5-Fluorouracil 0.5%/Salicylic Acid 10%

http://orlnow.blogspot.gr/2016/12/5-fluorouracil-05salicylic-acid-10-in.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Management of Carotid Body Tumor in pediatric patients: A case report and review of the literature

Publication date: Available online 20 December 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Apanisile Ifeoluwa, István Lázár, Éva Szövördi, Tamás Karosi
Carotid body tumors (CBTs) are rare types of extra-adrenal paragangliomas, which originate from the neuroendocrine cells of the adventitial layer of carotid bifurcation. An 8-year-old girl was admitted to our department with left-sided and pulsating neck swelling, which progressively grew over several months. The patient had no family history of CBTs. Computed tomography (CT) and CT angiography (CTA) scans revealed a contrast material enhancing, hypervascularized mass involving the left carotid bifurcation, internal carotid artery (ICA), and external carotid artery (ECA), respectively. Preoperative embolization and surgical resection were performed. Histopathological examination later confirmed a benign CBT. Current follow-up examination revealed no evidence of residual or recurrent tumor. A systemic review of the literature indicates that early diagnosis, and experienced multi-disciplinary management is required in case of unilateral, resectable forms of CBTs with no distant metastasis, in order to provide a long-time survival of patients. Surgical intervention of unilateral, solitary CBTs with preoperative embolization is a relatively safe procedure, allowing complete tumor removal with minimal morbidity and low recurrence rate.



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Topical corticosteroids (TCSs) or topical calcineurin inhibitors in the Treatment of Atopic Dermatitis in the Pediatric Population

http://orlnow.blogspot.gr/2016/12/topical-corticosteroids-tcss-or-topical.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Oral 30% glucose provides sufficient sedation in newborns during MRI

Abstract

Purpose

Newborns are often sedated during MRI but sedation itself creates adverse events and management is more challenging in this environment. Oral glucose/sucrose administration has been studied in newborns during painful procedures; however, its effectiveness in keeping newborns sleepy and motionlessness during painless procedures has not been demonstrated. The objective of this study was to describe effectiveness of oral 30% glucose administration by comparing with intravenous midazolam sedation for newborns during MRI.

Methods

One hundred twelve ASA II-III newborns who required care in the ICU and were scheduled for MRI with sedation were included. Group I received 30% glucose solution orally with 0.5–1 ml increments up to 2 ml/3 kg doses and group II received intravenous 0.1 mg/kg midazolam with 0.05 mg/kg repetition. The procedure was considered satisfactory when MRI images were not disturbed by patient movement after oral glucose or intravenous midazolam administration. The efficiency of the techniques, additional dose and rescue sedation requirements, blood glucose levels following oral 30% glucose suckling and presence of adverse events were recorded.

Results

Demographic data was similar between groups. The efficiency of the procedures were similar between groups (78.9%, in group I and 66.1%, in group II). The blood glucose levels were within normal range in group I whereas transient desaturation and apnea occurred in 8 neonates in group II (p = 0.006).

Conclusion

Oral 30% glucose administration for newborns during MRI is as effective as standard sedation protocol with midazolam. Thereby, we recommend and support the integration of this safe and reliable technique into routine practice for newborns during MRI.

http://ift.tt/2hpmmsk

Editorial Board/Reviewing Committee

Publication date: January 2017
Source:International Journal of Oral and Maxillofacial Surgery, Volume 46, Issue 1





http://ift.tt/2hTinYs

Islanded facial artery musculomucosal flap for tongue reconstruction

Publication date: Available online 20 December 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): S.T. Joseph, B.S. Naveen, T.M. Mohan
Reconstruction of the tongue can be achieved by means of various local, regional, and microvascular free flaps. Local flaps commonly used for tongue reconstruction include the nasolabial flap, submental flap, infrahyoid flap, and pedicled facial artery musculomucosal (FAMM) flap. The purpose of this article is to propose a technical modification to the FAMM flap for the reconstruction of small to medium-sized tongue defects post tumour excision: islanding the flap and tunnelling it from the lingual aspect of the mandible in a single-stage procedure. Islanding of the FAMM flap was found to be an extremely useful modification, giving excellent range of movement for the flap and eliminating the need for revision in a second stage procedure.



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Hypothyroid-induced acute compartment syndrome in all extremities

Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed. Postoperative Day 1, upper extremity motor function decreased significantly and paresthesias occurred. She therefore underwent bilateral forearm fasciotomies. The pathogenesis of hypothyroidism-induced compartment syndrome is unclear. Thyroid-stimulating hormone-induced fibroblast activation results in increased glycosaminoglycan deposition. The primary glycosaminoglycan in hypothyroid myxedematous changes is hyaluronic acid, which binds water causing edema. This increases vascular permeability, extravasation of proteins and impaired lymphatic drainage. These contribute to increased intra-compartmental pressure and subsequent ACS.

http://ift.tt/2haSm7j

Splenic injury following elective colonoscopy: a rare complication

Splenic injury is an extremely rare, yet serious, complication related to colonoscopy. So far, less than 80 cases have been reported worldwide since 1970. With the increasing use of colonoscopy, endoscopists, surgeons and radiologists are more likely to encounter this unusual complication. Increased splenocolic adhesions, splenomegaly or underlying splenic disease might, inter alia, constitute a predisposing factor. However, it might also occur in patients without significant adhesions or underlying splenic pathology. Patients with abdominal pain, hypotension and a fall in hematocrit without rectal bleeding after colonoscopy, should be suspected of having splenic injury. Most patients present with symptoms within 24 hours after colonoscopy, nevertheless, delayed presentations have been described as well. We report such a case of splenic injury secondary to colonoscopy. The patient was presented with hemorrhagic shock and abdominal pain following a colonoscopy which had taken place before 36 hours, an urgent splenectomy was required with successful outcome.

http://ift.tt/2hprVqQ

Rare small intestinal volvulus from entrapment in hepato-diaphragmatic adhesions in a 45-year-old lady

Small intestinal volvulus is rare in adults and rarely caused by string adhesions between the liver and the diaphragm. Similar adhesions were described in Fitz-Hugh-Curtis syndrome. We report a 45-year-old lady with small intestinal volvulus from entrapment of a loop in string adhesions between the liver and the diaphragm. Her plain radiographs showed a significant shadow of the trapped loop.

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Vascular structures in dermal nevi: a reappraisal

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Zika virus infection, issue on dermatological problem

http://ift.tt/2haTLLp

Single Point Mutations in Pediatric Differentiated Thyroid Cancer

Thyroid , Vol. 0, No. 0.


http://ift.tt/2hpAMZi

Virtual Surgical Planning and Intraoperative Imaging in Management of Ballistic Facial and Mandibular Condylar Injuries

Publication date: Available online 20 December 2016
Source:Atlas of the Oral and Maxillofacial Surgery Clinics
Author(s): Philipp Kupfer, Allen Cheng, Ashish Patel, Melissa Amudson, Eric J. Dierks, R. Bryan Bell




http://ift.tt/2h0m0r3

The Role of Intra-articular Surgery in the Management of Mandibular Condylar Head Fractures

Publication date: Available online 20 December 2016
Source:Atlas of the Oral and Maxillofacial Surgery Clinics
Author(s): Paolo Boffano, Pierre Corre, Stefano Righi




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Editorial Board/Reviewing Committee

http://ift.tt/2h0mj5n

Immunogenicity Evaluation of Modified Adenovirus Vaccines Expressing Porcine Circovirus Type 2 Capsid Protein in Pigs

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2haLfMb

Three Reviews Highlight Different Aspects of the Host Response to Viral Infection

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2hpshxm

Syndrome of inappropriate antidiuretic hormone secretion in a case of olfactory neuroblastoma without anti-diuretic hormone immunoreactivity: A case report and review of the literature

Publication date: Available online 20 December 2016
Source:Auris Nasus Larynx
Author(s): Takafumi Nakano, Junichi Motoshita, Fumi Sawada, Midori Okabe, Akihiro Tamae, Shinsuke Hiramatsu, Satoru Kodama, Hideki Shiratsuchi, Ryuji Yasumatsu, Torahiko Nakashima, Takashi Nakagawa
Olfactory neuroblastoma (ONB) is a relatively rare nasal or paranasal malignant tumor. This tumor is rarely accompanied by paraneoplastic syndromes such as syndrome of inappropriate antidiuretic hormone secretion (SIADH). Here, we report a 31-year-old female with histologically confirmed ONB who had been diagnosed with SIADH three years prior. She was treated with surgery followed by concurrent chemoradiotherapy. SIADH resolved immediately after surgical tumor resection. Immunohistochemically, both biopsy and resected specimens from the nasal cavity had been negative for ADH. Although extremely rare, ONB may be associated with SIADH, and the possibility of this cancer should be taken into account during the follow-up of idiopathic SIADH.



