Size-based separation methods of circulating tumor cells

Circulating tumor cells (CTCs) originate from the primary tumor mass and enter into the peripheral bloodstream. Compared to other "liquid biopsy" portfolios such as exosome, circulating tumor DNA/RNA (ctDNA/RNA), CTCs have incomparable advantages in analyses of transcriptomics, proteomics, and signal colocalization. Hence, CTCs hold the key to understanding the biology of metastasis and play a vital role in cancer diagnosis, treatment monitoring, and prognosis. Size-based enrichment features are prominent in CTC isolation. It is a label-free, simple and fast method. Enriched CTCs remain unmodified and viable for a wide range of subsequent analyses. In this review, we comprehensively summarize the differences of size and deformability between CTCs and blood cells, which would facilitate the development of technologies of size-based CTC isolation. Then we review representative size-/deformability-based technologies available for CTC isolation and highlight the recent achievements in molecular analysis of isolated CTCs. To wrap up, we discuss the substantial challenges facing the field, and elaborate on prospects.

Intra-manufacture Diameter Variability of Rotary Files and Their Corresponding Gutta-Percha Cones Using Laser Scan Micrometre

INTRODUCTION

Manufacturers offer gutta-percha (GP) cones matched with different sizes of endodontic files as an attempt to simplify the obturation process and create a tight seal in the canal. The purpose of this study was to evaluate whether intra-manufacture GP diameters matched the diameters of their corresponding files at different levels using laser micrometre.

METHODS AND MATERIALS

Twenty files and corresponding GP master cones of Reciproc R40 (40/0.06) (VDW, Munich, Germany), WaveOne Large(40/0.08)(Dentsply Maillefer, Ballaigues, Switzerland), ProTaper F3 (30/0.09) (Dentsply Maillefer, Ballaigues, Switzerland), and Mtwo 40/0.06 (VDW, Munich, Germany) were examined using laser micrometre (LSM 6000 by Mitutoyo, Japan) with accuracy of 1 nm to establish their actual diameter at D₀, D₁, D₃ and D₆. The data was analysed using the independent t-test. The differences were considered at 0.05.

RESULTS

The diameter of GP master cones was significantly larger than that of the corresponding files at all levels in all brands. ProTaper GP diameter was closest to the file diameter at D1 (GP=0.35, File=0.35 mm), and D3 (GP=0.48, File=0.49).

CONCLUSION

Within the same manufacturer, GP cone diameters do not match the diameters of their corresponding files. Clinicians are advised to use a GP gauge to cut the tip so as to appropriate the diameter from a smaller sized GP cone.

Prognostic Evaluations Tailored to Specific Gastric Neuroendocrine Neoplasms: Analysis Of 200 Cases with Extended Follow-Up

BACKGROUND

Gastric neuroendocrine neoplasms (NENs) are very heterogeneous, ranging from mostly indolent, atrophic gastritis-associated, type I neuroendocrine tumors (NETs), through highly malignant, poorly differentiated neuroendocrine carcinomas (pdNECs), to sporadic type III NETs with intermediate prognosis, and various rare tumor types. Histologic differentiation, proliferative grade, size, level of gastric wall invasion, and local or distant metastases are used as prognostic markers. However, their value remains to be tailored to specific gastric NENs.

METHODS

Series of type I NETs (n = 123 cases), type III NETs (n = 34 cases), and pdNECs (n = 43 cases) were retrospectively collected from four pathology centers specializing in endocrine pathology. All cases were characterized clinically and histopathologically. During follow-up (median 93 months) data were recorded to assess disease-specific patient survival.

RESULTS

Type I NETs, type III NETs, and pdNECs differed markedly in terms of tumor size, grade, invasive and metastatic power, as well as patient outcome. Size was used to stratify type I NETs into subgroups with significantly different invasive and metastatic behavior. All 70 type I NETs < 0.5 cm (micro-NETs) were uneventful. Ki67-based grading proved efficient for the prognostic stratification of type III NETs; however, grade 2 (G2) was not associated with tumor behavior in type I NETs. Although G3 NETs (2 type I and 9 type III) had a very poor prognosis, it was found that patient survival was longer with type III G3 NETs compared to pdNECs.

