Postoperative thoracic and low back pain following endovascular aortic repair associated with stenting location

Abstract

Background

We have noted that patients frequently complain of thoracic or low back pain after undergoing an endovascular aortic repair, which we speculated was caused by the indwelling stent.

Methods

We investigated the patients who underwent an elective thoracic or abdominal endovascular aortic repair (TEVAR or EVAR) and noted the location of stent, and postoperative pain. The incidence of either thoracic or low back pain at individual vertebra levels was determined, after which we fitted the sigmoidal function to the discrete data to obtain a cut-off line. The study patients were then divided into 2 groups using the cut-off line to compare the incidence of pain.

Results

We analyzed 96 patients (68 TEVAR, 28 EVAR). The incidence of thoracic pain was significantly higher in TEVAR as compared to EVAR (26.5% vs. 3.6%, P = 0.01), while that of low back pain was significantly higher in EVAR (35.7% vs. 16.2%, P = 0.04). With the cut-off line for thoracic pain set at the 12th thoracic vertebra, the incidence of thoracic pain was significantly higher in patients with the upper end of the stent above the cut-off as compared to at a lower point (26.5% vs. 3.6%, P = 0.01). As for low back pain, the cut-off line was set at the 9th thoracic vertebra, and the incidence of that pain was significantly higher in patients with the lower end of the stent below that line (30.9% vs. 0.0%, P < 0.01).

Conclusion

Thoracic and low back pain after an endovascular aortic repair procedure were associated with stenting site.

https://ift.tt/2AgB67q

Early aggressive intervention for infantile atopic dermatitis to prevent development of food allergy: a multicenter, investigator-blinded, randomized, parallel group controlled trial (PACI Study)—protocol for a randomized controlled trial

Atopic dermatitis is the first clinical manifestation of the atopic march, with the highest incidence in the first year of life. Those affected often go on to develop other allergic diseases including food all...

https://ift.tt/2FFEZZA

Surgical repair of partial anomalous pulmonary venous return with intact atrial septum in a 65-year-old woman: a case report

Partial anomalous pulmonary venous return is a rare congenital cardiac anomaly that usually involves the right pulmonary vein and an atrial septal defect. Isolated partial anomalous pulmonary venous return wit...

https://ift.tt/2TB4Rsu

Evaluation of teriparatide effect on healing of autografted mandibular defects in rats

To evaluate the effects of short-term teriparatide administration on healing of autologous bone graft in mandibular critical-size defects.

https://ift.tt/2OZaQDZ

Measurement of exhaled nitric oxide in young children with NIOX VERO

Fractional exhaled nitric oxide (FeNO) is a direct marker of Type 2 (T2)-driven inflammation in the airways and aids in the diagnosis of asthma.1, 2 FeNO is reproducible and easy to use in the clinic setting.3 - 5 FeNO measurement technique is often easier for younger children to master than spirometry6 and much less invasive than sputum induction or bronchoscopy.7, 8

https://ift.tt/2KrWT0L

Development of a Pediatric Asthma Predictive Index for Hospitalization

Asthma is the third leading cause of hospitalization among children in the United States.1 Currently 6.2 million children in the U.S. have asthma.1 In 2014, the number of emergency department (ED) visits for asthma exacerbation in children less than 15 years old was approximately 820,000.2 Recently, the total estimated cost of asthma to society was $82 billion.3 There is currently no standard protocol for asthma admissions in the ED. This often leads to wide variation in management and disparities in care.

https://ift.tt/2BtjPda

DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS) SYNDROME HYPERSENSITIVITY MYOCARDITIS PRESENTING WITH CARDIOGENIC SHOCK

DRESS Syndrome can vary in presentation from mild to life threatening. We report a case of suspected DRESS myocarditis presenting with cardiogenic shock.

https://ift.tt/2KtCUyO

An office based evaluation of various Itraconazole brands

https://ift.tt/2FCqYvJ

Early surgical management of traumatic dislocation of the tibialis posterior tendon: a case report and review of the literature

Traumatic dislocation of the tibialis posterior tendon at the ankle is a rare injury. Some of these cases are misdiagnosed as ankle sprains and are not treated properly. In addition, because the conservative t...

https://ift.tt/2DEPHwQ

A pilot study of a novel biodegradable magnesium alloy airway stent in a rabbit model

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Bangde Xue, Beibei Liang, Guangyin Yuan, Limin Zhu, Hao Wang, Zhaohui Lu, Zhiwei Xu

Abstract

Objective

To preliminarily investigate the feasibility of bioabsorption tracheal stenting for the therapeutic application of congenital tracheal stenosis (CTS).

Study Design

Experimental research.

Setting

Shanghai Children Medical Center, National Children's Medical Center.

Subjects

and Methods: Five kinds of magnesium alloys with different compositions were studied in this paper, a patented Mg–Nd–Zn–Zr alloy series namely JDBM (JiaoDa BioMg) and four Mg-Ca-Zn alloys. The cytotoxicity of alloys was evaluated by the MTS ([3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay in rabbit tracheal epithelial cells. Specific magnesium alloys had been immersed in the cell culture medium for 24 h. The tracheal stents that were made of magnesium alloy were implanted into the trachea of New Zealand rabbits and the ablation of the stent was monitored by fiber bronchoscopy. The routine blood examination was conducted prior to and following the stent placement. The rabbits were euthanized following 2–3 months of stenting. H&E staining of the main organs was conducted and the induction of apoptosis of the tracheal tissues was monitored.

Results

The cytotoxicity of the JDBM magnesium alloy was mild and lower than the remaining 4 alloys. The stents were placed successfully in five animals. The tracheal stents were successfully placed and gradually biodegradated as monitored by fiber bronchoscopy; no significant systemic inflammatory response was noted. No significant differences in the liver and/or kidney function prior to and following stent placement were noted. H&E staining indicated the absence of pathological changes in the trachea, liver, heart and/or kidney tissues. The apoptotic assay indicated that the apoptosis ratio of the tracheal tissues was comparable between rabbits with and without tracheal stenting.

Conclusion

The results suggested the feasibility of bioabsorption stents made of biodegradable magnesium alloys using in patients with tracheal stenosis, especially in infants.

https://ift.tt/2DVlc6R

Increased salivary fluid flow in children with newly diagnosed allergic rhinitis

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caixia Qiu, Si Ai, Xiangli Zhuang, Suping Huang, Jian Zheng

Abstract

Objectives

The pathogenesis of allergic rhinitis (AR) may involve dysregulation of the autonomic nervous system (ANS). Salivary fluid flow and salivary alpha-amylase (sAA) secretion are able to reflect the activity of parasympathetic (PNS) and sympathetic nervous system (SNS), respectively. The study aims to address the ANS profile in children with newly diagnosed AR by measuring the salivary secretion pattern.

Methods

We recruited thirty-three children with newly diagnosed AR and thirty-one age- and sex-matched healthy children as control. Saliva samples were collected in the morning and the salivary parameters, including salivary flow rate (SFR, ml/min) and sAA secretion rate (μg/min), were determined accordingly. We also measured the gene copy number of the sAA gene, AMY1, for each individual.

Results

We detected a significantly higher SFR in AR children compared with healthy control (2.20 ± 0.55 vs. 1.63 ± 0.61; p = 0.0002). Similar sAA secretion rate was observed between the two groups (312.8 ± 124.8 (Healthy) vs. 347.9 ± 114.0 (AR) μg/min; p = 0.2444). Besides, the two groups did not differ in AMY1 gene copy number (7.2 ± 2.3 (Healthy) vs. 7.7 ± 2.2 (AR); p = 0.3493).

Conclusions

Our results implicate an overactivity of the PNS while normal SNS activity in children with newly diagnosed AR. The findings support a contributing role of the ANS dysfunction in the pathogenesis of AR.

https://ift.tt/2SclwkN

Genetic screening involving 101 hot spots for neonates not passing newborn hearing screening and those random recruited in Dongguan

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Yanhui Liu, Lixin Ye, Pengyuan Zhu, Jingfan Wu, Shujuan Tan, Jingguo Chen, Chunqiu Wu, Yukang Zhong, Yu Wang, Xiaoxia Li, Hailiang Liu

Abstract

In order to investigate essential molecular causes for hearing loss and mutation frequency of deafness-related genes, 1315 newborns who did not pass the Newborn Hearing Screening (NHS) (audio-no-pass) and 1000 random-selected infants were subjected to detection for 101 hotspot mutations in 18 common deafness-related genes. Totally, 23 alleles of 7 deafness genes were detected out. Significant difference (χ²=25.320, p=0.000) existed in causative mutation frequency between audio-no-pass group (81/1315, 6.160%) and random-selected cohort (18/1000, 1.80%). Of the genes detected out, GJB2 gene mutation was with significant difference (χ²=75.132, p=0.000) between audio-no-pass group (417/1315, 31.711%) and random-selected cohort (159/1000, 15.900%); c.109G>A was the most common allele, as well as the only one with significantly different allele frequency (χ²=79.327, p=0.000) between audio-no-pass group (392/1315, 16.84%) and random-selected cohort (140/1000, 7.55%), which suggested c.109G>A mutation was critical for newborns' hearing loss. This study performed detection for such a large scale of deafness-associated genes and for the first time compared mutations between audio-no-pass and random-recruited neonates, which not only provided more reliable DNA diagnosis result for medical practioners and enhanced clinical care for the newborns, but gave more accurate estimation for mutation frequency.

https://ift.tt/2DVkQx3

The efficacy and safety of ciclesonide for the treatment of perennial allergic rhinitis: a systematic review and meta-analysis

Publication date: Available online 22 November 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Qi Yang, Fei Wang, Bin Li, Wenbin Wu, Dengpiao Xie, Li He, Nan Xiang, Yan Dong

Abstract

Introduction

Allergic rhinitis is a chronic inflammatory disease which affects 1 out of 6 individuals. Perennial allergic rhinitis accounts for 40% of AR cases. Ciclesonide is one of the relatively new intranasal steroid for allergic rhinitis.

