Pigmented Basal Cell Carcinoma: Increased Melanin or Increased Melanocytes?

Abstract

Background

Studies on the precise cause of increased melanization in pigmented basal cell carcinomas (BCC) are limited. We aimed to determine whether the cause of melanization is from increased number of melanocytes or increased melanin pigment, and if there is a difference in the number of melanocytes on different sun-exposed locations.

Methods

A retrospective review of 45 skin biopsies from January 2011 to February 2011 was performed; 30 were diagnosed as pigmented BCC and 15 as non-pigmented basal cell carcinoma. Immunohistochemistry for MART-1 (melanoma-associated antigen recognized by T-cell 1)/Melan-A (clone M2-7610 + M2-9E3; Leica) from Biocare Medical (Concord, CA) was performed on all biopsies. Associations between histopathologic features, number of melanocytes, location, and specific diagnoses were analyzed by Mann Whitney U test.

Results

The mean melanocyte count per high powered field in pigmented BCCs from sun-exposed skin was 101.9 and from intermittently sun-exposed skin was 122.5, as compared to the controls (nodular non-pigmented BCC) of 27.4 (p = 0.002) and 34.9 (p = 0.002), respectively.

Conclusions

Pigmented BCCs have a higher mean melanocyte count as compared to non-pigmented BCCs irrespective of location. Therefore, the pigment is not only due to increased melanin, but also due to increased melanocytes.

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Corrigendum to “Hyaluronic acid and upper airway inflammation in pediatric population: A systematic review” [Int. J. Pediatr. Otorhinolaryngol. 85 (June 2016) 22–26]

The authors regret the incorrect tagging of the author surnames. The correct names are M. Casale, P. Vella, A. Moffa, G. Oliveto, L. Sabatino, V. Grimaldi, P. Ferrara and F. Salvinelli. The authors would like to apologise for any inconvenience caused.

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Corrigendum to “Endotracheal tubes and the cricoid: Is there a good fit?” [Int. J. Pediatr. Otorhinolaryngol. (2016) 8–11]

The authors regret the error in Table 2 in the last column i.e. difference 95%–5%, 4th row transverse. The value is 3.5 instead of 13.5. The authors would like to apologise for any inconvenience caused.

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L-DOPA Oppositely Regulates Synaptic Strength and Spine Morphology in D1 and D2 Striatal Projection Neurons in Dyskinesia

Dopamine depletion in Parkinson's disease (PD) produces dendritic spine loss in striatal medium spiny neurons (MSNs) and increases their excitability. However, the synaptic changes that occur in MSNs in PD, in particular those induced by chronic L-3,4-dihydroxyphenylalanine (L-DOPA) treatment, are still poorly understood. We exposed BAC-transgenic D1-tomato and D2-eGFP mice to PD and dyskinesia model paradigms, enabling cell type-specific assessment of changes in synaptic physiology and morphology. The distinct fluorescence markers allowed us to identify D1 and D2 MSNs for analysis using intracellular sharp electrode recordings, electron microscopy, and 3D reconstructions with single-cell Lucifer Yellow injections. Dopamine depletion induced spine pruning in both types of MSNs, affecting mushroom and thin spines equally. Dopamine depletion also increased firing rate in both D1- and D2-MSNs, but reduced evoked-EPSP amplitude selectively in D2-MSNs. L-DOPA treatment that produced dyskinesia differentially affected synaptic properties in D1- and D2-MSNs. In D1-MSNs, spine density remained reduced but the remaining spines were enlarged, with bigger heads and larger postsynaptic densities. These morphological changes were accompanied by facilitation of action potential firing triggered by synaptic inputs. In contrast, although L-DOPA restored the number of spines in D2-MSNs, it resulted in shortened postsynaptic densities. These changes in D2-MSNs correlated with a decrease in synaptic transmission. Our findings indicate that L-DOPA-induced dyskinesia is associated with abnormal spine morphology, modified synaptic transmission, and altered EPSP-spike coupling, with distinct effects in D1- and D2-MSNs.