CONCLUSIONS

Given the marked, tumor type-related behavior differences, evaluation of gastric NEN prognostic parameters should be tailored to the type of neoplastic disease.

Bioaccumulation of heavy metals in oyster (Saccostrea cucullata) from Chabahar bay coast in Oman Sea: Regional, seasonal and size-dependent variations

The concentration of heavy metals was determined in tissues of oyster, Saccostrea cuccullata, phytoplanktons and water samples from intertidal regions of the Chabahar bay, Oman sea. Oysters were collected from 5 stations and during spring, summer and autumn seasons. The heavy metals content in oysters, planktons and water samples showed variations depending on season, sampling station and size of the oysters. The heavy metals in water, plankton and tissue of oyster were higher in summer and the lowest metal contents were observed in autumn. The oyster tissue samples of size-class had lowest concentrations of Co, Pb, Ar and Cu. The maximum tissue levels of Ar, Cu, Ni and Zn were observed in oysters of size-class II while the values of Cd, Co and Pb had maximum levels in those of size-class III. The minimum levels of Cd and also Ni and Zn were found respectively in tissue of the oysters of size-class II and size-class III. There were significant differences in heavy metal content of oyster tissue, planktons and water samples between sampling stations. In all sampling stations and during all sampling seasons, the concentrations of heavy metals (except Cu) were almost higher in soft tissues than in hard tissues of oysters especially in oysters of size-class II and III. Seasonal analysis of tissue heavy metal content of oysters showed no significant differences between sampling stations.

Retrospective comparison of measured stone size and posterior acoustic shadow width in clinical ultrasound images

PURPOSE

Posterior acoustic shadow width has been proposed as a more accurate measure of kidney stone size compared to direct measurement of stone width on ultrasound (US). Published data in humans to date have been based on a research using US system. Herein, we compared these two measurements in clinical US images.

METHODS

Thirty patient image sets where computed tomography (CT) and US images were captured less than 1 day apart were retrospectively reviewed. Five blinded reviewers independently assessed the largest stone in each image set for shadow presence and size. Shadow size was compared to US and CT stone sizes.

RESULTS

Eighty percent of included stones demonstrated an acoustic shadow; 83% of stones without a shadow were ≤ 5 mm on CT. Average stone size was 6.5 ± 4.0 mm on CT, 10.3 ± 4.1 mm on US, and 7.5 ± 4.2 mm by shadow width. On average, US overestimated stone size by 3.8 ± 2.4 mm based on stone width (p < 0.001) and 1.0 ± 1.4 mm based on shadow width (p < 0.0098). Shadow measurements decreased misclassification of stones by 25% among three clinically relevant size categories (≤ 5, 5.1-10, > 10 mm), and by 50% for stones ≤ 5 mm.

CONCLUSIONS

US overestimates stone size compared to CT. Retrospective measurement of the acoustic shadow from the same clinical US images is a more accurate reflection of true stone size than direct stone measurement. Most stones without a posterior shadow are ≤ 5 mm.

Ecomorphological inferences in early vertebrates: reconstructing Dunkleosteus terrelli (Arthrodira, Placodermi) caudal fin from palaeoecological data

Our knowledge about the body morphology of many extinct early vertebrates is very limited, especially in regard to their post-thoracic region. The prompt disarticulation of the dermo-skeletal elements due to taphonomic processes and the lack of a well-ossified endoskeleton in a large number of groups hinder the preservation of complete specimens. Previous reconstructions of most early vertebrates known from partial remains have been wholly based on phylogenetically closely related taxa. However, body design of fishes is determined, to a large extent, by their swimming mode and feeding niche, making it possible to recognise different morphological traits that have evolved several times in non-closely related groups with similar lifestyles. Based on this well-known ecomorphological correlation, here we propose a useful comparative framework established on extant taxa for predicting some anatomical aspects in extinct aquatic vertebrates from palaeoecological data and vice versa. For this, we have assessed the relationship between the locomotory patterns and the morphological variability of the caudal region in extant sharks by means of geometric morphometrics and allometric regression analysis. Multivariate analyses reveal a strong morphological convergence in non-closely related shark species that share similar modes of life, enabling the characterization of the caudal fin morphology of different ecological subgroups. In addition, interspecific positive allometry, affecting mainly the caudal fin span, has been detected. This phenomenon seems to be stronger in sharks with more pelagic habits, supporting its role as a compensation mechanism for the loss of hydrodynamic lift associated with the increase in body size, as previously suggested for many other living and extinct aquatic vertebrates. The quantification of shape change per unit size in each ecological subgroup has allowed us to establish a basis for inferring not only qualitative aspects of the caudal fin morphology of extinct early vertebrates but also to predict absolute values of other variables such as the fin span or the hypocercal and heterocercal angles. The application of this ecomorphological approach to the specific case of Dunkleosteus terrelli has led to a new reconstruction of this emblematic placoderm. Our proposal suggests a caudal fin with a well-developed ventral lobe, narrow peduncle and wide span, in contrast to classical reconstructions founded on the phylogenetic proximity with much smaller placoderms known from complete specimens. Interestingly, this prediction gains support with the recent discovery of fin distal elements (ceratotrichia) in a well preserved D. terrelli, which suggests a possible greater morphological variability in placoderm caudal fins than previously thought.

