Stakeholders’ Perspectives on Postmastectomy Breast Reconstruction: Recognizing Ways to Improve Shared Decision Making

Background: Postmastectomy breast reconstruction (PMBR) is an elective, preference-sensitive decision made during a stressful, time-pressured period after a cancer diagnosis. Shared decision making (SDM) can improve decision quality about preference-sensitive choices. Stakeholders' perspectives on ways to support PMBR decision-making were explored. Methods: Forty semi-structured interviews with stakeholders (20 postmastectomy patients, 10 PMBR surgeons, 10 PMBR nurses) were conducted. Clinicians were recruited from diverse practices across the United States. Patients were recruited using purposive sampling with varying PMBR experiences, including no reconstruction. The interview guide was based on an implementation research framework. Themes were identified using grounded theory approach, based on frequency and emotive force conveyed. Results: Engagement in SDM was variable. Some patients wanted more information about PMBR from clinicians, particularly about risks. Some clinicians acknowledged highlighting benefits and downplaying risks. Many patients felt pressured to make a choice by their clinicians. Clinicians who successfully engaged patients through decisions often used outside resources to supplement conversations. Conclusions: Patient–clinician trust was critical to high-quality decisions, and many patients expressed decision regret when they were not engaged in PMBR discussions. Patients often perceived a race- or age-related bias in clinician information sharing. Interventions to support SDM may enhance decision quality and reduce decision regret about PMBR, ultimately improving patient-centered care for women with breast cancer.

http://ift.tt/2j17g27

Creation of Nepal’s First Skin Bank: Challenges and Outcomes

Background: In Nepal, burn trauma causes more than 55,000 injuries each year. Burn-related mortality is high in Nepal, in part due to lack of allograft, leading to high infection rates. To address this challenge, our collaboration between Kirtipur Hospital, America Nepal Medical Foundation, Stanford University, and ReSurge International established Nepal's first skin bank. Methods: We identified 3 major tasks to create a sustainable skin banking program: 1) identify and acquire the equipment and personnel needed to collect, process, store, and graft cadaveric skin for burn injuries; 2) develop safe donation protocols and documentation tools that remain feasible for low-resource settings; and 3) develop a long-term awareness program to educate the Nepali people on skin donation, a previously foreign concept. Results: Kirtipur Hospital acquired the necessary equipment and materials for the skin bank through a combination of local and international fundraising efforts. Existing U.S. skin banking protocols were adapted for the Nepali setting and piloted on potential patients, donors, and physicians. For the first time in the hospital's history, patients with > 40% total body surface area burns were successfully treated with extensive allografts. Conclusions: It is feasible to create a skin bank in a country with no tradition of allograft skin use. Long-term sustainability now depends on spreading awareness and education in the Kathmandu Valley to overcome religious and cultural barriers that have hindered donor recruitment. Our low-cost and high-impact skin bank provides a model to expand this system to other hospitals both within Nepal and beyond.

http://ift.tt/2CvviYm

Effects of Autologous Fat and ASCs on Swine Hypertrophic Burn Scars: A Multimodal Quantitative Analysis

Background: Hypertrophic scar formation is unpredictable and poorly understood, afflicting both the pediatric and adult populations. Treatment methods with conservative and invasive approaches have low rates of compliance and high rates of morbidity. The purpose of this study was to test a reproducible scar model and investigate a new technique of scar modification through the use of adipose- derived progenitor stromal cells (ASCs). Methods: Twenty thermal deep-partial thickness contact burns were created on the dorsum of three 8-week-old domestic swine and allowed to mature for 10 weeks. Scars were then injected with 2 cc saline, expanded autologous ASCs, or 2 cc fresh lipoaspirate and sampled at 2 week intervals up to 10 weeks postinjection. Volumetric analysis with a 3-D scanner, mechanical elasticity testing through negative pressure transduction, and standardized photography evaluation with Image J was performed. RNA sequencing was performed on scar tissue samples, cultured cells, and fresh lipoaspirate to determine relevant gene transcription regulation. Immunohistochemistry was used to verify expression level changes within the scars. Results: Volumetric analysis demonstrates a reduction in average scar thickness at 6 weeks when injected with ASCs (−1.6 cc3) and autologous fat (−1.95 cc3) relative to controls (−0.121 cc3; P

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Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.

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Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.

Rhinology. 2017 Dec 30;:

Authors: Bidder T, Sahota J, Rennie C, Lund VJ, Robinson DS, Kariyawasam HH

Abstract
INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy.
OBJECTIVE: To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP.
METHODS: SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared.
RESULTS: Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery.
CONCLUSION: Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.

PMID: 29288573 [PubMed - as supplied by publisher]

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Functional anatomy of the nasal bones and adjacent structures. Consequences for nasal surgery.

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Functional anatomy of the nasal bones and adjacent structures. Consequences for nasal surgery.

Rhinology. 2017 Dec 29;:

Authors: Popko M, Verlinde-Schellekens SAMW, Huizing EH, Bleys RLAW

Abstract
The periosteum of the nasal bones, the periosteal-perichondrial nasal envelope, and the cartilaginous support of the bony vault were studied in serial coronal sections of four human cadaver noses. To differentiate between the various tissue components, the sections were stained according to Mallory-Cason and Verhoeff-Van Gieson stain. The results demonstrated: 1. the presence of clearly distinguishable layers of the periosteum covering the nasal bones; 2. the presence of a continuous periosteal-perichondrial covering of the bony and cartilaginous nasal vaults; 3. the way the cartilaginous support of the bony vault is constructed. The findings described in the present study may have clinical relevance in nasal surgery.

PMID: 29286059 [PubMed - as supplied by publisher]

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REM-associated sleep disordered breathing: prevalence and clinical significance in the hypnolaus cohort

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): P. Acosta-Castro, P. Marques-Vidal, P. Vollenweider, N. Tobback, J. Haba-Rubio, R. Heinzer




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Obstructive sleep apnea is highly undetected in non-obese patients with atrial fibrillation

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): A.M. Abumuamar, P. Sandor, P. Dorian, D. Newman, C. Shapiro




http://ift.tt/2q3HwoL

Use of occlusal splint or mandibular advancement appliance by sleep bruxism patients do not normalize arousal related heart rate variability

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): S. Abe, P.H. Rompré, N.T. Huynh, A. Landry-Schönbeck, M.-L. Landry, P. de Grandmont, F. Kawano, G.J. Lavigne




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Irregular sleep-wake rhythm disorder in a young woman with Townes-Brocks-syndrome

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): J. Acker, L. Gerber, M. Wüst, C. Niederberger, A. Nirkko




http://ift.tt/2q3HoFN

World Association of Sleep Medicine (WASM) historical summary

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): Allan O'Bryan, Luigi Ferini Strambi, Thomas Penzel




http://ift.tt/2EnwHAL

Treatment of obstructive sleep apnea decreases the recurrence of atrial and ventricular ectopy in patients with atrial fibrillation

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): A.M. Abumuamar, P. Dorian, D. Newman, P. Sandor, C. Shapiro




http://ift.tt/2q68Gez

Clinical and polysomnographic differences in elderly patients with obstructive sleep apnea (OSA)

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): M. Erdemir Isık, B. Gulbay, T. Acican, F. Çiftçi, Z.P. Önen, A. Azeez, K. Turkel




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Handheld mobile biofeedback of heart rate variability in patients with chronic insomnia disorder – a pilot study

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): J. Acker, A. Nirkko, M. Wüst, K. Richter




http://ift.tt/2q3H2yX

Effect of sleep apnea and insomnia on the association of depression with quantitative electroencephalogram measures (QEEG) in adult men during sleep – the MAILES study

Publication date: December 2017
Source:Sleep Medicine, Volume 40, Supplement 1
Author(s): R. Adams, S. Appleton, A. Vakulin, A. D'Rozario, R.D. McEvoy, P. Catcheside, S. Martin, C. Lang, A. Vincent, G. Wittert




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Surface EMG patterns for quantification of thigh muscle co-contraction in school-age children: Normative data during walking

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Francesco Di Nardo, Annachiara Strazza, Alessandro Mengarelli, Serena Ercolani, Nicole Morgoni, Laura Burattini, Valentina Agostini, Marco Knaflitz, Sandro Fioretti
Muscle co-contractions are particularly relevant in analyzing children pathologies. To interpret surface electromyography (sEMG) in pathological conditions, reliable normative data in non-pathological children are required for direct comparison. Aim of the study was the quantification of co-contraction activity between quadriceps femoris (QF) and hamstring muscles during walking in healthy children. To this aim, Statistical gait analysis was performed on sEMG signals from rectus femoris (RF), vastus medialis (VM), and lateral hamstrings (LH), in 16401 strides walked by 100 healthy school-age children. Co-contractions were assessed as overlapping period between activation intervals of considered muscles. Results showed full superimpositions of LH with both RF and VL activity from terminal swing, 80–100% of gait cycle, to successive loading response (0–15% of gait cycle), in around 90% of strides, as reported in adults. This indicates that children regularly use a cocontraction activity between QF and hamstring muscles in weight acceptance during walking, supporting the hypothesis of a regulatory role of co-contraction in providing knee joint stability. Concomitant activity of QF and hamstring muscles was detected also during push-off phase (30–50% of gait cycle), showing a large variability intra and inter subjects and a lower occurrence frequency (around 25% of strides). This could be intended for controlling rapid knee flexion and/or stabilizing pelvis during body progression. Present findings represent the first attempt to provide normative sEMG dataset on variability of QF and hamstring muscles co-contractions during child walking, useful for discriminating physiological and pathological behavior and for designing future studies on maturation of gait.



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"Int J Pediatr Otorhinolaryngol"[jour]; +46 new citations

46 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Int J Pediatr Otorhinolaryngol"[jour]

These pubmed results were generated on 2017/12/31

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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A novel pathogenic variant c.975G>A (p.Trp325*) in the POU3F4 gene in Yakut family (Eastern Siberia, Russia) with the X-linked deafness-2 (DFNX2).

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A novel pathogenic variant c.975G>A (p.Trp325*) in the POU3F4 gene in Yakut family (Eastern Siberia, Russia) with the X-linked deafness-2 (DFNX2).

