Background Massive hemoptysis is a life-threatening event with limited therapeutic options. Bronchoscopic placement of stents may offer an alternative option for massive hemoptysis. https://www.selleckchem.com/products/e7766-diammonium-salt.html However, traditional silicone stents have not been customized, making it difficult to tailor to individual patient's needs for achieving optimal hemostasis. To investigate the efficacy and safety of the modified silicone stent in patients with difficult-to-treat massive hemoptysis. Method Between May 2016 and November 2018, we enrolled 14 patients who underwent bronchoscopic placement of the modified silicone stent, which was fabricated manually based on the Y-shaped silicone stent by tailoring and suturing on site. We recorded the technical success, clinical success, and complications. Patients were followed up for recording the recurrence of massive hemoptysis and complications. Results Placement of the modified silicone stent was successful in all 14 patients with a mean duration of 69.6 minutes (technical success rate 100%). After stenting, no further massive hemorrhage episodes recurred in 12 patients (clinical success rate 85.7%). Two cases suffered from recurrent hemoptysis in 4 and 6 days after stenting, respectively. The main complications were sputum plugging, granuloma proliferation and pulmonary infection such as pneumonia. There were no adverse events of stent migration and suture dehiscence. After a median follow-up of 5.8 (range, 0.3-21.3) months, three patients withdrew and seven patients succumbed. Only one patient died of uncontrolled pneumonia which was possibly related to stent placement. Conclusions The modified silicone stent is an effective and safe gate-keeping therapeutic option for difficult-to-treat massive hemoptysis. 2020 Journal of Thoracic Disease. All rights reserved.Background Research into multiple-bar Nuss operations for the treatment of wide-range or significantly asymmetric pectus excavatum is rarely reported. This paper aims to explore the curative effects of multiple-bar Nuss operations on wide-range or significantly asymmetric pectus excavatum. Methods We reviewed the clinical data of 153 patients with pectus excavatum who were treated in our hospital from September 2006 to August 2014. All the patients had wide-range or significantly asymmetric pectus excavatum and underwent multiple-bar Nuss operations performed by the author. Results All 153 patients agreed to undergo the operation. The median age was 17 y (10.2-41 y). The median Haller index was 3.98 (3.2-25). One hundred and fifty-one patients accepted treatment with two bars, and 2 cases accepted treatment with three bars. The median operation time was 123 min (65-500 min), the median blood loss was 20 mL (2-200 mL), and the median postoperative hospital stay was 6 days (3-33 days). The incidence rates of plo explore technical improvements. 2020 Journal of Thoracic Disease. All rights reserved.Background Data regarding the incidence and risk factors of pneumothorax following pre-procedural ultrasound (US)-guided thoracentesis is scarce. We aimed to evaluate the incidence and risk factors of pneumothorax following pre-procedural US-guided thoracentesis in a tertiary medical center. Methods Retrospective analysis of patients who underwent pre-procedural US-guided thoracentesis in Sheba Medical Center between January 2016 and December 2018. Data collected included incidence of pneumothorax following thoracentesis, baseline clinical and demographic characteristics, and thoracentesis-associated factors. Outcomes evaluated included length of hospital stay, mortality, chest tube insertion and intensive care unit admission. Results A total of 550 patients with pleural effusions underwent pre-procedural US-guided thoracentesis. Sixty-six (12%) of them developed pneumothorax. Compared to patients who did not develop pneumothorax, those who developed pneumothorax had a higher rate of congestive heart failure (32.2% vs. 47%, P=0.026), a smaller depth of pleural fluid marking (3.4 vs. 3.2 cm, P=0.024), a larger amount of pleural fluid drained (1,093 vs. 903.5 mL, P=0.01), and were more likely to undergo bilateral procedures (7.6% vs. 2.3%, P=0.044). In the multivariate regression analysis, volume of pleural fluid drained was significantly associated with the development of pneumothorax (OR, 1.001, 95% CI, 1-1.001; P=0.042). Conclusions The incidence of pneumothorax following pre-procedural US-guided thoracentesis was relatively high in the present study. The amount of pleural fluid drained was the main factor associated with the risk of developing pneumothorax in these cases. 