Comparing growth in surface and cave morphs of the species Astyanax mexicanus: insights from scales

Background

Life in the darkness of caves is accompanied, throughout phyla, by striking phenotypic changes including the loss or severe reduction in eyes and pigmentation. On the other hand, cave animals have undergone constructive changes, thought to be adaptive, to survive in this extreme environment. The present study addresses the question of the evolution of growth in caves, taking advantage of the comparison between the river-dwelling and the cave-dwelling morphs of the Mexican tetra, Astyanax mexicanus.

Results

A sclerochronology approach was undertaken to document the growth of the species in these two very distinct habitats. Scales from 158 wild Astyanax mexicanus specimens were analyzed from three caves (Pachón, Tinaja and Subterráneo) and two rivers (Rio Gallinas and Arroyo Lagarto) in San Luis Potosi and Tamaulipas, Mexico. A 10–13% reduction in scales size was observed in the cave morphs compared to the surface morphs. Age could be reliably inferred from annual growth increments on the scales from the two morphs of the species. Further comparisons with growth curves in laboratory conditions, obtained using the von Bertalanffy growth model, were also performed. In the wild and in the laboratory, cavefish originating from the Pachón cave reached smaller sizes than surface fish from three different locations: Rio Gallinas and Arroyo Lagarto (wild sampling) and Texas (laboratory population), respectively. Wild Pachón cavefish also seemed to grow to smaller sizes than the two other wild cavefish populations studied, Tinaja and Subterráneo. Finally, growth in the laboratory was faster than in the wild, particularly in the two first years of life.

Conclusions

These data suggest that cavefish originating from the Pachón cave are subjected to an intrinsic limitation of their final size, which is at least in part independent from energy/food availability. This growth limitation may be an advantageous way of limiting energy expenditure and food needs in the cave environment. Moreover, growth regulation evolved differently in independently evolved cave populations. These results are discussed with regard to the sources of energy or general ecological conditions present in caves, and to the differences in behavior or feeding skills known in cavefish.

Surface and Size Effects in Spin-Crossover Nanocrystals

We perform Monte Carlo simulations to analyze the surface and size effects in spin-crossover nanocrystals using an Ising-like model including surface and core intermolecular interactions. The consequences of downsizing effect on the transition temperature and the width of hysteresis as finger of the system cooperativity are discussed. The critical temperature is calculated using the real-space renormalization method. The obtained results are in agreement with the experimental data.

Intraspecific variation in the diet of the Mexican garter snake Thamnophis eques

The Mexican Garter Snake (Thamnophis eques) is a terrestrial-aquatic generalist that feeds on both aquatic and terrestrial prey. We describe size-related variation and sexual variation in the diet of T. eques through analysis of 262 samples of identifiable stomach contents in snakes from 23 locations on the Mexican Plateau. The snake T. eques we studied consumed mostly fish, followed in lesser amounts by leeches, earthworms, frogs, and tadpoles. Correspondence analysis suggested that the frequency of consumption of various prey items differed between the categories of age but not between sex of snakes, and the general pattern was a reduction of prey item diversity with size of snake. Snake length was correlated positively with mass of ingested prey. Large snakes consumed large prey and continued to consume smaller prey. In general, no differences were found between the prey taxa of male and female snakes, although males ate two times more tadpoles than females. Males and females did not differ in the mass of leeches, earthworms, fishes, frogs and tadpoles that they ate, and males and females that ate each prey taxon were similar in length. We discuss proximate and functional determinants of diet and suggest that the observed intraspecific variation in T. eques could be explored by temporal variation in prey availability, proportions of snake size classes and possible sexual dimorphism in head traits and prey dimensions to assess the role of intersexual resource competition.

