Purpose of review: The aim of this study was to describe the most recent technical nuances for resection and reconstruction of Grade 1 and 2 laryngeal chondrosarcomas, with a special emphasis on those located at the level of the cricoid plate, which is the site of origin of the vast majority of these rare tumours. Recent findings: Even though inherently based on retrospective small clinical series or anecdotal case reports, a number of studies have been recently published focusing on conservative transoral and open-neck surgical procedures aimed at an oncologically sound removal of the tumour together with organ and function preservation. The open-neck conservative approaches herein reported can be roughly distinguished in those achieving a primary airway reconstruction by a tracheo-hyoido-epiglottopexy or an end-to-end crico-tracheal, thyro-crico-tracheal or thyro-tracheal anastomosis, and those requiring a single or double-staged transposition of different microvascular flaps, with or without cartilaginous graft insertion, to reconstruct a subtotal/total cricoidectomy and obtain a rigid and stable subglottic airway. Summary: No meaningful comparison in terms of oncologic and functional outcomes is still possible among the currently available conservative surgical strategies, due to the rarity of laryngeal chondrosarcomas and the heterogeneity of treatments proposed in the literature. However, a reasonable algorithm to approach this difficult clinical entity according to its site of origin and extent of cricoid circumference involved is herein presented. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2iP0lqH
Πέμπτη 5 Ιανουαρίου 2017
Airway Management With a Stereotactic Headframe In Situ-A Mannequin Study.
Background: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. Materials and Methods: We conducted an observational study using a mannequin. A Leksell stereotactic headframe was placed on a mannequin in the operating room and the frame was fixed to the operating room table. Anesthesia personnel were asked to insert a #4 laryngeal mask and then to intubate the mannequin, using both direct (DL) and video laryngoscopy (VL). In addition, participants were asked to perform the same airway techniques in the mannequin without the headframe. Data were analyzed for time taken for airway management using different devices with and without the headframe. In addition, we compared the time taken to secure the airway between different participant groups. Results: Thirty anesthesia personnel (7 residents, 12 fellows, and 11 consultants) participated in the study. With the headframe in situ, 97% of participants were able to insert a laryngeal mask on their first attempt; 93% and 97% of participants were able to intubate the mannequin using DL and VL respectively on their first attempt. Without the stereotactic headframe, all participants were able to insert the laryngeal mask and intubate on the first attempt. The average time taken to insert a laryngeal mask and intubate the mannequin using DL and VL with the headframe in situ was 39.3, 58.6, and 54.8 seconds, respectively. Conclusions: Our study showed that both laryngeal mask insertion and tracheal intubation can be performed with a stereotactic headframe in situ. A laryngeal mask is the quickest airway device to insert and can be inserted while the mannequin is in the standard surgical position. Further study is needed to validate the results in patients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved
http://ift.tt/2jhLmX3
http://ift.tt/2jhLmX3
Hemodynamic monitoring in thoracic surgical patients.
http://ift.tt/2iik3rj
Audiometric findings with voluntary tensor tympani contraction
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
http://ift.tt/2hYSiWY
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial n...
http://ift.tt/2iWTngH
Seroprevalence of Cytomegalovirus Infection Among a Rural Population of Côte d'Ivoire
Viral Immunology Jan 2017, Vol. 30, No. 1: 54-57.
http://ift.tt/2iKtsJs
Temporal Effect of Bariatric Surgery on Predicted 10-Year and Lifetime Cardiovascular Risk at 1 Month, 6 Months, and 5 Years Following Surgery: A Pilot Study
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
http://ift.tt/2ja8EtJ
Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years
To explore the techniques for mandibular reconstruction with composite free flaps and their outcomes, we systematically reviewed reports published between 1990 and 2015. A total of 9499 mandibular defects were reconstructed with 6178 fibular, 1380 iliac crest, 1127 composite radial, 709 scapular, 63 serratus anterior and rib, 32 metatarsal, and 10 lateral arm flaps including humerus. The failure rate was higher for the iliac crest (6.2%, 66/1059) than for fibular, radial, and scapular flaps combined (3.4%, 202/6018) (p<0.001).
http://ift.tt/2iWCiTR
Occupational asthma caused by sensitization to a cleaning product containing triclosan
A recent consensus statement has highlighted the increased risk of developing asthma after exposure to workplace and domestic cleaning products.1 Specific cleaning agents, such as benzylalkonium chloride, have been recognized as causes of occupational asthma by sensitization and now comprise a significant burden of work-related asthma. European Respiratory Society guidelines recommend that sensitizer-induced occupational asthma should be diagnosed by identifying the workplace as the cause and confirming sensitization to an asthmagen by specific inhalation challenge (SIC) in the absence of any available specific IgE tests.
http://ift.tt/2iKpSiw
Frequency and severity of reactions to a 325-mg aspirin dose during desensitization
The frequency with which patients with aspirin-exacerbated respiratory disease (AERD) react to 325 mg of aspirin during aspirin desensitization, or fail to react at all, is not fully known.
http://ift.tt/2iOlMrW
Accuracy of mandibular measurements of sexual dimorphism using stabilizer equipment
Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.
http://ift.tt/2hWGmBS
Antimicrobial activity of ozone and NaF-chlorhexidine on early childhood caries
Abstract An early childhood carie (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the action of ozone (O3), and the association of sodium fluoride (NaF) with chlorhexidine (CHX) on bacteria related to ECC. Overnight culture of the bacteria was performed. On exponential phase the suspension was adjusted (101-108 CFU/mL). A drop (10μL) of each concentration of bacteria was applied on sheep blood agar plates and treated with O3 (2, 20, 200, and 2,000 ppm); after 18 hours, recovery analysis of CFU verified the reduction of bacterial activity. For NaF-CHX, sterile 96-well plates were prepared and divided into groups: G1 (150 µL TSB); G2 (20 µL of bacteria + 25 µL CHX + 25 µL NaF); and G3 (150 µL TSB + 20 µL of bacteria + 50 µL water). The plates were verified by analysis of the optical density (0, 12, 14, 16, and 18 hours). The data from O3 test were submitted to ANOVA and Tukey's test (p < 0.05). For the data from NaF-CHX, the ANOVA 2-way and Bonferroni's test (p < 0.05) were used. The number of CFU/mL showed death > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the combination of NaF-CHX was more effective (p < 0.001) compared to each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all bacteria tested; O3 seemed to be a good alternative for controlling progression of carious lesions, while the association of NaF-CHX showed to be a good antimicrobial with easy and inexpensive application.
http://ift.tt/2iHo3oe
Evaluation of dentin hypersensitivity treatment with glass ionomer cements: A randomized clinical trial
Abstract A randomized, double-blind, split-mouth clinical trial was performed compared the desensitizing efficacy of the resin-modified glass ionomer cement (GIC) ClinproTM XT (3M ESPE, Minnesota, USA) and the conventional GIC Vidrion R (SS White, Gloucester, UK) in a 6-month follow-up. Subjects were required to have at least two teeth with dentin hypersensitivity. Teeth were divided at random into 2 groups, one group received Clinpro XT and the other conventional GIC Vidrion R. Treatments were assessed by tactile and air blast tests using Visual Analogue Scale (VAS) at baseline, after 20 minutes, and at 7, 15, 21, 30, 90 and 180 days post-treatment. Twenty subjects (152 teeth) were included. Both tests (tactile and air blast) showed a significant reduction of dentin hypersensitivity immediately after the application of Vidrion R and Clinpro XT (20 min). VAS scores obtained along the 6-month follow-up were statistically lower when compared to initial rates (p < 0.05). Both GIC were able to reduce dentin hypersensitivity up to 6-month post-treatment period without statistically significant differences among them (p > 0.05). Both cements provided satisfactory results in long-term dental sensitivity reduction.