2020 Journal of Thoracic Disease. All rights reserved.Background Both transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF) are master regulators of airway remodeling; however, their pathological roles in obstructive sleep apnea (OSA) remain unclear. The aim of the present study was to evaluate the expression of TGF-β and VEGF protein in the serum and exhaled breath condensate (EBC) before and after continuous positive airway pressure (CPAP) treatment in OSA patients. Methods Forty patients with moderate to severe OSA requiring CPAP and 20 healthy subjects were prospectively recruited. The concentrations of TGF-β and VEGF protein in the serum and EBC were evaluated by enzyme-linked immunosorbent assay. All OSA patients underwent a sleep study that was repeated 3 months after receiving CPAP therapy. Results Protein concentrations of TGF-β and VEGF in the serum did not differ between healthy controls and OSA patients before CPAP treatment. There was also no difference in the serum protein concentrations of TGF-β and VEGF of the OSA patients before and after CPAP treatment. However, both the TGF-β and VEGF protein concentrations in the EBC were higher in the OSA patients than those in control subjects, and recovered to normal levels after CPAP. Conclusions Successful treatment of OSA by CPAP can restore the TGF-β and VEGF protein concentrations in the EBC. 2020 Journal of Thoracic Disease. All rights reserved.Background CirRNA Circ_0058063 has been proven as an oncogene in bladder cancer, while its involvement in esophageal squamous-cell carcinomas (ESCC) is unknown. This study aimed to investigate the role of Circ_0058063 in ESCC. Methods Paired ESCC and non-tumor tissues were collected from ESCC patients and gene expression was analyzed by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Gene interactions were analyzed by overexpression experiment. Glucose uptake was analyzed by glucose uptake assay. Cell proliferation was analyzed by cell proliferation assay. Results We found that Circ_0058063 was upregulated in ESCC and positively correlated with GLUT1 mRNA. It is known that GLUT1 plays critical roles in glucose transportation and glucose supports the Warburg Effect as the major metabolic precursor. In ESCC cells, Circ_0058063 and GLUT1 overexpression both promoted glucose uptake. In ECSS cells, Circ_0058063 overexpression resulted in the upregulated, while Circ_0058063 knockdown resulted in downregulated GLUT1.

OBJECTIVES To assess the global oral lichen planus prevalence. MATERIAL AND METHODS We searched PubMed, Embase, Web of Science, and Scopus for studies published before Sep-2019. We evaluated the quality of studies and carried out several meta-analyses. RESULTS The global pooled prevalence was 1.01%, with a marked geographical difference (p less then 0.001).The highest prevalence was reported from Europe (1.43%) and the lowest in India (0.49%), where tobacco-associated keratosis appears to mask oral lichen planus resulting in attenuation of its prevalence. From the age of 40y, the prevalence increases significantly and progressively (OR=3.43,95%CI=2.48-4.73,p less then 0.001). Studies that define diagnostic criteria report a higher prevalence (1.31% vs. 0.70%,p=0.03), although the application of the WHO criteria (year) does not increase the ability to diagnose the disease compared with other criteria(p=0.11). The studies performed by oral medicine/oral pathology specialists report significantly higher prevalence (1.80%) than dentists (0.61%) and dermatologists (0.33%)(p less then 0.001). CONCLUSIONS We propose that reliable diagnostic criteria should be defined, which should include a set of essential criteria including the presence of white reticular lesions in any location of the oral mucosa. The impact of histopathological confirmation with defined diagnostic criteria must be researched in the future, although its main use should be to determine the presence or absence of epithelial dysplasia. The necessity to improve the knowledge of oral lichen planus among dentists and dermatologists through continuing education is apparent in the results of this meta-analysis. This article is protected by copyright. All rights reserved.Ollier disease (OD) and Maffucci syndrome (MS) are characterized by multiple enchondromas. Patients with MS also have benign vascular overgrowths that become malignant in 8.5% of cases. OD is characterized by multiple enchondromas, typically unilateral in distribution with a predilection for the appendicular skeleton. MS is characterized by multiple enchondromas bilaterally distributed in most of the cases. Both disorders feature multiple swellings on the extremity, deformity around the joints, limitations in joint mobility, scoliosis, bone shortening, leg-length discrepancy, gait disturbances, pain, loss of function, and pathological fractures. About 50% of patients with OD or MS develop a malignancy, such as chondrosarcoma, glioma, and ovarian juvenile granulosa cell tumor. To better understand the natural history of OD and MS, we reviewed 287 papers describing patients with OD and MS. We also created a survey that was distributed directly to 162 patients through Facebook. Here, we compare the review of the cases described in the literature to the survey's responses. The review of the literature showed that the patients with OD are diagnosed at a younger age; the prevalence of chondrosarcomas among patients with OD or MS was ~30%; in four patients, vascular anomalies were identified in internal organs only; and, the prevalence of cancer among patients with OD or MS was ~50%. With these data, health care providers will better understand the natural history, severity, and prognosis of these diseases and the prevalence of malignancies in these patients. Here, we recommend new guidelines for the care of patients with OD and MS. © 2020 Wiley Periodicals, Inc.The use of autonomous underwater vehicles (AUVs) for various applications have grown with maturing technology and improved accessibility. The deployment of AUVs for under-ice marine science research in the Antarctic is one such example. However, a higher risk of AUV loss is present during such endeavors due to the extremities in the Antarctic. A thorough analysis of risks is therefore crucial for formulating effective risk control policies and achieving a lower risk of loss. Existing risk analysis approaches focused predominantly on the technical aspects, as well as identifying static cause and effect relationships in the chain of events leading to AUV loss. Comparatively, the complex interrelationships between risk variables and other aspects of risk such as human errors have received much lesser attention. In this article, a systems-based risk analysis framework facilitated by system dynamics methodology is proposed to overcome existing shortfalls. To demonstrate usefulness of the framework, it is applied on an actual AUV program to examine the occurrence of human error during Antarctic deployment. Simulation of the resultant risk model showed an overall decline in human error incident rate with the increase in experience of the AUV team. Scenario analysis based on the example provided policy recommendations in areas of training, practice runs, recruitment policy, and setting of risk tolerance level. The proposed risk analysis framework is pragmatically useful for risk analysis of future AUV programs to ensure the sustainability of operations, facilitating both better control and monitoring of risk. https://www.selleckchem.com/products/cc-115.html © 2020 Society for Risk Analysis.The present study sought to investigate the effect of micronized resveratrol supplementation on serum levels of asymmetric de-methyl-arginine (ADMA) and paraoxonase-1 (PON1) activity in patients with type 2 diabetes (T2D). In this double-blinded randomized trial, 76 patients with T2D were recruited. Participants were randomly assigned to consume 1,000 mg resveratrol or placebo capsules (methylcellulose) per day, for 8 weeks. Serum levels of ADMA and PON1 enzyme activity were measured at the beginning and end of the intervention using the enzyme-linked immunosorbent assay method. In total, 71 participants completed the study. Our results showed that resveratrol significantly decreased serum levels of ADMA (-0.16 ± 0.11, p less then  .001) and improved PON1 enzyme activity (15.39 ± 13.99, p less then  .001) compared with placebo, after adjusting for confounding factors (age, sex, and baseline body mass index). Our findings suggest that 8-week resveratrol supplementation may produce beneficial effects on serum levels of ADMA and PON1 enzyme activity in patients with T2DM.