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Distant Space Processing is Controlled by tPA-dependent NMDA Receptor Signaling in the Entorhinal Cortex

In humans, spatial cognition and navigation impairments are a frequent situation during physiological and pathological aging, leading to a dramatic deterioration in the quality of life. Despite the discovery of neurons with location-specific activity in rodents, that is, place cells in the hippocampus and later on grid cells in the entorhinal cortex (EC), the molecular mechanisms underlying spatial cognition are still poorly known. Our present data bring together in an unusual combination 2 molecules of primary biological importance: a major neuronal excitatory receptor, N-methyl-D-aspartate receptor (NMDAR), and an extracellular protease, tissue plasminogen activator (tPA), in the control of spatial navigation. By using tPA-deficient mice and a structure-selective pharmacological approach, we demonstrate that the tPA-dependent NMDAR signaling potentiation in the EC plays a key and selective role in the encoding and the subsequent use of distant landmarks during spatial learning. We also demonstrate that this novel function of tPA in the EC is reduced during aging. Overall, these results argue for the concept that encoding of proximal versus distal landmarks is mediated not only by different anatomical pathways but also by different molecular mechanisms, with the tPA-dependent potentiation of NMDAR signaling in the EC that plays an important role.

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From Shortage to Surge: A Developmental Switch in Hippocampal-Prefrontal Coupling in a Gene-Environment Model of Neuropsychiatric Disorders

Cognitive deficits represent a major burden of neuropsychiatric disorders and result in part from abnormal communication within hippocampal–prefrontal circuits. While it has been hypothesized that this network dysfunction arises during development, long before the first clinical symptoms, experimental evidence is still missing. Here, we show that pre-juvenile mice mimicking genetic and environmental risk factors of disease (dual-hit GE mice) have poorer recognition memory that correlates with augmented coupling by synchrony and stronger directed interactions between prefrontal cortex and hippocampus. The network dysfunction emerges already during neonatal development, yet it initially consists in a diminished hippocampal theta drive and consequently, a weaker and disorganized entrainment of local prefrontal circuits in discontinuous oscillatory activity in dual-hit GE mice when compared with controls. Thus, impaired maturation of functional communication within hippocampal–prefrontal networks switching from hypo- to hyper-coupling may represent a mechanism underlying the pathophysiology of cognitive deficits in neuropsychiatric disorders.

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Table of Contents

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Guidelines for Contributing Authors

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Corrigendum to “The safety of tracheostomy speaking valve use during sleep in children: A pilot study” [Am J Otolaryngol 35(2014) 636–640]

In the originally published version of this article, the author Shahidul Islam was omitted from the author listing. The corrected author listing is reproduced above.

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Editorial Board

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Instructions for Contributors

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Table of Contents

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Calendar

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Calendar Listings

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Editorial Board

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Recent trends in disease severity and quality of life instruments for patients with atopic dermatitis: A systematic review

Publication date: Available online 8 September 2016
Source:Journal of the American Academy of Dermatology
Author(s): Mary K. Hill, Azin Kheirandish Pishkenari, Taylor L. Braunberger, April W. Armstrong, Cory A. Dunnick
BackgroundA significant number of instruments exist that are aimed at quantifying atopic dermatitis (AD) outcomes.ObjectiveWe sought to assess recent trends in the use of disease severity and quality of life (QOL) outcome instruments in randomized controlled trials (RCTs) conducted on patients with AD between July 2010 and July 2015.MethodsA total of 540 nonduplicate records were identified through searches of Scopus and Ovid MEDLINE. Included studies were RCTs conducted on humans with AD that were published in English between July 2010 and July 2015 and that reported the results of disease severity or QOL outcome measures.ResultsAll of the 135 included studies assessed disease severity. Only 45 studies assessed QOL. Sixty-two disease severity measures and 28 QOL scales were identified.LimitationsThis study was limited by its timeframe of 5 years and by the exclusion of non-RCTs and gray literature.ConclusionDisease severity and QOL outcome measures are instrumental in evaluating AD treatment efficacy. The number of such tools used in RCTs on patients with AD continues to rise. Standardization of outcomes instruments is essential for comparability among studies and improved quality of evidence.



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Post Hybrid Cochlear Implant Hearing Loss and Endolymphatic Hydrops.

Objective: To evaluate for potential causes of delayed loss of residual hearing that variably occurs with hybrid cochlear implants. Study Design: Histopathological evaluation of 29 human temporal bone (HTB) with cochlear implant (CI). Setting: The Neurotology and House HTB Laboratory of UCLA (House-UCLA). Subjects and Methods: HTB from CI patients from the House-UCLA HTB Laboratory (n = 28) and one courtesy of Massachusetts Eye and Ear Infirmary (MEEI). Histopathological analysis to identify the location of cochleostomy, fibrosis, and bone formation in the scala vestibuli and tympani, and endolymphatic hydrops. Spiral ganglion neuron counts were obtained. Statistical analysis compared presence of cochleostomy and location with the histopathological findings. Results: Seventeen of 29 bones with fibrosis in the scala vestibule (SV) and tympani had evidence of a cochleostomy involving the SV containing the ductus reunions, all of which had hydrops. Ten of 11 bones had no SV fibrosis, and a cochleostomy limited to the scala tympani, of which all had no hydrops. One HTB had moderate SV fibrosis not involving the ductus reuniens, and was without hydrops. One HTB had a SV cochleostomy but the electrode ruptured Reissner's membrane, and was without hydrops. Cochleostomy was significantly associated with SV fibrosis and hydrops (p

