A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling

Abstract

The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.

https://ift.tt/2R7wDvk

Two Cases of Lingual Arteriovenous Malformations with Comorbidities Treated by Glue Embolization: A Report with Review of Literature

Abstract

Arteriovenous malformations (AVMs) involving the tongue are uncommon lesions in the head and neck region. They present with bleeding that can be massive and life-threatening apart from debilitating symptoms of pain, ulcers, difficulty in phonation or swallowing. Various therapeutic approaches have been used in their management—surgery, endovascular embolization, radiation and ablation procedures like laser ablation. We report two patients—a 34 year-old man and 56 year-old female who presented with massive bleeding due to lingual AVM and had comorbidities as liver cirrhosis and chronic medical renal disease respectively, and treated with glue embolization, with a review of the literature.

https://ift.tt/2OYHjv5

Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings

Abstract

The aim of the study is to document the long term oncological results of trans-oral laser microsurgery (TLM) for early and moderately advanced glottic cancer in primary and salvage settings. In this prospective cohort study 43 consecutive patients of glottic cancer (T1–30, T2–7, and selected T3 with mobile cords-6) were recruited. TLM was performed in these 35 primary and 8 previously treated cases. In our series, the local disease control rate with TLM was 90% (27/30) for T1 disease, 71.4% (5/7) for T2 cancer and 66.6% (4/6) for T3 lesions. The overall disease control rates after subsequent treatment for locoregional recurrences were 100% (30/30), 85.7% (6/7) and 83.3% (5/6) for T1, T2, and T3 glottic cancers respectively. The 5-years disease free survival rate for primary cases was 100% and 50% for salvage cases. The 5-years local disease control rate was 96.4% and 41.67% in primary and salvage TLM settings respectively. The 5-years laryngectomy free rates were 96.3% and 18.75% for primary and salvage cases respectively. TLM offers a minimally invasive and oncologically robust treatment option for early glottic cancer with an overall disease free survival of 100% at 5 years noted for primary untreated cases in this experience. TLM for post radiation salvage cases has however been disappointing and alternate larynx preserving option of open partial laryngectomy needs to be considered in this setting.

https://ift.tt/2R7hDO9

Rab14 overexpression regulates gemcitabine sensitivity through regulation of Bcl-2 and mitochondrial function in pancreatic cancer

Abstract

Rab family protein Rab14 has been implicated in the development of human cancers. To date, its expression pattern, biological function, and potential mechanism in pancreatic cancer have not been explored. In this study, we analyzed Rab14 expression in 103 cases of pancreatic cancer tissues using immunohistochemistry (IHC) and found that Rab14 was overexpressed in 41/103 cases (39.8%). Rab14 overexpression correlated with the advanced stage. Moreover, elevated Rab14 levels indicated poor prognosis of patients with pancreatic cancers. We used BxPC-3 and Capan-2 respectively for plasmid and siRNA transfection. MTT and colony formation assays showed that Rab14 transfection increased cell proliferation and colony formation in BxPC-3 cells. Rab14 siRNA knockdown inhibits proliferation and colony formation ability in Capan-2 cell line. Cell cycle analysis showed that Rab14 facilitated cell cycle progression. Matrigel invasion assay showed that Rab14 promoted BxPC-3 cell invasion while its depletion inhibited Capan-2 cell invasion. In addition, MTT and AnnexinV/PI analysis demonstrated that overexpression of Rab14 reduced gemcitabine sensitivity which conversely was increased by Rab14 knockdown. We also demonstrated that Rab14 upregulated mitochondrial membrane potential (MMP) while its depletion downregulated MMP during gemcitabine treatment. In addition, western blotting revealed that Rab14 overexpression upregulated cyclin D1, cyclin A, cyclin E, p-Rb, and Bcl-2 and downregulated p21. Rab14 also downregulated caspase3, PARP cleavage, and cytochrome c release. In conclusion, our data indicated that Rab14 was overexpressed in pancreatic cancer and promotes growth and gemcitabine resistance, possibly through regulation of mitochondrial function and Bcl-2.

https://ift.tt/2y08cY3

miR-26b Inhibits Virus Replication Through Positively Regulating Interferon Signaling

Viral Immunology, Ahead of Print.


https://ift.tt/2QgeLgE

Clinical Notes on Herbert Screw Fixation for Fracture of Anterior Mandible

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0038-1670673

This article aims to present the outcomes of treating anterior mandibular fractures using Herbert's screw. A total of 10 patients were treated for fractures of anterior mandible by open reduction and internal fixation using the Herbert screw. The patients were collected starting from June 2016 to November 2017, at the Department of Craniomaxillofacial Surgery, Nasser Institute for Research and Treatment, Cairo, and Faculty of Dentistry, Ain Shams University, Cairo, Egypt. The follow-up plan was done to evaluate the postoperative clinical outcomes for malocclusion, neurosensory status, hardware failure, malunion/ nonunion, pain, and edema. There were no intraoperative or postoperative complications, except for one case where the Herbert screw was insufficient and needed additional 2.0-mm miniplate at the superior border. The postoperative orthopantomograms revealed satisfactory reduction and fixation of the fractures of all cases. The Herbert screw fixation of anterior mandibular fracture is a reliable technique but sensitive and surgeon dependent and needs further clinical investigation.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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FDA Approves Cemiplimab, First Drug for Advanced CSCC