http://ift.tt/2hWJyNO
One-year aging effects on microtensile bond strengths of composite and repairs with different surface treatments
Abstract The present study aimed to evaluate effects of different surface treatments and aging of composite cylinders on bond strength of composite resin repair. Thirty-two composite cylinders were produced and divided into four groups according to type of surface treatment and storage time of composite cylinder and repair. Cylinder surface of control group (Gcontrol) received no treatment before composite repair. Other groups were sandblasted with aluminum oxide (GAl2O3), followed by silane (GAl2O3sil) or adhesive (GAl2O3ad). Composite cylinders were stored in artificial saliva for either 24 hours or 1 year. Repairs were performed and stored in artificial saliva for 24 hours or 1 year and repair strength was evaluated using microtensile bond strength test. Data were submitted to Student's t test, two-way ANOVA, and post hoc test for storage time and treatment (α = 0.05). Gcontrol group showed lower values of aging of composite cylinder and storage time of repair (24 hours or 1 year for both) compared with other groups (p < 0.05). GAl2O3ad and GAl2O3sil groups did not exhibit decreased microtensile bond strength with aged repairs (1 year; p > 0.05). Polymer degradation was significant for composite cylinders during the first year of storage in Gcontrol, GAl2O3, and GAl2O3ad groups (p < 0.05). In GAl2O3sil group, storage time of composite cylinders was not significant (p > 0.05). Aging of composite resin influenced bond strength of restoration repair for up to 1 year. Sandblasting with Al2O3, followed by application of silane layer, produced high bond strength after composite or repair aging.
http://ift.tt/2iHiExN
The efficacy of low-level 940 nm laser therapy with different energy intensities on bone healing
Abstract The aim of this study was to evaluate the efficacy of low-level 940 nm laser therapy with energy intensities of 5, 10 and 20 J/cm2 on bone healing in an animal model. A total of 48 female adult Wistar rats underwent surgery to create bone defects in the right tibias. Low-level laser therapy (LLLT) was applied immediately after surgery and on post-operative days 2, 4, 6, 8, 10 and 12 in three study groups with energy intensities of 5 J/cm2, 10 J/cm2 and 20 J/cm2 using a 940 nm Gallium-Aluminium-Arsenide (Ga-Al-As) laser, while one control group underwent only the tibia defect surgery. All animals were sacrificed 4 or 8 weeks post-surgery. Fibroblasts, osteoblasts, osteocytes, osteoclasts and newly formed vessels were evaluated by a histological examination. No significant change was observed in the number of osteocytes, osteoblasts, osteoclasts and newly formed vessels at either time period across all laser groups. Although LLLT with the 10 J/cm2 energy density increased fibroblast activity at the 4th week in comparison with the 5 and 20 J/cm2 groups, no significant change was observed between the laser groups and the control group. These results indicate that low-level 940 nm laser with different energy intensities may not have marked effects on the bone healing process in both phases of bone formation.
http://ift.tt/2hWJLRk
Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients
Abstract This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21–13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.
http://ift.tt/2iHo37I
A Case of an Extensive Keratocystic Odontogenic Tumor in the Mandible Reconstructed with a Custom-Made Total Joint Prosthesis
Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0036-1597585
The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has previously been reported to enhance the planning for the reconstruction of mandibular continuity defects and to reduce surgical time. Reported is a case of a large keratocystic odontogenic tumor (KOT) affecting right hemimandible including the condylar neck. This case was initially reconstructed with a condyle-bearing reconstruction plate, but because of fatigue fracture 15 years later, a new reconstruction with a custom-made total joint temporomandibular prosthesis was performed.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Bone Allograft Segment Covered with a Vascularized Fibular Periosteal Flap: A New Technique for Pediatric Mandibular Reconstruction
Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0036-1593992
The free vascularized fibular graft is nowadays the preferred technique for pediatric mandibular reconstruction. Despite the versatility and proven efficacy for restoring the facial appearance and maxillomandibular function, those mandibular reconstructions with free vascularized fibula associate difficulties for a simultaneous restoration of the alveolar height and facial contour, which are derived from the height discrepancy between the fibula and the native mandible. In addition, the donor-site growth and morbidity are of special concern in the pediatric patient. We report a novel technique for pediatric mandibular reconstruction, in an 11-year-old girl, using a combination of a bone allograft segment with a vascularized fibular periosteal flap (VFPF), after resection of an Ewing sarcoma located at the right body of the mandible. The patient has showed optimal cosmetic, functional, and radiological outcomes, which have been maintained for 2.5 years, without detecting donor-site complications. Through this original technique, and based on the powerful osteogenic and vasculogenic properties of the pediatric VFPFs, we could effectively reconstruct a large mandibular defect providing a functional and aesthetic reconstruction, while avoiding the potential morbidity associated with the fibula resection.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2iNXpuI
Audiometric findings with voluntary tensor tympani contraction
Abstract
Background
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
Methods
Five volunteers possessing the ability to voluntarily contract their tensor tympani muscles were identified and enrolled. Tensor tympani contraction was confirmed with characteristic tympanometry findings. Study subjects underwent conventional audiometry. Air conduction and bone conduction threshold testing was performed with and without voluntary tensor tympani contraction.
Main outcome measure
Changes in air conduction and bone conduction thresholds during voluntary tensor tympani contraction.
Results
Audiometric results demonstrate a low frequency mixed hearing loss resulting from tensor tympani contraction. Specifically, at 250 Hz, air conduction thresholds increased by 22 dB and bone conduction thresholds increased by 10 dB.
Conclusions
Previous research has demonstrated a low frequency conductive hearing loss in the setting of tensor tympanic contraction. This is the first study to demonstrate a low frequency mixed hearing loss associated with tensor tympani contraction. This finding may aid in the diagnosis of disorders resulting from abnormal tensor tympani function. Tensor tympani contraction should be included on the differential for low frequency mixed hearing loss.
http://ift.tt/2j9EruL
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Abstract
Background
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause of facial nerve palsy.
Case presentation
The patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy.
An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After discussing options with the patient, the main stem of the facial nerve was resected to ascertain the diagnosis of MAC-like squamous cell carcinoma, and radiochemotherapy was subsequently started.
Conclusion
This case report shows that even rare neoplastic etiologies should be considered as a cause of refractory facial nerve palsy and that it is necessary to perform an extended diagnostic work-up to ascertain the diagnosis. This includes high-resolution MRI imaging and, as perilesional parotid biopsies might be inadequate for rare cases like ours, consideration of a direct nerve biopsy to establish the right diagnosis.
http://ift.tt/2hWgUBD
Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J.S. Brown, D. Lowe, A. Kanatas, A. Schache
To explore the techniques for mandibular reconstruction with composite free flaps and their outcomes, we systematically reviewed reports published between 1990 and 2015. A total of 9499 mandibular defects were reconstructed with 6178 fibular, 1380 iliac crest, 1127 composite radial, 709 scapular, 63 serratus anterior and rib, 32 metatarsal, and 10 lateral arm flaps including humerus. The failure rate was higher for the iliac crest (6.2%, 66/1059) than for fibular, radial, and scapular flaps combined (3.4%, 202/6018) (p<0.001). We evaluated rates of osteotomy, non-union, and fistulas. Implant-retained prostheses were used most often for rehabilitation after reconstruction with iliac crest (44%, 100/229 compared with 26%, 605/2295 if another flap was used) (p<0.001). There were no apparent changes in the choice of flap or in the complications reported. Although we were able to show some significant differences relating to the types of flap used, we were disappointed to find that fundamental outcomes such as the need for osteotomy, and rates of non-union and fistulas were under-reported. This review shows the need for more comprehensive and consistent reporting of outcomes to enable the comparison of different techniques for similar defects.