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Acknowledgements to reviewers

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Author Guidelines

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British Rhinological Society 14th Annual Meeting The Armouries, Leeds, 20 May 2016

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Influence of preoperative oral rehydration on arterial plasma rocuronium concentrations and neuromuscular blocking effects: A randomised controlled trial.

BACKGROUND: The influence of preoperative rehydration on the action of rocuronium has not yet been investigated. OBJECTIVE: The objective is to evaluate the hypothesis that preoperative rehydration lowers arterial rocuronium plasma concentrations and changes its associated neuromuscular blocking effects during induction of anaesthesia. DESIGN: Randomised, single-blinded study. SETTING: A secondary hospital from October 2013 to July 2014. PATIENTS: In total, 46 men undergoing elective surgery were eligible to participate and were randomly allocated into two groups. Exclusion criteria were severe hepatic, renal or cardiovascular disorder; neuromuscular disease; history of allergy to rocuronium; BMI more than 30 kg m-2; receiving medication known to influence neuromuscular function. INTERVENTION: Participants received 1500 ml of oral rehydration solution (rehydration group) or none (control group) until 2 hours before anaesthesia. Arterial blood samples were obtained 60, 90 and 120 s and 30 min after rocuronium (0.6 mg kg-1) administration during total intravenous anaesthesia. Responses to 0.1-Hz twitch stimuli were measured at the adductor pollicis muscle using acceleromyography. MAIN OUTCOME MEASURES: Arterial plasma rocuronium concentrations. RESULTS: Arterial plasma rocuronium concentrations at 60, 90 and 120 s in the rehydration and control groups were 9.9 and 13.7, 6.8 and 9.5 and 6.2 and 8.1 [mu]g ml-1, respectively (P = 0.02, 0.003 and 0.02, respectively); the onset times in the rehydration and control groups were 92.0 and 69.5 s (P = 0.01), and the times to twitch re-appearance were 25.3 and 30.4 min (P = 0.004), respectively. CONCLUSION: Preoperative rehydration significantly reduces arterial plasma rocuronium concentrations in the first 2 minutes after administration, prolonging the onset time and shortening the duration of effect. A higher dose or earlier administration should be considered for patients who receive preoperative rehydration. TRIAL REGISTRATION: Umin identifier: UMIN000011981. (C) 2016 European Society of Anaesthesiology

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Determination of loss of consciousness: a comparison of clinical assessment, bispectral index and electroencephalogram: An observational study.

BACKGROUND: Computer-processed algorithms of encephalographic signals are widely used to assess the depth of anaesthesia. However, data indicate that the bispectral index (BIS), a processed electroencephalography monitoring system, may not be reliable for assessing the depth of anaesthesia. OBJECTIVE: The aim of this study was to evaluate the ability of the BIS monitoring system to assess changes in the level of unconsciousness, specifically during the transition from consciousness to unconsciousness, in patients undergoing total intravenous anaesthesia with propofol. We compared BIS with the electroencephalogram (EEG), and clinical loss of consciousness (LOC) defined as loss of verbal commands and eyelash reflex. DESIGN: This was an observational cohort study. SETTING: University Hospital Linkoping, University Hospital Orebro, Finspang Hospital and Kalmar Hospital, Sweden from October 2011 to April 2013. PATIENTS: A total of 35 ASA I patients aged 18 to 49 years were recruited. INTERVENTIONS: The patients underwent total intravenous anaesthesia with propofol and remifentanil for elective day-case surgery. Changes in clinical levels of consciousness were assessed by BIS and compared with assessment of stage 3 neurophysiological activity using the EEG. The plasma concentrations of propofol were measured at clinical LOC and 20 and 30 min after LOC. MAIN OUTCOME MEASURES: The primary outcome was measurement of BIS, EEG and clinical LOC. RESULTS: The median BIS value at clinical LOC was 38 (IQR 30 to 43), and the BIS values varied greatly between patients. There was no correlation between BIS values and EEG stages at clinical LOC (r = -0.1, P = 0.064). Propofol concentration reached a steady state within 20 min. CONCLUSION: There was no statistically significant correlation between BIS and EEG at clinical LOC. BIS monitoring may not be a reliable method for determining LOC. CLINICAL TRIALS REGISTRY: This trial was not registered because registration was not mandatory at the time of the trial. (C) 2016 European Society of Anaesthesiology