Objective

The purpose of this study was to evaluate the efficacy and safety of ciclesonide in the treatment of perennial allergic rhinitis.

Methods

We searched Pubmed, Scientific Citation Index, Embase, Clinical Trial Registries for randomized controlled trials and Cochrane Central Register of Controlled Trials to find out the randomized controlled Trial comparing ciclesonide with placebo for PAR.

Results

Eight studies were included. In comparison with placebo groups, ciclesonide groups significantly decreased Reflective Total Nasal Symptom Score (MD = −0.56; 95% CI −0.72 to 0.39, p < 0.00001) with heterogeneity (p = 0.19, I² = 24%), Instantaneous Total Nasal Symptom Score (MD = −0.57; 95% CI −0.75 to −0.39, p < 0.00001) with heterogeneity (p = 0.34, I² = 11%). A significant effect for Reflective Nasal Symptom Score Subtotal (MD = −0.15; 95% CI −0.18 to −0.13, p < 0.00001; with heterogeneity, p = 0.12, I² = 24%) was also demonstrated. Rhinoconjunctivitis quality of life questionnaire score RQLQs (MD = −0.27; 95% CI −0.39 to −0.15, p < 0.00001; with heterogeneity, p = 0.58, I² = 0%) in the treatment of ciclesonide was also significantly reduced. In addition, the difference in Treatment-Emergent Adverse Events between the two groups was not significant.

Conclusion

Ciclesonide can improve perennial allergic rhinitis without increasing adverse events. Ciclesonide may be another valuable choice for perennial allergic rhinitis in the future.

Resumo

Introdução

A rinite alérgica é uma doença inflamatória crônica que afeta 1 a cada 6 indivíduos. A rinite alérgica perene é responsável por 40% dos casos de rinite alérgica. A ciclesonida é um dos corticosteroides intranasais mais novos para o tratamento dessa condição clínica.

Objetivo

O objetivo deste estudo foi avaliar a eficácia e segurança da ciclesonida no tratamento da rinite alérgica perene.

Método

Uma busca foi realizada nos bancos de dados Pubmed, Scientific Citation Index, Embase, e Clinical Trial Registries por ensaios clínicos randomizados e Cochrane Central Register of Controlled Trials por estudos controlados randomizados comparando ciclesonida com placebo no tratamento da rinite alérgica perene.

Resultados

Oito estudos foram incluídos. Em comparação com os grupos placebo, os grupos ciclesonida mostraram diminuição significante no escore do Reflective Total Nasal Symptom Score (rTNSS) (DM = −0,56; IC 95%: −0,72 a −0,39, p < 0,00001) com heterogeneidade (p = 0,19, I² = 24%), do Instantaneous Total Nasal Symptom Score (iTNSS) (DM = −0,57; IC95%: −0,75 a −0,39, p < 0,00001) com heterogeneidade (p = 0,34, I² = 11%). Um efeito significante no escore do Reflective Nasal Symptom Score (rNSS) Subtotal (DM = −0,15; IC 95%: −0,18 a −0,13, p < 0,00001; com heterogeneidade, p = 0,12, I² = 24%) também foi demonstrado. O escore do Rhinoconjunctivitis quality of life questionnaire score, RQLQs (DM = −0,27; IC 95%: −0,39 a −0,15, p < 0,00001; com heterogeneidade, p = 0,58, I² = 0%) também foi significantemente reduzido no tratamento com ciclesonida. Além disso, a diferença em relação aos eventos adversos emergentes do tratamento, entre os dois grupos não foi significante.

Conclusão

A ciclesonida pode melhorar a rinite alérgica perene sem aumentar os eventos adversos. Esse fármaco pode ser outra opção valiosa para a rinite alérgica perene no futuro.

https://ift.tt/2DGIXyj

Evaluation of language in children with pre-lingual hearing loss and cochlear implant

Publication date: Available online 22 November 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Emille Mayara Scarabello, Dionísia Aparecida Cusin Lamônica, Marina Morettin Zupelari, Liége Franzini Tanamati, Patrícia Dominguez Campos, Kátia de Freitas Alvarenga, Adriane Lima Mortari Moret

Abstract

Introduction

The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development.

Objective

The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language.

Methods

This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody Picture Vocabulary Test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months.

Results

The longer duration of the cochlear implant use, the younger age at surgery and the better performance at the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study.

Conclusion

The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.

Resumo

Introdução

O implante coclear é um tratamento eficaz para crianças com deficiência auditiva pré-lingual de grau severo e/ou profundo, uma vez que proporciona melhoria considerável na aquisição da linguagem oral por meio da via auditiva. O uso do implante coclear contribui para o desenvolvimento da percepção auditiva favorecendo a aquisição dos processos linguísticos voltados à aquisição de habilidades comunicativas que poderá repercutir positivamente em outras áreas do desenvolvimento.

Objetivo

O objetivo deste estudo foi verificar o desempenho de crianças usuárias de implante coclear quanto à linguagem oral expressiva e receptiva.

Método

Trata-se de um estudo prospectivo transversal onde os seguintes testes foram utilizados: Teste de linguagem infantil nas áreas de fonologia, vocabulário, fluência e pragmática e Test de Vocabulário de Imágenes Peabody. Participaram deste estudo 30 crianças de ambos os sexos na faixa etária de 36 a 72 meses, com deficiência auditiva sensorioneural de grau severo e/ou profundo bilateral, sem outros comprometimentos e usuárias de implante coclear unilateral com inserção total dos eletrodos há, no mínimo, 12 meses.

Resultados

O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva. Embora comparativamente ao processo de aquisição normativo da linguagem os resultados encontrados revelaram que estas crianças demonstraram habilidades linguísticas em padrões abaixo de sua idade cronológica, os resultados apontaram que estas crianças estão em evolução da linguagem oral expressiva e receptiva, sendo este o resultado que deve ser valorizado neste estudo.

Conclusão

O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva, porém não em todas as categorias semânticas estudadas.

https://ift.tt/2QdHJS8

Is the C reactive protein/albumin ratio a prognostic and predictive factor in sudden hearing loss?

Publication date: Available online 22 November 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Ramazan Öçal, Fatma Ceyda Akin Öçal, Mustafa Gulluev, Necat Alatas

Abstract

Introduction

Sudden hearing loss is a significant otologic emergency. Previous studies have revealed a coexistence of sudden hearing loss with chronic inflammation. The predictive importance of C-reactive protein/albumin values as a prognostic factor has been shown in various inflammatory and tumoral conditions.

Objectives

The aim of this study was to determine whether the C-reactive protein/albumin ratio in sudden hearing loss can be used for prognostic purposes and whether there is a relationship between the neutrophil/lymphocyte ratio and the C-reactive protein/albumin ratio.

Methods

A retrospective examination was made of 40 patients diagnosed with idiopathic sudden hearing loss and a control group of 45 healthy subjects. The pure tone averages of all the patients were determined on first presentation and repeated at 3 months after the treatment. The patients were separated into 2 groups according to the response to treatment. The neutrophil/lynphocyte ratio and the C-reactive protein/albumin ratios were calculated from the laboratory tests.

Results

The patients included 16 females and 24 males with a mean age of 44.1 ± 14.2 years and the control group was composed of 23 females and 22 males with a mean age of 42.2 ± 13.8 years. The mean C-reactive protein/albumin ratio was 0.95 ± 0.47 in the patient group and 0.74 ± 0.13 in the control group. The difference was statistically significant (p = 0.009). The mean C-reactive protein/albumin ratio was 0.79 ± 0.12 in the response to treatment group and 1.27 ± 0.72 in the non-response group, with no significant difference determined between the groups (p = 0.418). The mean neutrophil/lymphocyte ratio was 3.52 ± 3.00 in the response to treatment group and 4.90 ± 4.60 in the non-response group, with no statistically significant difference determined between the groups (p = 0.261).

Conclusion

C-reactive/albumin ratio was significantly higher in patients with sudden hearing loss than in the control group. Although C-reactive protein/albumin ratio was found to be lower in sudden hearing loss patients who responded to treatment compared to those who did not, the difference between two groups was not statistically significant.

Resumo

Introdução

A perda auditiva neurossensorial súbita ou surdez súbita é uma emergência otológica significativa. Estudos anteriores revelaram uma coexistência dessa condição com inflamação crônica. A importância preditiva dos valores da relação proteína C-reativa/albumina como fator prognóstico tem sido demonstrada em várias condições inflamatórias e tumorais.