The US Food and Drug Administration today approved cemiplimab for the treatment of patients with metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced, unresectable CSCC.
FDA Approvals

https://ift.tt/2OWnpAL

Coagulopathies and inflammatory diseases: ‘…glimpse of a Snark’

Silvina del Carmen | Sophie M Hapak | Sourav Ghosh | Carla V Rothlin

https://ift.tt/2zEluf6

Regulation of lymphocyte trafficking in central nervous system autoimmunity

Mohamed Oukka | Estelle Bettelli

https://ift.tt/2IoK869

ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

https://ift.tt/2OjDZgJ

Risk factors for periimplantitis and implant loss in orbital implants

After orbital exenteration a facial prosthesis is a viable option for rehabilitation. The aim of this study was to evaluate implant loss and peri-implantitis of solitary orbital implants with regard to risk factors.

https://ift.tt/2OlX41T

Improving the Accuracy of Automated Cleft Speech Evaluation

An automated cleft speech evaluator, available globally, has the potential to dramatically improve quality of life for children born with a cleft palate, as well as eliminating bias for outcome collaboration between cleft centers in the developed world. Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors to distinguish between normal speech, velopharyngeal dysfunction and articulatory speech errors. This article describes a significant update in the efficiency of our evaluator.

https://ift.tt/2Qgm8Vg

CDKN2A germline mutations are not associated with poor survival in an Italian cohort of melanoma patients

Cyclin dependent kinase inhibitor 2A gene (CDKN2A) germline mutations have recently been associated with poor survival in patients with melanoma. Despite the high mutation rate in our cohort (up to 10% in patients with apparently sporadic melanoma), information on the impact of CDKN2A on survival in this cohort is lacking.

https://ift.tt/2zDmNdS

Randomized in situ study on the efficacy of CO 2 laser irradiation in increasing enamel erosion resistance

Abstract

Objectives

The aim of this double-blind, randomized in situ study was to evaluate the erosion-preventive effect of a specific set of CO₂ laser parameters, associated or not with fluoride.

Methods

Two hundred forty bovine enamel blocks were prepared for individual palatal appliances (n = 6 samples/appliance). The study had four phases of 5 days each, with ten volunteers and the following treatments: CO₂ laser irradiation (L), fluoride treatment (F), combined fluoride and laser treatment (FL), and no treatment, control (C). Laser irradiation was performed at 0.3 J/cm² (5 μs/226 Hz/10.6 μm) and the fluoride gel contained AmF/NaF (12′500 ppm F⁻/pH = 4.8–6). For erosive demineralization, the appliances were immersed extra-orally in citric acid (0.05 M/20 min/pH = 2.3) twice daily. Analysis of enamel surface loss was done using a 3D-laser profilometer on 3 days. Additionally, fluoride uptake was quantified and scanning electron microscopies were done. Data were analyzed with repeated measures ANOVA and post hoc pairwise comparisons (α = 0.05).

Results

At all analyzing days, both laser groups caused the lowest means of enamel loss, which were also statistically significant lower than C (p < 0.05). At day 5, FL means ± SD (33.6 ± 12.6 μm) were even significantly lower than all other groups (C 67.8 ± 15.4 μm; F 57.5 ± 20.3 μm; L 46.8 ± 14.5 μm). Significantly increased enamel fluoride uptake was observed for both fluoride-containing groups (p < 0.05) at day 1.

Conclusion

Compared to the control, the CO₂ laser irradiation with a specific set of laser parameters (0.3 J/cm²/5 μs/226 Hz) either alone or in combination with a fluoride gel (AmF/NaF) could significantly decrease enamel erosive loss up to 5 days in situ.

Clinical relevance

Combined CO₂ laser-fluoride treatment has a significant anti-erosive effect.

https://ift.tt/2P1xdJW

Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk

Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-d...

https://ift.tt/2N9JcTF

Treatment of urticarial vasculitis: A systematic review

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Pavel Kolkhir, Maria Grakhova, Hanna Bonnekoh, Karoline Krause, Marcus Maurer

Abstract

Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review. Most UV patients are adult females with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic, but can be associated with drugs, malignancy, autoimmunity and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of skin symptoms in >80% of UV patients. However, their long-term administration can lead to potentially serious adverse effects. The addition of immunomodulatory or immunosuppressive agents often allows corticosteroids tapering and improves the efficacy of therapy. Biologicals, including omalizumab, as well as corticosteroids, cyclophosphamide, dapsone, mycophenolate mofetil, plasmapheresis, colchicine, hydroxychloroquine, intravenous immunoglobulins, NSAIDs, and cyclosporine can be effective for skin as well as systemic symptoms in UV patients. H₁-antihistamines, montelukast, danazol, H₂-antihistamines, pentoxifylline, doxepin and tranexamic acid are not effective in most UV patients. As of yet, no drugs have been approved for UV, and management recommendations are based mostly on case reports and retrospective studies. Prospective studies investigating the effects of treatment on the signs and symptoms of UV are needed.

https://ift.tt/2OYpEn6

A skewed pool of resident T cells triggers psoriasis-associated tissue responses in never-lesional psoriasis skin

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irène Gallais Sérézal, Elena Hoffer, Borislav Ignatov, Elisa Martini, Beatrice Zitti, Marcus Ehrström, Liv Eidsmo

Abstract

Background

Resident T cells are implicated in the maintenance and recurrence of psoriasis lesions. Whether skin that has not yet experienced psoriasis in subjects with established disease harbours pathogenic T cells is less investigated.

