Hyoid syndrome — A case report

A symptom complex consisting of referred pain along the branches of external carotid artery and unilateral pricking sensation in the pharynx without any organic lesion is known as hyoid syndrome. A rare case of hyoid syndrome due to chondroma of hyoid bone is presented.     

Carotid endarterectomy after Doppler ultrasonographic examination without angiography

We prospectively reviewed our experience with 32 carotid endarterectomies in 30 patients performed without angiography in a 7 year period. Although this represents 6.7 percent of our total experience with carotid endarterectomy in this period, carotid endarterectomy without angiography is increasing and comprises 17 percent of the last 2 years' total. We have adhered to strict criteria for patient selection that identifies circumstances for a safe operative experience in seven broad categories. Evidence is also presented to reduce an overriding concern for intracranial aneurysms and siphon stenosis if either one exists unrecognized. We are hopeful that in the future, the latter will be identified by intracranial Doppler studies currently being performed. Our experience in this small series has been favorable, with intraoperatively measured lesions equal to the preoperative noninvasive predictions. We suggest that Doppler ultrasonography in its current form can be effectively used in place of conventional angiography or digital subtraction angiography in selected patients.     

The middle scalene muscle and its contribution to the thoracic outlet syndrome

The predisposing anatomic alterations or features of thoracic outlet syndrome have been tallied to better define this difficult and inchoate issue. In the last 34 supraclavicular operations involving 33 patients (for a total operative experience of 128 procedures), we have found the anterior insertion of the middle scalene muscle to be present in 48 percent of our patients. This insertion, forward on the first rib, closes an already small interscalene triangle, so that the posteriorly placed brachial plexus is entrapped or irritated by the anterior edge of this muscle, which may be very sharp and firm. In addition, 10 percent of our patients had a middle scalene band intimately associated with the middle scalene muscle, often-times inseparable, for a 58 percent incidence of middle scalene involvement in the thoracic outlet syndrome. With data such as those presented herein, a more simplified operation than the heretofore popular all-out attack on the first rib may well be in the offering.     

Menopausal hormone therapy use and risk of primary liver cancer in the clinical practice research datalink

Primary liver cancer occurs less commonly among women than men in almost all countries. This discrepancy has suggested that hormone levels and/or exogenous hormone use could have an effect on risk, although prior studies have reached inconsistent conclusions. Thus, the current study was conducted to examine the relationship between menopausal hormone therapy (MHT) use and development of liver cancer. A nested case‐control study was conducted within the United Kingdom's Clinical Practice Research Datalink (CPRD). Controls were matched, at a 4‐to‐1 ratio, to women diagnosed with primary liver cancer between 1988 and 2011. A second match, based on whether the cases and controls had diabetes, was also conducted. Odds ratios (OR) and 95% confidence intervals (95%CI) for associations of MHT with liver cancer were estimated using conditional logistic regression adjusted for known risk factors. In the overall match, 339 women with liver cancer were matched to 1318 controls. MHT use was associated with a significantly lower risk of liver cancer (OR_adj = 0.58, 95%CI = 0.37–0.90) especially among users of estrogen‐only MHT (OR_adj = 0.44, 95%CI = 0.22–0.88) and among past users (OR_adj = 0.53, 95%CI = 0.32–0.88). Among the matched cases (n = 58) and controls (n = 232) with diabetes, the odds ratios were similar to the overall analysis (OR_adj = 0.57, 95%CI = 0.09–3.53), but did not attain statistical significance. In the current study, MHT use, especially estrogen‐only MHT use, was associated with a significantly lower risk of liver cancer. These results support the need of further investigation into whether hormonal etiologies can explain the variation in liver cancer incidence between men and women.     