http://ift.tt/2hWgQSm
Nichtvirale sexuell übertragene Infektionen – Epidemiologie, Klinik, Labordiagnostik und Therapie
Zusammenfassung
Seit 2010 steigen die Syphilis-Meldezahlen in Deutschland kontinuierlich an, um im Jahr 2015 mit 6834 Syphilis-Meldungen einen Höchstwert zu erreichen. Der größte Zuwachs an Meldungen betraf Männer, die Sex mit Männern haben. Antibiotikum der Wahl zur Behandlung der Syphilis ist nach wie vor Penicillin. Es gibt praktisch keine Penicillin-resistenten Treponema-pallidum-Stämme. Alternativen sind Ceftriaxon und Doxycyclin. Azithromycin ist in Deutschland zur Behandlung der Syphilis nicht zugelassen, zudem wurde über Therapieversagen berichtet. Die bakterielle Vaginose geht mit Fluor vaginalis einher. Das Vaginalsekret weist einen erhöhten pH-Wert von über 4,5 auf. Klinische Symptome sind Juckreiz, Brennen und der charakteristische Amin-Geruch. Die Wahrscheinlichkeit für eine bakterielle Vaginose ist am höchsten bei einer höheren Zahl von Sexualpartnern, bei unverheirateten Frauen, frühem erstem Geschlechtsverkehr, bei kommerziellen Sex-Arbeiterinnen und bei regelmäßiger Anwendung von Vaginalduschen. Leitkeim der bakteriellen Vaginose ist Gardnerella vaginalis. Die Therapie erfolgt mit Metronidazol, alternativ mit Clindamycin, das zusätzlich auch topisch verabreicht werden sollte. Die Trichomoniasis gilt als die nichtvirale sexuell übertragene Infektion mit der weltweit höchsten Prävalenz. Neben dem mikroskopischen Direktnachweis der Protozoen (Trophozoiten) im Vaginalsekret oder Urin hat sich die Polymerasekettenreaktion als diagnostische Methode mit der höchsten Empfindlichkeit erwiesen. Metronidazol ist Mittel der Wahl in der Behandlung.
http://ift.tt/2iNh51z
Versorgung des Melanoms in der Schwangerschaft
Zusammenfassung
Pro Jahr sieht jedes große Zentrum etwa 1 Fall mit einer schwangeren Patientin mit Erstdiagnose eines Melanoms. Diese seltene klinische Herausforderung gilt es zu meistern. Auf der Basis der Literatur ist evident, dass die primär chirurgische Therapie des Melanoms in der Schwangerschaft mit entsprechenden Anpassungen in gleichem Umfang erfolgen kann und soll, wie bei Nichtschwangeren. Anpassungen betreffen die Terminierung, Narkoseführung, Medikamente und die bildgebenden Untersuchungen. Für die adjuvante Interferontherapie und die Systemtherapie im seltenen Fall einer metastasierten Situation bestehen bei bisher nur 30 solchen Fällen in der Weltliteratur nur wenig klinische Erfahrungen, sodass auf der Basis der präklinischen Daten nur Hinweise für eine individuelle Entscheidungsfindung gegeben werden können.
http://ift.tt/2hW9kSG
Maspin inhibits macrophage phagocytosis and enhances inflammatory cytokine production via activation of NF-κB signaling
Publication date: February 2017
Source:Molecular Immunology, Volume 82
Author(s): Yimeng Wang, Luguo Sun, Zhenbo Song, Danfeng Wang, Yongli Bao, Yuxin Li
Maspin (mammary serine protease inhibitor) is a non-inhibitory member of the serine protease inhibitor superfamily and a tumor suppressor in several cancers due to its ability to inhibit cell invasion, angiogenesis, and promote apoptosis. However, its immunomodulatory function remains largely unexplored. Thus, we explored the potential link between Maspin and macrophage function, first evaluating the regulatory effects of conditioned medium (CM) of a Maspin-overexpressing CHO cell strain on mouse peritoneal macrophage phagocytosis and cytokine secretion. Next, we used a transwell co-culture system and recombinant Maspin (rMaspin) to confirm the effects of Maspin on macrophages, and attempted to clarify the underlying mechanisms. We found that irrespective of CM, rMaspin or co-culture of Maspin-overexpressing cells with macrophages impaired macrophages phagocytosing Saccharomyces cerevisiae. Furthermore, q-RT-PCR or ELISA confirmed increased IL-1β, TNF-α, IFN-γ, IL-6, IL-12, IL-10, and M1 marker iNOS production in macrophages after Maspin stimulation, but TGF-β and M2 marker Arg-1 production were suppressed. Western blot showed activated NF-κB signaling in Maspin-stimulated macrophages; upregulated cytokines were lowered, and impaired phagocytosis recovered after blocking NF-κB signaling with PDTC. Thus, Maspin mildly inhibited phagocytic activity, but markedly enhanced inflammatory cytokine production and likely skewed macrophages towards M1 polarization, partially due to activation of NF-κB signaling. These results reveal a novel biological function of Maspin in modulating macrophage activity and may open a new avenue for Maspin-based tumor therapy.
Graphical abstract
http://ift.tt/2ignBKF
Immunization with Leishmania donovani protein disulfide isomerase DNA construct induces Th1 and Th17 dependent immune response and protection against experimental visceral leishmaniasis in Balb/c mice
Publication date: February 2017
Source:Molecular Immunology, Volume 82
Author(s): Ajay Amit, Vijayamahantesh, Manas R. Dikhit, Ashish Kumar Singh, Vikash Kumar, Shashi S. Suman, Ashu Singh, Akhilesh Kumar, Ajit Kumar Thakur, Vidyanand Ravi Das, Pradeep Das, Sanjiva Bimal
In the present study, the efficacy of Leishmania donovani protein disulfide isomerase (LdPDI) as a DNA vaccine was evaluated in BALB/C mice. Mice immunized with the LdPDI-DNA construct were found to be the most immuno-reactive, as the construct induced higher T-cell proliferation. The increased T-cell proliferation was associated with a substantial rise in Th1 and Th17+ CD4 cell response and triggered a higher proportion of CD8+ T cells for the release of interferon-gamma along with a reduced splenic parasite load on Days20 and 60 post challenge (PC). Furthermore, the vaccine construct triggered increased interferon (IFN)-γ, interleukin(IL)-17A, and IL-22 release accompanied by decreased extracellular signal-regulated kinases (ERK) 1/2 signaling and increased mitogen-activated protein kinase (MAPK) signaling coinciding with an increase in the amount of nitrite and reactive oxygen species (ROS)in vaccinating the splenocyts. We summarize from our data that the PDI-DNA construct of Leishmania donovani has the potential to elicit protective immunity through the pro-inflammatory cytokines of CD8+ and CD4+(Th1 and Th17) following an intervention in the downstream signaling event of ERK1/2 (probably through p38MAPK signaling). Therefore, the study suggests a new control against visceral leishmaniasis in the future.
Graphical abstract
http://ift.tt/2ignlvj
Kimura Disease: A Rare Case Report From Himalayan Region
Abstract
Kimura's disease is a rare disorder of uncertain aetiology seen in Asian population, and presents as painless lymphadenopathy or subcutaneous masses in head-neck region. Peripheral eosinophilia, elevated levels of serum IgE, lymphoid proliferation and eosinophilic infiltration are its characteristic pathological features. We report a case of 40 year old male patient who presented with swelling behind right ear after successful ear surgery. The diagnosis was confirmed by histopathology and was treated by oral steroids.
http://ift.tt/2hXhzRv
Kimura Disease: A Rare Case Report From Himalayan Region
Abstract
Kimura's disease is a rare disorder of uncertain aetiology seen in Asian population, and presents as painless lymphadenopathy or subcutaneous masses in head-neck region. Peripheral eosinophilia, elevated levels of serum IgE, lymphoid proliferation and eosinophilic infiltration are its characteristic pathological features. We report a case of 40 year old male patient who presented with swelling behind right ear after successful ear surgery. The diagnosis was confirmed by histopathology and was treated by oral steroids.