Preoperative chemoradiotherapy changes the size criterion for predicting lateral lymph node metastasis in lower rectal cancer

PURPOSE

The purpose of this study was to identify the size criteria of lateral lymph node metastasis in lower rectal cancer both in patients who underwent preoperative CRT and those who did not.

METHODS

This study enrolled 150 patients who underwent resection for primary lower rectal adenocarcinoma with lateral lymph node dissection between 2013 and 2015. Patients were divided into two groups: the CRT group, treated with preoperative chemoradiotherapy before surgery, and the non-CRT group, treated with surgery alone. The short-axis diameter of each dissected lateral lymph node was measured. Receiver-operating characteristic curves were generated to reveal the optimal cutoff values for determining lateral lymph node metastasis in both groups.

RESULTS

In the non-CRT group (n = 131), the ROC curve demonstrated that the optimal cutoff value for determining metastasis was 6.0 mm, with a sensitivity of 78.5% and specificity of 82.9%, and the AUC was 0.845. In comparison, in the CRT group (n = 19), the optimal cutoff value was 5.0 mm, with a sensitivity of 71.4% and specificity of 85.3% and an AUC of 0.836.

CONCLUSION

The cutoff size for determining lateral lymph node metastasis was smaller in the CRT group than in the non-CRT group.

Relational concept learning in domestic dogs: Performance on a two-choice size discrimination task generalises to novel stimuli

One central issue in the study of animal cognition concerns conceptual behaviour, where an organism categorises objects, events, and relationships so as to transfer previously learned rules to novel contexts. In this study, we investigated whether or not dogs demonstrate conceptual behaviour in the form of simple relational class concept learning. A two-choice visual discrimination task was used to assess if dogs are capable of simple relational class concept learning by generalising the same rule (i.e. circle is larger or smaller than) to various novel shapes. Eight purebred Lagotto Romagnolos were included in the study. The results demonstrated that they were capable of generalising a previously learned size discrimination rule to novel stimuli; however, there were differences in dog's generalization capabilities across certain shapes. Considering their unique relationship with humans, and their immediacy in everyday life, a better understanding of conceptual behaviour and generalising abilities in domestic dogs may have implications for training and management methods, as well as contributing to comparative psychology and applied ethology.

The distribution of lymph node metastases and their size in colon cancer

PURPOSE

The purpose of this study is to clarify the optimal extent of lymph node dissection for colon cancer by evaluating the distributions of lymph node metastases and lymph node size according to tumor location and T stage.

METHODS

This study enrolled 662 patients who underwent curative resection for primary colon cancer between 2013 and 2015. Lymph node regions were classified into pericolic, intermediate, and main nodes. The short-axis diameter of each dissected lymph node was measured. The distributions of lymph node metastases and lymph node size were evaluated according to tumor location and T stage.

RESULTS

In the overall cohort, the incidence of metastases in pericolic nodes located more than 5 cm but no more than 10 cm from tumor and in pericolic nodes located more than 10 cm from tumor was 3.6 and 0.2%, respectively. More than 2% of patients with ≥ T2 tumor had metastases in main lymph nodes, and no patients with T1 tumor had metastases in main lymph nodes. Only 0.7% of patients with T1 tumor had lymph node metastases in pericolic nodes located more than 5 cm from the tumor. Both metastatic and non-metastatic lymph node sizes were significantly larger in right-sided colon cancer than in left-sided colon cancer, and both metastatic and non-metastatic lymph node sizes were significantly larger in ≥ T2 tumor than in T1 tumor.

CONCLUSION

It is necessary to resect 10 cm of normal bowel both proximal and distal to the tumor and to perform D3 lymph node dissection for ≥ T2 colon cancer.