Four electrode-based impedimetric biosensors for evaluating cytotoxicity of tamoxifen on cervical cancer cells

In the current study, novel four electrode-based impedimetric biosensors have been fabricated using photolithography techniques and utilized to evaluate the cytotoxicity of tamoxifen on cervical cancer cell lines. The cell impedance was measured employing the electric cell-substrate impedance sensing (ECIS) method over the frequency range of 100 Hz to 1 MHz. The results obtained from impedimetric biosensors indicate that tamoxifen caused a significant reduction in the number of HeLa cells on the electrode surfaces in a dose-dependent manner. Next, the impedance values recorded by the fabricated biosensors have been compared with the results obtained from the different conventional techniques such as 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), live-dead cell assay, and flow cytometric analysis to estimate the cytotoxicity of tamoxifen. The impedimetric cytotoxicity of tamoxifen over the growth and proliferation of HeLa cells correlates well with the traditional methods. In addition, the IC₅₀ values obtained from impedimetric data and MTT assay are comparable, signifying that the ECIS technique can be an alternative method to assess the cytotoxicity of different novel drugs. The working principle of the biosensor has been examined by scanning electron microscopy, indicating the detachment of cells from gold surfaces in a dose-dependent manner, signifying the decrease in impedance at higher drug doses.

In the current study, novel four electrode-based impedimetric biosensors have been fabricated using photolithography techniques and utilized to evaluate the cytotoxicity of tamoxifen on cervical cancer cell lines.     

Cortical visual loss in posterior reversible encephalopathy syndrome in late postpartum eclampsia: Case series

The purpose of this study was to determine the prevalence of visual disturbances in patients with posterior reversible encephalopathy syndrome (PRES) associated with late postpartum eclampsia. We retrospectively reviewed the clinical records of late postpartum eclampsia patients with features of PRES for the presence of visual disturbances and location of radiological abnormalities. We found a higher prevalence of cortical visual loss in patients with PRES associated with late postpartum eclampsia. Bilateral symmetrical vasogenic edema of the parieto-occipital lobe was the most common magnetic resonance imaging (MRI) abnormality noted. No significant differences were observed in the extent of edema in patients with and without visual loss.     

Prostate cancer detection using combined auto-fluorescence and light reflectance spectroscopy: ex vivo study of human prostates

This study was conducted to evaluate the capability of detecting prostate cancer (PCa) using auto-fluorescence lifetime spectroscopy (AFLS) and light reflectance spectroscopy (LRS). AFLS used excitation at 447 nm with four emission wavelengths (532, 562, 632, and 684 nm), where their lifetimes and weights were analyzed using a double exponent model. LRS was measured between 500 and 840 nm and analyzed by a quantitative model to determine hemoglobin concentrations and light scattering. Both AFLS and LRS were taken on n = 724 distinct locations from both prostate capsular (n_c = 185) and parenchymal (n_p = 539) tissues, including PCa tissue, benign peripheral zone tissue and benign prostatic hyperplasia (BPH), of fresh ex vivo radical prostatectomy specimens from 37 patients with high volume, intermediate-to-high-grade PCa (Gleason score, GS ≥7). AFLS and LRS parameters from parenchymal tissues were analyzed for statistical testing and classification. A feature selection algorithm based on multinomial logistic regression was implemented to identify critical parameters in order to classify high-grade PCa tissue. The regression model was in turn used to classify PCa tissue at the individual aggressive level of GS = 7,8,9. Receiver operating characteristic curves were generated and used to determine classification accuracy for each tissue type. We show that our dual-modal technique resulted in accuracies of 87.9%, 90.1%, and 85.1% for PCa classification at GS = 7, 8, 9 within parenchymal tissues, and up to 91.1%, 91.9%, and 94.3% if capsular tissues were included for detection. Possible biochemical and physiological mechanisms causing signal differences in AFLS and LRS between PCa and benign tissues were also discussed.OCIS codes: (170.1610) Clinical applications, (170.3650) Lifetime-based sensing, (170.6935) Tissue characterization, (170.4580) Optical diagnostics for medicine, (170.6510) Spectroscopy, tissue diagnostics