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The aims of this study were to evaluate and compare the operative outcomes and postoperative subjective functional parameters of transaxillary (TA) and retroauricular (RA) approach thyroidectomy, with those of conventional hemithyroidectomy.

From May 2011 through December 2013, 153 patients who underwent hemithyroidectomy were categorized prospectively into 3 groups according to the surgical approach used (TA, RA, and conventional hemithyroidectomy groups). All patients underwent prospective acoustic and functional evaluation, using a comprehensive battery of functional assessments, preoperatively and postoperatively at 1week, 1month, 3months, 6months, and 12months.

Age at diagnosis was significantly lower in the TA (n=50) and RA groups (n=42) than in the conventional group (n=61; P<.001). The frequency of occurrence of vocal cord paralysis, inadvertently excised parathyroid, and hematoma did not differ among the groups (P=.447, .519, and .069, respectively). Three months postoperatively, maximal vocal pitch was significantly higher in the RA group than in the conventional and TA groups (P=.021). Although the overall pain score was not different, the Dysphagia Handicap Index of the RA group at 1month postoperatively was significantly higher (P<.001) than in the other groups. Chest paresthesia was significantly more severe in the TA group, especially at 3months postoperative (P=.035). The cosmetic satisfaction score was significantly higher in the RA and TA groups than in the conventional group (P=.001 and 0.035, respectively) at 3 and 6months postoperatively.

Both TA and RA hemithyroidectomy were followed by excellent surgical outcomes, especially with regard to cosmesis. However, delayed recovery of swallowing in RA and chest paresthesia in TA may be mitigating factors.

Both TA and RA hemithyroidectomy were followed by excellent surgical outcomes, especially with regard to cosmesis. However, delayed recovery of swallowing in RA and chest paresthesia in TA may be mitigating factors.

The benefit of estrogen therapy in postmenopausal women is still uncertain. Based upon extensive observational data, it was believed that estrogen was cardioprotective. The relationship between the period of exposure to endogenous estrogens and the risk of cardiovascular disease (CVD) has not been studied in Korean women.

To assess associations between reproductive lifespan and CVD by using the Framingham risk score (FRS) in postmenopausal Korean women.

This cross-sectional, population-based study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) for the five years 2008-2012,after adjustment for relevant variables using complex sample analysis and data weighting.

Among 25,534 women, 1973 women were enrolled, after excluding those <20 or >80 years of age (n=6194), those with diabetes, CVD or cancer (n=491), those with unrecorded physical measurements (n=7335), those with menarche age ≤8 years or ≥20 years (n=6194), and premenopausal women (n=3347).

The FRS tended to show a significant negative correlation with the reproductive lifespan (p<0.001). In multiple linear regression analysis, a negative correlation was observed between the reproductive lifespan and FRS (adjusted relative risk [RR] for <28 reproductive years [shortest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], 1.2, p<0.001 and adjusted RR for >33 reproductive years [longest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], -0.42, p=0.011).

A longer reproductive lifespan is associated with a lower estimated risk of CVD in the next 10 years in postmenopausal women. This result suggests that estrogen has a long-term protective effect against CVD.

A longer reproductive lifespan is associated with a lower estimated risk of CVD in the next 10 years in postmenopausal women. This result suggests that estrogen has a long-term protective effect against CVD.

The aims of this study were to ascertain whether women with high levels of serum total testosterone (TT) or low levels of sex hormone-binding globulin (SHBG) are more likely to develop cardiovascular disease (CVD), and to investigate potential associations between sex hormones and mortality (all-cause, as well as cause-specific) in the general population.

Data on 2129 women with a mean age of 49.0 years were obtained from the population-based Study of Health in Pomerania over a median follow-up of 10.9 years. Associations of baseline levels of TT, SHBG, and rostenedione (ASD), and free testosterone (fT), and of the free androgen index (FAI), with follow-up CVD morbidity, as well as all-cause and CVD mortality, were analyzed using multivariable regression modeling.

At baseline the prevalence rate of CVD was 17.8% (378 women) and the incidence of CVD over the follow-up was 50.9 per 1000 person-years. We detected an inverse association between SHBG and baseline CVD in age-adjusted models (relative risk per standard deviation increase 0.83; 95% confidence interval 0.74-0.93). We did not detect any significant associations between sex hormone concentrations and incident CVD in age- and multivariable-adjusted Poisson regression models. Furthermore, none of the sex hormones (TT, SHBG, ASD, fT, FAI) were associated with all-cause mortality.

This population-based cohort study did not yield any consistent associations between sex hormones in women and incident CVD or mortality risk.

This population-based cohort study did not yield any consistent associations between sex hormones in women and incident CVD or mortality risk.