Objetivos

O objetivo deste estudo foi determinar se a relação proteína C-reativa/albumina na perda auditiva neurossensorial súbita pode ser utilizada para fins prognósticos e se existe uma associação entre as relações neutrófilo/linfócito e proteína C-reativa/albumina.

Método

Foram avaliados retrospectivamente 40 pacientes com diagnóstico de perda auditiva neurossensorial súbita idiopática e um grupo controle de 45 indivíduos saudáveis. As médias de tons puros de todos os pacientes foram determinadas na primeira consulta e repetidas 3 meses após o tratamento. Os pacientes foram separados em 2 grupos de acordo com a resposta ao tratamento. As relações neutrófilo/linfócito e proteína C-reativa/albumina foram calculadas a partir de testes laboratoriais.

Resultados

Os pacientes incluíam 16 mulheres e 24 homens, com média de idade de 44,1 ± 14,2 anos, e o grupo controle por 23 mulheres e 22 homens, com média de idade de 42,2 ± 13,8 anos. A média da relação proteína C-reativa/albumina foi de 0,95 ± 0,47 no grupo de pacientes e de 0,74 ± 0,13 no grupo controle, e a diferença foi estatisticamente significante (p = 0,009). A média da relação proteína C-reativa/albumina foi de 0,79 ± 0,12 do grupo com resposta ao tratamento e de 1,27 ± 0,72 no grupo sem resposta, sem diferença significante entre os grupos (p = 0,418). A média da relação neutrófilo/linfócito foi de 3,52 ± 3,00 no grupo com resposta ao tratamento e de 4,90 ± 4,60 no grupo sem resposta, sem diferença estatisticamente significativa entre os grupos (p = 0,261).

Conclusão

A relação proteína C-reativa/albumina foi significantemente maior nos pacientes com perda auditiva neurossensorial súbita do que no grupo controle. No entanto, embora a relação proteína C-reativa/albumina tenha sido menor nos pacientes com perda auditiva neurossensorial súbita que responderam ao tratamento em comparação a aqueles que não apresentaram resposta, a diferença entre os dois grupos não foi estatisticamente significante.

https://ift.tt/2DHCOlQ

“A Novel Approach for Total Nasal Reconstruction”

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Shahrouz Zarrabi, Mark Welch, John Neary, Beomjune Kim

Summary

A 61-year-old woman who lost her nose, upper lip, and most of her midface bony structures due to cancer 20 years ago underwent advanced surgical reconstruction. This patient had previously undergone multiple reconstructive surgeries that failed to satisfactorily restore her nose. Therefore, a multi-stage reconstruction was performed to recreate a complete nose and increase her upper lip length. Due to a lack of sufficient facial bone and nasal supporting structures, the reconstruction was extremely challenging. Virtual surgical planning technology was used to create a customized titanium nasal plate. The patient's nose was successfully reconstructed using the nasal plate, costal cartilage, and a paramedian forehead flap. The patient is highly satisfied with the cosmetic and functional results and has had significant psychosocial improvement since the reconstruction.

https://ift.tt/2PRmCWk

CSIOMS to Present Research

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s):

https://ift.tt/2R8YuLl

MNP triggers nasal allergy by modulating dendritic cell properties

Publication date: Available online 23 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Xiao-Yu Liu, Yong-Jin Wu, Li-Juan Song, Xian-Hai Zeng, Shuai Wang, Jiang-Qi Liu, Li-Hua Mo, Xiao-Rui Geng, Li-Teng Yang, Rui-Di Xie, Xiao-Wen Zhang, Zhi-Gang Liu, Ping-Chang Yang

https://ift.tt/2BseySS

IgE-class-specific immunosuppression in offspring by administration of anti-IgE to pregnant mice

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Hideaki Morita, Masato Tamari, Masako Fujiwara, Kenichiro Motomura, Yasuhiko Koezuka, Go Ichien, Kenji Matsumoto, Kimishige Ishizaka, Hirohisa Saito

https://ift.tt/2KqWKug

Transcriptome profiling of refractory atopic keratoconjunctivitis by RNA sequencing

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Akira Matsuda, Yosuke Asada, Naomasa Suita, Satoshi Iwamoto, Toshiaki Hirakata, Norihiko Yokoi, Yasuyuki Ohkawa, Yukinori Okada, Takehiko Yokomizo, Nobuyuki Ebihara

Summary

We found upregulation of 47 immunoglobulin genes and 22 S. aureus infection-related genes in refractory atopic keratoconjunctivitis tissue by RNA-seq analysis, suggesting that lymphoid neogenesis and stimuli from infection are essential components of the disorder.

https://ift.tt/2BseBy2

Vaccination of non-allergic individuals with recombinant hypoallergenic fragments of birch pollen allergen Bet v 1: Safety, effects and mechanisms

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Raffaela Campana, Katharina Marth, Petra Zieglmayer, Milena Weber, Christian Lupinek, Yury Zhernov, Olga Elisyutina, Musa Khaitov, Eva Rigler, Kerstin Westritschnig, Uwe Berger, Martin Wolkersdorfer, Fritz Horak, Friedrich Horak, Rudolf Valenta

Summary

This is the first double-blind, placebo-controlled study showing that vaccination with recombinant hypoallergenic allergen-derivatives is safe and induces sustained allergen-specific IgG responses which block allergic patients IgE binding to the allergen.

https://ift.tt/2Ks2PXn

Merkelzellkarzinom

Zusammenfassung

Das Merkelzellkarzinom ist ein seltener, hoch aggressiver Hauttumor des älteren Menschen. Er besitzt neuroendokrine Eigenschaften. Die Pathogenese ist mit chronischer UV-Licht-Exposition und dem Merkelzell-Polyomavirus assoziiert. Klinisch fällt das Merkelzellkarzinom durch einen solitären, kutan oder subkutan gelegenen, roten bis bläulichen Knoten auf. Da der Tumor frühzeitig lymphogen metastasiert, sind zum Zeitpunkt der Diagnosestellung in etwa 30 % der Fälle bereits lokoregionäre Metastasen vorhanden. Die häufigen Lokalrezidive sowie die regionäre und ferne Metastasierung zeigen sich meist innerhalb der ersten 2 bis 3 Jahre nach Erstdiagnose. Die erste Therapie nach Diagnosestellung besteht in der vollständigen operativen Entfernung des Primärtumors mit weitem Sicherheitsabstand sowie einer Sentinellymphknotenbiopsie. Anschließend sollte eine adjuvante Radiatio des Tumorbetts erfolgen. Durch eine zusätzliche Bestrahlung der regionären Lymphknotenstationen kann die Rate lokoregionärer Rezidive gesenkt werden. Für die systemische Therapie des fortgeschrittenen Merkelzellkarzinoms haben sich gegen die PD-1/PD-L1-Achse gerichtete Checkpoint-Inhibitoren als gut und dauerhaft wirksam erwiesen. Die vormals häufig eingesetzte Chemotherapie zeigt hingegen zwar mäßige bis gute Ansprechraten, diese sind jedoch in der Regel von sehr kurzer Dauer.

https://ift.tt/2Qeu5xP

Distribution of mast cells within the mouse heart and its dependency on Mitf

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Arnar Bragi Ingason, Fatich Mechmet, Diahann Alexandra Maria Atacho, Eiríkur Steingrímsson, Pétur Henry Petersen

Abstract

Although mast cell distribution has been described in both human and canine hearts, cardiac mast cells in mice have yet to be categorically localized. We therefore sought to describe mast cell distribution within the mouse heart and characterize their dependence on the Microphthalmia-associated transcription factor (Mitf). Cardiac mast cells were visualized using Toluidine Blue and avidin staining, and their distribution within the heart described. Cardiac mast cells were most prevalent in the epicardium (50%) or myocardium (45%). Less frequently, mast cells were noted in the endocardium (5%). Within the myocardium, 31% of the mast cells had perivascular location. By studying two different Mitf mutant strains, Mitf^mi−vga9 and Mitf^Mi-wh, we demonstrated that these mutations led to near-complete deficiency of cardiac mast cells. Accordingly, expression of the mMCP-4 and mMCP-5 genes was lost and chymase enzyme activity was severely reduced. Additionally, hearts from mice heterozygous for these Mitf mutations contained significantly fewer mast cells compared to wild-type mice. Our results demonstrated that the distribution of cardiac mast cells in mice is different from humans and dogs. Cardiac mast cells are dependent on Mitf expression, with loss-of-function mutation in the Mitf gene leading to near-complete lack of cardiac mast cells. Loss of a single Mitf allele is sufficient for relative mast cell deficiency.

https://ift.tt/2PU7GH6

Protective effect of ginsenoside Rg1 on LPS-induced apoptosis of lung epithelial cells

Publication date: Available online 22 November 2018

Source: Molecular Immunology

Author(s): Qijian Ji, Zhaozui Sun, Zhizhou Yang, Wei Zhang, Yi Ren, Weijun Chen, Mengya Yao, Shinan Nie

Abstract

Sepsis-induced acute lung injury (ALI) is a life-threatening medical condition with high mortality and morbidity in the critical care units. Though, it was commonly accepted that inflammation and apoptosis of lung epithelial cells played an essential role in the pathogenesis of ALI, the underlying mechanism remain unknown. In our study, we found that LPS-induced cell apoptosis could be counteracted by elevated cell autophagy. In LPS-treated MLE-12 cells, suppression of autophagy via 3-MA could aggravate LPS-induced apoptosis, while activation of autophagy via Rapamycin could effectively impair the apoptosis of MLE-12 cells induced by LPS. In order to further discover the molecular regulation mechanism between apoptosis and autophagy in LPS-treated MLE-12 cells, we demonstrated that autophagy could induced the expression of Nrf2, followed with the decrease of p-p65. Targeted inhibition of Nrf2 could induce enlarged cell apoptosis via increasing the level of p-p65. In addition, we demonstrated that ginsenoside Rg1 protected MLE-12 cells from LPS-induced apoptosis via augmenting autophagy and inducing the expression of Nrf2. Our data implicates that activation of autophagy and Nrf2 by ginsenoside Rg1 may provide a preventive and therapeutic strategy for ALI.

https://ift.tt/2R2WRPg

Taming hemodialysis-induced inflammation: Are complement C3 inhibitors a viable option?

