Varicella pseudo-Koebner phenomenon associated with vascular access opening

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Successful management of retinal metastasis from renal cancer with everolimus in a monophthalmic patient: a case report

The retina is an uncommon site for metastases, in particular from solid tumors. Some authors have reported a recent increase in the incidence of metastases in infrequent sites, such as brain or bone, probably ...

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Primary sinonasal tuberculosis: Our experiences in a tertiary care hospital of eastern India

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Santosh Kumar Swain, Ishwar Chandra Behera, Mahesh Chandra Sahu
BackgroundPrimary sinonasal tuberculosis is an extremely rare clinical entity. Often the clinician fail to diagnose the primary sinonasal tuberculosis, so treatment is frequently delayed and leading to complications.ObjectiveTo evaluate the clinical profile, diagnostic tools, treatment and outcome of primary sinonasal tuberculosis.Materials and MethodsRetrospective studies of six cases of primary sinonasal tuberculosis were done over period of five years. The detail clinical profile, diagnosis, treatment and outcome were studied in these patients.ResultsOut of the six cases of primary sinonasal tuberculosis, four cases were female and two were male. The mean age during the time of diagnosis was 35 years (16–67 years). The most common clinical presentations were chronic nasal obstruction, epistaxis and ulcerations at the nasal vestibule and nasal cavity. Diagnosis was confirmed by Histopathological diagnosis in all six cases. All cases received antitubercular therapy for 6–9 months. All six patients successfully responded to antitubercular therapy. Two year follow up showed no relapse, dissemination and death.ConclusionPrimary sinonasal tuberculosis is a rare clinical entity. It is always suspected among the patients with nasal obstruction, epistaxis and ulcerations at nasal vestibule and nasal cavity in the region with high prevalence of Tuberculosis.



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The role of Mannose-binding lectin 2 (MBL2) gene polymorphisms in adenoid hypertrophy among young children

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Husam Majeed Hameed, Ali S. Dawood
ObjectiveIs to determine the role of Mannose binding lectin (MBL) 2 (SNP 49 C/T rs#5030737) gene polymorphism among patients with adenoidal hypertrophy in Iraqi population.MethodsFrom July through December 2015, a total of 60 adenoid hypertrophy (study group) young child patients (35 males and 25 females) with an age between (4 and 12) years old, were enrolled in this study according to selection criteria. A second group of otherwise healthy young child who did not have any symptoms or signs of adenoid hypertrophy were considered to be a control group. Confirmation of adenoid hypertrophy was achieved by: clinical examination, radiological assessment of postnasal space and an endoscopic nasopharyngoscopy. Blood samples were collected from both groups and genotyping of MBL-2 gene polymorphism was performed using traditional PCR and allele-specific technique.ResultsMBL2 gene polymorphism and allele frequencies among adenoid hypertrophy patients and their control were studied and the results showed that CC = 40 (66.7%), TT = 13(21.7%), and CT = 7 (11.6) in study group, while in control group CC = 5(8.3), TT = 9 (15%).CT = 46 (67.7%). The P-value of genotypes (CC, TT and CT) in study groups versus the control group were P < 0.001 (highly significant), P = 0.435 (non-significant) and P < 0.001 (highly significant) respectively.ConclusionThe difference between the MBL2 (SNP 49 C/T rs#5030737) gene polymorphism among adenoid hypertrophy patients and healthy people may indicate it could be used as an early predictive factor for children whom will be prone to adenoid hypertrophy. The genotype CC could be considered as a risk factor while CT genotype could be considered a protective factor against adenoid hypertrophy in the current study. A further study needed to evaluate the use of the above mentioned polymorphism as a prognostic value foradenoid hypertrophy.



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Surgical strategy for frontal sinus inverted papilloma

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): A.A. Ibrahim, Haitham Morsi, Mohamed Hassab, Mohamed Eid, Samy Elwany
Inverted papilloma (IP) is a benign tumor with a local aggressive nature and has a tendency to recur after excision. Despite the evolution of endoscopic techniques in the management of IP, external approaches still play a crucial role in frontal sinus involvement.ObjectiveThe present study aimed at planning a strategy for managing IP arising in or involving the frontal recess and/or frontal sinus.Patients and methodsTen patients with frontal sinus IP were enrolled in the present study. The type of surgical procedure was tailored according to the site of origin and extent of the tumor.ResultsFive combined surgeries and five extended endoscopic surgeries were performed in 1 year and 4 months with a follow up period of 2 years. Complete resection of the tumor was achieved in all the cases and no recurrences were reported at the end of the follow up period.ConclusionsThe exact approach to frontal sinus IP differ from one case to the other. Endoscopic frontal surgery is the mainstay in treatment of frontal sinus IP. External or combined approaches still remain a valid option for lesions affecting the mucosa of the frontal sinus extensively or extending far lateral.



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Intracranial metastasis of follicular thyroid carcinoma mimicking cerebellopontine angle tumour

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Li Yun Lim, Jamuneswary Selvarajoo, Norhafiza Mat Lazim, Ing Ping Tang
Cerebellopontine angle (CPA) tumour is most commonly associated acoustic neuroma. The occurrence of metastatic brain tumour at CPA is rare. Follicular thyroid carcinoma is second most common well differentiated thyroid malignancy and brain metastasis is unusual. We would like to report an unusual presentation of follicular thyroid carcinoma with brain metastasis at the CPA region. A 60 year old gentleman presented with occipital headache, slurred speech with positive cerebellar signs and multiple cranial nerve palsies with no neurological deficit to upper and lower limbs. No other significant findings noted on examination. Imaging investigations revealed a CPA tumour. Transnasal transphenoidal tumour debulking was done and biopsy revealed a metastasis of follicular thyroid carcinoma. After total thyroidectomy, the patient was scheduled for radioactive iodine ablation. Metastasis brain tumour with high vascular supply can contribute to difficult tumour debulking. Embolisation and stereotactic therapy are the supporting and alternative method of treatment.



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Atypical multiple metastasis of recurrent pleomorphic adenoma

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Darshini Nagarajah, Irfan Mohamad, Norhafiza Mat Lazim, Sharifah Emilia Tuan Sharif, Nur Hidayati Mohamad Pakarul Razy
Pleomorphic adenoma is the commonest benign neoplasm of the parotid gland and minor salivary glands. It is composed of epithelial and myoepithelial cells arranged in various morphological patterns. The concrete reasons contributing to a recurrent disease are obvious or attempts of accidental tumor spillage, enucleation with rupture and incomplete excision during operation. The other solid reasons that could contribute to recurrence are known incomplete pseudocapsule, extracapsular extensions, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule matrix. Most recurrent pleomorphic adenoma are multinodular with different recurrent sites and time duration. We describe a case of 55-year-old lady who underwent left superficial parotidectomy for pleomorphic adenoma 14 years prior to current presentation. After 8 years, she presented with ipsilateral level II lymph node, in which excision showed pleomorphic adenoma. Within 2 years after excision, she experienced another multiple small neck swellings at the level II-III, in which histopathology examination of the excised masses were consistent with pleomorphic adenoma, without evidence of lymph node background to suggest metastasis.



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Issue Information - TOC

No abstract is available for this article.

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Issue Information - Journal Info page

No abstract is available for this article.

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Author Index: Volume 45

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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Keyword index: Volume 45

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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Editorial Board

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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BMP-2 plasmid DNA-loaded chitosan films – A new strategy for bone engineering

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12
Author(s): Juan Li, Jun Lin, Wenke Yu, Xiaojia Song, Qiaoling Hu, Jing-Hong Xu, Huiming Wang, Christian Mehl
ObjectivesBone defects are common in every area of medicine and remain a clinical challenge. Tissue engineering has led to promising new strategies in accelerating bone repair. Bone morphogenetic proteins (BMPs) play crucial roles in bone regeneration, but are required in supra-physiological doses, which are expensive and produce severe side effects.MethodsTo address these issues, we prepared BMP-2 plasmid DNA-loaded chitosan films, and examined their effects on mouse osteoblast-like MC3T3-E1 cell morphology, proliferation, and runt-related transcription factor 2 (RUNX2) expression. In vivo testing was performed using calvarial critical-sized defects and histomorphometry in 36 Sprague–Dawley rats. Unloaded chitosan films and empty defects served as controls.ResultsIn contrast to the controls, cells grown on BMP-2 plasmid DNA-loaded chitosan films had well established filopodia and lamellipodia, significantly higher proliferation 2, 4, and 6 days post-seeding (P ≤ 0.05), and higher nuclear RUNX2 expression. In vivo, new bone growth was significantly greater in the BMP-2 group than in the control groups at 4, 8, and 12 weeks (P ≤ 0.01).ConclusionsBased on our study findings, BMP-2 plasmid DNA-loaded chitosan films provide an effective strategy for GBR, combining cellular compatibility with biocapability in vivo.



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Corrigendum to “The influence of different abutment materials on tissue regeneration after surgical treatment of peri-implantitis – A randomized controlled preclinical study” [J Cranio-Maxillo-Facial Surg 45 (2017) 1190–1196]

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12
Author(s): Tobias Moest, Jan Wrede, Christian Martin Schmitt, Melanie Stamp, Friedrich Wilhelm Neukam, Karl Andreas Schlegel




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EACMFS Awards

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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Contents: Volume 45

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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Subcranial and orthognathic surgery for obstructive sleep apnea in achondroplasia

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12
Author(s): Srinivas M. Susarla, Gerhard S. Mundinger, Hitesh Kapadia, Mark Fisher, James Smartt, Christopher Derderian, Amir Dorafshar, Richard A. Hopper
PurposeObstructive sleep apnea (OSA) is a common problem in patients with achondroplasia. The purpose of this study was to assess changes in airway volumes following various degrees of facial skeletal advancement.MethodsThis was a retrospective evaluation of patients with achondroplasia who underwent facial skeletal advancement for obstructive sleep apnea. Patients were treated with either an isolated Le Fort III distraction (LF3) or Le Fort II distraction with or without subsequent Le Fort I and bilateral sagittal split osteotomies (LF2 ± LF1/BSSO). Demographic, cephalometric, volumetric, and polysomnographic variables were recorded pre- and postoperatively.ResultsSix patients with achondroplasia underwent midface advancement for treatment of OSA (2 LF2 + LF1/BSSO, 2 LF2, 2 LF3). Patients undergoing LF2 + LF1/BSSO had consistent volumetric improvements at the nasopharyngeal and oropharyngeal levels (Δ ≥ +347% and ≥+253%, respectively). Patients undergoing LF2 alone had consistent improvement in the nasopharyngeal airway alone (Δ ≥ +214%). Patients undergoing LF3 alone had consistent, but less dramatic, changes in nasopharyngeal volume (Δ ≥ +97.1%). All patients undergoing LF2 distraction (with or without LF1/BSSO) had a ≥50% reduction in the apnea–hypopnea index (AHI) postoperatively; there was no improvement in AHI with LF3 alone.ConclusionIn patients with achondroplasia-associated OSA there are variable improvements in airway volume. This preliminary report suggests that LF2 distraction, with or without subsequent LF1/BSSO, may provide consistent reductions in AHI relative to LF3 distraction.