Association of low-density lipoprotein pattern with mortality after myocardial infarction: Insights from the TRIUMPH study

BACKGROUND

Studies of incident coronary heart disease risk within low-density lipoprotein (LDL) subclass (small, dense vs large, buoyant) have shown mixed results. No prospective cohort study has examined the association of small, dense, or large, buoyant LDL with mortality after myocardial infarction (MI).

OBJECTIVE

The objective of the study was to examine association of LDL pattern after MI and death.

METHODS

In 2476 patients hospitalized for MI, LDL pattern (A [large, buoyant], A/B [mixed], and B [small, dense]) was established by ultracentrifugation using Vertical Auto Profile. Using time-to-event analysis, we examined the association with 5-year mortality within LDL patterns, after adjusting for important patient and treatment characteristics. We additionally adjusted for LDL cholesterol (LDL-C) and triglyceride levels and used directly measured LDL-C and non-high-density lipoprotein cholesterol as exposures.

RESULTS

Patterns A, A/B, and B were present in 39%, 28%, and 33% of patients, respectively, with incident rates (per 1000 patient-years) of 50, 34, and 24 for all-cause and 24, 19, and 10 for CV mortality. The hazard ratios (95% confidence interval) with LDL patterns A/B and B compared with pattern A were 0.77 (0.61, 0.99) and 0.67 (0.51, 0.88) for all-cause, 0.94 (0.67, 1.33) and 0.69 (0.46, 1.03) for cardiovascular, and 0.64 (0.45, 0.91) and 0.65 (0.45, 0.93) for noncardiovascular mortalities, respectively. Results were similar when further adjusted for LDL-C and triglycerides, or with LDL-C and non-high-density lipoprotein cholesterol as exposures.

CONCLUSION

Compared with LDL pattern A, pattern B was significantly associated with reduced all-cause and non-CV mortalities with a trend for lower CV mortality after MI, independent of LDL-C and triglycerides.

Grasp preparation modulates early visual processing of size and detection of local/global stimulus features

Preparing to grasp objects facilitates visual processing of object location, orientation and size, compared to preparing actions such as pointing. This influence of action on perception reflects mechanisms of selection in visual perception tuned to current action goals, such that action relevant sensory information is prioritized relative to less relevant information. In three experiments, rather than varying movement type (grasp vs point), the magnitude of a prepared movement (power vs precision grasps) was manipulated while visual processing of object size, as well as local/global target detection was measured. Early event-related potentials (ERP) elicited by task-irrelevant visual probes were enhanced for larger probes during power grasp preparation and smaller probes during precision grasp preparation. Local targets were detected faster following precision, relative to power grasp cues. The results demonstrate a direct influence of grasp preparation on sensory processing of size and suggest that the hierarchical dimension of objects may be a relevant perceptual feature for grasp programming. To our knowledge, this is the first evidence that preparing different magnitudes of the same basic action has systematic effects on visual processing.

Size effect on oral absorption in polymer-functionalized mesoporous carbon nanoparticles

In this manuscript, the effect of the particle size of polymer-functionalized mesoporous carbon (MPP) nanoparticles on enhancing oral absorption of a water-insoluble drug is first investigated. The insoluble drug, fenofibrate (Fen), was selected as the model drug loaded in the MPP nanoparticles. MPP nanoparticles with different particle sizes were designed for improving the oral bioavailability of drugs, in which the branched polyethyleneimine (PEI) and polyacrylic acid (PAA) were modified on the surfaces of mesoporous carbon nanoparticles (MCNs) with amide bonds. In addition, PEI-functionalized carbon quantum dots (PCA) and radioisotope ¹²⁵I were applied to label the MPP nanoparticles to trace in the vivo process. According to the data, the MPP nanoparticles could markedly improve the dissolution rate and oral bioavailability of Fen. Interestingly, the MPP nanoparticle size had a notable effect on Fen oral absorption, and intermediate sized MPP nanoparticles were expected to be more ideal oral drug carriers. The nanoparticles were safe and easily excreted. These findings present the prospect of MPP nanoparticles for oral application, and guides the rational design of an oral delivery system with respect to particle size.

