Age-related changes in the relationship between auditory brainstem responses and envelope-following responses.

Hearing thresholds and wave amplitudes measured using auditory brainstem responses (ABRs) to brief sounds are the predominantly used clinical measures to objectively assess auditory function. However, frequency-following responses (FFRs) to tonal carriers and to the modulation envelope (envelope-following responses or EFRs) to longer and spectro-temporally modulated stimuli are rapidly gaining prominence as a measure of complex sound processing in the brainstem and midbrain. In spite of numerous studies reporting changes in hearing thresholds, ABR wave amplitudes, and the FFRs and EFRs under neurodegenerative conditions, including aging, the relationships between these metrics are not clearly understood.

Surgical palliation for pancreatic malignancy: practice patterns and predictors of morbidity and mortality.

Introduction: Most patients with pancreatic cancer present with, or develop, biliary or duodenal obstruction. We sought to characterize palliative surgery utilization in a contemporary cohort and identify patients at high risk of morbidity and mortality.

Methods: The ACS NSQIP database (2005-2011) was queried for patients with a pancreatic malignancy undergoing gastrojejunostomy, biliary bypass, or laparotomy without resection.

Early discharge and readmission after colorectal resection.

Background: Emphasis on the provision of high quality, cost-effective healthcare has meant increasing efforts at reducing postoperative length of stay while reducing 30-d readmission rates. The aim of this study was to identify factors associated with early discharge (ED) and to evaluate the effectof ED on readmission after colorectal resection.

Materials And Methods: We identified all inpatients aged ≥18 y who underwent a colorectal resection in the American College of Surgeons National Surgical Quality Improvement Program Participant Use File, 2011.

Human melanoma metastases demonstrate nonstochastic site-specific antigen heterogeneity that correlates with T-cell infiltration.

Purpose: Metastasis heterogeneity presents a significant obstacle to the development of targeted cancer therapeutics. In this study, we sought to establish from a large series of human melanoma metastases whether there exists a determined pattern in tumor cellular heterogeneity that may guide the development of future targeted immunotherapies.

Experimental Design: From a cohort of 1,514 patients with metastatic melanoma, biopsies were procured over a 17-year period from 3,086 metastatic tumors involving various anatomic sites.

The influence of socioeconomic factors on gender disparities in lower extremity bypass.

Background: Some contend that gender differences in outcomes after lower extremity bypass (LEB) for peripheral arterial disease (PAD) relate to socioeconomic factors (SEFs). Here, we evaluate these disparities with attention to clinically relevant yet understudied SEF.

Methods: A retrospective cohort study of patients aged >50 y with PAD undergoing LEB was performed using data from Pennsylvania Health care and Cost Containment Council (2003-2011).

Preoperative radiation for retroperitoneal sarcoma is not associated with increased early postoperative morbidity.

Background And Objectives: Preoperative radiation (PR) in the management of retroperitoneal sarcoma (RPS) is controversial. Concern for increased perioperative morbidity may influence the decision to recommend PR. Here we compare 30-day morbidity and mortality (M + M) after resection of RPS with and without PR.

Imaging of auriculotemporal nerve perineural spread.

Importance: Adenoid cystic carcinomas (ACCs) are relatively rare tumours, notorious for wide local infiltration and perineural spread. Perineural extension commonly occurs along branches of the trigeminal and facial nerves, and its presence represents a poor prognostic factor with implications for treatment approach.

Observations: We report the case of a 61-year-old female presenting with worsening left facial numbness and weakness.

Prognosis of patients with melanoma and microsatellitosis undergoing sentinel lymph node biopsy.

Introduction: Melanoma microsatellitosis is classified as stage IIIB/C disease and is associated with a poor prognosis. Prognostic factors within this group, however, have not been well characterized.

Methods: We performed a retrospective analysis of 1,621 patients undergoing sentinel lymph node (SLN) biopsy at our institution (1996-2011) to compare patients with (n = 98) and patients without (n = 1,523) microsatellites.

Molecular basis for DNA double-strand break annealing and primer extension by an NHEJ DNA polymerase.

Nonhomologous end-joining (NHEJ) is one of the major DNA double-strand break (DSB) repair pathways. The mechanisms by which breaks are competently brought together and extended during NHEJ is poorly understood. As polymerases extend DNA in a 5'-3' direction by nucleotide addition to a primer, it is unclear how NHEJ polymerases fill in break termini containing 3' overhangs that lack a primer strand.

Postnatal development of auditory central evoked responses and thalamic cellular properties.

During development, the sense of hearing changes rapidly with age, especially around hearing onset. During this period, auditory structures are highly sensitive to alterations of the acoustic environment, such as hearing loss or background noise. This sensitivity includes auditory temporal processing, which is important for processing complex sounds, and for acquiring reading and language skills.