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Neck dissection with harmonic scalpel and electrocautery? A randomised study

Publication date: Available online 20 December 2016
Source:Auris Nasus Larynx
Author(s): Roshan K. Verma, Arulalan Mathiazhagan, Naresh K. Panda
ObjectiveIs the use of harmonic scalpel for neck dissection useful? Literature search did not show a single, prospective, randomised control trial. We intended to study the role of harmonic scalpel in neck dissection and compare it with conventional electrocautery technique for oral cavity carcinoma.Methods40 patients undergoing selective neck dissection for primary oral cavity malignancy were enrolled in this study. The harmonic scalpel (HS) group consisted of 20 patients, and the electrocautery technique (ET) group comprised of 20 patients. The following variables were examined: intraoperative blood loss, operative time, number of ligatures used, postoperative drain, and postoperative hospital stay.ResultsIntraoperative blood loss was found to be significantly reduced in harmonic scalpel group as compared to electrocautery group. However, we found no difference in other parameters like operative time, postop drain, postoperative hospital stay and number of ligatures used between both groups.ConclusionHarmonic scalpel for neck dissection is associated with significantly lesser intraoperative blood loss as compared to electrocautery. There is no effect on operative time and postoperative hospital stay in both groups.



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The temporalis muscle flap for reconstruction of soft palate and lateral oropharyngeal wall after transoral robotic surgery

Publication date: Available online 20 December 2016
Source:Auris Nasus Larynx
Author(s): Giuseppe Meccariello, Filippo Montevecchi, Alberto Deganello, Giovanni D'Agostino, Chiara Bellini, Ermelinda Zeccardo, Claudio Vicini
Trans Oral Robotic Surgery (TORS) is a prominent surgical approach for the resection of oropharyngeal tumors without division of the lip and mandible. Some defects following TORS are large and complex enough to benefit soft-tissue coverage. The pedicled temporalis muscle flap is a versatile and reliable flap and may be a valid option to reconstruct defects of the lateral pharyngeal wall and partial soft palate.



http://ift.tt/2hT5KfO

Tongue Base Schwannoma

Abstract

Intraoral schwannomas account for 1% of head and neck schwannoma, with tongue base schwannoma being reported rarely. In an English literature search from 1988 to 2014, not more than 38 cases of tongue base schwannoma have been reported. Large tongue base schwannomas pose a significant risk to airway, thereby calling for an early intervention. We report a rare case of tongue base schwannoma in a 25 year old female managed surgically by lateral pharyngotomy approach.

http://ift.tt/2gXsxCV

Tongue Base Schwannoma

Abstract

Intraoral schwannomas account for 1% of head and neck schwannoma, with tongue base schwannoma being reported rarely. In an English literature search from 1988 to 2014, not more than 38 cases of tongue base schwannoma have been reported. Large tongue base schwannomas pose a significant risk to airway, thereby calling for an early intervention. We report a rare case of tongue base schwannoma in a 25 year old female managed surgically by lateral pharyngotomy approach.

http://ift.tt/2gXsxCV

Optimizing acitretin use in patients with plaque psoriasis

Abstract

Acitretin is one of the systemic agents used for the treatment of psoriasis. Because different acitretin dosages resulted therapeutically successful, there is no general agreement on the optimal dose regimen. To report acitretin efficacy and safety in a real-life setting, wherein patient-tailored dose regimen is usually prescribed, a retrospective analysis evaluating charts of all plaque-type psoriasis patients treated with acitretin from the clinic database was performed. PASI score improvement, as well as PASI 50, 75, 90, and 100 responses were assessed throughout the observational period. Overall, 52% PASI score reduction and a satisfactory safety profile were detected. PASI 50, 75, 90, and 100 response was achieved by 53%, 48%, 28%, and 14%, respectively. Treatment consisted on a mean daily acitretin dose of 25.01 mg. The initial dose was increased (51.2% of cases) or decreased (48.8%) prescribing a mean daily dose of 29.8 mg and 20.02 mg, respectively. This study proposed a dose regimen customized on clinical response and patient's needs, to optimized acitretin benefit.

http://ift.tt/2gZRZHV

Effect of different types of therapeutic trauma on vitiligo lesions

Abstract

New treatment modalities for vitiligo acting by changing certain cytokines and metalloproteinases are newly emerging. The aim of this work is to To assess the efficacy of trichloroacetic acid (TCA) chemical peel, dermapen, and fractional CO₂ laser in treatment of stable non-segmental vitiligo and to detect their effects on IL-17 and MMP-9 levels. Thirty patients with stable vitiligo were recruited in a randomized controlled study. They were randomly categorized into three equal groups. Group 1: TCA peel, Group 2: dermapen machine, and Group 3: Fractional CO₂ laser. Skin biopsies were taken from treated areas and from control areas for which MMP-9 and IL-17 tissue levels were measured using ELISA. The 30 vitiligo patients had low basal tissue MMP-9 levels and high baseline IL-17 tissue levels. As regards the three different used modalities, all of them caused rise in MMP-9 as well as IL-17 levels and almost their levels were much more elevated with repetition of the previously mentioned traumatic procedures. TCA 25% peel proved to be the most effective modality both clinically and laboratory and it can be used prior or with other conventional therapies in the treatment of vitiligo.

http://ift.tt/2idkVx9

Narbenkorrektur mit Hyaluronidase-Injektionen

Zusammenfassung

Narben können funktionell und ästhetisch problematisch sein. In der Narbentherapie haben topische, chirurgische und Laserverfahren ihren Platz. Wir stellen die Korrektur von Narben mittels Hyaluronidase-Injektionen als weitere Alternative vor. Hierbei kommt es im Verlauf mehrerer Sitzungen zur schrittweisen Verbesserung der Texturveränderungen, Minderung der Straffheit und Unterstützung sekundärer Wundheilungsvorgänge. Dies zeigt sich in der Verbesserung der Vancouver Scar Scale von 6,3 ± 1,9 vor der Therapie auf 2,1 ± 1,6 nach Abschluss. Zusammenfassend kann die Hyaluronidase-Injektion als sichere und wirksame Alternative zu operativen und laserbasierten Narbenkorrekturen angesehen werden.

http://ift.tt/2hFtEel

Management of pulps exposed during carious tissue removal in adults: a multi-national questionnaire-based survey

Abstract

Objectives

The aim of the present study was to investigate and compare the management of pulps exposed during carious tissue removal by French, German, and Norwegian general dental practitioners (GDPs). We further aimed to assess possible dentist- and patient-related factors associated with these management decisions.

Materials and methods

A structured questionnaire was send via mail to a simple random sample of dentists.

Results

The analyzed sample consisted of 661 (33%) French GDPs, 622 (25%) German GDPs, and 199 (34%) Norwegian GDPs. No single management method gained uniform consensus in any of the three countries. However, the most preferred management option in all three countries was direct pulp capping (DPC) (68–93%) mainly performed with calcium hydroxide paste/slurry (CH). Alternatively, root canal treatment was performed (7–22%). The reasons that guided GDPs were the same in all three countries; "good results" and "ease of use, familiar with the technique." Having read scientific articles about cariology/operative dentistry in the last 5 years increased the odds for the preference of DPC instead of root canal treatment (OR = 2.1, 95% CI 1.3–3.2).

Conclusions

Among GDPs in France, Germany, and Norway, there was no uniform management option for pulp exposures during carious tissue removal. DPC with CH was the most preferred management, even though the current evidence suggests DPC with mineral trioxide aggregate (MTA) to be more successful. The outcome expectations and the assumed ease of use were reasons for GDPs' choice. Moreover, knowledge on current evidence towards such management options influenced treatment decisions.

