181 research outputs found
sj-xlsx-2-aor-10.1177_00034894221098471 – Supplemental material for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
No full textSupplemental material, sj-xlsx-2-aor-10.1177_00034894221098471 for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study by Jordan R. Salley, Andrew T. Day, Sanjana Balachandra, Joshua Mehr, Baran D. Sumer, David J. Sher, Elizabeth Mayfield Arnold, Esther Danphuong Ho, Simon Craddock Lee and Rebecca Eary in Annals of Otology, Rhinology & Laryngology</p
sj-docx-1-aor-10.1177_00034894221098471 – Supplemental material for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
No full textSupplemental material, sj-docx-1-aor-10.1177_00034894221098471 for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study by Jordan R. Salley, Andrew T. Day, Sanjana Balachandra, Joshua Mehr, Baran D. Sumer, David J. Sher, Elizabeth Mayfield Arnold, Esther Danphuong Ho, Simon Craddock Lee and Rebecca Eary in Annals of Otology, Rhinology & Laryngology</p
Aspiration Pneumonia and Perioperative Antibiotic Use in Transoral Robotic and Laser Microsurgery
No full textThe 53rd Annual Medical Student Research Forum at UT Southwestern Medical Center (Monday, January 26, 2015, 2-5 p.m., D1.602)INTRODUCTION: Aspiration pneumonia can follow transoral surgery for head and neck cancer due to abnormal swallowing function. While prophylactic post-operative antibiotics may decrease the incidence of this complication, excessive use can be costly, and lead to adverse reactions or antibiotic resistance. The objectives of this study are to 1) determine if the use post-op antibiotics prevent aspiration pneumonia. 2) Identify any complications related to the use of antibiotics.
METHODS: A retrospective review of 155 patients who underwent transoral surgery for squamous cell carcinoma (SCCA) between May 2008 and June 2014 was conducted and demographic data was collected. The MD Anderson dysphagia inventory (MDADI) was used to assess swallowing function.
RESULTS: Sixteen of 122 patients that received postoperative antibiotics (13.1%) developed pneumonia, compared to 4/32(12.5%) patients who did not receive antibiotics (p=0.925). Average antibiotic course was 39.2 days (median=23). Average time to infection was 290 days (median=217, range=11-979). Univariate analysis did not show a correlation between patients that developed pneumonia and antibiotic use (p=1.00), location (p=.1642), overall stage (p=.1599), comorbidity status (p=.5327), tobacco use (p=.6328), alcohol use (p=.351), and gastrostomy tube dependence (p=.254). Univariate analysis did show a correlation between pneumonia and tracheostomy placement (p=.0316), T stage (p=.0357), and days post-op of PEG placement (p=.0297). Multivariate analysis showed correlation with tracheostomy placement (p=.0236). No patients contracted C. difficile infection. No trend was observed in post-operative MDADI score.
DISCUSSION: Routine use of post-operative prophylactic antibiotic does not correlate with a decreased rate of pneumonia or improved functional outcomes. Given that tracheostomies are performed mainly for pulmonary toilet, and a larger T stage results in larger resections, the significant correlation was expected. PEG placement in pneumonia patients was significantly later than patients with no pneumonia. This, and the fact that pneumonia generally developed outside of the 30-day perioperative period, supports the idea that aspiration pneumonia development reflects a chronic worsening swallowing dysfunction. Therefore, dysphagia immediately after surgery is probably not a significant risk factor for developing aspiration pneumonia and routine post-operative antibiotic use for pneumonia prevention is not indicated after transoral surgery.Southwestern Medical Foundatio
pH Transistor Nanoprobe Advances Cancer Detection and Surgery
No full textThe file named "ZHAO-DISSERTATION-2015.pdf" is the primary dissertation file. Four (4) supplemental files are also available and may be viewed individually.The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.Cancer exhibits profound genetic and phenotypic differences, therefore broad yet cancer-specific detection of malignant tumors is challenging. Anatomy-based imaging modalities (e.g., CT, MRI) have good spatial resolution but provide little disease-specific information. 2-Deoxy-2-[18F]fluoroglucose positron emission tomography (FDG-PET) allows near universal tumor detection by leveraging altered tumor metabolism, but it is limited by low spatial resolution and high false positive rates.
Here we report a near infrared fluorescent pH transistor nanoprobe targeting extracellular tumor acidosis from dysregulated pH that drives many invasive properties of cancer. The nanoprobes delineated tumors with high spatial resolution (<1 mm) for a broad range of in vivo tumor models using different clinical cameras. Our results show targeting tumor pH downstream from deregulated metabolism provides a broad strategy with improved cancer specificity which makes the nanoprobe a useful adjuvant method to reduce false rates after FDG-PET.
To validate the ability of nanoprobes to provide real-time, highly sensitive and specific illumination of cancer, we performed tumor acidosis guided detection of occult disease as well as surgery and demonstrated significantly improved long-term survival benefit in head/neck and breast cancers.
