Titanium, a major constituent of blue ink, causes resistance to Nd-YAG (1064 nm) laser: results of animal experiments

A blue tattoo is more resistant to laser therapy than black or brown tattoos. This study aimed to confirm titanium as a key response-disturbing constituent in a blue tattoo ink after Nd-YAG (1064 nm) laser treatment by animal experiments. Rabbits' backs were tattooed with four ink colours, and the Nd-YAG (1064 nm) laser was used to remove the tattoos. The response to the laser treatment in the rabbits was evaluated and electron microscopic studies were also performed. Excellent to fair responses were observed for the black, brown and dark brown inks, but the blue ink responded poorly to the laser. Histological examination indicated that the blue pigments were unchanged even after the laser treatment. Quantitative energy dispersive spectrometry revealed that blue ink contained high amounts of titanium. Our animal experiments confirm that a blue tattoo ink containing titanium, is a key element in poor response to the Nd-YAG laser.     

A validation study of new risk grouping criteria for postoperative treatment in stage IB cervical cancers without high-risk factors: Rethinking the Gynecologic Oncology Group criteria

Objective

The aim of this study was to verify whether the Gynecologic Oncology Group (GOG) criteria are valid in a different cohort of patients and to investigate simplified new criteria tailoring adjuvant radiation therapy in patients with intermediate-risk factors after radical hysterectomy.

Study design

We analyzed the data of 332 patients with FIGO stage IB cervical cancer who underwent radical hysterectomy between 1994 and 2007. Two hundred and twenty-five patients without high-risk factors (lymph node metastasis, parametrial invasion, or positive surgical margins) were identified and were classified into low-risk and high-risk groups according to the GOG criteria and new criteria based on combinations of intermediate-risk factors (large tumor size, deep stromal invasion, lymph-vascular space invasion). We evaluated the prognostic significance of both criteria.

Results

We identified 140 low-risk patients and 85 high-risk patients in the application of the GOG criteria. Low-risk patients had significantly better disease-free survival (DFS) (P = 0.001) and overall survival (OS) (P = 0.013) than high-risk patients. There were 145 low-risk patients and 80 high-risk patients on applying the new criteria. Low-risk patients had significantly better DFS (P = 0.001) and OS (P = 0.013) than high-risk patients. The receiver operating characteristic (ROC) curves showed that both criteria had similar performance for predicting which patients would have help from adjuvant therapy.

Conclusion

This study demonstrated that the GOG criteria were still valid in the different population, the simplified new criteria were convenient to apply in practice, and the performance of the new criteria was as good as the GOGs.     

Myxoid Cellular Neurothekeoma: A New Entity of S100-Negative,CD68-Positive Myxoid Neurothekeoma

Neurothekeoma is a rare cutaneous neoplasm, occurring as a cutaneous papule or nodule on the face, shoulders, and upper extremities. Neurothekeoma has been subclassified as either the myxoid, cellular, or mixed type, depending on the amount of myxoid matrix and on immunohistochemical analysis. We observed a clinical case with conflicting histopathological and immunohistochemical findings. In this case, microscopic examination showed the typical presentation of myxoid neurothekeoma; however, immunohistochemical staining was negative for S100 protein and positive for CD68, which is the characteristic pattern of cellular neurothekeoma. We report a very rare form of myxoid cellular neurothekeoma of the face in a young woman.     

Clinical Outcomes and Complications after Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance Patients : A Long-Term Follow-Up Data

Objective

Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes.

Methods

We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during perioperative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation.

Results

Following surgery, lumbar lordosis increased from -14.1° ± 20.5° to -46.3° ± 12.8° (p < 0.0001), and the C7 plumb line improved from 115 ± 43 mm to 32 ± 38 mm (p < 0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results.

Conclusion

Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.     

Usefulness of plasma epigenetic changes of five major genes involved in the pathogenesis of colorectal cancer

Purpose

The purpose of present study was to investigate the methylation status of the promoter region in five genes (mothers against decapentaplegic homolog 4, fragile histidine triad protein, death-associated protein kinase 1, adenomatous polyposis coli (APC), and E-cadherin), which are known to be involved in the pathogenesis of colorectal cancer (CRC) and its clinicopathological significance.

Methods

The study subjects were 60 CRC patients, 40 patients with adenomatous colorectal polyp and 60 healthy control individuals. We further enrolled a total of 16 patients (two patients with Crohn’s disease, two patients with ulcerative colitis, one patient with serrated adenoma, and 11 patients with colorectal cancer). The methylation states of the five genes were determined in peripheral blood plasma using methylation-specific polymerase chain reaction single-strand conformation polymorphism analysis.

Results

This study showed the most sensitive epigenetic markers, E-cadherin (60 %), followed by APC (57 %), for detecting CRC. E-cadherin and APC had similar specificities and amplified 84 and 86 %, respectively, of CRC patients compared to non-CRC patients. Additionally, APC was the only marker to be significantly increased (OR?=?6.67, 95 % CI?=?1.19–23.4, P?=?0.045) and the most sensitive (57 %) and specific (89 %) marker in stage I CRC. Though we have not examined the paired cancer tissues and plasma, there was relatively high concordant rate (60–80 %) in our limited number of colorectal cancer patients.

Conclusions

Five genes, promoter methylation, in plasma were statistically significant risk factors in CRC patients. In this study, E-cad and APC genes may be particularly useful epigenetic biomarkers in plasma for the detection of CRC. Additionally, APC may able to identify early potential CRC.