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Announcements

Publication date: December 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 12





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Reply

Publication date: Available online 6 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Fernando Sergio Leitao Filho, Seung Won Ra, Andre Mattman, Robert S. Schellenberg, Don D. Sin




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Chronic obstructive pulmonary disease exacerbation frequency and serum IgG levels

Publication date: Available online 6 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Juthaporn Cowan, Sunita Mulpuru, Gonzalo Alvarez, Vicente Corrales-Medina, Donald W. Cameron




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Cutometric assessment of elasticity of skin with striae distensae following carboxytherapy

Summary

Objective

The aim of the study was to evaluate the effectiveness of carboxytherapy in the treatment of striae distensae. Additionally, discomfort and side effects associated with the treatment were assessed.

Materials and methods

This study involved 15 women aged 22-40 years. They underwent 3 sessions of carboxytherapy at one-week intervals. Treatment was performed in skin area within stretch marks located on stomach, buttocks, and thighs. Cutometric probe was used to evaluate skin elasticity. Four measurements were performed—immediately before each treatment and one month after the last session. Photographic documentation was made before and after a series of treatment to perform clinical evaluation of changes in skin condition.

Results

Statistical analysis of results obtained with the use of Cutometer (R2 and R8 parameters) demonstrated that carboxytherapy significantly improved skin elasticity within stretch marks (P < .05). The analysis of photographic documentation revealed 58% improvement in stretch mark visibility. The width and length of stretch marks decreased, and their color became more like the natural color of the skin. Carboxytherapy is associated with moderate pain/discomfort. The occurrence of hematoma is the main side effect of this procedure.

Conclusions

Carboxytherapy seems to be an effective method of reducing stretch marks. This procedure is safe, and it can be performed without the risk of complications. Moreover, it does not require special postoperative convalescence. Photographic documentation is a method of assessment of aesthetic procedures effectiveness, which is complementary to other objective methods (eg, the use of MPA probes).

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Toxocara species exposure, symptoms of asthma, and fractional exhaled nitric oxide in the US population

Asthma is a major cause of morbidity in the United States.1 Toxocariasis is caused by exposure to the eggs of the nematodes Toxocara canis and Toxocara cati.2,3 Clinic-based studies have reported the association of Toxocara species with asthma. A study using data from the Third National Health and Nutrition Examination Survey (NHANES III) of 1988 to 1994 examined the association between Toxocara species infection and lung function in the United States.4 Infection was negatively associated with forced expiratory volume in 1 second.

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Spectrum and prevalence of reactions to marijuana in a Colorado allergy practice

Since the legalization of medical marijuana (MJ) and recreational MJ in certain states, an increasing number of patients with allergy are presenting from MJ exposure. Most have substantial exposure from industrial cultivation or are heavy consumers, indicating that cannabis is a mild allergen.

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Could calcium channel blockers treat 2 illnesses with 1 pill?

Ever since Middleton's1 suggestion that excessive permeability of airway cells to calcium ions might play a role in the underlying mechanism of bronchial hyperresponsiveness (BHR) and asthma, researchers have questioned whether calcium channel blockers (CCBs) might be efficacious in the treatment of this illness. Their potential utility makes a great deal of sense, because cytoplasmic calcium is involved in bronchoconstriction, mast cell mediator release, vagal reflex stimulation, airway mucous gland secretion, chemotaxis of eosinophils, and possibly even smooth muscle remodeling.

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Table of Contents

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Editorial Board

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Innate lymphoid cells and allergic disease

Allergic diseases, including asthma, atopic dermatitis, and allergic rhinitis, are substantial causes of morbidity and mortality in developing and developed countries. An expansive set of cellular mediators and mechanisms have been identified that contribute to the initiation or exacerbation of allergic disease. During the past decade, the discovery of a new subset of leukocytes known as innate lymphoid cells (ILCs) has great expanded our understanding of the pathogenesis of allergic disease.

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Instructions for Authors

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Baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO

The Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab (PROSPERO) study was designed to better understand the types of patients who are begun on omalizumab in the real-world setting, including asthma burden, comorbidities, and biomarker profiles, and to evaluate what clinical parameters might be associated with better outcomes with the use of this biologic agent. In this month's issue of the Annals, Griffin et al1 report on the first of these 2 outcomes.

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Burden of skin pain in atopic dermatitis

Atopic dermatitis (AD) is associated with itch, skin inflammation and barrier disruption, and scratching, all of which may be associated with skin pain.

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Author Index to Volume 119, 2017

Abraham T, [Letters] 558

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Information for Readers

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Increasing our knowledge base of asthma

During the past decade, there has been an explosion in our knowledge of asthma. There are new descriptions of phenotypes, endotypes, and even genotypes. New approaches to management have been and continue to be developed. The realization and characterization of a spectrum of overlap with chronic obstructive pulmonary disease (COPD) in many patients with asthma have been reported in detail and approaches to management of patients with severe asthma continue on the forefront. These and other aspects of asthma are well represented in the more than 200 articles published on asthma since 2015 in the Annals of Allergy, Asthma and Immunology.

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The clinical role of fractional exhaled nitric oxide in asthma control

The potential role and characteristics of fractional exhaled nitric oxide (FeNO) remain unclear in the treatment of asthma.

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Mycobacterium tuberculosis of the elbow joint

Mycobacterium tuberculosis(TB) affecting the elbow joint is rarely reported in the developed world. We present the case of an 85-year-old Caucasian female who complained of a chronically discharging and painful wound across her left elbow during her admission for an ischaemic stroke. This was initially deemed to be either a bursitis or local manifestation of amyloid by her general practitioner and dermatologist respectively prior to admission. She was commenced on flucloxacillin by the medical team for presumed cellulitis with minimal response. A synovial fluid sample and repeated wound swabs yielded no growth from routine bacterial culture. Radiological assessment together with knowledge of her husband having previous TB raised the possibility of TB arthritis. Synovial fluid aspirate was subsequently sent for acid–alcohol fast bacilli microscopy and mycobacterial culture that confirmed M. tuberculosis. She was consequently started on multidrug TB therapy, over a year after the onset of her symptoms.

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Flat foveal contour simulating macular hole

Description

A 40-year-old healthy female was referred for macular hole in his both eyes detected during routine examination. Visual acuity was 20/20 OU unaided. Ocular examination of OD was unremarkable except for the presence of round red lesion at fovea (figure 1A, arrow) that was more prominent on green reflectance imaging (figure 1B, arrow). Spectral-domain optical coherence tomography showed a flattened foveal contour (figure 1C, arrows), which explained the appearance of macular hole. Similar findings were seen in OS. There were no ocular or systemic features suggestive of albinism.

Figure 1

Multicolour scanning laser image of right eye showing small red lesion (arrow) simulating macular hole (A) that is better seen on red free image (B). Apparent macular hole corresponds to flat foveal contour on optical coherence tomography (C).

The foveal contour and anatomy may vary...

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Complication of deep brain stimulation for Parkinsons disease

Description

A 58-year-old man with advanced Parkinson disease diagnosed 13 years before, was admitted for surgical placing of continuous bilateral high-frequency stimulation of the subthalamic nucleus.

The procedure was uneventful (lead used Medtronic DBS 3387; antibiotic prophylaxis: cefazolin 2 g at time of anaesthetic induction and 1 g every 8 hours in the first 24 hours) with a postoperative control CT scan showing good placement of the electrodes and no abnormalities (figure 1). The stimulation was switched on 72 hours after the procedure and within 24 hours the patient presented two epileptic seizures controlled with diazepam and stimulation was switched off. The head CT showed intra-axial hypodensity more prominent in the frontal area with a gaseous collection and oedema surrounding the right electrode pathway (figure 2). At the time there was no fever, no increase in inflammatory markers and a normal cell count in the lumbar puncture. However, antibiotic therapy (ceftriaxone...

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Contents: Volume 45

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Keyword index: Volume 45

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Announcements

Dear Colleagues,

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EACMFS Awards

The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments.

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Author Index: Volume 45

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Editorial Board

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Lipoid proteinosis: towards predictive clinical clues

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Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography

Publication date: Available online 6 December 2017
Source:Auris Nasus Larynx
Author(s): Norio Kondo, Toshio Yoshihara, Yukie Yamamura, Kaoru Kusama, Eri Sakitani, Yukako Seo, Mayako Tachikawa, Keiko Kujirai, Erika Ono, Yasuyo Maeda, Tomohito Nojima, Akiko Tamiya, Emiri Sato, Manabu Nonaka
Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjögren's syndrome and recurrent parotitis.



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Factors influencing recurrent emergency department visits for epistaxis in the elderly

Publication date: Available online 6 December 2017
Source:Auris Nasus Larynx
Author(s): Mohamad R. Chaaban, Dong Zhang, Vicente Resto, James S. Goodwin
ObjectiveOur objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly.MethodsWe used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months. We assessed the rates of ED visits for recurrent epistaxis in the 12 months following the incident visit. Our variables included demographics, geographic location, procedures performed during the incident visit and comorbidities.ResultsOut of the 4120 patients with incident epistaxis, 775 were readmitted with recurrent epistaxis within 12 months. 60% presented in the first 30days and 75% within 90 days. There was a significant increase in ED visits for patients over 75 years of age and in men compared to women. Recurrent ED visits for epistaxis was higher in patients with congestive heart failure, diabetes mellitus, and obstructive sleep apnea compared to those without these comorbidities.ConclusionAdditional ED visits for epistaxis are more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.



