Publication date: Available online 9 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): A. Wood, B.I. Conn
We present two further cases of sclerosing microcystic adenocarcinoma occurring in the tongue of two female patients; one aged 68 years old and the other 49 years old. Histopathologically, both tumours were characterized by a diffusely infiltrative lesion consisting of small cuboidal cells arranged in discrete, dispersed cords, isolated tubules and bilayered strands with intervening microcystic lumina set in a sclerotic background. Both lesions showed striking neurotopism with perineural and intraneural infiltration. Extensive invasion of adjacent skeletal muscle was also observed. The tumour cells showed diffuse staining with antibodies to CK7. A dual population of ductal and myoepithelial cells was identified, with antibodies to CAM5.2 & CK5/6 decorating the inner epithelial layer and antibodies to p63, p40 and S100 staining the outer myoepithelial cell layer. The Ki-67 proliferation index in both cases was <5%. An initial diagnosis of adenocarcinoma NOS of salivary gland origin was made on both incisional biopsies with a possible metastatic origin, particularly from breast, also raised. A local minor salivary gland origin was confirmed after staging investigations and surgical resection. Both patients were treated by surgery alone and remain well five years and one year and two months post treatment respectively.
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Τρίτη 9 Ιανουαρίου 2018
Sclerosing microcystic adenocarcinoma of the tongue: a report of two further cases and review of the literature.
Larval infestation of chronic ischaemic leg ulcer
Description
Several cases of obligatory wound myiasis have been reported in the medical literature.1–3 For a long time, such infestation was perceived as a complication of poor quality wound care in patients with chronic ulcers. There are only three cases of wound myiasis reported in the literature. Demirel et al reported on a 68-year-old male patient with larvae infestations of diabetic wound that were discovered during surgical debridement.3 Another two cases of traumatic larval infestation associated with Bowen carcinoma and with chronic leg ulcer were reported.3 Up to date, there is no report of chronic ulcer with massive larvae infestation as in this patient.
Figure 1 with video capture (video 1) demonstrates a massive larvae infestation of severe chronic ischaemic ulcer in a 60-year-old homeless male patient with HIV, who presented with unilateral leg pain without systemic or...
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Bilateral haemorrhagic basal ganglia infarction associated with early-onset group B streptococcus meningitis
A 2-day-old infant presented with poor feeding and grunting. Investigations revealed a raised C reactive protein of 164. Full septic screen was done, which subsequently confirmed a diagnosis of group B streptococcus meningitis. Baby was apyrexial and haemodynamically stable. There were no obvious neurological manifestations, and a routine cranial ultrasound scan was done, which revealed echogenic changes in the basal ganglia and thalami. MRI brain showed extensive haemorrhagic infarction within the lentiform and caudate nuclei with involvement of both posterior limbs of the internal capsule. This was followed by triventricular hydrocephalus needing shunt procedure. The clinical course was complicated by infantile spasms, which were treated with vigabatrin and steroids and subsequent global developmental delay and cerebral palsy.
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Hepatic amyloidosis: a cause of rapidly progressive jaundice
Description
An 83-year-old man presented with an acute history of weight loss and jaundice. He had a history of type 2 diabetes mellitus and hypertension. He consumed 30 units of alcohol per week.
The patient was cachectic and jaundiced with non-tender hepatomegaly and no evidence of chronic liver disease. There was evidence of hypoalbuminaemia (albumin 25 g/L, reference 34–51 g/L), hyperbilirubinaemia (bilirubin 188 μmol/L, reference <22 μmol/L) and a raised alkaline phosphatase (629 IU/L, reference 35–105 IU/L). Full blood count, coagulation tests and the remaining liver function tests were normal. An estimated Glomerular filtration rate (eGFR) was 71 mL/min/1.73 m2. Autoantibodies and immunoglobulins were normal. Hepatitis viral serology was negative. Serum light chain measurements revealed kappa chain concentration of 13.3 (reference 3.3–19.4 mg/L) and lambda chain concentration of 28.5 (reference 5.7–26.6 mg/L) with a ratio of 0.47 (reference 0.26–1.75). A CT abdomen revealed hepatomegaly and ascites. He subsequently had a liver biopsy (figures 1–3
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Extraocular muscle cysticercosis: never skip steroids
DescriptionCase description
A 16-year-old girl presented with a 2-month history of recurrent (three episodes) right upper eyelid drooping and oedema (figure 1A). Examination showed fullness in the right upper eyelid along with elevation deficit. Visual acuity was 20/20 in each eye, and anterior and posterior segments were essentially within normal limits in both the eyes. To explain the cause, ultrasonography of the orbit for extraocular muscles revealed a large cyst in the superior rectus muscle along with a central hyperechoic spot corresponding to the scolex (figure 1B). Non-contrast CT of the orbit and brain revealed inflammatory thickening of the superior rectus muscle with the central cystic area harbouring the scolex without any intracranial foci (figure 1C). Based on the history and imaging findings a diagnosis of myocysticercosis was confirmed and the patient was started on tablet prednisolone 1mg/kg body weight from day 1 and tablet albendazole 15 mg/kg from day 3. The patient...
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Coats disease with exudative retinal detachment simulating cysticercus cyst: misleading ultrasonography!
Description
A 5-year-old boy was brought to our clinic when parents noticed white reflex and divergent squint in the left eye. Snellen visual acuity was 20/20 in the right eye and inaccurate projection of rays in the left eye along with a 30 prism dioptre divergent squint in the latter. Anterior segment was within normal limits in both eyes on slit lamp evaluation. As the child was uncooperative for detailed fundus examination, we performed an ocular ultrasonography. Ocular ultrasonography of the left eye showed an intraocular cystic mass with a localised hyperechoic area adjacent to cyst wall which is typical of a cysticercus cyst with scolex (figure 1). On Optomap ultra-wide-field fundus photography (Optos, Scotland, UK) we found that the cystic mass on ultrasonography was actually a localised exudative retinal detachment and the scolex-like area of hyperechogenicity was a large confluent exudate collection in the subretinal...
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Brain abscess in a patient with chronic sinusitis
Description
A middle-aged patient with a previous history of chronic sinusitis and arterial hypertension was admitted because of altered mental status. Two days earlier, symptoms such as fever, chills, nasal obstruction and headache slowly developed. On examination, the patient was febrile and with stiff neck. The remainder of the physical examination was normal. CT scan (figure 1A,B) and T1-MRI (figure 2A–C) were both performed; besides signs of sinusitis, a 2 cm right periatrial expansive lesion surrounded by vasogenic oedema was found being compatible with brain abscess. A thorough investigation was done to exclude infectious endocarditis, including echocardiography and blood cultures which were all negative. Viral serologies, including HIV, were negative. Based on the brain lesion characteristics (size and peculiar location), a conservative approach with broad-spectrum antibiotics (ceftriaxone, metronidazole and vancomycin) was initially suggested by Neurosurgery. However, 20 days after, the patient presented with neurological deterioration....
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Acute-on-chronic mesenteric ischaemia by early and diffuse atherosclerosis in a young adult patient
Description
A 48-year-old Caucasian man with gypsy ethnicity had smoking habits (35 pack-years) and previous alcohol consumption (10 g/day; abstinent for 3 years). There was no relevant personal/family cardiovascular disease, history of illicit drug abuse, non-steroidal anti-inflammatory drug use or other previous/current medications. He had a 3-year history of chronic diarrhoea (3–4 bowel movements/day), abdominal pain and weight loss (25.9% of usual weight; body mass index=13.7 kg/m2). In the last month, an exacerbation of abdominal pain occurred with excruciating postprandial episodes requiring opioid analgesia. Laboratory analysis showed leucocytosis (34.8; N: 4–11x109/L), neutrophilia (90.6%), normocytic/normochromic anaemia (haemoglobin: 8.0; N: 13–17 g/dL), high Erythrocyte sedimentation rate (ESR) (54; N<20 mm/hour), faecal calprotectin (4890; n<50 mg/kg) and C-reactive protein (CRP) (10.7; N<0.5 mg/dL). Oesophagogastroduodenoscopy and ileocolonoscopy with biopsies showed multiple Helicobacter pylori-negative gastroduodenal ulcers (figure 1A,B) and non-specific mild ulceration of the terminal ileum and proximal colon, without granulomas. CT enterography showed distended small bowel loops without...
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Birt-Hogg-Dube syndrome: spontaneous pneumothorax as a first symptom
Birt-Hogg-Dubé syndrome (BHDS) is a rare hereditary autosomal dominant condition characterised by benign cutaneous lesions, lung cysts, increased risk of spontaneous pneumothorax and renal cancer. It shows great heterogenous presentation within and between affected families. We report a case of a Danish female patient with recurrent pneumothoraces as the first symptom of BHDS. Over the years, she developed skin changes, and a family history of skin changes, pneumothoraces and renal cancer was discovered. BHDS was suspected, a genetic analysis was performed and a pathogenic variation c.1285delC in FLCN gene was detected in the patient. As we stated the diagnosis BHDS, we discovered several undiagnosed family members all of them now entering a lifelong follow-up programme with abdominal imaging because of the increased risk of developing renal cancer. BHDS should be known to oncologists, dermatologists and pulmonologists as the patients most often present to these medical disciplines.
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Iatrogenic foreign body in an adult with presbyacusis
Description
Foreign bodies in the external auditory meatus are a common presentation to Otolaryngology both to clinic and as an emergency.1 Most objects referred to Otolaryngology are round and hard such as beads and are more difficult to remove.1While many patients are aware of what might be in their ear, some do not. The causative event can be missed, and the symptoms can be non-specific.2 They may present with a foreign body sensation, a feeling of fullness in the ear, otalgia and recurrent otitis externa. Many of these symptoms can be applied to a presentation of impacted cerumen.
