Feasibility and Safety of Video Endoscopic Inguinal Lymphadenectomy in Vulvar Cancer: A Systematic Review.

OBJECTIVE: To systematically review previous studies and to evaluate the feasibility and safety of video endoscopic inguinal lymphadenectomy (VEIL) in vulvar cancer. METHODS: We conducted a comprehensive review of studies published through September 2014 to retrieve all relevant articles. The PubMed, EMBASE, Web of Science, Cochrane Library, Wan Fang Data and Chinese National Knowledge Infrastructure databases were systematically searched for all relevant studies published in English or Chinese through September 2014. Data were abstracted independently by two reviewers, and any differences were resolved by consensus. RESULTS: A total of 9 studies containing 249 VEIL procedures involving 138 patients were reviewed. Of the 249 VEIL procedures, only 1 (0.4%) was converted to an open procedure for suturing because of injury to the femoral vein. The range of operative time was 62 to 110 minutes, and the range of estimated blood loss was 5.5 to 22 ml. The range of the number of harvested lymph nodes was 7.3 to 16. The length of hospital stay varied from 7 to 13.6 days across reports. The incidence of lymph node metastasis was 19.7% (27/138), and the recurrence rate was 4.3% (3/70) within 3 to 41 months of follow-up. One or more short-term complications were documented in 18 of 138 (13.0%) patients. Complications after VEIL were observed in 14 (10.13%) patients and in 15 (6.0%) of the VEIL cases, including major lymphocyst formation in 9 (3.6%), lymphorrhea in 2 (0.8%), inguinal wound infection without wound breakdown in 3 (1.2%) and lymphedema in 1 (0.4%). CONCLUSIONS: VEIL appears to be a feasible procedure in the management of vulvar cancer. There may be potential benefits that result in lower morbidity compared to traditional methods, but this has yet to be objectively proven.

Preferential Use of Carbon Sources in Culturable Aerobic Mesophilic Bacteria of Coptotermes curvignathus's (Isoptera: Rhinotermitidae) Gut and Its Foraging Area.

The lower termite, Coptotermes curvignathus, is one of the most prominent plantation pests that feed upon, digest, and receive nourishment from exclusive lignocellulose diets. The objective of this study was to examine the utilization of sole carbon sources by isolated culturable aerobic bacteria among communities from the gut and foraging pathway of C. curvignathus. We study the bacteria occurrence from the gut of C. curvignathus and its surrounding feeding area by comparing the obtained phenotypic fingerprint with Biolog's extensive species library. A total of 24 bacteria have been identified mainly from the family Enterobacteriaceae from the identification of Biolog Gen III. Overall, the bacteria species in the termite gut differ from those of foraging pathway within a location, except Acintobacter baumannii, which was the only bacteria species found in both habitats. Although termites from a different study area do not have the same species of bacteria in the gut, they do have a bacterial community with similar role in degrading certain carbon sources. Sugars were preferential in termite gut isolates, while nitrogen carbon sources were preferential in foraging pathway isolates. The preferential use of specific carbon sources by these two bacterial communities reflects the role of bacteria for regulation of carbon metabolism in the termite gut and foraging pathway.

Termite digestomes as a potential source of symbiotic microbiota for lignocelluloses degradation: a review.

Termites thrive in great abundance in terrestrial ecosystems and the symbiotic gut microbiota play important roles in digestion of lignocelluloses and nitrogen metabolism. Termites are excellent models of biocatalysts as they inhabit dense microbes in their guts that produce digestive enzymes to decompose lignocelluloses and convert it to end products such as sugars, hydrogen, and acetate. Different of digestive system between lower and higher termites which lower termites dependent on their dual decomposing system, consisting of termite's own cellulases and gut's protists. Higher termites decompose cellulose using their own enzymes, because of the absence of symbiotic protists. Termite gut prokaryotes efficiently support lignocelluloses degradation. In this review, a brief overview of recent experimental works, development and commercialization is discussed. Significant progress has been made to isolate cellulolytic strains from termites and optimise the digestion efficiency of cellulose. Future perspective should emphasize the isolation of cellulolytic strains from termites, genetically modifying or immobilization of the microbes which produce the desired enzyme and thus benefits on the microbiology and biotechnology.