OBJECTIVES To assess the global oral lichen planus prevalence. MATERIAL AND METHODS We searched PubMed, Embase, Web of Science, and Scopus for studies published before Sep-2019. We evaluated the quality of studies and carried out several meta-analyses. RESULTS The global pooled prevalence was 1.01%, with a marked geographical difference (p less then 0.001).The highest prevalence was reported from Europe (1.43%) and the lowest in India (0.49%), where tobacco-associated keratosis appears to mask oral lichen planus resulting in attenuation of its prevalence. From the age of 40y, the prevalence increases significantly and progressively (OR=3.43,95%CI=2.48-4.73,p less then 0.001). Studies that define diagnostic criteria report a higher prevalence (1.31% vs. 0.70%,p=0.03), although the application of the WHO criteria (year) does not increase the ability to diagnose the disease compared with other criteria(p=0.11). The studies performed by oral medicine/oral pathology specialists report significantly higher prevalence (1.80%) than dentists (0.61%) and dermatologists (0.33%)(p less then 0.001). CONCLUSIONS We propose that reliable diagnostic criteria should be defined, which should include a set of essential criteria including the presence of white reticular lesions in any location of the oral mucosa. The impact of histopathological confirmation with defined diagnostic criteria must be researched in the future, although its main use should be to determine the presence or absence of epithelial dysplasia. The necessity to improve the knowledge of oral lichen planus among dentists and dermatologists through continuing education is apparent in the results of this meta-analysis. This article is protected by copyright. All rights reserved.Ollier disease (OD) and Maffucci syndrome (MS) are characterized by multiple enchondromas. Patients with MS also have benign vascular overgrowths that become malignant in 8.5% of cases. OD is characterized by multiple enchondromas, typically unilateral in distribution with a predilection for the appendicular skeleton. MS is characterized by multiple enchondromas bilaterally distributed in most of the cases. Both disorders feature multiple swellings on the extremity, deformity around the joints, limitations in joint mobility, scoliosis, bone shortening, leg-length discrepancy, gait disturbances, pain, loss of function, and pathological fractures. About 50% of patients with OD or MS develop a malignancy, such as chondrosarcoma, glioma, and ovarian juvenile granulosa cell tumor. To better understand the natural history of OD and MS, we reviewed 287 papers describing patients with OD and MS. We also created a survey that was distributed directly to 162 patients through Facebook. Here, we compare the review of the cases described in the literature to the survey's responses. The review of the literature showed that the patients with OD are diagnosed at a younger age; the prevalence of chondrosarcomas among patients with OD or MS was ~30%; in four patients, vascular anomalies were identified in internal organs only; and, the prevalence of cancer among patients with OD or MS was ~50%. With these data, health care providers will better understand the natural history, severity, and prognosis of these diseases and the prevalence of malignancies in these patients. Here, we recommend new guidelines for the care of patients with OD and MS. © 2020 Wiley Periodicals, Inc.The use of autonomous underwater vehicles (AUVs) for various applications have grown with maturing technology and improved accessibility. The deployment of AUVs for under-ice marine science research in the Antarctic is one such example. However, a higher risk of AUV loss is present during such endeavors due to the extremities in the Antarctic. A thorough analysis of risks is therefore crucial for formulating effective risk control policies and achieving a lower risk of loss. Existing risk analysis approaches focused predominantly on the technical aspects, as well as identifying static cause and effect relationships in the chain of events leading to AUV loss. Comparatively, the complex interrelationships between risk variables and other aspects of risk such as human errors have received much lesser attention. In this article, a systems-based risk analysis framework facilitated by system dynamics methodology is proposed to overcome existing shortfalls. To demonstrate usefulness of the framework, it is applied on an actual AUV program to examine the occurrence of human error during Antarctic deployment. Simulation of the resultant risk model showed an overall decline in human error incident rate with the increase in experience of the AUV team. Scenario analysis based on the example provided policy recommendations in areas of training, practice runs, recruitment policy, and setting of risk tolerance level. The proposed risk analysis framework is pragmatically useful for risk analysis of future AUV programs to ensure the sustainability of operations, facilitating both better control and monitoring of risk. https://www.selleckchem.com/products/cc-115.html © 2020 Society for Risk Analysis.The present study sought to investigate the effect of micronized resveratrol supplementation on serum levels of asymmetric de-methyl-arginine (ADMA) and paraoxonase-1 (PON1) activity in patients with type 2 diabetes (T2D). In this double-blinded randomized trial, 76 patients with T2D were recruited. Participants were randomly assigned to consume 1,000 mg resveratrol or placebo capsules (methylcellulose) per day, for 8 weeks. Serum levels of ADMA and PON1 enzyme activity were measured at the beginning and end of the intervention using the enzyme-linked immunosorbent assay method. In total, 71 participants completed the study. Our results showed that resveratrol significantly decreased serum levels of ADMA (-0.16 ± 0.11, p less then  .001) and improved PON1 enzyme activity (15.39 ± 13.99, p less then  .001) compared with placebo, after adjusting for confounding factors (age, sex, and baseline body mass index). Our findings suggest that 8-week resveratrol supplementation may produce beneficial effects on serum levels of ADMA and PON1 enzyme activity in patients with T2DM.