A Case Report of Wire-localised Excision of Impalpable Recurrent Papillary Thyroid Carcinoma and Discussion of Wire-guided Excision in the Head and Neck Pathology.

INTRODUCTION/BACKGROUND: Wire localisation techniques are used widely for precision surgery in many specialities. This convenient technique has not yet become mainstream in the field of head and neck surgery. With limited space and many vital structures coursing through the head and neck region, pathological nodes that are difficult to palpate can be a challenge for clinicians. CASE PRESENTATION: A patient with a history of papillary thyroid cancer treated with surgery and radioactive iodine had a single pathological node detected on ultrasound surveillance. An isolated recurrence of papillary thyroid carcinoma was confirmed. An excisional biopsy was performed using ultrasound wire guidance to successfully remove the diseased node with minimal morbidity. CONCLUSION: Wire-guided lymph node excision biopsy is a safe and effective method that can be applied to multiple pathologies. As of yet, it is not routine practice to employ this technique. Larger studies would increase the generalisability and safety profile of this technique in the head and neck region.

Quality of life outcomes in cochlear implantation of children with profound and multiple learning disability.

This study was performed to investigate the effect of cochlear implantation on the Quality of Life (QoL) of children with profound and multiple learning disability (PMLD). This cohort of children has been viewed historically as poor candidates for cochlear implantation as they generally have poor speech and hearing outcomes. The Irish National Cochlear Implant Program's prospectively maintained database was examined for all children implanted from July 1996 to July 2015. All charts of the 381 children implanted during this time were reviewed retrospectively; 16 children met criteria for being PMLD. For this cohort of patients, speech and hearing performance and the Glasgow Children's Benefit Inventory scores were retrospectively analyzed. Speech and hearing outcomes, as measured by Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores, demonstrated little or no improvement from pre-implantation to an interval 3 years post-op; however, 11 out of 16 parents reported an improvement in their child's quality of life after implantation with 3 out of 16 reporting no improvement. This study suggests that despite children with PMLD performing poorly on traditional outcome measures such as CAP and SIR they may have improvement to their QoL after cochlear implantation. Further study is warranted to characterize the impact of CI on these children.

The use of a camera-enabled mobile phone to triage patients with nasal bone injuries.

OBJECTIVE: To identify the accuracy of a camera-enabled mobile phone in assessing patients with nasal bone injuries and to determine if treatment in the form of manipulation of the nasal bones and therefore outpatient attendance was necessary. METHODS: Prospective study of patients with nasal injuries attending the weekly ear-nose-throat emergency clinic. The patient is assessed and examined, and a preset questionnaire is filled out. An anteroposterior photograph and an overhead photograph of the nose are taken. The pictures are then e-mailed to a senior member of the team who reviews the pictures and determines based on the images whether intervention in the form of manipulation of nasal bones was required. The results were then compared with the actual assessment and management in the clinic. RESULTS: Of the 50 patients assessed, 94% showed a direct correlation between the perceived need for treatment based on the clinical images and the actual management in the outpatient clinic. The results also showed the test to be 88% specific and 100% sensitive. CONCLUSIONS: We conclude that the use of a mobile phone camera to assess nasal bone injuries could be a useful triage tool in correctly identifying patients who may require intervention in the form of nasal bone manipulation.

Body composition of elite, eumenorrheic and amenorrheic, adolescent cross-country runners.

The purpose of the study was to investigate the seasonal relationship of athletic amenorrhea and body composition in elite, adolescent, cross-country runners. The participants consisted of 28 female adolescent cross-country runners (mean age +/- SD = 15.4 +/- 1.5 years); 17 eumenorrheics and 11 amenorrheics. The participants' body composition was measured pre- and postseason using dual-energy X-ray Absorptiometer (DXA). The eumenorrheics' postseason BMD was significantly greater than the amenorrheics' postseason BMD (F(1,54) = 16.22, p < .05, partial eta2 = .231). The eumenorrheics' postseason bodyweight (F(1,54) = 7.65, p < .05, partial eta2 = .124), BF (F(1,54) = 8.56, p < .05, partial eta2 = .137), and BMC (F(1,54) = 8.52, p < .05, partial eta2 = .136) were significantly greater than the amenorrheic subgroup. There was also a significant seasonal increase in BMD (t(27) = -4.01, p < .05) for the overall group and the eumenorrheic subgroup (t(16) = -3.90, p < .05). Bodyweight best predicted BMD (F(1,26) = 46.434, p < .05, R2 = .641). In the study, athletic amenorrhea was highly associated with lower levels of BMD in the participants, and cross-country running was highly associated with increased BMD.

Enzymatic characterization of a human acyltransferase activity.

BACKGROUND: Non-histone protein acylation is increasingly recognized as an important posttranslational modification, but little is known as to the biochemical properties of protein serine acylating enzymes. METHODOLOGY/PRINCIPAL FINDINGS: We here report that we have identified a metal-stimulated serine octanoyltransferase activity in microsomes from human erythroleukemic (HEL) cells. The HEL acylating enzyme was linear with respect to time and protein, exhibited a neutral pH optimum (stimulated by cobalt and zinc), and inhibited by chelating reagents. Hydroxylamine treatment removed most, but not all, of the attached radioactivity. A salt extract of microsomal membranes contained the major portion of enzyme activity, indicating that this acyltransferase is not an integral membrane protein. Sucrose density fractionation showed that the acyltransferase activity is concentrated in the endoplasmic reticulum. In competition experiments, the acyltransferase was well inhibited by activated forms of fatty acids containing at least eight to fourteen carbons, but not by acetyl CoA. The zinc-stimulated HEL acyltransferase did not octanoylate proenkephalin, proopiomelanocortin, His-tagged proghrelin, or proghrelin lacking the amino-terminal His-tag stub of Gly-Ala-Met. The peptides des-acyl ghrelin and ACTH were also not acylated; however, des-acyl ghrelin containing the N-terminal tripeptide Gly-Ala-Met was acylated. Mutagenesis studies indicated a requirement for serine five residues from the amino terminus, reminiscent of myristoyl transferase, but not of ghrelin acylation. However, recombinant myristoyl transferase could not recapitulate the hydroxylamine sensitivity, zinc-stimulation, nor EDTA inhibition obtained with HEL acyltransferase, properties preserved in the HEL cell enzyme purified through four sequential chromatographic steps. CONCLUSIONS/SIGNIFICANCE: In conclusion, our data demonstrate the presence of a zinc-stimulated acyltransferase activity concentrated in the endoplasmic reticulum in HEL cells which is likely to contribute to medium-chain protein lipidation.

Assessment of condom use among Bolivian truck drivers through the lens of social cognitive theory.

This study demonstrates that Bolivian long distance truck drivers are a high risk population of HIV infection and transmission, supporting other global studies involving truck drivers and their high risk. The aims of this investigation were to estimate the prevalence of high risk behaviors and to identify predictors of condom use in this population. Analysis was completed on survey results from 246 male truckers (aged 18-67). About one in three of the truck drivers (30%) reported having had a sexually transmitted infection sometime in their past. More than half (56%) reported having sex with casual partners. Other risks involved unprotected anal sex. Age and two social cognitive constructs (outcome expectations and perceived social norms) predicted condom use from logistic regression analysis. The authors discuss the need for expanded HIV/sexually transmitted infection prevention programs that incorporate social cognitions.