Compost feedstock characteristics and ratio modelling for organic waste materials co-composting in Malaysia.

In Malaysia, large amounts of organic materials, which lead to disposal problems, are generated from agricultural residues especially from palm oil industries. Increasing landfill costs and regulations, which limit many types of waste accepted at landfills, have increased the interest in composting as a component of waste management. The objectives of this study were to characterize compost feedstock properties of common organic waste materials available in Malaysia. Thus, a ratio modelling of matching ingredients for empty fruit bunches (EFBs) co-composting using different organic materials in Malaysia was done. Organic waste materials with a C/N ratio of < 30 can be applied as a nitrogen source in EFB co-composting. The outcome of this study suggested that the percentage of EFB ranged between 50% and 60%, which is considered as the ideal mixing ratio in EFB co-composting. Conclusively, EFB can be utilized in composting if appropriate feedstock in term of physical and chemical characteristics is coordinated in the co-composting process.

Structure of epiglucan, a highly side-chain/branched (1 --> 3;1 --> 6)-beta-glucan from the micro fungus Epicoccum nigrum Ehrenb. ex Schlecht.

The extracellular fungal polysaccharide, epiglucan, synthesised by Epicoccum nigrum is a side-chain/branched (1 --> 3;1 --> 6)-D-beta-glucan. Methylation analysis, 13C DEPT NMR and specific enzymic digestion data show slight variation in branching frequency among the epiglucans from the three strains examined. The (1 --> 3)-beta-linked backbone has (1 --> 6)-beta-linked branches at frequencies greater than the homologous glucans, scleroglucan and schizophyllan, from Sclerotium spp. and Schizophyllum commune, respectively. The structural analyses do not allow a distinction to be made between structures I and II. [structures: see text] Epiglucan displays non-Newtonian shear thinning rheological properties, typical of these glucans.

Root coverage and pocket reduction as combined surgical procedures.

BACKGROUND: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots due to gingival recession. A large variety of mucogingival grafting procedures are available that give highly predictable and esthetically acceptable results when treating intact root surfaces. However, these procedures call for a second surgery site in the palate. The present study examines a series of cases in which connective tissue, obtained from the tuberosity during pocket reduction procedures in the posterior region of the maxilla, was used for root coverage. METHODS: Forty-four teeth from 25 patients with gingival recession of 3.30 +/- 0.14 mm (mean +/- SEM) were treated with subepithelial connective tissue grafts using connective tissue obtained from the tuberosity area during pocket reduction procedures in the posterior region of the maxilla. RESULTS: The mean root coverage recession after treatment was 0.16 +/- 0.06 mm, with effectiveness of coverage at 95.0% +/- 1.84 and a predictability of 84.1%. Periodontal probing depth reduction at the donor site was 4.08 +/- 0.24 mm. CONCLUSIONS: These results indicate that the subepithelial connective tissue graft obtained from the tuberosity area during pocket reduction procedures in the posterior region of the maxilla provides a very predictable and esthetic root coverage without the need for a second surgical site.

The Hettinger hand vibration test, vasospasm, and glaucoma.