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Occipitocervical Hemolymphangioma in an Adult with Neck Pain and Stiffness: Case Report and Literature Review

Introduction. Hemolymphangioma is an extremely rare malformation of the lymphatic and blood vessels. A limited number of hemolymphangioma cases occurring in the pancreas, extremities, spleen, and other organs have been reported until September 2017. To the best of our knowledge, no cases of hemolymphangioma in the occipitocervical region have been reported in the literature. Case Presentation. We reported the case of a 23-year-old male patient with an occipitocervical lesion presenting atypically as neck pain and stiffness over a period of five months. Although hemolymphangioma has historically demonstrated a female predilection (2.25 : 1 female to male) and presentation in the third to fourth decades of life, this case is an atypical manifestation occurring in a young male patient. The clinical characteristics and management choices of this uncommon case of hemolymphangioma in the occipitocervical region are discussed, and a review based on the available literature is also presented. Conclusion. Hemolymphangioma of the occipitocervical region is an uncommon presentation of a rare lesion. Although rare, hemolymphangioma should be considered a differential diagnosis for masses occurring in the occipitocervical region. Complete surgical resection is the treatment of choice and affords a good prognosis.

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The composite palatal island flap: modification of an existing technique to reconstruct the maxillary alveolus

Palatal submucosal flaps have been used for a long time to reconstruct the alveolus.1 Although there have been great advances in tissue engineering recently, autogenous bone remains the "gold standard" to treat atrophy of the ridge.2 We describe a new technique to reconstruct the hard and soft tissues of the maxillary alveolus simultaneously, by incorporating an island of palatine bone into a submucosal flap.

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Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures

Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts.

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Revisiting lip shave: a solution for disorders of the vermilion border

Actinic keratosis, leukoplakia, carcinoma in situ, and superficially invasive carcinomas of the lower lip are caused mainly by the cumulative effects of exposure of the vermilion of the lower lip to ultraviolet radiation. Current treatments all have limitations: cryosurgery or electrosurgery is suitable to treat only focal lesions; topical chemotherapy, which is an option for diffuse actinic damage, yields unreliable results; and laser treatment fails to rejuvenate the vermilion. However, "lip shave", which involves full-thickness excision of the damaged vermilion and reconstruction with an advancement labial mucosal flap, will produce a fresh mucosal lining to the vermilion border.

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Effectiveness of irrigation with chlorhexidine after removal of mandibular third molars: a randomised controlled trial

To evaluate the effect of postoperative irrigation with chlorhexidine on inflammatory complications after the extraction of lower third molars under local anaesthesia, we recruited 100 patients to participate in a controlled, single-blind, randomised clinical trial. They were assigned to one of two groups: the intervention group (postoperative irrigation of the surgical site with chlorhexidine for seven days) or the control group (postoperative chlorhexidine mouth rinse for seven days). The primary outcome variables were pain, swelling, trismus, infection, and alveolar osteitis.

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Risk factors for intraoperative bradycardia during ear, nose, throat and maxillofacial surgery

Abstract

Intraoperative bradycardia (IOB) is one of the most common cardiac arrhythmias observed in clinical anaesthetic practice. Controlled hypotension, as a strategy of lowering patient's blood pressure during anesthesia has been practiced for decades in head and neck surgery. The aim of our study was to determine the incidence and the risk factors for intraoperative bradycardia in maxillofacial, ear, nose and throat surgery, as well as to determine whether controlled hypotension affects the occurrence of IOB. The retrospective study included 2304 patients who underwent maxillofacial, ear, nose or throat surgery. We studied the influence of: sex, age, comorbidity, type of surgery, duration of anesthesia and controlled hypotension on the occurrence of IOB. IOB was registered in 473 patients (20.5%). Patients with controlled hypotension had IOB significantly more often than patients without controlled hypotension (33.9 vs 15.1%) (p = 0.000). The significant predictors of IOB were: age (OR = 1.158; 95% CI = 1.068–1.256; p = 0.000), sex (OR = 0.786; 95% CI = 0.623–0.993; p = 0.043), ischemic heart disease (OR = 2.016; 95% CI = 1.182–3.441; p = 0.010); ear surgery (OR = 1.593; 95% CI = 1.232–2.060; p = 0.000), anesthesia duration, (OR = 1.006; 95% CI = 1.004–1.007; p = 0.000) and controlled hypotension (OR = 2.204; 95% CI = 1.761–2.758; p = 0.000). IOB is common in maxillofacial, ear, nose and throat surgery, particularly in male, older age and patients with ishemic heart disease. The ear surgery, longer anesthesia duration and controlled hypotension raise the risk for occurrence of IOB.

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Overexpression of osteopontin promotes cell proliferation and migration in human nasopharyngeal carcinoma and is associated with poor prognosis

Abstract

Nasopharyngeal carcinoma (NPC), a malignant tumor at the top and side of the nasopharyngeal cavity, highly occurs in the southern region of China. Cancer cell metastasis is one of the leading causes of death in NPC patients. Osteopontin (OPN), is a phosphorylated extracellular matrix protein with a variety of functions, was found to be overexpressed in many cancers. However, the expression and role of OPN in patients with NPC in Guangxi, China are unclear. Here, we observed that NPC patients had upregulated OPN at mRNA protein and levels. Immunochemistry (IHC) analysis of OPN expression in 68 NPC clinical specimens indicated that high expression of OPN had positive correlation with NPC lymph node metastasis (P = 0.012), distant metastasis (P = 0.001) and TNM staging (P = 0.018). Moreover, compared with relatively low OPN, NPC patients with higher expression of OPN showed a poorer overall survival rate (P = 0.001, log rank test). Multivariate analysis showed that OPN expression in NPC was an independent prognostic marker. The proliferation, apoptosis and migration ability of CEN-2Z cancer cells in NPC were determined by MTT, flow cytometry and wound-healing assays, respectively. Upregulation of OPN in CEN-2Z cancer cells promoted cancer cell proliferation and migration, and suppressed apoptosis. In sum, our result suggests OPN could be used as a valuable oncoprotein and show that overexpression of OPN in NPC may serve as a potential prognostic marker.

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The effectiveness of two types of MADS for OSA therapy

Abstract

Objectives

The purpose of this study was to determine differences in effectiveness between two types of mandibular advancement device (MAD).

Material and methods

In this retrospective, cohort study, the two devices used were MAD type "Somnodent-Flex" (MAD 1) and MAD type "Herbst" (MAD 2). One hundred thirty-seven patients participated in this study, 67 patients were treated with MAD 1, and 70 patients with MAD 2. The indication MAD with obstructive sleep apnea (OSA) is based on a polysomnography test, in accordance with the CBO guidelines. The effectiveness of MAD therapy can be determined by a second polysomnography test (with the MAD in situ). The apnea-hypopnea index (AHI) is registered during the first and the second polysomnography test. Changes in these values determine the effectiveness.

Results

A significant decrease in AHI was found regarding T1 and T2 for both the MADs: F (1, 134) = 140,850, p < 0,001. The mean differences of both the MADs turned out to correlate to T1. After correcting for this covariance, there was no significant difference between the two MAD devices regarding the AHI value: F (1, 134) = 1160, p = 0,283.

Conclusions

The results of the present study show no significant difference in effectiveness between MAD 1 and MAD 2 in respect to the AHI value.

Clinical relevance

Since 2012, healthcare insurance companies in the Netherlands refunds MAD type "Somnodent" used for treatment of sleep apnea. It is important to investigate if this type of MAD is as more effective or less effective as other types of MADs. If research points out that other MADs are more effective in reducing the sleep apnea, refund policies have to be adapted.

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Ixekizumab Gets FDA Nod for Active Psoriatic Arthritis

Ixekizumab significantly improves symptoms of psoriatic arthritis in patients naive to prior biologic therapy and in patients who had failed prior to biologic therapy.
FDA Approvals

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Unilateral sagittal split ramus osteotomy: an alternative for some cases of asymmetric mandibular prognathism

The objective of this study was to propose a treatment protocol for patients with lateral prognathism based on the unilateral sagittal split ramus osteotomy (USSRO). This was a prospective study involving 31 patients with lateral prognathism, who required a bilateral sagittal split ramus osteotomy (BSSRO). Two groups were formed using the proposed protocol, with specific inclusion criteria for each group: BSSRO (n=17) and USSRO (n=14). Occlusal parameters (dental midline deviation, overbite, and overjet) were measured preoperatively (T0), at model surgery (T1), 1 month postoperative (T2), and 1year after surgery (T3) and compared.

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Production of Monoclonal Antibody That Recognizes Zika Virus and Other Flaviviruses in Serum-Free Conditions

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.


http://ift.tt/2kufLmD

Genomic integration and expression of the Aggregatibacter actinomycetemcomitans catalase gene in Aggregatibacter aphrophilus

Publication date: Available online 5 December 2017
Source:Archives of Oral Biology
Author(s): Yuting Alice Yang, Ya-An Cheng, Casey Chen
ObjectiveTo test the hypothesis that virulence genes of Aggregatibacter actinomycetemcomitans can be expressed and confer fitness advantages in the closely related Aggregatibacter aphrophilus.DesignClinical isolates of A. aphrophilus were screened for natural competence with marked genomic DNA from A. actinomycetemcomitans and A. aphrophilus. The gene katA of A. actinomycetemcomitans D7S-1 and its flanking regions were constructed and inserted into a comparable locus in the genome of naturally competent A. aphrophilus strains by a markerless protocol via natural transformation. Mutants of A. actinomycetemcomitans with or without katA were also constructed by a similar protocol. Discs soaked with either 0.03% hydrogen peroxide or broth culture of Streptococcus gordonii Challis were placed on the agar with cultures of A. actinomycetemcomitans or A. aphrophilus. The size of the growth inhibition zone associated with the disc was measured after 2-day culture.ResultsFive of the 13A. aphrophilus strains exhibited a transformation frequency of 10⁻⁶ or higher. The intra- and inter-species transformation frequencies were comparable. The inhibition zones for katA-negative strains of A. actinomycetemcomitans or A. aphrophilus were 3- to 7-fold larger than those associated with katA-positive strains (p<0.05).ConclusionsThere was no apparent species barrier for the transfer and expression of A. actinomycetemcomitans katA in A. aphrophilus. The inserted A. actinomycetemcomitans-specific katA gene in A. aphrophilus strain NJ8700 conferred resistance to inhibition by hydrogen peroxide or S. gordonii. The potential to swap genes between these two closely related oral species may be an alternative approach for investigating the virulence determinants of A. actinomycetemcomitans.



http://ift.tt/2Az0tD9

Anti-inflammatory Activity of Cannabinoid Receptor 2 Ligands in Primary hPDL Fibroblasts