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:94-97

Authors: Barashkov NA, Klarov LA, Teryutin FM, Solovyev AV, Pshennikova VG, Konnikova EE, Romanov GP, Tobokhov AV, Morozov IV, Bondar AA, Posukh OL, Dzhemileva LU, Tomsky MI, Khusnutdinova EK, Fedorova SA

Abstract
Here, we report a novel hemizygous transition c.975G>A (p.Trp325*) in POU3F4 gene (Xq21) found in two deaf half-brothers from one Yakut family (Eastern Siberia, Russia) with identical inner ear abnormalities ("corkscrew" cochlea with an absence of modiolus) specific to X-linked deafness-2 (DFNX2). Comprehensive clinical evaluation (CT and MR-imaging, audiological and stabilometric examinations) of available members of this family revealed both already known (mixed progressive hearing loss) and additional (enlargement of semicircular canals and postural disorders) clinical DFNX2 features in affected males with c.975G>A (p.Trp325*). Moreover, mild enlargement of semicircular canals, postural abnormalities and different types of hearing thresholds were found in female carrier of this POU3F4-variant.

PMID: 29287890 [PubMed - in process]

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A novel mutation of the EYA4 gene associated with post-lingual hearing loss in a proband is co-segregating with a novel PAX3 mutation in two congenitally deaf family members.

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A novel mutation of the EYA4 gene associated with post-lingual hearing loss in a proband is co-segregating with a novel PAX3 mutation in two congenitally deaf family members.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:88-93

Authors: Cesca F, Bettella E, Polli R, Cama E, Scimemi P, Santarelli R, Murgia A

Abstract
OBJECTIVES: This work was aimed at establishing the molecular etiology of hearing loss in a 9-year old girl with post-lingual non-syndromic mild sensorineural hearing loss with a complex family history of clinically heterogeneous deafness.
METHODS: The proband's DNA was subjected to NGS analysis of a 59-targeted gene panel, with the use of the Ion Torrent PGM platform. Conventional Sanger sequencing was used for segregation analysis in all the affected relatives. The proband and all the other hearing impaired members of the family underwent a thorough clinical and audiological evaluation.
RESULTS: A new likely pathogenic mutation in the EYA4 gene (c.1154C > T; p.Ser385Leu) was identified in the proband and in her 42-year-old father with post-lingual non-syndromic profound sensorineural hearing loss. The EYA4 mutation was also found in the proband's grandfather and uncle, both showing clinical features of Waardenburg syndrome type 1. A novel pathogenic splice-site mutation (c.321+1G > A) of the PAX3 gene was found to co-segregate with the EYA4 mutation in these two subjects.
CONCLUSION: The identified novel EYA4 mutation can be considered responsible of the hearing loss observed in the proband and her father, while a dual molecular diagnosis was reached in the relatives co-segregating the EYA4 and the PAX3 mutations. In these two subjects the DFNA10 phenotype was masked by Waardenburg syndrome. The use of NGS targeted gene-panel, in combination with an extensive clinical and audiological examination led us to identify the genetic cause of the hearing loss in members of a family in which different forms of autosomal dominant deafness segregate. These results provide precise and especially important prognostic and follow-up information for the future audiologic management in the youngest affected member.

PMID: 29287889 [PubMed - in process]

http://ift.tt/2Cr3kQd

A novel splicing mutation in SMPX is linked to nonsyndromic progressive hearing loss.

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A novel splicing mutation in SMPX is linked to nonsyndromic progressive hearing loss.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:47-50

Authors: Niu Z, Yan D, Bressler S, Mei L, Feng Y, Liu X

Abstract
OBJECTIVE: X-linked nonsyndromic hearing impairment is the rarest form of genetic hearing loss and represents only a minor fraction of all cases. The aim of this study was to investigate the cause of X-linked nonsyndromic sensorineural hearing loss in a three-generation American family.
METHODS: Whole-exome sequencing and co-segregation analysis were used to identify disease-causing genes.
RESULTS: In this study, we described in detail the clinical characteristics of the family and identified a novel frameshift mutation creating a premature stop codon (c.133-1 G > A, p.(Gly45fs*36)) of SMPX. The loss-of-function mutation was co-segregated with the progressive hearing loss phenotype and was absent in 200 normal controls.
CONCLUSIONS: We report the first SMPX (DFNX4) mutation in a North American family. Our findings contribute to the existing genotypic and phenotypic spectrum of SMPX associated hearing loss. Furthermore, our data suggest that exome sequencing is promising in the genetic diagnosis of hearing loss.

PMID: 29287879 [PubMed - in process]

http://ift.tt/2CrDbAs

Germinal mosaicism of PAX3 mutation caused Waardenburg syndrome type I.

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Germinal mosaicism of PAX3 mutation caused Waardenburg syndrome type I.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:200-204

Authors: Chen K, Zhan Y, Wu X, Zong L, Jiang H

Abstract
OBJECTIVES: Waardenburg syndrome mutations are most often recurrent or de novo. The rate of familial recurrence is low and families with several affected children are extremely rare. In this study, we aimed to clarify the underlying hereditary cause of Waardenburg syndrome type I in two siblings in a Chinese family, with a mother affected by prelingual mild hearing loss and a father who was negative for clinical symptoms of Waardenburg syndrome and had a normal hearing threshold.
METHODS: Complete characteristic features of the family members were recorded and genetic sequencing and parent-child relationship analyses were performed.
RESULTS: The two probands were found to share double mutations in the PAX3/GJB2 genes that caused concurrent hearing loss in Waardenburg syndrome type I. Their mother carried the GJB2 c.109G > A homozygous mutation; however, neither the novel PAX3 c.592delG mutation, nor the Waardenburg syndrome phenotype, was observed in either parent.
CONCLUSION: These previously unreported digenic mutations in PAX3/GJB2 resulted in deafness associated with Waardenburg syndrome type I in this family. To our knowledge, this is the first report describing germinal mosaicism in Waardenburg syndrome. This concept is important because it complicates genetic counseling of this family regarding the risk of recurrence of the mutations in subsequent pregnancies.

PMID: 29287868 [PubMed - in process]

http://ift.tt/2CpPHkc

SLC52A2 mutations cause SCABD2 phenotype: A second report.

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SLC52A2 mutations cause SCABD2 phenotype: A second report.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:195-199

Authors: Babanejad M, Adeli OA, Nikzat N, Beheshtian M, Azarafra H, Sadeghnia F, Mohseni M, Najmabadi H, Kahrizi K

Abstract
INTRODUCTION: Autosomal recessive cerebellar ataxias (ARCAs) are a large group of neurodegenerative disorders that manifest mainly in children and young adults. Most ARCAs are heterogeneous with respect to age at onset, severity of disease progression, and frequency of extracerebellar and systemic signs.
METHODS: The phenotype of a consanguineous Iranian family was characterized using clinical testing and pedigree analysis. Whole-exome sequencing was used to identify the disease-causing gene in this family.
RESULTS AND CONCLUSION: Using whole exome sequencing (WES), a novel missense mutation in SLC52A2 gene is reported in a consanguineous Iranian family with progressive severe hearing loss, optic atrophy and ataxia. This is the second report of the genotype-phenotype correlation between this syndrome named spinocerebellar ataxia with blindness and deafness type 2 (SCABD2) and SLC52A2 gene.

PMID: 29287867 [PubMed - in process]

http://ift.tt/2Cqj8SW

A novel variant in the CDH23 gene is associated with non-syndromic hearing loss in a Chinese family.

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A novel variant in the CDH23 gene is associated with non-syndromic hearing loss in a Chinese family.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:108-112

Authors: Liang Y, Wang K, Peng Q, Zhu P, Wu C, Rao C, Chang J, Li S, Lu X

Abstract
OBJECTIVES: To explore the pathogenic causes of a proband who was diagnosed with non-syndromic hearing loss.
METHODS: We performed targeted capture of 159 known deafness-related genes and next-generation sequencing in the proband who was tested negative for the twenty hotspot variants in four common deafness-related genes(GJB2, GJB3, SLC26A4 and MTRNR1); Clinical reassessments, including detailed audiological and ocular examinations were performed in the proband and his normal parents.
RESULTS: We identified a novel heterozygous variant of CDH23:c.4567A > G (p.Asn1523Asp) in exon 37 (NM_022124), in conjunction with a reported mutation of CDH23:c.5101G > A (p.Glu1701Lys) in exon 40, to be a potentially pathogenic compound heterozygosity in the proband. The unaffected father has a heterozygous variant of CDH23:c.4567A > G, and the normal mother has another heterozygous variant, CDH23:c.5101G > A. The novel variant was absent in the 1000 Genomes Project. The clinical reassessments revealed binaural profound sensorineural hearing loss (DFNB12) without retinitis pigmentosa in the proband.
CONCLUSIONS: This study demonstrates that the novel variant c.4567A > G (p.Asn1523Asp) in compound heterozygosity with c.5101G > A (p. Glu1701Lys) in the CDH23 gene is the main cause of DFNB12 in the proband. Simultaneously, this study provides a foundation to further elucidate the CDH23-related mechanisms of DFNB12.

PMID: 29287849 [PubMed - in process]

http://ift.tt/2Co6i7S

Marinobufagin, a molecule from poisonous frogs, causes biochemical, morphological and cell cycle changes in human neoplasms and vegetal cells.

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Marinobufagin, a molecule from poisonous frogs, causes biochemical, morphological and cell cycle changes in human neoplasms and vegetal cells.

Toxicol Lett. 2017 Dec 26;:

Authors: Pinheiro Ferreira PM, da Conceição Machado K, de Sousa LQ, Barbosa Lima DJ, Soares BM, Cavalcanti BC, Anna Maranhão SS, da Costa de Noronha J, de Jesus Rodrigues D, Gadelha Militão GC, Chaves MH, Vieira-Júnior GM, Pessoa C, de Moraes MO, de Castro E Sousa JM, de Carvalho Melo-Cavalcante AA

Abstract
Skin toad secretion present physiologically active molecules to protect them against microorganisms, predators and infections. This work detailed the antiproliferative action of marinobufagin on tumor and normal lines, investigate its mechanism on HL-60 leukemia cells and its toxic effects on Allium cepa meristematic cells. Initially, cytotoxic action was assessed by colorimetric assays. Next, HL-60 cells were analyzed by morphological and flow cytometry techniques and growing A. cepa roots were examined after 72 h exposure. Marinobufagin presented high antiproliferative action against all human tumor lines [IC50 values ranging from 0.15 (leukemia) to 7.35 (larynx) μM] and it failed against human erythrocytes and murine lines. Human normal peripheral blood mononuclear cells (PBMC) were up to 72.5-fold less sensitive [IC50: 10.88 μM] to marinobufagin than HL-60 line, but DNA strand breaks were no detected. Leukemia treaded cells exhibited cell viability reduction, DNA fragmentation, phosphatidylserine externalization, binucleation, nuclear condensation and cytoplasmic vacuoles. Marinobufagin also reduced the growth of A. cepa roots (EC50: 7.5 μM) and mitotic index, caused cell cycle arrest and chromosomal alterations (micronuclei, delays and C-metaphases) in meristematic cells. So, to find out partially targeted natural molecules on human leukemia cells, like marinobufagin, is an amazing and stimulating way to continue the battle against cancer.

