Follow-up of low-risk differentiated thyroid cancer patients who underwent radioiodine ablation of postsurgical thyroid remnants after either recombinant human thyrotropin or thyroid hormone withdrawal

BACKGROUND

We previously demonstrated comparable thyroid remnant ablation rates in postoperative low-risk thyroid cancer patients prepared for administration of 3.7GBq (131)I (100 mCi) after recombinant human (rh) TSH during T(4) (L-T4) therapy vs. withholding L-T4 (euthyroid vs. hypothyroid groups). We now compared the outcomes of these patients 3.7 yr later.

PATIENTS AND METHODS

Fifty-one of the 63 original patients (28 euthyroid, 23 hypothyroid) participated. Forty-eight received rhTSH and serum thyroglobulin (Tg) sampling. A (131)I whole-body scan was performed in 43 patients, and successful ablation was defined by criteria from the previous study. Based on the criterion of uptake less than 0.1% in thyroid bed, 100% (43 of 43) remained ablated. When no visible uptake instead was used, five patients (four euthyroid, one hypothyroid) had minimal visible activity. When the TSH-stimulated Tg criterion was used, only two of 45 (one euthyroid, one hypothyroid) had a stimulated Tg level greater than 2 ng/ml.

RESULTS

No patient in either group died, and no patient declared disease free had sustained tumor recurrence. Nine (four euthyroid, five hypothyroid) had received additional (131)I between the original and current studies due to detectable Tg or imaging evidence of disease; with follow-up, all now had a negative rhTSH-stimulated whole-body scan and seven (three euthyroid, four hypothyroid) had a stimulated serum Tg less than 2 ng/ml.

CONCLUSIONS

In conclusion, after a median 3.7 yr, low-risk thyroid cancer patients prepared for postoperative remnant ablation either with rhTSH or after L-T4 withdrawal were confirmed to have had their thyroid remnants ablated and to have comparable rates of tumor recurrence and persistence.

Self-assembled growth of nanocomposites consisting of TiO(2) nanopillars and Pb(Zr(0.52)Ti(0.48))O(3) thin films

We report for the first time the self-assembled growth of nanocomposites of 'TiO(2) nanopillars on Pb(Zr(0.52)Ti(0.48))O(3) (PZT) thin films' using a modified sol-gel processing. Both TiO(2) nanopillars and PZT thin films are simultaneously formed during the post-annealing process. The growth behaviours of TiO(2) nanopillars are controlled by adjusting the Ti excess amounts of PZT solutions and the post-annealing conditions. The self-assembled growth can be explained on the basis of the combined effects of five factors which can have influence during the annealing process: a Ti ion diffusion to the film surface, a phase separation of PZT and TiO(2), a void formation on the film surface, a Ti oxidation at the film surface under oxygen atmosphere, and a nanopillar growth on the film surface.

Variation of skin surface pH, sebum content and stratum corneum hydration with age and gender in a large Chinese population

BACKGROUND AND OBJECTIVES

Evidence suggests the importance of skin biophysical properties in predicting diseases and in developing appropriate skin care. The results to date of studies on skin surface pH, stratum corneum (SC) hydration and sebum content in both genders and at various ages have been inconclusive, which was in part due to small sample size. Additionally, little is known about the skin physical properties of Asian, especially Chinese, subjects. In the present study, we assess the difference in skin surface pH, sebum content and SC hydration at various ages and in both genders in a large Chinese population without skin diseases.

METHODS

713 subjects (328 males and 385 females) aged 0.5-94 years were enrolled in this study. The subjects were divided by age into 5 groups, i.e., 0-12, 13-35, 36-50, 51-70 and over 70 years old. A multifunctional skin physiology monitor was used to measure SC hydration, skin surface pH and sebum content on both the forehead and the forearms.