Clinical relevance

GDPs are encouraged to adopt management options based on current scientific evidence.

http://ift.tt/2hQGpAP

Use of AC impedance spectroscopy for monitoring sound teeth and incipient carious lesions

Abstract

Objective

The objective of this study was to assess the ability of alternating current impedance spectroscopy technique (ACIST) to monitor sound tooth surfaces and incipient carious lesions.

Subjects and methods

Two hundred ninety-two teeth were examined in 30 patients. Occlusal surfaces were classified according to International Caries Detection and Assessment System (ICDAS). Two consecutive ACIST measurements at the investigation sites already visually examined were taken (t1). Examinations were repeated after 6 (t2) and 12 months (t3). Reproducibility of ACIST findings was calculated with the intra-class correlation coefficient. Values of the ACIST measurements were categorized, and kappa values were calculated. Spearman correlation coefficients (r _s) were calculated for correlations between ICDAS findings and ACIST measurements. To test whether ACIST detected changes similarly to ICDAS, Wilcoxon's test was used (α = 0.05).

Results

Intra-class correlation coefficient values of ACIST measurements ranged between 0.88 and 0.98. Kappa values for ACIST categories were 0.66–0.80. Rank correlation coefficient of ICDAS and ACIST readings was 0.38–0.65 at different time intervals (p < 0.01). Significant differences could be shown for ICDAS findings between t1/t2 (p = 0.001), t2/t3 (p = 0.021), and over the total duration of the study (t1/t3, p < 0.001). No significant differences between the various examination periods were found for the impedance measurements (p > 0.05).

Conclusions

ACIST exhibited in vivo high reproducibility but moderate correlation to visual findings at each time of examination.

Clinical relevance

ACIST can be used for monitoring sound teeth and early carious lesions although its suitability as a single detection method is limited since not all changes could be detected with respect to visual findings.

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Intramammary metastatic melanoma of unknown primary origin in a 58-year old patient: a case report

Malignant melanoma metastasis to the breast is a rare disease.

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Disseminated tungiasis in a 78-year-old woman from Tanzania: a case report

Tungiasis is one of the neglected tropical diseases; it affects up to 40% of individuals living in societies with poor housing and sanitation standards. In endemic areas, Tunga infestation, which predominantly af...

http://ift.tt/2hXRyzA

Difficulties in diagnosis and treatment of severe secondary Raynaud’s phenomenon in a Cameroonian woman: a case report

Raynaud's phenomenon is a microvascular disorder that results in exaggerated vasoconstriction over vasodilatation secondary to an alteration in autonomic control. Though benign, it can result in severe ulcerat...

http://ift.tt/2hSyLby

Spontaneous renal artery dissection presenting as an aortic dissection: a case report

Renal artery dissection is a condition that has been associated with traumatic injuries and connective tissue disorders. It has been managed in the past by multiple methods because there is no standard treatme...

http://ift.tt/2hXZwbN

Acute polyarthritis in a young patient caused by meningococcal and parvovirus B19 infections: a case report and review of the literature

Meningococcal infection is a multifaceted disease including acute polyarthritis. This presentation should be known by clinicians in order to prevent delay in treatment. We report what we believe to be the firs...

http://ift.tt/2hSFbaI

Validation of international classification of disease ninth revision codes for atopic dermatitis

Abstract

Background

Evaluation of large-scale data sets is needed to better understand the epidemiology, cost and burden of atopic dermatitis (AD). We sought to validate the use of ICD-9-CM codes for identifying AD.

Methods

Patients from a large metropolitan quaternary care medical center with a diagnostic code of either 691.8 (AD) or 692.9 (eczema and contact dermatitis) were queried. Medical records were reviewed for demographics, Hanifin & Rajka (H&R) and United Kingdom Working Party (UKWP) criteria. Sensitivity, specificity and positive predictive values (PPV) of the codes were calculated.

Results

Of 43,278 patients identified with associated ICD-9 codes of 691.8 or 692.9, 519 and 253 with 691.8 and 692.9 were randomly selected for chart review. There was extensive overlap: 34.3% had ≥1 occurrences of 691.8 and 692.9; 25.6% had multiple occurrences of both codes. Among patients with ≥1 occurrence of 691.8, 29.9% and 30.8% met the H&R and UKWP criteria, respectively. Similarly, among patients with ≥1 occurrence of 692.9, 33.7% and 32.2% met the H&R and UKWP criteria. Increased PPV was associated with concomitant diagnoses of asthma, hay fever and food allergy, and increased disease severity.

Conclusions

In the outpatient setting, the ICD-9-CM codes 691.8 and 692.9 alone have poor PPV. Incorporation of diagnoses of asthma, hay fever and food allergy improves PPV and specificity. In the inpatient setting, a primary discharge diagnosis of 691.8 had excellent PPV. Although ICD-10 has been adopted in Europe and more recently the US, the same systematic errors would likely occur unless providers standardize their coding.

This article is protected by copyright. All rights reserved.

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BASALIT-trial: Double blind placebo controlled allergen immunotherapy with rBet v 1-FV in birch related soy allergy

Abstract

Background

Conflicting results exist on the effect of allergen immunotherapy (AIT) on pollen related food allergy. We aimed to investigate the efficacy of one year AIT with the folding variant (FV) of recombinant (r) Bet v 1 on birch related soy allergy.

Methods

Out of 138 subjects with Bet v 1 sensitization, 82 were positive at double blind placebo controlled food challenge (DBPCFC) with soy. 56/82 were randomized 2:1 (active: placebo). Per protocol population (PPP) had received >150μg of allergen or placebo preparation. Outcome measures: lowest observed adverse effect levels (LOAEL), post interventional occurrence of objective signs (objS) at any dose level, sIgE/IgG4 against Bet v 1 and Gly m 4. Between-group changes were investigated (ANCOVA, Mann-Whitney-U-, Fisher exact test).

Results

Baseline characteristics including LOAELs were comparable in both groups with objS and subjS occurring in 82% and 95% of active (n=38) versus 78% and 83% of placebo group (n=18). After AIT, objS occurred in 24% and 47%, respectively. LOAEL group differences showed a beneficial tendency (p=0.081) for LOAEL_objective in PPP (30 verum, 15 placebo). sIgG4 raised only in active group (Bet v 1: p=0.054, Gly m 4: p=0.037), no relevant changes occurred for sIgE. Only 56% of the intended sample size was recruited.

Conclusion

For the first time, we present data on the effect of rBet v 1-FV on birch related soy allergy. rBet v 1-FV AIT induced significant immunogenic effects. Clinical assessment showed a tendency in favor of the active group but did not reach statistical significance.

This article is protected by copyright. All rights reserved.

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The structure of the mite allergen Blo t 1 explains the limited antibody cross-reactivity to Der p 1

Abstract

The Blomia tropicalis (Blo t) mite species is considered a storage mite in temperate climate zones and an important source of indoor allergens causing allergic asthma and rhinitis in tropical and subtropical regions. Here, we report the crystal structure of one of the allergens from Blo t, recombinant proBlo t 1 (rproBlo t 1), determined at 2.1 Å resolution. Overall, the fold of rproBlo t 1 is characteristic for the pro-form of cysteine proteases from the C1A class. Structural comparison of experimentally mapped Der f 1/Der p1 IgG epitopes to the same surface patch on Blo t 1, as well as of sequence identity of surface exposed residues, suggests limited cross-reactivity between these allergens and Blo t 1. This is in agreement with ELISA inhibition results showing that, although cross-reactive human IgE epitopes exist, there are unique IgE epitopes for both Blo t 1 and Der p 1.

This article is protected by copyright. All rights reserved.

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Vitamin D contributes to mast cell stabilization

Abstract

Background and aims

Mast cells are the major effector cells in allergic disorders and many other informatory disorders. The mechanism of mast cell stabilization is not fully understood. Cumulative reports indicate that vitamin D (VitD) contributes to the homeostasis in the body. This study tests a hypothesis that VitD is required in the maintenance of the stability of mast cells.