PMID: 29287997 [PubMed - as supplied by publisher]

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Recurrent laryngeal nerve reinnervation for management of aspiration in a subset of children.

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Recurrent laryngeal nerve reinnervation for management of aspiration in a subset of children.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:104-107

Authors: Zur KB, Carroll LM

Abstract
Pediatric aspiration is a multifactorial process that is often complex to manage. Recurrent laryngeal nerve (RLN) injury can cause glottic insufficiency and aspiration. We describe three cases of unilateral vocal fold paralysis resulting in aspiration and the successful use of the RLN reinnervation for its treatment. The theory for utilizing the reinnervation procedure is that when glottic closure improves and a less breathy vocalization occurs, then the larynx is better equipped to protect the lower airway and avoid aspiration. Our cases demonstrate stronger voice and improved swallow function, with normalization of modified barium swallow evaluation, at approximately 6-months post reinnervation.

PMID: 29287848 [PubMed - in process]

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"Int J Pediatr Otorhinolaryngol"[jour]; +46 new citations

46 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Int J Pediatr Otorhinolaryngol"[jour]

These pubmed results were generated on 2017/12/31

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Sulfur dioxide exposure enhances Th2 inflammatory responses via activating STAT6 pathway in asthmatic mice.

Sulfur dioxide exposure enhances Th2 inflammatory responses via activating STAT6 pathway in asthmatic mice.

Toxicol Lett. 2017 Dec 27;:

Authors: Li X, Huang L, Wang N, Yi H, Wang H

Abstract
Sulfur dioxide (SO2) is one of potential risk factors for induction and/or exacerbation of asthma, but the underlying mechanisms are not well understood. In this study, we investigate the role of SO2 in asthma using a classical asthmatic model with allergic airway inflammation by treating C57BL/6 mice with ovalbumin (OVA) and/or 10 mg/m3 SO2. Our results showed that SO2 exposure alone induced slight pathological changes but did not significantly increase inflammatory cell counts, pro-inflammatory cytokine expression, and mucus production in the airway of mice, whereas SO2 exposure in OVA-induced asthmatic mice caused marked pulmonary pathological changes and significantly increased the counts of eosinophil-rich leukocytes compared with OVA alone asthmatic mice. The expression of MUC5AC, TNF-α, Th2 cytokines (IL-4, IL-5, and IL-13) and STAT6 was further up-regulated in OVA plus SO2 treated mice compared with OVA alone treated mice. In addition, exposure to SO2 alone markedly elevated STAT6 mRNA levels and hydrogen peroxide (H2O2) content in the lung. These findings suggest that SO2 amplifies Th2 inflammatory responses in OVA-induced asthmatic mice by activating STAT6, which can further induce Th2 cytokine expression. Induction of STAT6 expression might be an important mechanism underlying the increased risk for asthma after environmental exposure.

PMID: 29288730 [PubMed - as supplied by publisher]

http://ift.tt/2CqSiKN

Hold your horses: A comparison of human laryngomalacia with analogous equine airway pathology

Publication date: February 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 105
Author(s): Rachael J. Lawrence, Matthew J. Butterell, James D. Constable, Matija Daniel
ObjectivesLaryngomalacia is the most common cause of stridor in infants. Dynamic airway collapse is also a well-recognised entity in horses and an important cause of surgical veterinary intervention. We compare the aetiology, clinical features and management of human laryngomalacia with equine dynamic airway collapse.MethodsA structured review of the PubMed, the Ovid Medline and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews).ResultsThere are numerous equine conditions that cause dynamic airway collapse defined specifically by the anatomical structures involved. Axial Deviation of the Aryepiglottic Folds (ADAF) is the condition most clinically analogous to laryngomalacia in humans, and is likewise most prevalent in the immature equine airway. Both conditions are managed either conservatively, or if symptoms require it, with surgical intervention. The operative procedures performed for ADAF and laryngomalacia are technically comparable.ConclusionDynamic collapse of the equine larynx, especially ADAF, is clinically similar to human laryngomalacia, and both are treated in a similar fashion.



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Hold your horses: A comparison of human laryngomalacia with analogous equine airway pathology

Publication date: February 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 105
Author(s): Rachael J. Lawrence, Matthew J. Butterell, James D. Constable, Matija Daniel
ObjectivesLaryngomalacia is the most common cause of stridor in infants. Dynamic airway collapse is also a well-recognised entity in horses and an important cause of surgical veterinary intervention. We compare the aetiology, clinical features and management of human laryngomalacia with equine dynamic airway collapse.MethodsA structured review of the PubMed, the Ovid Medline and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews).ResultsThere are numerous equine conditions that cause dynamic airway collapse defined specifically by the anatomical structures involved. Axial Deviation of the Aryepiglottic Folds (ADAF) is the condition most clinically analogous to laryngomalacia in humans, and is likewise most prevalent in the immature equine airway. Both conditions are managed either conservatively, or if symptoms require it, with surgical intervention. The operative procedures performed for ADAF and laryngomalacia are technically comparable.ConclusionDynamic collapse of the equine larynx, especially ADAF, is clinically similar to human laryngomalacia, and both are treated in a similar fashion.



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Priorities for future research into asthma diagnostic tools: A PAN-EU Consensus exercise from the European asthma research innovation partnership (EARIP)

Abstract

The diagnosis of asthma is currently based on clinical history, physical examination and lung function; and to date there are no accurate objective tests either to confirm the diagnosis or to discriminate between different types of asthma. This consensus exercise reviews the state-of-the-art in asthma diagnosis to identify opportunities for future investment based on the likelihood of their successful development, potential for widespread adoption and their perceived impact on asthma patients.

Using a two-stage e-Delphi process and a summarising workshop, a group of European asthma experts including health professionals, researchers, people with asthma and industry representatives ranked the potential impact of research investment in each technique or tool for asthma diagnosis and monitoring. After a systematic review of the literature, 21 statements were extracted and were subject of the two-stage Delphi process. Eleven statements were scored 3 or more and were further discussed and ranked in a face to face workshop.

The three most important diagnostic/predictive tools ranked were: "New biological markers of asthma (e.g. genomics, proteomics and metabolomics) as a tool for diagnosis and/or monitoring", "Prediction of future asthma in preschool children with reasonable accuracy" and "Tools to measure volatile organic compounds (VOCs) in exhaled breath".

This article is protected by copyright. All rights reserved.

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The effects of insomnia symptoms and objective short sleep duration on memory performance in adolescents and young adults

Introduction: Insufficient sleep and sleep disruption, especially insomnia symptoms, are common problems among adolescents and young adults. While the association between insufficient sleep and poor memory performance is well established, there has been limited research on how insomnia may affect memory performance, especially in adolescents. Recent evidence suggests that insomnia with objective short sleep duration, a more severe insomnia phenotype, is associated with an elevated risk for medical morbidity as well as neurocognitive impairments.

http://ift.tt/2CnjREA

Effects of chronic sleep restriction on decision making in youth

Introduction: Adolescence is often linked to sleep deprivation and increased impulsivity and risk behaviours. Whilst previous research has found that sleep deprivation is associated with increased impulsivity and risk-taking, most of previous studies adopted an experimentally induced sleep deprivation paradigm for a certain period of time. There has been limited research on the effects of habitual chronic sleep restriction on behavioural consequences. The current study aimed to examine the influence of habitual chronic sleep restriction on decision making among youth.

http://ift.tt/2BZHCPI

On the effects of two versions of slow wave sleep deprivation in the relation to REM sleep

Introduction: Although a number of interesting articles have been published about rapid eye movement (REM)-sleep regulation considering the results of total sleep deprivation or REM-sleep deprivation, the idea that REM-sleep propensity accumulates during waking or non-rapid eye movement sleep, slow wave sleep (SWS), in particular, is still debatable. This study was aimed to analyze the changes in sleep-wake architecture occurred during SWS deprivation and recovery periods.

http://ift.tt/2Cp6Wls

A path towards brain rejuvenation: the effect of chronic physical activity on EEG slow-wave activity in mice

Introduction: Physical activity is beneficial for health. It has been shown to improve brain functioning and cognition, reduce severity of mood disorders as well as promote healthy sleep and healthy aging. We recently found that aged mice have increased absolute electroencephalogram (EEG) slow-wave activity (SWA, EEG power density between 0.75-4.0 Hz) during non-rapid eye movement (NREM) sleep compared to young controls, suggesting changes in brain connectivity in the course of aging.

http://ift.tt/2BX2nvj

Use of occlusal splint or mandibular advancement appliance by sleep bruxism patients do not normalize arousal related heart rate variability

Introduction: Oral appliance is among first-line therapy for sleep bruxism (SB). However, mechanism of action for SB remains unknown. The aim of study is to assess if changes in heart rate variability (HRV) related to SB arousal could explain their action.

http://ift.tt/2CnjPfW

Graph theory-based analysis of EEG during nREM sleep reveals changes in functional connectivity in sleep-related hypermotor epilepsy (SHE)

Introduction: Dynamic key points of sleep microstrucure have been shown to be associated with epileptic activation in Sleep-Related Hypermotor Epilepsy (SHE), identified within the system of the cyclic alternating pattern (CAP), that correlate with reactive slow wave events [1].

http://ift.tt/2BZUnK0

Treatment of obstructive sleep apnea decreases the recurrence of atrial and ventricular ectopy in patients with atrial fibrillation

Introduction: Obstructive Sleep Apnea (OSA) has been recognized as an independent risk factor for the development and progression of atrial fibrillation (AF). OSA decreases patients' response to anti-arrhythmic medication, and decreases the success rate of surgical ablation of AF. OSA remains undiagnosed in many patients with AF. There is evidence that continuous positive airway pressure (CPAP) treatment decreases the activity of the sympathetic nervous system and oxidative stress, which play a crucial role in the development of AF.

http://ift.tt/2CpeSDy

The effect of zonisamide on abnormal muscle tone during REM sleep in a mouse model of REM sleep behavior disorder