http://ift.tt/2hXhzRv
Travelling Wave Pulse Coupled Oscillator (TWPCO) Using a Self-Organizing Scheme for Energy-Efficient Wireless Sensor Networks
by Zeyad Ghaleb Al-Mekhlafi, Zurina Mohd Hanapi, Mohamed Othman, Zuriati Ahmad Zukarnain
Recently, Pulse Coupled Oscillator (PCO)-based travelling waves have attracted substantial attention by researchers in wireless sensor network (WSN) synchronization. Because WSNs are generally artificial occurrences that mimic natural phenomena, the PCO utilizes firefly synchronization of attracting mating partners for modelling the WSN. However, given that sensor nodes are unable to receive messages while transmitting data packets (due to deafness), the PCO model may not be efficient for sensor network modelling. To overcome this limitation, this paper proposed a new scheme called the Travelling Wave Pulse Coupled Oscillator (TWPCO). For this, the study used a self-organizing scheme for energy-efficient WSNs that adopted travelling wave biologically inspired network systems based on phase locking of the PCO model to counteract deafness. From the simulation, it was found that the proposed TWPCO scheme attained a steady state after a number of cycles. It also showed superior performance compared to other mechanisms, with a reduction in the total energy consumption of 25%. The results showed that the performance improved by 13% in terms of data gathering. Based on the results, the proposed scheme avoids the deafness that occurs in the transmit state in WSNs and increases the data collection throughout the transmission states in WSNs.http://ift.tt/2hWWRkG
Scabiose de l’appareil unguéal chez un nourrisson
Source:Annales de Dermatologie et de Vénéréologie
Author(s): A. Finon, G. Desoubeaux, M. Nadal, G. Georgescou, R. Baran, A. Maruani
IntroductionLa prise en charge de la gale du nourrisson n'est pas codifiée et les récidives sont fréquentes à cet âge. Nous rapportons un cas exceptionnel d'atteinte sous-unguéale et d'onychopathie des pieds, séquellaires d'une gale commune chez un nourrisson.ObservationUn nourrisson de 7 mois, traité par esdépalléthrine pour une gale 6 semaines auparavant, était vu en consultation pour des modifications unguéales acquises des orteils. Il existait un épaississement unguéal de trois orteils avec hyperkératose sous-unguéale. Le reste de l'examen cutanéo-muqueux et des phanères était normal. L'analyse mycologique de prélèvements d'ongles était négative, mais l'examen direct en microscopie optique trouvait de nombreuses larves de Sarcoptes scabiei, ainsi que des débris d'œufs. Le traitement consistait en une avulsion chimique des ongles atteints (urée à 40 %) associée à des applications d'esdépalléthrine topique et à une prise orale d'ivermectine ; l'enfant a été perdu de vue.DiscussionL'atteinte unguéale a été rapportée dans la gale hyperkératosique et exceptionnellement dans la gale commune de l'adulte. La localisation sous-unguéale et unguéale de S. scabiei pourrait constituer une source de réinfestation de la gale chez les nourrissons. Son traitement reste à définir mais reposerait sur une avulsion chimique de l'ongle et l'application prolongée d'antiscabieux topiques sur le lit unguéal.BackgroundThere are no guidelines regarding the management of scabies in infants and recurrence is common at this age. We report the case of an infant with subungual hyperkeratosis and ungual lesions subsequent to classic scabies.Patients and methodsA 7-month-girl, treated 6 weeks earlier with esdepallethrin for scabies, consulted for acquired lesions on 3 toe nails. These nails were thickened and displayed subungual hyperkeratosis. Physical examination of the skin, the finger nails and mucous membranes was otherwise normal. Fungal analyses were negative, but direct microscopic examination revealed numerous larvae of Sarcoptes scabiei as well as ovular debris. The child was treated with urea 40% to obtain chemical avulsion of the nails, and with topical esdepallethrin and a quarter tablet of ivermectin orally; there was no follow-up of the child.DiscussionUngual scabies has already been reported in crusted scabies and very rarely in classic scabies. Subungual and ungual locations of S. scabiei may constitute a source of reinfestation with scabies in infants. Treatment is not well defined and currently involves chemical avulsion of the nails and the application of topical antiscabies treatment.
http://ift.tt/2jeWBiQ
Risques infectieux similaires entre anti-TNFα et thérapies systémiques classiques dans le psoriasis
Source:Annales de Dermatologie et de Vénéréologie
Author(s): J.-L. Schmutz
http://ift.tt/2ifB0Tl
Middle Ear Mass Causing Vertigo and Facial Nerve Weakness
A woman had vertigo, profound mixed hearing loss, a mass obstructing the external auditory canal, and facial nerve weakness; computed tomography revealed a soft-tissue mass emanating from the middle ear involving the facial canal with surrounding bony erosion. What is your diagnosis?
http://ift.tt/2iUhBIi
http://ift.tt/2iUhBIi
Entry-Level 3-Dimensional Printing of Maxillofacial Skeletal Models
This case series compares cost and anatomical model fidelity and clinical versatility of in-house 3-dimensional production modeling vs high-end, third-party-vendor modeling for pediatric mandibular reconstruction.
http://ift.tt/2hVk4Wb
http://ift.tt/2hVk4Wb
Otolaryngology Consultation Trends at an Academic Quaternary Care Center
This study examines trends in otolaryngology–head and neck surgery consultations conducted in emergency departments and inpatient services.
http://ift.tt/2iUnDsH
http://ift.tt/2iUnDsH
The Changing Cochlear Implant Center
This Viewpoint summarizes the origins, challenges, and future of the cochlear implant center.
http://ift.tt/2hVwgWO
http://ift.tt/2hVwgWO
Subcutaneous Methotrexate Safe, Effective for Psoriasis
Subcutaneous methotrexate with an intensified 52-week dosing schedule should be considered for patients with psoriasis because of its favorable risk-benefit profile.
Medscape Medical News
http://ift.tt/2iplirX
A Model of Electrically Stimulated Auditory Nerve Fiber Responses with Peripheral and Central Sites of Spike Generation
Abstract
A computational model of cat auditory nerve fiber (ANF) responses to electrical stimulation is presented. The model assumes that (1) there exist at least two sites of spike generation along the ANF and (2) both an anodic (positive) and a cathodic (negative) charge in isolation can evoke a spike. A single ANF is modeled as a network of two exponential integrate-and-fire point-neuron models, referred to as peripheral and central axons of the ANF. The peripheral axon is excited by the cathodic charge, inhibited by the anodic charge, and exhibits longer spike latencies than the central axon; the central axon is excited by the anodic charge, inhibited by the cathodic charge, and exhibits shorter spike latencies than the peripheral axon. The model also includes subthreshold and suprathreshold adaptive feedback loops which continuously modify the membrane potential and can account for effects of facilitation, accommodation, refractoriness, and spike-rate adaptation in ANF. Although the model is parameterized using data for either single or paired pulse stimulation with monophasic rectangular pulses, it correctly predicts effects of various stimulus pulse shapes, stimulation pulse rates, and level on the neural response statistics. The model may serve as a framework to explore the effects of different stimulus parameters on psychophysical performance measured in cochlear implant listeners.
http://ift.tt/2iFPMUm
Expression of Dlx-5 and Msx-1 in craniofacial skeletons and ilia of rats treated with zoledronate
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Bin Xuan, Pan Yang, Shichao Wu, Lin Li, Jian Zhang, Wenyi Zhang
PurposeDue to the different embryological origins of the craniofacial skeleton and ilium, differences in gene expression patterns have been observed between the jaw bones and ilium. Distal-less homeobox genes and Msh homeobox genes, particularly Dlx-5 and Msx-1, play major roles in cell differentiation and osteogenesis. The purpose of this study was to investigate the effects of zoledronate on the craniofacial skeleton and ilium by detecting changes in Dlx-5 and Msx-1 expression at both the protein and mRNA levels.Materials and methodsA total of 24 female Sprague-Dawley rats were randomly divided into two groups: a zoledronate group (n=12), in which the rats were injected intraperitoneally with zoledronic acid for 12 weeks; and a control group (n=12), in which the rats were injected with saline solution for 12 weeks. Using immunohistochemistry, Western blotting and reverse transcription-polymerase chain reaction (RT-PCR), the expression levels of Dlx-5 and Msx-1 in the craniofacial skeleton (including the maxilla, mandible and parietal bone) and ilium were examined.ResultsDlx-5 expression in the maxilla and mandible was increased at the protein and mRNA levels in the ZOL group compared with the control group (P<0.01). In addition, Msx-1 expression in the maxilla and mandible was decreased in the ZOL group (P<0.01). Further, Dlx-5 and Msx-1 expression in the ilium was decreased in the ZOL group (P<0.05). However, no significant difference in Dlx-5 or Msx-1 expression in the parietal bone was observed between the two groups (P>0.05).ConclusionsSite-specific differences in the effects of zoledronate on the craniofacial skeleton and ilium could be explained by differently altered tendencies in Msx-1 and Dlx-5 expression. The jaw bones were more susceptible to the effects of zoledronate than the parietal bone and ilium.