RESULTS

In males, the highest sebum content was found on the forearm and the forehead in the age groups 36-50 (93.47 +/- 10.01 microg/cm(2)) and 51-70 years (9.16 +/- 1.95 microg/cm(2)), while in females, the highest sebum content was found on the forearm and the forehead in the age groups 13-35 (61.91 +/- 6.12 microg/cm(2)) and 51-70 years (7.54 +/- 2.55 microg/cm(2)). The forehead sebum content was higher in males aged 13-70 years than in age-matched females; the sebum content on the forehead in both males and females was higher than that on the forearm. Skin surface pH on the forehead of both males and females over the age of 70 years was higher than that in younger groups. SC hydration on the forehead in both males and females was lower above the age of 70, and the one in males aged 13-35 was higher than that in females (43.99 +/- 1.88 vs. 36.38 +/- 1.67 AU, p < 0.01). SC hydration on the forehead in both males and females did not significantly differ from that on the forearm.

CONCLUSIONS

In a large Chinese cohort, the skin surface pH, sebum content and SC hydration vary with age, gender and body site.

Telephone pre-anaesthesia assessment for ambulatory breast surgery

OBJECTIVE

To review the efficacy of telephone preoperative anaesthesia assessment in patients undergoing ambulatory breast surgery.

DESIGN

Retrospective study.

SETTING

Day Surgery Centre, Tung Wah Hospital, Hong Kong.

PATIENTS

Patients with breast lumps to be excised were seen by dedicated breast surgeons and informed of day procedures and preoperative anaesthesia assessment. Those who fulfilled the selection criteria of age (18-45 years) and American Society of Anesthesiologists grade I were recruited for telephone anaesthesia assessment preoperatively. The patients were contacted by senior day surgery nurses via telephone before the scheduled operation date, and information was retrieved using a standard assessment form. Prospective data from January 2002 to December 2007 were analysed.

MAIN OUTCOME MEASURES

Proportion of patients who successfully underwent day surgery after telephone preoperative anaesthesia assessment.

RESULTS

Of 482 patients receiving ambulatory surgery for breast lumps during the study period, 283 patients were selected for preoperative telephone anaesthesia assessment. Five (2%) patients with problems identified by this method underwent further assessment at the Day Surgery Centre; the remaining 278 (98%) required no further assessment and proceeded to have a successful day surgery procedure.

CONCLUSION

Preoperative anaesthesia assessment by telephone is an effective means of preoperative assessment in selected patients undergoing ambulatory breast surgery.

Day surgery varicose vein treatment using endovenous laser

OBJECTIVE

To examine the safety and efficacy of endovenous laser obliteration to treat varicose vein in a day surgery setting, using sedation and local anaesthesia.

DESIGN

Prospective study.

SETTING

Day surgery centre in a regional hospital in Hong Kong.

PATIENTS

A total of 24 patients with duplex-confirmed long saphenous vein insufficiency underwent endovenous laser (940 nm) varicose vein treatment from July to November 2007 in a single day surgery centre. Adjuvant phlebectomy and injection sclerotherapy were performed in the same session if indicated. All patients had postprocedural venous duplex scan and clinic assessment on day 7 and day 10 respectively.

MAIN OUTCOME MEASURES

Procedure success rate, unplanned hospital admissions and re-admissions, major complications, and long saphenous vein obliteration rate.

RESULTS

A total of 31 limbs of the 24 patients were treated with endovenous laser varicose vein treatment under local anaesthesia and sedation. The procedural success rate was 100%. All but two patients were admitted on the day of treatment and none were re-admitted. The patients' mean visual analogue pain score for the whole procedure was 2.3 (standard deviation, 1.5; range, 0-5). Post-procedural duplex scans showed 100% thrombosis of the treated long saphenous veins with no deep vein thrombosis. There were no skin burns or instances of thrombophlebitis. Induration of the treated long saphenous vein was relatively common (54%). The majority of the patients (54%) experienced mild discomfort in the early postoperative period.

CONCLUSION

Endovenous laser varicose vein treatment performed under local anaesthesia and sedation in a day surgery setting is safe, and yields satisfactory clinical and duplex outcomes.