Publication date: Available online 22 November 2018

Source: Clinical Immunology

Author(s): Dimitrios C. Mastellos, Edimara S. Reis, Ali-Reza Biglarnia, Meryl Waldman, Richard J. Quigg, Markus Huber-Lang, Marc A. Seelen, Mohamed R. Daha, John D. Lambris

Abstract

Owing to an increasing shortage of donor organs, the majority of patients with end-stage kidney disease remains reliant on extracorporeal hemodialysis (HD) in order to counter the lifelong complications of a failing kidney. While HD remains a life-saving option for these patients, mounting evidence suggests that it also fuels a vicious cycle of thromboinflammation that can increase the risk of cardiovascular disease. During HD, blood-borne innate immune systems become inappropriately activated on the biomaterial surface, instigating proinflammatory reactions that can alter endothelial and vascular homeostasis. Complement activation, early during the HD process, has been shown to fuel a multitude of detrimental thromboinflammatory reactions that collectively contribute to patient morbidity. Here we discuss emerging aspects of complement's involvement in HD-induced inflammation and put forth the concept that targeted intervention at the level of C3 might constitute a promising therapeutic approach in HD patients.

https://ift.tt/2R2T04K

Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study

Publication date: Available online 22 November 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): P. Papi, E. Brauner, S. Di Carlo, D. Musio, M. Tombolini, F. De Angelis, V. Valentini, V. Tombolini, A. Polimeni, G. Pompa

Abstract

The aim of this prospective cohort study was to evaluate how the radiation technique can affect crestal bone loss and the implant survival rate in head and neck cancer patients treated with radiotherapy. In this study, the type of radiotherapy treatment, i.e. three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT), was the predictor variable. The primary outcome variable was crestal bone loss, recorded at implant placement and after 3, 6, 12, and 24 months. A descriptive analysis and ANOVA test were performed; significance was set at P < 0.05. Thirty-two patients were enrolled and a total of 113 dental implants placed in irradiated residual bone. There was no statistically significant difference in crestal bone loss levels between the groups at any of the intervals (P > 0.05), except after 6 months (P = 0.028). The cumulative dental implant survival rate was 94.7%. After 24 months, the mean marginal bone loss was 0.83 ± 0.12 mm in the 3D-CRT group and 0.74 ± 0.15 mm in the IMRT group (P = 0.179). The data suggest that the different radiation techniques did not affect the outcomes of implant-supported prosthetic rehabilitation, as related to crestal bone loss and implant survival. However, long-term follow-up studies are necessary to evaluate the real influence of the radiotherapy technique on dental implants.

https://ift.tt/2BsAtcH

Nuclear expression of onco-suppressors NM23-H1 and maspin are associated with lower recurrence rate in laryngeal carcinoma

Publication date: Available online 22 November 2018

Source: American Journal of Otolaryngology

Author(s): Gino Marioni, Giancarlo Ottaviano, Cosimo de Filippis, Elena Fasanaro, Benedetto Randon, Stefano Meneghesso, Luciano Giacomelli, Laura Astolfi, Stella Blandamura

Abstract

Purpose

The main aim of the study was to preliminarily investigate the possibly related role of nuclear onco-suppressors maspin and nm23-H1, a metastasis suppressor, in laryngeal squamous cell carcinoma (LSCC).

Materials and methods

Maspin expression pattern and nuclear nm23-H1 expression were ascertained in 62 consecutive LSCCs.

Results

Recurrence rate was significantly lower in patients with a nuclear maspin pattern of expression; nuclear nm23-H1 expression was significantly lower in patients who experienced disease recurrence. Disease free survival (DFS) was significantly longer in patients with maspin nuclear pattern or with nuclear nm23-H1 expression ≥10%. A significant association was found between nuclear nm23-H1 expression and maspin pattern of expression in LSCC. KNN discriminant analysis considered N status, maspin sub-cellular localization and nuclear nm32-H1 expression. The selected variables' accuracy in terms of relapse was 82%. Positive predictive accuracy was 100%, and negative predictive accuracy 79%.

Conclusions

Nuclear nm23-H1 expression and maspin pattern, also in association, show promise as recurrence indicators in LSCC. Further studies are needed to shed more light on the nm23-H1 mechanism of action in LSCC and thus find ways to restore nm23-H1 loss. These preliminary findings suggest that re-activating maspin functions might represent an important goal in the treatment of advanced LSCC.

https://ift.tt/2R8pMl4

Quality of life related to symptomatic outcomes in patients with vestibular schwannomas: A Canadian Centre perspective

Publication date: Available online 22 November 2018

Source: American Journal of Otolaryngology

Author(s): Andrea L.O. Hebb, Niki Erjavec, David P. Morris, Liam Mulroy, Manohar Bance, Nael Shoman, Simon Walling

Abstract

Patients with vestibular schwannomas (VS) typically present with hearing loss and tinnitus as well as variable cranial nerve dysfunctions. Surgical resection, stereotactic radiotherapy and/or conservative management employing serial magnetic resonance or computed tomography imaging serve as the main treatment options. Quality of life (QoL) may be impacted by the extent of tumour burden and exacerbated or relieved by treatment. Subjective assessment and quality of life inventories provide valuable information in client centered approaches with important implications for treatment. The intention of QoL measurements affecting VS patients within a clinical setting is to facilitate discussions regarding treatment options and objectively evaluate patient- centered clinical outcomes in a naturalistic setting.

https://ift.tt/2POTEq8

Mitchell–Hoole–Kanatas (MHK) questionnaire: the first to measure patient-reported outcomes relating to problems with intimacy after diagnosis and treatment of head and neck cancer

Publication date: Available online 22 November 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): J. Hoole, D.A. Mitchell, A.B. Smith, A. Kanatas

Abstract

Patient-reported outcomes are increasingly used by clinical teams as indicators of quality when assessing treatment after a diagnosis of head and neck cancer. About a third of patients report reduced sexual interest or enjoyment after such treatment but, despite that, there is no questionnaire about intimacy that has been developed specifically for them. The aim of this study was to develop such a questionnaire, to gain an indication of the relative incidence of individual items, and to compare characteristics such as age, stage, treatment, time since treatment for an established head and neck cancer, and a health-related quality of life (QoL) measure (European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 with the Head and Neck 35 module). The development of the new instrument was based on an exploratory observational study that included quantitative and qualitative methods. The qualitative element was achieved by the generation of items - from published studies, the comments of patients and carers, and a cross-sectional survey of patients with head and neck cancer who were alive and free of disease. The quantitative element comprised analysis of exploratory and confirmatory factors, internal reliability assessment (Cronbach's alpha), and a correlation analysis. Forty-two patients were included in the focus groups, and 101 patients participated in the cross-sectional survey (both male and female, in a relationship and single, age range 30–70 years for the focus group, and 62–117 in the cross-sectional survey). All treatments were included. We found that the ability to enjoy a sex life had been adversely affected in about half the sample and that this had significantly changed from before their cancer in a third. The qualitative part of the study resulted in 22 items that covered a range of domains from dry mouth and thick saliva to loss of sensation (lips, fingertips), restricted head/neck movement, fatigue, and pain. The exploratory analysis covered four domains (physical, sensation, movement, and communication) from 12 of 22 items. Cronbach's alphas ranged from 0.62 to 0.84, and the correlation analysis indicated "good fit" statistics for these domains. In terms of the EORTC QoL Questionnnaire – Head and Neck 35, the four MHK domains showed good levels of association with anticipated domains. Head and neck cancer and its associated treatments significantly adversely affect intimacy and sexuality in half the population sampled. The MHK tool may be used to identify specific issues related to intimacy in patients with a history of diagnosis and treatment of head and neck cancer. Further work is essential to identify its precise role and to help develop specific interventions.

https://ift.tt/2QdCOAw

Deep neck infection in patients with and without human immunodeficiency virus: a comparison of clinical features, complications, and outcomes

Publication date: Available online 22 November 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): P. Sittitrai, C. Srivanitchapoom, D. Reunmakkaew

Abstract

We retrospectively studied the clinical features, complications, and outcomes of deep neck infections in 31 adult patients with the human immunodeficiency virus (HIV) (HIV group) and 192 patients without (non-HIV group). In the HIV group, the cause was more likely to be odontogenic (21 (68%) compared with 90 (47%); odds ratio (OR) 2.38; 95% CI 1.06 to 5.32). In both groups, the parapharyngeal, submandibular, and masticator spaces, were those most often involved. However, in the HIV group, Ludwig's angina was common, and was the main cause of airway obstruction. Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa were most often isolated in the HIV group. Upper airway obstruction tended to be more common in the HIV group (5/31 compared with 13/192). These patients also had a higher risk of other complications (sepsis, mediastinitis, jugular vein thrombosis, and pneumonia) (6/31 compared with 12/192; OR 3.60; 95% CI 1.24 to 10.45), a higher mortality rate (3/31 compared with 2/192), and longer hospital stay (19 days compared with 16 days). Factors associated with an increased risk of complications in this group were an age of 55 years or over and a CD4 count of less than 350 cells/mm³. Deep neck infections in these patients are more severe. Dental health care, appropriate empirical antibiotics, early detection, and management of the airway and complications, may improve outcomes.

https://ift.tt/2DFmrWG

Atopic dermatitis at preschool age and contact allergy in adolescence: a population‐based cohort study

Abstract

Background

Atopic dermatitis (AD) is characterized by an impaired skin barrier that can allow enhanced penetration of allergens. It is not clear whether AD influences the risk of developing contact allergy.