Objective

To analyse the composition of resident T cells and T cell driven tissue responses in skin never affected by disease from psoriasis patients.

Methods

Never-lesional skin was collected from patients with mild psoriasis. T cell profiles were assessed with confocal imaging and flow cytometry. Tissue responses to T cell stimulation were measured by multiplex and Nanostring.

Results

T cell activation ex vivo triggered psoriasiform and type-I interferon tissue responses in epidermis from never-lesional psoriasis. Accordingly, keratinocytes from never-lesional psoriasis responded to IFN-γ stimulation with MX1 expression and IFN-α release. Additionally, CCR6 expressing resident T cells poised to produce IFN-γ and IL-17 were enriched in never-lesional epidermis whereas dermal tissue responses and T cell compositions were similar to healthy skin. Finally, never-lesional keratinocytes exposed to IL-17 and skin explants exposed to common fungal antigens responded with upregulation of the CCR6-ligand CCL20.

Conclusion

Epidermal resident T cells capable of triggering psoriasiform tissue responses accumulate in never-lesional epidermis. Our global analysis of never-lesional psoriasis reveals that microbial interplay with genetically predisposed keratinocytes may shape the local pool of resident T cells.

Graphical abstract

https://ift.tt/2Olwshu

Laryngeal reconstruction in children with recurrent respiratory papillomatosis

Publication date: Available online 28 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): M.L. Scatolini, A. Cocciaglia, C.G. Pérez, H.A. Rodríguez

Abstract

OBJETIVES

To describe our experience in reconstructive laryngeal surgery in patients with recurrent respiratory papillomatosis (RRP). INTRODUCTION: RRP is a rare laryngeal disease requiring multiple surgical endoscopic interventions during its course. These interventions may cause secondary lesions that may compromise airway patency. Open larynx reconstructive surgery, as tracheostomy, is a procedure considered to potentially favor extralaryngeal papilloma dissemination. In patients with RRP, the use of endoscopic posterior cricoid grafting has not been previously described.

METHODS

The clinical charts of 230 patients with RRP seen between 1996 and 2017 were reviewed. All patients who underwent airway expansion procedures either by open or endoscopic approach were included in the study. RESULTS: Four patients with RRP underwent laryngeal surgery for laryngeal stenosis were included. A doble-stage open approach was used in two patients and a single-stage endoscopic approach in the remaining two. The two tracheostomized patients were decannulated while tracheostomy was avoided in the two patients who underwent a single-stage endoscopic procedure. Two patients had active papillomatous lesions limited to the larynx at the time of surgery; no dissemination was observed during follow-up (cases 1 and 3). One patient had extralaryngeal disseminated papilomatosis; surgery did not lead to an increased lesion load compared to presurgical lesions (case 4). The patient who did not have active lesions did not have recurrence (case 2).

CONCLUSIONS

Reconstructive laryngeal surgery is a safe and effective option in the management of stenotic sequelae resulting from the surgical treatment of RRP, allowing for decannulation or avoiding tracheostomy.

https://ift.tt/2Oicapa

An analysis of the literature addressing tonsillectomy knowledge gaps

Publication date: Available online 27 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Craig M. Cooper, Jake X. Checketts, Lacy Brame, Harrison Gray, Jaye Bea Downs, Matt Vassar

Abstract

Importance

The ability of clinical practice guidelines to improve patient outcomes depends on the quality of evidence that they are built upon. Research into tonsillectomy in children is lacking, and the gaps in evidence were identified by guideline authors.

Objective

The objective of this study is to evaluate the extent that new research is addressing the gaps identified in the AAO-HNS Tonsillectomy in Children Guideline.

Design

For each recommendation in the AAO-HNS guideline Tonsillectomy In Children, we created PICO (Participants, Intervention, Comparator, Outcome) questions and search strings. PubMed was searched to locate studies undertaken after the final literature search performed by the AAO-HNS work group. These studies were then extracted and analyzed.

Setting

This study is relevant to all invested in focusing otolaryngological research on questions which currently lack strong evidence.

Participants

Trials in tonsillectomy that started after the development of the AAO-HNS clinical practice guidelines.

Main Outcome Measures

The main outcome measures of this study is the extent to which tonsillectomy research is addressing the evidence gaps listed in the clinical practice guideline.

Results

Of the 2519 studies included in our sample, 276 (11%) were relevant to the 18 recommendations made within the Tonsillectomy in Pediatric Patients clinical practice guideline. All but one of the recommendations was met by at least one study.

Conclusions

and Relevance: Our findings indicate that knowledge gaps within the guideline at publication may have since been addressed and a guideline update may thus be warranted.