Different clinical and magnetic resonance imaging features between Charcot-Marie-Tooth disease type 1A and 2A

Charcot-Marie-Tooth disease type 1A (CMT1A) is the more frequent cause of demyelinating CMT, and CMT2A is the most common cause of axonal CMT. We conducted a magnetic resonance imaging (MRI) study on 39 CMT1A and 21 CMT2A patients to compare their neuroimaging patterns and correlate with clinical features. CMT1A patients showed selective fatty infiltration with a preference for anterior and lateral compartment muscles, whereas CMT2A patients showed a preference for superficial posterior compartment muscles. Early-onset CMT2A patients showed more severe leg fatty atrophy than late-onset CMT2A patients. In late-onset CMT2A, soleus muscle was the earliest, and most severely affected than the other leg muscles. Selective involvement of intrinsic foot muscles is a characteristic pattern of minimal CMT1A and CMT2A. Our MRI study demonstrates different patterns of fatty infiltration involving superficial posterior compartment muscles in CMT2A (partial T-type), and peroneal nerve innervated muscles in CMT1A (P-type).

DCT-Yager FNN: a novel Yager-based fuzzy neural network with the discrete clustering technique

Earlier clustering techniques such as the modified learning vector quantization (MLVQ) and the fuzzy Kohonen partitioning (FKP) techniques have focused on the derivation of a certain set of parameters so as to define the fuzzy sets in terms of an algebraic function. The fuzzy membership functions thus generated are uniform, normal, and convex. Since any irregular training data is clustered into uniform fuzzy sets (Gaussian, triangular, or trapezoidal), the clustering may not be exact and some amount of information may be lost. In this paper, two clustering techniques using a Kohonen-like self-organizing neural network architecture, namely, the unsupervised discrete clustering technique (UDCT) and the supervised discrete clustering technique (SDCT), are proposed. The UDCT and SDCT algorithms reduce this data loss by introducing nonuniform, normal fuzzy sets that are not necessarily convex. The training data range is divided into discrete points at equal intervals, and the membership value corresponding to each discrete point is generated. Hence, the fuzzy sets obtained contain pairs of values, each pair corresponding to a discrete point and its membership grade. Thus, it can be argued that fuzzy membership functions generated using this kind of a discrete methodology provide a more accurate representation of the actual input data. This fact has been demonstrated by comparing the membership functions generated by the UDCT and SDCT algorithms against those generated by the MLVQ, FKP, and pseudofuzzy Kohonen partitioning (PFKP) algorithms. In addition to these clustering techniques, a novel pattern classifying network called the Yager fuzzy neural network (FNN) is proposed in this paper. This network corresponds completely to the Yager inference rule and exhibits remarkable generalization abilities. A modified version of the pseudo-outer product (POP)-Yager FNN called the modified Yager FNN is introduced that eliminates the drawbacks of the earlier network and yi- elds superior performance. Extensive experiments have been conducted to test the effectiveness of these two networks, using various clustering algorithms. It follows that the SDCT and UDCT clustering algorithms are particularly suited to networks based on the Yager inference rule.

Shape recovery from shading by a new neural-based reflectance model

In this paper, we present a neural-based reflectance model of which the physical parameters of the reflectivity under different lighting conditions are interpreted by the network weights. The idea of our method is to optimize a proper reflectance model by an effective learning algorithm and to recover the object surface by a simple shape from shading recursive algorithm with this resulting model. Experimental results, including synthetic and real images, were performed to demonstrate the performance of the proposed method for practical applications.

Learning parametric specular reflectance model by radial basis function network

For the shape from shading problem, it is known that most real images usually contain specular components and are affected by unknown reflectivity. In this paper, these limitations are addressed and a new neural-based specular reflectance model is proposed. The idea of this method is to optimize a proper specular model by learning the parameters of a radial basis function network and to recover the object shape by the variational approach with this resulting model. The obtained results are very encouraging and the performance is demonstrated by using the synthetic and real images in the case of different specular effects and noisy environments.

WITHDRAWN: Prognostic factors of biochemical recurrence after radical prostatectomy in Korean men with high-risk prostate cancer

This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.

Congenitally missing maxillary primary canines: report of three cases

BACKGROUND

Hypodontia is uncommon in the primary dentition and lateral incisors are the most commonly missing primary teeth in the patients affected. Studies have found that hypodontia in the primary dentition involving only maxillary canine is rare.