These images refer to a 67-year-old man who presented to Otolaryngology having been referred by his General Practitioner. On presentation to the clinic, he had persistent otalgia in the left ear and reduced hearing for the past 3 months. He also described a feeling of fullness...
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Modification of the Fitzpatrick system of skin phototype classification for the Indian population, and its correlation with narrowband diffuse reflectance spectrophotometry
Summary
Background
The Fitzpatrick classification for skin phototyping is widely used, but its usefulness in dark-skinned populations has been questioned by some researchers. Recently, skin colour measurement has been proposed for phototyping skin colour objectively.
Aims
To modify the Fitzpatrick system of skin phototyping for the Indian population and to study its correlation with skin colour using narrowband diffuse reflectance spectrophotometry
Methods
Answer choices for three items (eye colour, hair colour, colour of unexposed skin) out of 10 in the original Fitzpatrick questionnaire were modified, followed by self-administration of the original and the modified Fitzpatrick questionnaire by 70 healthy Indian volunteers. Skin colour (melanin and erythema indices) was measured from two photoexposed and two photoprotected sites using a narrowband reflectance spectrophotometer.
Results
The mean ± SD scores for the original and modified Fitzpatrick questionnaires were 25.40 ± 4.49 and 23.89 ± 4.82, respectively (r = 0.97, P < 0.001). The two items related to tanning habits were deemed irrelevant based on the subjects' response and were removed from the modified questionnaire. The Melanin Index (MI) of all sites correlated moderately well with both the modified (r = 0.61–0.64, P < 0.001) and original Fitzpatrick questionnaire scores (r = 0.64–0.67, P < 0.001), while the Erythema Index showed poor correlation with both. An MI value of ≧42 was found to be the cut-off between skin phototypes I–III and IV, and ≥ 47 between IV and V–VI.
Conclusions
Our modification of the Fitzpatrick questionnaire makes it more relevant to the Indian population. Spectrophotometry can be a useful objective tool for skin phototyping.
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Dermoscopic characterization of cutaneous lymphomas: a pilot survey
Abstract
Background
While substantial dermoscopic analysis of melanocytic lesions has been performed, dermoscopic characterization of cutaneous lymphoid proliferations has been limited. Cutaneous lymphoma, particularly early mycosis fungoides (MF) and its variants, is often challenging to clinically and pathologically distinguish from inflammatory processes of the skin. This study aimed to survey the dermoscopic findings of cutaneous lymphomas and to discern whether any patterns might potentially serve as specific signatures.
Methods
Fifteen patients with an established diagnosis of cutaneous lymphoma were prospectively recruited and seen in the university multidisciplinary cutaneous lymphoma program with MF, an MF- variant, CD30-positive lymphoproliferative disorder, or cutaneous B-cell lymphomas and were included in our study. Dermoscopic findings, histologic features, clinical characteristics, and demographic data were analyzed.
Results
Patch stage MF was characterized by interconnected white structureless patches encircling small fine linear vessels, yielding an overall trabeculated to fenestrated pattern under dermoscopy. Corresponding histopathologic findings for these patterns included epidermotropism, atypical pleomorphic cells, and lichenoid infiltrates. Folliculotropic mycosis fungoides (FMF) was characterized by folliculocentric erosions surrounded by dotted and fine linear vessels, loss of terminal follicles, comedo-like openings, and interconnected regular-appearing structureless patches. Corresponding histopathologic findings in these FMF cases were typical of FMF. Notably, these changes were not appreciated in lymphomatoid papulosis. Primary cutaneous follicle center B cell lymphoma showed crystalline structures and vascular pseudopods.
Conclusions
Cutaneous lymphomas appear to demonstrate characteristic dermoscopic patterns, reflective of the specific lymphoma type and its corresponding histopathology, which have not been seen in inflammatory skin conditions, such as psoriasis and eczematous dermatitis.
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The early repigmentation pattern of vitiligo is related to the source of melanocytes and by the choice of therapy: a retrospective cohort study
Abstract
Background
Patients with vitiligo present with different repigmentation patterns in the early recovery stage.
Objectives
To analyze the relationships between early repigmentation patterns in vitiliginous patches, their clinical characteristics, and therapeutic choices.
Methods
Patients with vitiligo seen in the Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University from 2010 to 2015, were included, and their clinical records, especially photographs and medical treatments, were reviewed.
Results
One hundred and sixteen patients were included in this study, and 326 lesions with different degrees of depigmentation, locations, stages, distributions, therapies, and repigmentation patterns were included and analyzed. Perifollicular repigmentation occurred more frequently in lesions with complete depigmentation (P = 0.005), in non-sun exposed areas (P < 0.001), a stable stage (P = 0.008), and lesions treated with narrow band ultraviolet B (NB-UVB) (P < 0.001, despite lesion distributions). Marginal repigmentation is more frequent in lesions with complete depigmentation (P = 0.016), lesions treated without NB-UVB (P = 0.002), and facial lesions treated with topical vitamin D analogs (TVDAs) monotherapy (P = 0.022). Diffuse repigmentation is the predominant pattern in lesions with incomplete depigmentation (P < 0.001), in sun-exposed areas (P < 0.001), progressive stage (P = 0.044), and truncal lesions treated with TVDAs (P < 0.001).
Conclusions
The different repigmentation patterns of vitiligo lesions depend on the different source and status of melanocytes and their abilities to produce melanin on the choice of therapy.
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Efficacy and safety of noncultured melanocyte-keratinocyte transplant procedure for vitiligo and other leukodermas: a critical analysis of the evidence
Abstract
Vitiligo is an acquired pigmentary skin of depigmentation occurring secondary to melanocyte destruction. Vitiligo and other leukodermas have a profound impact on quality of life. Current therapies include medical options, such as phototherapy, topical and systemic corticosteroids, topical calcineurin inhibitors, immunomodulators, and antioxidiants, and surgical options. Surgical options provide melanocytic cells to previously depigmented areas and use either tissue grafting or cellular grafting methods. Topical treatments are often insufficient, and many of the current surgical procedures have shown variable response rates. In this review, we discuss the process of the cellular grafting melanocyte-keratinocyte transplantation procedure (MKTP) and critically analyze its efficacy and safety in the treatment of vitiligo and other leukodermas. PubMed was searched for studies (2001–2017) describing the use of MKTP in patients with vitiligo or other leukodermas. Articles or trials discussing the use of MKTP for these patients were selected for in-depth review. Clinically relevant results regarding efficacy and safety of MKTP in vitiligo and leukoderma patients were analyzed. Numerous trials and case series/reports have demonstrated tolerability and efficacy of MKTP with repigmentation for patients with refractory, stable vitiligo. However, the response rates have been variable, likely influenced by vitiligo type and affected areas. Future research and clinical reporting will provide more insight on which phenotypes may benefit from MKTP.
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Hypopigmented mycosis fungoides: a 20-case retrospective series
Abstract
Background
Hypopigmented mycosis fungoides (hMF) is a rare subtype of mycosis fungoides. The aim of this study was to identify the clinical–epidemiological profile of our patient group and also to provide additional information about treatment responses and prognosis.
Methods
This is a cross-sectional retrospective observational study, with exploratory analysis. The outcome variables were disease progression and related death.
Results
Twenty patients with hMF were selected from a group of 102 patients diagnosed with MF. There was no gender difference (10 females and 10 males). Mean age at diagnosis was 43.85 years, and most patients had mixed or black skin color. The mean time between the onset of the lesions and the diagnosis was 66.75 months. Patients were equally distributed in stages IA (50%) and IB (50%). Photochemotherapy (psoralen and ultraviolet A) was the predominant therapeutic modality. The mean follow-up time was 7.25 years. In 10%, disease progression was observed. Death related to the disease occurred in one patient.
Conclusions
The clinical and epidemiological profile of patients with hypopigmented MF found in our sample is in agreement with what is described in the literature, with the exception of the age at diagnosis, higher than expected. Diagnostic delay time, despite long, is also consistent with the medical literature; however, in this sample, we had two cases of disease progression, with death of one patient, despite the treatment, which is extremely important since hypopigmented MF is usually associated with good prognosis.
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Evaluation of ICAM-1 expression and vascular changes in the skin of patients with plaque, pustular, and erythrodermic psoriasis
Abstract
Background
Psoriasis is a chronic inflammatory disease. Pustular, erythrodermic, and extensive plaque psoriasis are responsible for systemic complications. Systemic capillary leak syndrome is the complication with greater progression to death and occurs due to vascular changes.
Purpose
The aim of this study was to evaluate vascular changes through the expression of CD34 and ICAM-1 in plaque, pustular, and erythrodermic psoriasis.
Methods
The sample consisted of seven patients with erythrodermic psoriasis, 24 with moderate-severe plaque psoriasis, 14 with mild plaque psoriasis and 13 with pustular psoriasis. Patients were submitted to physical examination and skin biopsy for histopathological examination and immunohistochemical analysis with anti-CD34 and anti-ICAM-1 antibodies. Subsequently, tissue fragments were organized by groups using the Tissue Macroarray (TMA) technique to perform immunohistochemistry.
