Chondrocytes from osteoarthritic cartilage can be stimulated to undergo 100-fold expansion and then redifferentiation, suggesting that they may be useful as a cell source for joint-scale cartilage tissue engineering.

Our literature review found more involvement of the maxillary and ethmoid sinuses compared with the nasal cavity, and that the role of radiation and surgical approach was varied. ES of the sinonasal tract is a rare entity with high mortality, but few standardized treatment protocols exist. Further study and evidence-based treatment protocols are needed. This article outlines the role of relevant imaging, a multidisciplinary team approach, and the optimal timing of surgery, chemotherapy, and radiation.

IMPORTANCE Accurately characterizing nasal septal deviations is valuable for surgical planning, classifying nasal septal deviations, providing a means to accurately perform outcomes research, and understanding the causes of chronic conditions.OBJECTIVE To determine and quantify regions of septal deformity that can be used to develop a comprehensive classification system. DESIGN, SETTING, AND PARTICIPANTSA retrospective case series study was conducted at an academic tertiary care hospital. Sixty-four participants were selected based on a convenience sample of computed tomography (CT) scans of the paranasal sinuses and midface available between June 29, 2011, and August 16, 2012. Exclusion criteria consisted of incomplete or inadequate CT series. The most recent CT scans were chosen for analyses regardless of the indication for imaging. Digital Imaging and Communications in Medicine format bitmap file-formatted data were obtained and analyzed using MATLAB and OsiriX. The line to curve ratio, deviation area, and root mean square (RMS) values of the septal contour vs the ideal straight septum fit were calculated. Analysis was performed to detect significant differences (P < .05) using the 3 measures. MAIN OUTCOMES AND MEASURESQuantitative analysis of nasal septal deviation. RESULTSThe population consisted of 50 male and 14 female patients aged 3 to 83 years (mean, 42 years). Mean line to curve ratios, areas, and RMS values were highest in contours that intersected the perpendicular plate-vomer junction, with a mean line to curve ratio of 1.04 and mean deviated area of 627.16 arbitrary units (P = .02). Maximal deviation areas were also seen midway from the perpendicular plate-vomer junction to the nasal spine with a mean area of 577.31 arbitrary units (P = .01). The RMS values were significantly elevated along the crista galli and perpendicular plate-vomer junction (P < .05). CONCLUSIONS AND RELEVANCEMaximum septal deviation is seen at the perpendicular plate-vomer junction and in the regions near the crista galli and anterior nasal spine. Deviation area and RMS values are important measures to characterize septal deviations. Understanding septal deviations can aid in developing a functional classification system of nasal septal deviations for clinical use and a means to better record and compare surgical outcomes.LEVEL OF EVIDENCE NA.

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Objectives: To examine the association between treatment status and mortality risk among patients with papillary thyroid cancer (PTC). Methods: We identified 3,679 adults with PTC. Thirty-one untreated patients were matched to 155 treated patients. Hazards ratios (HR) and 95% confidence intervals (CIs) were calculated to estimate all-cause and disease-specific mortality. A low-risk subgroup was analyzed for differences in all-cause mortality. Results: The adjusted HRs (95% CIs) for all-cause mortality at 5 and 10 years were 4.2 (1.7-10.3) and 4.1 (1.9-9.4) and for disease- specific mortality were 14.1 (3.4-59.3) and 10.2 (2.9-36.4), respectively, for untreated versus treated patients. The adjusted HRs (95% CIs) for all- cause mortality was 0.7 (0.1-6.4) for low-risk untreated versus matched treated patients. Conclusions: Compared to treated patients, untreated PTC patients were at higher risk of death while low-risk untreated PTC patients had comparable rate of metastasis and no increased risk of all-cause mortality. Level of evidence: 3

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Background Papillary thyroid cancer (PTC) incidence continues to rise. We describe the natural history of untreated PTC patients. Methods Retrospective case series of 31 untreated PTC patients. Results We identified 31 untreated patients from the Kaiser Permanente Cancer Registry with PTC from 1973 to 2010. Patients were categorized as low risk (n = 16), high risk (n = 12), or low risk but medically contraindicated for surgery (n = 3). At diagnosis, 7 (58.3%) in the high‐risk group had cervical lymph node metastases and 5 (41.7%) had distant metastases, compared to none in the low‐risk group. Among the latter, three (18.8%) patients developed tumor growth >3 mm and one (6.3%) developed regional lymph node metastases without distant metastases. The 10‐year overall survival was 71% and 35% for the low‐risk and high‐risk groups, respectively. Conclusions Patients with low‐risk untreated PTC were less likely to develop new regional or distant metastases and had better overall survival than patients with high‐risk untreated PTC. Level of Evidence 4

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