Level of Evidence

NA.

https://ift.tt/2DD8vxY

IDO1 impairs NK cell cytotoxicity by decreasing NKG2D/NKG2DLs via promoting miR-18a

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s): Jiahui Zhang, Xiao Han, Xiao Hu, Fengjiao Jin, Zihe Gao, Liyong Yin, Junfang Qin, Fuzai Yin, Chen Li, Yue Wang

Abstract

Background

Indoleamine-2,3-dioxygenase 1 (IDO1) is an important enzyme for altering the tumour microenvironment and assisting tumour cells to escape the immune system.

Results

In this study, a significant reduction in NK cell cytotoxicity that was associated with a high expression of IDO1 in a reconstructed tumour microenvironment was observed. In a co-culture system of tumour cell culture supernatant (TSN) and murine NK cell, IDO1 was substantially increased, while NKG2D was markedly downregulated in NK cells. Based on computational predictions, miR-18a, which has two definite binding sites consisting of the 3′UTR of NKG2D and the 3′UTR of NKG2D ligand (Mult-1), was suspected to be a negative regulator of which its conjoined. As expected, the IDO1 could promote the expression of miR-18a and promote the downregulation effect of miR-18a on NKG2D and NKG2DL, and INCB024360 (INCB) could reverse the result. For digging the mechanism deeper, we authenticated IDO1 promoted the combination of miR-18a and AGO2 after argonaute 2 (AGO2) co-immunoprecipitation, which then degraded Mult-1 mRNA and inhibited the translation of it, further destructing NK cell cytotoxicity.

Conclusion

Our findings revealed a new regulatory axis, IDO1/miR-18a/NKG2D/NKG2DL, in the regulation of NK cell function. This may provide insight into the mechanism of the priming effect of IDO1 inhibitors and miR-18a interference, then elicit possible new methods of cancer treatment.

Graphical abstract

https://ift.tt/2N7kPpR

A Study to Evaluate the Effect of ACT-774312 in Subjects With Bilateral Nasal Polyposis

Condition:   Bilateral Nasal Polyposis
Interventions:   Drug: ACT-774312;   Drug: Placebo
Sponsor:   Idorsia Pharmaceuticals Ltd.
Not yet recruiting

https://ift.tt/2zCWdBJ

Examine the Prognostic Role of FLT PET/CT for Patients With LR-NPC Treated by Carbon Ion Therapy

Condition:   Recurrent Nasopharyngeal Carcinoma
Intervention:   Diagnostic Test: FLT PET/CT
Sponsor:   Shanghai Proton and Heavy Ion Center
Not yet recruiting

https://ift.tt/2OTlU6s

Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors

Conditions:   Non Small Cell Lung Cancer;   Urothelial Carcinoma;   Malignant Melanoma;   Ovarian Cancer;   Colorectal Cancer;   Breast Cancer;   Squamous Cell Carcinoma of the Head and Neck;   Metastatic Cancer
Intervention:   Biological: ARG1-18,19,20
Sponsor:   Inge Marie Svane
Not yet recruiting

https://ift.tt/2zCsBVe

A Phase 3 Study of the Effects of GC4419 on Radiation Induced Oral Mucositis in Patients With Head/Neck Cancer

Conditions:   Oral Mucositis;   Head and Neck Cancer
Interventions:   Drug: GC4419;   Drug: Placebo
Sponsor:   Galera Therapeutics, Inc.
Not yet recruiting

https://ift.tt/2OVyulB

Impact of non-invasive continuous blood pressure monitoring on maternal hypotension during cesarean delivery: a randomized-controlled study

Abstract

Purpose

This study aimed to investigate the efficacy of the ClearSight™ system (Edwards Lifesciences, Irvine, CA) for reducing the incidence of hypotension compared with the traditional oscillometric blood pressure monitoring in cesarean delivery under spinal anesthesia.

Methods

Forty patients undergoing cesarean delivery under spinal anesthesia were enrolled. The patients were randomly divided into two groups (Control and ClearSight groups). All patients received spinal anesthesia using 0.5% hyperbaric bupivacaine (11.5 mg) and fentanyl (10 µg). Blood pressure was managed with the same protocol using the ClearSight™ system (ClearSight group) and oscillometric blood pressure monitoring (Control group). Furthermore, we compared the accuracy of the ClearSight™ system with the traditional oscillometric monitoring for blood pressure measurement using Bland–Altman, four-quadrant plot, and polar plot analyses.

Results

The incidence of hypotension was significantly lower in the ClearSight group from induction to delivery (45% vs. 0%, p < 0.001) and to the end of surgery (50% vs. 20%, p = 0.049). Intraoperative nausea occurred more frequently in the Control group (45% vs. 10%, p = 0.012). The ClearSight™ system demonstrated acceptable accuracy with a bias of − 4.3 ± 11.7 mmHg throughout the procedure. Four-quadrant analysis revealed an excellent trending ability of the ClearSight™ system with a concordance rate of approximately 95%. In the polar plot analysis, the angular bias and concordance rate were − 13.5° ± 19.0° and 76.9%, respectively.