Results
In 58 patients, analysis of vessels using anti-CD34 demonstrated vascular immunostaining in superficial dermis and between dermal papillae. There were more blood vessels in erythrodermic psoriasis, followed by plaque psoriasis. In erythrodermic psoriasis, there were small and few tortuous blood vessels with great dilatation, while plaque psoriasis presented larger vessels that were less dilated and more tortuous. There was an intense and localized expression of ICAM-1 in endothelial and lymphocytic cells in all groups, with significant differences.
Conclusions
Vascular alterations are important in psoriasis, with an increase in the number of blood vessels and ICAM-1 overexpression, especially in erythrodermic form. Therefore, vascular changes and the expression of intercellular adhesion molecules could help to diagnose the erythrodermic form of psoriasis.
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Clinico-etiologic profile of hand dermatitis and patch response of patients at a tertiary hospital in Lagos, Nigeria: results of a prospective observational study
Abstract
Background
Hand dermatitis is an acute or chronic inflammation of the skin of the hands from a multifactorial cause which may be endogenous, exogenous, or a combination of both. With a wide range in severity and recurrent periods of flares, it has significant impact on the quality of life of its sufferers. A history of atopy predisposes patients to hand dermatitis, but contact dermatitis, either allergic or irritant, is the more commonly implicated factor in the etiology of hand dermatitis. Patch testing is an important tool in identifying the allergen responsible for allergic hand dermatitis, and this knowledge will contribute to improved management.
Aim and Objectives
This study was undertaken to evaluate the clinical and etiologic profile and review the patch responses of patients who presented with hand dermatitis at a foremost tertiary skin clinic in the most populous state of the most populous country in Africa.
Methods
A prospective, observational study in which consecutive walk-in patients who fulfilled the inclusion criteria were enrolled. Ethical clearance was obtained. Study tools included self-administered questionnaires, physical examination, and patch tests (European Hermal series), amongst others. The patch tests were carried out. Results were documented, and treatment was individualized based on clinical and investigation findings. The results were collated and analyzed with SPSS® 17.0 edition (SPSS II).
Results
Hand dermatitis was seen in 177 (13.3%) patients who presented during the study period. The mean age was 34.6 + 17.4 years. Almost two-thirds of patients (119; 67.2%) had chronic hand dermatitis, while 53 (32.8%) presented acutely. Patch responses were positive in 65 (36.7%) patients with paraphenylenediamine identified as the most frequent cause. Respondents had at least one (+) response to 20 of the 28 allergens, while there was no response to eight of the allergens in the European series.
Conclusion
The study reveals that hand dermatitis is present in a younger age group and a variety of subtypes coexist. Locally sourced allergens are needed to improve the yield of patch responses.
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Nail changes in alopecia areata: an update and review
Abstract
Nail changes are a common feature of alopecia areata (AA) and are a significant source of cosmetic disfigurement and functional impairment. This review provides an update of the prevalence, clinical and histopathological features, pathogenesis, differential diagnosis, clinical course, prognosis, and management of nail changes in patients with AA. Searches for peer-reviewed journal articles were conducted using the PubMed/MEDLINE database with the search terms "nail changes alopecia areata," "alopecia areata nails," and specific searches on "trachyonychia alopecia areata" and "pitting alopecia areata." Other sources of articles included the reference lists of retrieved articles. Nail changes are a common feature of AA, with an average prevalence of 30%, and can cause significant disfigurement and loss of function. Pitting and trachyonychia were by far the most common manifestations of AA, with an average prevalence of 20 and 8%, respectively. Red spotted lunulae, onycholysis, and punctate leukonychia were other reported findings. Other etiologies, such as onychomycosis or lichen planus, may coexist with or confound the diagnosis. There is limited published data on the clinical manifestations of AA-associated nail changes and therapeutic options. Larger controlled trials are necessary to guide treatment decisions.
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Comparative evaluation of skin moisture after topical application of 10% and 30% lactobionic acid
Summary
Background
Dry skin is characterized by symptoms such as itching, redness, excessive exfoliation. These symptoms cause discomfort and contribute to secondary bacterial infections. Dry skin treatments are based on topical applications of various formulations. Among many of them are polyhydroxy acids, which recently gained more attention.
Aims
The aim of this study was a comparative assessment of hydration level (corneometric) after application of lactobionic acid (LA) in the form of peel at concentrations of 10% and 30%.
Material and Methods
The study involved 10 Caucasian individuals aged 26-73 years. Eight treatments were performed at weekly intervals. The peels were applied using the "Split face" method—on the left side of the face 10% LA, and the right side 30% LA which consisted of specified concentration of LA, deionized water, xanthan gum, ethoxydiglycol. The test subjects received a 5% LA cream for overnight use. The cream consisted of deionized water, LA, isopropyl palmitate, ascorbyl palmitate, methylparaben. The products for this study were provided by Grehen Ltd. Celestynów, Poland. Prior to each procedure, the skin hydration level was measured using Corneometer CM 825 from Courage + Khazaka electronic GmbH.
Results
There was a statistically significant improvement in hydration level after 8 treatments for all measuring points and both concentrations. The difference of the skin hydration level between 10% LA and 30% LA could not be determined.
Conclusions
Lactobionic acid is a highly moisturizing agent. There was no significant difference in moisturizing effect between 10% LA concentration and 30% LA concentration.
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Can exposure to acidic beverages following the application of fluoride varnish cause changes in the amount of fluoride release? an in vitro study
Journal of Orofacial Sciences 2017 9(2):91-94
Introduction: Fluoride varnishes are found to be effective in the prevention of early childhood caries. Postvarnish application, the instructions provided by the manufacturer seem to be inadequate because they do not mention the type of beverages which can be consumed after the specified time, considering the widespread consumption of soft acidic drinks in children. Aim: The study was conducted to evaluate the amount of fluoride released from fluoride varnishes − Fluorprotector and Bifluorid in artificial saliva and acidic conditions. Materials and Methods: Polymethyl methacrylate blocks were painted with fluoride varnish and placed into artificial saliva for 30 min. Blocks were then placed in either 1% citric acid or 0.3% citric acid solutions for 30 min with the solutions being replaced every 5 min. The solution was analyzed for fluoride content. Results and Conclusion: The statistical tests applied were repeated measures of analysis of variance and student's t-test. The level of significance was kept at P < 0.05. Significant difference in fluoride release was noted in different acidic mediums. Fluoride release from fluoride varnishes varied considerably and also depended on the dissolution medium.
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A biochemical study to assess and compare salivary magnesium levels in periodontal health and diseases
Journal of Orofacial Sciences 2017 9(2):111-113
Background: Chronic magnesium (Mg) deficiency has been associated with a number of chronic systemic diseases, including osteoporosis, hypertension, diabetes and coronary heart disease. Mg may also alter the course and outcome of the periodontal disease. Aim: To evaluate salivary Mg levels in healthy individuals and patients with chronic gingivitis and chronic periodontitis (CP). Materials and Methods: A total of 150 individuals were selected randomly, which included both males and females with age range between 20 and 45 years. Periodontal status was recorded using the following parameters − gingival index, plaque index, oral hygiene index − simplified and clinical attachment loss. Following periodontal examination, individuals were divided into three groups as follows: Group 1: (n = 50) − comprised of healthy individuals; Group 2: (n = 50) − comprised of patients with gingivitis; Group 3: (n = 50) − comprised of patients with CP. The unstimulated saliva samples from the study individuals were collected and subjected to the estimation of salivary Mg levels using Abcam's Mg assay kit and Erba EM 360 fully automated auto analyzer (Erba Diagnostic, Mannheim, Germany). Results: In this study, there was an increase in salivary Mg level with increasing severity of the periodontal disease. A significant increase in salivary Mg levels was recorded in patients with gingivitis (1.66 ± 0.28 mg/dl) and periodontitis (2.05 ± 0.66 mg/dl) as compared to healthy individuals (1.35 ± 0.28 mg/dl). Conclusion: Salivary Mg does not play an active role in the modulation of periodontal disease process and, hence, cannot be used as a reliable biomarker associated with periodontal health and disease.
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Ethics in research and publication
Journal of Orofacial Sciences 2017 9(2):69-70
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Tooth morphometry and the pattern of palatal rugae among monozygotic and dizygotic twins in India
Journal of Orofacial Sciences 2017 9(2):99-105
Introduction: A stronger correlation of physical traits among monozygotic (MZ) twins than dizygotic (DZ) twins indicates predominant contribution by genetic factors than environmental factors. Exploring the degree of resemblance in tooth morphometry and the pattern of rugae among twins shall aid in forensic identification. Aim and Objective: To find out the degree of correlation in tooth morphometry and the palatal rugae pattern among MZ and DZ twins. Materials and Methods: The maximum coronal mesiodistal and buccolingual dimensions of the maxillary teeth excluding the second and third molars in 21 pairs of MZ and 12 pairs of DZ twins along with a MZ triplet were recorded using digital calipers calibrated to 0.01 mm. The dimensions of the teeth based on the number, shape, size, and the unification palatal rugae pattern among twin pairs were analyzed and recorded. Results: Our results suggest a stronger correlation of tooth dimension among MZ than DZ twins, which differs for individual maxillary tooth. There may be a separate set of genes responsible for controlling the mesiodistal and buccolingual tooth dimensions. The maxillary canine and maxillary premolars do show the least amount of genetic variability. The results in our study provide remarkable evidence regarding the existence of mirror imaging in tooth dimension as well as the number and shape of the palatal rugae. Conclusion: This first of its kind study in the Indian population suggests a remarkable similarity with regard to the tooth's size and uniqueness of the palatal rugae pattern among MZ and DZ twins, which suggests their strong inheritability potential. This may be useful as additional tools for zygosity determination along with other dental traits. The significant evidence of mirror imaging of tooth dimension and rugae shall definitely contribute to the concept of development of human body.