http://ift.tt/2hVkoiH
Sinonasal Hemangioma: Diagnosis, Treatment and Follow up of 37 Patients at a Single Center
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jong Seung Kim, Sam Hyun Kwon
Background and ObjectivesHemangioma is a common benign vascular lesion of the head and neck region. It rarely involves the mucous membranes of nasal cavity and paranasal sinuses. It should be added to the differential diagnosis of nasal cavity masses when the presenting symptoms are epistaxis or nasal obstruction.Materials and MethodsWe performed a retrospective chart review with a histologic diagnosis of lobular capillary hemangioma or cavernous hemangioma of the sinonasal mucous membranes treated at the Chonbuk National University Hospital between January 1995 and December 2015. There were a total of 1479 patients diagnosed with hemangiomas in the total body area. The medical records were reviewed to gather data on clinical symptoms, demographic characteristics, site of tumor, imaging and histologic features, and treatment. We also performed a review of the literature on previously diagnosed cases of sinonasal hemangioma.ResultsThree hundred patients had hemangiomas in the head and neck region and only 37 patients (12.5%) had hemangiomas of the sinonasal mucous membranes. The most common complaint was nasal obstruction (59.5%), followed by epistaxis (51.4%). There were 18 males (48.6%) and 19 females (51.4%). The predominant subsites were the nasal septum, (40.5%) followed by inferior turbinate (29.7%), maxillary sinus (8.1%), and uncinate process (8.1%). Lobular capillary hemangioma (24/ 37) was more common than cavernous hemangioma (13/37). There was a significant correlation between the histologic type and tumor site of the hemangioma.ConclusionSinonasal hemangiomas are relatively uncommon. Clinicians should be aware of the clinical, radiological and histological features of sinonasal hemangiomas to avoid misdiagnosis as a malignant tumor, angiofibroma or other benign masses.
http://ift.tt/2iFGIkn
Interventions for the management of Oral lichen planus: A review of the conventional and novel therapies
Abstract
Objective
This narrative review focuses on the rationale & role of conventional and newer therapies in the management of Oral lichen planus with emphasis on randomized controlled trials reported over 2 decades.
Materials and methods
Literature search was conducted to identify randomized controlled trials for management of OLP from 1/1/1995 to 31/12/2015; Medline, and Cochrane databases complemented with manual search was used. Primary outcome as resolution of pain was evaluated with analysis of clinical resolution of erythema and ulceration as secondary outcome.
Results
The search provided 260 abstracts, of which 70 full text articles were included. Majority of trials used topical steroids with very few trials on newer therapies. It was found that topical steroids are effective for symptomatic management of OLP with equal efficacy shown by topical calcineurin inhibitors and retinoids. However, the side effect of transient burning sensation with relapse was more with calcineurin inhibitors.
Conclusion
Although the newer therapies offer advantage over steroids for management of OLP in recalcitrant cases, extensive lesions and cases unresponsive to steroids, but sufficient clinical data on their use is still lacking. Hence, more RCTs with large sample size, adequate treatment duration and long term follow up is required for clinical utility.
This article is protected by copyright. All rights reserved.
http://ift.tt/2iUadg2
Inhibitory effects of Lactobacillus rhamnosus and Lactobacillus casei on Candida biofilm of denture surface
Source:Archives of Oral Biology, Volume 76
Author(s): Young-Gyun Song, Sung-Hoon Lee
ObjectiveCandida albicans biofilm is associated with denture-related stomatitis and oral candidiasis of elderly. Probiotics are beneficial bacteria and have antibacterial activity against pathogenic bacteria. The purpose of this study was to investigate the antifungal activity of various probiotics against C. albicans and the inhibitory effects of probiotics on Candida biofilm on the denture surface.DesignThe spent culture media of various probiotics were investigated the antifungal efficacy against C. albicans. Candida biofilm was formed on a denture base resin and was then treated with Lactobacillus rhamnosus and Lactobacillus casei. Also, the biofilms of L. rhamnosus and L. casei were formed and were sequentially treated with C. albicans. Colony-forming units of C. albicans on the denture surface were counted after spreading on agar plate. The denture base resin was treated with the spent culture media for 30days, after which the denture surface roughness was analyzed with an atomic force microscope.ResultsL. rhamnosus and L. casei exhibited stronger antifungal activity than other probiotics. The spent culture medium of L. rhamnosus and L. casei exhibited the antifungal activity against blastoconidia and biofilm of C. albicans. L. rhamnosus and L. casei showed the antifungal activity against Candida biofilm, and the biofilm of L. rhamnosus and L. casei inhibited formation of Candida biofilm on denture surface. Neither of the probiotics affected the surface roughness of the denture base resin.ConclusionsL. rhamnosus and L. casei may be the ideal probiotics for the prevention and treatment of denture-related stomatitis.
http://ift.tt/2hV7E0z
Expression of MMP-2 and TIMP-1 during Rapid Maxillary Expansion in Rats
Source:Archives of Oral Biology
Author(s): Jianwei Chen, Jing Zhou, Fan Li, Jianfeng Sun, Guifeng Li, Shujuan Zou, Qingsong Ye
ObjectiveThe aim of this study was to investigate the expression of MMP-2 and TIMP-1 during midpalatal suture expansion in rats.Design72 male Wistar rats were randomly divided into 2 groups: the experimental group and the control group. In the experimental group, opening loops were applied across the midpalatal suture with an initial force of 50g, whereas in the control group, rats were subjected to sham installation of opening loops without activation. On day 1, 4, 7 and 14, nine rats from each group were sacrificed, and the maxillae were dissected and prepared for Immunohistochemistry (IHC) and RT- PCR examination of MMP-2 and TIMP-1 expression.ResultsThe results of IHC and Real Time PCR revealed that both protein and mRNA expression of MMP-2 and TIMP-1 were significantly increased after midpalatal expansion, and the ratio of MMP-2/TIMP-1 was also significantly enhanced.ConclusionsThe data suggested that MMP-2 and TIMP-1 might play an important role during the mid-palatal suture remodeling process of maxillary expansion.
http://ift.tt/2iU4WoJ
Time Dependent Deformation Behavior of Dentin
Source:Archives of Oral Biology
Author(s): C. Montoya, D. Arola, E.A. Ossa
ObjectiveThe viscoelastic behavior of dentin and its ability to undergo time dependent deformation are considered to be important to oral functions and its capacity to resist fracture. There are spatial variations in the microstructure of dentin within the crown, which could be important to the viscous behavior. However, a spatially resolved description for the viscoelastic behavior of coronal dentin has not been reported.MethodsIn this investigation spherical indentations were made in three regions of coronal dentin including the outer, middle and inner regions. Power law relations were developed to quantitatively describe the stress-strain responses of the tissue.ResultsResults showed that the deformation behavior was strongly dependent on the composition (mineral to collagen ratio) and microstructure (tubule density), which contributed to an increase in the rate of viscous deformation with increasing proximity to the pulp.ConclusionsA model accounting for spatial variations in composition and microstructure was developed to describe the steady-state time dependent deformation behavior of coronal dentin, and a good agreement was found with the experimental results.