Conclusions

The accuracy and trending ability of the ClearSight™ system for blood pressure measurement was clinically acceptable in cesarean delivery under spinal anesthesia, leading to reductions in maternal hypotension and nausea.

https://ift.tt/2Qi5PYg

Improving the Accuracy of Automated Cleft Speech Evaluation

Publication date: Available online 28 September 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): James R. Seaward, Rami R. Hallac, Megan Vucovich, Blaike Dumas, Cortney Van'T Slot, Caitlin Lentz, Julie Cook, Alex A. Kane

Summary

An automated cleft speech evaluator, available globally, has the potential to dramatically improve quality of life for children born with a cleft palate, as well as eliminating bias for outcome collaboration between cleft centers in the developed world. Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors to distinguish between normal speech, velopharyngeal dysfunction and articulatory speech errors. This article describes a significant update in the efficiency of our evaluator.

Speech samples from our Craniofacial Team clinic were recorded and rated independently by two experienced speech pathologists: 60 patients were used to train the evaluator, and the evaluator was tested on the 13 subsequent patients. All sounds from 6 of the CAPS-A-AM sentences were used to train the system.

The inter-speech pathologist agreement rate was 79%. Our cleft speech evaluator achieved 85% agreement with the combined speech pathologist rating, compared with 65% agreement using the previous training model.

This automated cleft speech evaluator demonstrates good accuracy despite low training numbers. We anticipate that as the training samples increase, the accuracy will match human listeners.

https://ift.tt/2zC1QjG

Rotation tendency of the posteriorly displaced proximal segment after vertical ramus osteotomy

Publication date: Available online 27 September 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Jong Chan Park, Jun Lee, Hun Jun Lim, Bong Chul Kim

Abstract

Intraoral Vertical Ramus Osteotomy (IVRO) is one of the operative techniques used for orthognathic surgery. The aim of this study was to assess the posterior displacement of the proximal segment in patients undergoing IVRO at 1-year follow-up.

In total, 52 hemimandibles from 26 patients who underwent IVRO in whom the proximal segment was posteriorly displaced without overlap with the distal segment at immediate post-operation (Imm) (30 cases, experimental group), and 26 patients in whom the proximal segment was not posteriorly displaced with overlap with the distal segment (Imm) (22 cases, control group) under three-dimensional computed tomography (3D CT) were included in the study. To analyze the movement of segments, the positions of the mid condyle point (MCP) and angle of condyle line (Con) were determined and the movement of the ramus angle (posterior edge of proximal segments) was measured at the proximal segment.

Regression of the proximal segment in sagittal direction of the MCP was observed in both groups and all directions of the ramus angle in the experimental group, and only sagittal direction in the control group.

In conclusion, posterior displacement of the proximal segment after IVRO showed tendency to regress its original position.

https://ift.tt/2DClwI9

Feasibility of carbon-fiber-reinforced polymer fixation plates for treatment of atrophic mandibular fracture: a finite element method

Publication date: Available online 27 September 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Diker Nurettin, Bayram Burak

Abstract

The objective of this study was to conduct a computer assessment of the biomechanical stability of locking fixation plates of different thicknesses, made of titanium alloy and carbon-fiber- reinforced polyetheretherkotone (CFR-PEEK) in Class III atrophic mandibular fractures. Class III atrophic mandibular models were constructed using three-dimensional finite element models. After simulation of fracture on the left side, plates with different thicknesses (1.0, 1.5, 2.0, and 2.5 mm) were adapted to the models and three locking screws on each side of the fracture were used for fixation. Titanium alloy and CFR-PEEK material properties were assessed for all plate models. Von Mises stress values decreased gradually with an increase in plate profile thickness. Von Mises stress values for screws and plates were lower in models using CFR-PEEK plates. An increase in plate profile enhanced the load-sharing performance of the fixation systems, with rigid titanium alloy plates sharing the load among the screws more evenly. 1.0 mm, 1.5 mm, and 2.0 mm CFR-PEEK plates produced strain values of 2–10%, which promote proper healing via formation of callus in the fracture line. In terms of investigated biomechanical parameters, and with a Young's modulus similar to that of cortical bone, CFR-PEEK materials appear to be suitable for the treatment of atrophic mandibular fractures.

https://ift.tt/2zCGgLL

Taurine administration prevents the intestine from the damage induced by beta-lactoglobulin sensitization in a murine model of food allergy

Publication date: Available online 27 September 2018

Source: Allergologia et Immunopathologia

Author(s): S. Aïnad-Tabet, H. Grar, A. Haddi, H. Negaoui, A. Guermat, O. Kheroua, D. Saïdi

Abstract

Background

Allergy to cow's milk proteins has often been associated with dysfunction of the intestinal mucosa caused by chronic inflammation in infants. This study evaluated the protective effect of taurine on intestinal damage induced by beta-lactoglobulin (β-Lg) in Balb/c mice used as an animal model of allergy to cow's milk proteins.

Methods

Balb/c mice were treated with taurine administered orally by gavage (3 mmol/kg/day) or intraperitoneally (100 mg/kg/day) for two weeks, then sensitized intraperitoneally with β-Lg. The electrophysiological parameters: active ion transport of chloride (Short-circuit current: Isc) and the passive ion permeability (Conductance: G) were measured ex vivo in Ussing chamber by intestine challenge with β-Lg. Histological study was used to assess gut inflammation. Serum levels of TNF-α and IL-6 were measured. Serum IgG and IgE anti-β-Lg were determined by ELISA.