Ocular vasospasm in response to local and/or systemic stimuli may contribute to ischemia of the optic nerve. The Hettinger hand vibration test was applied to patients with and without glaucoma to identify subgroups with a high systemic vasospastic tendency. A total of 580 subjects were tested (113 controls, 86 glaucoma suspects, 270 with primary open-angle glaucoma, 71 with secondary open-angle glaucoma, 30 with normal-tension glaucoma, and 10 with angle-closure glaucoma). The frequency distribution curve of Hettinger scores (HS) was bimodal, suggesting two distinct groups. Within each diagnostic group, a subpopulation with a high HS could be identified. Multivariate analysis demonstrated a significant association between the nonselective topical beta-blocker timolol and higher mean HS (P = 0.04) and a significantly higher proportion of subjects with HS of 1.5 or more (P = 0.01). Although subjects taking systemic beta1-selective blockers had significantly lower mean HS (P = 0.04), the proportion of patients with HS of 1.5 or more was not affected significantly by topical and systemic beta1-selective blocker use. Whereas topical nonselective beta-blockers may have an adverse effect on vasospastic tendency, systemic beta1-selective blockers may be partially protective against this effect.

Visual field responses to a hand vibration stimulus.

Two short visual field tests were performed on 106 subjects approximately 5 minutes apart with or without a hand vibration stimulus between the field tests. There were 31 eyes in the control group (10 without glaucoma, eight glaucoma suspects, 10 with primary open-angle glaucoma, and three with secondary open-angle glaucoma). There were 75 eyes in the hand vibration group (16 without glaucoma, 20 glaucoma suspects, 25 with primary open-angle glaucoma, eight with secondary open-angle glaucoma, three with normal-tension glaucoma, and three with other forms of glaucoma). Average visual field sensitivities were significantly reduced in the arcuate zones after a hand vibration stimulus (-0.42 dB; SD, 1.26 dB) when compared with sensitivities in the arcuate zones in subjects without the hand vibration stimulus (+0.38 dB; SD, 1.53 dB; P = 0.01). Multivariate analysis demonstrated a significant reduction in this response in the arcuate zone associated with use of betaxolol (P = 0.021) and timolol (P = 0.047). Betaxolol was associated with significantly smaller reductions in visual field sensitivities in the paracentral zone (P = 0.01). Reductions in visual field sensitivities that may be related to ocular vasospasm occurred after a hand vibration stimulus. This response may be able to be modified pharmacologically with topical beta-blockers, particularly betaxolol.

[Evaluation of asthmatic children presenting at the emergency room at Barzilai Hospital].

Bronchial asthma in the pediatric age group has become prevalent recently. Many children who suffer from asthma arrive at the emergency room (ER) with exacerbations which did not respond to medical treatment at home. Between July and December 1997, 136 children 8 months to 14 years of age (61% below 3 years), were studied in our pediatric ER. Investigation included physical examination and pulse oximetry, which were used as guidelines for scoring the children on arrival and post-treatment. Spirometry was done in those who could cooperate. For each patient a detailed questionnaire about medical and sociodemographic factors was filled. Primary pediatricians used mainly beta-agonist and corticosteroid inhalators, while pediatric pulmonologists used mainly inhaled steroids. There was no relationship between severity of attack on arrival at the ER, mode of treatment and speed of recovery in the ER. More children treated by a general pediatrician more were admitted to hospital. Low parental education and paternal smoking were risk factors for recurrent hospital admissions. Our results indicate that parents must be educated to stop smoking, especially those with asthmatic children, and primary pediatricians should be updated with regard to proper treatment and follow-up of asthma.

Oncogenic evaluation of tetrachlorvinphos in the B6C3F1 mouse.