Methods

The stability of mast cell lines, HMC1 cells, RBL-2H3 cells, p815 cells and mouse bone marrow-derived mast cells (BMMC) was tested in the presence or absence of VitD3.

Results

mast cells activated automatically in a vitamin D (VitD)-deficient environment. Exposure to calcitriol in the culture increased the expression of VitD receptor (VDR) in mast cells. VDR formed complexes with Lyn in mast cells to inhibit the binding of Lyn to the β chain of FcεRI and MyD88, which decreased the phosphorylation of Syk, decreased the levels of MAPK and NF-κB. VDR bound to the promoter of TNF-α to decrease the acetylation of histone H3/H4, RNA polymerase II and OCT1 (a transcription factor of TNF-α) at the promoter locus and repressed the expression of TNF-α in mast cells.

Conclusions

The data demonstrate that VitD is required to maintain the stability of mast cells. The deficiency of VitD results in mast cell activation.

This article is protected by copyright. All rights reserved.

http://ift.tt/2hoVQPL

A novel bispecific DARPin targeting FcγRIIB and FcεRI-bound IgE inhibits allergic responses

Abstract

Background

Binding of allergen-specific IgE to its high-affinity receptor FcεRI on basophils and mast cells is a central event in the development of allergies. Exposure of these cells to allergens induces the release of soluble mediators causing allergic symptoms. The inhibitory low-affinity IgG Fc-receptor FcγRIIB is co-expressed on allergic effector cells and has been implicated in negative regulation of immediate hypersensitivity responses. In order to harvest the inhibitory function of this receptor we aimed to select specific binders against FcγRIIB and to generate a bispecific molecule simultaneously targeting FcγRIIB and FcεRI-bound IgE on the surface of allergic effector cells.

Methods

We selected FcγRIIB-specific binding molecules from a library of designed ankyrin repeat proteins using ribosome display technology. The bispecific binding modality was generated by molecular cloning and recombinant protein expression. We determined binding characteristics on molecular and cellular levels using SPR, ELISA and flow cytometry. The inhibitory potential of the newly described molecules was assessed in different cellular degranulation assays ex vivo and in a mouse model of passive systemic anaphylaxis.

Results

We demonstrate that the selected DARPin^® proteins recognize FcγRIIB with high affinity. Furthermore, the bispecific binding protein successfully interferes with allergen-induced cell degranulation and efficiently inhibits systemic anaphylaxis in vivo. Mechanistically, we report that FcγRIIB-mediated inhibition of effector cell activation requires direct ligation to an activating FcεRI receptor.

Conclusion

The described bispecific DARPin protein has the ability to co-ligate FcγRIIB with FcεRI-bound IgE on allergic effector cells and represents an efficient dual-modality to interfere with allergic hypersensitivity reactions.

This article is protected by copyright. All rights reserved.

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Behandlungsalgorithmen Endometriumkarzinom

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Do new NICE oral cancer referral guidelines (NG12) risk delay in cancer diagnosis? An audit comparing outcomes of the new guidelines against old guidelines

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Jaymit Patel, David Grimes, Christopher Avery




http://ift.tt/2idc6TW

Aberrant temporal branch of facial nerve

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Tun Wildan, Nasser Nasser
There is a high risk of injury to the temporal branch of the facial nerve during operations on the head and neck because of the complexity of its course. We report an aberrant branch that arose from the main trunk before bifurcation into the temporofacial and cervicofacial divisions. It had no anastomosis with other branches, and damage could have caused uncompensated injury.



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Effects of Hypericum perforatum on the healing of xenografts: a histomorphometric study in rabbits

Publication date: Available online 20 December 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): İ. Damlar, O.F. Arpağ, U. Tatli, A. Altan
The aim of this study was to investigate effects of the Hypericum perforatum (St John's Wort) on bone healing in rabbit calvarium. Ten male New Zealand rabbits each had three bicortical defects made in the calvarial bones, which were filled with xenograft, xenograft+H perforatum oil extract, and autogenous graft. Four weeks postoperatively all rabbits were killed and the bony defects examined histomorphometrically. Tissue compartments including new bone (p<0.001), marrow space (p<0.001), and residual bone grafts (p=0.014) differed significantly among groups (p=0.00?). The volume of residual graft was significantly decreased in the xenograft/H perforatum group compared with those with xenografts alone (p=0.0147). The differences in microarchitectural variables of de novo bone formation were also significant (trabecular thickness (p<0.001), trabecular width (p<0.001), trabecular separation (p=0.001). There were no significant differences in node:terminus ratio between the xenograft/H perforatum group and the other two groups. However, the difference in node:terminus ratio between the autogenous graft and xenograft group was significant (p=0.001) Oil extracts of H perforatum improved bony healing in defects filled with bovine-derived xenografts.



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To biopsy or not to biopsy? That is the question...

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Meera Pajpani, Hardeep Kooner, Syedda Abbas




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A Clinical Audit on the Management of Oral Lichen Planus within the Oral and Maxillo-facial Department at the University Hospital of Manchester

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Alexandra Perks




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Editorial Board

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10





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Sublingual lymphangioma that presented as a plunging ranula in a baby boy

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Amal Faisal Al-Abdulla, Shilpa Prabhu, Mohammed A. Al-Muharraqi, Abdulla Hassan Darwish, Veena Nagaraj




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Extended retroauricular access to the medial temporomandibular joint space

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): JNSTJ. Blythe, M.Y. Mommaerts




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Urgent or Not? Analysis of referrals to Oral and Maxillofacial Surgery in NHS Lanarkshire in a 1 month period

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Ailish Clark, Vikas Sood




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Quality of Informed Consent Given to Surgical Skin Cancer Patients at Gloucester Royal Hospital

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Imogen Midwood, Rothith Gaikwad, Daryl Godden, Mark Singh, Margaret Coyle




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The Inclusion of Mandibular Condyles in Orthopantomogram radiographs for Trauma cases: a retrospective audit at a Regional Maxillofacial Unit

Publication date: December 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 10
Author(s): Simrun Chowdhary, Iffah Zaman, Atheer Ujam, Michael Perry




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Elucidating the Role of Hyposalivation and Autoimmunity in Oral Candidiasis

Abstract

Introduction

Oral candidiasis (OC) is a potential oral complication in Sjögren's Syndrome (SS). Some studies indicate that the low stimulated salivary flow and not low unstimulated salivary flow is associated with OC in SS, while others report that the underlying autoimmune disorders contributes to OC, based solely on correlation coefficients. Given the conflicting and limited existing evidence, we purposed to ascertain the role of both salivary gland dysfunction (hyposalivation based on unstimulated and stimulated flow rates) and autoimmunity (SS, other autoimmune disorders) in OC among those with SS, other salivary gland dysfunction and non-salivary gland dysfunction controls (NSGD).

Methods

A nested case-control study was designed within a larger NIH/NIDCR cohort. Descriptive analyses, non-parametric tests, comparative analyses, and multivariate logistic regression analyses were undertaken.

Results

Data on 1,526 subjects (701 SS, 247 ISS, 355 Sicca, and 223 NSGD) were obtained from the source cohort of 2,046 and analyzed for this current study. The median whole unstimulated salivary flow rate (WUS, ml/15min) was lower in SS (0.8, interquartile range (IQR) 1.8) compared to ISS (5.5, IQR 5.2, p<0.001) and NSGD (3.8, IQR 3.8, p<0.001) but comparable with that of Sicca (1.0, IQR 1.5, p=0.777) participants. The median total stimulated salivary flow rate (TSS, ml/15min) was lowest in SS (7.0, IQR 12.4, p<0.001) compared to other groups. Of the 45 OC cases in this cohort, 71.1% (n=32) were from the SS group. The prevalence of OC was highest in the SS group (4.6%, p=0.008). SS group had twice the risk of OC than NSGD (OR =2.2, 95%CI: 1.1-4.2,p=0.02) and Sicca (OR =2.2, 95%CI:1.0-4.8, p=0.03), adjusting for confounders; hyposalivation [WUS (OR=5.1, 95%CI: 2.5-10.4, p<0.001), TSS (OR=1.9, 95%CI:1.0-3.5, p=0.04)], history of other autoimmune disorders (OR=4.4, 95%CI:1.7-11.3, p=0.002), medications for extraglandular manifestations (OR=2.3, 95%CI:1.1-4.9, p=0.03), and diabetes mellitus (4.2, 95%CI:1.2-15.2, p=0.02) were independent predictors of OC; females had a lower risk than males (OR =0.29, 95%CI:0.13-0.67,p=0.004). Age, race, anti-SSA/SSB autoantibodies, focus score, other medications, anxiety, fatigue, cigarette smoking, alcohol, and caffeine use were not associated with oral candidiasis.