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Ammaar H. Abidi, Chaela S. Presley, Mustafa Dabbous, David A. Tipton, Suni M. Mustafa, Bob M. Moore II
ObjectivesApproximately 65 million adults in the US have periodontitis, causing tooth loss and decreased quality of life. Cannabinoids modulate immune responses, and endocannabinoids are prevalent during oral cavity inflammation. Targets for intervention in periodontal inflammation are cannabinoid type 1 and 2 receptors (CB1R, CB2R), particularly CB2R because its levels increase during inflammation. We previously demonstrated that SMM-189 (CB2R inverse agonist) decreased pro-inflammatory cytokine production in primary microglial cells. The hypothesis of this study was that cannabinoids anandamide (AEA), HU308 (CB2R selective agonist), and SMM-189 decrease pro-inflammatory IL-6 and MCP-1 production by primary human periodontal ligament fibroblasts (hPDLFs) stimulated with P.gingivalis LPS, TNFα, or IL-1β.DesignCytotoxic effects of cannabinoid compounds (10⁻⁴ −10^−6.5M), LPS (1–1000ng/ml), TNFα (10ng/ml) and IL-1β (1ng/ml) were assessed by measuring effects on cellular dehydrogenase activity. IL-6 and MCP-1 production were measured using Mesoscale Discovery (MSD) Human Pro-Inflammatory IL-6 and MSD Human Chemokine MCP-1 kits and analyzed using MSD Sector 2400 machine.ResultsEC50 values for AEA, SMM-189, and HU308 were 16μM, 13μM, and 7.3μM respectively. LPS (1μg/ml), TNFα (10ng/ml), and IL-1β (1ng/ml) increased IL-6 and MCP-1 production, which were inhibited by AEA, SMM-189, and HU308. AEA alone significantly increased IL-6, but not MCP-1 levels, but the other cannabinoids alone had no effect.ConclusionThe effective inhibition of LPS, TNFα, IL-1β-stimulated IL-6 and MCP-1 production by CB2R ligands in hPDLFs suggests that targeting the endocannabinoid system may lead to development of novel drugs for periodontal therapy, aiding strategies to improve oral health.



http://ift.tt/2jmRITr

Dickkopf-1 may regulate bone coupling by attenuating wnt/β-catenin signaling in chronic apical periodontitis

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): Xuelian Tan, Dingming Huang, Wei Zhou, Li Yan, Junli Yue, WanLu Lu, Dongzhe Song, Xuedong Zhou, Ling Ye, Lan Zhang
ObjectiveAlveolar bone loss is a common outcome of chronic apical periodontitis. In this study, we investigated the involvement of the Dickkopf-1-Wnt/β-catenin signaling pathway in the attenuation of osteogenic differentiation induced by Escherichia coli lipopolysaccharide, and we evaluated the use of Dickkopf-1 inhibitor and Dickkopf-1 recombinant protein to reverse bone loss in different phases of osteogenic differentiation.MethodsMC3T3-E1 cells grown in osteogenic medium were treated with Escherichia coli lipopolysaccharide for 24h during osteogenic induction on days 0, 1, 7, 14 and 21. Dickkopf-1 siRNA was added on days 0 and 1, and Dickkopf-1 recombinant was added on days 7, 14, and 21. Quantitative real-time PCR, Western blotting and alkaline phosphatase activity assays were performed to measure osteogenic marker expression and Wnt/β-catenin signaling. A rat apical periodontitis model was used to further evaluate the function of Dickkopf-1 in relation to bone loss.ResultsMC3T3-E1 cells treated with Escherichia coli lipopolysaccharide showed decreased mRNA expression of osteogenic markers. Wnt/β-catenin signaling was also inhibited, and Dickkopf-1 showed corresponding variations as quantified by Western blotting. Using Dickkopf-1 inhibitor or Dickkopf-1 recombinant protein at different phases of osteogenic differentiation in vitro partially reversed the decrease in osteogenic marker expression. The rat apical periodontitis model indicated that the Dickkopf-1 inhibitor could restore bone loss in the periapical area in vivo.ConclusionsDickkopf-1 may play a key regulatory role in determining the outcome for bone in inflammatory environments, and modulating the Wnt/β-catenin signaling pathway via Dickkopf-1 inhibitor or recombinant protein may provide a potential therapeutic option to prevent bone destruction in endodontic disease.



http://ift.tt/2jnf4Is

High-refined carbohydrate diet promotes detrimental effects on alveolar bone and femur microarchitecture

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): C.C. Montalvany-Antonucci, M.C. Zicker, S. Macari, T.S.F. Pereira, I.M.A. Diniz, I. Andrade, A.V.M. Ferreira, T.A. Silva
The impact of high-refined carbohydrate (HC) diet on fat accumulation, adipokines secretion and systemic inflammation is well described. However, it remains unclear whether these processes affect bone remodeling.ObjectiveTo investigate the effects of HC diet in the alveolar bone and femur parameters.MethodsBalbC mice were fed with conventional chow or HC diet for 12 weeks. After experimental time maxillae, femur, blood and white adipose tissue samples were collected.ResultsThe animals feed with HC diet exhibited considerable increase of adiposity index and adipose tissue levels of TNF-α, IL-6, IL-10, IL-1β, TGF-β and leptin. Microtomography analysis of maxillary bone revealed horizontal alveolar bone loss and disruption of trabecular bone in mice feed with HC diet. These deleterious effects were correlated with a disturbance in bone cells and an augmented expression of Rankl/Opg ratio. Consistently, similar effects were observed in femurs, which also exhibited a reduction in bone maximum load and stiffness.ConclusionOur data indicates that HC diet consumption disrupts bone remodeling process, favoring bone loss. Underlying mechanisms relies on fat tissue accumulation and also in systemic and local inflammation.



http://ift.tt/2Az0rLx

Dentin sialophosphoprotein expression in enamel is regulated by Copine-7, a preameloblast-derived factor

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Su-Jin Park, Hye-Kyung Lee, You-Mi Seo, Chul Son, Hyun Sook Bae, Joo-Cheol Park
ObjectiveDentin sialophosphoprotein (Dspp) is expressed in odontoblasts and transiently expressed in early ameloblasts. However, the origin of Dspp in ameloblasts remains unclear. Our previous studies demonstrated that copine-7 (CPNE7), a molecule that is secreted by the dental epithelium, is expressed in early ameloblasts and is then translocated to differentiating odontoblasts; its expression levels correlate with odontoblast differentiation under the control of Dspp expression. The objective of this study is to figure out the relationship between CPNE7 and Dspp during amelogenesis.DesignThe gene expression patterns of CPNE7 and dentin sialoprotein (DSP) were examined by immunohistochemistry, western blot analysis, and real-time polymerase chain reaction. The effects of CPNE7 on Dspp regulation were investigated using luciferase and chromatin immunoprecipitation assays in ameloblastic HAT-7 cells.ResultsThe gene expression pattern of Cpne7 was similar to that of Dspp during ameloblast differentiation. Moreover, Gene expression omnibus profiles indicated that there is a close correlation between Cpne7 and Dspp expression in various normal human tissues. We also confirmed the effects of CPNE7 on the induction of Dspp in ameloblastic HAT-7 cells. Cpne7 overexpression promoted Dspp expression, whereas Dspp expression was down-regulated by Cpne7 inactivation.ConclusionsThese results suggest that the expression of Dspp in early amelogenesis is linked to CPNE7, a preameloblast-derived factor.



http://ift.tt/2AChXMU

Genomic integration and expression of the Aggregatibacter actinomycetemcomitans catalase gene in Aggregatibacter aphrophilus

Publication date: Available online 5 December 2017
Source:Archives of Oral Biology
Author(s): Yuting Alice Yang, Ya-An Cheng, Casey Chen
ObjectiveTo test the hypothesis that virulence genes of Aggregatibacter actinomycetemcomitans can be expressed and confer fitness advantages in the closely related Aggregatibacter aphrophilus.DesignClinical isolates of A. aphrophilus were screened for natural competence with marked genomic DNA from A. actinomycetemcomitans and A. aphrophilus. The gene katA of A. actinomycetemcomitans D7S-1 and its flanking regions were constructed and inserted into a comparable locus in the genome of naturally competent A. aphrophilus strains by a markerless protocol via natural transformation. Mutants of A. actinomycetemcomitans with or without katA were also constructed by a similar protocol. Discs soaked with either 0.03% hydrogen peroxide or broth culture of Streptococcus gordonii Challis were placed on the agar with cultures of A. actinomycetemcomitans or A. aphrophilus. The size of the growth inhibition zone associated with the disc was measured after 2-day culture.ResultsFive of the 13A. aphrophilus strains exhibited a transformation frequency of 10⁻⁶ or higher. The intra- and inter-species transformation frequencies were comparable. The inhibition zones for katA-negative strains of A. actinomycetemcomitans or A. aphrophilus were 3- to 7-fold larger than those associated with katA-positive strains (p<0.05).ConclusionsThere was no apparent species barrier for the transfer and expression of A. actinomycetemcomitans katA in A. aphrophilus. The inserted A. actinomycetemcomitans-specific katA gene in A. aphrophilus strain NJ8700 conferred resistance to inhibition by hydrogen peroxide or S. gordonii. The potential to swap genes between these two closely related oral species may be an alternative approach for investigating the virulence determinants of A. actinomycetemcomitans.



http://ift.tt/2Az0tD9

Anti-inflammatory Activity of Cannabinoid Receptor 2 Ligands in Primary hPDL Fibroblasts

