Canonical Wnt/β-catenin signaling activation in soft-tissue sarcomas: A comparative study of synovial sarcoma and leiomyosarcoma.

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Canonical Wnt/β-catenin signaling activation in soft-tissue sarcomas: A comparative study of synovial sarcoma and leiomyosarcoma.

Rare Tumors. 2018;10:2036361318813431

Authors: Briski LM, Thomas DG, Patel RM, Lawlor ER, Chugh R, McHugh JB, Lucas DR

Abstract
Background: Previous studies have shown that aberrant activation of the Wnt/β-catenin pathway is associated with many malignant neoplasms. This includes some soft-tissue sarcoma phenotypes, most notably synovial sarcoma, implicating potential targets for novel molecular therapies.
Objective: We investigate the level of Wnt/β-catenin pathway activation present in leiomyosarcomas relative to synovial sarcomas, using expression of LEF1 and β-catenin as surrogates.
Methods: Cancer outlier profile analysis was performed on messenger RNA expression datasets in Oncomine (70 synovial sarcomas, 178 leiomyosarcomas). Results for LEF1 and β-catenin messenger RNA expression were reported in terms of median-centered intensity. Separate immunohistochemical studies were performed on tissue microarrays created from 77 synovial sarcomas and 89 leiomyosarcomas using antibodies to LEF1 and β-catenin. Tumors with unequivocal strong nuclear staining involving ⩾5% of cells were interpreted as positive.
Results: Cancer outlier profile analysis demonstrated a higher level of LEF1 messenger RNA expression in synovial sarcomas than in leiomyosarcomas (p < 0.0001), but showed no significant difference in β-catenin messenger RNA expression (p = 0.868). Immunohistochemistry showed most synovial sarcomas had strong nuclear expression of LEF1 (79%) and β-catenin (84%), while a small minority of leiomyosarcomas had strong nuclear expression of LEF1 (5%) and β-catenin (6%).
Conclusion: These results provide further evidence that aberrant activation of the Wnt/β-catenin pathway is present in most synovial sarcomas, but not in most leiomyosarcomas. While targeting the constituents of this pathway might be effective in the treatment of synovial sarcomas, it is not likely to be an effective strategy in the treatment of leiomyosarcomas.

PMID: 30505422 [PubMed]

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A New Technique for Reconstruction of Medium-Sized Eyelid Defects (A Modification of Tessier Nasojugal Flap).

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A New Technique for Reconstruction of Medium-Sized Eyelid Defects (A Modification of Tessier Nasojugal Flap).

Facial Plast Surg. 2018 Dec 04;:

Authors: Yousefiazar A, Hassanzadazar M

Abstract
Eyelid reconstructions are considered challenging surgical procedures, which are mostly performed due to trauma, tumor resections, and congenital defects. Several techniques can be used to reconstruct the lower eyelid defects. In this study, the authors aimed to introduce a new single-step technique for the reconstruction of medium-sized lower eyelid defects while preventing ectropion. A modified nasojugal flap was designed and harvested after making a complete incision. A dermal extension from the nasolabial area was added to the end of the nasojugal flap. A tunnel was created under the orbicularis oculi muscle, and the dermal tail was passed through this tunnel toward the lateral canthus. The flap was fixed in its new position by suturing. The defect in the nasojugal area was repaired by bilateral advancement of the surrounding tissue. The recovery of the patients was followed up for 6 months, which included assessment of the eyelid position and donor site morbidity. A total of four patients with an age range of 64 ± 8 years who suffered from basal cell carcinoma were treated using the technique introduced in this study. No ectropion or abnormal eyelid position nor donor site morbidity was observed during the follow-up period. Reconstruction of a medium-sized lower eyelid defect using nasolabial flap with local modification combined with orbital canthus fixation resulted in appropriate functional and cosmetic outcomes and limited the risk of complications and morbidity.

PMID: 30513538 [PubMed - as supplied by publisher]

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Deep Plane Facelift: An Evaluation of the High-SMAS versus Standard Incision Points.