Conclusion

Salivary gland dysfunction (hyposalivation with WUS being a stronger predictor than TSS) and autoimmunity (SS, other autoimmune disorders, medications i.e., DMARDS) are both independent predictors of OC. Diabetes mellitus is an independent predictor of OC among those with salivary gland dysfunction. Our findings suggest that these independent predictors should be considered in the prevention and management of OC in this population.

This article is protected by copyright. All rights reserved.

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Fetuin-A, serum amyloid A and tumor necrosis factor alpha levels in periodontal health and disease

Abstract

Objectives

The present study is evaluating fetuin-A, serum amyloid A (SAA) and tumor necrosis factor alpha (TNF-α) levels in gingival crevicular fluid (GCF) and serum samples in periodontal health and disease.

Material and Methods

Sixty patients were divided into three groups: Group 1 periodontal health (n=20), group 2 gingivitis (n=20) and group 3 chronic periodontitis (CP) (n=20). GCF and serum samples were evaluated using enzyme linked immunosorbent assay kit.

Results

SAA and TNF-α levels in GCF and serum were significantly higher in patients with gingivitis and CP compared with controls (P<0.016). Contrarily, fetuin-A levels in GCF and serum were significantly higher in controls than in patients with gingivitis and CP (P<0.016). In CP group, a significant correlation was observed between GCF SAA amount and the number of sites with 4 ≤ PPD ≤ 5 mm (P < 0.05). There was a significant correlation between GCF fetuin-A levels and the number of sites with PPD ≥6 mm (P < 0.05). GCF TNF-α was found to have a significant relationship with the number of sites with 4≤PPD≤5 mm and PPD≥6 mm (P <0.05).

Conclusions

In conclusion, serum and total levels of SAA significantly increased, whereas Fetuin-A levels significantly decreased, with increasing severity of PD.

This article is protected by copyright. All rights reserved.

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Effect of shorter pulse duration in cochlear neural activation with an 810-nm near-infrared laser

Abstract

Optical neural stimulation in the cochlea has been presented as an alternative technique to the electrical stimulation due to its potential in spatially selectivity enhancement. So far, few studies have selected the near-infrared (NIR) laser in cochlear neural stimulation and limited optical parameter space has been examined. This paper focused on investigating the optical parameter effect on NIR stimulation of auditory neurons, especially under shorter pulse durations. The spiral ganglion neurons in the cochlea of deafened guinea pigs were stimulated with a pulsed 810-nm NIR laser in vivo. The laser radiation was delivered by an optical fiber and irradiated towards the modiolus. Optically evoked auditory brainstem responses (OABRs) with various optical parameters were recorded and investigated. The OABRs could be elicited with the cochlear deafened animals by using the 810-nm laser in a wide pulse duration ranged from 20 to 1000 μs. Results showed that the OABR intensity increased along with the increasing laser radiant exposure of limited range at each specific pulse duration. In addition, for the pulse durations from 20 to 300 μs, the OABR intensity increased monotonically along with the pulse duration broadening. While for pulse durations above 300 μs, the OABR intensity basically kept stable with the increasing pulse duration. The 810-nm NIR laser could be an effective stimulus in evoking the cochlear neuron response. Our experimental data provided evidence to optimize the pulse duration range, and the results suggested that the pulse durations from 20 to 300 μs could be the optimized range in cochlear neural activation with the 810-nm-wavelength laser.

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Azathioprine-induced rosacea

Abstract

In a recent study from our department 7/54 adult atopic dermatitis patients treated with systemic immunosuppressants were referred by ophthalmologists because of severe ocular involvement keratoconjunctivitis with or without keratoconus associated with milder skin symptoms (2).

We report the case of a woman affected by atopic dermatitis and asthma in childhood who developed at 63 years of age conjunctivitis associated with blepharitis without causative contact allergen identification at skin testing. She received multiple topical and systemic treatments including cyclosporine 2mg/kg/day stopped after 4 days because of digestive adverse effects.

This article is protected by copyright. All rights reserved.

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Efficacy of an emollient cream in the treatment of xerosis in diabetic foot: a double-blind, randomized, vehicle-controlled clinical trial

Abstract

Background

Peripheral neuronal impairment compromises foot health in diabetic patients. Clinically, xerosis is the most common mild complication, but it should not be underestimated. An effective treatment must be able to restore the cutaneous barrier and prevent water loss, to maintain adequate hydration and protection.

Objective

This study aimed to assess the efficacy of an emollient cream on foot xerosis in diabetic patients.

Methods

This is a prospective, multicenter, randomized, double-blind contralateral vehicle-controlled study in 57 diabetic patients. Patients were treated twice daily for 27 ± 2 days with the study emollient containing glycerol 15%, liquid and soft paraffin 10%, glycerol monostearate, stearic acid, polydimethylcyclosiloxane, silicone oil, macrogol 600, trolamine, propyl parahydroxybenzoate and purified water (Dexeryl^®; Pierre Fabre Medicament, France), or its vehicle (glycerol monostearate, stearic acid, polydimethylcyclosiloxane, silicone oil, macrogol 600, trolamine, propyl parahydroxybenzoate and purified water). Efficacy was assessed after a 28-day treatment period using a validated score (Xerosis Assessment Scale [XAS] score), instrumental measurements, and subjective assessment.

Results

The XAS score decreased to 3.2 ± 2.6 points with the emollient and 4.1 ± 2.3 with the vehicle (P = 0.001). Improvement was observed from day 14 (P = 0.012). Compared with the vehicle, the emollient also significantly improved the overall skin score, hydration index, D-Squame^® test, skin roughness, and patients' opinions.

Conclusion

Treatment with an emollient is effective for improving foot xerosis in diabetic patients.

This article is protected by copyright. All rights reserved.

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Clinical and dermoscopic features of common warts

Abstract

Common warts have a distinctive appearance and can usually be diagnosed with the unaided eye; however, early growth stages and post-treatment warts are less easily diagnosed. Published dermoscopic features of common warts include frogspawn pattern,¹ mosaic pattern,² and dotted, linear, globular or coiled vessels.^1,2 Our study shows that exophytic keratotic projection pattern, daisy flower pattern and hairpin vessels can be seen in common warts via dermoscopy, alongside the above patterns and structures.

This article is protected by copyright. All rights reserved.

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p16 INK4 expression is of prognostic and predictive value in oropharyngeal cancers independent of human papillomavirus status: a Hungarian study

Abstract

Head and neck cancer treatment protocols still lack well-established biomarkers of prognostic and predictive value. It is well known that human papillomavirus (HPV)-related and non-HPV-related oropharyngeal cancers are distinct entities concerning tumor biology and clinical outcome. However, there is an ongoing debate whether tumor suppressor p16^INK4 status alone or both p16^INK4 and HPV detection should be used in clinical settings. The aim of this study was to investigate p16^INK4-immunolabelled and HPV-induced rates and determine their clinical significance in 110 primary head and neck squamous cell carcinomas. The expression of p16^INK4 protein was assessed with immunohistochemistry, while high-risk HPV detection was performed using DNA PCR method. P16^INK4 immunolabelling was detected in 17.3% of all tumor samples, and in 38.1% of oropharyngeal malignancies. Oropharyngeal, p16^INK4-immunolabelled tumors showed an improved disease-specific survival compared to the non-p16^INK4-immunolabelled group (median survival: 30.3 vs. 8.8 months, p < 0.001 with the log-rank test). Furthermore, 56% of p16^INK4-immunolabelled cases were tested positive for HPV-DNA. The HPV-induced group presented better disease-specific survival compared to the non-HPV-induced cases (median survival: 25.9 vs. 9.5 months, p = 0.024 with the log-rank test). Improved response rates to neoadjuvant chemotherapy were observed both in p16^INK4-immunolabelled and p16^INK4- immunolabelled/HPV DNA- containing groups (Fisher's exact test: p = 0.025 and p = 0.009). In conclusion, p16^INK4 immunohistochemistry proved to be a reliable and affordable tool for prognostic and predictive testing of head and neck squamous cell cancers. The p16^INK4 immunopositivity status alone was confirmed to be an equally precise indicator of clinical outcome as p16^INK4/HPV DNA PCR double testing.