Introduction: Zonisamide, first launched as an anti-epileptic drug (Excegran® or Zonegran®), has been approved as a drug for Parkinson's disease (PD) in Japan (Trerief®). Zonisamide ameliorates motor symptoms and improves activities of daily living in patients with advanced PD. In addition, it has been recently reported that zonisamide also improves the symptom of REM sleep behavior disorder (RBD) in some PD patients. In this study, we examined the effectiveness of zonisamide for RBD, by using a novel RBD model, Glra1flox/flox; Chat-Cre mice.

http://ift.tt/2BYckbR

Obstructive sleep apnea is highly undetected in non-obese patients with atrial fibrillation

Introduction: Obstructive sleep apnea (OSA) is a sleep disorder associated with several cardiovascular morbidity. OSA is an independent risk factor for the development and progression of atrial fibrillation (AF). We aimed to estimate the prevalence of OSA in patients with AF, and to investigate the relation between obesity and OSA in these patients.

http://ift.tt/2CjN8QH

Sleep disturbance mediates the relationship between injury severity and executive function difficulties in children 18 months following traumatic brain injury

Introduction: Sleep is a neurorestorative process and provides a plausible candidate mechanism to explain variability in children's functional outcomes after Traumatic Brain Injury (TBI). A common consequence of TBI is difficulty with self-regulation and the mental processes required for planning, working memory and focussed attention. The aim of this study was to examine whether sleep disturbance mediates the relationship between TBI severity and executive functioning difficulties.

http://ift.tt/2C05se6

Clinical and polysomnographic differences in elderly patients with obstructive sleep apnea (OSA)

Introduction: Although sleep related complaints are common in the community, there is little information on the clinical and polysomnographic differences elderly patients with obstructive sleep apnea (OSA).

http://ift.tt/2Cp3EyQ

Pain drawing characteristics and risk for sleep breathing disorders in an orofacial pain service

Introduction: Subjects living with chronic pain are at risk for developing sleep breathing disorders (SBD). Altered sleep modifies the perception and reported intensity of pain. Many tools exist to evaluate pain, including validated scales and pain drawings. Pain drawings are associated to psychological profiles and prognostic variables in published studies on nociceptive lower back or peripheral pain. The utility of pain drawings in the orofacial pain area may be associated to disability, pain intensity, and risk for altered sleep.

http://ift.tt/2BZkaC0

Irregular sleep-wake rhythm disorder in a young woman with Townes-Brocks-syndrome

Introduction: Referral of female 22-year-old former psychology-student from oncology unit.

http://ift.tt/2Cl0jAN

Preliminary data of a prospective study on the effectiveness and compliance of a mandibular advancement device alone versus a mandibular advancement device combined with a sleep positioning pillow in the treatment of mild to moderate sleep apnea

Introduction: Although continuous positive airway pressure treatment (CPAP) remains the primary intervention for moderate to severe obstructive sleep apnea (OSA), a wide array of therapeutic interventions exist for treating the milder sleep-related breathing disorders (SRBD). Oral appliances (in particular mandibular advancement devices–MAD) and positional therapy (PT) are the most frequently used in day-to-day practice as a result of their affordable pricing as well as their relative ease of use.

http://ift.tt/2BZUkxO

Handheld mobile biofeedback of heart rate variability in patients with chronic insomnia disorder – a pilot study

Introduction: The hyperarousal concept in patients with insomnia has been tested by measuring autonomous variables, including electrocardiogram (ECG)-derived heart rate and heart rate variability. In stress-related insomnia an elevated nocturnal sympathetic activity was found, while parasympathetic activity was reduced. In this Pilot-study we tested the usefulness of a mobile heart-rate-variability (HRV) biofeedback device in outpatients of a specialized sleep clinic.

http://ift.tt/2CpsFda

Comparison of actigraphy scoring protocols to define the rest interval and optimally derive pediatric sleep dimensions

Introduction: While polysomnography is the established gold standard, technological advances have enabled more resource efficient (cost, time, user-ease) assessment of select sleep dimensions and patterns. Wrist actigraphy is an ambulatory wearable increasingly used in research and clinical settings as it permits unobtrusive measurement of sleep in one's home environment. Previous research analyzed accelerometry data to yield validated algorithms (e.g., Sadeh, Cole) to distinguish sleep/wake epochs.

http://ift.tt/2BZHz6u

REM-associated sleep disordered breathing: prevalence and clinical significance in the hypnolaus cohort

Introduction: Nocturnal respiratory events are usually more frequent and of longer duration in rapid eyes movement sleep (REM) compared with non-REM sleep (NREM), probably due to greater pharyngeal muscle relaxation and a reduction in the hypoxic and hypercapnic ventilatory response throughout . However, the prevalence and clinical impact of REM-related sleep-disordered breathing (REM-SDB) are still debated. The aim of this study was to determined the prevalence of REM-related sleep-disordered breathing (REM-SDB) in the general population and to investigate the associations between REM-SDB and hypertension, metabolic syndrome, diabetes and depression.

http://ift.tt/2ClMfXI

Association between SaO2 levels and brain connectivity using PDC (partial directed coherence) in a Brazilian populational based sample (EPISONO)

Introduction: Desaturation during sleep is initially associated with poor quality of sleep in short term. However, in long term, due to chronically intermittent hypoxia, some degree of brain structural impairment can be detected using interconnectivity dependence measurements like PDC (partial Directed Coherence) in PSG data during sleep. Our aim is to assess the association between Desaturation among sleep stages and EEG bands with PDC levels in a Brazilian populational Based sample (EPISONO).

http://ift.tt/2BZzIWA

Effect of sleep apnea and insomnia on the association of depression with quantitative electroencephalogram measures (QEEG) in adult men during sleep – the MAILES study

Introduction: Quantitative EEG (qEEG) abnormalities are present in 80% of patients with psychiatric disorders. Small studies of resting, awake qEEG in patients with depression show variation in findings. Both increase and decrease in slow wave activity has been reported in depressed patients in addition to increased alpha and beta activity. We have previously shown co-morbid sleep apnea and insomnia have additive effects on depression prevalence and severity. We aimed to determine the effect of sleep apnea and insomnia symptoms on the relation between sleep qEEG parameters and depression in a large sample of community dwelling men.

http://ift.tt/2CpvRp9

PSQI largely ignores sleep on work-free days both in the general population and in clinical sleep medicine samples

Introduction: The Pittsburgh Sleep Quality Index (PSQI) is currently the most common measure of sleep quality. Its questions refer to "usual" sleep habits over the past month. However, for long it is known that sleep timing and sleep duration varies significantly between workdays and work-free days. A recently submitted study in the general population used the original and two adapted versions of the PSQI that replaced "usual" by explicitly referring to sleep on work- or work-free days. This study showed, that also sleep quality differs significantly between work- and work-free days.

http://ift.tt/2BZzn6g

MED-EL Announces Winners of Its Ideas4Ears Competition

​MED-EL (http://ift.tt/1pfpn1t) has announced the winners of its global Ideas4Ears children's invention contest. Parker Welsh from Ozawkie, KS, won the grand prize with his entry involving inserting regenerative cells from salamanders, which are responsible for tissue repair and regeneration, into human macrophages. Welsh won a $1,000 college scholarship and a trip for two to MED-EL's international headquarters in Innsbruck, Austria. The Ideas4Ears competition challenged children to create a piece of artwork showcasing their invention to improve the quality of life for people living with hearing loss. More than 240 entries were received from around the world, and winners were selected from seven countries, including the United States, Austria, Brazil, Germany, Italy, New Zealand and the United Kingdom. Avery Bennett from Chicago, IL, was awarded the finalist prize.​

Published: 12/30/2017 5:23:00 PM

http://ift.tt/2C0Y5Dn

Effect of different doses and durations of teriparatide therapy on resolution of medication-related osteonecrosis of the jaw: A randomized, controlled preclinical study in rats

To evaluate the effects of different doses and durations of teriparatide therapy on MRONJ resolution in rats.

http://ift.tt/2zRRlWm

Overexpression of sprouty2 in human oral squamous cell carcinogenesis

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Pei-Hsien Liao, Yen-Yun Wang, Wen-Chen Wang, Chung-Ho Chen, Yu-Hsun Kao, Jing-Wei Hsu, Ching-Yi Chen, Ping-Ho Chen, Shyng-Shiou Yuan, Yuk-Kwan Chen
ObjectiveThis study investigated SPRY2 expression in human oral potentially malignant disorders (OPMDs) and oral squamous cell carcinomas (OSCCs).Methods75 OSCCs, 23 OPMDs with malignant transformation (MT), 17 OPMDs without MT, and eight normal oral mucosa (NOM) tissues were used for immunohistochemical staining; three OSCC tissues with normal tissue counterparts were used for western blotting. Three human oral cancer cell lines (OCCLs), an oral precancer cell line (DOK), and a NOM primary culture (NOMPC) were used for western blotting; OCCLs and NOMPC were employed for real-time quantitative reverse transcription-polymerase chain reaction. OCCLs were evaluated in terms of proliferation, migration, invasion and BRAF V600E point mutation assays.ResultsSignificantly increased SPRY2 protein expression was observed in OSCCs as compared with NOM, and SPRY2 expression also differed between OSCC patients with and without lymph-node metastasis. SPRY2 protein and mRNA expressions were significantly enhanced as compared with NOMPC. Increased phospho-ERK expression was observed in OCCLs as compared with NOMPC. Significant decreases in the proliferation rate, degrees of migration and invasion were noted in OCCLs with SPRY2 siRNA transfection as compared with those without SPRY2 siRNA transfection. No BRAF V600E point mutation was observed for OCCLs as compared with NOMPC. A significantly increased SPRY2 protein level was noted in OPMDs with MT as compared to those without MT, and was also found in OPMDs with MT in comparison with NOM, as well as in DOK in comparison with NOMPC.ConclusionsOur results indicated that SPRY2 overexpression is associated with human oral squamous-cell carcinogenesis.