Objectives

To examine the association between AD at preschool age and contact allergy at 16 years of age.

Methods

At 16 years of age, 2215 adolescents from the population‐based cohort BAMSE were included. These adolescents had been followed with repeated questionnaires regarding AD throughout childhood, and contact allergy was assessed by skin patch test at 16 years.

Results

AD at preschool age was associated with contact allergy to at least one of the tested substances at 16 years of age among boys (adjusted odds ratio [OR] 1.51, 95% confidence interval 1.03‐2.20), but not among girls (adjusted OR 0.77, 95% CI 0.54‐1.10). AD at preschool age was not associated with contact allergy to nickel in either boys or girls. In contrast, AD at preschool age was associated with contact allergy to fragrance mix I (adjusted OR 3.10, 95% CI 1.66‐5.80). This association was observed especially for AD at preschool age in combination with immunoglobulin E (IgE) sensitization to airborne or food allergens (adjusted OR 3.80, 95% CI 1.67‐8.61).

Conclusions

The results suggest that AD in early childhood may be associated with contact allergy to fragrances, but not to nickel, in adolescence.

This article is protected by copyright. All rights reserved.

https://ift.tt/2BrMvD6

Clinical features and outcomes of spitzoid proliferations in children and adolescents

Summary

Background

Spitzoid proliferations range from Spitz nevi to melanomas, and there are few studies describing clinical features and outcomes in the pediatric population.

Objectives

Determine clinical features and outcomes of a large pediatric cohort with histopathologically‐confirmed Spitz tumors.

Methods

Retrospective cohort study of Boston Children's Hospital patients younger than 20 years with a histopathologic diagnosis of spitzoid proliferation from 1/1/1994 – 10/23/2012.

Results

Five hundred ninety‐five patients with 622 spitzoid proliferations were identified [median age = 7.4 years, (25^th, 75^th) quartiles = (4.6, 11.7) years]. Five hundred twelve (82.3%) proliferations were typical, 107 (17.2.%) were atypical, and 3 (0.5%) were melanomas. Median age at biopsy was 7.4, 7.2, and 17.2 years, respectively, and there was a significant difference in age at biopsy for patients with typical or atypical proliferations versus melanoma (p<0.01). Among samples with positive margins (n = 153), 55.1% (54/98) of typical proliferations, 77.4% (41/53) of atypical proliferations, and 100.0% (2/2) of melanomas were re‐excised. Six patients had sentinel lymph node biopsy performed, with 3 patients demonstrating nodes positive for melanocytic cells. With median follow‐up of 4.1 years for the full cohort, there were no related deaths.

Conclusion

Spitz tumors have strikingly benign outcomes in the pediatric population, though this study is limited by low number of melanomas and restriction to a single pediatric institution. Aggressive management recommendations should be reconsidered for children and adolescents with banal‐appearing Spitz nevi, based upon the clinically indolent behavior in this cohort.

This article is protected by copyright. All rights reserved.

https://ift.tt/2Kue1mi

Corrigendum to “MMP-3 and MMP-8 in rat mandibular condylar cartilage associated with dietary loading, estrogen level, and aging” [Arch. Oral Biol. 97 (2019) 238–244]

Publication date: February 2019

Source: Archives of Oral Biology, Volume 98

Author(s): Jia Yu, Eerika Mursu, Matleena Typpö, Sakari Laaksonen, Hanna-Marja Voipio, Paula Pesonen, Aune Raustia, Pertti Pirttiniemi

https://ift.tt/2PQv33Y

The effect of unilateral lingual nerve injury on the kinematics of mastication in pigs

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): Stéphane J. Montuelle, Rachel A. Olson, Hannah Curtis, JoAnna V. Sidote, Susan H. Williams

Abstract

Objective

This study evaluates the effect of unilateral lingual sensory loss on the spatial and temporal dynamics of jaw movements during pig chewing.

Design

X-ray Reconstruction of Moving Morphology (XROMM) was used to reconstruct the 3-dimensional jaw movements of 6 pigs during chewing before and after complete unilateral lingual nerve transection. The effect of the transection were evaluated at the temporal and spatial level using Multiple Analysis of Variance. Temporal variables include gape cycle and phase durations, and the corresponding relative phase durations. Spatial variables include the amplitude of jaw opening, jaw yaw, and of mandibular retraction-protraction.

Results

The temporal and spatial dynamics of jaw movements did not differ when chewing ipsi-versus contralateral to the transection. When compared to pre-transection data, 4 of the 6 animals showed significant changes in temporal characteristics of the gape cycle following the transection, irrespective of chewing side, but the specific response to the lesion was highly dependent on the animal. On the other hand, in affected individuals the amplitude of jaw movements was altered similarly in all 3 dimensions: jaw opening and protraction-retraction increased whereas jaw yaw decreased.

Conclusion

The variable impact of this injury in this animal model suggests that individuals use different compensatory strategies to adjust or maintain the temporal dynamics of the gape cycle. Because the amplitude of jaw movements are more adversely affected than their timing, results suggest that maintaining the tongue-jaw coordination is critical and this can come at the expense of bolus handling and masticatory performance.

https://ift.tt/2R8xvjd

Screening of hydrogel-based scaffolds for dental pulp regeneration—A systematic review

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): K.A. Fukushima, M.M. Marques, T.K. Tedesco, G.L. de Carvalho, F. Gonçalves, H. Caballero-Flores, S. Morimoto, M.S. Moreira

Abstract

Objective

The aim of this systematic review was to evaluate the most appropriate hydrogel scaffold type (natural, synthetic or hybrid) to be applied with stem cells for dental pulp regeneration. The findings should help clinicians make an informed choice about the appropriate scaffold to be applied for this approach.

Design

Three electronic databases were searched (Medline, Web of Science and Scopus). The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).

Results

From 4,990 potentially relevant studies initially identified, 18 papers fulfilled the eligibility criteria and were considered for this review. Natural scaffolds were applied in most studies. Collagen was the most studied scaffold. In 5 of 10 studies, only growth factors were added to the constructs. Even without growth factors, these scaffolds containing stem cells were able to support the formation of dentin. The synthetic scaffolds were the least studied. Only 4 studies were selected, and in 3 of them, the same scaffold (Puramatrix) was evaluated. Puramatrix by itself was unable to form dental pulp when dental pulp stem cells were not present. Synthetic and hybrid hydrogels were unable to attract stem cells from the host. The presence of growth factors in these constructs seems to be of relevance since dental pulp tissue formation was achieved only when the hybrid scaffold was applied with growth factors.

Conclusion

All types of hydrogel-based scaffolds, when containing mesenchymal stem cells, are able to form connective tissue with different degrees of similarity to dental pulp. However, current data is too heterogeneous to compare and identify the advantages of any specific scaffold.

https://ift.tt/2PTWOJi

Molecular docking and in silico studies of the physicochemical properties of potential inhibitors for the phosphotransferase system of Streptococcus mutans

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): Wbeimar Andrey Rivera-Péreza, Andrés Felipe Yépes-Pérez, Maria Cecilia Martínez-Pabóna

Abstract

This study identified potential inhibitory compounds of the phosphoenolpyruvate-sugar

Phosphotransferase system of S. mutans, specifically enzyme II mannose transporter (EII^Man) in its subunits IIA, IIB and IIC by means of a selection protocol and in silico molecular analysis.

Intervening the phosphotransferase system would compromise the physiological behavior and the pathogenic expression of S. mutans, and possibly other acidogenic bacteria that use phosphotransferases in their metabolism—making the phosphotransferase system a therapeutic target for the selective control of acidogenic microorganisms in caries control.

Several computational techniques were used to evaluate molecular, physicochemical, and toxicological aspects of various compounds. Molecular docking was used to calculate the binding potential (ΔG) between receptor protein subunits and more than 836,000 different chemical compounds from the ZINC database. Physicochemical parameters related to the compounds' pharmacokinetic and pharmacodynamic indicators were evaluated, including absorption, distribution, metabolism, excretion, and toxicity (ADMET), and chemical analysis characterized the compounds structures.

