Neck dissection in the management of regional metastases in patients with undifferentiated nasopharyngeal carcinomas

Residual regional disease after the primary treatment of nasopharyngeal carcinoma is still considered to be a therapeutic problem. The limitations of prophylactic radical radiation, further doses of irradiation as a useful salvage procedure, and the effects on vital structures were the reasons that we employed a therapeutic protocol consisting of radical neck dissection after 40 Gy of radiotherapy and a full tumor dose after surgery. The initial treatment consisted of chemotherapy. Between 1977 and 1991 surgical removal of residual neck metastases was performed in 44 patients with undifferentiated nasopharyngeal carcinomas who had regional metastases at the time of diagnosis. Fourteen patients (group A) had radical neck dissections after initial chemotherapy (using doxorubicin, etoposide, bleomycin and/or 5-fluouracil) and between two courses of locoregional radiotherapy. The remaining 30 patients (group B) were operated on after finishing chemotherapy and locoregional radiotherapy (group B 1) or receiving only full-dose locoregional radiotherapy (group B 2). All patients had histopathologically proven complete remission of primary tumors before neck surgery. The five-year survival rates for group A were 78%, 40% for group B 1 and 27% for group B 2. There were statistically significant differences between groups A and B (P < 0.01), but not between groups B 1 and B 2. In group A one patient died from subsequent distant metastases and two from local tumor recurrences. Twenty patients died in group B, regional relapses occurred in 40% of the patients in group B 1 and 33% in group B 2, while distant metastases developed in 40% of group B 2. These findings again showed that radical neck dissection was an effective approach for controlling neck disease. When performed after initial chemotherapy and between two courses of radiotherapy, surgery significantly improves the prognosis of patients with positive regional lymph nodes at the time of diagnosis. Received: 2 June 1998 / Accepted: 21 October 1998     

A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Musculoskeletal System

Several negative adaptations to the musculoskeletal system occur following anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) such as arthrogenic muscle inhibition, decreased lower extremity muscle size, strength, power, as well as alterations to bone and cartilage. These changes have been associated with worse functional outcomes, altered biomechanics, and increased risk for re-injury and post-traumatic osteoarthritis. After ACL injury and subsequent ACLR, examination and evaluation of the musculoskeletal system is paramount to guiding clinical decision making during the rehabilitation and the return to sport process. The lack of access many clinicians have to devices necessary for gold standard assessment of muscle capacities and force profiles is often perceived as a significant barrier to best practices. Fortunately, testing for deficits can be accomplished with methods available to the clinician without access to costly equipment or time-intensive procedures. Interventions to address musculoskeletal system deficits can be implemented with a periodized program. This allows for restoration of physical capacities by adequately developing and emphasizing physical qualities beginning with mobility and movement, and progressing to work capacity and neuromuscular re-education, strength, explosive strength, and elastic or reactive strength. Additional considerations to aid in addressing strength deficits will be discussed such as neuromuscular electrical stimulation, volume and intensity, eccentric training, training to failure, cross-education, and biomechanical considerations. The American Physical Therapy Association adopted a new vision statement in 2013 which supported further development of the profession’s identity by promoting the movement system, yet validation of the movement system has remained a challenge. Application of a multi-physiologic systems approach may offer a unique understanding of the musculoskeletal system and its integration with other body systems after ACLR. The purpose of this clinical commentary is to highlight important musculoskeletal system considerations within a multi-physiologic system approach to human movement following ACLR.Level of Evidence5     

Evaluation of intrarenal oxygenation by BOLD MRI at 3.0 T

PURPOSE: To examine the benefit of using higher field strengths for BOLD MRI to detect changes in renal medullary oxygenation following pharmacological maneuvers. MATERIALS AND METHODS: Renal BOLD MRI, primarily at 1.5 T, has been shown to be useful for monitoring changes in medullary oxygenation status. We performed the present studies on a 3.0 T scanner using a multiple gradient-echo (mGRE) sequence with a multicoil array to acquire 16 T2*-weighted images within a single breath-hold. Data were obtained before and after administration of furosemide (20 mg iv). RESULTS: The baseline renal R2* (mean +/- SE) at 3.0 T was 37.4+/-1.2 Hz in the medulla, and 21.8 +/- 1.2 Hz in the cortex. The BOLD response to furosemide (DeltaR2*) at 3.0 T was 11.8 +/- 1.1 Hz in the medulla, and 3.0 +/- 0.5 Hz in the cortex. CONCLUSION: Higher magnetic field strength is beneficial for renal BOLD MRI studies. The cortico-medullary contrast on the R2* map was significantly improved at 3.0 T, with no evidence of increased bulk susceptibility artifacts. Baseline R2* and DeltaR2* in the renal medulla at 3.0 T were both significantly higher compared to our previously reported data obtained at 1.5 T.     