Results

Compared with sensitized mice, β-Lg challenge of intestinal epithelium of taurine-pre-treated mice in Ussing chamber did not influence the intensity of Isc, nor produce any changes in the G, reflecting a reduction in the secretory response and epithelial permeability. Histological and morphometric analysis showed that taurine reduced the intestinal damage and limited intestine retraction caused by β-Lg sensitization. No statistically significant difference in the serum levels of TNF-α or IL-6 was found after oral or intraperitoneal administration of taurine. Treatment with taurine significantly decreased the IgG (p < 0.001) and IgE anti β-Lg levels (p < 0.05).

Conclusions

These results have for the first time provided evidence that pre-treatment with taurine appears to prevent intestinal damage induced by β-Lg.

https://ift.tt/2Oi8Wlr

Danger-Associated Molecular Patterns (DAMPs): the Derivatives and Triggers of Inflammation

Abstract

Purpose of Review

Allergen is an umbrella term for irritants of diverse origin. Along with other offenders such as pathogens, mutagens, xenobiotics, and pollutants, allergens can be grouped as inflammatory agents. Danger-associated molecular patterns (DAMPs) are altered metabolism products of necrotic or stressed cells, which are deemed as alarm signals by the innate immune system. Like inflammation, DAMPs play a role in correcting the altered physiological state, but in excess, they can be lethal due to their signal transduction roles. In a vicious loop, inflammatory agents are DAMP generators and DAMPs create a pro-inflammatory state. Only a handful of DAMPs such as uric acid, mtDNA, extracellular ATP, HSPs, amyloid β, S100, HMGB1, and ECM proteins have been studied till now. A large number of DAMPs are still obscure, in need to be unveiled. The identification and functional characterization of those DAMPs in inflammation pathways can be insightful.

Recent Findings

As inflammation and immune activation have been implicated in almost all pathologies, studies on them have been intensified in recent times. Consequently, the pathologic mechanisms of various DAMPs have emerged. Following PRR ligation, the activation of inflammasome, MAPK, and NF-kB is some of the common pathways.

Summary

The limited number of recognized DAMPs are only a fraction of the vast array of other DAMPs. In fact, any misplaced or abnormal level of metabolite can be a DAMP. Sophisticated analysis studies can reveal the full profile of the DAMPs. Lowering the level of DAMPs is useful therapeutic intervention but certainly not as effective as avoiding the DAMP generators, i.e., the inflammatory agents. So, rather than mitigating DAMPs, efforts should be focused on the elimination of inflammatory agents.

https://ift.tt/2DEjrvz

Invasion of the mandible in gingivobuccal complex cancers: Histopathological analysis of routes of tumour entry and correlation with preoperative assessment

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): DA. Chaukar, M. Dandekar, S. Kane, S. Arya, N. Purandare, V. Rangarajan, AK. D'Cruz

Abstract

Objectives

To determine the most accurate imaging modality predicting mandibular invasion in gingivobuccal (GB) complex cancers. To determine patterns of invasion and routes of tumour entry into the mandible by detailed histopathologic analysis.

Material and methods

Prospective observational study of GB Complex cancers juxtaposed with the mandible clinically necessitating some form of mandibular resection. Orthopantomogram (OPG), Multi Detector Computed Tomography (MDCT), DENTA scan and Single Photon Emission Computed Tomography scan (SPECT) were performed after which the patient was subjected to surgery. Histopathological assessment was systematically performed with serial cuts of the mandibular segment.

Results

Of 70 patients, MDCT was the most accurate with area under curve (AUC) of 0.833. OPG, DENTA and SPECT had AUC of 0.714, 0.786 and 0.738 respectively. Mean calculated difference of involved height was −0.025 cm by MDCT (p value 0.87), −0.2 cm by OPG (p value 0.09) and 0.12 by DENTA scan (p value 0.41). Mean difference of involved length was −0.51 cm (p value 0.08) and −1.02 cm (p value 0.04) for MDCT and OPG respectively. 50% of tumour invasion was through the occlusal route while large tumours demonstrated multiple routes of entry.

Conclusion

-Gingivobuccal complex cancers are homogenous with respect to mandibular invasion, preferred route of tumour entry being the occlusal surface.

-Multidetector CT scan is fairly accurate in detecting mandibular involvement and predicting extent of involvement.

-Oncological safety can be achieved by positioning the bone cuts corresponding to the adjacent soft tissue margins in segmental mandibulectomy.

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Onkologie

https://ift.tt/2xTzmQp

Danger-Associated Molecular Patterns (DAMPs): the Derivatives and Triggers of Inflammation

Abstract

Purpose of Review

Allergen is an umbrella term for irritants of diverse origin. Along with other offenders such as pathogens, mutagens, xenobiotics, and pollutants, allergens can be grouped as inflammatory agents. Danger-associated molecular patterns (DAMPs) are altered metabolism products of necrotic or stressed cells, which are deemed as alarm signals by the innate immune system. Like inflammation, DAMPs play a role in correcting the altered physiological state, but in excess, they can be lethal due to their signal transduction roles. In a vicious loop, inflammatory agents are DAMP generators and DAMPs create a pro-inflammatory state. Only a handful of DAMPs such as uric acid, mtDNA, extracellular ATP, HSPs, amyloid β, S100, HMGB1, and ECM proteins have been studied till now. A large number of DAMPs are still obscure, in need to be unveiled. The identification and functional characterization of those DAMPs in inflammation pathways can be insightful.