This binary nanotransistor design achieves digitization of an analog biologic signal (pH) for signal amplification and noise reduction that improves the accuracy of cancer detection, intraoperative tumor visualization, and imaging of therapeutic response while providing a powerful tool for understanding dysregulated pH and cellular energetics in cancer
Molecular Basis of Cooperativity in pH-Triggered Supramolecular Self-Assembly
No full textResponsive nanomaterials have become an attractive biosensing platform because of their versatility in varying the size, composition, shape and other physicochemical properties to address the deficiency of conventional sensors such as low sensitivity and specificity. Compared to small molecular sensors, nanoparticle sensors often deploy a multitude of non-covalent interactions (hydrogen bonding, hydrophobic and electrostatic interactions) and the resulting system frequently displays cooperative behaviors.
pH is an important physiological parameter that plays a critical role in cellular and tissue homeostasis. Dysregulated pH has been recognized as a universal hallmark of cancer. pH-sensitive nanoparticles have been widely used for tumor imaging, study of endosome/lysosome biology and cancer-targeted drug delivery. Recently, we have established a library of ultra-pH sensitive (UPS) nanoprobes with sharp pH transitions that are finely tunable in a broad range of physiological pH (4-8). The UPS nanoprobes showed significantly improved sensitivity and biological precision over commonly used small molecular and polymeric pH sensors.
Here, we performed the mechanistic study of sharp pH response and binary on/off switch, which are absent in common small molecular and polymeric pH sensors or buffers, in pH-triggered supramolecular self-assembly process. Hydrophobic nanophase separation drove cooperative deprotonation of protonated unimers into neutral copolymers inside micelles. This divergent proton distribution characteristic of a representative PDPA copolymers was not observed in commonly used small molecular and polymeric bases (e.g., PEI). The cooperative deprotonation dynamics can explain the significantly decreased pKa and sharpened pH response. Combination of theoretical modeling and experimental validation allowed identification of key structural parameters on impacting pKa and sharpness in pH transition. Inspired by the impact of counter-ions on the self-assembly of UPS block copolymers, we reported a novel specific anion-induced micellization process. In vitro and in vivo experiments suggested an "capture and integration" mechanism underlying the binary tumor margin delineation performance of UPS nanoparticles.
Results from this study offer molecular insights to help establish the general principles in nanophase transition and supramolecular self-assembly for the development of new nanomaterials-based sensors with binary on/off switch in chemical and biological sensing
Effect of Perioperative Hypothyroidism on Pharyngocutaneous Fistula Formation Following Total Laryngectomy
No full textPROTOTYPE DEVELOPMENT AND EXPERIMENTAL VERIFICATION OF A CAST MODULAR CONNECTOR FOR SEISMIC-RESISTANT STEEL FRAMES.
No full textRights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author
Experiments with non-uniform sediment in case of bed-load transport
No full textAn experimental study was carried out in the framework of a research project concerning the development of a mathematical model for morphological computations in rivers in case of non-uniform sediment. The study consists of a series of laboratory experiments in a straight flume under steady, uniform (equilibrium) conditions with a restriction to bed-load transport and dune regime. The flume was fed upstream by different mixtures of two very narrow sieved size fractions. During one experiment the total amount and composition of the input mixture, the water discharge and the downstream water level were kept constant. When equilibrium was reached besides regular registrations of water and bed level the dunes were extensively sampled. The latter occurred in such a way that vertical probability distributions of the size fractions could be determined. The main results of the experiments are: (i) Vertical sorting of the size fractions occurred in all experiments: at the steep lee side of the dunes the coarse size fraction is generally deposited at a lower level than the fine size fraction. Differences in volume concentration per size fraction until 30% occur between upper and lower layers. (ii) A transition layer was found which is generally below the propagating dunes; it has a relatively coarse composition (vertical sorting:) and has a thickness of 0.1 - 0.5 H (H = average dune height). Exchange of size fractions between this layer and the upper bed layer occurs at a time scale much larger than the dune period. (iii) Because of the phenomena described above several assumptions in a mathematical model for non-uniform sediment (Ribberink, 1980) concerning the transport layer and the deposition/erosion of size fractions to/from non-moving bed are generally not fulfilled. (iv) Data are obtained for the verification and development of semi empirical components in the mathematical model (i.e. transportformula per size fraction, predictors for dune height and bed roughness).The theory of Egiazaroff (1965) concerning the critical bed shear stress per size fraction seems to be useful in a bed-load formula per size fraction of the type of Meyer-Peter & Mueller (1948). (v) A bed sampling technique was developed and suggestions are made concerning the conditions of a non -equilibrium experiment which has the aim to verify the above-mentioned mathematical model for non-uniform sediment.Hydraulic EngineeringCivil Engineering and Geoscience
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