The objective of this study is to provide a comprehensive classification system for parotidectomy operations. Data sources include Medline publications, author’s experience, and consensus round table ...at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term “parotidectomy” and “definition”. The various definitions of parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of parotidectomy procedures is proposed.
Supramolecular assemblies that interact with light have recently garnered much interest as well-defined nanoscale materials for electronic excitation energy collection and transport. However, to ...control such complex systems it is essential to understand how their various parts interact and whether these interactions result in coherently shared excited states (excitons) or in diffusive energy transport between them. Here, we address this by studying a model system consisting of two concentric cylindrical dye aggregates in a light-harvesting nanotube. Through selective chemistry we are able to unambiguously determine the supramolecular origin of the observed excitonic transitions. These results required the development of a new theoretical model of the supramolecular structure of the assembly. Our results demonstrate that the two cylinders of the nanotube have distinct spectral responses and are best described as two separate, weakly coupled excitonic systems. Understanding such interactions is critical to the control of energy transfer on a molecular scale, a goal in various applications ranging from artificial photosynthesis to molecular electronics.
Sialodochitis fibrinosa and allergic parotitis have described rare patients with recurrent salivary gland swelling and mucus plugs, often with atopy. We have evaluated three patients with atopic ...disease, recurrent salivary gland swelling, and an eosinophilic sialodochitis. Two had eosinophil‐rich mucus plugs. Fifty‐six additional cases were identified in a medical literature database search, each defined by recurrent salivary gland swelling associated with eosinophil‐rich mucus plugs or sialodochitis with periductal eosinophilic infiltration. The majority (78%) were reported from Japan. Females were predominantly affected (F:M = 2.3) with a median age of 47 years at evaluation. The parotid and submandibular glands were involved, respectively, in 71% and 46%. Allergic symptoms were present in 66%, atopic disease in 63% of those with reported allergy testing, and blood eosinophilia in 71%. Contrast sialography and other imaging modalities documented ductal dilatation in 82%. Treatments included anti‐allergic medications (58%), systemic glucocorticoids (25%), duct cannulation with irrigation, steroid injection, and/or duct dilatation (36%), and glandular resection (19%). We recommend the diagnosis ‘eosinophilic sialodochitis’ be applied to patients who meet this case definition. The disease is a unique cause of chronic recurrent salivary gland swelling. Its likely allergic etiology may be amenable to current or future biologic therapies.
Invasive lobular breast cancer (ILC) is characterized by a relatively high risk for late recurrence and a unique metastatic pattern with an increased risk for metastasis to gynecologic organs and ...peritoneum. We present a unique case of recurrent ILC with metastasis to the abdominal peritoneum as well as the uterine myometrium and cervix. Treatment was complicated by the discovery of concomitant uterine carcinosarcoma. This patient was effectively treated with a combination of hormonal therapy for her metastatic ILC and a combination of chemotherapy and immunotherapy for uterine carcinosarcoma. Molecular evaluation revealed a characteristic CDH1 mutation within the ILC and a PI3KCA mutation within the uterine carcinosarcoma, both of which have been linked to epithelial-to-mesenchymal transitions. Examination of the tumor immune microenvironment revealed proportionally more cytotoxic NK cells. This robust immune infiltration may be an indicator of the response to immunotherapy observed in this tumor or a result of the metastatic breast cancer within the uterus. This report provides a characterization of the molecular and immunologic landscape in this case with metastatic ILC and uterine carcinosarcoma.
Abstract
During intracellular infection, T follicular helper (T
FH
) and T helper 1 (T
H
1) cells promote humoral and cell-mediated responses, respectively. Another subset, CD4-cytotoxic T ...lymphocytes (CD4-CTLs), eliminate infected cells via functions typically associated with CD8
+
T cells. The mechanisms underlying differentiation of these populations are incompletely understood. Here, we identify the transcription factor Aiolos as a reciprocal regulator of T
FH
and CD4-CTL programming. We find that Aiolos deficiency results in downregulation of key T
FH
transcription factors, and consequently reduced T
FH
differentiation and antibody production, during influenza virus infection. Conversely, CD4-CTL programming is elevated, including enhanced Eomes and cytolytic molecule expression. We further demonstrate that Aiolos deficiency allows for enhanced IL-2 sensitivity and increased STAT5 association with CD4-CTL gene targets, including Eomes, effector molecules, and IL2Ra. Thus, our collective findings identify Aiolos as a pivotal regulator of CD4-CTL and T
FH
programming and highlight its potential as a target for manipulating CD4
+
T cell responses.