EGFt is a truncated form of human epidermal growth factor (hEGF) that is non-biologically active but retains binding and internalization into EGFR-positive cells. Our aim was to compare EGFt and hEGF for delivery of (111)In to human breast cancer (BC) cells and tumors and evaluate its cytotoxicity against EGFR-positive BC cells, mediated by the Auger electron emissions of (111)In.

The binding, internalization and nuclear localization of EGFt and hEGF in MDA-MB-468 human BC cells were first assessed by confocal fluorescence microscopy. Subcellular fractionation was then used to quantify the cellular and nuclear uptake of (111)In-EGFt and (111)In-hEGF in MDA-MB-468 cells. The effect of exposure in vitro to (111)In-EGFt or (111)In-hEGF on the clonogenic survival of MDA-MB-468 (10(6) EGFR/cell) or MCF-7 cells (10(4) EGFR/cell) was determined. CQ31 ic50 The pharmacokinetics and tumor and normal tissue biodistribution of (111)In-EGFt was compared to (111)In-hEGF in CD-1 athymic mice with s.c. MDA-MB-468 and MCF-7 tumors.F, and was blocked by anti-EGFR monoclonal antibody, nimotuzumab. Nuclear uptake into MDA-MB-468 tumor cells was higher for (111)In-EGFt than (111)In-hEGF, but when the lower tumor uptake of (111)In-EGFt was considered, there were no overall differences.

We conclude that the absence of biological activity of EGFt makes it attractive for delivery of Auger electron-emitting (111)In to EGFR-overexpressing BC, but its lower cellular and tumor uptake would limit its effectiveness compared to (111)In-hEGF.

(111)In-EGFt may reduce the adverse effects previously observed in patients administered (111)In-hEGF since it is not biologically active, but its lower uptake by BC cells and tumors would limit its effectiveness for treatment of breast cancer.

(111)In-EGFt may reduce the adverse effects previously observed in patients administered (111)In-hEGF since it is not biologically active, but its lower uptake by BC cells and tumors would limit its effectiveness for treatment of breast cancer.

Implantable cardioverter-defibrillators (ICDs) are implanted with the intention to prolong life in selected patients with inherited arrhythmia syndromes, but ICD implantation is also associated with inappropriate shocks and complications.

We aimed to quantify the rate of inappropriate shocks and other ICD-related complications to be able to weigh benefit and harm in these patients.

We performed a systematic review and meta-analysis of inappropriate shock and/or other ICD-related complication rates, including ICD-related mortality, in patients with inherited arrhythmia syndromes, that is, arrhythmogenic right ventricular cardiomyopathy/dysplasia, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, hypertrophic cardiomyopathy, dilated cardiomyopathy due to a mutation in the lamin A/C gene, long QT syndrome, and short QT syndrome. We searched MEDLINE and EMBASE from inception to May 30, 2014.

Of 2471 unique citations, 63 studies comprising 4916 patients with inherited arrhythmia syndd decision making.

Premature ventricular complex (PVC) ablation has been shown to improve left ventricular ejection fraction (LVEF) and New York Heart Association functional class in patients with left ventricular dysfunction. Both are considered key variables in predicting risk of sudden cardiac death.

The objective of this study was to assess whether ablation might remove the primary prevention (PP) implantable cardioverter-defibrillator (ICD) indication in patients with frequent PVC.

Sixty-six consecutive patients with PP-ICD indication and frequent PVC [33 (50%) men; mean age 53 ± 13 years; 11 (17%) with ischemic heart disease] underwent PVC ablation. The ICD was withheld and the indication was reevaluated at 6 and 12 months.

LVEF progressively improved from 28% ± 4% at baseline to 42% ± 12% at 12 months (P < .001). New York Heart Association functional class improved from 2 patients with NYHA functional class I (3%) at baseline to 35 (53%) at 12 months (P < .001). The brain natriuretic peptide level decreased from 246 ± 187 to 176 ± 380 pg/mL (P = .004). The PP-ICD indication was removed in 42 patients (64%) during follow-up, from 38 (92%) of them at 6 months, showing an independent association with baseline PVC burden and successful sustained ablation. In patients with successful sustained ablation, a cutoff value of 13% PVC burden had a sensitivity of 100% and a specificity of 93% (area under the curve 99%) for removing ICD indication postablation. No sudden cardiac deaths or malignant ventricular arrhythmias were observed.

In patients with frequent PVC and PP-ICD indication, ablation improves LVEF and, in most cases, allows removal of the indication. Withholding the ICD and reevaluating within 6 months of ablation seems to be a safe and appropriate strategy.

In patients with frequent PVC and PP-ICD indication, ablation improves LVEF and, in most cases, allows removal of the indication. Withholding the ICD and reevaluating within 6 months of ablation seems to be a safe and appropriate strategy.

Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy.

People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment.

Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n=7,970, mean work years=24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death.