the mechanical stimulation, but increased those to the cold stimulation. In the responses to the electric stimuli of sciatic nerve, A delta-nociceptive response was increased by SOM, while C-nociceptive response was decreased. On the other hand, MOR inhibited the dorsal horn cell responses to all the noxious stimuli. From the above results, it is concluded that SOM suppresses the transmission of nociceptive heat and mechanical stimuli, especially via C-fiber, while it facilitates those of nociceptive cold stimuli via A delta-fiber.