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Objective: Cervical cancer screening is as important in female‐to‐male transgender (FTMT) patients as it is in cisgender female patients. The aim of this study was to examine the impact of clinical information regarding gender identity and testosterone therapy on the cytological interpretations. Methods: A list of FTMT patients and cisgender female patients who had received a cervical Papanicolaou (Pap) test for cancer screening was obtained. The cytological diagnoses, rendered at the time of collection, were recorded. A retrospective slide review with knowledge of the pertinent clinical information, including testosterone therapy status, was performed. The data sets were statistically compared. Results: Of 122 cervical Pap tests in 111 FTMT individuals, 23 (19%) had surgical follow‐ups; 73 (60%) had HPV testing, of which 12 (16%) were positive for high‐risk strains; and 79 (65%) were known to be receiving testosterone. On the "original" review, 12 (9.8%) tests were diagnosed as unsatisfactory. Seventy‐one (58%) Pap tests were initially diagnosed as negative for intraepithelial lesion or malignancy (NILM) without atrophy and 32 (26%) with atrophy. Seven (5.7%) of the tests were initially diagnosed as abnormal. On the "retrospective" review, the rate of unsatisfactory tests remained the same, and atrophy was observed in 76 (62%) tests. The number of abnormal tests was reduced to 4 (3.3%) after the retrospective review. Almost all comparative studies returned a P‐value of ≤0.05. Conclusion: Our findings indicate that clinical information regarding whether a subject is transgender and/or is receiving testosterone therapy is crucial to avoiding Pap test overcalls. [ABSTRACT FROM AUTHOR]

Background: Cryoneurolysis is a term used to describe the application of extreme cold to targeted nerve tissue. The primary goal of the application of a thermal neurolytic technique is to disrupt the conduction of pain signals from the periphery to the central nervous system and eliminate or diminish the experience of pain. Recent advancements in ultrasound technology coupled with the development and approval of handheld devices specifically designed to deliver cryoneurolysis has expanded the use of this modality in the perioperative setting. Application: Surgical procedures including total knee arthroplasties, shoulder arthroplasties, thoracotomies, and mastectomies have all demonstrated long‐term pain relief benefits when cryoneurolysis has been administered days to weeks prior to the planned procedure. In addition, the newly designed handheld device allows for office‐based clinical use and has been utilized for various chronic pain conditions including neuropathic and phantom limb pain. Conclusion: The evidence clearly demonstrates that cryoneurolysis has a low risk profile and when administered appropriately, provides prolonged analgesia without promoting motor blockade. This narrative review article describes the unique mechanism of action of cryoneurolysis for prolonged pain relief and provides emerging evidence to support its applications in both acute and chronic pain management. [ABSTRACT FROM AUTHOR]

New Findings What is the central question of this study? Acetylcholine released from cholinergic nerves can activate both muscarinic and nicotinic receptors. Although each receptor can independently induce cutaneous vasodilatation and eccrine sweating, it remains to be elucidated whether the two receptors interact in order to mediate these responses., What is the main finding and its importance? We show that although nicotinic receptor activation does not modulate muscarinic cutaneous vasodilatation, it lowers the muscarinic receptor agonist threshold at which onset for eccrine sweating (augmentation of muscarinic eccrine sweating) occurs in young men in normothermic resting conditions. These results provide new insights into the physiological significance of nicotinic receptors in the regulation of cutaneous perfusion and eccrine sweating., Acetylcholine released from cholinergic nerves can activate both muscarinic and nicotinic receptors; each is known independently to induce cutaneous vasodilatation and eccrine sweating in humans. However, it is not known whether the two receptors interact in order to mediate cutaneous vasodilatation and eccrine sweating. In 10 young men (27 ± 6 years old), cutaneous vascular conductance and sweat rate were evaluated at intradermal microdialysis sites that were continuously perfused with either lactated Ringer's solution (control) or three different concentrations of nicotine (0.1, 1 and 10 m m), a nicotinic receptor agonist. Co-administration of methacholine, a muscarinic receptor agonist, was performed at all skin sites in a dose-proportional fashion (0.0125, 0.25, 5, 100 and 2000 m m, each for 25 min). Administration of nicotine alone caused dose-dependent transient increases in cutaneous vascular conductance and sweat rate (all P ≤ 0.05), which thereafter returned to pre-nicotine levels, except that a portion of transient responses remained with continuous administration of 10 m m nicotine (both P ≤ 0.05). Cutaneous vascular conductance was increased by administration of ≥0.25 m m methacholine at the control site, and this response was likewise observed in the presence of co-administration of all doses of nicotine used (all P ≤ 0.05). Sweat rate at the control site was increased by administration of ≥0.25 m m methacholine, but the lowest dose of methacholine (0.0125 m m) was able to increase sweat rate in the presence of 10 m m nicotine ( P ≤ 0.05). We conclude that nicotinic receptor activation lowers the muscarinic receptor agonist threshold for eccrine sweating (augmentation of muscarinic sweating) but does not affect muscarinic cutaneous vasodilatation in young men in normothermic resting conditions. [ABSTRACT FROM AUTHOR]