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Deep Plane Facelift: An Evaluation of the High-SMAS versus Standard Incision Points.

Facial Plast Surg. 2018 Dec 04;:

Authors: Sand JP, Amodeo CA, Nabili V, Keller GS

Abstract
In surgery of the aging face, operative adjustments of the superficial musculoaponeurotic system (SMAS) enhance facial contours. The senior author has observed that the standard deep plane face lift entry points on the SMAS do not provide as much tissue movement in a vertical direction as high-SMAS deep plane face lift entry points. In this study, tissue movement was measured comparing the conventional SMAS entry point with a high-SMAS entry point for deep plane face lifts. Institutional review board approval was obtained. Fourteen facelift patients were enrolled, 10 female and 4 male. Average age was 63.4 (50-81) years. Tissue movement at three points along the jaw line was measured intraoperatively. Standard SMAS entry point suspension resulted in average vertical movements of 6.4, 10.3, and 13.8 mm and average horizontal movements of 3.5, 5.7, and 6.5 mm. High-SMAS entry point resulted in average vertical movements of 11.8, 17.9, and 24.1 mm and average horizontal movements of 5.8, 9.8, and 9.9 mm. This resulted in a 77.3% increase (p = 0.03) in vertical movement and a 61.4% increase (p = 0.02) in horizontal movement with a high-SMAS entry compared with standard SMAS entry. The high-SMAS entry point for a deep plane facelift resulted in a significant increase in lift for both the horizontal and vertical vector on the facial skin flap when compared with the conventional entry.

PMID: 30513537 [PubMed - as supplied by publisher]

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Effects of Topical Mandelic Acid Treatment on Facial Skin Viscoelasticity.

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Effects of Topical Mandelic Acid Treatment on Facial Skin Viscoelasticity.

Facial Plast Surg. 2018 Dec 04;:

Authors: Jacobs SW, Culbertson EJ

Abstract
Mandelic acid is an α-hydroxy acid with reported benefit in treating acne and hyperpigmentation. The authors have developed a topical mandelic acid formulation that subjectively improves the quality of aged skin. Although the gold standard for assessing outcomes, photographic documentation is limited by subjective interpretation. Tools for measuring physical skin properties allow for an objective assessment of changes in skin quality. The authors sought to objectively study the viscoelastic changes to the skin following treatment with topical mandelic acid, using the Cutometer MPA 580. Twenty-four patients, twenty females and four males, aged 42 to 68 years, were studied over a four-week period. Mandelic acid was applied topically to the face twice a day for four weeks. The lower eyelid skin viscoelastic properties were assessed weekly using the Cutometer. After four weeks of topical mandelic acid treatment, the elasticity of lower eyelid skin increased 25.4% (P = .003). Skin firmness increased 23.8% (P = .029). Improvement in photographic appearance correlated with these findings. Mandelic acid is another topical treatment option for improving skin quality, and is well tolerated by patients. The authors feel that the Cutometer or similar device should be used routinely in facial plastic surgery to objectively assess outcomes of various treatment modalities.

PMID: 30513536 [PubMed - as supplied by publisher]

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The rhinologist's role in the management of rathke's cleft cysts.

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The rhinologist's role in the management of rathke's cleft cysts.

Curr Opin Otolaryngol Head Neck Surg. 2018 Nov 16;:

Authors: Kuan EC, Palmer JN, Adappa ND

Abstract
PURPOSE OF REVIEW: To review the recent literature regarding the growing role of rhinologists and otolaryngologists with neurosurgeons in the joint multidisciplinary team approach for managing patients with Rathke's cleft cysts (RCC).
RECENT FINDINGS: The transnasal endoscopic approach to the skull base has become relatively mainstream for surgical treatment of RCCs. Suprasellar lesions, especially those that are purely suprasellar, are associated with higher recurrence rates, though an extended approach may improve dissection and access and therefore aid in lesion removal. Endoscopic cyst drainage is a well tolerated and effective way to treat RCC, and often avoids the postoperative endocrinopathies associated with complete cyst wall removal. Novel techniques have been described for maintaining tract patency, including the use of stents and flaps, in order to prevent cyst stenosis and reaccumulation. A frontier in skull base surgery is in applications for pediatric patients, and managing RCCs in this population surgically appears to be associated with positive outcomes overall.
SUMMARY: Team-based endoscopic skull base surgery has spurred advances in our understanding of skull base disease, including RCCs. Optimal outcomes are most apparent when the experience and technique of both the endoscopist and neurosurgeon have developed jointly over time.

PMID: 30507691 [PubMed - as supplied by publisher]

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Open-neck organ preservation surgery for hypopharyngeal cancer: indications, techniques, limits, and outcomes.

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Open-neck organ preservation surgery for hypopharyngeal cancer: indications, techniques, limits, and outcomes.

Curr Opin Otolaryngol Head Neck Surg. 2018 Nov 16;:

Authors: Bradley PJ, Liu L

Abstract
PURPOSE OF REVIEW: To appraise the practice and role of open-neck organ preserving surgery for hypopharyngeal squamous cell carcinoma and to update the current indications, techniques, limits, and outcomes.
RECENT FINDINGS: The role of primary surgery for hypopharyngeal carcinoma has shifted over the past two decades to primary nonsurgical management with the use of induction or concurrent chemoradiotherapy. The preferred and most suitable tumours for open-neck surgery are the small-volume T stage diseases, with small to medium-volume neck metastases, however such patients are exceedingly rare. Nonetheless, more advanced tumours with cartilage invasion, vocal cord paralysis, or located at piriform apex and postcricoid area, previously unsuitable for open-neck organ preserving surgery, can now be excised and repaired, minimizing morbidity and improving quality of patients' life. Much of this surgical progress has been developed by innovative surgeons using free tissue transfer, accurate placement surgery, reconstruction of a neoglottis, and perfecting the pharyngoesophageal anastomosis. Current practice of open-neck organ preserving surgery for hypopharyngeal carcinoma has been mainly reported in Asia: Korea, Taiwan, Japan, and China.
SUMMARY: There are some patients who are deemed unsuitable and/or unwilling for current treatment by nonsurgical approaches, and open-neck organ preserving laryngopharyngeal surgery may be a more suitable alternative than selecting a 'lesser or modified' chemo or bioradiotherapy regimen, resulting in a prolonged quantity and quality of life.

PMID: 30507694 [PubMed - as supplied by publisher]

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Salivaomics in oral cancer.

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Salivaomics in oral cancer.

Curr Opin Otolaryngol Head Neck Surg. 2018 Nov 30;:

Authors: Aro K, Kaczor-Urbanowicz K, Carreras-Presas CM

Abstract
PURPOSE OF REVIEW: The goal of cancer screening is to detect tumor at an early stage, and early cancer detection is the hallmark of successful treatment. In addition to traditional tissue biopsy-based diagnostics, more reliable, inexpensive, and noninvasive methods are required for early diagnosis of cancer. In this review, we highlight some of the recent advancements in the field of salivary diagnostics in oral cancer.
RECENT FINDINGS: 'Salivaomics' is a broad collection of technologies used to explore different types of molecules contained in saliva. Although many protein and mRNA salivary biomarkers have been identified that can detect oral squamous cell carcinoma (OSCC), none have so far been validated for current clinical use. As the heterogeneity in carcinogenesis and multifactorial cause for OSCC, the most reliable results are gathered with the use of multiple biomarker candidates to improve accuracy and sensitivity of the test used. This further requires sensitive technology to detect salivary biomarkers in low quantities.
SUMMARY: Large scale studies that incorporate proteomic, transcriptomic, and additional 'omics,' need to be initiated to bring technology to clinical point-of-care applications.

PMID: 30507690 [PubMed - as supplied by publisher]

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