Thirteen compounds with EII binding potential of the phosphotransferase system of S. mutans and favorable ADMET properties were identified. Six spirooxindoles and three pyrrolidones stand out from the found compounds; unique structural characteristics of spirooxindoles and pyrrolidones associated with various reported biological activities like anti-microbial, antiinflammatory, anticancer, nootropic, neuroprotective and antiepileptic effects, among other pharmacological effects with surprising differences in terms of mechanisms of action.

Following studies will provide more evidence of the action of these compounds on the phosphotransferase system of S. mutans, and its possible applications.

https://ift.tt/2R9NWLR

Corrigendum to “MMP-3 and MMP-8 in rat mandibular condylar cartilage associated with dietary loading, estrogen level, and aging” [Arch. Oral Biol. 97 (2019) 238–244]

Publication date: February 2019

Source: Archives of Oral Biology, Volume 98

Author(s): Jia Yu, Eerika Mursu, Matleena Typpö, Sakari Laaksonen, Hanna-Marja Voipio, Paula Pesonen, Aune Raustia, Pertti Pirttiniemi

https://ift.tt/2PQv33Y

The effect of unilateral lingual nerve injury on the kinematics of mastication in pigs

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): Stéphane J. Montuelle, Rachel A. Olson, Hannah Curtis, JoAnna V. Sidote, Susan H. Williams

Abstract

Objective

This study evaluates the effect of unilateral lingual sensory loss on the spatial and temporal dynamics of jaw movements during pig chewing.

Design

X-ray Reconstruction of Moving Morphology (XROMM) was used to reconstruct the 3-dimensional jaw movements of 6 pigs during chewing before and after complete unilateral lingual nerve transection. The effect of the transection were evaluated at the temporal and spatial level using Multiple Analysis of Variance. Temporal variables include gape cycle and phase durations, and the corresponding relative phase durations. Spatial variables include the amplitude of jaw opening, jaw yaw, and of mandibular retraction-protraction.

Results

The temporal and spatial dynamics of jaw movements did not differ when chewing ipsi-versus contralateral to the transection. When compared to pre-transection data, 4 of the 6 animals showed significant changes in temporal characteristics of the gape cycle following the transection, irrespective of chewing side, but the specific response to the lesion was highly dependent on the animal. On the other hand, in affected individuals the amplitude of jaw movements was altered similarly in all 3 dimensions: jaw opening and protraction-retraction increased whereas jaw yaw decreased.

Conclusion

The variable impact of this injury in this animal model suggests that individuals use different compensatory strategies to adjust or maintain the temporal dynamics of the gape cycle. Because the amplitude of jaw movements are more adversely affected than their timing, results suggest that maintaining the tongue-jaw coordination is critical and this can come at the expense of bolus handling and masticatory performance.

https://ift.tt/2R8xvjd

Screening of hydrogel-based scaffolds for dental pulp regeneration—A systematic review

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): K.A. Fukushima, M.M. Marques, T.K. Tedesco, G.L. de Carvalho, F. Gonçalves, H. Caballero-Flores, S. Morimoto, M.S. Moreira

Abstract

Objective

The aim of this systematic review was to evaluate the most appropriate hydrogel scaffold type (natural, synthetic or hybrid) to be applied with stem cells for dental pulp regeneration. The findings should help clinicians make an informed choice about the appropriate scaffold to be applied for this approach.

Design

Three electronic databases were searched (Medline, Web of Science and Scopus). The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).

Results

From 4,990 potentially relevant studies initially identified, 18 papers fulfilled the eligibility criteria and were considered for this review. Natural scaffolds were applied in most studies. Collagen was the most studied scaffold. In 5 of 10 studies, only growth factors were added to the constructs. Even without growth factors, these scaffolds containing stem cells were able to support the formation of dentin. The synthetic scaffolds were the least studied. Only 4 studies were selected, and in 3 of them, the same scaffold (Puramatrix) was evaluated. Puramatrix by itself was unable to form dental pulp when dental pulp stem cells were not present. Synthetic and hybrid hydrogels were unable to attract stem cells from the host. The presence of growth factors in these constructs seems to be of relevance since dental pulp tissue formation was achieved only when the hybrid scaffold was applied with growth factors.

Conclusion

All types of hydrogel-based scaffolds, when containing mesenchymal stem cells, are able to form connective tissue with different degrees of similarity to dental pulp. However, current data is too heterogeneous to compare and identify the advantages of any specific scaffold.

https://ift.tt/2PTWOJi

Molecular docking and in silico studies of the physicochemical properties of potential inhibitors for the phosphotransferase system of Streptococcus mutans

Publication date: Available online 22 November 2018

Source: Archives of Oral Biology

Author(s): Wbeimar Andrey Rivera-Péreza, Andrés Felipe Yépes-Pérez, Maria Cecilia Martínez-Pabóna

Abstract

This study identified potential inhibitory compounds of the phosphoenolpyruvate-sugar

Phosphotransferase system of S. mutans, specifically enzyme II mannose transporter (EII^Man) in its subunits IIA, IIB and IIC by means of a selection protocol and in silico molecular analysis.

Intervening the phosphotransferase system would compromise the physiological behavior and the pathogenic expression of S. mutans, and possibly other acidogenic bacteria that use phosphotransferases in their metabolism—making the phosphotransferase system a therapeutic target for the selective control of acidogenic microorganisms in caries control.

Several computational techniques were used to evaluate molecular, physicochemical, and toxicological aspects of various compounds. Molecular docking was used to calculate the binding potential (ΔG) between receptor protein subunits and more than 836,000 different chemical compounds from the ZINC database. Physicochemical parameters related to the compounds' pharmacokinetic and pharmacodynamic indicators were evaluated, including absorption, distribution, metabolism, excretion, and toxicity (ADMET), and chemical analysis characterized the compounds structures.

Thirteen compounds with EII binding potential of the phosphotransferase system of S. mutans and favorable ADMET properties were identified. Six spirooxindoles and three pyrrolidones stand out from the found compounds; unique structural characteristics of spirooxindoles and pyrrolidones associated with various reported biological activities like anti-microbial, antiinflammatory, anticancer, nootropic, neuroprotective and antiepileptic effects, among other pharmacological effects with surprising differences in terms of mechanisms of action.

Following studies will provide more evidence of the action of these compounds on the phosphotransferase system of S. mutans, and its possible applications.

https://ift.tt/2R9NWLR

Obesity, but not metabolic syndrome, as a risk factor for late-onset asthma in Japanese women

Publication date: Available online 23 November 2018

Source: Allergology International

Author(s): Yasuhiro Tomita, Yuma Fukutomi, Mari Irie, Kazuhiro Azekawa, Hiroaki Hayashi, Yosuke Kamide, Kiyoshi Sekiya, Yoichi Nakamura, Chiharu Okada, Terufumi Shimoda, Yoshinori Hasegawa, Masami Taniguchi

Abstract

Background

Several cross-sectional studies have suggested an association between obesity and asthma. However, few studies have investigated this relationship longitudinally, especially in middle-aged subjects. Although metabolic syndrome is a well-known risk factor for many non-communicable diseases, its contribution to asthma remains controversial.

Methods

From 2008, specific health checkups for metabolic syndrome have been conducted throughout Japan. To seek relationships of obesity and metabolic syndrome with late-onset asthma in Japan, we analyzed data collected from health insurance claims and specific health checkups for metabolic syndrome at three large health insurance societies. Among subjects aged 40–64 years (n = 9888), multivariate logistic regression analyses were performed to investigate the relationships of obesity and metabolic syndrome in fiscal year 2012 (from April 2012 to March 2013) with the incidence of late-onset asthma in the following two years (from April 2013 to March 2015).

Results

In women, BMI 25–29.9 kg/m² or ≥30 kg/m², waist circumference ≥90 cm, and waist-to-height ratio ≥0.5 were shown to be significant risk factors for asthma, with adjusted odds ratios (95% CI) of 1.92 (1.35–2.75), 2.24 (1.23–4.09), 1.89 (1.30–2.75), and 1.53 (1.15–2.03), respectively. Significance was retained even after adjustment for metabolic syndrome, and there were no significant relationships between metabolic syndrome itself and the incidence of asthma in men or women.