The effect of particle shape on cellular interaction and drug delivery applications of micro- and nanoparticles

Encapsulation of therapeutic agents in nanoparticles offers several benefits including improved bioavailability, site specific delivery, reduced toxicity and in vivo stability of proteins and nucleotides over conventional delivery options. These benefits are consequence of distinct in vivo pharmacokinetic and biodistribution profile of nanoparticles, which is dictated by the complex interplay of size, surface charge and surface hydrophobicity. Recently, particle shape has been identified as a new physical parameter which has exerted tremendous impact on cellular uptake and biodistribution, thereby in vivo performance of nanoparticles. Improved therapeutic efficacy of anticancer agents using non-spherical particles is the recent development in the field. Additionally, immunological response of nanoparticles was also altered when antigens were loaded in non-spherical nanovehicles. The apparent impact of particle shape inspired the new research in the field of drug delivery. The present review therefore details the research in this field. The review focuses on methods of fabrication of particles of non-spherical geometries and impact of particle shape on cellular uptake, biodistribution, tumor targeting and production of immunological responses.

A Laplacian characterization of phytoplankton shape

Phytoplankton exhibit pronounced morphological diversity, impacting a range of processes. Because these impacts are challenging to quantify, however, phytoplankton are often approximated as spheres, and when effects of non-sphericity are studied it is usually experimentally or via geometrical approximations. New methods for quantifying phytoplankton size and shape generally, so all phytoplankton are analyzable by the same procedure, can complement advances in microscopic imagery and automated classification to study the influence of shape in phytoplankton. Here we apply to phytoplankton a technique for defining the size of arbitrary shapes based on the Laplacian-the operator that governs processes, such as nutrient uptake and fluid flow, where phytoplankton shape is expected to have the greatest effect. Deviations from values given by spherical approximation are a measure of phytoplankton shape and indicate the fitness increases for phytoplankton conferred by their non-spherical shapes. Comparison with surface-to-volume quotients suggests the Laplacian-based metric is insensitive to small-scale features which can increase surface area without affecting key processes, but is otherwise closely related to surface-area-to-volume, demonstrating this metric is a meaningful measure. While our analysis herein is limited to axisymmetric phytoplankton due to relative sparsity of 3D information about other phytoplankton shapes, the definition and method are directly generalizable to 3D shape data, which will in the near future be more readily available.

The effect of motorcycle helmet fit on estimating head impact kinematics from residual liner crush

Proper helmet fit is important for optimizing head protection during an impact, yet many motorcyclists wear helmets that do not properly fit their heads. The goals of this study are i) to quantify how a mismatch in headform size and motorcycle helmet size affects headform peak acceleration and head injury criteria (HIC), and ii) to determine if peak acceleration, HIC, and impact speed can be estimated from the foam liner's maximum residual crush depth or residual crush volume. Shorty-style helmets (4 sizes of a single model) were tested on instrumented headforms (4 sizes) during linear impacts between 2.0 and 10.5m/s to the forehead region. Helmets were CT scanned to quantify residual crush depth and volume. Separate linear regression models were used to quantify how the response variables (peak acceleration (g), HIC, and impact speed (m/s)) were related to the predictor variables (maximum crush depth (mm), crush volume (cm³), and the difference in circumference between the helmet and headform (cm)). Overall, we found that increasingly oversized helmets reduced peak headform acceleration and HIC for a given impact speed for maximum residual crush depths less than 7.9mm and residual crush volume less than 40cm³. Below these levels of residual crush, we found that peak headform acceleration, HIC, and impact speed can be estimated from a helmet's residual crush. Above these crush thresholds, large variations in headform kinematics are present, possibly related to densification of the foam liner during the impact.

Prognostic markers in well differentiated papillary and follicular thyroid cancer (WDTC)

OBJECTIVES

WDTC (papillary and follicular thyroid cancer) make up around 90% of all thyroid tumours. Overall, the prognosis in patients with WDTC is excellent. However, there are small cohorts of patients who experience a more aggressive form of disease which is often associated with certain poor prognostic factors. Identifying these patients at an early stage is imperative for guiding treatment decisions. With recent developments in this area we plan to discuss the current evidence surrounding prognostic markers.

