Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Παρασκευή 12 Μαΐου 2017

Interface-induced growth of boronate-based metal-organic framework membrane on porous carbon substrate for aqueous phase molecular recognition

Publication date: 15 September 2017
Source:Chemical Engineering Journal, Volume 324
Author(s): Shucheng Liu, Sudhirkumar Shinde, Jianming Pan, Yue Ma, Yongsheng Yan, Guoqing Pan
For metal-organic frameworks (MOFs), introduction of special functional groups and integration on porous support will endow the MOF with specific molecular affinity and tunable membrane-like surface properties. Herein, we demonstrated a facile interface-induced Zn(II)-ligand-fragment co-assembly strategy to in situ fabricate boronate-based MOF membrane on hydrophobic porous carbon substrate for specific molecular recognition and separation. Due to the phenylboronic acid groups and hydrophobic porous carbon supporting layer, a catechol-containing medicinal natural flavone Luteolin was found to be efficiently and selectively recognized on the MOF composite in water-containing solution. As compared to the separated MOF particles and carbon substrate, the MOF composite exhibited similar adsorption kinetics but significant higher adsorption capacity in static separation. Dynamic separation also revealed that the MOF composite could achieve a desirable maximum adsorption capacity under mild separation condition, implying its applicability in industrial application. As a proof of this concept, a commercially available Luteolin with 85% purity could be easily extracted and concentrated to 99.90% purity by the MOF composite in highly aqueous solution, and the products possessed the similar antibacterial performance with standard substance. These results demonstrated that, a membrane-like functionalized MOF composite with enhanced surface hydrophobicity and improved molecular specificity has great potential for separation of industrial and even biological samples under water compatible conditions.

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Influence of laser offset on laser welding-brazing of Al/brass dissimilar alloys

Publication date: 15 September 2017
Source:Journal of Alloys and Compounds, Volume 717
Author(s): L. Zhou, Z.Y. Li, X.G. Song, C.W. Tan, Z.Z. He, Y.X. Huang, J.C. Feng
Laser welding-brazing of dissimilar metals 5052 aluminum alloy and H62 brass in butt configuration was performed with Zn-15%Al filler metal. Laser beam offset was defined as the deviation from the center of the laser beam to the butted joint face. Influence of laser offset (defined Al side (−) and brass side (+)) on microstructure and mechanical properties of welded-brazed joints were investigated. Satisfied and defect-free joints were obtained when laser beam was irradiated at Al side, while poor wetting at the bottom, interfacial cracks and lack of penetration occurred when laser offset was shifted to brass side. When the laser offset was −0.6–0 mm, the interfacial microstructure mainly consisted of serrated layer Al4.2Cu3.2Zn0.7 adjacent to the weld seam and continuous layer CuZn close to the brass substrate. When the laser offset moved towards brass side (0.3 mm), Al4Cu9 phase formed in between CuZn and Al4.2Cu3.2Zn0.7, due to more melting and dissolution of brass. Tensile test indicated that joint strength increased first and then reduced with laser offset from Al side to brass side, and the maximum tensile strength of 128 MPa was obtained at laser offset of −0.3 mm, which was 55.7% of that of Al base metal. All the joints fractured along the bottom of brass side with brittle fracture surface and fracture location extended into the weld seam at the upper of the joints.



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Comparison of ashes from fixed/fluidized bed combustion of swine sludge and olive by-products. Properties, environmental impact and potential uses