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The expression of Bcl-2 in oral squamous cell carcinoma—A review
Journal of Orofacial Sciences 2017 9(2):71-74
Currently, oral cancer is one of the most alarming health problems facing mankind. More than 90% of all oral cancers are oral squamous cell carcinoma (OSCC). BCL-2 proteins are one of the most prominent anti-apoptotic proteins expressed in OSCC. They contribute to cancer development and mediate resistance to current anticancer treatments. Various studies have been conducted to evaluate the expression of Bcl-2 in OSCC. This article emphasizes the importance of Bcl-2 expression as a prognostic indicator in OSCC.
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New groups of drugs suspected in the medication-related osteonecrosis of the jaws (MRONJ)
Journal of Orofacial Sciences 2017 9(2):67-68
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A brief description about the evolution of the masticatory complex, its causes and future effects: A review
Journal of Orofacial Sciences 2017 9(2):75-79
The diversity of mammalian teeth remains a major attraction both scientifically and aesthetically. Bizarre-shaped teeth are a good reminder of both evolutionary flexibility and the precision of the developmental control mechanism. With time and adaptation to changing environments, several changes have occurred over a span of million years. These adaptations resulted in both positive and negative changes. The review article was written after an initial thorough search of both online and offline databases regarding articles related to evolution and craniofacial evolution. All available information related to the field of dentistry was compiled together. Ethical clearance was not necessary due to the nature of the study. This article provides a brief review on the changes in the teeth and jaw over the course of evolution and the factors that triggered it. A question arises whether, keeping the past in mind and seeing the present, we can predict the future changes that might occur in the human dentition.
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The wetting ability of root canal sealers after using various irrigants
Journal of Orofacial Sciences 2017 9(2):95-98
Aims: To evaluate and compare the wettability of root canal sealers after using various irrigants. To determine wettability, we evaluated the contact angle, because lower the contact angle, better the wettability. Green tea has antibacterial and anti-inflammatory properties; therefore, it was used as an irrigant. Materials and Methods: Seventy-two freshly extracted, human, single-rooted teeth were used in the study. The roots were split into 144 dentin sections. The specimens were divided into the following four groups having 36 samples each: Group I—sodium hypochlorite 3%, Group II—chlorhexidine (CHX) 2%, Group III—green tea extract, and Group IV (control)—normal saline. The groups were further subdivided based on the sealer used. Results: There was highly significant difference among the mean contact angle values of zinc oxide eugenol sealer, AH Plus sealer, and MTA Fillapex sealer using 2% CHX (P < 0.01). The least contact angle was observed with green tea as root canal irrigant and MTA as root canal sealer (25.20 ± 4.00). Conclusion: The type of irrigant used had an influence on the contact angle of sealer. Among all the irrigants and sealers used in this study, the least contact angle was observed with green tea root canal irrigant and MTA Fillapex sealer.
http://ift.tt/2ErJYYo
Detection of molecular biomarkers as a diagnostic tool in the planning and progression of orthodontic treatment
Journal of Orofacial Sciences 2017 9(2):80-84
Orthodontic treatment focuses on providing patient care at the appropriate timing to utilize the growth potential for best results. It involves growth modification of the craniofacial region along with alveolar bone remodeling during tooth movement. The dynamic process of bone metabolism involves the release of biochemical mediators in the circulation. These molecules are indicative of the bone remodeling activity of osteoblastic deposition and osteoclastic resorption. Such biomarkers when detectable in the systemic circulation highlight the skeletal maturity of orthodontic patients and when detected locally as, in gingival crevicular fluid (GCF) and saliva, indicate the progression of orthodontically induced alveolar bone remodeling. Assessment of molecular biomarkers of bone remodeling in the body fluids would aid the clinicians in planning orthodontic treatment at the ideal timing and evaluating the advent of the treatment.
http://ift.tt/2FlWBW0
Prevention of collapse of the contralateral half of the mandible after hemimandibulectomy: Our experience in a low-resource center
Journal of Orofacial Sciences 2017 9(2):106-110
Background: The management of pathologic lesions of the mandible includes plans for the reconstruction of the resultant defect to give the patients optimal surgical reconstructive and prosthetic results. Objective: To evaluate the degree of deviation of the contralateral half of the mandible toward the surgical defect after hemimandibulectomy and intermaxillary fixation (IMF). Patients and Methods: This is a 9-year prospective single-blinded clinical study conducted at the Dental and Maxillofacial Surgery Clinic of our institution. Information obtained from the patients included age, gender, type of mandibular lesion, method of wound closure, duration of IMF, temporo-mandibular joint (TMJ) symptom(s), and the deviation toward the surgical defect of the remnant contralateral half of the mandible, measured in centimeter at maximum mouth opening. Results: Ninety-six patients, unevenly distributed according to their duration of tolerance of IMF, were studied. The age of the patients ranged from 29 to 57 years with an overall mean age of 42.6 ± 5.1 years. There were 72 males and 24 females with a male-to-female ratio of 3:1 (P = 0.001). The lesions that were extirpated were all benign, and ameloblastoma was the most common tumor (P = 0.001). The shorter the duration of IMF, the greater the deviation of the mandibular mid-line toward the surgical defect (P = 0.001). Conclusion: This study shows that there is a deviation of mid-line of the residual mandible toward the surgical defect after hemimandibulectomy, even after its immobilization with IMF for 4–12 weeks. IMF is still useful in the prevention of mandibular collapse after hemimandibulectomy.
http://ift.tt/2EpkIlB
Estimation of CCL2/MCP-1 levels in serum and gingival crevicular fluid in periodontal health, disease and after treatment – A clinico biochemical study
Journal of Orofacial Sciences 2017 9(2):85-90
Background: The objective of the present study was to evaluate the role of monocyte chemoattractant protein-1 (MCP-1), in periodontal disease (PD) progression and also to investigate the effect of periodontal therapy on MCP-1 concentration in serum and gingival crevicular fluid (GCF). Materials and Methods: Clinical parameters including gingival index, pocket probing depth, and clinical attachment level were recorded for 60 subjects, who divided into four groups. Group I (healthy, n = 20), Group II (gingivitis, n = 20), Group III (chronic periodontitis, n = 20), and Group IV (after treatment group, n = 20). Scaling and root planning (SRP) was performed, and GCF and serum were collected initially and after 12 weeks of treatment. MCP-1 levels were estimated using enzyme-linked immunosorbent assay. Results: The mean MCP-1 concentration in GCF and serum was found to be the highest in Group III, and significantly defers from Groups I, II, and IV. The results of present study also suggest that MCP-1 levels increased progressively in GCF and serum from healthy to periodontitis subjects and levels decreased considerably after SRP. Conclusion: As the PD progresses, there is a substantial increase of MCP-1 concentrations in serum and GCF. The data indicate that high GCF and serum levels of MCP-1 are at a significantly greater risk for the progression of periodontitis. However, controlled, longitudinal studies are needed to confirm this possibility.
http://ift.tt/2FkOGbK
Florid expansile cemento-osseous dysplasia of the jaws: Cone beam computed tomography study and review of the literature
Journal of Orofacial Sciences 2017 9(2):114-117
An interesting case of florid expansile cemento-osseous dysplasia (FECOD) of the maxilla and mandible in a 36-year-old female is being presented. The patient presented for consultation for orthognathic surgery and was unaware of these lesions. Upon clinical and radiographic examination, including cone beam computed tomography, massive cemento-osseous lesions in all quadrants were observed. The radiographic appearance of the lesions was consistent with cemento-osseous dysplasia (COD), the key difference being extreme expansion. Expansion, although not a new phenomenon, is present in all quadrants. These radiographic features suggest a variation of florid cemento-osseous dysplasia and is more aptly termed FECOD. This name is proposed for its diagnostic relevance based on the radiographic features. As with similar CODs, unless the lesions are disfiguring, conservative management is the preferred approach. Biopsy was not indicated unless there are additional associated complications. A detailed review of the pertinent literature was undertaken.
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Detecting tumour-positive resection margins after oral cancer surgery by spraying a fluorescent tracer activated by gamma-glutamyltranspeptidase
Publication date: March 2018
Source:Oral Oncology, Volume 78
Author(s): Maxime D. Slooter, Henricus J.M. Handgraaf, Martin C. Boonstra, Lily-Ann van der Velden, Shadhvi S. Bhairosingh, Ivo Que, Lorraine M. de Haan, Stijn Keereweer, Pieter B.A.A. van Driel, Alan Chan, Hisataka Kobayashi, Alexander L. Vahrmeijer, Clemens W.G.M. Löwik
ObjectivesTumour-positive resection margins are a major problem during oral cancer surgery. gGlu-HMRG is a tracer that becomes fluorescent upon activation by gamma-glutamyltranspeptidase (GGT). This study aims to investigate the combination of gGlu-HMRG and a clinical fluorescence imaging system for the detection of tumour-positive resection margins.Materials and methodsThe preclinical Maestro and clinical Artemis imaging systems were compared in vitro and ex vivo with cultured human head and neck cancer cells (OSC19, GGT-positive; and FaDu, GGT negative) and tumour-bearing nude mice. Subsequently, frozen sections of normal and oral cancer tissues were ex vivo sprayed with gGlu-HMRG to determine the sensitivity and specificity. Finally, resection margins of patients with suspected oral cancer were ex vivo sprayed with gGlu-HMRG to detect tumour-positive resection margins.ResultsBoth systems could be used to detect gGlu-HMRG activation in vitro and ex vivo in GGT positive cancer cells. Sensitivity and specificity of gGlu-HMRG and the Artemis on frozen tissue samples was 80% and 87%, respectively. Seven patients undergoing surgery for suspected oral cancer were included. In three patients fluorescence was observed at the resection margin. Those margins were either tumour-positive or within 1 mm of tumour. The margins of the other patients were clear (≥8 mm).ConclusionThis study demonstrates the feasibility to detect tumour-positive resection margins with gGlu-HMRG and a clinical fluorescence imaging system. Applying this technique would enable intraoperative screening of the entire resection margin and allow direct re-resection in case of tumour-positivity.