http://ift.tt/2hVdX3Z
Inhibitory effects of Lactobacillus rhamnosus and Lactobacillus casei on Candida biofilm of denture surface
Source:Archives of Oral Biology, Volume 76
Author(s): Young-Gyun Song, Sung-Hoon Lee
ObjectiveCandida albicans biofilm is associated with denture-related stomatitis and oral candidiasis of elderly. Probiotics are beneficial bacteria and have antibacterial activity against pathogenic bacteria. The purpose of this study was to investigate the antifungal activity of various probiotics against C. albicans and the inhibitory effects of probiotics on Candida biofilm on the denture surface.DesignThe spent culture media of various probiotics were investigated the antifungal efficacy against C. albicans. Candida biofilm was formed on a denture base resin and was then treated with Lactobacillus rhamnosus and Lactobacillus casei. Also, the biofilms of L. rhamnosus and L. casei were formed and were sequentially treated with C. albicans. Colony-forming units of C. albicans on the denture surface were counted after spreading on agar plate. The denture base resin was treated with the spent culture media for 30days, after which the denture surface roughness was analyzed with an atomic force microscope.ResultsL. rhamnosus and L. casei exhibited stronger antifungal activity than other probiotics. The spent culture medium of L. rhamnosus and L. casei exhibited the antifungal activity against blastoconidia and biofilm of C. albicans. L. rhamnosus and L. casei showed the antifungal activity against Candida biofilm, and the biofilm of L. rhamnosus and L. casei inhibited formation of Candida biofilm on denture surface. Neither of the probiotics affected the surface roughness of the denture base resin.ConclusionsL. rhamnosus and L. casei may be the ideal probiotics for the prevention and treatment of denture-related stomatitis.
http://ift.tt/2hV7E0z
Expression of MMP-2 and TIMP-1 during Rapid Maxillary Expansion in Rats
Source:Archives of Oral Biology
Author(s): Jianwei Chen, Jing Zhou, Fan Li, Jianfeng Sun, Guifeng Li, Shujuan Zou, Qingsong Ye
ObjectiveThe aim of this study was to investigate the expression of MMP-2 and TIMP-1 during midpalatal suture expansion in rats.Design72 male Wistar rats were randomly divided into 2 groups: the experimental group and the control group. In the experimental group, opening loops were applied across the midpalatal suture with an initial force of 50g, whereas in the control group, rats were subjected to sham installation of opening loops without activation. On day 1, 4, 7 and 14, nine rats from each group were sacrificed, and the maxillae were dissected and prepared for Immunohistochemistry (IHC) and RT- PCR examination of MMP-2 and TIMP-1 expression.ResultsThe results of IHC and Real Time PCR revealed that both protein and mRNA expression of MMP-2 and TIMP-1 were significantly increased after midpalatal expansion, and the ratio of MMP-2/TIMP-1 was also significantly enhanced.ConclusionsThe data suggested that MMP-2 and TIMP-1 might play an important role during the mid-palatal suture remodeling process of maxillary expansion.
http://ift.tt/2iU4WoJ
Time Dependent Deformation Behavior of Dentin
Source:Archives of Oral Biology
Author(s): C. Montoya, D. Arola, E.A. Ossa
ObjectiveThe viscoelastic behavior of dentin and its ability to undergo time dependent deformation are considered to be important to oral functions and its capacity to resist fracture. There are spatial variations in the microstructure of dentin within the crown, which could be important to the viscous behavior. However, a spatially resolved description for the viscoelastic behavior of coronal dentin has not been reported.MethodsIn this investigation spherical indentations were made in three regions of coronal dentin including the outer, middle and inner regions. Power law relations were developed to quantitatively describe the stress-strain responses of the tissue.ResultsResults showed that the deformation behavior was strongly dependent on the composition (mineral to collagen ratio) and microstructure (tubule density), which contributed to an increase in the rate of viscous deformation with increasing proximity to the pulp.ConclusionsA model accounting for spatial variations in composition and microstructure was developed to describe the steady-state time dependent deformation behavior of coronal dentin, and a good agreement was found with the experimental results.
http://ift.tt/2hVdX3Z
Adenotonsillectomy outcomes in patients with Down syndrome and obstructive sleep apnea
Objective
To review the literature for studies examining polysomnography (PSG) outcomes in patients with Down syndrome (DS) and obstructive sleep apnea (OSA) following adenotonsillectomy (T&A), and to review our experience with these patients.
Data Sources
PubMed-NCBI, Scopus, Ovid, EBSCO, Cochrane, and EMBASE databases; tertiary academic center medical records.
Review Methods
A systematic review of the medical literature identified articles reporting objective outcomes following T&A for OSA treatment in patients with DS. Articles were critically appraised to assess level of evidence and bias, and the results of articles were summarized. A case series of confirmed patients with DS and OSA was conducted, evaluating T&A efficacy by comparing pre- and posttreatment PSG data.
Results
Six articles were identified, which demonstrated some improvement after T&A in the treatment of OSA; however, subjects frequently had persistent disease. At our institution, preoperative Apnea-Hypopnea Index (AHI) improved from 13.75 (interquartile range [IQR] = 6.65–23.43) to 3.5 (IQR = 1.96–9.63) postoperatively; P = 0.004. Ten percent of patients had preoperative AHIs < 5; this proportion increased to 60% following surgery. Twenty percent of patients had postoperative AHIs < 1.
Conclusion
There is little objective data in the medical literature addressing T&A efficacy in treating OSA in patients with DS patients. Patients show objective improvement in sleep parameters following T&A for OSA. Adenotonsillectomy should be suggested as a first-line treatment for children with DS and OSA, keeping in mind that monotherapy may be insufficient. Future studies utilizing objective measures are required to further quantify the effect in this patient population.
Level of Evidence
Laryngoscope, 2017
http://ift.tt/2iFe3Mk
Omission of Intact Parathyroid Hormone Testing During Surgery in Treating Patients With Primary Hyperparathyroidism
Conditions: Parathyroid Gland Adenoma; Primary Hyperparathyroidism
Interventions: Other: Laboratory Biomarker Analysis; Procedure: Parathyroidectomy
Sponsors: Roswell Park Cancer Institute; National Cancer Institute (NCI)
Recruiting - verified January 2017
http://ift.tt/2iHTgpC
Interventions: Other: Laboratory Biomarker Analysis; Procedure: Parathyroidectomy
Sponsors: Roswell Park Cancer Institute; National Cancer Institute (NCI)
Recruiting - verified January 2017
http://ift.tt/2iHTgpC
Multicenter Phase II Study of Sentinel Node Detection in Squamous Cell Carcinoma T1-T2N0 of the Oropharynx Treated With Radiotherapy and Larynx Treated by Surgery, Laser or Robot
Condition: Head and Neck Cancer
Intervention: Procedure: Detection and resection of sentinel lymph node
Sponsor: Gustave Roussy, Cancer Campus, Grand Paris
Recruiting - verified January 2017
http://ift.tt/2iLV6bt
Intervention: Procedure: Detection and resection of sentinel lymph node
Sponsor: Gustave Roussy, Cancer Campus, Grand Paris
Recruiting - verified January 2017
http://ift.tt/2iLV6bt
Effect of Patient Information Leaflet on Working Pattern and Patient Satisfaction Level for Day Care Surgeries.