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Level I lymph node involvement in patients with N1b papillary thyroid carcinoma: a prospective study

Abstract

Most of the studies on the incidence, pattern, and predictive factors of lymph node (LN) metastasis with papillary thyroid carcinoma (PTC) have been performed retrospectively and no common consensus has been reached regarding the predictors for the involvement of level I LNs. This study was conducted prospectively to determine the incidence and the possible predictors of level I involvement in N1b PTC patients. The study included 30 consecutive patients with N1b stage of PTC. All the patients underwent neck dissection (ND) including level I. The relation between involvement of level I LNs and various clinicopathological variables was studied. Unilateral neck dissection was performed in 24 patients and bilateral neck dissection in six patients leading to 36 NDs. Level I was excised in all patients, with five specimens (14%) positive for metastasis. Levels II, III, IV, V, VI, and VII were positive in 52.8, 58.3, 58.3, 33.3, 63, and 22.2%, respectively. Level I involvement was significantly related to the number of lymph node levels affected (p = 0.003) and macroscopic extranodal invasion (p = 0.04). It was not related to the involvement of other individual levels, gender, age, size of the largest thyroid nodule, size of the largest LN involved, or histo-pathological variant of the tumor. This study suggests that including level I in therapeutic neck dissection for N1b PTC patients might be recommended in selected cases of multiple level involvement and macroscopic extranodal invasion requiring sacrifice of internal jugular vein, spinal accessory nerve, or sternomastoid muscle.

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Cartilage island on stapes: autologous PORP in the hypoventilated middle ear

Abstract

The most common technique in sound restoration of the middle ear is prosthetic surgery. Hypoventilation of the middle ear may cause adhesive otitis or atelectasis resulting in a higher risk of prosthetic extrusion rate and recurrence of the underlying cholesteatoma. We report long-term results using an island of tragal cartilage as an autologous PORP in selected patients with poor middle ear ventilation. Retrospective chart reviews were performed for procedures involving 52 patients between year 2000 and 2009. All patients that underwent surgery using tragal cartilage interposed between the suprastructure of the stapes and the tympanic membrane were included in this study. Audiological parameters using four frequencies, 0.5, 1, 2 and 3 kHz, according to AAO-HNS guidelines, were assessed pre-and postoperatively. The hearing results on different PTA frequencies were also investigated. We report long-term follow-up of patients with hypoventilated middle ear with a success rate of 71% (ABG <20%). With regards to the ABG, the low frequency component (5 and 1 kHz) showed a significantly (p < 0.05) larger improvement of mean values after surgery as compared to the high-frequency component (2 and 3 kHz). Cartilage island PORP on stapes is a stable and efficient method for selected patients with chronic middle ear disease.

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A New Genetic Diagnostic for Enlarged Vestibular Aqueduct Based on Next-Generation Sequencing

by Yalan Liu, Lili Wang, Yong Feng, Chufeng He, Deyuan Liu, Xinzhang Cai, Lu Jiang, Hongsheng Chen, Chang Liu, Hong Wu, Lingyun Mei

Enlarged vestibular aqueduct (EVA) is one of the most common congenital inner ear malformations and accounts for 1–12% of sensorineural deafness in children and adolescents. Multiple genetic defects contribute to EVA; therefore, early molecular diagnosis is critical for EVA patients to ensure that the most effective treatment strategies are employed. This study explored a new genetic diagnosis method for EVA and applied it to clinic diagnoses of EVA patients. Using next-generation sequencing technology, we set up a multiple polymerase chain reaction enrichment system for target regions of EVA pathogenic genes (SLC26A4, FOXI1, and KCNJ10). Forty-six EVA samples were sequenced by this system. Variants were detected in 87.0% (40/46) of cases, including three novel variants (SLC26A4 c.923_929del, c.1002-8C>G, and FOXI1 c.519C>A). Biallelic potential pathogenic variants were detected in 27/46 patient samples, leading to a purported diagnostic rate of 59%. All results were verified by Sanger sequencing. Our target region capture system was validated to amplify and measure SLC26A4, FOXI1, and KCNJ10 in one reaction system. The result supplemented the mutation spectrum of EVA. Thus, this strategy is an economic, rapid, accurate, and reliable method with many useful applications in the clinical diagnosis of EVA patients.

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Progressive Verhärtung der Haut mit derben Papeln

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Conservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature

Abstract

Aims

The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines.

Materials and Methods

A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010–2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added.

Results

Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases.

Conclusion

Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.

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Cloning, expression and purification of autolysin from methicillin-resistant Staphylococcus aureus: potency and challenge study in Balb/c mice

Publication date: February 2017
Source:Molecular Immunology, Volume 82
Author(s): Setareh Haghighat, Seyed Davar Siadat, Seyed Mehdi Rezayat Sorkhabadi, Abbas Akhavan Sepahi, Mehdi Mahdavi
Staphylococcus aureus (MRSA) is an opportunistic pathogen which causes a variety of clinical diseases and leads to high rates of morbidity and mortality. Development of an effective vaccine appears to be a useful strategy to control the infection.Here, the internal region of atl was cloned into the pET24a plasmid and expressed in E. coli BL21 (DE3). Cloning of atl was confirmed by colony-PCR, enzymatic digestion and sequencing. Protein expressed in E coli, BL21 DE3 and was confirmed with SDS-PAGE and western blot analysis. Subsequently, BALB/c mice were injected subcutaneously three times with 20μg of the recombinant autolysin. After Bleeding, autolysin-specific total IgG antibodies and isotypes were evaluated using ELISA. Opsonophagocytic killing assay was performed and experimental challenge was done by intraperitoneal injection with sub lethal doses of MRSA in mice and also survival rate was regularly monitored.Results showed that vaccinated mice could exhibit higher levels of autolysin-specific antibodies (P<0.0001) with a predominant IgG1 response versus control group. Results from in vitro experiments indicated that S. aureus opsonized with immunized-mice sera displayed significantly increased phagocytic uptake and effective intracellular killing versus non-immunized mice. The number of viable bacteria in the kidney of immunized mice showed 1000 times less than the control mice; additionally, an increased survival rate was found after immunization with the candidate vaccine versus control group.Results from this study demonstrated that the autolysin is a valuable target for the development of immunotherapeutic strategies against S. aureus and candidate vaccines.



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Disruption of Serinc1, which facilitates serine-derived lipid synthesis, fails to alter macrophage function, lymphocyte proliferation or autoimmune disease susceptibility

Publication date: February 2017
Source:Molecular Immunology, Volume 82
Author(s): Edward P.F. Chu, Colleen M. Elso, Abigail H. Pollock, May A. Alsayb, Leanne Mackin, Helen E. Thomas, Thomas W.H. Kay, Pablo A. Silveira, Ashley S. Mansell, Katharina Gaus, Thomas C. Brodnicki
During immune cell activation, serine-derived lipids such as phosphatidylserine and sphingolipids contribute to the formation of protein signaling complexes within the plasma membrane. Altering lipid composition in the cell membrane can subsequently affect immune cell function and the development of autoimmune disease. Serine incorporator 1 (SERINC1) is a putative carrier protein that facilitates synthesis of serine-derived lipids. To determine if SERINC1 has a role in immune cell function and the development of autoimmunity, we characterized a mouse strain in which a retroviral insertion abolishes expression of the Serinc1 transcript. Expression analyses indicated that the Serinc1 transcript is readily detectable and expressed at relatively high levels in wildtype macrophages and lymphocytes. The ablation of Serinc1 expression in these immune cells, however, did not significantly alter serine-derived lipid composition or affect macrophage function and lymphocyte proliferation. Analyses of Serinc1-deficient mice also indicated that systemic ablation of Serinc1 expression did not affect viability, fertility or autoimmune disease susceptibility. These results suggest that Serinc1 is dispensable for certain immune cell functions and does not contribute to previously reported links between lipid composition in immune cells and autoimmunity.