Recent Findings

As inflammation and immune activation have been implicated in almost all pathologies, studies on them have been intensified in recent times. Consequently, the pathologic mechanisms of various DAMPs have emerged. Following PRR ligation, the activation of inflammasome, MAPK, and NF-kB is some of the common pathways.

Summary

The limited number of recognized DAMPs are only a fraction of the vast array of other DAMPs. In fact, any misplaced or abnormal level of metabolite can be a DAMP. Sophisticated analysis studies can reveal the full profile of the DAMPs. Lowering the level of DAMPs is useful therapeutic intervention but certainly not as effective as avoiding the DAMP generators, i.e., the inflammatory agents. So, rather than mitigating DAMPs, efforts should be focused on the elimination of inflammatory agents.

https://ift.tt/2DEjrvz

Imaging of salivary gland pathology

Publication date: Available online 28 September 2018

Source: Operative Techniques in Otolaryngology-Head and Neck Surgery

Author(s): Gopi K. Nayak, Mari Hagiwara

ABSTRACT

The major salivary glands can be affected by a variety of acute or chronic, systemic, and neoplastic conditions. Several modalities can be used for salivary gland imaging, each with its own advantages and limitations. The article reviews the optimal imaging modality for different clinical scenarios, the typical imaging appearance of commonly encountered pathologies, and seeks to provide a framework for generating an appropriate differential diagnosis. Additionally, with regard to neoplastic conditions, the goals of the review are to highlight features suggestive of benign or low-grade lesions verses high grade malignancy, while recognizing the limitations of imaging in making specific histologic diagnoses.

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Mechanical and hydrolytic degradation of an Ormocer®-based Bis-GMA-free resin composite

Abstract

Objectives

The aim of the study was to evaluate the mechanical stability of bisphenol A-glycidyl methacrylate (Bis-GMA) and Ormocer-based resin composites before and after water absorption and to examine water saturation.

Material and methods

Disc-shaped specimens of the Bis-GMA (Grandio SO, Voco) and the Ormocer-based (Admira Fusion, Voco) dental resin composites were produced, stored in water, and weighed after pre-determined times to measure the absorbed water. Bend bars were produced and stored for 24 h in dry conditions as well as in distilled water for 14 days or 60 days at 37 °C. The initial flexural strength (FS) under quasi-static loading and flexural fatigue strength (FFS) under cyclic loading were determined under 4-point bending. Fracture toughness (K_Ic) of both composites was measured using the single-edge-V-notch-beam (SEVNB) technique after the same storage conditions under 3-point bending.

Results

Within the first 14 days, storage conditions did not affect the initial FS of Grandio SO, while a significant drop in initial FS was observed for Admira Fusion after 2 weeks in water and most of the water was absorbed within this time. FFS for the Bis-GMA composite was not reduced before 2 months in water, whereas for the Ormocer®-based composite, there has been a significant decrease in strength after cyclic fatigue already at 2 weeks of water storage. K_Ic of Admira Fusion decreased significantly after both storage periods, while K_Ic of Grandio SO decreased only significantly after 2 weeks of water storage.

Conclusion

All mechanical properties of the Bis-GMA composite were superior to those of the Ormocer®-based material, except water sorption.

Clinical significance

Water storage seems to have a much more pronounced effect on the mechanical properties of Ormocer®-based dental composites in comparison to Bis-GMA-based composites.

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Concomitant 1p36 deletion and TNFRSF14 mutations in primary cutaneous follicle center lymphoma frequently expressing high levels of EZH2 protein

Abstract

Primary cutaneous follicle center lymphoma (PCFCL) is an indolent variant of follicular lymphoma (FL) with limited information available on the genetic background of the disease. The genetic hallmark of nodal FL, the t(14;18) translocation, affecting the BCL2 gene, is rare in PCFCL. Loss of 1p36, the most common secondary chromosomal abnormality in nodal FL, has been recently reported in 16.7% of PCFCL cases. In order to further characterize PCFCL, 21 cases were analyzed using interphase fluorescence in situ hybridization with BCL2 break apart and 1p36/1q25 dual color probes. Sanger sequencing was used to investigate TNFRSF14 and EZH2 mutations and immunohistochemistry to assess BCL2, EZH2 protein expressions.

1p36 deletion occurred in 22% (5/21), BCL2 gene break in 10% (2/20) of the PCFCL cases. Mutations of the candidate tumor suppressor gene of the 1p36 region, TNFRSF14 mutations were detected in 4/17 (23.5%) cases with 2 cases presenting with concurrent 1p36 deletion. EZH2 hotspot mutations at Y641, A682, and A692 were not found. High EZH2 protein expression associated with a BCL2 negative phenotype was observed in 43% (9/21) of the cases. BCL2 gene break or 1p36 deletion did not impact the prognosis; however, they showed association with advanced stages at diagnosis (p = 0.016) and a tendency with shorter event free survival (p = 0.052).

In conclusion, 1p36 deletion co-occurs with acquired TNFRSF14 mutations, suggesting a role of this tumor suppressor gene in the development of a subgroup of PCFCL. High EZH2 protein expression associated with BCL2 negative phenotype is common and might represent an ideal therapeutic target.