Publication date: November 2017
Source:Renewable Energy, Volume 112
Author(s): Despina Vamvuka, George Kaniadakis, Despina Pentari, George Alevizos, Zoe Papapolikarpou
Residues from agriculture and processing industries or from the livestock sector play an important role for the power generation sector. However, ash materials produced during combustion may create several technical and environmental problems. In this work, bottom and fly ashes obtained from lab-scale fixed/fluidized bed combustion of swine sludge, olive by-products and their mixtures, from the island of Crete, were characterized by mineralogical, chemical, particle size distribution and fusibility analyses, as well as by standard leaching tests. Slagging and fouling propensities were determined and their environmental impact and potential uses were assessed. The results showed that the ashes were rich in Ca, Si, Mg, P, K, Cu, Zn and Sr minerals. Slagging/fouling potential of swine manure was significant. Heavy metals showed less preference for fly ashes. Toxic metal ions were released in low quantities through the soil, below the legislative limit values. The low leachability of the elements was attributed to the higher alkalinity of the extracts, as well as the mineralogical and chemical composition of the solids involved. All ashes could be used as secondary building materials, or for road construction. Alternatively, they could be used in mixtures with other byproducts as liming agents and fertilizers on acidic soils.



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Mineral and fatty acid profile of high intensity pulsed electric fields or thermally treated fruit juice-milk beverages stored under refrigeration

Publication date: October 2017
Source:Food Control, Volume 80
Author(s): Laura Salvia-Trujillo, Mariana Morales-de la Peña, Alejandra Rojas-Graü, Jorge Welti-Chanes, Olga Martín-Belloso
The influence of High Intensity Pulsed Electric Fields (HIPEF) or Thermal Treatment (TT) on minerals and fatty acids of fruit juice-whole (FJ-WM) or skimmed milk (FJ-SM) beverages was assessed after processing and during chilled storage. Mineral profile of both beverages was characterized by Ca, Zn, Fe, Mg, Cu, and Mn; being Ca the macroelement detected at the highest concentration (3.06–3.17mg/100 mL). Neither HIPEF nor TT significantly affected mineral concentration of the beverages, except Fe, which augmented after HIPEF (300%) or TT (43%). During storage (56 days), mineral content in both bevearges remained highly stable, regardless of the treatment applied. 11 fatty acids were identified in untreated and processed FJ-WM beverages. Palmitic acid was detected at highest concentration (21.83–24.37 mg/100 g of fat). Immediately after HIPEF or TT, most fatty acids remained with no significant changes, only linoleic acid increased (20%) in HIPEF treated beverage. Fatty acid content of HIPEF treated FJ-WM beverages was kept constant along storage; only palmitic, linoleic and linolenic acids showed lower concentrations (12–20%) at day 56. Conversely, the concentration of most fatty acids in the heated beverage underwent a significant reduction (7–19%) with time, except palmitic acid, which remained constant. HIPEF can be considered as a potential alternative to conventional pasteurization to obtain stable mixed beverages with significant concentrations of health-related compounds.



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The ASA Committee for Neuroanesthesia and Anesthesia Quality Institute: Report for Demographic Patterns for Neurosurgical Anesthesia Practice in the United States.

No abstract available

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Epidural Injection of Platelet Rich Plasma for Postlumbar Puncture Headaches.

No abstract available

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JNA Journal Club.

No abstract available

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Effect of Albumin in Combination With Mannitol on Whole-blood Coagulation In Vitro Assessed by Thromboelastometry.

Background: Albumin and mannitol may interfere with hemostasis, but their coinfluence is unclear. We aimed to determine the effects of albumin alone and in combination with mannitol or Ringer acetate (RAC) on hemostasis in crossover in vitro study. Materials and Methods: From citrated fresh whole blood withdrawn from 10 volunteers, we prepared 2.5, 5, 10, 15, and 20 vol% dilutions of 4% albumin (Alb group). Each sample was thereafter diluted by 15% mannitol (Alb/Man group) or RAC (Alb/RAC group) at a ratio of 9:1. Using thromboelastometry, FibTEM (fibrinogen ROTEM) and ExTEM (extrinsic ROTEM) tests were performed. Results: A 20 vol%, but not 2.5 to 15 vol% dilution of albumin caused a prolonged clot formation time, [alpha]-angle decrease, and maximum clot firmness (MCF) weakening compared with undiluted sample (P