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Do morphometric parameters and geological conditions determine chemistry of glacier surface ice? Spatial distribution of contaminants present in the surface ice of Spitsbergen glaciers (European Arctic)

Abstract

The chemism of the glaciers is strongly determined by long-distance transport of chemical substances and their wet and dry deposition on the glacier surface. This paper concerns spatial distribution of metals, ions, and dissolved organic carbon, as well as the differentiation of physicochemical parameters (pH, electrical conductivity) determined in ice surface samples collected from four Arctic glaciers during the summer season in 2012. The studied glaciers represent three different morphological types: ground based (Blomlibreen and Scottbreen), tidewater which evolved to ground based (Renardbreen), and typical tidewater glacier (Recherchebreen). All of the glaciers are functioning as a glacial system and hence are subject to the same physical processes (melting, freezing) and the process of ice flowing resulting from the cross-impact force of gravity and topographic conditions. According to this hypothesis, the article discusses the correlation between morphometric parameters, changes in mass balance, geological characteristics of the glaciers and the spatial distribution of analytes on the surface of ice. A strong correlation (r = 0.63) is recorded between the aspect of glaciers and values of pH and ions, whereas dissolved organic carbon (DOC) depends on the minimum elevation of glaciers (r = 0.55) and most probably also on the development of the accumulation area. The obtained results suggest that although certain morphometric parameters largely determine the spatial distribution of analytes, also the geology of the bed of glaciers strongly affects the chemism of the surface ice of glaciers in the phase of strong recession.

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Occurrence of Giardia intestinalis and Cryptosporidium sp. in wastewater samples from São Paulo State, Brazil, and Lima, Peru

Abstract

The objectives of the study were to detect and genotype Cryptosporidium spp. and Giardia intestinalis in wastewater samples obtained from five cities with high transit of people in the State of São Paulo, Brazil, and at the entrance of a Wastewater Treatment Plant (WWTP) in Lima, Peru. Samples were collected and concentrated by centrifugation. The genomic DNA was extracted for molecular characterization by nested PCR for Cryptosporidium and double nested PCR for Giardia, followed by sequencing and phylogenetic analysis. G. intestinalis was found in 63.6 % of the samples, and the human assemblages A and B were identified. Cryptosporidium sp. was found in 36.4 % of the samples, and the species were corresponding to Cryptosporidium hominis, Cryptosporidium cuniculus, and Cryptosporidium muris. Results revealed the presence of human pathogenic Cryptosporidium species and G. intestinalis human pathogenic assemblages. Molecular tools highlight the importance to map the genetic diversity of these parasites, as well as to detect their epidemiological circulation pathway in the environment.

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Risk assessment of PBDEs and PAHs in house dust in Kocaeli, Turkey: levels and sources

Abstract

Indoor dust samples were collected from 40 homes in Kocaeli, Turkey and were analyzed simultaneously for 14 polybrominated diphenyl ethers (PBDEs) and 16 poly aromatic hydrocarbons (PAHs) isomers. The total concentrations of PBDEs (Σ₁₄PBDEs) ranged from 29.32 to 4790 ng g⁻¹, with a median of 316.1 ng g⁻¹, while the total indoor dust concentrations of 16 PAHs (Σ₁₆PAHs) extending over three to four orders of magnitude ranged from 85.91 to 40,359 ng g⁻¹ with a median value of 2489 ng g⁻¹. Although deca-PBDE products (BDE-209) were the principal source of PBDEs contamination in the homes (median, 138.3 ng g⁻¹), the correlation in the homes was indicative of similar sources for both the commercial penta and deca-PBDE formulas. The PAHs diagnostic ratios indicated that the main sources of PAHs measured in the indoor samples could be coal/biomass combustion, smoking, and cooking emissions. For children and adults, the contributions to ∑₁₄PBDEs exposure were approximately 93 and 25 % for the ingestion of indoor dust, and 7 and 75 % for dermal contact. Exposure to ∑₁₆PAHs through dermal contact was the dominant route for both children (90.6 %) and adults (99.7 %). For both groups, exposure by way of inhalation of indoor dust contaminated with PBDEs and PAHs was negligible. The hazard index (HI) values for BDE-47, BDE-99, BDE-153, and BDE-209 were lower than the safe limit of 1, and this result suggested that none of the population groups would be likely to experience potential health risk due to exposure to PBDEs from indoor dust in the study area. Considering only ingestion + dermal contact, the carcinogenic risk levels of both B2 PAHs and BDE-209 for adults were 6.2 × 10⁻⁵ in the US EPA safe limit range while those for children were 5.6 × 10⁻⁴ and slightly higher than the US EPA safe limit range (1 × 10⁻⁶ and 1 × 10⁻⁴). Certain precautions should be considered for children.