Condition: Patient Compliance
Intervention: Other: Information leaflet
Sponsor: Tata Memorial Hospital
Not yet recruiting - verified January 2017
http://ift.tt/2iHQ0KS
Intervention: Other: Information leaflet
Sponsor: Tata Memorial Hospital
Not yet recruiting - verified January 2017
http://ift.tt/2iHQ0KS
Combination of Radiation Therapy and Peptide Specific CTL Therapy in Treating Patients With Esophageal Cancer
Conditions: Esophageal Neoplasms; Esophageal Diseases; Digestive System Diseases
Intervention: Biological: peptide specific CTL
Sponsor: Shixiu Wu
Recruiting - verified January 2017
http://ift.tt/2iLXxuC
Intervention: Biological: peptide specific CTL
Sponsor: Shixiu Wu
Recruiting - verified January 2017
http://ift.tt/2iLXxuC
A Novel Robotic System for Single Port and Natural Orifice Transluminal Endoscopic Surgery
Conditions: Colorectal Neoplasms; Urologic Neoplasms; Urologic Diseases; Nasopharyngeal Neoplasms; Oropharyngeal Neoplasms; Oral Neoplasms; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; ENT Diseases
Intervention: Procedure: Robotic single port surgery and NOTES
Sponsor: Chinese University of Hong Kong
Recruiting - verified January 2017
http://ift.tt/2iHSclt
Intervention: Procedure: Robotic single port surgery and NOTES
Sponsor: Chinese University of Hong Kong
Recruiting - verified January 2017
http://ift.tt/2iHSclt
Rare Presentation of Left Lower Lobe Pulmonary Artery Dissection
Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR) images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. Conclusion. To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension.
http://ift.tt/2iLSPgd
Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–Sponsored Expert Panel
Abstract
Background
Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.
Objectives
Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy.
Results
The addendum provides three separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation.
Conclusions
Guidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy.
http://ift.tt/2hUIEla
After the Party’s Over
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. While driving home from an evening…
http://ift.tt/2hUaJxF
T-helper 2 cytokine–induced heat shock protein 70 secretion and its potential association with allergic rhinitis
Background
Various inflammatory mediators have been found to be involved in the pathogenesis of allergic disease (AR). The role of heat shock proteins in AR has not been studied. The aim of this study was to investigate the levels of heat shock protein 70 (Hsp70) in the nasal lavage fluids of AR patients and controls to elucidate the role of Hsp70 in the pathogenesis of AR.
Methods
Using an enzyme-linked immunosorbent assay, the levels of Hsp70, Hsp90, interleukin (IL)-4, IL-13, and IL-8 in nasal lavage fluid from patients were measured and statistically analyzed. Primary human nasal epithelial cells were cultured in vitro and T-helper 2 (Th2) cytokines (IL-4, IL-13) were added to the culture medium. We evaluated the mRNA and protein expression levels of Hsp70 using real-time polymerase chain reaction and western blot assay.
Results
Hsp70 was easily detected in nasal lavage fluid and the levels of Hsp70 were higher in AR patients than in healthy controls. Other clinical characteristics of subjects were not significantly associated with Hsp70 levels. Furthermore, we found that treatment with IL-4 and IL-13 induced the secretion of Hsp70 in human nasal epithelial cells.
Conclusion
We found that Hsp70 was abundant and positively detected in nasal lavage fluid samples from all subjects, and that Hsp70 levels were significantly higher in AR patients. We demonstrated, both in vivo and in vitro, that Hsp70 could play an important role in the pathogenesis of AR, and we suggest that Hsp70 can be used as a disease marker for AR.
http://ift.tt/2j7NqMY
Superoxide Dismutase 3 attenuates experimental Th2-driven allergic conjunctivitis
Source:Clinical Immunology
Author(s): Hyun Jung Lee, Bo-Mi Kim, Soojung Shin, Tae-Yoon Kim, So-Hyang Chung
Allergic conjunctivitis is an inflammatory eye disease mediated by Th2 type immune response. The role of extracellular superoxide dismutase 3 (SOD3) in immune response and allergic conjunctival inflammation was examined in a murine model for experimental allergic conjunctivitis (EAC). Allergic conjunctivitis was induced in mice by allergen challenge with ovalbumin in alum via the conjunctival sac. SOD3 was topically applied and allergy indicators were compared. Clinical signs associated with conjunctivitis, such as OVA-specific IgE production, IgG1/G2a ratio and eosinophil infiltration, were drastically reduced in mice treated with SOD3. They also had less dendritic cells and CD4+ T cells in conjunctiva than controls. Attenuated allergic inflammation was accredited to reduced Th2 type cytokine responses and increased Treg cytokine in draining lymph node. The characteristics of EAC were attributed to the absence of SOD3. Our findings suggest that SOD3 might be considered as a potential target for Th2 driven allergic conjunctival inflammation.
http://ift.tt/2ieJGJF
Eosinophilic Esophagitis vs Proton Pump Inhibitor-Responsive Esophageal Eosinophilia: Transcriptome Analysis
Source:Journal of Allergy and Clinical Immunology
Author(s): Tetsuo Shoda, Akio Matsuda, Ichiro Nomura, Naoko Okada, Kanami Orihara, Hironobu Mikami, Norihisa Ishimura, Shunji Ishihara, Kenji Matsumoto, Yoshikazu Kinoshita
Transcriptome analysis of eosinophilic esophagitis and proton pump inhibitor-responsive esophageal eosinophilia suggests these are a single syndrome, which casts doubt on the current guideline leading to the two distinct disease examinations according to PPI responses.
http://ift.tt/2iTaUWZ
Detection of phosphoglucomutase-3 (PGM3) deficiency by lectin-based flow cytometry
Source:Journal of Allergy and Clinical Immunology
Author(s): Ryan J. Carlson, Michelle R. Bond, Shermaine Hutchins, Yishai Brown, Lynne A. Wolfe, Christina Lam, Celeste Nelson, Thomas DiMaggio, Nina Jones, Sergio D. Rosenzweig, Kelly D. Stone, Alexandra F. Freeman, Steven M. Holland, John A. Hanover, Joshua D. Milner, Jonathan J. Lyons
Teaser
Lectin-based flow cytometry using L-PHA provides a method to screen for PGM3 deficiency.http://ift.tt/2iTaG2c
Editorial Board/Reviewing Committee
Source:International Journal of Oral and Maxillofacial Surgery, Volume 46, Issue 2
http://ift.tt/2iLFPXZ
Calendar of Events
Source:International Journal of Oral and Maxillofacial Surgery, Volume 46, Issue 2
http://ift.tt/2iHqPYC
Does photobiomodulation therapy is better than cryotherapy in muscle recovery after a high-intensity exercise? A randomized, double-blind, placebo-controlled clinical trial
Abstract
This study aimed to determine the effectiveness of photobiomodulation therapy (PBMT) and cryotherapy, in isolated and combined forms, as muscle recovery techniques after muscle fatigue-inducing protocol. Forty volunteers were randomly divided into five groups: a placebo group (PG); a PBMT group (PBMT); a cryotherapy group (CG); a cryotherapy-PBMT group (CPG); and a PBMT-cryotherapy group (PCG). All subjects performed four sessions at 24-h intervals, during which they submitted to isometric assessment (MVC) and blood collection in the pre-exercise period, and 5 and 60 min post-exercise, while the muscle fatigue induction protocol occurred after the pre-exercise collections. In the remaining sessions performed 24, 48, and 72 h later, only blood collections and MVCs were performed. A single treatment with PBMT and/or cryotherapy was applied after only 2 min of completing the post-5-min MVC test at the first session. In the intragroup comparison, it was found that exercise led to a significant decrease (p < 0.05) in the production of MVC in all groups. Comparing the results of MVCs between groups, we observed significant increases in the MVC capacity of the PBMT, CPG, and PCG volunteers in comparison with both PG and CG (p < 0.05). We observed a significant decrease in the concentrations of the biochemical markers of oxidative damage (TBARS and PC) in all groups and muscle damage (creatine kinase—CK) in the PBMT, PCG, and CPG compared with the PG (p < 0.01). The clinical impact of these findings is clear because they demonstrate that the use of phototherapy is more effective than the use of cryotherapy for muscle recovery, additionally cryotherapy decreases PBMT efficacy.