http://ift.tt/2CYO6mv
Effectiveness and safety of foam sclerotherapy with 5% ethanolamine oleate in the treatment of low-flow venous malformations in the head and neck region: a case series
The aim of this study was to evaluate the effectiveness and safety of 5% ethanolamine oleate (EO) foam in the treatment of low-flow venous malformations in the head and neck region. Seventeen consecutive patients (six male, 11 female) and 34 low-flow venous malformations were enrolled. The vascular anomalies ranged between 20mm and 80mm in size. The typical clinical indication was a swelling (88.2%) with a purple colour (85.3%); the most frequent location was the tongue (23.5%). Ethanolamine oleate foam was produced via the Tessari method and applied at 10mg per 1cm to the vascular anomalies.
http://ift.tt/2CUiVZk
Local administration of Tiludronic Acid downregulates important mediators involved in periodontal tissue destruction in experimental periodontitis in rats
Source:Archives of Oral Biology
Author(s): Flávia A.C. Furlaneto, Nara L.T. Nunes, Ricardo B. Souza, Kely O. Yamamoto, Ivan L. Oliveira Filho, Nicolly P.R. Frota, Hellíada Chaves, Mario Lisboa, Mario Taba, Edilson Ervolino, Michel R. Messora
ObjectiveThe purpose of this study was to evaluate whether local administration of TIL could influence the expression of the inflammatory mediators IL-1β, TNF-α, MMP-8 and COX-2 in rats with experimental periodontitis (EP).MethodsTwenty-four adult male rats (Rattus norvegicus, albinus, Wistar) were assigned to groups C, EP, EP-TIL (C–Control group, EP–Periodontitis groups). On EP groups, a ligature was placed around maxillary 2nd molars on day 1. On group EP-TIL, 20 μl of TIL solution (1 mg/kg body weight) was injected into the subperiosteal palatal area adjacent to the maxillary 2nd molar every other day until euthanasia (day 11). Alveolar bone loss was morphometrically analyzed. mRNA expressions of IL-1β, TNF-α, MMP-8 and COX-2 were assessed by qPCR. IL-1β, TNF-α, MMP-8 and COX-2 were immunohistochemically analyzed. Data were analyzed statistically.ResultsGroup EP-TIL presented reduced alveolar bone loss when compared with group EP (p < 0.05). Group EP-TIL presented decreased mRNA expressions of IL-1β, TNF-α, MMP-8 and COX-2 and reduced immunolabeling of IL-1β, TNF-α and MMP-8 when compared with group EP (p<0.05). No differences regarding the immunolabeling of COX-2 were found when group EP-TIL was compared with the other groups (p>0.05).ConclusionWithin the limits of this study, it can be concluded that local administration of TIL downregulates important mediators involved in periodontal tissue destruction in ligature-induced periodontitis in rats.
http://ift.tt/2DgsbDW
Local administration of Tiludronic Acid downregulates important mediators involved in periodontal tissue destruction in experimental periodontitis in rats
Source:Archives of Oral Biology
Author(s): Flávia A.C. Furlaneto, Nara L.T. Nunes, Ricardo B. Souza, Kely O. Yamamoto, Ivan L. Oliveira Filho, Nicolly P.R. Frota, Hellíada Chaves, Mario Lisboa, Mario Taba, Edilson Ervolino, Michel R. Messora
ObjectiveThe purpose of this study was to evaluate whether local administration of TIL could influence the expression of the inflammatory mediators IL-1β, TNF-α, MMP-8 and COX-2 in rats with experimental periodontitis (EP).MethodsTwenty-four adult male rats (Rattus norvegicus, albinus, Wistar) were assigned to groups C, EP, EP-TIL (C–Control group, EP–Periodontitis groups). On EP groups, a ligature was placed around maxillary 2nd molars on day 1. On group EP-TIL, 20 μl of TIL solution (1 mg/kg body weight) was injected into the subperiosteal palatal area adjacent to the maxillary 2nd molar every other day until euthanasia (day 11). Alveolar bone loss was morphometrically analyzed. mRNA expressions of IL-1β, TNF-α, MMP-8 and COX-2 were assessed by qPCR. IL-1β, TNF-α, MMP-8 and COX-2 were immunohistochemically analyzed. Data were analyzed statistically.ResultsGroup EP-TIL presented reduced alveolar bone loss when compared with group EP (p < 0.05). Group EP-TIL presented decreased mRNA expressions of IL-1β, TNF-α, MMP-8 and COX-2 and reduced immunolabeling of IL-1β, TNF-α and MMP-8 when compared with group EP (p<0.05). No differences regarding the immunolabeling of COX-2 were found when group EP-TIL was compared with the other groups (p>0.05).ConclusionWithin the limits of this study, it can be concluded that local administration of TIL downregulates important mediators involved in periodontal tissue destruction in ligature-induced periodontitis in rats.
http://ift.tt/2DgsbDW
Antimicrobial activity of Psidium cattleianum associated with calcium hydroxide against Enterococcus faecalis and Candida albicans : an in vitro study
Abstract
Objective
Evaluate, in vitro, the antimicrobial activity of Psidium cattleianum leaf extracts combined with calcium hydroxide against Enterococcus faecalis and Candida albicans biofilm.
Materials and methods
Dentin specimens obtained from extracted bovine incisors were infected during 14 days with E. faecalis ATCC 29212 and C. albicans ATCC 10231. The specimens were filled with calcium hydroxide pastes prepared with the following vehicles: Psidium cattleianum ethanolic, Psidium cattleianum propylene glycolic, distilled water, and saline as control. After 24 h, 3, 7, and 14 days, the canals were irrigated with sterile saline and dried. Dentin samples were collected from the canals with burs of increasing diameters. To determine the number of colony-forming units (CFU), samples were inoculated onto BHI agar supplemented with yeast extract (0.5%), at 37 °C, for 48 h, in CO2 enriched atmosphere. Comparisons among the groups for the variation factors were performed by ANOVA and Tukey's test.
Results
Ethanolic and propylene glycolic extracts showed significantly higher antimicrobial activity against E. faecalis (p < 0.01) when compared with distilled water. The ethanolic extract exhibited in 24 h the same antibacterial activity that propylene glycolic extract and distilled water after 7 and 14 days. For C. albicans, all were effective in reducing the number of CFU at all periods.
Conclusion
The P. cattleianum ethanolic extract presented the fastest and highest antimicrobial activity against E. faecalis, significantly reducing the microbial load in 24 h. All medications were effective against C. albicans.
Clinical relevance
The antibacterial potential of P. cattleianum and its biological compatibility associated with calcium hydroxide indicate promising applications in the field of dentistry.
http://ift.tt/2AJy9dO
The effect of dental treatment on oral health-related quality of life in adolescents
Abstract
Objectives
The objective of the study is to assess the effect of dental treatment on the oral health-related quality of life (OHRQoL) of adolescents from a city in South Brazil.
Materials and methods
This longitudinal study included 129 adolescents aged 10 to 15 years who received dental caries treatment in a university clinic in Santa Maria, Brazil. The OHRQoL was measured using the Brazilian version of the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11–14). The questionnaire was administered through face-to-face interviews before treatment and 1 month after its completion. Paired t tests and effect sizes were used to evaluate changes in CPQ11–14 scores after completion of treatment.
Results
In total, 43.4% of the study participants received solely restorations, 15.5% received endodontic treatment, and 44.2% underwent tooth extractions. The mean CPQ11–14 score before treatment was 15.9 ± 10.3, which decreased to 6.3 ± 6.5 after treatment (P < 0.001). The same pattern was observed in the four domains of CPQ11–14 (oral symptoms, functional limitation, emotional well-being, and social well-being). The effect sizes varied from 0.4 to 1.1, with oral symptoms and emotional well-being domains showing the greatest changes.
Conclusions
Dental treatment resulted in a significant improvement in the OHRQoL of the evaluated adolescents.
Clinical relevance
Providing dental treatment has beneficial effects on the quality of life of adolescents, especially for oral symptoms and emotional well-being.
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Development of an Anti-HER2 Monoclonal Antibody H2Mab-139 Against Colon Cancer
Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.