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Eyelid Reconstruction Using Oral Mucosa and Ear Cartilage Strips as Sandwich Grafting

imageBackground: The eyelid structure can be divided into an inner layer and an outer layer. Reconstruction of a full-thickness eyelid defect is accomplished by full-thickness composite tissue transfer or combined layered reconstruction. We present a new technique for inner layer reconstruction using ear cartilage and oral mucosa. Methods: The oral mucosa graft is harvested from the inner side of the lower lip to fit the defect size and shape. The ear cartilage graft is harvested as a rectangular strip. The harvested mucosa is sutured to the defect margin and the cartilage strip graft is interposed to the defect. Finally, the outer layer of the defect is covered with skin flaps. Consequently, the ear cartilage graft is sandwiched between the mucosa graft and the skin flap. Results: We used this technique for the reconstruction of 13 full-thickness eyelid defects of various locations, sizes, and shapes. Ten cases involved the lower eyelid, 2 cases involved the lower eyelid including the medial canthus, and 1 case involved the upper eyelid. The oral mucosa graft survived in all patients. The reconstructions were successful and there were no postoperative reports of conjunctival or corneal irritation. Conclusions: The present technique using a combination of an ear cartilage strip graft and oral mucosa graft is an easy and versatile technique for reconstruction of inner layer eyelid defects. We believe that the beneficial effects of tears, which are richly oxygenated, improved survival of the grafted mucosa.

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Current Standards and Improvements in the Use of SLIT Tablets for Allergen Immunotherapy

Opinion statement

The clinical use of sublingual allergen immunotherapy (SLIT) can be traced back several decades. Ever since that first use, scientists have sought to develop new ways of application for immunotherapy. SLIT with aqueous formulations was mainly used but has a number of practical limitations, such as the need for refrigeration, poor dosing accuracy, and allergen spreading from the sublingual zone to other enoral and pharyngeal regions. Solid pharmaceutical formulations of allergen extracts in the form of freeze-dried sublingual tablets have been first clinically studied in the 1990s and were followed by DBPC prospective studies from 2006 onwards. Today, there are numerous different products of fast dissolving SLIT tablets for several allergens. Their clinical use and scientific background and evidence are discussed.



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Sonographic findings of IgG4-related disease of the salivary glands: Case report and review of the literature.

http:--media.wiley.com-assets-7315-19-Wi Related Articles

Sonographic findings of IgG4-related disease of the salivary glands: Case report and review of the literature.

J Clin Ultrasound. 2017 May 11;:

Authors: Narayan AK, Baer A, Fradin J

Abstract
IgG4-related disease is a relatively newly described entity with findings that historically have been confused with a variety of other diseases with markedly different treatments and prognoses, including Sjogren's syndrome and MALT lymphoma. We present a case of IgG4-related disease of the salivary glands and review the literature on sonographic findings of IgG4-related disease. By connecting sonographic features of IgG4 disease with common ancillary features of IgG4 disease in other sites (pancreas, hilar lymph nodes, biliary tree, thyroid, and retroperitoneum), radiologists can play a pivotal role in the early diagnosis and identification of IgG4-related disease. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound, 2017.

PMID: 28493480 [PubMed - as supplied by publisher]



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Guidelines for Contributing Authors



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Editorial Board



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Table of Contents



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Table of Contents



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Guidelines for Contributing Authors



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Editorial Board



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CONTENTS 1

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Publication date: April 2017
Source:Materials Today, Volume 20, Issue 3





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CONTENTS 2

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Publication date: April 2017
Source:Materials Today, Volume 20, Issue 3





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Widespread biphasic amyloidosis related to ipilimumab treatment for metastatic melanoma



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MYH9, a Nonmuscle Myosin, Regulates FOXE1 and PTCSC2, Two Genes Involved in Thyroid Development, Function, and Risk of Papillary Thyroid Cancer

Clinical Thyroidology May 2017, Vol. 29, No. 5: 198-199.


http://ift.tt/2qfeXAW

Surgery for Neck Recurrence of Thyroid Cancer Can Achieve Complete Remission in a Majority of Patients

