Exclusive real-time monitoring during recurrent laryngeal nerve dissection in conventional monitored thyroidectomy.

During conventional intermittent intraoperative neuromonitoring (IONM) in thyroidectomy, recurrent laryngeal nerve (RLN) injury is detected by an electromyographic (EMG) loss of signal (LOS) after the nerve dissection. Exclusive continuous monitoring during the phase of RLN dissection may be helpful in detecting adverse EMG changes earlier. A total of 208 RLNs at risk were enrolled in this study. Standardized IONM procedures were followed. We continuously stimulated the RLN at the lower exposed end with a stimulator to exclusively monitor the real-time quantitative EMG change during RLN dissection. Once the amplitude decreased by more than 50% of the initial signal, the surgical maneuver was paused and the RLN was retested every minute for 10 minutes to determine amplitude recovery before restarting the dissection. The procedure was feasible in all patients. No LOS was encountered in this study. Nineteen RLNs had an amplitude reduction of more than 50%. Eighteen nerves showed gradual amplitude recovery (16 nerves had a traction injury and two nerves had a compression injury). After 10 minutes, the recovery was complete (i.e., >90%) in eight nerves, 70-90% in seven nerves, and 50-70% in three nerves. Among these 18 nerves, only one nerve developed temporary vocal palsy because it was exposed to unavoidable repeated nerve traction after restarting the dissection. Another nerve showed no gradual recovery from thermal injury, and developed temporary vocal palsy. The temporary and permanent palsy rates were 1% and 0%, respectively. During intermittent IONM, exclusive real-time monitoring of the RLN during dissection is an effective procedure to detect an adverse EMG change, and prevent severe RLN injuries that cause LOS.

Lovastatin inhibited the growth of gastric cancer cells.

BACKGROUND/AIMS: Gastric cancer cells required large amount of cholesterol to grow and proliferate. The objective of this study was to examine whether the growth of gastric cancer cells was inhibited in vivo by using lovastatin, an effective cholesterol-lowing drug. METHODOLOGY: The mice models for gastric cancer cells MKN45 were divided into two groups, the control and experimental group. Lovastatin was administered orally to the experimental group, while saline given to the control group. We measured the volume and weight of tumors, and calculated RTV (relative tumor volume), T/C (relative added value of tumor) and the inhibition rate. Then the expression levels of PCNA in gastric cancer tissues were examined immunohistochemically. RESULTS: The volume of tumors in the control and experimental groups was 3.801 +/- 1.078 and 3.325 +/- 0.745, respectively (p > 0.05), while RTV was 49.684 +/- 12.250 and 42.506 +/- 10.515, respectively (p > 0.05). T/C, an indication of antitumor, was 85.55%. The weight of tumors of the mice in control and experimental group was 3.23 +/- 0.43 and 2.65 +/- 0.58, respectively (p < 0.05). The inhibition rate was 20.48%. The PCNA index in the lovastatin group was 32.35 +/- 6.43%, while in the control group was 91.24 +/- 6.59%. The PCNA index of lovastatin group was much lower (P < 0.01). CONCLUSIONS: Lovastatin inhibited the growth of gastric cancer cells.

The correlation of the fetal cytokeratin expressing in epidermal cells and the different outcomes of wound repairing / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the changing regular of specific cytokeratin (CK) markers expressing in human pseudoepitheliomatous hyperplasia (PEH), keloids (Ke) and hypertrophic scar (HS) lesion, and to explore the correlation between such changes and the different outcomes of wound repair.</p><p><b>METHODS</b>Histopathology and immunohistochemistry (IHC) double staining methods were used in samples of human PEH, Ke, HS and NS to determine the distribution characteristics and changing regularity of CKs in epidermal tissues.</p><p><b>RESULTS</b>No CK8&18 and CK17 expressed in epidermis of NS group, while CK8&18(+) cells and CK17(+) cells were detected in epidermis of active-stage Ke, HS and PEH. The quantities of CK8&18(+) cells and CK17(+) cells ranked as follows: PEH > Ke > HS and HS > Ke > PEH (P < 0.05). CK19(+) cells and CK5&6(+) cells expressed similar changing trend, while reverse trend of CK10(+) cells was detected in epidermal cells, with local epidermal hyperplasia, cells morphological changes and sub-epidermal inflammatory reaction.</p><p><b>CONCLUSION</b>Different degree of de-differentiation and terminal differentiation imbalance are found in epidermal cells of active-stage PEH, Ke and HS, which hint the correlation between the abnormal proliferation and differentiation of epidermal cells and the different outcomes of wound repair.</p>