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Re: re: Mandibular stability using sliding compared with conventional four-hole plates for fixation after bilateral sagittal split ramus osteotomy for mandibular setback
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): H.G. Lee, K.J. Agpoon, A.N. Besana, H.K. Lim, H.S. Jang, E.S. Lee
http://ift.tt/2AKROde
Editorial Board
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
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Reviewer thank you list
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
http://ift.tt/2AJvJvR
Corrigendum to “Craniofacial implants at a single centre 2005–2015: retrospective review of 451 implants” [Br J Oral Maxillofac Surg 2017;55:242-5]
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): R. Elledge, J. Chaggar, N. Knapp, T. Martin, N. White, D. Evriviades, S. Edmondson, S. Parmar
http://ift.tt/2CYeCfN
Prognosis of oral cancer: a comparison of the staging systems given in the 7th and 8th editions of the American Joint Committee on Cancer Staging Manual
Publication date: January 2018
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): G. Tirelli, A. Gatto, F. Boscolo Nata, R. Bussani, A. Piccinato, A.V. Marcuzzo, M. Tofanelli
The 8th edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces "depth of invasion" and "extranodal extension" into the head and neck section, and our aim was to find out if these changes have an impact on prognosis. We evaluated 174 patients who had had oral squamous cell carcinomas (SCC) resected between 2003 and 2012. The clinical records were reviewed, the patients' tumours restaged according to the 8th edition of the AJCC, and we analysed five-year survival to verify whether different correlations were made between the T and N stages and disease-specific survival using the 7th and 8th editions. We excluded seven cases because information was incomplete, and the final sample was 167 patients. The five-year overall survival was 68% and the five-year disease-specific survival was 78%. The variable pT was upstaged in 51 patients (31%), and no tumour was downstaged. When we used the 7th edition, the pT category did not correlate with survival (p=0.055), but when we used the 8th edition, there was a significant association between increased pT categories and disease-specific survival (p=0.01). In the pN category 23 cases were upstaged (14%) and this affected disease-specific survival using both the 7th and the 8th editions (p=0.001). When patients were restaged, there was an improvement in discrimination between T categories in relation to disease-specific survival, and confirmation of the prognostic impact of the variable pN. T stage and depth of invasion are complementary predictors of disease-specific survival, and their combination results in the new AJCC staging system giving a better prognosis.
http://ift.tt/2AKNElQ
Making and working of a new electronic resource for patients, carers and professionals: maxfacts.uk
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): D.A. Mitchell, A. Sebald, L. Tomasello
Many maxillofacial patients have serious short, medium, or long-term problems, as well as having to make informed decisions about often life-changing interventions. Validated comprehensive information, at the right time and the right level for a diverse group of users (patients, carers, and professionals), is vital if patients are to make a serious contribution to their treatment. We describe the development of an online resource for this purpose. Maxfacts.uk aims to cover every aspect of oral and maxillofacial surgery and care, from neck dissection and ballistic wounds to physiotherapy and texture-modified foods.The principles of design, and the multilayered structure, interface, and functions of such a multiuser website are outlined, including accessibility and engagement. The maxfacts model and design could easily be adapted for other users with similar, complex, long-term needs.
http://ift.tt/2CVY4Vt
Is routine holistic assessment with a prompt list feasible during consultations after treatment for oral cancer?
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): S.N. Rogers, S. Ahiaku, D. Lowe
The head and neck cancer Patient Concerns Inventory (PCI-HN) is a holistic, self-reported list of items that can help patients to disclose their needs and concerns during routine follow-up consultations. The aim of this study was to report how often it was used during the first three years of follow up after treatment for oral cancer, and the range of issues that were raised. The sample comprised consecutive patients treated over a three-year period with curative intent. All clinic attendances were reviewed until October 2015 or until patients had a recurrence, a subsequent primary, metastases, or were discharged home or to follow up at a peripheral hospital, or started palliative care. We identified 92 patients and data were available for 88 of them. The median (IQR) age at the time of treatment was 65 (57-76) years, and 48 (55%) were men. Reviews alternated between the surgeon and oncologist, and typically there were 4.4 surgical reviews in year one, 2.8 in year two, and 1.6 in year three. The inventory was completed 157 times; at least once by 71% (55/77) during year one, 57% (29/51) during year two, and 37% (13/35) during year three. Of those who completed none, nearly half (7/17) died within 12 months, and another six were over 80 years of age. In conclusion, the diversity of concerns raised by patients highlights the need for holistic assessment during follow up, and integration of the inventory into routine consultations will mean that we can repeat it.
http://ift.tt/2CZE0BO
Retroseptal transconjunctival approach for fractures of the zygomaticomaxillary complex: a retrospective study
Publication date: January 2018
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): Rohit Sharma, Shailey Singh, Seema Patrikar
We designed a retrospective study to evaluate the efficacy of retroseptal transconjunctival approaches in the management of fractures of the zygomaticomaxillary complex (ZMC). The patients were from a single institution, and had had three-point fixation of fractures of the ZMC between 2008 and 2016. A total of 77 patients (56 men and 21 women with a mean (range) age of 28 (18–54) years), were divided into two groups. Group I (n=51) had had reduction and fixation of the infraorbital rim using a retroseptal transconjunctival approach. In group II (n=26) the same approach had been used with lateral canthotomy and inferior canthlolysis for both the infraorbital rim and the zygomaticofrontal region. We analysed the association of both approaches with the outcomes of reduction, fixation, and complications. Suboptimal results were found in 13 patients in group I and one in group II (p=0.017). There were also three patients with trichiasis and two with entropion in group I, and one each of both complications in group II. There was only one patient with a malopposed lateral canthus in group II. All 26 patients in group II had no perceptible scar along the extended line of incision. The risk of a suboptimal outcome was reduced by 20% (relative risk=0.8) in group II. The retroseptal transconjunctival approach with lateral canthotomy and inferior cantholysis is safe, aesthetic, and effective in the management of fractures of the ZMC.
http://ift.tt/2AKipar
Reconstruction of intraoral defects after resection of cancer with two types of submental artery perforator flaps
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): L. Huang, W.-M. Wang, X. Gao, Y.-X. Yuan, X.-Q. Chen, X.-C. Jian
The submental island flap is a common choice for reconstruction of intraoral defects. To obtain a thinner, more pliable flap and get a better oncological result, the submental artery perforator flap has been proposed, and to assess its feasibility for closure of defects after resection of cancers of the oral cavity we studied 20 patients, each of whom was treated in this way. All the flaps were classified into those with septocutaneous perforators (n=16) and those with musculocutaneous perforators (n=4), and the main veins that drained the flaps were two submental veins (n=17). There were two patterns of venous drainage: in pattern 1 (n=9) the external jugular vein provided the primary venous drainage, and in pattern 2, the submental veins drained mainly into the facial vein, the common facial vein, and the internal jugular (n=10). In one patient the submental veins bypassed the facial vein to drain into the internal jugular. Eighteen of the 20 patients had no postoperative complications. The remaining two developed mild venous congestion of the flaps, which was resolved with conservative management and no skin loss. No local or regional recurrence was detected after a mean (range) follow-up of 21 (4-35) months. This is a simple, reliable flap that can be used for the reconstruction of intraoral defects after resections for cancer, but its oncological outcome still requires proof in long-term, large-scale, clinical trials.
http://ift.tt/2CWbHnU
Is a fractured mandible an emergency?
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): D. Hammond, S. Parmar, J. Whitty, M. McPhillips, R. Wain
We retrospectively audited the records of 708 patients who presented with the diagnosis of fractured mandible between January 2009 and July 2013 at the Queen Elizabeth Hospital, Birmingham. We assessed the different factors that may have altered their outcomes, and found that delay before definitive fixation caused no harm in either the short or the long term.
http://ift.tt/2ALnUWk
Corrigendum to “Schneider membrane thickness classification evaluated by cone-beam computed tomography and its importance in the predictability of perforation. Retrospective analysis of 200 patients” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) 1106–1110]
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): M. Rapani, C. Rapani, L. Ricci
http://ift.tt/2CVOjXx
Dimensions of hard and soft tissue around adjacent, compared with single-tooth, zirconia implants
Publication date: January 2018
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): K. Kniha, A. Modabber, H. Kniha, S.C. Möhlhenrich, F. Hölzle, S. Milz
Preservation or regeneration of the papilla has always been a challenge around consecutive implants or with implants next to teeth, and many studies have evaluated the papilla's behaviour and patterns based on surgical technique and prosthetic design, though evidence about its behaviour around zirconia implants is scarce. The aim of this study was to evaluate papilla behaviour between implants and teeth (tooth-implant group) and between consecutive implants (implant–implant group). Ninety patients with 122 zirconia implants (Straumann® PURE Ceramic Implant) were examined at the one-year follow up. We measured the effect of the distance: first from the base of the contact point of the crowns to the contact with bone at the implant site (D1); secondly, to the contact with the bone at the neighbouring tooth or implant site (D2); and thirdly on the papillary deficit (D3). In both the tooth-implant group and the implant–implant group, D1 and D2 correlated significantly with the papillary deficit (D3), whereas D2 was the major determinant factor (Spearman's rho=0.60). In both groups, when D1 and D2 were <6mm, the papilla was present every time. The papillary deficit was significantly greater in the tooth-implant group than in the implant–implant group (p=0.048). We conclude that the ideal distance from the base of the contact point to the bone contact at the implant and to the bone contact at the adjacent tooth in both groups is <6mm. The height of the bone on the teeth adjacent to implants has a significant impact on that of the papilla.