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Superhydrophilic co-polymer coatings on denture surfaces reduce Candida albicans adhesion—An in vitro study

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Masahiro Hirasawa, Chiaki Tsutsumi-Arai, Kensuke Takakusaki, Toyohisa Oya, Kenji Fueki, Noriyuki Wakabayashi
ObjectiveIn this study, we aimed to investigate denture-base-resin coatings prepared with a crosslinkable co-polymer containing sulfobetaine methacrylamide (SBMAm) and the relationship between their surface characteristics and the initial adhesion of Candida albicans (C. albicans).MethodsAcrylic resin discs were coated with co-polymers containing various concentrations of SBMAm and N,N'-(4,7,10-trioxa-1,13-tridecadiamine) diacrylamide (JDA) as crosslinking agent. Uncoated discs were used as controls. An acquired pellicle was formed on each disc using artificial saliva, and the discs were immersed in a suspension of C. albicans (JCM2085) cells. After incubation, tetrazolium salt (XTT-reduction) and colony forming unit (CFU) assays were performed and the morphogenesis of C. albicans was examined using scanning electron microscopy (SEM). The surface roughness, film thickness, and the water contact angle of each disc surface were measured.ResultsAll coating groups showed significantly lower amounts of adhered C. albicans in the XTT-reduction and CFU assays than the control, confirmed by the SEM images. Many wrinkle structures were observed on the surfaces coated with co-polymers containing more than 30% SBMAm. There were no significant differences in surface roughness among all groups. The co-polymer films on the coated discs were less than 5.0 μm in thickness, and these surfaces exhibited significantly lower mean water contact angles than the control.ConclusionCrosslinkable co-polymers containing SBMAm can enhance the hydrophilicity of the surface of denture-base resins and reduce the initial adhesion of C. albicans.



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Immunoexpression of proteins involved in cytoskeleton remodeling in benign odontogenic lesions

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Paula Nascimento Antonio, Natália Galvão Garcia, Agnes Assao, José Roberto Pereira Lauris, Fernando Augusto Soares, Denise Tostes Oliveira
ObjectiveThe present study was designed to analyze the immunolocalization of proteins involved in cytoskeleton remodeling, such as moesin and Rho-A, in benign odontogenic lesions that present with expansive growth and invasive clinical behavior.Materials and methodsExpressions of moesin and Rho-A in odontogenic epithelium were evaluated by immunohistochemical analysis in 45 odontogenic lesions using monoclonal antibodies.ResultsOur results demonstrated strong membranous and cytoplasmic expressions of moesin in the epithelial cells in 66.7% and 44.4% of the odontogenic lesions, respectively. Furthermore, Rho-A expression in odontogenic epithelium was strong in the membrane and cytoplasm of 51.1% and 62.2% of the odontogenic lesions, respectively. A statistically significant correlation was found between the membranous and cytoplasmic expressions of moesin (p = 0.000) and those of Rho-A (p = 0.048) in odontogenic epithelial cells, while no statistically significant correlation was found between moesin and Rho-A expressions (p > 0.05).ConclusionsThe present study confirmed the strong expressions of moesin and Rho-A by odontogenic epithelial cells, suggesting their involvement in the development of benign odontogenic lesions. However, this study has failed to detect the connection between the moesin and Rho-A interaction in expansive growth and local invasiveness of these lesions.



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via IFTTT

Overexpression of sprouty2 in human oral squamous cell carcinogenesis

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Pei-Hsien Liao, Yen-Yun Wang, Wen-Chen Wang, Chung-Ho Chen, Yu-Hsun Kao, Jing-Wei Hsu, Ching-Yi Chen, Ping-Ho Chen, Shyng-Shiou Yuan, Yuk-Kwan Chen
ObjectiveThis study investigated SPRY2 expression in human oral potentially malignant disorders (OPMDs) and oral squamous cell carcinomas (OSCCs).Methods75 OSCCs, 23 OPMDs with malignant transformation (MT), 17 OPMDs without MT, and eight normal oral mucosa (NOM) tissues were used for immunohistochemical staining; three OSCC tissues with normal tissue counterparts were used for western blotting. Three human oral cancer cell lines (OCCLs), an oral precancer cell line (DOK), and a NOM primary culture (NOMPC) were used for western blotting; OCCLs and NOMPC were employed for real-time quantitative reverse transcription-polymerase chain reaction. OCCLs were evaluated in terms of proliferation, migration, invasion and BRAF V600E point mutation assays.ResultsSignificantly increased SPRY2 protein expression was observed in OSCCs as compared with NOM, and SPRY2 expression also differed between OSCC patients with and without lymph-node metastasis. SPRY2 protein and mRNA expressions were significantly enhanced as compared with NOMPC. Increased phospho-ERK expression was observed in OCCLs as compared with NOMPC. Significant decreases in the proliferation rate, degrees of migration and invasion were noted in OCCLs with SPRY2 siRNA transfection as compared with those without SPRY2 siRNA transfection. No BRAF V600E point mutation was observed for OCCLs as compared with NOMPC. A significantly increased SPRY2 protein level was noted in OPMDs with MT as compared to those without MT, and was also found in OPMDs with MT in comparison with NOM, as well as in DOK in comparison with NOMPC.ConclusionsOur results indicated that SPRY2 overexpression is associated with human oral squamous-cell carcinogenesis.



http://ift.tt/2CfPxg5

Superhydrophilic co-polymer coatings on denture surfaces reduce Candida albicans adhesion—An in vitro study

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Masahiro Hirasawa, Chiaki Tsutsumi-Arai, Kensuke Takakusaki, Toyohisa Oya, Kenji Fueki, Noriyuki Wakabayashi
ObjectiveIn this study, we aimed to investigate denture-base-resin coatings prepared with a crosslinkable co-polymer containing sulfobetaine methacrylamide (SBMAm) and the relationship between their surface characteristics and the initial adhesion of Candida albicans (C. albicans).MethodsAcrylic resin discs were coated with co-polymers containing various concentrations of SBMAm and N,N'-(4,7,10-trioxa-1,13-tridecadiamine) diacrylamide (JDA) as crosslinking agent. Uncoated discs were used as controls. An acquired pellicle was formed on each disc using artificial saliva, and the discs were immersed in a suspension of C. albicans (JCM2085) cells. After incubation, tetrazolium salt (XTT-reduction) and colony forming unit (CFU) assays were performed and the morphogenesis of C. albicans was examined using scanning electron microscopy (SEM). The surface roughness, film thickness, and the water contact angle of each disc surface were measured.ResultsAll coating groups showed significantly lower amounts of adhered C. albicans in the XTT-reduction and CFU assays than the control, confirmed by the SEM images. Many wrinkle structures were observed on the surfaces coated with co-polymers containing more than 30% SBMAm. There were no significant differences in surface roughness among all groups. The co-polymer films on the coated discs were less than 5.0 μm in thickness, and these surfaces exhibited significantly lower mean water contact angles than the control.ConclusionCrosslinkable co-polymers containing SBMAm can enhance the hydrophilicity of the surface of denture-base resins and reduce the initial adhesion of C. albicans.



http://ift.tt/2zQe19v

Immunoexpression of proteins involved in cytoskeleton remodeling in benign odontogenic lesions

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Paula Nascimento Antonio, Natália Galvão Garcia, Agnes Assao, José Roberto Pereira Lauris, Fernando Augusto Soares, Denise Tostes Oliveira
ObjectiveThe present study was designed to analyze the immunolocalization of proteins involved in cytoskeleton remodeling, such as moesin and Rho-A, in benign odontogenic lesions that present with expansive growth and invasive clinical behavior.Materials and methodsExpressions of moesin and Rho-A in odontogenic epithelium were evaluated by immunohistochemical analysis in 45 odontogenic lesions using monoclonal antibodies.ResultsOur results demonstrated strong membranous and cytoplasmic expressions of moesin in the epithelial cells in 66.7% and 44.4% of the odontogenic lesions, respectively. Furthermore, Rho-A expression in odontogenic epithelium was strong in the membrane and cytoplasm of 51.1% and 62.2% of the odontogenic lesions, respectively. A statistically significant correlation was found between the membranous and cytoplasmic expressions of moesin (p = 0.000) and those of Rho-A (p = 0.048) in odontogenic epithelial cells, while no statistically significant correlation was found between moesin and Rho-A expressions (p > 0.05).ConclusionsThe present study confirmed the strong expressions of moesin and Rho-A by odontogenic epithelial cells, suggesting their involvement in the development of benign odontogenic lesions. However, this study has failed to detect the connection between the moesin and Rho-A interaction in expansive growth and local invasiveness of these lesions.



http://ift.tt/2CfiAjO

Comparative Evaluation of Clinical Outcomes Using Delta Plates and Conventional Miniplates for Internal Fixation of Mandibular Condylar Fractures In Adults

Publication date: Available online 30 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Suraj Arjun Ahuja, Jyotsna Galinde, Usha Asnani, Yusuf A. Mistry
PurposeIn recent years numerous osteosynthesis devices are available for management of condylar fracture, the aim of this study was to compare and evaluate the clinical outcomes of delta plates and conventional miniplates for internal fixation of mandibular condylar fractures in adults.Material and MethodsA prospective study was performed on 20 patients with subcondylar fracture requiring open reduction and internal fixation for their management. Patients were randomly divided into two groups using computer software, patients under Group A [N=10] were treatment using delta plate while under Group B [N=10] using conventional miniplates via extraoral retromandibular transparotid approach.ResultsThere was no statically difference between delta plates and conventional miniplates for internal fixation of mandibular condylar fractures in adults. However, the time taken for adaptation of the delta plates & ease of adaptation was significantly lower than that required for the two miniplates [p=0.000].ConclusionsThe study results indicated that delta plate and miniplate are equally effective in terms of long-term clinical success in the management of mandibular subcondylar fractures in adults. The delta plates are superior in terms of handling characteristics, such as ease of adaptation and time required for adaptation as only one plate and four screws are required as compared to two plates and eight screws.



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Impact of temporomandibular joint discectomy on condyle morphology: an animal study

Publication date: Available online 30 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Reinaldo Abdala-Júnior, Arthur Rodriguez Gonzalez Cortes, Eduardo Massaharu Aoki, Simone Ferreira, João Gualberto Cerqueira Luz, Emiko Saito Arita, Jefferson Xavier de Oliveira
PurposeTemporomandibular disorders (TMD) lead to parafunctional activity that may alter bone remodeling of mandibular components. This animal study aimed to assess the impact of temporomandibular joint discectomy on condyle bone microarchitecture.Material and MethodsA total of 30 one-month-old Wistar rats were assessed and divided in three equal groups (two tests and one control) of 10. The first test group underwent disc removal (DRm; the second test group underwent disc and condylar cartilage removal (DCR); and the 10 remaining rats were analyzed as sham-operated controls (CTR), following a split-mouth design. Rats were sacrificed two months after surgery, and the respective mandibles were scanned with micro-CT for quantitative morphometric analysis.ResultsThere were significant differences among the three groups analyzed (DR, DCR and CTR) for Bone volume fraction (BV/TV, p=0.044), Structure model index (p<0.001), Fractal Dimension (p=0.024) and porosity (p=0.023). In addition, operated and contralateral non-operated sides significantly differed for all variables in at least one of the test groups (p<0.05), but not in the control group (p>0.05).ConclusionWithin the limitations of this study, the present results suggest that discectomy may lead to alterations of the mandibular condylar morphology.