CASE REPORTS

Three cases of hypodontia in the primary dentition involving only maxillary canine are presented. Two of them were affected by hypodontia and hyperdontia in the permanent dentitions respectively, yet all the permanent canines developed normally in these three cases.

CONCLUSION

In children with congenitally missing maxillary canines, the permanent dentitions may show diverse anomalies in tooth numbers, ranging from hypodontia to hyperdontia.

Concomitant developmental dental anomalies in Chinese children with dens evaginatus

AIM

To determine the prevalence of concomitant developmental dental anomalies in a group of Chinese children with dens evaginatus.

METHODS

The dental records and orthopantomograms of 10-15 year old children and adolescents who had been diagnosed with dens evaginatus in a school dental clinic were reviewed retrospectively.

RESULTS

Four hundred and forty-eight of 7102 (6.3%) children were found to have dens evaginatus. Concomitant developmental dental anomalies were found in 77 children (17.2%). The most commonly seen dental anomalies in the study population were hypodontia, hyperdontia, microdontic maxillary lateral incisor, and dental impaction. The prevalence of these anomalies did not differ significantly to that found in the general Chinese population. When analysed separately, however, the prevalence of supernumerary premolars was found to be higher in children with dens evaginatus than in the general population, and the difference was statistically significant (P < 0.01).

CONCLUSION

Supernumerary premolars appeared to be more prevalent in Chinese children with dens evaginatus than in the general population. There may be an association of supernumerary premolars with dens evaginatus in this study population.

Positive regulation of hepatic carnitine palmitoyl transferase 1A (CPT1A) activities by soy isoflavones and L-carnitine

BACKGROUND

Genistein increases CPT1A, a rate-limiting enzyme in the beta-oxidation pathway, enzyme activity by increasing CPT1A transcription in HepG2 cells and, consequently, suppresses high fat induced obesity in C57BL/6J mice. Genistein and daidzein are the most abundant isoflavones in soy.

AIM OF STUDY

To investigate the effect of co-treatment of genistein and L-carnitine on CPT1A enzyme activity and to determine whether daidzein also increases CPT1A activity and to establish a cell line that can be used to screen chemicals to regulate CPT1A transcription.

METHODS

The enzyme activities of CPT1A were determined after HepG2 cells were incubated with 10 microM genistein or 10 microM daidzein or 1 mM L-carnitine or in combination with 10 microM genistein and 1 mM L-carnitine or in combination with 10 microM daidzein and 1 mM L-carnitine. The mRNA expression levels of CPT1A were determined by real time PCR method after HepG2 cells were incubated with 10 microM genistein or 10 microM daidzein. A suggested CPT1A promoter region was cloned from human genomic DNA and the CPT1A promoter-luciferase reporter gene construct was made, and the promoter-reporter gene construct was transfected into human hepatoma cell line Huh7.

RESULTS

The enzyme activity of CPT1A was at least 2.3- fold higher in L-carnitine and genistein co-treated HepG2 cells than either single-agent treated cells. Daidzein also significantly increased the mRNA expression of CPT1A as well as the enzyme activity of CPT1A. A stable Huh7 cell line, which was selected after Huh7 cells were transfected with CPT1A promoter luciferase reporter gene construct, was characterized by confirming that luciferase activity of the cell line can be regulated by genistein and daidzein as well as clofibrate, a well-known CPT1A mRNA up-regulating drug.

CONCLUSIONS

Genistein and daidzein can up-regulate CPT1A enzyme activity through up-regulation of CPT1A transcription. Co-treatment of L-carnitine and genistein additively increases CPT1A enzyme activity in HepG2 cells. A stable Huh7 cell line transfected with the CPT1A promoter luciferase reporter gene was established and characterized.

Dental abscess in a tooth with intact dens evaginatus

This article reports a case of dental abscess in a mandibular premolar with intact dens evaginatus. Dentists are advised to critically evaluate those teeth with dens evaginatus, both clinically and radiographically, before attempting prophylactic treatments. This is particularly important medicolegally in case the tooth develops symptoms shortly after the prophylactic treatment. Dentists practising in Western countries should also be aware of this dental anomaly because of the increasing global migration of people from Asia.