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Screening for Genital Herpes

Primum non nocere, the old maxim meant to guide physician conduct, translates as "first, do no harm." Physicians too often stop following the maxim, as translated, halfway through.

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Effectiveness of a Community-Based Physical Activity and Nutrition Behavior Intervention on Features of the Metabolic Syndrome: A Cluster-Randomized Controlled Trial

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.


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Ascending aortic dissection presented as inferior myocardial infarction: a clinical and diagnostic mimicry

Acute ST segment elevation myocardial infarction (STEMI) is typically associated with acute coronary thrombosis or plaque rupture. Rarely, STEMI can be associated with ascending aortic dissection, which represents the majority of acute aortic syndrome aetiologies and carries dreadful outcomes. Routine cardiac intervention with emergent cardiac catheterisation may lead to a higher mortality rate in this group of patients. We present a case of painless inferior STEMI in the setting of ascending aortic dissection. The patient had an inferior STEMI due to the involvement of the right coronary artery as an extension of the ascending aortic dissection. In this era of protocol-driven practice and the pressure to fulfil quality measures, we aim to alert emergency physicians, cardiologists and interventionalists of the possible presentation of painless ascending aortic dissection as an STEMI. The two pathologies characterise by crucial differences in their initial and ultimate management.

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Bilateral choroidal detachment with exudative retinal detachment in a patient with septicaemia

We present a case of bilateral choroidal and exudative retinal detachment with hypotony in a patient with septicaemia. Our patient after initial hospitalisation was treated by the local ophthalmologist as a case of sterile pan uveitis with systemic and topical steroids that did not have any effect. Our patient responded well to timely surgical intervention of choroidal drainage and vitrectomy with silicone oil tamponade followed by steroids and antibiotics. Cataract progression in both eyes occurred due to hypotony, inflammation, use of steroids and the vitreous surgery. It was successfully managed with timely surgical removal of cataract and intraocular lens implantation in both eyes facilitating early visual rehabilitation. Topical medications included frequent topical steroids and antibiotics as per our published protocols.

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Melanoderma: uncommon presentation of a common condition

A 64-year-old man presented with blackish pigmentation of skin and tongue for more than 2 years that did not improve with local remedies. He had no history of comorbid medical or surgical illnesses. General examination showed severe hyperpigmentation of skin and mucosa and also showed anaemia. Systemic examination was unremarkable except for Romberg sign and mild hyperreflexia. Adrenal insufficiency was ruled out by normal cortisol levels and haemogram showed macrocytosis with hypersegmented neutrophils suggestive of severe vitamin B12 deficiency which confirmed by low serum B12 levels. After 3 months of parenteral vitamin B12 treatment, the pigmentation and anaemia improved significantly. The mechanism of hyperpigmentation due to B12 deficiency is postulated to be increased melanin deposition in the basal layer of the epidermis. Since vitamin B12 deficiency is not uncommonly encountered in general practice, atypical presentation of this easily diagnosable and treatable condition is emphasised.

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Blue rubber bleb naevus syndrome: a rare cause of chronic occult blood loss and iron deficiency anaemia

Blue rubber bleb naevus syndrome (BRBNS) is a rare vascular disorder with malformed veins, or blebs, appearing in the skin or internal organs. Gastrointestinal tract involvement is the most common feature and often subject to bleeding, potentially resulting in chronic occult blood loss and iron deficiency anaemia. We present the case of a 10-year-old boy with venous malformations on the feet and severe anaemia. Although massive sudden haemorrhage rarely occurs, awareness of the illness is necessary to prevent complications.

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Tibialis anterior muscle hernia: rare but not uncommon

Muscular hernias in the lower limb are a rare entity that have seldom been described in the literature, to the extent that the seminal paper on the subject remains a case series from 1929. Here, we present a case of tibialis anterior muscle hernia and discuss the aetiology behind the same. Furthermore, we attempt to amalgamate existing knowledge to provide some guidance for investigation and management of this important diagnostic consideration.

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Patch of hair in the hyoid region

Description

An 8-year-old previously healthy girl, was referred to our clinic with a symptom of a tuft of terminal hair on the anterior neck region (figures 1 and 2). The underlying skin had no pigmentary changes. According to the parents, the localised hair had started to appear at 1 year of age and there was no history of preceding trauma, inflammation, radiation or use of topical and systemic drugs. Complete physical examination, including neurological and ophthalmological examination, did not reveal other comorbidities. Her parents were not consanguineous and the family history was negative for this disorder. Clinical features were consistent with the diagnosis of anterior cervical hypertrichosis (ACH) or hairy throat syndrome, which is a rare form of local hair growth at the midline of the neck.

Figure 1

A tuft of terminal hair on the anterior neck: anterior view.

...

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Uterine leiomyomatosis with intracardiac extension

Description

A 40-year-old woman under investigation for a pelvic mass presented following a syncopal episode. A large fibroid-like pelvic mass and venous thrombus, extending from the left gonadal vein into the inferior vena cava and right atrium, were noted on CT scan (figures 1 and 2). She was referred to the nearest Sarcoma Unit; single-stage excision was planned.

Figure 1

Thrombus extending up inferior vena cava into the right atrium (superior arrow) with large uterine mass (19.5x16.7x13.7 cm) (inferior arrow).

Figure 2

Thrombus extending up inferior vena cava into the right atrium.

At laparotomy, a 28-week uterus was found. Total abdominal hysterectomy with bilateral salpingo-oophrectomy was performed. The full length of the inferior vena cava and left renal vein were exposed while median sternotomy was undertaken. Following aorto-atrial cannulation, the patient was cooled to 18°C...

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Moving target: transient rotational stenosis precipitating jugular bow hunter's syndrome

A 60-year-old man presented with a 10-month history of of stereotypical spells characterized by vertigo, tinnitus, blurred vision, left hemibody numbness, and occasional syncope, precipitated by turning his head leftwards. Cerebral angiography and CT angiography of the head and neck with provocative maneuvers did not demonstrate vertebral artery narrowing. However, there was narrowing of the left internal jugular vein due to extrinsic compression from the sternocleidomastoid with leftward head rotation in the setting of hypoplasia of the right internal jugular vein. The patient underwent a cervical venogram which confirmed the finding. Manometric evaluation demonstrated a gradient of 29 mm Hg across the stenosis with the head turned leftwards compared with 1 mm Hg in the neutral position. The patient was treated with myectomies of the left sternocleidomastoid, posterior belly of the digastric, stylohyoid and omohyoid and styloid process removal. Following surgery, the patient reported complete resolution of symptoms. Repeat venography demonstrated resolution of the stenosis and pressure gradient.

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Role of immediate recurrent laryngeal nerve reconstruction in surgery for thyroid cancers with fixed vocal cords

Abstract

Background

Quality of voice after immediate recurrent laryngeal nerve (RLN) reconstruction in thyroid cancers has not been thoroughly studied.

Methods

Thirteen patients with fixed vocal cords (fixed vocal cord group) and 8 patients with intact or impaired mobile vocal cords (mobile vocal cord group) who had immediate RLN reconstruction simultaneously with total thyroidectomy, and patients who had arytenoid adduction and thyroplasty for vocal cord paralysis caused by previous surgery (arytenoid adduction thyroplasty group) were enrolled in this study.

Results

Preoperative phonation efficiency index was significantly lower (p = .008) in the fixed vocal cord group than in the mobile vocal cord group. One year after surgery, all voice parameters of the patients in the fixed vocal cord group had improved, compared with their preoperative data. The fixed vocal cord group had attained satisfactory voice qualities equivalent to those of the mobile vocal cord group in terms of various voice parameters.

Conclusion

The present results support the idea that immediate RLN reconstruction at the time of surgery for thyroid cancers may spare the need for subsequent arytenoid adduction thyroplasty even in the patients with preoperatively fixed vocal cords. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

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Use of pretreatment serum uric acid level to predict metastasis in locally advanced nasopharyngeal carcinoma

Abstract

Background

The purpose of this study was to determine the predictive value of pretreatment serum uric acid (SUA) for metastasis in locally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy.

