The relationship between complement levels and disease activity in Japanese family cases of hereditary angioedema with C1-INH deficiency

Publication date: Available online 13 April 2018
Source:Allergology International
Author(s): Atsushi Fukunaga, Shinji Tsuchiyama, Kasumi Lee, Ken Washio, Chinami Hashimura, Takahiko Horiuchi, Chikako Nishigori




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Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study

Publication date: Available online 13 April 2018
Source:Allergology International
Author(s): Yasutaka Kuniyoshi, Masahiro Kikuya, Masako Miyashita, Chizuru Yamanaka, Mami Ishikuro, Taku Obara, Hirohito Metoki, Naoki Nakaya, Fuji Nagami, Hiroaki Tomita, Atsushi Hozawa, Ichiro Tsuji, Shigeo Kure, Nobuo Yaegashi, Masayuki Yamamoto, Shinichi Kuriyama
BackgroundThe association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires.MethodsOf 46,648 invited children, we analyzed 9954 (21.3%) in the 2nd to the 8th grades from the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey in Miyagi Prefecture, Japan. We defined eczema status as "normal," "mild/moderate," or "severe," based on the presence of persistent flexural eczema and sleep disturbance, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Eczema Symptom Questionnaire. Clinical ranges of Strengths and Difficulties Questionnaire (SDQ) total difficulties scores and four SDQ subcategories of emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems were defined as scores ≥16, ≥5, ≥5, ≥7, and ≥5, respectively.ResultsThe mean SDQ total difficulties score significantly increased as eczema status worsened (all P ≤ 0.004 for trend). The OR of scores in the clinical range for SDQ total difficulties were 1.51 (95% CI, 1.31–1.74) for mild/moderate eczema and 2.63 (95% CI, 1.91–3.63) for severe eczema (P < 0.001 for trend), adjusted for sex, school grade, current wheeze, and disaster-related factors, using normal eczema as a reference. The association between severity of eczema and four SDQ subcategories showed a similar trend (all P ≤ 0.017 for trend).ConclusionsWe found a significant association between severity of eczema and mental health problems. The presence of eczema was associated with four SDQ subcategories.



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Severe asthma concomitant with allergic bronchopulmonary aspergillosis successfully treated with mepolizumab

Publication date: Available online 14 April 2018
Source:Allergology International
Author(s): Naohiro Oda, Nobuaki Miyahara, Satoru Senoo, Junko Itano, Akihiko Taniguchi, Daisuke Morichika, Utako Fujii, Yoshinobu Maeda, Katsuyuki Kiura, Arihiko Kanehiro




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Comparative genomic analysis of oral versus laryngeal and pharyngeal cancer

Publication date: June 2018
Source:Oral Oncology, Volume 81
Author(s): David M. Vossen, Caroline V.M. Verhagen, Marcel Verheij, Lodewyk F.A. Wessels, Conchita Vens, Michiel W.M. van den Brekel
ObjectiveLocally advanced oral squamous cell carcinoma (OSCC) shows lower locoregional control and disease specific survival rates than laryngeal and pharyngeal squamous cell carcinoma (L/P-SCC) after definitive chemoradiotherapy treatment. Despite clinical factors, this can point towards a different tumor biology that could impact chemoradiotherapy response rates. This prompted us to compare the mutational profiles of OSCC with L/P-SCC.MethodsWe performed target capture DNA sequencing on 111 HPV-negative HNSCC samples (NKI dataset), 55 oral and 56 laryngeal/pharyngeal, and identified somatic point mutations and copy number aberrations. We next expanded our analysis with 276 OSCC and 134 L/P-SCC sample data from The Cancer Genome Atlas (TCGA dataset). We focused our analyses on genes that are frequently mutated in HNSCC.ResultsThe mutational profiles of OSCC and L/P-SCC showed many similarities. However, OSCC was significantly enriched for CASP8 (NKI: 15% vs 0%; TCGA: 17% vs 2%) and HRAS (TCGA: 10% vs 1%) mutations. LAMA2 (TCGA: 5% vs 19%) and NSD1 (TCGA: 7% vs 25%) mutations were enriched in L/P-SCC. Overall, we find that OSCC had fewer somatic point mutations and copy number aberrations than L/P-SCC. Interestingly, L/P-SCC scored higher in mutational and genomic scar signatures associated with homologous recombination DNA repair defects.ConclusionDespite showing a similar mutational profile, our comparative genomic analysis revealed distinctive features in OSCC and L/P-SCC. Some of these genes and cellular processes are likely to affect the cellular response to radiation or cisplatin. Genomic characterizations may guide or enable personalized treatment in the future.