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Effect of different doses and durations of teriparatide therapy on resolution of medication-related osteonecrosis of the jaw: A randomized, controlled preclinical study in rats

Publication date: Available online 30 December 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Mohammad Zandi, Arash Dehghan, Najmeh Zandipoor, Payam Amini, Shideh Doulati
ObjectiveTo evaluate the effects of different doses and durations of teriparatide therapy on MRONJ resolution in rats.Subjectsand methods: A total of 120 rats that had been affected with MRONJ (after six weekly zoledronate injections and tooth extraction) were randomly divided into eight subgroups: 2, 10, and 20 μg/kg/day teriparatide were administered to L4, M4, and H4 for 4 weeks, and to L8, M8, and H8 for 8 weeks, respectively. C4 and C8 received saline for 4 and 8 weeks, respectively. One week after the final injection, rats were sacrificed and assessed clinically (bone exposure/fistula) and histologically (number of osteocytes in extraction socket and empty lacunae in alveolar bone).ResultsMRONJ was clinically improved in 72.2%, 61.5%, and 40% of stage I, II, and III experimental rats, respectively. In the control rats, the results were 20.8% for stage I and no improvement for stages II and III. Aside from L4 and L8, the experimental subgroups had a significantly higher rate of clinical and histological improvement compared with their corresponding controls. There was a significantly higher number of osteocytes and lower number of empty lacunae in M4 and H4 compared with C4, in H4 compared with L4, in M8 and H8 compared with C8, and in H8 compared with L8.ConclusionTeriparatide therapy improved clinical and histological features of MRONJ in a dose-dependent manner, but clinically relevant doses of teriparatide might not be sufficient for MRONJ resolution in rats. Extending the duration of teriparatide therapy from 4 to 8 weeks did not affect treatment outcomes.



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Autografting in the treatment of large, auricular keloids

(Source: The Laryngoscope)

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Jet ventilation in obese patients undergoing airway surgery for subglottic and tracheal stenosis

ConclusionsJet ventilation in obese patients can be done successfully, and complications are similar between obese patients and nonobese patients. Level of Evidence4. Laryngoscope, 00:000–000, 2017 (Source: The Laryngoscope)

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Intranasal tissue necrosis associated with opioid abuse: Case report and systematic review

ConclusionIntranasal opioid abuse is a prevalent condition associated with chronic pain and tissue necrosis that is clinically concerning for invasive fungal disease. Whereas IFRS must be excluded, even in patients without known immunodeficiency, complete resolution of symptoms can be expected following surgical debridement with cessation of opioid abuse. Laryngoscope, 2017 (Source: The Laryngoscope)

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Aggregating the symptoms of superior semicircular canal dehiscence syndrome

ConclusionsThis systematic review of symptoms reported by patients with SCDS identified a 22‐item common symptom set. These items can be used to create an evidence‐based patient‐reported outcome measure to evaluate health‐related quality of life in SCDS. Laryngoscope, 2017 (Source: The Laryngoscope)

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Silent aspiration: Who is at risk?

ConclusionSilent aspiration may be associated with a number of underlying conditions and is more common than previously described. Caregivers and clinicians should be aware that the absence of cough does not eliminate the possibility of aspiration. Modified barium swallow studies can reveal silent aspiration, which is difficult to detect on clinical feeding evaluation. Modified barium swallow findings can guide feeding therapy and the overall management of aspiration. Level of Evidence4. Laryngoscope, 2017 (Source: The Laryngoscope)

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Tongue motion variability with changes of upper airway stimulation electrode configuration and effects on treatment outcomes

ConclusionsUAS is highly effective for OSA treatment in selected patients with an apnea‐hypopnea index between 15 and 65 events per hour and higher body mass index. Attention should be given to patients with shifting tongue movement in response to change of electrode configuration. The intraoperative cuff placement should be reassessed when tongue movement shifting is observed. Level of Evidence4 Laryngoscope, 2017 (Source: The Laryngoscope)

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Unexpected prominent tension pneumosella five years after endoscopic endonasal transsphenoidal surgery

Tension pneumosella (TP) is a rare entity reported as the invagination of the sphenoid sinus mucosa into the skull base after endonasal transsphenoidal surgery. Few studies have reported on TP, and in these studies, invagination is confined to either the intrasellar or suprasellar area. We encountered a case of unexpected prominent TP toward the intracranial space 5 years after endoscopic endonasal transsphenoidal surgery (EETS) for a nonfunctioning pituitary adenoma. In addition, we present a hypothesis of the underlying mechanism by a pressure gradient change between the extracranial and intracranial space in TP formation. For repair, a pedicled nasal septal flap was fabricated from the remaining part of the septal mucosa, and a pedicled inferior turbinate flap was created. Moreover, the...

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The effects of concurrent chemoradiation therapy to the base of tongue in a preclinical model

ConclusionsThe current study is the first to describe a preclinical model of CCRT to the head and neck with an emphasis on clinical relevance. Tongue strength decreased at 2 weeks and 5 months post‐CCRT. Tongue displacement increased only at 5 months post‐CCRT. Fibrosis was not detected, implicating alternative causative factors for these findings. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)

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Down syndrome and pediatric obstructive sleep apnea surgery: A national cohort

ConclusionsTonsillectomy with adenoidectomy remains the most commonly performed procedure, although there was a significant increase in other sleep surgeries performed (lingual tonsillectomy, tongue‐base reduction, and supraglottoplasty) between the two study periods, especially in children with DS. Level of Evidence2c. Laryngoscope, 00:000–000, 2017 (Source: The Laryngoscope)

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TSR2 Induces laryngeal cancer cell apoptosis through inhibiting NF ‐κB signaling pathway

ConclusionsThe results indicated that TSR2‐induced apoptosis was mediated by inhibiting the NF‐κB signaling pathway, which may provide an effective target in gene therapy for LSCC. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)

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National trends in primary tracheoesophageal puncture after total laryngectomy

ConclusionsPrimary TEP is associated with earlier voice restoration after TL but is infrequently performed. The majority of primary TEPs are performed in teaching hospitals, and primary TEP is associated with concurrent cricopharyngeal myotomy. Future studies should investigate practice patterns associated with primary TEP. Level of Evidence4 Laryngoscope, 2017 (Source: The Laryngoscope)

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Is deep plane rhytidectomy superior to superficial musculoaponeurotic system plication facelift?

(Source: The Laryngoscope)

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Hemi-laryngeal Setup for Studying Vocal Fold Vibration in Three Dimensions.

Hemi-laryngeal Setup for Studying Vocal Fold Vibration in Three Dimensions.

J Vis Exp. 2017 Nov 25;(129):

Authors: Herbst CT, Hampala V, Garcia M, Hofer R, Svec JG

Abstract
The voice of humans and most non-human mammals is generated in the larynx through self-sustaining oscillation of the vocal folds. Direct visual documentation of vocal fold vibration is challenging, particularly in non-human mammals. As an alternative, excised larynx experiments provide the opportunity to investigate vocal fold vibration under controlled physiological and physical conditions. However, the use of a full larynx merely provides a top view of the vocal folds, excluding crucial portions of the oscillating structures from observation during their interaction with aerodynamic forces. This limitation can be overcome by utilizing a hemi-larynx setup where one half of the larynx is mid-sagittally removed, providing both a superior and a lateral view of the remaining vocal fold during self-sustained oscillation. Here, a step-by-step guide for the anatomical preparation of hemi-laryngeal structures and their mounting on the laboratory bench is given. Exemplary phonation of the hemi-larynx preparation is documented with high-speed video data captured by two synchronized cameras (superior and lateral views), showing three-dimensional vocal fold motion and corresponding time-varying contact area. The documentation of the hemi-larynx setup in this publication will facilitate application and reliable repeatability in experimental research, providing voice scientists with the potential to better understand the biomechanics of voice production.

PMID: 29286438 [PubMed - in process]

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EZH2 overexpression in head and neck cancer is related to lymph node metastasis.

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EZH2 overexpression in head and neck cancer is related to lymph node metastasis.

J Oral Pathol Med. 2017 Dec 29;:

Authors: Nienstedt JC, Schroeder C, Clauditz T, Simon R, Sauter G, Muenscher A, Blessmann M, Hanken H, Pflug C

Abstract
BACKGROUND: Enhancer of zeste homolog 2 (EZH2), the catalytic subunit of the polycomb repressive complex 2, plays an important role in tumor development and progression by interacting with histone and non-histone proteins. EZH2 represents a putative therapeutic target and has been suggested as a prognostic marker in several cancer types.
MATERIAL AND METHODS: The present study investigates the prognostic relevance of immunohistochemical EZH2 expression in head and neck squamous cell carcinoma. Tissue microarray sections with 667 cancers of oral cavity, oro- and hypopharynx and larynx were analyzed for EZH2 expression.
RESULTS: Nuclear EZH2 staining was recorded in 322 (81.8%) of 394 cases. Staining was weak in 33 (10.2%), moderate in 128 (39.6%) and strong in 103 (32.0%) cancers. The prevalence of EZH2 expression in tumors of the oral cavity and the orohypopharynx was higher as compared to cancers of the larynx (p=0.0023). EZH2 expression was correlated to presence of lymph node metastasis (p=0.0089) but was unrelated to histological grade, tumor stage, surgical margin or distant metastasis. EZH2 expression had no impact on patient survival.
CONCLUSION: The high prevalence of EZH2 expression in head and neck squamous cell carcinoma stresses its capability as a therapeutic target. This article is protected by copyright. All rights reserved.

PMID: 29285811 [PubMed - as supplied by publisher]

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A bronchogenic cyst of the larynx: A case report.

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A bronchogenic cyst of the larynx: A case report.

Exp Ther Med. 2017 Dec;14(6):5523-5526

Authors: Lu D, Yu R, Yang H, Liu J

Abstract
A 12-year-old female presented with a 2-month history of dyspnea and a progressively worsening hoarseness lasting >10 years. The subsequently identified mass was completely resected from the patient's supraglottic area using a laser and suspension laryngoscope. The mass was diagnosed as a bronchogenic cyst using histopathology. While the prognosis for these cysts is good, long-term follow-up remains necessary for such patients because there are several reports in the literature indicating the potential for malignancy to develop. The patient in the present study experienced no complications or recurrence of the bronchogenic cyst 2 years following surgery. To the best of our knowledge, only 2 cases of bronchogenic cysts arising from the larynx have been reported in China, and the present study introduces the first case of a bronchogenic cyst of the larynx in a Chinese patient reported in English.