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Ammaar H. Abidi, Chaela S. Presley, Mustafa Dabbous, David A. Tipton, Suni M. Mustafa, Bob M. Moore II
ObjectivesApproximately 65 million adults in the US have periodontitis, causing tooth loss and decreased quality of life. Cannabinoids modulate immune responses, and endocannabinoids are prevalent during oral cavity inflammation. Targets for intervention in periodontal inflammation are cannabinoid type 1 and 2 receptors (CB1R, CB2R), particularly CB2R because its levels increase during inflammation. We previously demonstrated that SMM-189 (CB2R inverse agonist) decreased pro-inflammatory cytokine production in primary microglial cells. The hypothesis of this study was that cannabinoids anandamide (AEA), HU308 (CB2R selective agonist), and SMM-189 decrease pro-inflammatory IL-6 and MCP-1 production by primary human periodontal ligament fibroblasts (hPDLFs) stimulated with P.gingivalis LPS, TNFα, or IL-1β.DesignCytotoxic effects of cannabinoid compounds (10⁻⁴ −10^−6.5M), LPS (1–1000ng/ml), TNFα (10ng/ml) and IL-1β (1ng/ml) were assessed by measuring effects on cellular dehydrogenase activity. IL-6 and MCP-1 production were measured using Mesoscale Discovery (MSD) Human Pro-Inflammatory IL-6 and MSD Human Chemokine MCP-1 kits and analyzed using MSD Sector 2400 machine.ResultsEC50 values for AEA, SMM-189, and HU308 were 16μM, 13μM, and 7.3μM respectively. LPS (1μg/ml), TNFα (10ng/ml), and IL-1β (1ng/ml) increased IL-6 and MCP-1 production, which were inhibited by AEA, SMM-189, and HU308. AEA alone significantly increased IL-6, but not MCP-1 levels, but the other cannabinoids alone had no effect.ConclusionThe effective inhibition of LPS, TNFα, IL-1β-stimulated IL-6 and MCP-1 production by CB2R ligands in hPDLFs suggests that targeting the endocannabinoid system may lead to development of novel drugs for periodontal therapy, aiding strategies to improve oral health.



http://ift.tt/2jmRITr

Dickkopf-1 may regulate bone coupling by attenuating wnt/β-catenin signaling in chronic apical periodontitis

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): Xuelian Tan, Dingming Huang, Wei Zhou, Li Yan, Junli Yue, WanLu Lu, Dongzhe Song, Xuedong Zhou, Ling Ye, Lan Zhang
ObjectiveAlveolar bone loss is a common outcome of chronic apical periodontitis. In this study, we investigated the involvement of the Dickkopf-1-Wnt/β-catenin signaling pathway in the attenuation of osteogenic differentiation induced by Escherichia coli lipopolysaccharide, and we evaluated the use of Dickkopf-1 inhibitor and Dickkopf-1 recombinant protein to reverse bone loss in different phases of osteogenic differentiation.MethodsMC3T3-E1 cells grown in osteogenic medium were treated with Escherichia coli lipopolysaccharide for 24h during osteogenic induction on days 0, 1, 7, 14 and 21. Dickkopf-1 siRNA was added on days 0 and 1, and Dickkopf-1 recombinant was added on days 7, 14, and 21. Quantitative real-time PCR, Western blotting and alkaline phosphatase activity assays were performed to measure osteogenic marker expression and Wnt/β-catenin signaling. A rat apical periodontitis model was used to further evaluate the function of Dickkopf-1 in relation to bone loss.ResultsMC3T3-E1 cells treated with Escherichia coli lipopolysaccharide showed decreased mRNA expression of osteogenic markers. Wnt/β-catenin signaling was also inhibited, and Dickkopf-1 showed corresponding variations as quantified by Western blotting. Using Dickkopf-1 inhibitor or Dickkopf-1 recombinant protein at different phases of osteogenic differentiation in vitro partially reversed the decrease in osteogenic marker expression. The rat apical periodontitis model indicated that the Dickkopf-1 inhibitor could restore bone loss in the periapical area in vivo.ConclusionsDickkopf-1 may play a key regulatory role in determining the outcome for bone in inflammatory environments, and modulating the Wnt/β-catenin signaling pathway via Dickkopf-1 inhibitor or recombinant protein may provide a potential therapeutic option to prevent bone destruction in endodontic disease.



http://ift.tt/2jnf4Is

High-refined carbohydrate diet promotes detrimental effects on alveolar bone and femur microarchitecture

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): C.C. Montalvany-Antonucci, M.C. Zicker, S. Macari, T.S.F. Pereira, I.M.A. Diniz, I. Andrade, A.V.M. Ferreira, T.A. Silva
The impact of high-refined carbohydrate (HC) diet on fat accumulation, adipokines secretion and systemic inflammation is well described. However, it remains unclear whether these processes affect bone remodeling.ObjectiveTo investigate the effects of HC diet in the alveolar bone and femur parameters.MethodsBalbC mice were fed with conventional chow or HC diet for 12 weeks. After experimental time maxillae, femur, blood and white adipose tissue samples were collected.ResultsThe animals feed with HC diet exhibited considerable increase of adiposity index and adipose tissue levels of TNF-α, IL-6, IL-10, IL-1β, TGF-β and leptin. Microtomography analysis of maxillary bone revealed horizontal alveolar bone loss and disruption of trabecular bone in mice feed with HC diet. These deleterious effects were correlated with a disturbance in bone cells and an augmented expression of Rankl/Opg ratio. Consistently, similar effects were observed in femurs, which also exhibited a reduction in bone maximum load and stiffness.ConclusionOur data indicates that HC diet consumption disrupts bone remodeling process, favoring bone loss. Underlying mechanisms relies on fat tissue accumulation and also in systemic and local inflammation.



http://ift.tt/2Az0rLx

Dentin sialophosphoprotein expression in enamel is regulated by Copine-7, a preameloblast-derived factor

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Su-Jin Park, Hye-Kyung Lee, You-Mi Seo, Chul Son, Hyun Sook Bae, Joo-Cheol Park
ObjectiveDentin sialophosphoprotein (Dspp) is expressed in odontoblasts and transiently expressed in early ameloblasts. However, the origin of Dspp in ameloblasts remains unclear. Our previous studies demonstrated that copine-7 (CPNE7), a molecule that is secreted by the dental epithelium, is expressed in early ameloblasts and is then translocated to differentiating odontoblasts; its expression levels correlate with odontoblast differentiation under the control of Dspp expression. The objective of this study is to figure out the relationship between CPNE7 and Dspp during amelogenesis.DesignThe gene expression patterns of CPNE7 and dentin sialoprotein (DSP) were examined by immunohistochemistry, western blot analysis, and real-time polymerase chain reaction. The effects of CPNE7 on Dspp regulation were investigated using luciferase and chromatin immunoprecipitation assays in ameloblastic HAT-7 cells.ResultsThe gene expression pattern of Cpne7 was similar to that of Dspp during ameloblast differentiation. Moreover, Gene expression omnibus profiles indicated that there is a close correlation between Cpne7 and Dspp expression in various normal human tissues. We also confirmed the effects of CPNE7 on the induction of Dspp in ameloblastic HAT-7 cells. Cpne7 overexpression promoted Dspp expression, whereas Dspp expression was down-regulated by Cpne7 inactivation.ConclusionsThese results suggest that the expression of Dspp in early amelogenesis is linked to CPNE7, a preameloblast-derived factor.



http://ift.tt/2AChXMU

Mucosal Dehiscence After Alveolar Bone Graft in Cleft

Abstract Cleft lip and palate patient represent a challenging experience for the surgeon. This kind of patients had to be followed by a multidisciplinary team from the beginning to the end to avoid the deformation sequelae. During the several surgical procedures, the bone graft represents a possible procedure that, through the new procedure, could be avoided. Unfortunately, patient treated following the previous procedure must be submitted to alveolar bone graft to coordinate the arch, to restore the maxillary integrity, to allow the correct dentition. Address correspondence and reprint requests to Giulia Amodeo, MD, Via Giovanni Martinotti 20, 00135 Rome, Italy; E-mail: gamodeo@live.it Received 11 July, 2017 Accepted 19 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

http://ift.tt/2BHui1Y

Age-Related Volumetric Changes in Mandibular Condyles

Abstract A precise knowledge of the condylar changes with advancing age may improve understanding of pathophysiological alterations of the mandibular condyles. However, the majority of studies focusses on morphological changes, although volumetric analysis based upon cone beam computerized tomography may provide important additional data to characterize mandibular condyles. Therefore, we aimed to provide and compare volumetric data of mandibular condyles of a young and old patient group. This is a retrospective chart review of 195 patients with cone beam computerized tomography between 2007 and 2016. Student t test, analysis of variance, and Pearson correlation test were performed to analyze associations between categorical and continuous variables. P values

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The Aesthetic Analyzing of Midface Ratio After Folding Aponeurosis of Levator Palpebrae Superioris Muscle in the Ptosis Correction

Background: Some fordless-eyelid patients with moderate upper lid ptosis characterize in a higher eyebrow position which leads to an increased midfacial ratio. Apart from performing blepharoplasty to create dynamic folds, additional procedures such as folding aponeurosis of levator palpebrae superioris muscle were effective to revise the enlarged ratio of midface through lowering eyebrow, which gains good aesthetic results. However, the specific changes in the proportion of facial aesthetics and the importance of these change were serious lack in the literature as far as the authors know. Purpose: To measure the ratio of the length between upper edge of eyebrow and edge of lower eyelid (L1)/the length between edge of lower eyelid and nasal base (L2) in the fordless-eyelid and upper lid ptosis patients who received levator aponeurosis folding surgery, and to analyze the change in the proportion of midfacial aesthetics. Method: From December 2015 to October 2016, the pre- and postoperative photographs from 21 cases of patients with foldless eyelid and upper lid ptosis who underwent the levator aponeurosis folding procedures in the authors' department were collected as study group. Additional full-face pictures of 20 Chinese female movie stars were prepared as control group. The ratios of L1/ L2 (J) were measured via Adobe Photoshop CS6. The statistical significance was analyzed and the change of midfacial proportion was evaluated. Result: In the study group, the mean value of preoperative L1/L2 (J1) is 0.746, and (J2) 0.657 postoperatively. In the control group, the mean value of L1/L2 (J3) is 0.667. Statistical differences showed between the pre- and postoperative samples and between preoperative samples and control group. There was no statistical difference between postoperative samples and control group samples. The ratios between L1 and L2 in postoperative samples are close to those in the control group, which are closer to the golden radio. Conclusion: Levator aponeurosis folding can effectively lower eyebrow in patients with upper lid ptosis, shortening the length between eyebrow and lower eyelid, and therefore harvesting a more appropriate and harmonious ratio of L1/ L2 according to the golden section theory. The changes in the proportion of midfacial aesthetics after operation could be used as a key point in the preoperative communication and postoperative effect evaluation, besides the size of palpebral fissure and corneal exposure rate. Address correspondence and reprint requests to Chenyang Ji, MD, Sun Yat-Sen University, 33 NO. of Yingfeng Street, Guangzhou City, Guangdong Province, China; E-mail: jichenyang@163.com Received 10 July, 2017 Accepted 28 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

http://ift.tt/2BGY4nr

Pierre Robin Sequence: An Evidence-Based Treatment Proposal

Background: The Pierre Robin sequence (PRS) has been defined as the presence of micrognathia, glossoptosis, and respiratory obstruction in the neonatal period. Since its original description, different therapeutic approaches have been proposed obtaining different success rates, but there is no consensus about its management. Methods: A literature review was conducted in PubMed, Embase, and Cochrane databases, for the period of January,1985 to November, 2016. A number of 23 articles resulting from clinical studies, discussing diagnostic tests or therapeutic approaches, and directly or indirectly comparing diagnostic or treatment modalities were selected and assessed using the GRADE methodology. Results: After reviewing and analyzing the selected articles, an evidence-based algorithm for diagnosis and integral management of PRS patients was designed. Conclusion: Based on the anatomical principles and natural evolution of PRS, the clinical scenario must be evaluated thoroughly as a dynamic event to develop a management sequence that minimizes morbidity and mortality and accelerates patients' reinsertion to normal life. Address correspondence and reprint requests to Oswaldo J. Gómez, MD, Edificio Altos del Bosque, Calle 134 # 7-83, Consultorio 232, Bogotá, Colombia 110111; E-mail: oswaldogomez@me.com Received 6 April, 2017 Accepted 30 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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An Anatomic Morphological Study of Occipital Spurs in Human Skulls