Conclusions

Only the obesity measures, not metabolic syndrome, were shown to be significant risk factors for the incidence of late-onset asthma but only in middle-aged Japanese women, and not in men.

https://ift.tt/2FEc08C

Airway innate lymphoid cells in the induction and regulation of allergy

Publication date: Available online 23 November 2018

Source: Allergology International

Author(s): Taylor A. Doherty, David H. Broide

Abstract

The recent discovery of innate lymphoid cells has revolutionized our understanding of the pathogenesis of immune diseases including allergy and asthma. Innate lymphoid cells (ILCs) are a heterogeneous collection of lymphocytes that lack antigen-specificity (non-T, non-B cells) and potently produce characteristic cytokines of T cell subsets (Th1, Th2, Th17). ILCs are divided into group 1 (ILC1s), group 2 (ILC2s), or group 3 (ILC3s). Similar to Th2 cells, ILC2s produce IL-4, IL-5, and IL-13, among others, and are present in increased numbers in samples from patients with many allergic disorders including asthma and chronic rhinosinusitis (CRS). Animal models have identified that ILC2s contribute to eosinophilic tissue infiltration, airway hyperresponsiveness, mucus production, as well as coordinate adaptive immune responses. Finally, recent studies support regulation of ILC2s by neuro-immune mechanisms as well as demonstrate a significant degree of plasticity between ILC subsets that may impact the immune responses in asthma and allergic airway diseases. Here, we review the current literature on ILC2s in human asthma and allergic airway diseases, as well as highlight some recent mechanistic insights into ILC2 function from in vitro studies and in vivo animal models.

https://ift.tt/2qZFT8W

Critical role of platelets in the production of thymus and activation-regulated chemokine in children: A case series study

Publication date: Available online 22 November 2018

Source: Allergology International

Author(s): Yuka Okura, Yutaka Takahashi, Ichiro Kobayashi

https://ift.tt/2FCFOCi

The American Academy of Oral Medicine clinical practice statement: dental care for the patient on antiresorptive drug therapy

Publication date: Available online 23 November 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Juan M. Bugueno, Cesar A. Migliorati

https://ift.tt/2QhnhQi

Disseminated dermatophytosis due to Nannizzia gypsea (Microsporum gypseum) in an elderly patient

https://ift.tt/2DU1ad0

Lichen sclerosus et atrophicus diagnosed in a child accompanied with local periodontal attachment loss and maxillary deficiency: A rare case report

https://ift.tt/2S9TPbZ

Evaluation of teriparatide effect on healing of autografted mandibular defects in rats

Publication date: Available online 23 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Mohammad Zandi, Arash Dehghan, Faezeh Gheysari, Leila Rezaeian, Naser Mohammad Gholi Mezerji

Abstract

Objective

To evaluate the effects of short-term teriparatide administration on healing of autologous bone graft in mandibular critical-size defects.

Subjects

and methods: A 5-mm mandibular bone defect was created and iliac bone graft was harvested in 135 rats. Rats were randomly divided into 3 groups of negative control (NC), control (C), and study (S). In groups S and C, iliac graft was placed in defect and 2 μg/kg/day teriparatide or saline, respectively, was administered for 20 days. In group NC, iliac graft was not transferred to the defect and saline was injected for 20 days. Twenty, 40, and 60 days after surgery, 15 rats in each group were euthanized and the healing process was histologically evaluated and scored using a grading system (1 to 6).

Results

In group NC, defects did not heal or were predominantly filled with fibrous tissue. At day 20, bone defects in both C and S groups contained a large area of graft particles, numerous collagen fibers and some areas of new trabeculae. At the day 40, defects in group S showed a larger bone graft area, more new bone formation, smaller connective tissue area, and a higher healing score compared to group C (P<0.05). At day 60, most of the defect in group S was filled with graft particles and mature bone while in group C, new trabecular bone formation was still underway (P<0.05).

Conclusion

Teriparatide therapy improves healing of bone defects reconstructed with autograft by reducing bone graft resorption and enhancing new bone formation and maturation.

https://ift.tt/2AdIuAn

The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma

Publication date: Available online 22 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Kai Qian, Kai Guo, Xiaoke Zheng, Wenyu Sun, Tuanqi Sun, Lili Chen, Ding Ma, Yi Wu, Qinghai Ji, Zhuoying Wang

Summary

Purpose

To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma.

Materials and methods

The rates of regional failure-free survival and disease-free survival were calculated using Kaplan–Meier methods and Cox models. The risk factors for occult lymph node metastasis (OLNM) in cN0 patients undergoing END was analyzed using logistic regression. A nomogram was formulated to calculate the estimated probability of OLNM.

Results

Neck dissection was performed in 84 patients (43.3%). OLNM was detected in eight of the patients who underwent END. During the follow-up period, regional recurrences involving cervical lymph nodes were found in 10 patients. Cox model analysis revealed that neck dissection was not related to regional failure-free survival and disease-free survival. Logistic regression analysis revealed that older age, neural symptoms, and positive adjacent lymph nodes were associated with OLNM. A nomogram comprising age, neural symptoms, and adjacent lymph nodes was developed to predict the risk of OLNM.

Conclusion

The incidence of OLNM was low in cN0 patients after detailed preoperative evaluations. There was no strong evidence supporting END as a conventional therapy in cN0 patients with salivary cancers. Our nomogram is a simple and practical instrument for strengthening the prediction of OLNM.

https://ift.tt/2TwxtTP

The Effects of Le Fort I Osteotomy on Velopharyngeal Function in Cleft Patients

Publication date: Available online 22 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Suvi Alaluusua, Leena Turunen, Anne Saarikko, Ahmed Geneid, Junnu Leikola, Arja Heliövaara

https://ift.tt/2AeJcxy

Erratum to “Protective effect of an astaxanthin nanoemulsion against neomycin-induced hair-cell damage in zebrafish” [Auris Nasus Larynx 45 (2018) 20–25]

Publication date: Available online 23 November 2018

Source: Auris Nasus Larynx

Author(s): Yosuke Takemoto, Yoshinobu Hirose, Kazuma Sugahara, Makoto Hashimoto, Hirotaka Hara, Hiroshi Yamashita

https://ift.tt/2TBEqmy

Metastasis of adenoid cystic carcinoma from a submandibular gland to the larynx

Publication date: Available online 23 November 2018

Source: Auris Nasus Larynx

Author(s): Tomohiko Ishikawa, Masaru Tateda, Hidetoshi Oshima, Akari Sawada, Naomi Oka, Hiroyoshi Suzuki, Sho Hashimoto

Abstract

The present article discusses the first reported case of adenoid cystic carcinoma (ACC) metastasis from a submandibular gland to the larynx. Both treatments of distant metastasis of ACC and secondary laryngeal tumor are challenging. Despite its slow progression, ACC is associated with high rates of local recurrence, distant metastasis, and poor prognosis. Patients with secondary laryngeal cancer often have other concurrent metastatic lesions. Therefore, treatment selection should consider the biological behavior of the tumor and characteristics of the laryngeal lesion, along with the general condition and quality of life of the patient. The patient (55-year-old female) had a history of ACC of the right submandibular gland, removed surgically 9 years prior to the present consultation. Follow-up showed multiple pulmonary metastases. The patient complained of dysphonia lasting 3 months. Following the diagnosis of ACC metastasis to the larynx (supraglottic) and a neck lymph node via biopsy, we performed partial laryngectomy, left neck dissection, and tracheotomy. Histopathological examination showed an increase in the tumor grade over time. Two months after discharge, there was no obvious local recurrence or increase in lung metastasis.

https://ift.tt/2AbVoiq

Cardiac metastasis in a living patient with oral cancer

Publication date: Available online 22 November 2018

Source: Auris Nasus Larynx

Author(s): Hisami Fujio, Naoki Otsuki, Yuto Horichi, Shungaku Yanagisawa, Mari Nishio, Masanori Teshima, Hirotaka Shinomiya, Kazunobu Hashikawa, Ken-ichi Nibu

Abstract

Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography–computed tomography scan.

https://ift.tt/2Tz9vr7

Erratum to “Surgical outcomes in the treatment of temporal bone cerebrospinal fluid leak: A systematic review” [Auris Nasus Larynx 45 (2018) 903–910]

Publication date: Available online 22 November 2018

Source: Auris Nasus Larynx

Author(s): Federico Maria Gioacchini, Ettore Cassandro, Matteo Alicandri-Ciufelli, Shaniko Kaleci, Claudia Cassandro, Alfonso Scarpa, Massimo Re

https://ift.tt/2AeyLdk

Intensity modulated proton therapy (IMPT) – The future of IMRT for head and neck cancer

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Amy C. Moreno, Steven J. Frank, Adam S. Garden, David I. Rosenthal, Clifton D. Fuller, Gary B. Gunn, Jay P Reddy, William H. Morrison, Tyler D. Williamson, Emma B. Holliday, Jack Phan, Pierre Blanchard

Abstract

Radiation therapy plays an integral role in the management of head and neck cancers (HNCs). While most HNC patients have historically been treated with photon-based radiation techniques such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical benefits of proton therapy over IMRT in the definitive, postoperative and reirradiation settings given the unique physical properties of protons. Intensity modulated proton therapy (IMPT), also known as "pencil beam proton therapy," is a sophisticated mode of proton therapy that is analogous to IMRT and an active area of investigation in cancer care. Multifield optimization IMPT allows for high quality plans that can target superficially located HNCs as well as large neck volumes while significantly reducing integral doses. Several dosimetric studies have demonstrated the superiority of IMPT over IMRT to improve dose sparing of nearby organs such as the larynx, salivary glands, and esophagus. Evidence of the clinical translation of these dosimetric advantages has been demonstrated with documented toxicity reductions (such as decreased feeding tube dependency) after IMPT for patients with HNCs. While there are relative challenges to IMPT planning that exist today such as particle range uncertainties and high sensitivity to anatomical changes, ongoing investigations in image-guidance techniques and robust optimization methods are promising. A systematic approach towards utilizing IMPT and additional prospective studies are necessary in order to more accurately estimate the clinical benefit of IMPT over IMRT and passive proton therapy on a case-by-case basis for patients with sub-site specific HNCs.

https://ift.tt/2DCrSFX

HPV related head and neck squamous cell carcinoma: New evidences for an emerging spontaneous animal model

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Gennaro Altamura, Giuseppe Borzacchiello

https://ift.tt/2Q9B4bF

Prognostic factors and selection criteria in the retreatment of head and neck cancers

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Michael E. May, Elizabeth D. Cash, Craig L. Silverman, Rebecca A. Redman, Cesar A. Perez, Liz D. Wilson, Paul A. Tennant, Jeffrey M. Bumpous, Neal E. Dunlap

Abstract

Objectives

To determine predictors of treatment selection, outcome, and survival, we examined a cohort of previously irradiated head and neck squamous cell carcinoma (HNSCC) patients.