Methods

This retrospective study examined 1063 patients with locally advanced NPC. Multivariate survival analysis was used.

Results

High pretreatment SUA level (>353.4 μmol/L) independently predicted distant metastasis-free survival (p = .013) and was associated with high white blood cell (p = .005), lymphocyte counts (p < .001), and male sex (p < 0.001). In addition, SUA levels were significantly elevated in patients with T1 to T3 classification (p = .042). For patients with subsequent lung metastases after treatment, markedly higher pretreatment SUA levels were detected compared with patients who had other distant metastases (p =.012) and patients without distant metastasis (p = .024).

Conclusion

Pretreatment SUA may be a useful biomarker for evaluating treatment options for patients with locally advanced NPC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

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Investigation of arguments against properly indicated extracapsular dissection in the parotid gland

Abstract

Background

The ideal extent of surgical intervention for benign parotid tumors remains a matter of controversy. The purpose of this study was to examine the existing arguments against extracapsular dissection and present our experience over the last 16 years.

Methods

A retrospective evaluation was carried out on the records of all patients who underwent extracapsular dissection for benign parotid tumors at a tertiary referral center between 2000 and 2015.

Results

A total of 1359 cases were included in the study. Temporary postoperative facial palsy was detected in 68 cases (5%), permanent facial palsy in 5 cases (0.37%), and postoperative Frey's syndrome in 31 cases (2.3%). Recurrences of pleomorphic adenomas were shown in 4 cases (0.87%).

Conclusion

Our analysis could not justify the arguments against correctly indicated implementation of extracapsular dissection and showed that increased performance of this modality was associated with excellent oncologic and functional outcomes. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

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Stereotactic body radiotherapy for recurrent head and neck cancer: A critical review

ABSTRACT

The management of patients with recurrent head and neck cancers remains a challenging clinical dilemma. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab. In the second portion of this review, we present our systematic review of published experiences with SBRT in recurrent head and neck cancers in an attempt to provide data on response rates (RR), overall survival and toxicity. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

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Fluorescence for Sentinel Lymph Node Identification in Cancer Surgery

Conditions:   Breast Carcinoma;   Head and Neck Cancer;   Melanoma (Skin);   Squamous Cell Carcinoma, Skin;   Cervix Cancer;   Endometrium Cancer;   Ovary Cancer;   Vulva Cancer;   Anus Cancer;   Rectum Cancer
Interventions:   Drug: Indocyanine green;   Drug: Technetium99;   Device: Optonuclear probe
Sponsor:   Institut de Cancérologie de Lorraine
Not yet recruiting - verified December 2016

http://ift.tt/2gY0KCo

Randomised Controlled Trial of Hemiarthroplasty Versus Total Hip Replacement for Intracapsular Hip Fractures

Condition:   Hip Fractures
Interventions:   Device: Hemiarthroplasty;   Device: Total hip arthroplasty
Sponsor:   Peterborough and Stamford Hospitals NHS Foundation Trust
Recruiting - verified December 2016

http://ift.tt/2hmW0Y4

Randomised Controlled Trial of Cemented Hemiarthroplasty Versus Uncemented Furlong Hemiarthroplasty

Condition:   Hip Fractures
Interventions:   Device: Uncemented Furlong Hemiarthroplasty;   Device: Cemented tapered stem hemiarthroplasty
Sponsor:   Peterborough and Stamford Hospitals NHS Foundation Trust
Recruiting - verified December 2016

http://ift.tt/2h89I4K

Study of Pembrolizumab in Locally Advanced Esophageal Adenocarcinoma

Condition:   Esophageal Adenocarcinoma
Interventions:   Drug: Pembrolizumab;   Drug: Taxol;   Drug: Carboplatin
Sponsor:   Weill Medical College of Cornell University
Not yet recruiting - verified December 2016

http://ift.tt/2hn6xCg

Journal of Antibiotics

TABLE OF CONTENTS Volume 69, Issue 12 (December 2016) In this issue Original Articles Meeting Report Corrigenda Indexes Also new  AOP   Sign up for e-alerts   Recommend to your library   Web feed    Subscribe ORIGINAL ARTICLES Top DNA sequence-selective C8-linked pyrrolobenzodiazepine–heterocyclic polyamide conjugates show anti-tubercular-specific activities Federico Brucoli, Juan D Guzman, Mohammad A Basher, Dimitrios Evangelopoulos, Eleanor McMahon, Tulika Munshi, Timothy D McHugh, Keith R Fox and Sanjib Bhakta J Antibiot 2016 69: 843-849; advance online publication, May 11, 2016; 10.1038/ja.2016.43 Abstract | Full Text Antibacterial activity of the novel semisynthetic lantibiotic NVB333 in vitro and in experimental infection models Steven Boakes, William J Weiss, Mary Vinson, Sjoerd Wadman and Michael J Dawson J Antibiot 2016 69: 850-857; advance online publication, May 18, 2016; 10.1038/ja.2016.47 Abstract | Full Text Kinetic characterization of GES-22 β-lactamase harboring the M169L clinical mutation Aysegul Saral, David A Leonard, Azer Ozad Duzgun, Aysegul Copur Cicek, Cynthia M June and Cemal Sandalli J Antibiot 2016 69: 858-862; advance online publication, May 11, 2016; 10.1038/ja.2016.48 Abstract | Full Text Quantitative measurement of the outer membrane permeability in Escherichia coli lpp and tol–pal mutants defines the significance of Tol–Pal function for maintaining drug resistance Hikaru Kowata, Saeko Tochigi, Tomonobu Kusano and Seiji Kojima J Antibiot 2016 69: 863-870; advance online publication, May 11, 2016; 10.1038/ja.2016.50 Abstract | Full Text Efficacy of ampicillin against methicillin-resistant Staphylococcus aureusrestored through synergy with branched poly(ethylenimine) Melissa A Foxley, Anthony W Friedline, Jessica M Jensen, Susan L Nimmo, Erin M Scull, Jarrod B King, Stoffel Strange, Min T Xiao, Benjamin E Smith, Kieth J Thomas III, Daniel T Glatzhofer, Robert H Cichewicz and Charles V Rice J Antibiot 2016 69: 871-878; advance online publication, May 18, 2016; 10.1038/ja.2016.44 Abstract | Full Text Preclinical development of Ramizol, an antibiotic belonging to a new class, for the treatment of Clostridium difficile colitis OPEN Shasha Rao, Clive A Prestidge, Lynn Miesel, Deb Sweeney, Dean L Shinabarger and Ramiz A Boulos J Antibiot 2016 69: 879-884; advance online publication, May 18, 2016; 10.1038/ja.2016.45 Abstract | Full Text MEETING REPORT Top Eighth Korea–Japan Chemical Biology symposium: chemical biology notes from a small island Tilman Schneider-Poetsch, Shunji Takahashi, Jae-Hyuk Jang, Jong Seog Ahn and Hiroyuki Osada J Antibiot 2016 69: 885-888; advance online publication, June 1, 2016; 10.1038/ja.2016.58 Full Text CORRIGENDA Top Corrigendum: Tripropeptins, novel antimicrobial agents produced by Lysobactersp. II. structure elucidation Hideki Hashizume, Sehei Hirosawa, Ryuichi Sawa, Yasuhiko Muraoka, Daishiro Ikeda, Hiroshi Naganawa and Masayuki Igarashi J Antibiot 2016 69: 889-891; 10.1038/ja.2016.104 Full Text Corrigendum: A new type of tripropeptin with anteiso-branched chain fatty acid from Lysobacter sp. BMK333-48F3 Hideki Hashizume, Masayuki Igarashi, Ryuichi Sawa, Hayamitsu Adachi, Yoshio Nishimura and Yuzuru Akamatsu J Antibiot 2016 69: 892-893; 10.1038/ja.2016.105 Full Text INDEXES Top Author Index for Volume 69 J Antibiot 2016 69: 894-897; 10.1038/ja.2016.118 Full Text Substance Index for Volume 69 J Antibiot 2016 69: 898-900; 10.1038/ja.2016.119 Full Text

Alexandros Sfakianakis
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