miR-497 as a potential serum biomarker for the diagnosis and prognosis of osteosarcoma.

OBJECTIVE: The aim of this manuscript is to analyze the diagnostic and prognostic value of circulating miR-497 in the plasma of patients with osteosarcoma. PATIENTS AND METHODS: Serum miR-497 expression levels were measured by quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). Correlations between miR-497 expression and the clinicopathological features and prognosis of osteosarcoma patients were then evaluated. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to evaluate diagnostic accuracy. RESULTS: Our data showed that serum miR-497 expression was down-regulated in osteosarcoma patients compared with the matched healthy controls (p < 0.001). Then, low miR-497 expression was significantly associated with clinical stage (p = 0.001), distant metastasis (p = 0.001) and response to chemotherapy (p = 0.007). The receiver operating characteristic (ROC) curve analysis of the accuracy in distinguishing osteosarcoma patients from healthy controls yielded an area under the curve (AUC) value of 0.848 (95% confidence interval (CI), 0.773-0.923). Kaplan-Meier analysis results showed that patients with lower expression of miR-497 had shorter survival times (p < 0.001). Univariate and multivariate analyses revealed that the miR-497 expression level and various clinicopathological features were independent prognostic parameters. CONCLUSIONS: Our data showed that low serum miR-497 level was correlated with aggressive progression and poor prognosis of osteosarcoma. Serum miR-497 may be a potential biomarker for early detection and clinical evaluation in patients with osteosarcoma.

SHIP-1 inhibits CD95/APO-1/Fas-induced apoptosis in primary T lymphocytes and T leukemic cells by promoting CD95 glycosylation independently of its phosphatase activity.

SHIP-1 (SH2 (Src homology 2)-containing inositol 5'-phosphatase-1) functions as a negative regulator of immune responses by hydrolyzing phosphatidylinositol-3,4,5-triphosphate generated by phosphoinositide-3 (PI 3)-kinase activity. As a result, SHIP-1 deficiency in mice results in myeloproliferation and B-cell lymphoma. On the other hand, SHIP-1-deficient mice have a reduced T-cell population, but the underlying mechanisms are unknown. In this work, we hypothesized that SHIP-1 plays anti-apoptotic functions in T cells upon stimulation of the death receptor CD95/APO-1/Fas. Using primary T cells from SHIP-1(-/-) mice and T leukemic cell lines, we report that SHIP-1 is a potent inhibitor of CD95-induced death. We observed that a small fraction of the SHIP-1 pool is localized to the endoplasmic reticulum (ER), in which it promotes CD95 glycosylation. This post-translational modification requires an intact SH2 domain of SHIP-1, but is independent of its phosphatase activity. The glycosylated CD95 fails to oligomerize upon stimulation, resulting in impaired death-inducing signaling complex (DISC) formation and downstream apoptotic cascade. These results uncover an unanticipated inhibitory function for SHIP-1 and emphasize the role of glycosylation in the regulation of CD95 signaling in T cells. This work may also provide a new basis for therapeutic strategies using compounds inducing apoptosis through the CD95 pathway on SHIP-1-negative leukemic T cells.

Microsurgical reconstruction in children's burns.

There have been few reports on microsurgical procedures performed on children who have been left with disability and deformity as a result of burn injury. The reality is that whilst there are many children who could benefit from such procedures they do not have access to the resources that can provide them. Where these resources are available there has been a reluctance to use them partially due to a misconception that such procedures are technically challenging and carry significant risk. This paper presents a series of 21 children in whom 29 microsurgical procedures were performed. There were two failures but in all other cases there was significant improvements in the functional ability and/or the aesthetic appearance of the child. This series includes novel variations on the antero-lateral thigh flap; tissue engineering, dual flap harvest, size and age. Refinements of inset are described to prevent pin-cushioning and linear scar contracture. In selected cases microsurgical reconstruction can produce life long benefits, with minimal surgical and donor site morbidity.

The repeatability and accuracy of axial length and anterior chamber depth measurements from the IOLMaster .

BACKGROUND: Axial length and anterior chamber depth have been measured clinically using conventional ultrasound biometry. Recently, a non-contact device has become available to measure these parameters. This study evaluated the repeatability and accuracy of this device. METHODS: The axial length and anterior chamber depth were measured by two practitioners on a group of young subjects using the IOLMaster followed by a conventional ultrasound biometer operated by a third practitioner. The accommodation was controlled in ultrasound biometry through a full correction on the non-measured eye and a distant fixation target. RESULTS: There was good repeatability and accuracy of axial length assessment. The mean difference between the IOLMaster and ultrasound biometry was -0.099 mm, with 95% limits of agreement between 0.66 and -0.85 mm. The axial length was slightly shorter from the IOLMaster and the difference was not significant. The anterior chamber depth was repeatable but was shown to be deeper than the ultrasound results. The mean difference in anterior chamber depth between the IOLMaster and ultrasound biometry was 0.15 mm, with 95% limits of agreement between 0.34 and -0.03 mm. It is suggested that the former device is not measuring the axial anterior chamber depth. CONCLUSIONS: The IOLMaster is a non-contact 'optical' A-scan which is simple to use and good for axial length assessment. The anterior chamber depth assessment should be further evaluated.