Clark level risk stratifies patients with mitogenic thin melanomas for sentinel lymph node biopsy.

Background: The role for sentinel lymph node biopsy (SLNB) in patients with thin melanoma (≤1 mm) remains controversial. We examined a large cohort of patients with thin melanoma to better define predictors of SLN positivity.

Methods: From 1995 to 2011, 781 patients with thin primary melanoma and evaluable clinicopathologic data underwent SLNB at our institution.

Changes to mitochondrial ultrastructure in optic nerve vulnerable to secondary degeneration in vivo are limited by irradiation at 670 nm.

Background: Traumatic injury to the central nervous system results in damage to tissue beyond the primary injury, termed secondary degeneration. Key events thought to be associated with secondary degeneration involve aspects of mitochondrial function which may be modulated by red/near-infrared irradiation therapy (R/NIR-IT), but precisely how mitochondria are affected in vivo has not been investigated. Secondary degeneration was modelled by transecting the dorsal aspect of the optic nerve in adult rats and mitochondrial ultrastructure in intact ventral optic nerve vulnerable to secondary degeneration investigated with transmission electron microscopy.

Morbidity and mortality of cytoreduction with intraperitoneal chemotherapy: outcomes from the ACS NSQIP database.

Background: Cytoreduction with intraperitoneal chemotherapy (IPC) for treatment of peritoneal surface malignancies is increasingly utilized. However, the described morbidity and mortality rates are based predominantly on the experience at high-volume centers. We analyzed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database for a nationwide perspective on morbidity and mortality associated with IPC.

Can axial-based nodal size criteria be used in other imaging planes to accurately determine "enlarged" head and neck lymph nodes?

Objective. We evaluate if axial-based lymph node size criteria can be applied to coronal and sagittal planes. Methods.

The effect of colorectal cancer screening mandates on access to care and clinical outcomes: a retrospective study of patients undergoing operations of the colon and rectum.

Introduction: Policies that mandate colorectal screening coverage by private insurers are associated with increased use of screening procedures. We seek to understand whether such mandates have improved access to care and short-term operative outcomes for patients undergoing operations of the colon and rectum (OCR).

Methods: Privately insured OCR patients, ages 50-64, enrolled in the Nationwide Inpatient Sample (NIS) (2000-2009) were identified.

Economic impacts of environmentally attributable childhood health outcomes in the European Union.

Background: There is increasing evidence of the role that exposure to industrial chemicals plays in the development of childhood disease. The USA and the European Union (EU) have taken divergent policy approaches to managing this issue, and economic estimates of disease costs attributable to environmental exposures in children are available in the USA but not the EU. We undertook the first economic evaluation of the impacts of childhood environmental chemical exposures in the EU.

The organization and physiology of the auditory thalamus and its role in processing acoustic features important for speech perception.

The auditory thalamus, or medial geniculate body (MGB), is the primary sensory input to auditory cortex. Therefore, it plays a critical role in the complex auditory processing necessary for robust speech perception. This review will describe the functional organization of the thalamus as it relates to processing acoustic features important for speech perception, focusing on thalamic nuclei that relate to auditory representations of language sounds.

Sartorius transposition during inguinal lymphadenectomy for melanoma.

Background: Inguinal lymph node dissection (ILND) for melanoma has been associated with high rates of wound complication (WC). Sartorius transposition (ST) is a technique that has been proposed to minimize morbidity. We report the frequency of utilization of ST and associated clinical outcomes in a national sample.

Ribonucleolytic resection is required for repair of strand displaced nonhomologous end-joining intermediates.

Nonhomologous end-joining (NHEJ) pathways repair DNA double-strand breaks (DSBs) in eukaryotes and many prokaryotes, although it is not reported to operate in the third domain of life, archaea. Here, we describe a complete NHEJ complex, consisting of DNA ligase (Lig), polymerase (Pol), phosphoesterase (PE), and Ku from a mesophillic archaeon, Methanocella paludicola (Mpa). Mpa Lig has limited DNA nick-sealing activity but is efficient in ligating nicks containing a 3' ribonucleotide.

Surgery for metastatic neuroendocrine tumors with occult primaries.

Introduction: Neuroendocrine tumors (NETs) frequently metastasize prior to diagnosis. Although metastases are often identifiable on conventional imaging studies, primary tumors, particularly those in the midgut, are frequently difficult to localize preoperatively.

Materials And Methods: Patients with metastatic NETs with intact primaries were identified.

Postnatal development of synaptic properties of the GABAergic projection from the inferior colliculus to the auditory thalamus.

The development of auditory temporal processing is important for processing complex sounds as well as for acquiring reading and language skills. Neuronal properties and sound processing change dramatically in auditory cortex neurons after the onset of hearing. However, the development of the auditory thalamus or medial geniculate body (MGB) has not been well studied over this critical time window.