Materials and methods

We retrospectively analyzed 100 patients at our institution who were treated for recurrent or second primary (RSP) HNSCC, focusing on subgroups receiving reirradiation (ReRT) alone and those undergoing surgical salvage (SS) with or without post-operative reirradiation therapy (POReRT). Logistic regression modeling was performed to identify factors predictive of retreatment modality. Cox regression modeling was used to determine prognostic factors for progression free survival (PFS) and overall survival (OS).

Results

ReRT alone was less likely in current smokers and neck recurrences, with reirradiation more likely in primary site recurrences. POReRT was significantly more likely in patients with positive surgical margins (PSM), neck dissection, or organ dysfunction. POReRT omission negatively impacted PFS when PSM (HR: 8.894, 95% CI: 1.742–45.403) and perineural invasion (PNI) (HR: 3.391, 95% CI: 1.140–10.089) were present. Tracheostomy was associated with worse OS, but ReRT alone and POReRT improved OS. PSM correlated with worse OS, regardless of whether POReRT was given (HR: 14.260, 95% CI: 2.064–98.547).

Conclusion

This analysis confirms known factors for predicting outcome and shows nonsmoking status and primary site recurrence as predictors for ReRT alone. POReRT for PSM and PNI improves PFS. Tracheostomy patients are more likely to have ReRT due to acute toxicity not limiting treatment and POReRT improves OS compared to surgery alone. The presence of PSM negatively impacts survival which cannot be overcome by POReRT.

https://ift.tt/2DFdUmL

Rapid, non-invasive fluorescence margin assessment: Optical specimen mapping in oral squamous cell carcinoma

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Stan van Keulen, Nynke S. van den Berg, Naoki Nishio, Andrew Birkeland, Quan Zhou, Guolan Lu, Han-Wei Wang, Lyle Middendorf, Tymour Forouzanfar, Brock A. Martin, A. Dimitrios Colevas, Eben L. Rosenthal

Abstract

Objective

Surgical resection remains the primary treatment for the majority of solid tumors. Despite efforts to obtain wide margins, close or positive surgical margins (<5 mm) are found in 15–30% of head and neck cancer patients. Obtaining negative margins requires immediate, intraoperative feedback of margin status. To this end, we propose optical specimen mapping of resected tumor specimens immediately after removal.

Materials and methods

A first-in-human pilot study was performed in patients (n = 8) after infusion of fluorescently labeled antibody, panitumumab-IRDye800 to allow surgical mapping of the tumor specimen. Patients underwent standard of care surgical resection for head and neck squamous cell carcinoma (HNSCC). Optical specimen mapping was performed on the primary tumor specimen and correlated with pathological findings after tissue processing.

Results

Optical mapping of the specimen had a 95% sensitivity and 89% specificity to detect cancer within 5 mm (n = 160) of the cut surface. To detect tumor within 2 mm of the specimen surface, the sensitivity of optical specimen mapping was 100%. The maximal observed penetration depth of panitumumab-IRDye800 through human tissue in our study was 6.3 mm.

Conclusion

Optical specimen mapping is a highly sensitive and specific method for evaluation of margins within <5 mm of the tumor mass in HNSCC specimens. This technology has potentially broad applications for ensuring adequate tumor resection and negative margins in head and neck cancers.

https://ift.tt/2Qfqf7M

Oral cancer prevention worldwide: Challenges and perspectives

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Jean-Philippe Foy, Chloé Bertolus, Pierre Saintigny

https://ift.tt/2DF7VOG

Functional imaging early during (chemo)radiotherapy for response prediction in head and neck squamous cell carcinoma; a systematic review

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Roland M. Martens, Daniel P. Noij, Meedie Ali, Thomas Koopman, J. Tim Marcus, Marije R. Vergeer, Henrica de Vet, Marcus C. de Jong, C. René Leemans, Otto S. Hoekstra, Remco de Bree, Pim de Graaf, Ronald Boellaard, Jonas A. Castelijns

Abstract

This systematic review gives an extensive overview of the current state of functional imaging during (chemo)radiotherapy to predict locoregional control (LRC) and overall survival (OS) for head and neck squamous cell carcinoma. MEDLINE and EMBASE were searched for literature until April 2018 assessing the predictive performance of functional imaging (computed tomography perfusion (CTp), MRI and positron-emission tomography (PET)) within 4 weeks after (chemo)radiotherapy initiation. Fifty-two studies (CTp: n = 4, MRI: n = 19, PET: n = 26, MRI/PET: n = 3) were included involving 1623 patients. Prognostic information was extracted according the PRISMA protocol. Pooled estimation and subgroup analyses were performed for comparable parameters and outcome. However, the heterogeneity of included studies limited the possibility for comparison. Early tumoral changes from (chemo)radiotherapy can be captured by functional MRI and ¹⁸F-FDG-PET and could allow for personalized treatment adaptation. Lesions showed potentially prognostic intratreatment changes in perfusion, diffusion and metabolic activity. Intratreatment ADC_mean increase (decrease of diffusion restriction) and low SUV_max (persistent low or decrease of ¹⁸F-FDG uptake) were most predictive of LRC. Intratreatment persistent high or increase of perfusion on CT/MRI (i.e. blood flow, volume, permeability) also predicted LRC. Low SUV_max and total lesion glycolysis (TLG) predicted favorable OS. The optimal timing to perform functional imaging to predict LRC or OS was 2–3 weeks after treatment initiation.

https://ift.tt/2QhTW84

Lingual ectopic papillary thyroid carcinoma: Two case reports and review of the literature

Publication date: Available online 22 November 2018

Source: Oral Oncology

Author(s): Nai-si Huang, Wen-jun Wei, Ning Qu, Yu-long Wang, Yu Wang, Qing-hai Ji

Abstract

Ectopic thyroid occurs when it is not located on the normal thyroid compartment. While 90% of the ectopic thyroids were located at the base of the tongue, only 1% were lingual thyroid carcinoma (LTC). Only 56 LTC cases have been reported so far. Here we reported two cases of LTC. Patient 1 was a 47-year-old female with LTC and co-current sub-hyoid ectopic thyroid. She experienced major hematemesis and dyspnea requiring emergent tracheotomy. Patient 2 was a 61-year old female who was presented with LTC with multiple lymph node metastasis and bilateral lung metastasis. Both of the patients' lingual masses were removed via trans-submaxillary excisions. Pathology revealed ectopic papillary thyroid carcinoma. Then they were treated with radio-active iodine (RAI). These patients had full recovery and there were no complications. A review of literature was also presented.

https://ift.tt/2DE4Zlq

Enhanced Recovery After Surgery: Are the Principles Applicable to Adult and Geriatric Acute Care and Trauma Surgery?

Publication date: Available online 22 November 2018

Source: Anesthesiology Clinics

Author(s): Mandeep Singh, Reza Askari, Matthias Stopfkuchen-Evans

https://ift.tt/2FxWNFU

Relevanter Fortschritt beim nichtkleinzelligen Lungenkarzinom

https://ift.tt/2TvSwpz

Gliome und ihre medikamentöse Behandlung

Zusammenfassung

Hintergrund

Gliome stellen in Bezug auf Diagnostik, Einteilung und Therapie eine Besonderheit im Vergleich zu anderen soliden Tumoren dar. Insbesondere die Vulnerabilität des betroffenen Organs Gehirn erfordert eine sorgfältige Planung von operativer, strahlentherapeutischer und medikamentöser Therapie sowie die sorgsame Begleitung und Therapieberatung der Betroffenen.

Methode

Eine selektive Literaturrecherche wurde durchgeführt.

Ergebnisse

Ohne integrierte Diagnose von histomorphologischen und molekularen Kriterien ist eine differenzierte Therapie nicht möglich. Aufgrund des meist diffus infiltrierenden Charakters kommt der medikamentösen Therapie ein entscheidender Stellenwert sowohl in der Erstbehandlung als auch beim Rezidiv oder Progress zu. Der rasante Zuwachs der Kenntnis von zugrunde liegenden molekularen und genetischen Veränderungen, die zur Tumorentstehung führen, lässt für die Zukunft eine weitere Diversifizierung in verschiedene Entitäten erwarten, welche die Therapiemöglichkeiten erweitern kann.

Schlussfolgerungen

Dogmen, wie eine immunprivilegierte Stellung des ZNS und fehlende ZNS-Gängigkeit von Medikamenten aufgrund der Besonderheit der Bluthirnschranke rücken im Zusammenhang mit modernen Therapiemöglichkeiten wie „small molecules", Antikörpern sowie immunonkologischen Therapieverfahren in den Hintergrund. Weitere sowohl klinische als auch präklinische Forschung ist dringend erforderlich, um die für viele Gliome immer noch schlechte Prognose zu verbessern.

https://ift.tt/2PL79qJ