Groups of 80 male and 80 female B6C3F1 mice were fed diets containing 17.5, 64, 320, 1600, 8000, and 16000 ppm tetrachlorvinphos (TCVP) for up to 103 weeks. Another group of 80 male and 80 female mice were fed TCVP (16000 ppm) that was used in a previous bioassay. One hundred-sixty male and 160 female mice served as the control group. Ten treated and 20 control mice/sex/group were killed at 6, 12, and 18 months. It was estimated that the study maximum-tolerated dose was exceeded by three- and sixfold in the 8000- and 16000-ppm dose groups, respectively. Consequently, these exposures produced excessive cytotoxicity and regenerative changes in the liver and kidneys which were associated with sex-hormonal imbalance and metabolic overload in liver. A significant decrease (15-40%) in body weight was observed in mice fed 8000 and 16000 ppm TCVP. These treated mice did not gain weight during the study. Reduced food consumption and caloric intake throughout the study were probably responsible for the increased survival and the decreased incidence of spontaneous neoplasia in mice fed 8000 and 16000 ppm TCVP. Classification of pathologic lesions observed in these high-dose groups differed among study and consulting pathologists. The consultant and Shell pathologists concluded that the liver and kidney changes were causally related to excessive toxicity which was manifest primarily by hepatocellular hyperplasia and renal tubular adenoma. Study pathologist in accordance with his classification found statistically significant increases in hepatocellular carcinoma, hepatocellular adenoma or carcinoma, and renal tubular carcinoma in male mice fed 16000 ppm TCVP. The incidence of hepatic neoplasms as evaluated by the study pathologist in female mice fed 8000 and 16000 ppm TCVP although statistically significant was of questionable biologic significance when compared with historical female controls. The only statistically significant finding observed by the consulting pathologist was an increased incidence of renal tubular adenoma and renal tubular adenoma or carcinoma in male mice fed 16000 ppm TCVP. Use of results from these high-dose groups is contraindicated due to the many compromising factors affecting mice fed 8000 and 16000 ppm TCVP. TCVP was found not to be oncogenic in B6C3F1 mice at dose levels not exceeding the maximum tolerated dose.

Swine microsomal acyl-CoA synthetase activity: effect of age and diet.

Fatty acid activation was examined by assessing the activity of acyl-CoA synthetase (ACS) in microsomal fractions of liver and adipose tissue obtained from swine of various ages. Liver ACS activity increased from ca. 200 to 800 nmol/(minute x g tissue) between birth and 25 days postpartum; enzyme activity generally remained elevated postweaning through 155 days of age. The preweaning hepatic patterns on a wet weight and protein basis were similar, but the wet weight- and protein-based patterns diverged after weaning due to an increase in microsomal protein. As in liver, adipose tissue ACS activity rose rapidly from birth to 25 days of age [20-110 nmol/(minute x g tissue)] but declined to lower levels after weaning. Expression of enzyme activity on a wet weight, protein, or cellular basis revealed similar developmental patterns for adipose tissue. The postweaning fall in adipose tissue ACS activity was partially explained by decreasing cellularity per unit tissue weight. In swine fed equal amounts of isoenergetic-isonitrogenous diets with low or high fat content, hepatic ACS activity tended to increase in pigs fed the high fat diet with no effect of diet on the adipose enzyme. Starvation elevated liver ACS activity, whereas the adipose enzyme activity was marginally decreased.

Factors influencing the lipogenic rate in swine adipose tissue.

Measurements of the lipogenic rate in adipose tissue samples obtained sequentially by biopsy from the same pig may be useful for many nutritional experiments. The average lipogenic rate over a short period (several days to 2 weeks) appears to be relatively stable if the pigs weigh about 20 kg initially and if approximately 10 animals are allotted to each experimental group. The lipogenic rate is readily influenced by the feeding regimen (amount and timing). It is easily lowered by less than ad libitum dietary intakes and is influenced especially by the intake pattern for several days preceding the rate determination. In two different experiments, the lipogenic rate obtained at either 20 or 50 kg body weight was not effective as a predictor of backfat thickness or loineye area measured 13 or 6 weeks later, respectively.

Effects of diet on swine glyceride lipid metabolism.

Swine were fed equal amounts of isoenergetic-isonitrogenous diets with low-fat or high-fat content. The high-fat diet, as well as starvation, suppressed the synthesis of fatty acid from glucose in adipose tissue. Diet had no effect on adipose tissue enzymes associated with glyceride synthesis; whereas starvation caused all activities expressed per g tissue to decrease. The hepatic enzyme activities associated with glyceride synthesis tended to be greater in swine fed the the high-fat diet compared to the low-fat diet. Starvation lowered the hepatic esterification of glycerol-3-phosphate but did not influence other enzymes.