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Training Groups
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
http://ift.tt/2CY5Eim
Clinical outcome after 36 months of treatment with injections of autologous blood for recurrent dislocation of the temporomandibular joint
Publication date: January 2018
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): H. Yoshida, Y.-i. Nakatani, S. Gamoh, K. Shimizutani, S. Morita
We investigated the prognosis after three years of treatment for recurrent dislocation of the temporomandibular joint with autologous blood given intravenously in 21 patients with a mean (range) age 64 (17-92) years of whom 16 had coexisting systemic disease. The mean (range) follow up from the first injection was 64 (41-99) months. Eighteen patients had no recurrence during the first 36 months after their first injection, which showed that this minimally-invasive treatment was effective, particularly for those who had conditions that made a mouthpiece or operation unsuitable.
http://ift.tt/2ALnIGA
Nodular fasciitis of the temporomandibular joint: a case report
Publication date: January 2018
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): I. Jenkyn, A. King, K.A. Moutasim, S. Sharma
Nodular fasciitis is a relatively rare benign lesion of the soft tissue, which often presents in the fascia or deep subcutaneous tissues. It most commonly presents in the upper extremities and trunk and the head and neck region, particularly in younger patients. Its pathogenesis is poorly understood and it is predominantly thought to be a reactive lesion, although some have suggested that it may be a benign neoplasm. Advances in molecular testing and imaging have greatly assisted diagnosis. We discuss the benefits of ubiquitin-specific protease 6 (USP6) gene rearrangement testing and magnetic resonance imaging (MRI) to aid this uncommon diagnosis.
http://ift.tt/2CVY3AT
Small-diameter compression screws completely embedded in bone for rigid internal fixation of the condylar head of the mandible
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): Marcin Kozakiewicz
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Recurrence of oral mucocoeles in adolescents after excision
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 1
Author(s): Y.-J. Won, S.-H. Kang
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Multi-Envelope HIV-1 Vaccine Development: Two Targeted Immune Pathways, One Desired Protective Outcome
Viral Immunology , Vol. 0, No. 0.
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Ultrasound Identification of Diaphragm by Novices Using ABCDE Technique
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Relative Contributions of Adductor Canal Block and Intrathecal Morphine to Analgesia and Functional Recovery After Total Knee Arthroplasty: A Randomized Controlled Trial
http://ift.tt/2FmUH7R
Cricothyroid membrane puncture guided tracheostomy: a new technique for emergency airway access
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Youbai Chen, Yan Han, Meredith August, Nalton F. Ferraro, Qixu Zhang, Haizhong Zhang
PurposeTo compare cricothyroid membrane puncture guided tracheostomy (CMPGT) to surgical cricothyroidotomy (SC) and percutaneous tracheostomy with Griggs' guidewire dilating forceps (GWDF) for establishing an emergency airway in a porcine model. The investigators hypothesized that CMPGT was associated with a shorter time to ventilation and more rapid restoration of oxygenation.MethodsThe investigators implemented a small pilot animal study. Eighteen miniature pigs were randomly assigned to undergo CMPGT, SC or GWDF. The predictor variable was the technique utilized. The primary outcome variable was time to ventilation. Other outcome variables were efficiency of oxygenation restoration, procedure duration and procedure-related complications. The data were assessed using one-way ANOVA and Boferroni correction. The SpO2 changes over time were graphed using a time series line plot. P value was set at 0.05.ResultsAirways were successfully established in all eighteen pigs. SC (68±4 s) showed the shortest procedure duration compared to GWDF (95±3 s) and CMPGT (96±4 s); however, the time to ventilation using CMPGT (21±2 s) was significantly shorter than SC (68±4 s) and GWDF (95±3 s) (p<0.01). SpO2 in each group increased post-operatively, reaching 95% at 120 s, 131 s and 144 s in the CMPGT, SC and GWDF groups, respectively. The slopes of the ascending phase of SpO2 curve for each procedure was CMPGT (0.38), SC (0.42), and GWDF (0.53) (p<0.05). Two pigs in each group had minor intraoperative bleeding and one pig in SC group had moderate bleeding.ConclusionThe results of this animal study suggest that CMPGT is a time-efficient and safe technique for emergency airway access which allows for more rapid return of ventilation and obviates the need for conversion to definitive tracheostomy. Further cadaver study is ongoing.
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Factors affecting survival in surgically salvaged locoregional recurrences of squamous cell carcinoma of the tongue
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Narayana Subramaniam, Deepak Balasubramanian, Tsu-Hui Hubert Low, Samskruthi Murthy, Jonathan R. Clark, Krishnakumar Thankappan, Subramania Iyer
PurposeTo determine the factors affecting outcome in surgically salvaged, locoregionally recurrent squamous cell carcinoma of the tongue (SCCT)MethodsIn a retrospective cohort of patients who underwent successful salvage of locoregionally recurrent SCCT we performed this observational analytical study to determine survival and their determinants. Details extracted from the database were patients characteristics (age, gender, tobacco use), treatment characteristics and characteristics of recurrent disease (stage, adverse pathological features like grade, perineural invasion, lymphovascular invasion, etc). Overall survival (OS) curves were plotted using Kaplan Meier method. Cox proportional hazards model was used to determine impact of patient, disease and treatment characteristics on OS.ResultsFrom 52 patients with locoregional recurrences of surgically treated SCCT, 25 (48.1%) patients underwent surgical salvage with curative intent. The median overall OS for this cohort was 26 months. Factors predictive of worse OS were previous adjuvant therapy (p=0.016) and increasing adverse pathological features (APFs) in recurrent tumour histology (p=0.008). Lymphovascular invasion in recurrent tumour histology and those with a disease free interval of <6 months showed worse survival (p=0.008 and p=0.058 respectively).ConclusionAmong patients with locoregional recurrence, the number of patients who are eligible for curative intent surgical salvage is small. Those who received previous adjuvant therapy and those with increasing APFs in recurrent tumours had poor outcome in spite of attempt with surgical salvage, particularly patients with early recurrence.
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Hate Crime Perpetrators: The Psychopath and the Perseverator
Violence and Gender , Vol. 0, No. 0.
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The Treatment of Antibody-Mediated Rejection in Kidney Transplantation: An Updated Systematic Review and Meta-Analysis
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High intrapatient variability of tacrolimus exposure in the early period after liver transplantation is associated with poorer outcomes
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Pockmarks: Treatments and home remedies
There are a number of treatments and home remedies that may help reduce the appearance of the scars and improve the look and feel of the skin.
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LINC00511 interacts with miR-765 and modulates tongue squamous cell carcinoma progression by targeting LAMC2
Abstract
Background
Aimed at underlying the molecular regulatory mechanism and overall biological functions of LINC00511 in tongue squamous cell carcinoma (TSCC).
Methods
The expression level of LINC00511 was examined by QRT-PCR. In particular, Tca-8113 cell line was selected for subsequent experiments, in which the expression level of LINC00511 was the most significant. Meanwhile, the effects of LINC00511 on cells proliferation, cell cycle distribution and invasion of TSCC cells were explored using RNA knockdown tools with CCK-8, flow cytometry analysis, colony formation and transwell assay. Further, bioinformatic analysis and the dual-luciferase reporter assay both were conducted to invalidate the ceRNAs regulatory mechanism of LINC00511 in TSCC.
Results
LINC00511 was obviously up-regulated in TSCC tissues and cell lines. Moreover, it was found that LINC00511 served as a competing endogenous RNA (ceRNA)through sponging miR-765 and ultimately modulated the derepression of laminin subunit gamma 2 (LAMC2). The inhibitory effects of miR-765 on TSCC cells proliferation, invasion as well as cell cycle distribution can be restored by the ectopic overexpression of LINC00511. Additionally, the restored capacity of LINC00511 promoted the expression of LAMC2, which was a downstream target of miR-765 and can be negatively regulated by miR-765.
Conclusions
A novel molecular axis of LINC00511/miR-765/LAMC2 was investigated to regulate the tumor development of TSCC. LINC00511 promoted the expression of LAMC2 via the ceRNA mechanism of sponging miR-765. The ceRNA regulatory network provided a novel understanding of TSCC pathogenesis and also shed light on exploiting the new field of lncRNA-directed therapy against TSCC.
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Canadian genome-wide association study and meta-analysis confirm HLA as a risk factor for peanut allergy independent of asthma
Source:Journal of Allergy and Clinical Immunology
Author(s): Yuka Asai, Aida Eslami, C. Dorien van Ginkel, Loubna Akhabir, Ming Wan, David Yin, George Ellis, Moshe Ben-Shoshan, Ingo Marenholz, David Martino, Manuel A. Ferreira, Katrina Allen, Bruce Mazer, Hans de Groot, Nicolette W. de Jong, Roy Gerth van Wijk, Anthony E.J. Dubois, Sarah Grosche, Sarah Ashley, Franz Rüschendorf, Birgit Kalb, Kirsten Beyer, Markus M. Nöthen, Young-Ae Lee, Rick Chin, Steven Cheuk, Joshua Hoffman, Eric Jorgensen, John S. Witte, Ronald B. Melles, Xiumei Hong, Xiaobin Wang, Jennie Hui, Arthur W. (Bill) Musk, Michael Hunter, Alan L. James, Gerard H. Koppelman, Andrew J. Sandford, Ann E. Clarke, Denise Daley
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A functional splicing variant associated with decreased asthma risk abolishes the ability of gasdermin B (GSMDB) to induce epithelial cell pyroptosis
Publication date: Available online 9 January 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Ronald A. Panganiban, Maoyun Sun, Amber Dahlin, Hae-Ryung Park, Mengyuan Kan, Blanca E. Himes, Jennifer A. Mitchel, Carlos Iribarren, Eric Jorgenson, Scott H. Randell, Elliot Israel, Kelan Tantisira, Stephanie Shore, Jin-Ah Park, Scott T. Weiss, Ann Chen Wu, Quan Lu
BackgroundGenetic variants in the chromosomal region 17q21 are consistently associated with asthma. However, mechanistic studies have not yet linked any of the associated variants to a function that could influence asthma, and as a result, the identity of the asthma gene(s) remains elusive.ObjectivesWe sought to identify and characterize functional variants in the 17q21 locus. Methods: We used the Exome Aggregation Consortium (ExAC) browser to identify coding (amino acid-changing) variants in the 17q21 locus. We obtained asthma association measures for these variants in both the GERA cohort (16,274 cases and 38,269 matched controls) and the EVE Consortium study (5,303 asthma cases and 12,560 individuals). Gene expression and protein localization were determined by quantitative RT-PCR and fluorescence immunostaining, respectively. Molecular and cellular studies were performed to determine the functional effects of coding variants.ResultsTwo coding variants (rs2305480 and rs11078928) of the gasdermin B (GSDMB) gene in the 17q21 locus were associated with lower asthma risk in both GERA (OR = 0.92; P= 1.01 × 10-6) and EVE (OR= 0.85; Joint PEVE = 1.31 ×10-13). In GERA, rs11078928 had a minor allele frequency (MAF) of 0.45 in unaffected (non-asthmatic) controls and 0.43 in asthma cases. For European Americans in EVE the MAF of rs2305480 was 0.45 for controls and 0.39 for cases; for all EVE subjects the MAF was 0.32 for controls and 0.27 for cases. GSDMB is highly expressed in differentiated airway epithelial cells, including the ciliated cells. We found that when the GSDMB protein is cleaved by inflammatory caspase-1 to release its N-terminal fragment, potent pyroptotic cell death was induced. The splicing variant rs11078928 deletes the entire exon 6, which encodes 13 amino acids in the critical N-terminus, and abolishes the pyroptotic activity of the GSDMB protein.ConclusionsOur study identified a functional asthma variant in the GSDMB gene of the 17q21 locus and implicates GSDMB-mediated epithelial cell pyroptosis in pathogenesis.