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Research and application of method of oxygen isotope of inorganic phosphate in Beijing agricultural soils

Abstract

Phosphorus (P) in agricultural ecosystems is an essential and limited element for plants and microorganisms. However, environmental problems caused by P accumulation as well as by P loss have become more and more serious. Oxygen isotopes of phosphate can trace the sources, migration, and transformation of P in agricultural soils. In order to use the isotopes of phosphate oxygen, appropriate extraction and purification methods for inorganic phosphate from soils are necessary. Here, we combined two different methods to analyze the oxygen isotopic composition of inorganic phosphate (δ¹⁸O_P) from chemical fertilizers and different fractions (Milli-Q water, 0.5 mol L⁻¹ NaHCO₃ (pH = 8.5), 0.1 mol L⁻¹ NaOH and 1 mol L⁻¹ HCl) of agricultural soils from the Beijing area. The δ¹⁸O_P results of the water extracts and NaHCO₃ extracts in most samples were close to the calculated equilibrium value. These phenomena can be explained by rapid P cycling in soils and the influence of chemical fertilizers. The δ¹⁸O_P value of the water extracts and NaHCO₃ extracts in some soil samples below the equilibrium value may be caused by the hydrolysis of organic P fractions mediated by extracellular enzymes. The δ¹⁸O_P values of the NaOH extracts were above the calculated equilibrium value reflecting the balance state between microbial uptake of phosphate and the release of intracellular phosphate back to the soil. The HCl extracts with the lowest δ¹⁸O_P values and highest phosphate concentrations indicated that the HCl fraction was affected by microbial activity. Hence, these δ¹⁸O_p values likely reflected the oxygen isotopic values of the parent materials. The results suggested that phosphate oxygen isotope analyses could be an effective tool in order to trace phosphate sources, transformation processes, and its utilization by microorganisms in agricultural soils.

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Occurrence and diversity of tetracycline resistance genes in the agricultural soils of South Korea

Abstract

Reports on the occurrence and diversity of antibiotic-resistant bacteria and genes, which are considered to be emerging pollutants worldwide, have, to date, not been published on South Korean agricultural soils. This is the first study to investigate the persistence of tetracycline (oxytetracycline, tetracycline, and chlortetracycline)-resistant bacterial community and genes in natural and long-term fertilized (NPK, pig, and cattle manure composts) agricultural soils in South Korea. The results showed that oxytetracycline and chlortetracycline could be the dominant residues in animal manures; regular fertilization of manures, particularly pig manures, may be the prime cause for the spread and abundance of tetracycline resistance in South Korean agricultural soils. Both the country's natural and agricultural soils are reservoirs of antibiotic-resistant species. Of the 113 tetracycline-resistant isolates identified (19 typical bacterial genera and 36 distinct species), approximately 40 to 99 % belonged to Gram-positive bacteria and Bacillus constituted the predominant genera. Of the 24 tet genes targeted, tetG, tetH, tetK, tetY, tetO, tetS, tetW, and tetQ were detected in all soil samples, highlighting their predominance and robust adaptability in soils. Meanwhile, it is suggested that tetC, tetE, tetZ, tetM, tetT, and tetP(B) are the common residues in pig manures, and furthermore, the treatment of soils with pig manures may wield a different impact on the tet gene resistome in agricultural soils. This study thus highlights the necessity for regulating the usage of tetracyclines in South Korean animal farming. This must be followed by proper monitoring of the subsequent usage of animal manures especially that derived from pig farms located in agricultural soils.