Fibromatosis of the head and neck region.

OBJECTIVE: Five cases of head and neck fibromatosis were analyzed. The imaging and pathologic findings, surgical management, and clinical outcome were discussed. STUDY DESIGN AND SETTING: A retrospective study of 5 adult head and neck fibromatosis cases, evaluating long-term follow-up results of conservative treatment. RESULTS: The 5 patients (2 male and 3 female) ranged in age from 16 to 51 years. The lesion size ranged from 1 to 8 cm. Four cases had limited surgical resection; 1 case was followed only. One of the surgically treated cases had a recurrence that was irradiated. All patients were well for a follow-up period of 2 to 8 years. CONCLUSION: Aggressive excision of head and neck fibromatosis cannot be achieved easily. Vigilant follow-up with or without conservative surgical excision achieves good disease control. Low dose radiotherapy can be used for inoperable cases. SIGNIFICANCE: Judicious conservative treatment should be attempted for head and neck fibromatosis to achieve optimal functional preservation.

A case of parotid mucoepidermoid carcinoma complicated by fatal gastrointestinal bleeding.

Mucoepidermoid carcinoma is one of the most common of the salivary gland neoplasms. Histologically, it is classified as either a low-, intermediate-, or high-grade tumor, and there are significant differences in prognosis among the different grades. Patients with low-grade disease have an excellent chance of survival. High-grade tumors behave aggressively, and they frequently manifest as local recurrences and distant metastases. We describe a case of a high-grade mucoepidermoid carcinoma of the parotid gland that had metastasized to the skin, stomach, and liver. The disease culminated in a rapidly fatal bleeding from the stomach metastasis. Such a complication is unusual and to our knowledge has not been previously reported. We briefly discuss the clinical features, biologic behavior, and treatment of this tumor.

Subcranial anterior skull base dural repair with galeal frontalis flap.

The pericranial flap has been widely used to repair surgically created anterior skull base defects during craniofacial resection. This report describes a technique of subcranial dural repair with a galeal frontalis flap after resection of an ethmoidal adenoid cystic carcinoma.

Necrosis of the nasal ala after improper taping of a nasogastric tube.

Inserting a nasogastric tube during various abdominal procedures is a common maneuver to decompress the upper gastrointestinal tract. Improper placement and taping of the nasogastric tube results in excessive pulling on the nasal ala and subsequent pressure necrosis. This complication not only carries serious cosmetic morbidity, it is also preventable if a proper taping technique is employed.

A prospective study of the effect of botulinum toxin A on masseteric muscle hypertrophy with ultrasonographic and electromyographic measurement.

We evaluated the effect of botulinum toxin A on masseteric muscle hypertrophy by using ultrasound and electromyography. Five patients (four with bilateral and one with unilateral masseteric muscle hypertrophy) were studied prospectively. In each patient, ultrasound-guided percutaneous intramuscular injection of botulinum toxin A was carried out. The change in muscle bulk was evaluated using serial ultrasonography and the electrical activity was assessed with electromyography. All five patients (nine hypertrophic muscles) showed a good response, with the maximal effect of a 31% reduction in muscle bulk seen 3 months after treatment. The effect remained stable one year after injection for six of the hypertrophic muscles, whereas three muscles needed a second injection to maintain the atrophy. This preliminary prospective study suggests that botulinum toxin A is a safe alternative method of treating masseteric muscle hypertrophy. However, the effect may be temporary and further intramuscular injection may be required to maintain atrophy.

Nasopharyngectomy for recurrent nasopharyngeal carcinoma: an innovative transnasal approach through a mid-face deglove incision with stereotactic navigation guidance.

Traditional approaches to nasopharyngectomy for the treatment of recurrent nasopharyngeal carcinoma carry considerable complications. This paper presents an innovative transnasal approach with stereotactic navigation guidance through a mid-face deglove incision which has been done for 15 patients with minimal morbidity. All patients had resumed their oral diet within a week, and were discharged within 10 days. The intraoral wound had healed within a week. The only complications were a mild degree of saddling of the nasal dorsum in one patient and temporary facial numbness that resolved within six weeks in three. Tumour had been resected with clear margins in 12/15, in the other three being stuck to the carotid artery.