PMID: 29285086 [PubMed]

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A Retrospective Analysis on Anesthetic Management during Rigid Bronchoscopy in Children with Foreign Body Aspiration: Propofol and Sevoflurane with Controlled Ventilation.

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A Retrospective Analysis on Anesthetic Management during Rigid Bronchoscopy in Children with Foreign Body Aspiration: Propofol and Sevoflurane with Controlled Ventilation.

Anesth Essays Res. 2017 Oct-Dec;11(4):871-874

Authors: Annigeri RV, Patil RS

Abstract
Background: Bronchoscopic removal of foreign body in the airway is one of the important life-saving procedure and demands skill and expertise on the part of the surgeon and anesthesiologist.
Aim: To study the outcome of controlled ventilation during rigid bronchoscopy in children with foreign body aspiration.
Materials and Methods: A review of fifty cases of foreign body in the bronchi, from January 2014 to December 2015 was undertaken in Vittal Institute of Child Care Hospital, Dharwad, through patient case records. Patients between 6 months and 14 years were included in the study. Cases of foreign body in the larynx and trachea were excluded. Patients were induced with propofol and maintained on sevoflurane. The parameters observed were bronchoscopy attempts, succinylcholine requirement, episodes of laryngospasm, cough, bronchospasm and spontaneous recovery. Statistical analysis was done by Chi-square test using software OpenEpi version 7.3.
Results: Of 45 patients with organic foreign body, 42 (94%) patients required one attempt of bronchoscopy and 3 (6%) patients required two attempts. Five (100%) patients with inorganic foreign body required single attempt (P = 0.66). Forty-three (96%) patients with organic foreign body required two repeat doses of succinylcholine and 2 (4%) patients required three repeat doses. All 5 (100%) patients with inorganic foreign body required two repeat doses (P = 0.7461). Two (4%) patients aspirated with organic foreign body had laryngospasm, and there was no cough or bronchospasm with either patient. Two (4%) patients with organic foreign body required tracheostomy. Inorganic foreign body group of patients had lesser complications.
Conclusion: In our study, patients on controlled ventilation had few intraoperative complication and smooth early recovery. Controlled ventilation with relaxation should be preferred for any pediatric bronchoscopies. Eliciting history of type of foreign body helps in planning and management of procedure.

PMID: 29284841 [PubMed]

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Morphological Characteristics of the Oropharyngeal Cavity (Tongue, Palate and Laryngeal Entrance) in the Eurasian Coot (Fulica atra, Linnaeus, 1758).

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Morphological Characteristics of the Oropharyngeal Cavity (Tongue, Palate and Laryngeal Entrance) in the Eurasian Coot (Fulica atra, Linnaeus, 1758).

Anat Histol Embryol. 2017 Aug;46(4):347-358

Authors: Abumandour MMA, El-Bakary NER

Abstract
The present study represents the first definitive anatomical description of the oropharyngeal cavity of the coot Fulica atra. For this purpose, the organs of six birds were prepared to examine grossly and by SEM and stereomicroscope. The oval lingual apex had multiple overlapping branched acicular processes on its anterior and lateral border. The lingual apex and body had multiple caudally directed filiform-like papillae. By stereomicroscopy, the lingual root had a characteristic appearance and consisted of four parts. The openings of the anterior glands were present on the dorsal lingual surface of the body, while the projected papillae with wide openings of the posterior glands were present on the dorsal surface of lingual root. There was a row of caudally directed pharyngeal papillae at the caudal border of the laryngeal mound. Grossly, the pharyngeal papillae arrangement took a W-shape, while by stereomicroscopy was observed to be heart shape. The palate was divided into two regions: a small rostral non-papillary and a large caudal papillary region, but the rostral region was characterized by the presence of three longitudinal ridges. The papillary crest had two paramedian longitudinal papillary rows, which continued caudally until the beginning of the third median row. The freely distributed papillae took a caudolateral direction, while the papillae encircling the rostral part of choanal cleft took a caudomedial direction. There was a transverse papillary row between the two parts of choanal cleft. There was a transverse papillary row between the caudal border of the infundibular cleft and oesophagus.

PMID: 28543621 [PubMed - indexed for MEDLINE]

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A fast and flexible MRI system for the study of dynamic vocal tract shaping.

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A fast and flexible MRI system for the study of dynamic vocal tract shaping.

Magn Reson Med. 2017 Jan;77(1):112-125

Authors: Lingala SG, Zhu Y, Kim YC, Toutios A, Narayanan S, Nayak KS

Abstract
PURPOSE: The aim of this work was to develop and evaluate an MRI-based system for study of dynamic vocal tract shaping during speech production, which provides high spatial and temporal resolution.
METHODS: The proposed system utilizes (a) custom eight-channel upper airway coils that have high sensitivity to upper airway regions of interest, (b) two-dimensional golden angle spiral gradient echo acquisition, (c) on-the-fly view-sharing reconstruction, and (d) off-line temporal finite difference constrained reconstruction. The system also provides simultaneous noise-cancelled and temporally aligned audio. The system is evaluated in 3 healthy volunteers, and 1 tongue cancer patient, with a broad range of speech tasks.
RESULTS: We report spatiotemporal resolutions of 2.4 × 2.4 mm2 every 12 ms for single-slice imaging, and 2.4 × 2.4 mm2 every 36 ms for three-slice imaging, which reflects roughly 7-fold acceleration over Nyquist sampling. This system demonstrates improved temporal fidelity in capturing rapid vocal tract shaping for tasks, such as producing consonant clusters in speech, and beat-boxing sounds. Novel acoustic-articulatory analysis was also demonstrated.
CONCLUSION: A synergistic combination of custom coils, spiral acquisitions, and constrained reconstruction enables visualization of rapid speech with high spatiotemporal resolution in multiple planes. Magn Reson Med 77:112-125, 2017. © 2016 Wiley Periodicals, Inc.

PMID: 26778178 [PubMed - indexed for MEDLINE]

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Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis

AbstractObjectiveThe aim of this prospective study was to evaluate the efficacy of sialendoscopy in the management of adult chronic recurrent parotitis without sialolithiasis. In addition, preliminary results of an initial randomized placebo-controlled trial of single-dose intraductal steroid injection given concurrently with sialendoscopy, are presented.MethodsForty-nine adult patients with chronic recurrent parotitis without sialoliths were included in this study. They underwent sialendoscopy and were randomized to receive either a concurrent intraductal injection of isotonic saline solution or 125  mg of hydrocortisone. Symptom severity was evaluated with visual analogue scale (VAS) and by recording symptom frequency and course with a multiple-choice questionnaire completed preoperativ...

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Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

J Laryngol Otol. 2018 Jan;132(1):1

Authors: Fisher E, Youngs R, Hussain M, Fishman J

PMID: 29286000 [PubMed - in process]

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Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

J Laryngol Otol. 2018 Jan;132(1):1

Authors: Fisher E, Youngs R, Hussain M, Fishman J

PMID: 29286000 [PubMed - in process]

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Surgical management of pulsatile tinnitus secondary to jugular bulb or sigmoid sinus diverticulum with review of literature

Publication date: Available online 29 December 2017
Source:American Journal of Otolaryngology
Author(s): W.X. Yeo, S.H. Xu, T.Y. Tan, Y.M. Low, H.W. Yuen
IntroductionJugular bulb and sigmoid sinus anomalies are well-known causes of vascular pulsatile tinnitus. Common anomalies reported in the literature include high-riding and/or dehiscent jugular bulb, and sigmoid sinus dehiscence. However, cases of pulsatile tinnitus due to diverticulosis of the jugular bulb or sigmoid sinus are less commonly encountered, with the best management option yet to be established. In particular, reports on surgical management of pulsatile tinnitus caused by jugular bulb diverticulum have been lacking in the literature.ObjectivesTo report two cases of pulsatile tinnitus with jugular bulb and/or sigmoid sinus diverticulum, and their management strategies and outcomes. In this series, we describe the first reported successful case of pulsatile tinnitus due to jugular bulb diverticulum that was surgically-treated.Subjects and methodsTwo patients diagnosed with either jugular bulb and/or sigmoid sinus diverticulum, who had presented to the Otolaryngology clinic with pulsatile tinnitus between 2016 and 2017, were studied. Demographic and clinical data were obtained, including their management details and clinical outcomes.ResultsTwo cases (one with jugular bulb diverticulum and one with both sigmoid sinus and jugular bulb diverticula) underwent surgical intervention, and both had immediate resolution of pulsatile tinnitus post-operatively. This was sustained at subsequent follow-up visits at the outpatient clinic, and there were no major complications encountered for both cases intra- and post-operatively.ConclusionTransmastoid reconstruction/resurfacing of jugular bulb and sigmoid sinus diverticulum with/without obliteration of the diverticulum is a safe and effective approach in the management of bothersome pulsatile tinnitus arising from these causes.



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Surgical management of pulsatile tinnitus secondary to jugular bulb or sigmoid sinus diverticulum with review of literature

Publication date: Available online 29 December 2017
Source:American Journal of Otolaryngology
Author(s): W.X. Yeo, S.H. Xu, T.Y. Tan, Y.M. Low, H.W. Yuen
IntroductionJugular bulb and sigmoid sinus anomalies are well-known causes of vascular pulsatile tinnitus. Common anomalies reported in the literature include high-riding and/or dehiscent jugular bulb, and sigmoid sinus dehiscence. However, cases of pulsatile tinnitus due to diverticulosis of the jugular bulb or sigmoid sinus are less commonly encountered, with the best management option yet to be established. In particular, reports on surgical management of pulsatile tinnitus caused by jugular bulb diverticulum have been lacking in the literature.ObjectivesTo report two cases of pulsatile tinnitus with jugular bulb and/or sigmoid sinus diverticulum, and their management strategies and outcomes. In this series, we describe the first reported successful case of pulsatile tinnitus due to jugular bulb diverticulum that was surgically-treated.Subjects and methodsTwo patients diagnosed with either jugular bulb and/or sigmoid sinus diverticulum, who had presented to the Otolaryngology clinic with pulsatile tinnitus between 2016 and 2017, were studied. Demographic and clinical data were obtained, including their management details and clinical outcomes.ResultsTwo cases (one with jugular bulb diverticulum and one with both sigmoid sinus and jugular bulb diverticula) underwent surgical intervention, and both had immediate resolution of pulsatile tinnitus post-operatively. This was sustained at subsequent follow-up visits at the outpatient clinic, and there were no major complications encountered for both cases intra- and post-operatively.ConclusionTransmastoid reconstruction/resurfacing of jugular bulb and sigmoid sinus diverticulum with/without obliteration of the diverticulum is a safe and effective approach in the management of bothersome pulsatile tinnitus arising from these causes.