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Amoxicillin degradation from contaminated water by solar photocatalysis using response surface methodology (RSM)

Abstract

In this study, the solar photocatalytic process in a pilot plant with compound parabolic collectors (CPCs) was performed for amoxicillin (AMX) degradation, an antibiotic widely used in the world. The response surface methodology (RSM) based on Box-Behnken statistical experiment design was used to optimize independent variables, namely TiO₂ dosage, antibiotic initial concentration, and initial pH. The results showed that AMX degradation efficiency affected by positive or negative effect of variables and their interactions. The TiO₂ dosage, pH, and interaction between AMX initial concentration and TiO₂ dosage exhibited a synergistic effect, while the linear and quadratic term of AMX initial concentration and pH showed antagonistic effect in the process response. Response surface and contour plots were used to perform process optimization. The optimum conditions found in this regard were TiO₂ dosage = 1.5 g/L, AMX initial concentration = 17 mg/L, and pH = 9.5 for AMX degradation under 240 min solar irradiation. The photocatalytic degradation of AMX after 34.95 kJ_UV/L accumulated UV energy per liter of solution was 84.12 % at the solar plant.

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Efficiency of several leaching reagents on removal of Cu, Pb, Cd, and Zn from highly contaminated paddy soil

Abstract

The efficiency of five different single leaching reagents (tartaric acid (TA), citric acid (CA), CaCl₂, FeCl₃, EDTA) and two different composite leaching reagents (CA + FeCl₃, CA + EDTA) on removing Cu, Pb, Zn, and Cd from contaminated paddy soil in Hunan Province (in China) was studied. The results indicated that the efficiencies of CA, FeCl₃, and EDTA on extracting Cu, Pb, Cd, and Zn from soil were greater than that of TA and CaCl₂, and their extraction efficiencies were EDTA ≥ FeCl₃ > CA. The efficiencies of CA + FeCl₃ on extracting Cu, Pb, Cd, and Zn were higher than that of single CA or FeCl₃. The 25 mmol L⁻¹ CA + 20 mmol L⁻¹ FeCl₃ was a promising composite leaching reagent for paddy soil, and it could remove Cu (57.6 %), Pb (59.3 %), Cd (84.8 %), and Zn (28.0 %), respectively. With the same amount of leaching reagent, the efficiency of continuous leaching by several times was higher than that by once. In addition, the easily reducible and oxidizable fractions of heavy metals showed significant decrease during the process of leaching.

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Reply to the letter to the editor “TCDD and birth weight of Vietnamese infants”

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Evaluation of the multiple biomarkers on identification of the vulnerable coastal pollution hotspots

Abstract

This paper presents multiple biomarkers on metal accumulation and its impacts along the Chennai to Puducherry, southeast coast of India using bivalves as bioindicators. In this regard, water samples and Perna viridis were collected from three stations and the accumulation of metals and its biological impacts were assessed. Among the three sampling stations, the maximum accumulation was noticed in Ennore (S1) than the Puducherry (S3) followed by Kovalam (S2). Mean accumulation pattern of metals in Perna viridis was found to be in the following order Zn > Cu > Ni > Cr > Pb > Cd, which were in close match with the metal concentration in seawater at respective site. The ambient metal concentration and behavior of multiple biomarkers were positively correlated indicating that the uptake of metals might induce biological changes, particularly in the internal organs, thus significantly affecting health of the aquatic organisms. P. viridis provides reliable information concerning the adverse effects and reflects the integrated effects of all contaminants. Thus, study confirmed that Ennore (S1) coast is highly vulnerable for significant pollution, in terms of metal toxicity in the study area. Overall investigation revealed that metal enrichment was observed close to the major urban areas in the S1 and S2 which were associated with industrialized areas. The assessment of multiple biomarkers on metal accumulation was the first step in determining the trophic transfer factors on marine foot web, which can be evaluated in the future based on this study.

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Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach

Summary

Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P < 0·001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.

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A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth

Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children.

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Siah-1 is associated with expression of hypoxia-inducible factor-1α in oral squamous cell carcinoma

Hypoxia-inducible factor-1 (HIF-1) is a heterodimeric basic helix-loop-helix transcription factor composed of the HIF-1α and HIF-1β subunits. HIF-1 is a central regulator of responses to hypoxia; it enhances metastasis-related factors such as matrix metalloproteinases and vascular endothelial growth factor (VEGF). We have reported critical roles for HIF-1α in tumor microenvironments, and oncogenic properties of HIF-1α have been suggested in malignancies. Seven in absentia homologue (Siah) appeared to upregulate HIF-1 production, which prompted us to investigate the Siah association with HIF-1α expression in oral squamous cell carcinoma (OSCC).

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Free-flap reconstruction for the management of life-threatening hereditary hemorrhagic telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant multi-systemic disease that exhibits increasing penetrance with age. Some patients present with severe life-threatening epistaxis which is intractable to all common treatment modalities.A 63-year-old female patient with hereditary hemorrhagic telangiectasia (HHT) presented with recurrent life-threatening epistaxis that required repeated transfusions despite multiple embolizations and septodermoplasty. Previous septodermoplasty failed due to septal perforation.