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Novel steps forward in the histopathology of non-celiac gluten sensitivity

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Novel steps forward in the histopathology of non-celiac gluten sensitivity, authors’ reply

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HLA-G expression in gastric carcinoma: clinicopathological correlations and prognostic impact

Abstract

To analyze expression of human leukocyte antigen-G (HLA-G) in gastric adenocarcinoma and correlate its expression with histological and clinical variables. A continuous series of 94 unselected patients with gastric adenocarcinoma (stage I to III) were selected. All histological and clinical variables were collected including the intensity of intra- and peri-tumor lymphocytic infiltration. HLA-G expression was investigated using immunohistochemistry. All histological samples analyzed for HLA-G expression were taken from the primary gastric lesion and included non-neoplastic mucosa. Evaluation of HLA-G expression was performed on the transition zone between tumor and non-neoplastic mucosa, and the invasive front of the tumor and assessment was performed as follows: percentage of positive (strong expression vs weak) cells. A variable amount of HLA-G-positive tumor cells was found in 24 out of 94 cases (25.5%). No significant correlation was found between HLA-G expression and other clinicopathological variables (sex, age, stage, grade, histotype). The overall median survival was worse in patients with HLA-G-positive adenocarcinoma (24.3 months, CI_95% 7.7–41.0) compared to those with HLA-G-negative tumors (66.3 months, CI_95% 53.0–79.7; p < 0.0001). Two- and 5-year survival rates of HLA-G-negative patients were 88 and 44%, respectively, while were 42 and 11% in those HLA-G-positive. This trend was observed in all stages but was more marked in stage III. HLA-G expression is associated with poor survival in stage III gastric cancer patients and represents a possible immunoescape mechanism of cancer cells.

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Case of bilateral elastofibroma on the tensor fasciae latae

The Journal of Dermatology, EarlyView.


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Tofacitinib for the treatment of lichen planopilaris: A case series

Dermatologic Therapy, EarlyView.


https://ift.tt/2DDpaS9

Treatment of Vocal Cord Paralysis by Autologous Fat Injection: Our Experience with 41 Patients

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2zCUjkH

A 20 year observational cohort of a 5 million patient population – tonsillectomy rates in the context of two national policy changes

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


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Our Experience of Long Term Result of Tympanoplasty Using Areolar Tissue in 359 patients

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


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Snoring sound energy as a potential biomarker for disease severity and surgical response in childhood obstructive sleep apnea: a pilot study

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


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Total parenteral nutrition in the pleural space

Description  

A male infant was delivered spontaneously at 29+3 weeks and transferred to the local neonatal unit for uplift in care. This included 24 hours of ventilation, 12 hours of dobutamine and placement of a peripherally inserted central catheter (PICC) for total parenteral nutrition (TPN). By 24 hours he was extubated onto Optiflow at 6 L/min and Fraction of Inspired Oxygen (FiO₂) of 0.21. Expressed breastmilk was commenced whilst awaiting PICC placement.

A 22G 80 mm Leaderflex PICC was aseptically inserted on day 2 into the right antecubital fossa. The line did not bleed but flushed easily. A 0.9% sodium chloride infusion was commenced whilst awaiting confirmation of line position. Chest X-ray showed the PICC projected over the subclavian vein with mild residual airspace shadowing in both lungs (figure 1). The PICC position was felt to be acceptable when the X-ray was reviewed prospectively and retrospectively.

Figure 1

Chest X-ray showing peripherally inserted central catheter...

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Histone modifications associated with biological drug response in moderate‐to‐severe psoriasis

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2R2X1Xv

43rd National AOMSI Conference

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Extracranial meningiomas concurrently found in the lung and vertebral bone: a case report

Primary pulmonary meningiomas are very rare, and primary intraosseous meningiomas outside the head and neck region have not yet been reported. We report an extremely unusual case of concurrent meningiomas aris...

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Use of cold atmospheric pressure plasma to treat warts: a potential therapeutic option

Clinical and Experimental Dermatology, EarlyView.


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A painful vegetating finger

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2R51fxJ

Loricrin palmoplantar keratoderma: full‐thickness skin grafting for pseudoainhum

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2Qe2Wrm

Impact of a combined dermatology–rheumatology clinic on management of autoimmune connective tissue disorders

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2R50UuX

Melanocytic soluble adenylyl cyclase protein expression around lentigo maligna and in contralateral control skin

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2Qc89zV

Erythematous lesion with peripheral purpura on the face

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2R50pkz

Grover disease and bullous pemphigoid: a clinicopathological study of six cases

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2Qd9ruo

Recent Developments and Highlights in rhinitis and allergen immunotherapy

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Og8eoW

Morse code‐like hairs in tinea capitis disappear after successful treatment

International Journal of Dermatology, EarlyView.


https://ift.tt/2Oo7AWi

Fibroepithelioma of Pinkus in a 6‐year‐old boy: a case report

International Journal of Dermatology, EarlyView.


https://ift.tt/2xSP0vm

Pitfalls in diagnosing primary cutaneous aggressive epidermotropic CD8+ T‐cell lymphoma

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


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