METHODS

The literature regarding prognostic factors in WDTC was reviewed using an electronic database Medline - Pubmed. Using the MeSH search engine specific prognostic factors including age, size, grade, lymph node involvement, distant metastasis, extension/invasion, ethnic background, radioactive iodine avidity, and thyroglobulin level and their association with WDTC were evaluated. A broader search of prognostic markers in thyroid cancer was also carried out to avoid missing other pertinent markers.

RESULTS

Multiple clinical and pathologic variables have been shown to be poor prognostic factors in WDTC with statistical significance. Extensive extrathyroidal extension and age may be the most important factors when predicting clinical outcomes in WDTC, although the age threshold may be increased from 45 to 55 years in due course.

CONCLUSIONS

Management of WDTC has changed considerably over the last two years as reflected in evolving British and American Thyroid Guidelines. In all cases a combined multi-disciplinary approach, with consideration of the available guidelines and stratification systems should be utilised when planning an individualised treatment program to offer the best contemporary care to WDTC patients.

Differentiation of low- and high-grade clear cell renal cell carcinoma: Tumor size versus CT perfusion parameters

PURPOSE

To compare the utility of tumor size and CT perfusion parameters for differentiation of low- and high-grade clear cell renal cell carcinoma (RCC).

MATERIALS AND METHODS

Tumor size, Equivalent blood volume (Equiv BV), permeability surface-area product (PS), blood flow (BF), and Fuhrman pathological grading of clear cell RCC were retrospectively analyzed.

RESULTS

High-grade clear cell RCC had significantly higher tumor size and lower PS than low grade. Tumor size positively correlated with Fuhrman grade, but PS negatively did.

CONCLUSIONS

Tumor size and PS were significantly independent indexes for differentiating high-grade from low-grade clear cell RCC.

Size distribution of extracellular vesicles by optical correlation techniques

Understanding the colloidal properties of extracellular vesicles (EVs) is key to advance fundamental knowledge in this field and to develop effective EV-based diagnostics, therapeutics and devices. Determination of size distribution and of colloidal stability of purified EVs resuspended in buffered media is a complex and challenging issue - because of the wide range of EV diameters (from 30 to 2000nm), concentrations of interest and membrane properties, and the possible presence of co-isolated contaminants with similar size and densities, such as protein aggregates and fat globules - which is still waiting to be fully addressed. We report here a fully detailed protocol for accurate and robust determination of the size distribution and stability of EV samples which leverages a dedicated combination of Fluorescence Correlation Spectroscopy (FCS) and Dynamic Light Scattering (DLS). The theoretical background, critical experimental steps and data analysis procedures are thoroughly presented and finally illustrated through the representative case study of EV formulations obtained from culture media of B16 melanoma cells, a murine tumor cell line used as a model for human skin cancers.

The landmark for removal of sialoliths using sialendoscopy alone in parotid gland sialolithiasis

OBJECTIVE

To assess the general guidelines for removal of sialoliths in parotid gland sialolithiasis using sialendoscopy alone.

METHODS

We analyzed 34 sialoliths treated using sialendoscopy in 26 patients with parotid gland sialolithiasis. We divided the Stensen's duct and parotid gland into for parts using computed tomography findings: (A) front of the masseter, (B) anterior and lateral to the center (anterolateral) of the masseter, (C) posterior and lateral to the center (posterolateral) of the masseter, (D) behind of the masseter. The location and size of each sialolith was assessed.

RESULTS

The removal rates of sialoliths in the different locations by sialendoscopy alone were as follows: front of the masseter, 68.8%; anterolateral of the masseter, 60.0%; posterolateral of the masseter, 0%; and behind of the masseter, 33.3%. The removal rate using sialendoscopy alone was significantly higher in the sections anterior to the center of the masseter than in those posterior to the center of the masseter (66.7% [14/21] vs. 20.0% [2/10]; P=0.019). The size of the sialolith was not correlated to the removal rate by sialendoscopy alone.

CONCLUSION

Sialoliths of the parotid gland located in positions anterior to the center of the masseter are significantly easier to remove by sialendoscopy alone. The center of the masseter is a general landmark for removal of sialoliths from the parotid gland using sialendoscopy alone. The size of the sialolith is not correlated with removal, except rare huge sialoliths.