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Effect of paranasal anatomical variants on outcomes in patients with limited and diffuse chronic rhinosinusitis

The role of anatomical variants of the paranasal sinuses in the aetiology of chronic rhinosinusitis (CRS) is not well understood. Furthermore, the effect of anatomical variants on long-term outcomes has not been described. This study aims to assess the effects of anatomical variants of the middle meatus on patients with limited and diffuse CRS.

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Marcus Gunn Jaw-Winking Syndrome: A Comprehensive Review and Report of Four Novel Cases.

Purpose: To report 4 cases of Marcus Gunn jaw-winking synkinesis (MGJWS) in the absence of ptosis. Methods: A retrospective review of patients with MGJWS and congenital ptosis was compiled from the public and private subspecialty adult and pediatric oculoplastic practices of the 2 senior authors (AAM, TGH). Clinical data collected on patients with MGJWS included visual acuity, stereopsis, ocular motility, side of jaw-wink, presence or absence of ptosis, levator function, clinical photographs and videos, and any management undertaken. Results: A total of 848 cases of congenital ptosis were seen. Of these, there were 72 consecutive patients with MGJWS, of which 4 cases (5.6%) had no ptosis. One patient had bilateral MGJWS, with ptosis on one side only. The authors found the incidence of MGJWS in our study population to be 8.5% of all congenital ptosis cases. When the authors excluded syndromic, neurogenic, and myopathic causes of congenital ptosis, the incidence was 12.1%. In addition, the authors found a trend toward females with simple congenital ptosis and MGJWS being affected on the left side, however this was not statistically significant. Conclusions: The authors report the first case series of MGJWS in the absence of ptosis within the second largest series ever reported. These findings may help further our understanding of the etiology behind MGJWS. (C) 2016 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Conjunctival Squamous Cell Carcinoma With Orbital Extension.

No abstract available

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A Single- Versus Double-Layered Closure Technique in Anophthalmic Surgery.

Purpose: To compare the frequency of orbital implant exposure and extrusion following eye removal with a simplified closure technique, closing Tenon's capsule and conjunctiva in 1 layer versus the classic technique of closure in 2 separate layers. Methods: The authors conducted a retrospective case note review of patients who underwent evisceration or enucleation treated by 1 surgeon between 2001 and 2013. Between 2001 and 2004, Tenon's capsule and conjunctiva were closed in separate layers; after 2004, a simplified 1-layer closure following eye removal was used. The primary outcome parameters were presence or absence of implant exposure or extrusion. Results: One hundred fifty-seven patients who underwent evisceration and 172 patients who underwent enucleation were included. Following evisceration, 2.5% developed exposure or extrusion of the implant, this was 2.5% in the 1-layer closure technique and 2.7% in the 2-layer closure technique (p = 0.95). Following enucleation, 1.7% developed exposure or extrusion of the implant, this was 1.8% in the 1-layer closure technique and 1.7% in the 2-layer closure technique (p = 0.96). Overall implant exposure and extrusion was 2.1%, this was 2.2% in the 1-layer closure technique and 2.1% in the 2-layer closure technique (p = 0.96). Conclusions: No difference was found in the frequency of spheric acrylic implant exposure or extrusion in patients who underwent eye removal with single-layer closure of Tenon's capsule and conjunctiva compared with patients treated with separate closure of these layers. (C) 2016 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Efficacy of Orbital Color Doppler Imaging and Neuroimaging in the Diagnosis of Carotid Cavernous Fistulas.