Abstract Occipital spurs are quite common; however, they are also the source of frequent discomfort to the patients. Their role has been implicated in causation of pain at the base of skull, which may extend to shoulder limiting the movement of the shoulder and neck. The present was carried out to find out the prevalence of occipital spur in human skull and to find out the anatomic morphological characteristics of occipital spur. A total of 30 cadaveric skulls were examined in the Department of Anatomy, Uttar Pradesh University of Medical Sciences, for the presence of occipital spur. These skulls were the part of boneset obtained as a part of undergraduate training in the department. All the measurements were taken using a digital Vernier Caliper after taking all necessary precaution to avoid any damage to these spurs. The prevalence of occipital spur in the present study was 10%. The mean width recorded in the present study was 13.40 mm (±6.7) and the mean length recorded was 13.45 mm (±1.05). Similarly, mean thickness noted was 2.43 mm (±0.43). Thus, the present study concludes that occipital spurs are the frequent source of discomfort to patients. The knowledge of this tubercle is of paramount importance to neurosurgeons, sports physicians, and radiologists for the diagnosis of such discomfort. Address correspondence and reprint requests to Monika Srivastava, MS, Lecturer, Department of Anatomy, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, 206130, India; E-mail: monikad07@rediffmail.com Received 21 January, 2017 Accepted 29 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

http://ift.tt/2BGY2Ml

Scaffold Free Bone Regeneration Using Platelet-Rich Fibrin in Calvarial Defect Model

Abstract Bone regeneration is a complex process influenced by various physiological factors. Platelet-rich plasma (PRP) contains many growth factors and has shown osteogenic effects. The PRP is usually activated before use. However, the authors showed that nonactivated PRP (nPRP) and activated PRP have comparable osteogenic effects in the previous study. Generally, a scaffold has been needed for the application of PRP in the cranial defect model. In this study, the authors aimed to compare the performance of scaffold free platelet-rich fibrin (PRF) to nPRP as an adjuvant for bone regeneration. Twenty-four New Zealand White rabbits were randomly allocated into 3 groups: control, nPRP, and PRF. A 15 × 15 mm2 defect was created on each rabbit's cranium. Acellular collagen sponges (Gelfoam) were placed on the defects of the control group, Gelfoam with nPRP was used for the nPRP group, and PRF membrane was directly applied for the PRF group. nPRP and PRF were obtained from each subject's peripheral blood. Sixteen weeks later, the volume of regenerated bone was measured using 3-dimensional computed tomography. The surface area was measured via autopsy, and the samples were then obtained for histological analysis. Bone regeneration in the experimental groups was significantly greater than that in the control group. There were no significant differences in the area of regeneration or histological characteristics between the nPRP and PRF groups. In the calvarial defect of the rabbits, the use of PRF and scaffolded PRP showed comparable bone regeneration effects, which suggested that PRF might be a therapeutic alternative for bone grafts. Address correspondence and reprint requests to In Sik Yun, MD, PhD, Associate Professor, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul 135-720, Korea; E-mail: eqatom@yuhs.ac Received 13 July, 2017 Accepted 21 September, 2017 This work was supported by grants from the National Research Foundation of Korea (NRF) funded by the Korean government (Nos. NRF-2012R1A1A1006572 and NRF-2015R1D1A1A01060361, ISY). Conflict of interest: None of the authors have any conflicting or potentially influential interests with respect to this research. © 2017 by Mutaz B. Habal, MD.

http://ift.tt/2iwtwgI

Mandibular Reconstruction by Osteogenic Distraction Due to Two Different Injuries

Abstract Varied factors, whether intrinsic or extrinsic, may lead to a decrease in the bone volume of the jaws. Trauma and pathology can be listed as examples of such factors. The aim of this study is to present the osteogenic distraction technique as alternative to augmentation of low mandibular bone volume caused by different etiologies. The first case reports a mandibular marginal resection of ameloblastoma and the second one reports a male patient presenting mandibular fracture sequelae. Both cases were treated according to the osteogenic distraction technique. Several factors have influence on the decision of treatment management of these conditions. Although autogenous bonegraft is considered criterion standard for alveolar reconstruction, its high rates of resorption and the morbidity associated to donor sites lead surgeons to seek for other surgical alternatives such as osteogenic distraction. Therefore, it also aims to expose the advantages and benefits of this technique as well as the satisfactory results achieved. Address correspondence and reprint requests to Guilherme dos Santos Trento, Dental School at Araraquara – Unesp – Brazil, 1680th Humaitá Street, Araraquara, São Paulo14801-903, Brazil; E-mail: guilhermetrento@yahoo.com.br Received 4 August, 2017 Accepted 21 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Detailed Anatomy of Osteoperiosteal Ligamentous Structures in the Forehead

Abstract This study aimed to present the anatomic characteristics of osteoperiosteal ligamentous attachments of the forehead and provide a better understanding of lateral eyebrow descent for safe and effective foreheadplasty. Anatomic dissections of the face were performed in 10 fresh Korean adult cadavers (20 hemifaces) using 2.5× magnification surgical loupes. Supraorbital, inferomedial orbital, and frontonasal osteoperiosteal ligamentous attachments were identified as fibrous tissues originating from a bone, and their tensile strengths were measured. The supraorbital osteoperiosteal ligamentous attachment had medial and lateral parts. It can be classified into 4 subtypes. It was located 11.0 ± 6.6 mm lateral to the midline and 9.2 ± 12.3 mm superior to the superior orbital margin. The inferomedial orbital osteoperiosteal ligamentous attachment was located 16.2 ± 3.9 mm lateral to the midline and 2.2 ± 2.7 mm inferior to the superior orbital margin, whereas the frontonasal osteoperiosteal ligamentous attachment was located 5.4 ± 2.3 mm lateral to the midline and 1.4 ± 8.5 mm superior to the superior orbital margin. Tensile strengths of all the osteoperiosteal ligamentous attachments in the forehead were above 10 N. These results indicate that osteoperiosteal ligamentous attachments develop in the rather medial region of the eyebrow and have a tensile strength adequate enough to maintain the medial eyebrow. Thus, the current study provides surgeons with detailed anatomic information that can be used as a valuable reference for forehead rejuvenation procedures. Address correspondence and reprint requests to Yong Seok Nam, PhD, and In-Beom Kim, MD, PhD, Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; E-mail: boffin@catholic.ac.kr [YSN] and ibkimmd@catholic.ac.kr [I-BK] Received 31 August, 2017 Accepted 23 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Nasal Septal Cavernous Hemangioma

Abstract Hemangiomas are benign tumors originating from the skin, mucosa, muscle, gland, and vascular tissue in the bone. Although it is common in the head and neck region, it is rarely seen in the nasal cavity and paranasal sinuses. Histologically capillary, cavernous, and mixed types are present, the most common is cavernous-type hemangioma. Cavernous hemangiomas in the nasal cavity, generally originated from the lateral nasal wall, cause symptoms as nasal obstruction and epistaxis. In the author's patient, cavernous hemangioma was originated from the nasal septum, where rarely seen. The author wanted to discuss this rare disease by presenting a 78-year-old woman who presented with nasal obstruction and recurrent epistaxis to the author's clinic. Address correspondence and reprint requests to Ahmet Baki, MD, Otorhinolaryngology Clinic, Health Sciences University, Umraniye Education and Training Hospital, Istanbul, Turkey; E-mail: dr.ahmet170@yahoo.com Received 17 June, 2017 Accepted 23 September, 2017 The author reports no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Cross-Sectional Study of four Serological Bone Turnover Markers for the Risk Assessment of Medication-Related Osteonecrosis of the Jaw

Background: Despite the benefits related to the use of bisphosphonates and denosumab, medication-related osteonecrosis of the jaw (MRONJ) is a serious complication. The purpose of this study was to investigate the utility of 4 biochemical markers including serum c-terminal telopeptide cross-link of type I collagen (s-CTX), serum osteocalcin (s-OC), serum parathormon (s-PTH), and serum bone-specific alkaline phosphatase (s-BAP) as useful clinical tools to help assess the risk for MRONJ prior to invasive oral surgery. Materials and Methods: Twenty patients diagnosed with MRONJ and 20 controls who have been on antiresorptive therapies with no occurrence of MRONJ were included in this 2-arm cross-sectional study. The s-CTX, s-OC, s-PTH, and s-BAP values were measured. Mann–Whitney U test compared the s-CTX, s-OC, s-PTH, and s-BAP values of the MRONJ group and the controls (P 

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Review of “Surgical Mentorship: A Great Tradition, But Can We Do Better for the Next Generation?” by Lillemoe KD in Ann Surg 266:401–410; 2017