New Findings What is the central question of this study? Protease-activated receptor 2 (PAR2) is located in the endothelial cells of skin vessels and eccrine sweat glands. However, a functional role of PAR2 in the control of cutaneous blood flow and sweating remains to be assessed in humans in vivo., What is the main finding and its importance? Our results demonstrate that in normothermic resting humans in vivo, activation of PAR2 elicits cutaneous vasodilatation partly through nitric oxide synthase-dependent mechanisms, but does not mediate sweating. These results provide important new insights into the physiological significance of PAR2 in human skin., Protease-activated receptor 2 (PAR2) is present in human skin, including keratinocytes, endothelial cells of skin microvessels and eccrine sweat glands. However, whether PAR2 contributes functionally to the regulation of cutaneous blood flow and sweating remains entirely unclear in humans in vivo. We hypothesized that activation of PAR2 directly stimulates cutaneous vasodilatation and sweating via actions of nitric oxide synthase (NOS) and cyclo-oxygenase (COX). In 12 physically active young men (29 ± 5 years old), cutaneous vascular conductance (CVC) and sweat rate were measured at four intradermal microdialysis forearm skin sites that were treated with the following: (i) lactated Ringer's solution (control); (ii) 10 m m NG-nitro- l-arginine (NOS inhibitor); (iii) 10 m m ketorolac (COX inhibitor); or (iv) a combination of both inhibitors. At all sites, a PAR2 agonist (SLIGKV-NH2) was co-administered in a dose-dependent fashion (0.06, 0.18, 0.55, 1.66 and 5 m m, each for 25 min). The highest dose of SLIGKV-NH2 (5 m m) increased CVC from baseline at the control site ( P ≤ 0.05). This increase in CVC associated with PAR2 activation was attenuated by NOS inhibition regardless of the presence or absence of simultaneous COX inhibition (both P ≤ 0.05). However, COX inhibition alone did not affect the PAR2-mediated increase in CVC ( P > 0.05). No increase in sweat rate was measured at any administered dose of SLIGKV-NH2 (all P > 0.05). We show that in normothermic resting humans in vivo, PAR2 activation does not increase sweat rate, whereas it does modulate cutaneous vasodilatation through NOS-dependent mechanisms. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis To examine the sinus-related sequelae of free flap reconstruction for complex orbitofacial defects. Study Design Retrospective chart review. Methods Demographic, clinical, and radiographic data on a series of 55 patients who had undergone free tissue transfer for orbitofacial reconstruction was retrospectively reviewed. Follow-up of ≥ 3 months was available for 49 patients. Outcome measures studied included clinical or radiographic evidence of sinusitis and the need for sinus surgery. Results The most commonly involved sinuses were the ethmoid (n = 40) and maxillary (n = 38) sinuses, and the anterolateral thigh was the most common flap used (n = 41). Clinical and/or radiographic sinusitis was evident in 21 patients (43%), and 10 patients (20%) required sinus surgery at some point during follow-up. Involvement of multiple sinuses in the initial orbitofacial surgery was associated with a significantly increased need for subsequent sinus surgery ( P = 0.009). Adjuvant radiotherapy and adjuvant chemoradiotherapy were associated with a significantly increased risk for the development of rhinosinusitis ( P = 0.045 and 0.016, respectively). Conclusion Rhinosinusitis and the need for operative management of sinus obstruction are common in patients having undergone complex orbitofacial reconstruction. Careful management of the paranasal sinuses is an important component of the multidisciplinary treatment of such patients. Level of Evidence 4. Laryngoscope, 124:1059-1065, 2014 [ABSTRACT FROM AUTHOR]