Purpose: To evaluate the diagnostic sensitivity and specificity of orbital color Doppler imaging (CDI) and conventional neuroimaging (CT/MRI) compared with cerebral angiography in patients with carotid-cavernous fistulas (CCFs). Methods: The study design was a retrospective patient chart and imaging review. The authors reviewed 655 charts of all patients who underwent CDI and neuroimaging (CT/MRI) between 2006 and 2015 at one institution. Sixty patients had a presumptive diagnosis of CCF without thrombosis. Thirty-seven patients with 43 events met the inclusion criteria of the study. The diagnostic sensitivity of the 3 noninvasive imaging modalities (CDI, CT, MRI) for CCF was compared with the gold standard 6-vessel cerebral angiography. Significance testing was performed using the 2-tailed Fisher test. Results: Color Doppler imaging had high sensitivity (96.8%) but low specificity (41.7%) for the diagnosis of CCFs with anterior orbital findings. A negative CDI had more diagnostic value than a positive CDI. While an arterial wave form in the superior ophthalmic vein was the most common finding of CCF on CDI, enlargement of the superior ophthalmic vein was the only statistically significant finding. Posterior cortical venous drainage was noted in about 10% of the patients with indirect (low-flow) fistulas, who presented with unilateral orbital signs and symptoms, a finding not previously reported in the literature. Conclusion: Color Doppler imaging is a useful noninvasive, radiation-free modality for diagnosis of CCF with anterior drainage, with higher sensitivity than CT or MRI, but equivalent specificity. A significant limitation of CDI is the lack of usefulness in diagnosing fistulas with posterior cortical venous drainage, which carry a risk of intracerebral hemorrhage and stroke. In this series, 10% of unilateral CCFs with anterior orbital signs and symptoms showed angiographic evidence of posterior cortical venous drainage. (C) 2016 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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A Retrospective Review of Orbital Decompression for Thyroid Orbitopathy with Endoscopic Preservation of the Inferomedial Orbital Bone Strut.

Purpose: To determine incidence of new-onset diplopia, resolution of preexisting diplopia, and impact on proptosis resulting from endoscopic orbital decompression with and without preservation of the inferomedial orbital strut for thyroid orbitopathy. Methods: Retrospective review of all patients undergoing endoscopic 2- or 3-wall decompression with or without preservation of the strut for thyroid orbitopathy from January 2012 to June 2015. Results: Twenty-six patients (45 orbits) were included and divided into 4 primary categories: 2-wall decompression with strut preservation (4 orbits, 8%), 2-wall decompression with strut removal (7 orbits, 16%), 3-wall decompression with strut preservation (27 orbits, 60%), and 3-wall decompression with strut removal (7 orbits, 16%). The incidence of new-onset diplopia was 20% (2/10 patients without preoperative diplopia) overall and 16% in the strut preservation group (1/6 patients without preoperative diplopia). Resolution of diplopia occurred in 4 of 16 patients (25%) with preoperative diplopia, and all 4 had been treated with a 3-wall decompression with strut preservation. Resolution of diplopia in the group treated with strut preservation was 36% (4/11 patients with preoperative diplopia), and 0% of the 5 diplopic patients treated without strut preservation. Reduction in proptosis was statistically greater in those treated with strut removal (p = 0.003). Conclusions: This study demonstrates that endoscopic orbital decompression with preservation of the inferomedial bone strut results in a comparable to lower rate of new-onset diplopia compared with other reported techniques. When combined with 3-wall balanced decompression, this technique demonstrates a high rate of resolution of preexisting diplopia. (C) 2016 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Application of Palpebral Spring in Asian Patients With Paralytic Lagophthalmos.

Purpose: Literature on palpebral springs is scarce, and even more so for the Asian population. In this study, the authors evaluated their experience with palpebral spring placement for paralytic lagophthalmos in an Asian population. The authors report the unique challenges encountered due to the distinctive features in Asian eyelids and how they overcome them. To the best of our knowledge, this is the first report on the application of palpebral springs in Asians. Methods: All patients treated for paralytic lagophthalmos in the Department of Surgery, Queen Mary Hospital, from November 2013 to December 2015, were included in this study. The authors retrieved and analyzed the demographic data, preoperative assessment details, and treatment outcomes. Results: A total of 17 patients were recruited. The median interval between facial palsy occurrence and surgery was 66 months. Preoperatively, vertical palpebral fissure was 12.3 +/- 1.7 mm with margin reflex distance 1 of 3.7 +/- 0.3 mm and margin reflex distance 2 of 8.6 +/- 1.6 mm. Lagophthalmos before surgery was 9.6 +/- 2.3 mm. After the palpebral spring surgeries, vertical palpebral fissure was reduced to 9.1 +/- 1.4 mm. margin reflex distance 1 is slightly reduced (3.3 +/- 0.8 mm) and margin reflex distance 2 improved to 5.8 +/- 1.0 mm. Lagophthalmos reduced significantly to 0.8 +/- 1.3 mm. Seven patients required revision procedures. Conclusions: Palpebral spring is a safe and effective treatment for Asian patients with paralytic lagophthalmos. However, surgeons should be aware of the unique challenges associated with the anatomy of Asian eyelids. Special adaptation of the procedure is required to optimize the outcome. (C) 2016 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Mirror, Mirror on the Roof!

No abstract available

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Fixed drug eruption due to three antihistamines of a same chemical family: Cetirizine, levocetirizine, and hydroxyzine

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Aspergillus: An uncommon pathogen of eumycetoma

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