No abstract available

http://ift.tt/2BGZu1h

Seasonal Variation of Orofacial Clefts

Background: Orofacial clefts represent the most common craniofacial malformation diagnosed at birth and may be divided into isolated cleft lip (CL), cleft lip and palate (CL/P), or isolated cleft palate (CP). The causes of orofacial clefts have long been understood to be multifactorial; however, research into the genetic and environmental factors underpinning these disorders in African populations is scant. Seasonal variation in the occurrence of orofacial clefts was investigated. Seasonal variation is defined as differences due to periodic, temporal, and external influences, namely the particular time or season of the year. Methods: The study design is a retrospective record review and sampled patients presenting to the Cleft Clinic at Charlotte Maxeke Johannesburg Academic Hospital during the time period October 2000 to October 2015. Ethical approval was obtained. Information recorded included patient demographics (date of birth and gender), diagnosis and laterality of the cleft. Results: This study includes 512 infants. This study shows seasonal variation in the incidence of orofacial clefts limited to patients with both a CL/P. There was no significant seasonal variation observed in isolated CL or CP and laterality of the cleft. Significant seasonal variation was observed only in those born in winter versus summer, with more children born with a CL/P in winter months. Conclusion: Seasonal (or temporal) variation indicates a distinct environmental influence on the formation of orofacial clefts in utero, more specifically in pregnancies with the first trimester during spring. Several reasons have been advanced and include sunlight exposure and vitamin D levels, weight gain, and maternal obesity. More study is required to further elucidate these reasons. Address correspondence and reprint requests to Chrysis Sofianos, MBBCh, MRCS, Box 79663, Senderwood 2145, South Africa; E-mail: sofianosc@gmail.com Received 30 March, 2017 Accepted 25 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Tracing the Use of Cautery in the Modern Surgery

No abstract available

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Mandibular Reconstruction Using a Customized Three-Dimensional Titanium Implant Applied on the Lingual Surface of the Mandible

Abstract A patient had a right mandibular defect due to resection of an ameloblastoma. Previously, the defect had been reconstructed by an iliac bone graft, and subsequently, a titanium mesh with xenograft was used. However, it was not successfully reconstructed. For the recovery of mandible continuity and rehabilitation of jaw movement, we manufactured a customized 3-dimensional titanium implant by computer-aided design and manufacturing and electron beam melting technology. This implant was designed to have a porous body structure and lingual plate. The customized implant was accurately inserted in the bony defect. As a result, the patient showed a normal range of mouth opening and jaw movement. New bone migration was observed in the porous structure of the implant. Although there was a slight plate exposure and lack of alveolar bone formation, the customized 3D titanium implant successfully reconstructed the mandibular discontinuous defect and recovered jaw movement. Address correspondence and reprint requests to Hyun Seok, DDS, PhD, Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea; E-mail: address: sok8585@hanmail.net Received 16 May, 2017 Accepted 14 August, 2017 This work was carried out with the support of "Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ01121404)," Rural Development Administration, Republic of Korea. The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://ift.tt/2iuFjMi). © 2017 by Mutaz B. Habal, MD.

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The Effect of Midface Advancement Surgery on Obstructive Sleep Apnoea in Syndromic Craniosynostosis

Background: Children with syndromic craniosynostosis frequently suffer from obstructive sleep apnoea (OSA). The aim of the authors' study was to investigate if midface advancement surgery for patients with SC improved the severity of OSA by examining the results of sleep studies before and after surgery. Methods: A retrospective comparison of the pre and postoperative sleep study data of children undergoing midface advancement surgery at Great Ormond Street Hospital between 2007 and 2016. Results: A total of 65 children underwent midface advancement surgery between 2007 and 2016 at Great Ormond Street Hospital and had recorded pre- and postoperative sleep studies. Thirteen patients were excluded from the analysis as their sleep study techniques before and after surgery were not comparable (e.g., different conditions with prong/continuous positive airway pressure use). Fifty-six percent of the patients were treated by monobloc surgery and the remainder with bipartition surgery. A greater proportion of patients had a normal OSA grading following midface advancement (42.3% postoperatively vs. 23.1% preoperatively, P = 0.059) although no statistically significant categorical changes in OSA grade were observed. Seventy-one percent of the patients had a decrease in Apnoea-Hypopnoea Index after surgery (21 patients 2011 onward). Similarly, there was no significant change in median oxygen desaturation index or in oxygen saturation nadir following surgery. Conclusion: The authors report one of the largest reviews of the effects of midface advancement surgery on sleep study parameters. Most patients showed improvements in Apnoea-Hypopnoea Index and OSA grading, although measures of oxygenation showed no consistent change. Address correspondence and reprint requests to Clair Saxby, BM, MRCS (ENT), Great Ormond Street Hospital For Children NHS Trust, London WC1N 3JH, UK; E-mail: cesaxby@doctors.net.uk Received 19 June, 2017 Accepted 10 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Temporomandibular Joint Ankylosis: Algorithm of Treatment

No abstract available

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Review of “Surgical Performance: A Pathway to Excellence” by Aggarwal R in Ann Surg 266:220–222, 2017

No abstract available

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Effect Evaluation of Modified Uvulopalatopharyngoplasty With Low-Temperature Plasma and Selective Nasal Cavity Vasodilatation With Tongue Volume Reduction in Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To compare the clinical effects of modified uvulopalatopharyngoplasty (UPPP) with low-temperature plasma with selective nasal cavity vasodilatation with tongue volume reduction for obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods: A retrospective analysis based on 156 patients with serious OSAHS was used for the evaluation. These patients were divided into 2 groups according to surgery methods according to 1:1.s. The patients in observation group accepted modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue root volume reduction on the basis of fully preparation for surgery, while the patients in the control group accepted normal treatment. The clinic effects, operative complications, postoperative relapse, and other indexes were compared. Result: After 6 months of follow-up visit, the general effective rates of the observation group and control groups were 80.77% and 61.54%, the difference was statistically significant (P 

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Three-Dimensional Bioprinting Can Help Bone

No abstract available

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Effect of Septoplasty on the Heart Rate Variability in Patients With Nasal Septum Deviation

Background: Nasal septum deformities (NSD) are one of the most common causes of upper airway obstruction. Heart rate variability (HRV) is a physiologic parameter that is affected by the balance between the sympathetic and parasympathetic tonus. Objective: The aim of this study was to evaluate the effects of a septoplasty operation on HRV parameters as assessed by 24 hours ambulatory Holter recordings in patients with NSD. Methods: The prospective study involved 54 consecutive patients (16 women and 38 men) who underwent septoplasty due to a marked C- or S-shaped NSD. Twenty-four-hour Holter monitoring was performed to all patients pre- and 2 months postseptoplasty operation. For the HRV analyses, the definitions of evaluated parameters were made according to the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology on HRV. Results: Low-frequency norm () (73 [68–86] versus 78 [70–81], P = 0.039) values were significantly increased after septoplasty whereas changes in other parameters were not statistically significant. Conclusion: The authors' study showed that low-frequency norm values were significantly increased after septoplasty operation in patients with NSD which may be interpreted as a decreased sympathetic tone. Address correspondence and reprint requests to Metin Celiker, MD, Department of Ear Nose and Throat Surgery, Recep Tayyip Erdogan University Hospital, Sehitler Avenue, No:74, Rize, Turkey; E-mail: meceliker@hotmail.com Received 20 July, 2017 Accepted 23 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Race as a Predictor of Patient Preferences for Biopsy Result Communication

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Generational Influence on Patient Learning Preferences in Dermatology

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Do TV Drug Ads Say Too Much About Risks?

The FDA thinks that less may be more when it comes to drug ads on TV and radio.
Medscape Reader Polls

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Hurricane Katrina: Exploring justice and fairness as a sociology of common good(s)

Publication date: Available online 6 December 2017
Source:Critical Perspectives on Accounting
Author(s): Stephanie Perkiss, Lee Moerman
Disasters or crises present opportunities to challenge society's taken-for-granted assumptions about the order of things. This paper applies the sociology of worth (SOW), as detailed by Boltanski & Thévenot, ([1991] 2006), to conceptualize the 'common good' in complex social situations or disputes, in this case a disaster. We use SOW to construct a narrative of Hurricane Katrina according to a nuanced understanding of disruptions to the social order. Previous accounting studies of disasters have demonstrated how accounts play a pivotal role in defining questions of justice and accountability – to whom and for what? SOW provides a framework to accommodate multiple rationalities and experiences in relation to a particular 'situation'. We argue that the common good, evaluated through logic and reasoning within a 'situation' or social reality, is multiple. This study contributes to our understanding of and making visible the contentions, compromises and conflicts that arise from a disaster and mobilize neglected or hidden accounts of what it means to achieve the common good.



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Complete B Cell Deficiency Reduces Allograft Inflammation and Intragraft Macrophages a Rat Kidney Transplant Model

ABSTRACT Background Increasingly it is being appreciated that B cells have broad roles beyond the humoral response, and are able to contribute to and regulate inflammation. The specific role of B cells in the pathogenesis of early allograft inflammation remains unclear. Methods To address this question, we generated B cell deficient Lewis rats via CRISPR technology. In a full mismatch transplant model, kidneys from Brown Norway donors were transplanted into B cell deficient Lewis recipients (B-/-) or wild type Lewis recipients. T cell mediated rejection was attenuated with cyclosporine. Results Renal inflammation was reduced at 1 week after transplant (Banff scores for interstitial inflammation, microvascular inflammation, glomerulitis, and C4d) in allografts from B-/- recipients. The reduction in interstitial inflammation was predominantly due to a decline in graft infiltrating macrophages. Intragraft T cell numbers remained unchanged. In addition, B cell deficiency was associated with increased T regulatory cells and reduced splenic T follicular helper cells at baseline; and significantly increased intragraft and splenic IL-10 mRNA levels after transplant. In vitro, B-/- and wild type splenic T cells produced similar levels of IFN-γ in response to T cell specific activation. Conclusions B cell deficiency in this model produced an anti-inflammatory phenotype with a shift towards regulatory T cell populations, production of anti-inflammatory cytokines (IL-10), and a reduction in allograft inflammation. These findings define a role for B cells to influence the cell populations and mediators involved in the pathogenesis of early allograft inflammation. Corresponding author: Sarah E. Panzer, MD, Division of Nephrology, Department of Medicine, 1685 Highland Avenue, Madison, WI 53705, sepanzer@medicine.wisc.edu Authorship statement: Sarah E. Panzer: concept, study design, performance of research, data analysis, writing of paper Nancy A. Wilson: performance of research, data analysis, writing of paper Bret M. Verhoven: performance of research, data analysis, writing of paper Ding Xiang: performance of research, review of manuscript C. Dustin Rubinstein: performance of research, data analysis, writing of paper Robert R. Redfield: data analysis, review of manuscript Weixiong Zhong: performance of research, review of manuscript Shannon R. Reese: study design, performance of research, data analysis, writing of paper Disclosure: The authors declare no conflict of interest. Funding: This project was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427, and the KL2 training Award (KL2TR000428). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Comparison of Preemptive Therapy and Antiviral Prophylaxis for Prevention of Cytomegalovirus in Seropositive Liver Transplant Recipients

