PAH exposure-associated lung cancer: an updated meta-analysis.

Background: Occupational exposure to polycyclic aromatic hydrocarbons (PAHs) has been shown to be associated with lung cancer in various epidemiological studies in industries such as aluminium reduction/smelting, coal gasification, coke production, iron/steel foundries, coal/coke and related products and carbon/graphite electrodes production. Aims: To update data on the association between PAH exposure and morbidity and mortality due to lung cancer among workers in different occupations, including smoking data. Methods: A comprehensive literature search was conducted to retrieve relevant papers for meta-analysis. Cohort studies with standardized mortality ratios or standardized incidence ratios and calculated overall risk ratio with their corresponding 95% confidence intervals (CIs) were included in the analysis. Chi-square test for heterogeneity was used to evaluate the consistency of findings between the studies. Results: A significant risk of lung cancer was observed among the coal/coke and related product industry 1.55 (95% CI 1.01-2.37) and the iron/steel foundry industry 1.52 (95% CI 1.05-2.20). There was a wide variation in smoking habits and PAHs exposure among studies. Conclusions: Coal/coke industry and iron/steel industry workers showed a higher risk of lung cancer compared with other occupations exposed to PAHs. The confounding effects of smoking and individual exposure levels of PAH should be taken into account.

Schwannoma base tongue: Case report and review of literature.

Schwannomas are benign peripheral nerve sheath tumors. These are rare in the oral cavity (1%). The most common site of involvement in oral cavity is the tongue. Posterior third of tongue is not frequently involved. The aim of this paper is to present a case report of base tongue schwannoma and review literature of this rare tumor. Data from literature were analyzed for age, gender, presenting symptom, size at presentation, and surgical approach. We report a case of 26 year-old male who presented with swelling posterior 1/3rd tongue and change in quality of voice. He was evaluated for the same with MR and incision biopsy and was planned for surgery. Surgery was abandoned at a district hospital due to difficulty in intubation. At our center he underwent fibro optic bronchoscopy guided intubation followed by general anesthesia. He underwent excision of mass using left paramedian lip spitting approach with mandibulotomy and mandibular swing. Tumor was excised in toto. His postoperative recovery was uneventful. Literature review between 2001 and 2012 was done. 15 cases of base tongue schwannoma were identified. The most common age group involved was between 30-40 years. There was a slightly higher incidence in females. All patients were symptomatic at presentation. Most common complaints were related to swallowing and throat pain. Most patients underwent transoral excision of the tumor.

Simultaneous dual scope endotherapy of esophago-airway fistulas and obstructions.

Management of esophago-airway fistulas (EAF) and obstructions often involves therapy with esophageal and/or airway stents. We present a unique approach for the management of EAF and obstructions with simultaneous upper endoscopy and bronchoscopy (two scopes inserted simultaneously through the mouth). The aim is to assess the efficacy and safety of a simultaneous dual scope approach for management of EAF and obstructions. The endoscopy database at the University of Florida was reviewed from October 2007 to April 2012 to identify adult patients who had undergone simultaneous upper endoscopy and bronchoscopy for EAF and obstructions. Medical records were reviewed for demographics, indication, pathology, imaging, simultaneous endoscopic and bronchoscopic findings/maneuvers, outcomes, and adverse events. Outcomes assessed included: (i) technical success, (ii) fistula occlusion, (iii) dysphagia score, and (iv) adverse events. Thirteen patients with EAF and/or obstruction underwent simultaneous dual scope endoscopy. Dual scope procedures were technically successful in 12/13 (92%) patients. Dysphagia score improved from three to one in both patients with dysphagia without EAF. Fistula occlusion was observed in 7/10 patients (70%) with EAF. With this technique, stents were placed accurately without airway compression, migrated esophageal stents extracted from the tracheal lumen without trauma, and tracheal stents not displaced during esophageal manipulations. EAF not otherwise apparent were identified in two patients. Adverse events occurred in 2/13 (15%) patients, and 5/13 (38%) patients died from advanced cancer during follow up (mean 4.1 months, range 1-8 months). Simultaneous dual scope (two scopes inserted through the mouth at the same time) therapy of EAF and obstructions is feasible, effective, and safe, and may develop to be the preferred approach for the management of complex esophago-airway diseases.

Terahertz technology: a boon to tablet analysis.