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A treatment protocol for fractures of the edentulous mandible

Publication date: Available online 14 April 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Enkh-Orchlon Batbayar, Ruud R.M.Bos, Baucke van Minnen
PurposeThe incidence of fractures of edentulous mandibles is relatively low. Knowledge about the management of these fractured edentulous mandibles relies heavily upon case reports and observational studies. Based on current literature, we compiled a treatment protocol for fractures of the edentulous mandible and hypothesized that this protocol results in fewer complications.Patients and MethodsWe conducted a retrospective cohort study of edentulous patients with mandibular fractures. The predictor variable was the fulfillment of the treatment protocol (yes, no). The outcome variables were postoperative complications and reoperation. Demographic variables of patients were collected from patient records. A chi-square test was used for statistical analysis between predictor and outcome variables.ResultsOf 61 edentulous mandibular fractures (36 patients), 53 fractures were treated according to the protocol and 8 were not. Four complications were observed first group in the (complication rate 4/53=7.5%) and four in the second group (complication rate 4/8=50%). The fracture treatments that followed the protocol had a significantly (p=.001, OR=.082) lower postoperative complication rate, and needed fewer reoperations (p=.0001, OR=.019) compared to the treatments that did not follow the protocol.ConclusionThe results of this study show that following the compiled treatment protocol for fractures of edentulous mandibles significantly reduces postoperative complications and reoperations.



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Does the Deep Layer of the Deep Temporalis Fascia really exist?

Publication date: Available online 14 April 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Hui Li, Kaide Li, Wenhao Jia, Chaoying Han, Jinlong Chen, Lei Liu
PurposeIt has been widely accepted that a split of the deep temporal fascia occurs approximately 2 to 3 cm above the zygomatic arch, into the superficial and deep layers. The deep layer of the deep temporal fascia lies between the superficial temporal fat pad and the temporal muscle. However, during procedures, we noted the absence of the deep layer of the deep temporal fascia between superficial temporal fat pad and the temporal muscle. This prospective study was conducted to clarify the presence or absence of a deep layer of the deep temporal fascia.Materials and MethodsThe anatomic layers of soft tissues of the temporal region, with reference to the deep temporal fascia, were investigated in 130 cases operated upon for zygomaticofacial fractures using the supratemporalis approach from June 2013 to June 2017.ResultsAmong 130 surgeries, we found the absence of a thick, obviously identifiable fascial layer between superficial temporal fat pad and temporal muscle. In fact, we found nothing above the temporal muscle in a majority of cases. In a few cases we observed only a small amount of scattered loose connective tissue between the superficial temporal fat pad and the temporal muscle.ConclusionsOur clinical study has demonstrated the absence of thick, obviously identifiable fascial layer between superficial temporal fat pad and temporal muscle, which suggested that there may not exist a so-called "deep layer of the deep temporal fascia."Clinical RelevanceIt has long been thought that a split of the deep temporal fascia occurs approximately 2 to 3 cm above the zygomatic arch into the superficial and deep layers. However, in our clinical study, we have found the absence of a thick, obviously identifiable fascial layer between superficial temporal fat pad and temporal muscle, which suggested that there may not exist a so-called "deep layer of the deep temporal fascia." Our initial findings are critical in further understanding of the surgical planes and dissection techniques within the temporal region.



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National Survey on Bisphosphonate-Related Osteonecrosis of the Jaws in Japan

Publication date: Available online 14 April 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Takahiko Shibahara, Takamichi Morikawa, Kaori Yago, Hiromitsu Kishimoto, Yutaka Imai, Kenichi Kurita
PurposeFrom 2011 to 2013, a nationwide retrospective cohort study was conducted by the Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society of Dentistry in medically compromised patients, to assess the development of Bisphosphonate (BP)-related osteonecrosis of the jaws (BRONJ), and to elucidate the outcomes and factors associated with remission.Materials and MethodsA written questionnaire, including the clinical characteristics, management and outcomes of patients with BRONJ, was sent to 501 institutions.ResultsThis large-scale study included 4.797 cases, with a preponderance of females. BRONJ occurred twice as often in the mandible as compared to the maxilla. Most patients were BRONJ stage 2 (61.4%), followed by stage 1 (20.7%) and stage 3 (16.8%); stage 0 was excluded. The most common primary disease was malignant neoplasm (46.5%), followed by osteoporosis (including prevention, 45.3%). The proportion of patients on oral BPs has increased, with the incidence now approaching that receiving BP parenterals. Surgical therapy rates of patients with BRONJ stages 1, 2 and 3 were 14.0, 37.6, and 53.5%, respectively.Outcome assessment in a total of 936 patients with BRONJ stage 2 who underwent surgical therapy indicated remission in 46.3% of cases, improvement in 30.6%, disease progression in 5.4%, and no change in 6.1%. Good prognosis (remission or improvement) was seen in 76.9% of cases and poor prognosis (disease progression or no change) in 11.5%. Analysis showed that risk factors for onset of BRONJ (p = 0.031), surgical procedure (p < 0.024), condition of the wound (p = 0.017), and discontinuation of BP (p < 0.001) were factors affecting prognosis.ConclusionThe number of patients with BRONJ has increased in Japan. Attention to oral BP and proper treatment is required to minimize the number of cases. Surgical therapy seems to be effective for BRONJ stage 2 disease.



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