Previous studies of the murine Ly49 and human KIR gene clusters implicated competing sense and antisense promoters in the control of variegated gene expression. In the current study, an examination ...of transcription factor genes defines an abundance of convergent and divergent sense/antisense promoter pairs, suggesting that competing promoters may control cell fate determination. Differentiation of CD34+ hematopoietic progenitors in vitro shows that cells with GATA1 antisense transcription have enhanced GATA2 transcription and a mast cell phenotype, whereas cells with GATA2 antisense transcription have increased GATA1 transcripts and an erythroblast phenotype. Detailed analyses of the AHR and RORC genes demonstrate the ability of competing promoters to act as binary switches and the association of antisense transcription with an immature/progenitor cell phenotype. These data indicate that alternative cell fates generated by promoter competition in lineage-determining transcription factors contribute to the programming of cell differentiation.
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•18% of human transcription factors contain both divergent and convergent antisense•Cells transcribing GATA1 or GATA2 antisense are distinct from cells with coding transcripts•Stable sense or antisense transcriptional states exist in transcription factor genes•Antisense transcription is associated with progenitor cells
Li and colleagues describe the presence of a regulatory motif containing both convergent and divergent antisense promoters in 18% of human transcription factors. They demonstrate the ability of competing promoters to act as switches and propose a role for these elements in the programming of cell fate.
The program entails serious treatment, but the children approach it with a sense of fun. ...the focus was on understanding how these factors impact blood glucose control, and less so the children’s ...experiences as human beings. Declarations Disclosures The author declares no conflict of interest.
The COVID-19 pandemic has altered innumerable lives. Although recent mass vaccinations offer a glimmer of hope, the rising death toll and new variants continue to dominate the current scenario. As we ...begin to understand more about SARS-CoV-2 infections, the territory of reinfections with COVID-19 remains unexplored. In this review, we will discuss several aspects of reinfection: (a) How is COVID-19 reinfection characterized? (b) Does prior literature differentiate between reinfection and reactivation? (c) What SARS-CoV-2 strains do the vaccines target and can they protect against new strains? Larger and longer timeline studies are needed to understand reinfection risks. With the ongoing distribution of the SARS-CoV-2 vaccines to provide protection, the understanding of the possibility for SARS-CoV-2 reinfection remains critical.
Abbreviations CDC: Centers for Disease ControlSARS-CoV-2: Severe acute respiratory syndrome coronavirus 2COVID-19: Coronavirus disease 2019RT-PCR: Reverse Transcription Polymerase Chain ReactionPASC: Post-Acute Sequelae of SARS-CoV-2 infection
To assess the risk factor of capsular rupture for individual prognosis and potential therapeutic decision making, the present meta-analysis elaborated the prognostic significance of perinodal spread ...in a large group of patients suffering from head and neck squamous cell carcinomas (HNSCC). A review of the published literature was conducted, and fixed and random effects models were applied for estimation of the summarised odds ratio and 95% confidence intervals, including a test for homogeneity of the odds ratios. Study methodology allowed the enrollment of only nine studies of 115 published papers. Excluded studies lacked regarding primary tumour location, number and location of lymph node metastases, values on five-year survival, or adequate follow-up data. A summarised odds ratio of 2.7 leads to the conclusion that perinodal spread negatively impacts the five-year survival. The lower confidence limit of more than 2 also supports the concept that perinodal spread significantly reduces (doubled risk) the five-year-survival. These results support the conclusion that perinodal spread is a significant adverse risk factor for survival in patients with HNSCC.
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