The terahertz gap has a frequency ranges from approximately 0.3 THz to approximately 10 THz in the electromagnetic spectrum which is in between microwave and infrared. The terahertz radiations are invisible to naked eye. In comparison with x-ray they are intrinsically safe, non-destructive and non-invasive. Terahertz spectroscopy enables 3D imaging of structures and materials, and the measurement of the unique spectral fingerprints of chemical and physical forms. Terahertz radiations are produced by a dendrimer based high power terahertz source and spectroscopy technologies. It resolves many of the questions left unanswered by complementary techniques, such as optical imaging, Raman and infrared spectra. In the pharmaceutical industries it enables nondestructive, internal, chemical analysis of tablets, capsules, and other dosage forms. Tablet coatings are a major factor in drug bioavailability. Therefore tablet coatings integrity and uniformity are of crucial importance to quality. Terahertz imaging gives an unparalleled certainty about the integrity of tablet coatings and the matrix performance of tablet cores. This article demonstrates the potential of terahertz pulse imaging for the analysis of tablet coating thickness by illustrating the technique on tablets.

Inducible nitric oxide synthase (iNOS) activity promotes ischaemic skin flap survival.

We have examined the role of nitric oxide (NO) in a model of functional angiogenesis in which survival of a skin flap depends entirely on angiogenesis to provide an arterial blood supply to maintain tissue viability. The different effects of nitric oxide synthase (NOS) inhibitors on rat skin flap survival appeared to be explained on the basis of their NOS isoform selectivity. Skin flap survival was decreased by iNOS-selective (inducible NOS) inhibitors, S-methyl-isothiourea, aminoguanidine and aminoethylthiorea; unaffected by the non-selective inhibitor nitro-imino-L-ornithine; and enhanced by the cNOS (constitutive NOS, that is endothelial NOS (eNOS) and neuronal NOS (nNOS)) inhibitor, nitro-L-arginine methyl ester. Skin flap survival was reduced in mice with targeted disruption of the iNOS gene (iNOS knockout mice), and the administration of nitro-L-arginine methyl ester significantly increased flap survival in iNOS knockout mice (P<0.05). iNOS immunoreactivity was identified in mast cells in the angiogenic region. Immunoreactive vascular endothelial growth factor (VEGF) and basic fibroblast growth factor were also localized to mast cells. The combination of interferon-gamma and tumour necrosis factor-alpha induced NO production and increased VEGF levels in mast cells cultured from bone marrow of wild-type, but not iNOS KO mice. The increased tissue survival associated with the capacity for iNOS expression may be related to iNOS-dependent enhancement of VEGF levels and an ensuing angiogenic response. Our results provide both pharmacological and genetic evidence that iNOS activity promotes survival of ischaemic tissue.

Cold storage of rat skeletal muscle free flaps and pre-ischemic perfusion with modified UW solution.

We used the rat medial gastrocnemius free flap, based on a pedicle of the femoral artery and vein, in order to test the tolerance of skeletal muscle to cold ischemia-reperfusion (IR) injury, and to determine whether tolerance can be enhanced by pre-ischemic perfusion with tissue/organ preservation solutions. Muscle flaps (n = 6 per group) were subjected to variable periods of cold storage (0, 1, 2, 3, or 4 days) and 24-h normothermic reperfusion. Muscle viability, as determined by nitroblue tetrazolium (NBT) histochemical staining of viable mitochondria and supported by histological examination, was 100%, 26%, 11%, 4%, and 1%, respectively. Using 24-h cold storage/24-h reperfusion as the experimental conditions, groups of muscle flaps (n = 5 per group) were perfused immediately before cold storage with either modified, colloid-free University of Wisconsin (UW) solution, a solution described by Kohout et al. (Br J Plast Surg 1995;48:132-144) or normal saline. Perfusion with modified UW solution or Kohout's solution increased survival to 33% (P < 0.05) and 28% (not statistically significant), respectively, compared with the 19% viability of separate groups of nonperfused or saline-perfused controls. These findings indicate that cold-stored skeletal muscle is highly susceptible to cold IR injury and that the viability can be increased by prior perfusion with a tissue preservation solution such as modified UW solution.

The dual nature of specific immunological activity of tumor-derived gp96 preparations.

Mice immunized with optimal doses of autologous tumor-derived gp96 resist a challenge with the tumor that was the source of gp96. Immunization with quantities of gp96 5-10 times larger than the optimal dose does not elicit tumor immunity. This lack of effect is shown to be an active, antigen-specific effect, in that immunization with high doses of tumor-derived gp96, but not normal tissue-derived gp96, downregulates the antitumor immune response. Furthermore, immunization with fractionated doses of gp96 elicits the same kind and level of response as elicited by a single dose equivalent to the total of the fractionated doses. This is true of the tumor-protective doses as well as the high downregulatory doses of gp96. The downregulatory activity can be adoptively transferred by CD4(+) but not CD8(+) T lymphocytes from mice immunized with high doses of gp96. These observations indicate that immunization with gp96 induces a highly regulated immune response that, depending upon the conditions of immunization, results in tumor immunity or downregulation.

New source of vein graft for rabbit experimentation.