Background Few studies have directly compared preemptive therapy (PET) and antiviral prophylaxis (AP) for prevention of cytomegalovirus disease in CMV seropositive (R+) orthotopic liver transplant (OLT) recipients. Methods We prospectively assessed CMV disease and clinical outcomes among 160 consecutive R+ OLT recipients who received PET (weekly plasma CMV PCR for 3 months, oral valganciclovir 900 mg twice daily for CMV viremia >250 IU/mL, until 2 consecutive negative weekly PCR results) and compared them to a historical cohort of 156 R+ recipients who received AP (valganciclovir 900 mg daily for 3 months). Results Patient characteristics were similar between PET and AP cohorts (p>0.05 all comparisons). In the PET group, 24% (39/160) developed CMV viremia >250 IU/mL at a median of 42 (range 7-93) days post-OLT. CMV monitoring adherence in the PET cohort was 85% (1488/1760 required tests) and 86% (30/36) initiated PET within 3 days of the CMV result. By 12 months post-OLT, the incidence of CMV disease, acute allograft rejection, major infection, or death in the PET and AP cohorts was not significantly different: 2% vs 2%, 19% vs 16%, 10.5% vs 10.8%, and 5% vs 8%, respectively (p > 0.05 all comparisons). The estimated proportion of drug-exposed patients and average antiviral drug exposure were significantly lower with PET vs AP: 24% vs 100%, p

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Influence of Blood Pressure and Calcineurin Inhibitors on Kidney Function After Heart or Liver Transplantation

ABSTRACT Background Chronic kidney disease is common after heart or liver transplantation, with calcineurin inhibitors (CNI) considered the key contributor. A possible influence of posttransplant blood pressure has not been extensively examined. Methods Data from adult recipients of a first heart or liver transplant were analyzed regarding the relationship between blood pressure at year 1, renal function at year 5, and CNI therapy. Results Whereas we confirmed the well-known detrimental effect of increased 1-year systolic blood pressure on 5-year kidney graft survival, heart or liver graft survival were not affected. However, among 2,534 heart transplant recipients with good renal function at year 1, increasing systolic blood pressure at year 1 was associated with higher rates of poor renal function at year 5 posttransplant. This association was confirmed on multivariate analysis overall (odds ratio [OR] 1.25 per 20 mmHg increment, P

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Liver Transplantation in Cryptogenic Cirrhosis: Outcome comparisons between NASH, Alcoholic and AIH cirrhosis

ABSTRACT Background The outcomes of liver transplantation (LT) in patients with cryptogenic cirrhosis (CC) have not been adequately examined except for small case series. We believe that patients currently listed as CC have truly cryptogenic liver disease and may have different post-LT outcomes compared to nonalcoholic steatohepatitis (NASH). Methods: We compared the post-LT outcomes of adults with CC (n=3241) and compared them with cirrhosis from NASH (n=4089), alcohol (AC, n=7837) and autoimmune hepatitis (AIH, n=1435) using the UNOS database from 2002-16. We excluded those who had multi-organ transplantation and hepatocellular carcinoma. In addition to the well-known predictors of liver transplant outcomes, we analyzed the impact of Karnofsky Performance Status (KPS) score at LT on immediate and late outcomes. Results There were significant differences in clinical characteristics between the groups. Despite these differences in clinical characteristics and risk factors, CC had similar graft and patient survival to NASH, AC and AIH when assessed by Kaplan-Meier survival. Multivariate Cox regression analysis showed that graft and patient survival was similar in all 4 groups after adjusting for other confounders. Hispanics had a 24% lower risk of death (Hazard Ratio {HR} 0.76) compared to Whites in these combined cohorts after adjusting for all risk factors. In addition to other known risk factors, KPS score of 30% or less was associated with a 33% increase in risk of death (HR 1.33) on multivariate analysis. Conclusion Patients with CC had similar graft and patient survival when compared to NASH, AC and AIH cirrhosis. Address for correspondence: Paul J. Thuluvath, MD, FAASLD, FRCP, Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD 21202, Tel: 410 332 9308; Fax: 410 659 1178; Email: thuluvath@gmail.com Conflicts of interest: None; Financial support: None Contributions: PJT and SH contributed to the idea, YS did the statistical analysis, PJT wrote the manuscript, SH and YS reviewed the final manuscript Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Variation in Practice Patterns for Listing Patients for Renal Transplantation in the United Kingdom: a National Survey

Introduction Despite the availability of guidelines for the evaluation of candidates for renal transplantation, variation in access to transplantation exists. This national survey investigates whether centre variation exists in the assessment of patients for renal transplantation in the UK. Methods An online survey, informed by qualitative interviews, was distributed to all UK renal centres. This survey examined centre approaches to chronic kidney disease service provision, transplant recipient assessment, education provision and wait-listing decision making processes. Centre re-evaluation policies for patients already listed and priorities for future development were also examined. Results All 71 renal centres responded. Of these, 83% reviewed predialysis patients in a low clearance clinic. In 26% of centres transplantation was not discussed as a treatment option with all patients. Fourteen centres reported having a dedicated transplant assessment clinic whilst 28% did not have a formal assessment protocol. Age was an exclusion criterion for listing in 3 centers, all of which had a cut off at 75 years. 83% of centres excluded patients with a high BMI. Cardiac investigations were risk-stratified in 90% of centres. Surgical involvement varied with 11% of centres listing patients without formal surgical review. There was no formal protocol in place to re-evaluate listed patients in 62% of centres. Conclusions There is wide variation in UK practice patterns for listing patients for renal transplantation, though its impact on access to transplantation is unclear. The extent to which centre-specific and patient-specific factors affect access to transplantation requires further analysis in a prospective cohort of patients. Rommel Ravanan PhD, Paul J. Roderick MD, denotes joint final author Corresponding author: Rishi Pruthi, Consultant Nephrologist, Royal Free Hospital, London NW3 2QG, UK, Tel: 020 7794 0500, Email: rishi.pruthi@nhs.net Authorship The authors declare no conflicts of interest. This article presents independent research funded by the National Institute for Health Research (NIHR) under the Programme Grants for Applied Research scheme (RP-PG-0109-10116). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analyses. Presented (as an abstract) at the Joint British Transplantation Society and Nederlandse Transplantatie Vereniging Congress, Bournemouth, 2015; and at the American Society of Nephrology Kidney Week, Philadelphia, 2014 Research idea and study design: RP, GL, CE, CT, AB, JLF, CB, JC, CD, CW, HD, RJ, WM, DF, RR, PJR; data acquisition: RP, STC, MC; data analysis/interpretation: RP, STC, GCO, RR, PJR; statistical analysis: RP; supervision or mentorship: RR, CE, GL, RR, PJR. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. RP takes responsibility that this study has been reported honestly, accurately, and transparently; and that no important aspects of the study have been omitted. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Recurrence of renal cell cancer after renal transplantation in a multicenter French cohort

ABSTRACT Background Renal cancer accounts for 3% of adult malignancies; renal cell carcinoma (RCC) represents 80% of all renal cancers, and is characterized by late recurrences. Recurrences after kidney transplantation are associated with a high mortality rate. We aimed to determine if recurrences are linked to tumor characteristics and to delays between diagnosis and transplantation. Methods We retrospectively analyzed data from French kidney-transplanted patients with medical histories of pre-transplant renal cancer, focusing on the most common histological subtypes: clear cell and papillary cancers. Characteristics of the tumors, patients, and kidney transplantations were documented, and posttransplant patient survival was analyzed. Results Of 143 patients, 13 experienced cancer recurrence after kidney transplantation. The mean delay in recurrence was 3±2.3 years posttransplantation, and the cumulative incidences of recurrence were 7.7% at 5 years and 14.9% at 10 years. The risk of recurrence was higher in patients with clear cell RCC (13% vs. 0%, p=0.015). There was no correlation between posttransplant recurrence and the interval before transplantation. Factors associated with a higher risk of cancer recurrence were histological clear cell RCC (p=0.025), tumor stage pT2 (p=0.002) and Fuhrman grade IV (p

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An abrupt bleeding of the anteriorly- displaced sigmoid sinus: a rare complication of myringoplasty

The location of the sigmoid sinus within the mastoid cavity is quite variable. An anteriorly- displaced vertical segment of the sigmoid sinus constitutes an uncommon but dangerous anatomical variation that sur...

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Optical Coherence Tomography Features of Dermatophytoma

This case report illustrates the optical coherence tomography features of dermatophytoma.

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Practicing Safe Dermatology—Screening Out Liability

The article "Characteristics of Medical Liability Claims Against Dermatologists From 1991 Through 2015" by Kornmehl and colleagues is a welcome addition in our quest to understand how to reduce dermatology practice risk. The study confirms much of what we already knew or suspected but also provides some new interesting insights. It is reassuring to see that most malpractice cases against dermatologists are "abandoned, withdrawn or dismissed." Similarly, it is comforting to know that there has been a net reduction of 29.2% in paid claims for dermatologists. Is this secondary to improved patient care? The changing landscape of tort reform? Or both?

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Knowledge to Detect Scalp and Neck Melanoma

This study tests the association between a video intervention and hairdresser knowledge of melanoma and self-confidence in skin lesion detection.

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Trends in Medical Liability Claims Against Dermatologists

This study analyzes 24 years of data through 2015 from a nationally representative liability claims registry to compare the medical liability claims against dermatologists vs nondermatologists.

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Immunotherapy and Overall Survival in Elderly Patients With Melanoma

This cohort study evaluates if age influences clinical outcome and immune adverse events in patients treated by immunotherapy for `metastatic melanoma.

http://ift.tt/2AvI769

Effect of Tannic acid on skin barrier function

Abstract

In this study, we investigated how tannic acid (TA) protects the skin from inflammation caused by external irritation. The effects of TA were evaluated by using a mouse 12-O-tetradecanoylphorbol 13-acetate (TPA)-induced skin inflammation model and a reconstructed human epidermal model (RHEM). We then used Lucifer Yellow for visual confirmation of TA's suppression effect at the SC surface. TA treatment of the skin prevented Lucifer Yellow from permeating the skin. This result suggests that TA acts as a barrier against external stimulants such as TPA and artificial sweat on the SC surface.

This article is protected by copyright. All rights reserved.

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Table of Contents

Publication date: January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 1





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Society Page

Publication date: January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 1





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Information for Readers

Publication date: January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 1





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