Effect of tacrolimus (FK506) and sirolimus (rapamycin) mono- and combination therapy in prolongation of renal allograft survival in the monkey

BACKGROUND: Our previous studies confirmed that tacrolimus (FK506) and sirolimus [rapamycin (RAPA)], in combination, are not antagonistic but are synergistic in the prolongation of heart and small bowel grafts in the rodent. The aim of this study was to confirm further the synergistic effect of combined FK506 and RAPA in the more clinically relevant model, kidney transplantation in monkeys. METHODS: A total of 60 male Vervet monkeys were randomly assigned to 10 groups (n> or =5). Monkeys with renal allografts were treated with different doses of FK506 and/or RAPA orally for 60 days. Graft survival, body weight, clinical biochemistry determinations, oral glucose tolerance test, trough levels of the two drugs, and histopathology were investigated. RESULTS: Low doses of FK506 (1 or 4 mg/kg) combined with RAPA (0.5 mg/kg) produced synergistic effect in the prolongation of renal graft survival [combination index (CI) = 0.292, 0.565]. There were no additive or synergistic drug-associated toxicities such as hyperglycemia, nephrotoxicity, and hyperlipidemia. There also was no pharmacological antagonism. CONCLUSION: Concomitant therapy of low-dose (drug-optimal) FK506 and RAPA produced a synergistic effect in the prolongation of kidney allograft survival in Vervet monkeys without additive drug-associated toxicities.     

Electronic structure and interface contact of two-dimensional van der Waals boron phosphide/Ga2SSe heterostructures

In this work, we systematically examine the electronic features and contact types of van der Waals heterostructures (vdWHs) combining single-layer boron phosphide (BP) and Janus Ga₂SSe using first-principles calculations. Owing to the out-of-plane symmetry being broken, the BP/Ga₂SSe vdWHs are divided into two different stacking patterns, which are BP/SGa₂Se and BP/SeGa₂S. Our results demonstrate that these stacking patterns are structurally and mechanically stable. The combination of single-layer BP and Janus Ga₂SSe gives rise to an enhancement in the Young’s modulus compared to the constituent monolayers. Furthermore, at the ground state, the BP/Ga₂SSe vdWHs possess a type-I (straddling) band alignment, which is desired for next-generation optoelectronic applications. The interlayer separation and electric field are effectively used to tune the electronic features of the BP/Ga₂SSe vdWH from the type-I to type-II band alignment, and from semiconductor to metal. Our findings show that the BP/Ga₂SSe vdWH would be appropriate for next-generation multifunctional optoelectronic and photovoltaic devices.

In this work, we systematically examine the electronic features and contact types of van der Waals heterostructures (vdWHs) combining single-layer boron phosphide (BP) and Janus Ga₂SSe using first-principles calculations.     

Insights into antiradical mechanism and pro-oxidant enzyme inhibitor activity of walterolactone A/B 6-O-gallate-β-d-pyranoglucoside originating from Euonymus laxiflorus Champ. using in silico study

The ability of a new compound, Wal, (walterolactone A/B 6-O-gallate-β-d-pyranoglucoside) originating from Euonymus laxiflorus Champ. as a hydroperoxyl radical scavenger and pro-oxidant enzyme inhibitor was studied in silico. Different mechanisms, reaction locations, and chemical species of Wal in aqueous solution were taken into consideration. Formal hydrogen transfer from the OH group has been discovered as the chemical process that contributes most to the antioxidant properties of Wal in nonpolar and aqueous solutions. The overall rate coefficients for polar and non-polar environments are expected to have values of 7.85 × 10⁶ M⁻¹ s⁻¹ and 4.84 × 10⁵ M⁻¹ s⁻¹, respectively. According to the results of the investigation, Wal has greater scavenging activity against the HOO˙ radical than the reference antioxidant Trolox at physiological pH (7.4). In addition, docking results indicate that Wal''s antioxidant properties involve the inhibition of the activity of enzyme families (CP450, MP, NO, and XO) that are responsible for ROS production.

In silico evaluation of a novel compound isolated from Euonymus laxiflorus Champ. for its ability as a hydroperoxyl radical scavenger and pro-oxidant enzyme inhibitor.     

Correction: Rapid prediction of possible inhibitors for SARS-CoV-2 main protease using docking and FPL simulations

Correction for ‘Rapid prediction of possible inhibitors for SARS-CoV-2 main protease using docking and FPL simulations’ by Minh Quan Pham et al., RSC Adv., 2020, 10, 31991–31996, https://doi.org/10.1039/D0RA06212J.

In the original article at the time of publication, ref. 44 had only been uploaded to ChemRXiv (DOI: https://doi.org/10.26434/chemrxiv.12771068.v1) and had not been published in a finalised format, so the full reference information was not included. The research described in ref. 44 has been published, and the full details of this reference are included below:44 S. T. Ngo, H. M. Nguyen, L. T. Thuy Huong, P. M. Quan, V. K. Truong, N. T. Tung and V. V. Vu, Assessing potential inhibitors of SARS-CoV-2 main protease from available drugs using free energy perturbation simulations, RSC Adv., 2020, 10, 40284–40290.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.