The results of catalytic treatment of vapors exiting a g/min pyrolysis unit before product condensation to the liquid phase using a Ru/TiO2 catalyst for oak and switchgrass pyrolysis are reported. The pyrolysis is conducted at 500°C and the catalysis at 400°C at atmospheric pressure with a hydrogen partial pressure of 0.58 atm. It is found that the catalytic treatment provides significant conversion of light oxygenates to larger, less oxygenated, molecules and, simultaneously, bio-oil phenolics are also converted to less oxygenated phenolics with methoxy methyl groups transferred to the ring. The activity of the catalyst gradually diminished with increasing biomass fed to the system. Untreated pyrolysis oil forms a single liquid phase with some tarry material, consistent with the literature, whereas the treated liquid product forms separate oil and aqueous phases, the latter of which is about 80% water. The oil from the treated vapors has a lower initial viscosity with only a small increase upon accelerated aging compared to the untreated product oil, which has a dramatic increase in viscosity after aging. This is indicative of poor oil stability for untreated oil that is further confirmed by large increases in molecular weight, while the treated oil has a small increase in molecular weight after accelerated aging. In an effort to understand compatibility with refinery streams, the solubility of the oils in tetralin was examined. The untreated oil was found to have very limited solubility in tetralin, whereas the treated oil phase was completely soluble except for a small aqueous phase that appeared. There are a number of challenges in developing a high yield process for pyrolysis based conversion of biomass to transportation fuels. The Ru/TiO2 catalyst used here shows promise for conducting multiple types of favorable reactions in the presence of the full spectrum of primary pyrolysis products that creates significant product stability under mild conditions. This could lead to higher liquid yields of stable, refinery compatible, product oil. © 2013 American Institute of Chemical Engineers AIChE J, 59: 2275-2285, 2013 [ABSTRACT FROM AUTHOR]

Abstract: Diabetic retinopathy is a chronic low-grade inflammatory disease; however, the mechanisms remain elusive. In the present study, we demonstrated that endoplasmic reticulum (ER) stress was activated in the retina in animal models of diabetes and oxygen-induced retinopathy (OIR). Induction of ER stress by tunicamycin resulted in significantly increased expression of inflammatory molecules in the retina. Inhibition of ER stress by chemical chaperone 4-phenyl butyric acid ameliorated inflammation in cultured human retinal endothelial cells exposed to hypoxia, and in the retinas of diabetic and OIR mice. These findings indicate that ER stress is a potential mediator of retinal inflammation in diabetic retinopathy. [Copyright &y& Elsevier]

Because previous studies of three-dimensional skeletal muscle cultures have shown limited differentiation, the goal of this study was to establish conditions that would produce mature sarcomeres in a mammalian-derived skeletal muscle construct. We evaluated the differentiation of bioartificial muscles generated from C(2)C(12) myoblasts in a collagen gel cultured under steady, passive tension for up to 36 days. Staining for alpha-actinin, myosin, and F-actin indicated the presence of striated fibers as early as 6 days post-differentiation. Electron microscopy at 16 days post-differentiation revealed multinucleated myotubes with ordered, striated myofibers. At 33 days, the cultures contained collagen fibers and showed localization of paxillin at the fiber termini, suggesting that myotendinous junctions were forming. The present study demonstrates mature muscle synthesis in a three-dimensional system using a pure mammalian myoblast cell line. Our results suggest that this culture model can be used to evaluate the effects of various mechanical and biochemical cues on muscle development under normal and pathological conditions. [ABSTRACT FROM AUTHOR]

Angiostatin is a potent angiogenic inhibitor. The present study identified a new activity of angiostatin: reducing vascular leakage, which is associated with diabetic macular edema, tumor growth and inflammation. An intravitreal injection of angiostatin significantly reduced retinal vascular permeability in rats with oxygen-induced retinopathy and in those with streptozotocin-induced diabetes, but not in normal rats. Consistent with its effect on permeability, angiostatin downregulated vascular endothelial growth factor (VEGF) expression in the retina in both the rat models but not in normal controls. These results suggest that the effect of angiostatin on vascular leakage is mediated, at least in part, through blockade of VEGF overexpression. [Copyright &y& Elsevier]

Presents a study which aims to determine the antiinflammatory effect of pigment epithelium-derived factor (PEDF) and its therapeutic potential in diabetic retinopathy. Decrease of PEDF levels in the retina and plasma in a rat model of endotoxin-induced uveitis; Reduction of retinal vascular permeability by PEDF in rats with oxygen-induced retinopathy and diabetes; PEDF inhibited vascular endothelial growth factor (VEGF)-induced endothelial monolayer hyperpermeability; Decrease of retinal cytokine levels and VEGF, VEGF receptor 2 levels by PEDF in oxygen-induced retinopathy.