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Malignisierung eines Vestibularisschwannoms 13 Jahre nach Bestrahlung
Zusammenfassung
Beschrieben wird eine Patientin, bei der es 13 Jahre nach fraktionierter stereotaktischer Bestrahlung zu einer malignen Transformation eines Vestibularisschwannoms kam, die eine akut lebensbedrohliche Zustandsverschlechterung begründete. Obwohl bislang nur Fallberichte als Referenz herangezogen werden können, muss doch von einem relevanten Risiko ausgegangen werden, dass es im Langzeitverlauf strahlentherapeutisch behandelter Patienten mit Vestibularisschwannomen zu einer malignen Transformation kommt. Lebenslange MRT-Verlaufskontrollen sind daher zu diskutieren.
http://ift.tt/2iHfyb1
Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel
Source:Annals of Allergy, Asthma & Immunology
Author(s): Alkis Togias, Susan F. Cooper, Maria L. Acebal, Amal Assa'ad, James R. Baker, Lisa A. Beck, Julie Block, Carol Byrd-Bredbenner, Edmond S. Chan, Lawrence F. Eichenfield, David M. Fleischer, George J. Fuchs, Glenn T. Furuta, Matthew J. Greenhawt, Ruchi S. Gupta, Michele Habich, Stacie M. Jones, Kari Keaton, Antonella Muraro, Marshall Plaut, Lanny J. Rosenwasser, Daniel Rotrosen, Hugh A. Sampson, Lynda C. Schneider, Scott H. Sicherer, Robert Sidbury, Jonathan Spergel, David R. Stukus, Carina Venter, Joshua A. Boyce
BackgroundFood allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.ObjectivesPrompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy.ResultsThe addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation.ConclusionsGuidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy.
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Comparison of effects of zoledronic acid and clodronate on the bone structure: Imaginological and histomorphometrical study in vivo
Abstract
Objectives
To compare histologically and imaginologically the bone structure of rats' mandibles treated with bisphosphonates (BPs) and rats that did not receive BPs.
Methods
Thirty-four rat specimens (Rattus novergicus, Wistar strain) were divided in 3 groups: (1) 12 rats treated with zoledronic acid; (2) 12 rats treated with clodronate; and (3) the control group, containing 10 rats that received saline solution. All individuals were exposed to cone beam computed tomography (CBCT). The images were processed and analised to obtain the Hounsfield scores, using the software OsiriX 7.0. Sixty-eight histological slides were obtained from the specimens and stained with hematoxilin and eosin (HE). Using the software Adobe Photoshop CS6, the histological areas containing non-vital bone were identified and quantified.
Results
Non-vital bone presented positive association with the zoledronic acid and clodronate groups. Statistically, no significant difference in bone density was observed among the groups.
Conclusions
Based on the results, the BP therapy alone was sufficient to induce osteonecrosis. In addition, the CBCT was not a sensible method for detection of the early signs of bone modification in individuals under BP therapy.
This article is protected by copyright. All rights reserved.
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Enzymatic antioxidants status in patients with recurrent aphthous stomatitis
Abstract
Background
Oxidative stress (OS) has been thought to play a main role in the etiopathogenesis of recurrent aphthous stomatitis (RAS), which is one of the most common oral mucosal diseases characterized by recurrent and painful oral ulcers. The aim of this investigation was to evaluate the enzymatic antioxidants status in patients with RAS in the active stage and remission stage.
Methods
Ninety seven patients with idiopathic minor RAS and 102 race, age and gender-matched healthy individuals were recruited. All these subjects were allocated to three groups: RAS patients with active lesion (group A); the same patients in group A in the remission stage of RAS (group B); healthy individuals without RAS (group C). Following an overnight fast, blood samples were obtained. The serum levels of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSHPx) were measured by the spectrophotometric method. Independent sample t-test and paired t-test were performed for statistical evaluation.
Results
The serum levels of SOD, GSHPx, and CAT (83.9±17.1 U/mL, 6687.2±2629.2 U/mL, 1789.7±593.8 U/L) were found to be significantly lower in group A as compared to those of group B (99.8±11.1 U/mL, 9364.1±1607.9 U/mL, 2789.1±1113.4 U/L; P<0.05) or group C (97.3±12.1 U/mL, 9246.2±2376.1 U/mL, 2819.0±914.8 U/L; P<0.05). No significant differences were found between group B and group C with respect to any one of these enzymatic antioxidants (P>0.05).
Conclusions
Our results indicate that enzymatic antioxidant defense system is impaired in RAS patients with active lesion and seems to play a crucial role in its pathogenesis.
This article is protected by copyright. All rights reserved.
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Assessment of interfering factors in non-adherence to oral appliance therapy in severe sleep apnea
Abstract
Objective
Oral appliances (OA) are recommended for patients with severe obstructive sleep apnea who fail to comply with continuous positive airway pressure (CPAP) therapy. This mixed methods study aimed to quantify adherence to OA therapy and evaluate subjective reasons associated with non-adherence.
Materials and Methods
The medical records of 52 patients with an apnea-hypopnea index (AHI) ≥ 40, treated with OA after discontinuation of CPAP treatment, were examined for OA adherence. Patients were divided according to usage at the time of a phone interview. The USER group included all forms of usage whereas those who completely ceased using the OA were in the NUSE group. The timing of the phone interview was from five months to six years (average 44.63±17.17 months) after OA delivery.
Results
The overall adherence rate was 57.7% (30/52 patients). The mean usage times were 10.07±8.96 and 44.30±17.3 months in the NUSE and NUSE groups respectively. The main factors associated with non-adherence were concerns about the effects of the OA on teeth (22%) and insufficient efficacy (22%). Other factors were discomfort (15%) or improved wellbeing following weight loss (15%). The overall number of interfering and discontinuity factors was significantly higher in the NUSE group than in the USER group (p=0.041). Nine out of 52 (17.3%) patients resumed CPAP use. Subjective and objective outcomes, determined by using a second sleep test with OA in 69.2% of patients, were related to the continuation of treatment.
Conclusions
Non-adherence to OA is strongly associated with patient reservations regarding the effects of the device on teeth, possible lack of efficacy and discomfort. Clinicians should closely monitor adherence patterns and assess potential interfering factors during their diagnostic work up. Patients should be reassured regarding device safety, particularly following dental work that may interfere with the insertion of the OA.
This article is protected by copyright. All rights reserved.
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Case of Superficial Cancer Located at the Pharyngoesophageal Junction Which Was Dissected by Endoscopic Laryngopharyngeal Surgery Combined with Endoscopic Submucosal Dissection
Aims. In order to determine the indications of transoral surgery for a tumor located at the pharyngoesophageal junction, the trumpet maneuver with transnasal endoscopy was used. Its efficacy is reported here. Material and Methods. An 88-year-old woman complaining of dysphagia, diagnosed with cervical esophageal cancer, and hoping to preserve her voice and swallowing function was admitted to our hospital. Conventional endoscopy showed that the tumor had invaded the hypopharynx. When inspecting the hypopharynx and the orifice of the esophagus, we asked the patient to blow hard and puff her cheeks with her mouth closed (trumpet maneuver). After the trumpet maneuver, the pharyngeal mucosa was stretched out. The pedicle of the tumor arose from the left-anterior wall of the pharyngoesophageal junction, so we decided to perform endoscopic resection. Result. Under general anesthesia, the curved laryngoscope made it possible to view the whole hypopharynx, including the apex of the piriform sinus and the orifice of the esophagus. The cervical esophageal cancer was pulled up to the hypopharynx. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en bloc by endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection. Conclusion. Transnasal endoscopy using the trumpet maneuver is useful for a precise diagnosis of the pharyngoesophageal junction. Close collaboration between head and neck surgeons and endoscopists can provide good results in treating tumors of the pharyngoesophageal junction.
http://ift.tt/2hT8R3B
Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome
A 56-year-old female with a background of metastatic rectal adenocarcinoma presented with a subglottic mass causing biphasic stridor. Transoral laser microsurgery and the use of fibrin glue prevented the need for tracheostomy. Six months postoperatively there was no evidence of recurrence. Laryngeal metastasis of colorectal adenocarcinoma, although remarkably rare, is perhaps more prevalent than commonly perceived and the presence of laryngeal symptoms in a patient with colorectal adenocarcinoma should raise concern. This case is presented to aid physicians should they encounter a similar presentation of metastasis to the subglottis.
http://ift.tt/2iDqCYv
Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel
Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.
http://ift.tt/2j72kTL
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