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Balloon dilatation of the Eustachian tube in adult patients with chronic dilatory tube dysfunction: a retrospective cohort study.

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Balloon dilatation of the Eustachian tube in adult patients with chronic dilatory tube dysfunction: a retrospective cohort study.

Eur Arch Otorhinolaryngol. 2017 Dec 29;:

Authors: Satmis MC, van der Torn M

Abstract
OBJECTIVES: The aim of this study is to assess the subjective and objective short-term results and safety of transnasal balloon dilatation of the Eustachian tube (BET) in adult patients with chronic dilatory Eustachian tube dysfunction (ETD).
DESIGN: Retrospective cohort study. Data collection was performed preoperatively, 1 and 3 months after BET.
SETTING: Tertiary referral hospital.
PARTICIPANTS: A cohort of 42 consecutive patients (66 ears).
MAIN OUTCOME MEASURES: ETDQ-7 score, bone conduction threshold, air-bone gap, the ability to perform Valsalva's and/or Toynbee's manoeuvre, tympanic membrane and middle ear conditions were collected pre- and postoperatively. Subjective satisfaction and complications were collected postoperatively.
RESULTS: The ETDQ-7 score improved significantly from 4.28 to 3.09 1 month postoperatively and from 4.10 to 2.96 3 months postoperatively. Bone conduction thresholds did not differ significantly postoperatively. A significant improvement of air-bone gap was found postoperatively. The tympanic membrane and middle ear condition showed improvement in 62%. Subjective satisfaction 1 and 3 months postoperatively was around 43 and 48%. A small number of minor (self-limiting) complications did occur.
CONCLUSIONS: BET has shown to be a safe intervention, which may have a positive effect on objective and subjective indicators for chronic dilatory ETD in adult patients. We observed subjective positive effects in less than half of the patients. For certain indications, there was a measurable positive effect on the findings of the eardrum and ETDQ-7, whereas in other patients it seemed not to have any effect at all. Careful patient selection may improve this success rate. Randomized controlled trials with a prolonged follow-up are required to assess the value of BET in comparison to grommets.

PMID: 29285624 [PubMed - as supplied by publisher]

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Introduction: Antibody-Mediated Therapy Special Issue Part 2

Antibodies have been used therapeutically for well over a century but the breadth and depth of their applications are increasing so rapidly and successfully that clinical studies are informing mechanistic questions while basic research continues to interrogate how antibodies are made and function, so their properties can be further refined. The first part of this Special Issue comprised five review articles (1); this second part includes four more reviews. Once again, we thank the authors for their excellent contributions. This issue also includes an original research article that builds on observations from patients with hyper-IgM syndrome to further define the mechanism for antibody class-switch recombination (CSR).

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Cover

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Table of Contents

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A pro-inflammatory role of Fcα/μR on marginal zone B cells in sepsis

Abstract

Fc receptors play important roles for a wide array of immune responses. In contrast to the well-defined Fcγ and Fcε receptors, the molecular and functional characteristics of Fc receptors for IgA and IgM have remained incompletely understood for years. Recent progress has unveiled the characteristics of Fc receptors for IgA and IgM, including Fcα/μ receptor (Fcα/μR) (CD351), polymeric immunoglobulin receptor (poly-IgR), Fcα receptor (FcαRI) (CD89) and Fcμ receptor (FcμR). In this review, we summarize the molecular and functional characteristics of Fcα/μR in comparison with poly-IgR, FcμR and FcαRI, and focus particularly on the pro-inflammatory function of Fcα/μR expressed on marginal zone B cells in sepsis.

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Depletion of recombination-specific cofactors by the C-terminal mutant of the activation-induced cytidine deaminase causes the dominant negative effect on class switch recombination

Abstract

Activation-induced cytidine deaminase (AID) is essential for class-switch recombination (CSR) and somatic hypermutation (SHM) of immunoglobulin genes. Studies on in vitro mutagenized AID as well as its mutations in human patients with hyper-IgM (HIGM)-syndrome type II revealed that C-terminal AID mutations were defective in CSR whereas their DNA cleavage and SHM activities remained intact. The C-terminal mutants of AID were speculated to exert the dominant negative effect on wild-type (WT) AID whereas its mechanism remains unknown. We generated the JP41 (R190X) mutation in one allele and a null mutation on the other allele in a mouse B cell line (CH12F3-2A) using CRISPR/Cas9 genome-editing tools and studied the effect of JP41 expression on the function of exogenously introduced WT AID fused with estrogen receptor (AIDER) in AID^JP41/∆/AIDER CH12F3-2A cells. We found that JP41 expression strongly suppressed not only CSR but also Igh/c-Myc chromosomal translocations by AIDER. We showed that the dominant negative effect is not evident at the DNA cleavage step but obvious at both deletional and inversional recombination steps. We also confirmed the dominant negative effect of other C-terminal mutants, JP8Bdel (R183X) and P20 (34-aa insertion at residue 182) in AID-deficient spleen B cells. Finally, we showed that the expression of JP41 reduced the binding of AIDER with its cofactors (hnRNP L, SERBP1 and hnRNP U). Together, these data indicate that dominant negative effect of JP41 on CSR is likely due to the depletion of the CSR-specific RNA-binding proteins from WT AID.

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Targeted antibody therapy and relevant novel biomarkers for precision medicine for rheumatoid arthritis

Abstract

Over the past two decades, the management of rheumatoid arthritis (RA) has progressed remarkably, encompassing the development of new diagnostic tools and efficacious biological agents, such as monoclonal antibodies against inflammatory cytokines and surface markers on immune cells. In addition to the significant efficacy of these biological agents, biomarkers for RA are under consideration for their potential to classify heterogeneous patients into several groups based on clinical and immunological phenotypes for the prediction of clinical course and prognosis and the facilitation of appropriate and precise treatment with the appropriate therapeutic monoclonal antibodies. Biomarkers, particularly those for the prediction and monitoring of the responses to therapeutic monoclonal antibodies for RA, are in demand, with many approaches examined in recent years. In this article, we have summarized the background research on biomarkers and introduced recent topics in the field that enable the possible clinical applications of biomarkers, especially those related to pathogenic cytokines, to guide the treatment of RA.

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Sweet SIGNs: IgG glycosylation leads the way in IVIG-mediated resolution of inflammation

Abstract

A hallmark of many chronic inflammatory and autoimmune diseases is that there is an impaired resolution of inflammation and return to the steady state. The infusion of high doses of pooled serum IgG preparations from thousands of donors [intravenous immunoglobulin (IVIG) therapy] has been shown to induce resolution of inflammation in a variety of chronic inflammatory and autoimmune diseases, suggesting that IgG molecules can instruct the immune system to stop inflammatory processes and initiate the return to the steady state. The aim of this review is to discuss how insights into the mechanism of IVIG activity may help to understand the molecular and cellular pathways underlying resolution of inflammation. We will put a special emphasis on pathways dependent on the IgG F_C domain and IgG sialylation, as several recent studies have provided new insights into how this glycosylation-dependent pathway modulates innate and adaptive immune responses through different sets of C-type or I-type lectins.

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IVIG-mediated effector functions in autoimmune and inflammatory diseases

Abstract

Intravenous immunoglobulin (IVIG) is a pooled preparation of normal IgG obtained from several thousand healthy donors. It is widely used in the immunotherapy of a large number of autoimmune and inflammatory diseases. The mechanisms of action of IVIG are complex and, as discussed in this review, experimental and clinical data provide an indicator that the therapeutic benefit of IVIG therapy is due to several mutually non-exclusive mechanisms affecting soluble mediators as well as cellular components of the immune system. These mechanisms depend on Fc and/or F(ab′)₂ fragments. A better understanding of the effector functions of IVIG should help in identification of biomarkers of responses to IVIG in autoimmune patients.

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Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

Optimising care in an age of austerity: patient-reported outcome measures in paediatric ENT, journal bias, tonsillectomy and endoscopic ear surgery.

J Laryngol Otol. 2018 Jan;132(1):1

Authors: Fisher E, Youngs R, Hussain M, Fishman J

PMID: 29286000 [PubMed - in process]

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Olfaction, Philosophy and the Missing Object

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Barrier dysfunction in allergy

Publication date: January 2018
Source:Allergology International, Volume 67, Issue 1
Author(s): Kenji Kabashima, Kenji Izuhara




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Food Protein-Induced Proctocolitis. The shadow of allergic disorders

Publication date: January–February 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 1
Author(s): C.A. Sánchez-Salguero




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Type III interferons are critical host factors that determine susceptibility to Influenza A viral infection in allergic nasal mucosa

Abstract

Background

Allergic respiratory conditions have been associated with increased susceptibility to viral infection due to impaired interferon (IFN)-related immune responses but the mechanisms for reinforcement of mucosal immunity against viral infection in allergic diseases are largely unknown.

Objectives

To determine whether IFN induction would be impaired in allergic nasal mucosa and to identify if higher loads of influenza A virus (IAV) in allergic nasal mucosa could be controlled with IFN treatment.

Methods

IAV mRNA, viral titers and IFN expression were compared in IAV-infected normal human nasal epithelial (NHNE, N=10) and allergic rhinitis nasal epithelial (ARNE, N=10) cells. We used in vivo model of allergic rhinitis (BALB/C mouse, N=10) and human nasal mucosa from healthy volunteers (N=72) and allergic rhinitis patients (N=29) to assess the induction of IFNs after IAV infection.

Results

IAV mRNA levels and viral titers were significantly higher in ARNE compared with NHNE cells. IFN-β and -λs were induced in NHNE and ARNE cells up to 3 days after IAV infection. Interestingly, induction of IFN-λs mRNA levels and the amount of secreted proteins were considerably lower in ARNE cells. The mean IFN-λs mRNA level was also significantly lower in the nasal mucosa of AR patients and we found that recombinant IFN-λ treatment attenuated viral mRNA levels and viral titers in IAV-infected ARNE cells. In vivo AR mouse were exhibited higher viral load after IAV infection but intranasal inoculation of IFN-λ completely decreased IAV protein expression and viral titer in nasal mucosa of IAV-infected AR mouse.

Conclusion

Higher susceptibility of the allergic nasal mucosa to IAV may depend on impairment of type III IFN induction, and type III IFN is a key mechanistic link between higher viral loads and control of IAV infection in allergic nasal mucosa.

This article is protected by copyright. All rights reserved.

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