The present report introduces a new source of vein graft in rabbit experimentation which is long and of large caliber. The average length of available vein was 13.3+/-0.9 cm (mean+/-SD). The average external diameter of the vein was 1.8+/-0.2 mm (mean+/-SD), 1.4+/-0.4 mm (mean+/-SD), and 1.8+/-0.2 mm (mean+/-SD) at the proximal, middle, and distal portions, respectively. The average number of valves throughout the vein was 7+/-1. The vein is anatomically termed the lateral saphenous vein distally and the ischiadic vein proximally, and is superficially located on the lateral aspect of the pelvic limb. Therefore, this vein is easily harvested from the lower crus to the upper-thigh, providing a long length of vein graft for experimental study.

The beneficial antiinflammatory effect of dexamethasone administration prior to reperfusion on the viability of cold-stored skin flaps.

The main purpose of this study was to investigate the possible protective effect of a single dose of glucocorticoid dexamethasone administered just before reperfusion on the viability of cold-stored inferior epigastric rat skin flaps. We also sought evidence for the antiinflammatory mechanism of action of dexamethasone involved in this model of cold ischemia-reperfusion. The viability of flaps on reperfusion day 7, after 1, 2, 3, 4, or 5 days of cold ischemia, was 80, 74, 60, 47 and 12% respectively. Four days' cold ischemia time was chosen to test the effect of intraperitoneal dexamethasone administration (2.5 mg/kg) 30 min prior to reperfusion. Flap survival after 4 days' cold ischemia/7 days' reperfusion increased significantly from a mean of 37.0% survival in saline-treated controls to 73.3% in dexamethasone-treated rats (p < 0.05). Dexamethasone treatment also resulted in significantly lower skin flap water content (a measure of edema) and myeloperoxidase activity (an indicator of neutrophil infiltration) but had no significant effect on skin levels of hydroperoxides (a measure of free radical activity). In conclusion, dexamethasone attenuates ischemia-reperfusion injury in cold-stored skin flaps by reducing the tissue levels of several proinflammatory mediators.

Congenital midline palatomandibular bony fusion with a mandibular cleft and a bifid tongue.

Congenital fusion of the maxillary and mandibular alveolar arches and a cleft of the mandible are each quite rare. A patient who had both a midline palatomandibular bony fusion as well as a mandibular cleft with a bifid tongue is presented.

Traumatic wound dehiscence after penetrating keratoplasty.

Eighteen eyes with wound dehiscence after penetrating keratoplasty were studied. Keratoplasty was performed for corneal scarring (n = 8), dystrophies (n = 6), graft failure (n = 2), and corneal edema (n = 2). The mean duration between keratoplasty and wound dehiscence was 6.54 months. All eyes underwent wound repair with or without iris excision, lensectomy, and vitrectomy. Grafts remained clear in eight eyes. Five eyes developed phthisis bulbi. Visual acuity was better than 20/200 in seven eyes. There was no site (quadrant) specificity for dehiscence. Trivial trauma resulted in dehiscence in 10 of the 18 eyes. The major determinants of visual outcome were the force of trauma and status of the posterior segment. Dehiscence of the graft-host junction in all cases reflects its persistent weakness after surgery.

Identical unusual subtotal penile amputation in children: a report of four cases.

4 cases are reported in whom an accidental or iatrogenic near complete slow amputation of the penis at the corona glandis was observed at first presentation. A representative case is presented in detail with illustrations showing the surgical repair carried out. The future erectile ability of this reconstructed phallus is speculated upon.

Intensity transformation by rectangular tapered reflective coupling.

A complete analysis of light propagation through a hollow coupling with a uniformly varying cross section and specularly reflecting walls is given. This enables one to relate the entrance and exit intensity distributions when the input is incoherent but collimated. Results indicate that the input aperture can be partitioned into sections characterized by the total number of reflections an incoming ray has within the coupling. Input radiation in every section is linearly spread over the entire exit aperture. Hence nonuniformities in the input intensity profile are reduced at the output. This effect can be enhanced by proper design as discussed in the paper.

Right angle bends in light pipes: analysis.

An expression for the fraction of incident radiation transmitted by a right angle bend in a rectangular light pipe is derived. This expression is used to show that, in a planar light pipe structure with right angle bends, light attenuation is due only to reflection losses at the walls if the launching angle is 45 degrees .

Coupling efficiency between light pipes of different dimensions.

An expression for the transmitted fraction of the uniform and parallel radiation incident upon the coupler between two rectangular light pipes of different physical dimensions is derived. It is a function of the pipe dimension ratio and the angle of the incident radiation. It is shown that for radiation nearly parallel to the pipe axis, it is possible to design a coupler for any pipe dimension ratio so that all the radiation incident upon it is transmitted by it. Design curves for various incidence angles and the pipe dimensions are presented.

Coupling between two cylindrical light pipes: a design.

An expression for the transmission characteristics of a conical coupling is derived. This expression is shown to be useful for choosing an optimum coupling length.