Towards quality assessed characterization of nanomaterial: Transfer of validated protocols for size measurement by dynamic light scattering and evaluation of zeta potential by electrophoretic light scattering

Quality control analysis of nanomaterials has been identified as a major issue to pursue their development in different industrial fields including nanomedicine. One difficulty is the lack of standardized and validated protocols suitable to achieve their characterization. In a previous work, we have developed standardized protocols for the evaluation of the size and zeta potential of nanomaterials based on methods described in the ISO standard and have performed validation of each one. The present work was aimed to transfer these protocols in three independent receiving laboratories. No official guideline was described in the literature to achieve such a transfer. A comparative study for receiving laboratories equipped with the same instrument as the sending laboratory was designed based on the Code of Federal Regulation edited by the Food and Drug Administration. For the receiving laboratory equipped with an instrument working at a different wavelength, a new validation was designed and applied. Corresponding statistical methods were used for the analysis of the results. A successful transfer of the protocols in all receiving laboratories was achieved. All laboratories recorded consistent results applying in blind the protocol of size measurements on two samples of nanomaterials from which included one reference.

Recurrence of vocal fold leukoplakia after carbon dioxide laser therapy

This work aims to analyze the recurrence of vocal fold leukoplakia after carbon dioxide (CO₂) laser resection. In this retrospective study, all patients undergoing CO₂ laser resection of vocal fold leukoplakia were followed up for at least 2 years. Recurrence was diagnosed as any presence of leukoplakia in the vocal cord subsequent to previous successful complete resection. A total of 326 patients with complete resection of vocal fold leukoplakia and follow-up subsequent surveillance laryngoscopy were studied. The recurrence rate, the recurrence time, and risk factors were evaluated. Of these, 52 (16.0%) patients experienced recurrence with a mean follow-up time of 50.5 ± 15.4 months. The mean time to recurrence was 16.2 ± 14.1 months. Univariate analysis showed that the size of lesion (P < 0.001, Pearson χ ² test; P < 0.001, log-rank test) and the pathological grade (P = 0.025, Pearson χ ² test; P = 0.028, log-rank test) were significantly related to recurrence. The size of lesion was an independent prognostic factor for recurrence using multivariate analysis (P = 0.001, logistic regression; P = 0.001, Cox proportional hazards model). Considering the possible recurrence of vocal fold leukoplakia, long-term follow-up is required after CO₂ laser resection. In conclusion, the size of lesion combined with the pathological grade are important risk factors that predict vocal fold leukoplakia recurrence.

Physical micro-environment interventions for healthier eating in the workplace: protocol for a stepped wedge randomised controlled pilot trial

BACKGROUND

An estimated one third of energy is consumed in the workplace. The workplace is therefore an important context in which to reduce energy consumption to tackle the high rates of overweight and obesity in the general population. Altering environmental cues for food selection and consumption-physical micro-environment or 'choice architecture' interventions-has the potential to reduce energy intake. The first aim of this pilot trial is to estimate the potential impact upon energy purchased of three such environmental cues (size of portions, packages and tableware; availability of healthier vs. less healthy options; and energy labelling) in workplace cafeterias. A second aim of this pilot trial is to examine the feasibility of recruiting eligible worksites, and identify barriers to the feasibility and acceptability of implementing the interventions in preparation for a larger trial.

METHODS

Eighteen worksite cafeterias in England will be assigned to one of three intervention groups to assess the impact on energy purchased of altering (a) portion, package and tableware size (n = 6); (b) availability of healthier options (n = 6); and (c) energy (calorie) labelling (n = 6). Using a stepped wedge design, sites will implement allocated interventions at different time periods, as randomised.

DISCUSSION

This pilot trial will examine the feasibility of recruiting eligible worksites, and the feasibility and acceptability of implementing the interventions in preparation for a larger trial. In addition, a series of linear mixed models will be used to estimate the impact of each intervention on total energy (calories) purchased per time frame of analysis (daily or weekly) controlling for the total sales/transactions adjusted for calendar time and with random effects for worksite. These analyses will allow an estimate of an effect size of each of the three proposed interventions, which will form the basis of the sample size calculations necessary for a larger trial.

TRIAL REGISTRATION

ISRCTN52923504.