Graphical abstract
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Oncomodulin Expression Reveals New Insights into the Cellular Organization of the Murine Utricle Striola
Abstract
Oncomodulin (OCM, aka β-parvalbumin) is an EF-hand calcium binding protein that is expressed in a restricted set of hair cells in the peristriolar region of the mammalian utricle. In the present study, we determined the topologic distribution of OCM among hair cell phenotypes to advance our understanding of the cellular organization of the striola and the relationship of these phenotypes with characteristics of tissue polarity. The distributions of OCM-positive (OCM+) hair cells were quantified in utricles of mature C57Bl/6 mice. Immunohistochemistry was conducted using antibodies to OCM, calretinin, and β3-tubulin. Fluorophore-conjugated phalloidin was used to label hair cell stereocilia, which provided the basis for determining hair cell counts and morphologic polarizations. We found OCM expression in striolar types I and II hair cells, though the distributions were dissimilar to the native striolar type I and II distributions, favoring type I hair cells. The distribution of OCM immunoreactivity among striolar type I hair cells also reflected nonrandom distribution among type Ic and Id phenotypes (i.e., those receiving calretinin-positive and calretinin-negative calyces, respectively). However, many OCM+ hair cells were found lateral to the striola, and within the epithelial region encompassing OCM+ hair cells, the distributions of OCM+ types Ic and Id hair cells were similar to the native distributions of Ic and Id in this region. Summarily, these data provide a quantitative perspective supporting the existence of different underlying factors driving the topologic expression of OCM in hair cells than those responsible for tissue polarity characteristics associated within the utricular striola, including calretinin expression in afferent calyces.
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Oncomodulin Expression Reveals New Insights into the Cellular Organization of the Murine Utricle Striola
Abstract
Oncomodulin (OCM, aka β-parvalbumin) is an EF-hand calcium binding protein that is expressed in a restricted set of hair cells in the peristriolar region of the mammalian utricle. In the present study, we determined the topologic distribution of OCM among hair cell phenotypes to advance our understanding of the cellular organization of the striola and the relationship of these phenotypes with characteristics of tissue polarity. The distributions of OCM-positive (OCM+) hair cells were quantified in utricles of mature C57Bl/6 mice. Immunohistochemistry was conducted using antibodies to OCM, calretinin, and β3-tubulin. Fluorophore-conjugated phalloidin was used to label hair cell stereocilia, which provided the basis for determining hair cell counts and morphologic polarizations. We found OCM expression in striolar types I and II hair cells, though the distributions were dissimilar to the native striolar type I and II distributions, favoring type I hair cells. The distribution of OCM immunoreactivity among striolar type I hair cells also reflected nonrandom distribution among type Ic and Id phenotypes (i.e., those receiving calretinin-positive and calretinin-negative calyces, respectively). However, many OCM+ hair cells were found lateral to the striola, and within the epithelial region encompassing OCM+ hair cells, the distributions of OCM+ types Ic and Id hair cells were similar to the native distributions of Ic and Id in this region. Summarily, these data provide a quantitative perspective supporting the existence of different underlying factors driving the topologic expression of OCM in hair cells than those responsible for tissue polarity characteristics associated within the utricular striola, including calretinin expression in afferent calyces.
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Strategies for a regenerative therapy of hearing loss
Abstract
Despite impressive technical progress in the field of conventional hearing aids and implantable hearing systems, the hopes for the treatment of inner ear diseases such as hearing loss and tinnitus have become increasingly directed toward regenerative therapeutic approaches. This review discusses the currently most promising strategies for hair cell regeneration in the inner ear to treat hearing loss, including stem cell-based, gene transfer-based, and pharmacological interventions. Furthermore, previous milestones and ground-breaking work in this scientific field are identified. After many years of basic research, the first clinical trials with a regenerative therapeutic approach for hearing-impaired patients were recently initiated. Although there is still a long and bumpy road ahead until a true breakthrough is achieved, it seems more realistic than ever that regenerative therapies for the inner ear will find their way into clinical practice.
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Circulating 25-hydroxyvitamin D, nasopharyngeal airway metabolome, and bronchiolitis severity
Abstract
Low circulating 25-hydroxyvitamin D (25OHD) levels are a risk factor for acute respiratory infection (e.g., bronchiolitis) in children. However, little is known about the relation of circulating 25OHD with the many downstream functional molecules in target organs – such as the airway – and with clinical outcomes. In this prospective multicenter study of infants (age <1 year) hospitalized with bronchiolitis, we measured serum 25OHD levels and profiled the metabolome of 144 nasopharyngeal airway samples. Among 254 metabolites identified, we defined a set of 20 metabolites that are related to lower serum 25OHD and higher vitamin D-binding protein levels. Of these metabolites, 9 metabolites were associated with a significantly higher risk of positive pressure ventilation use. These metabolites were glycerophosphocholines esterified with proinflammatory fatty acids (palmitate, arachidonate, linoleate, and stearate), sphingomyelins, alpha-hydroxyisovalerate, 2-hydroxybutyrate, and 3-(4-hydroxyphenyl)lactate (all FDR<0.05). Based on the multicenter data, vitamin D-related airway metabolites were associated with risks of bronchiolitis severity.
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TNF Family Member LIGHT Acts with IL-1β and TGF-β to Promote Airway Remodeling During Rhinovirus Infection
Abstract
Background
Rhinovirus (RV) can exacerbate allergen-driven asthma. However, it has been suggested that serial infections with RV may also lead to asthma-like features in childhood without prior allergen exposure.
Aim
We sought to test the effects of RV infection in the absence of allergen challenge on lung tissue remodeling and to understand if RV induced factors in common with allergen that promote remodeling.
Methods
We infected C57BL/6 mice multiple times with RV in the absence or presence of allergen to assess airway remodeling. We used knockout mice and blocking reagents to determine the participation of LIGHT (TNFSF14), as well as IL-1β and TGF-β, each previously shown to contribute to lung remodeling driven by allergen.
Results
Recurrent RV infection without allergen challenge induced an increase in peribronchial smooth muscle mass and subepithelial fibrosis. RV induced LIGHT expression in mouse lungs after infection, and alveolar epithelial cells and neutrophils were found to be potential sources of LIGHT. Accordingly, LIGHT-deficient mice, or mice where LIGHT was neutralized, displayed reduced smooth muscle mass and lung fibrosis. Recurrent RV infection also exacerbated the airway remodeling response to house dust mite allergen and this was significantly reduced in LIGHT deficient mice. Furthermore, neutralizing IL-1β or TGF-β also limited subepithelial fibrosis and/or smooth muscle thickness induced by RV.
Conclusion
Rhinovirus can promote airway remodeling in the absence of allergen through upregulating common factors that also contribute to allergen-associated airway remodeling.
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Food allergen-sensitized CCR9+ lymphocytes enhance airways allergic inflammation in mice
Abstract
Background
The mechanisms of the atopic march, characterized by a natural progression from food and cutaneous allergies to rhinitis and asthma, are still unknown. However, as several organs can be involved, chemokines and their receptors might be implicated in this process and may be instrumental factors.
Objectives
We hypothesized that the T-cell gut-homing receptor CCR9 could be implicated in the evolution of allergic diseases.
Methods: We characterized the immune response and the role of CCR9 in a murine model combining food allergy to wheat gliadin and a model of acute airways inflammation in response to house dust mite.
Results
Compared with solely asthmatic-like mice, we demonstrated that the aggravation of pulmonary symptoms in consecutive food and respiratory allergies, characterized by an increase in pulmonary resistance and a higher Th17/ Treg ratio, was abrogated in CCR9 knock-out mice. Moreover, transfer of food-allergic CD4+ T cells from wild-type but not from CCR9-/- aggravated airways inflammation demonstrating that CCR9 is involved in food allergy-enhanced allergic airway inflammation to unrelated allergens.
Conclusion
Taken together, our results demonstrated a crucial role of the T-cell homing receptor CCR9 in this model and validated its potential for use in the development of therapeutic strategies for allergic diseases.
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