Clinical Thyroidology May 2017, Vol. 29, No. 5: 169-172.


http://ift.tt/2qfejmV

First -Degree Family Members of Patients with Hypothyroidism Due to Hashimoto's Thyroiditis Are at a Ninefold Increased Risk for the Same

Clinical Thyroidology May 2017, Vol. 29, No. 5: 180-182.


http://ift.tt/2puukIU

Pregnant Women of African Descent Have Lower TSH Concentrations and a Lower Risk of TPO-Antibody Positivity

Clinical Thyroidology May 2017, Vol. 29, No. 5: 192-194.


http://ift.tt/2qffKly

How Often Does a Thyroid Cancer Patient Need to Undergo Surveillance with Cervical Ultrasound?

Clinical Thyroidology May 2017, Vol. 29, No. 5: 173-175.


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LETTER: Women with Gestational Thyroid Dysfunction May Be at Higher Risk for Thyroid Disease Developing Postpartum

Clinical Thyroidology May 2017, Vol. 29, No. 5: 204-205.


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Meta-Analysis Confirms the Deleterious Effects of Combined BRAFV600E and Telomerase Reverse Transcriptase Promoter Mutations on the Course and Mortality of Papillary Thyroid Carcinoma

Clinical Thyroidology May 2017, Vol. 29, No. 5: 176-179.


http://ift.tt/2puvbJe

Many Patients Who Become Hypothyroid After Lobectomy Will Recover Normal Thyroid Function Without Supplementation

Clinical Thyroidology May 2017, Vol. 29, No. 5: 183-185.


http://ift.tt/2puuj7O

124I PET–CT May Be Useful in Identifying Radioiodine-Avid Lesions in Differentiated Thyroid Cancer

Clinical Thyroidology May 2017, Vol. 29, No. 5: 195-197.


http://ift.tt/2qfASIs

A New Assessment of the Prevalence and Risk Factors of Liver Abnormalities in Hyperthyroidism

Clinical Thyroidology May 2017, Vol. 29, No. 5: 186-188.


http://ift.tt/2puC8tT

Case Report: The Utility of PTH Needle Washout in Distinguishing Recurrent Thyroid Bed Lesions in Thyroid Cancer Patients at Risk for Hyperparathyroidism

Clinical Thyroidology May 2017, Vol. 29, No. 5: 200-203.


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Higher Preconception TSH Values Are Associated With Adverse Obstetric Outcomes

Clinical Thyroidology May 2017, Vol. 29, No. 5: 189-191.


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The Author Replies

Clinical Thyroidology May 2017, Vol. 29, No. 5: 206-207.


http://ift.tt/2qeTfx5

Acetaminophen and Asthma in Children: Association or Causality?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


http://ift.tt/2pHA64Q

Pregnant Women of African Descent Have Lower TSH Concentrations and a Lower Risk of TPO-Antibody Positivity

Clinical Thyroidology May 2017, Vol. 29, No. 5: 192-194.


http://ift.tt/2qffKly

How Often Does a Thyroid Cancer Patient Need to Undergo Surveillance with Cervical Ultrasound?

Clinical Thyroidology May 2017, Vol. 29, No. 5: 173-175.


http://ift.tt/2puvSCA

LETTER: Women with Gestational Thyroid Dysfunction May Be at Higher Risk for Thyroid Disease Developing Postpartum

Clinical Thyroidology May 2017, Vol. 29, No. 5: 204-205.


http://ift.tt/2qfeXRp

Meta-Analysis Confirms the Deleterious Effects of Combined BRAFV600E and Telomerase Reverse Transcriptase Promoter Mutations on the Course and Mortality of Papillary Thyroid Carcinoma

Clinical Thyroidology May 2017, Vol. 29, No. 5: 176-179.


http://ift.tt/2puvbJe

MYH9, a Nonmuscle Myosin, Regulates FOXE1 and PTCSC2, Two Genes Involved in Thyroid Development, Function, and Risk of Papillary Thyroid Cancer

Clinical Thyroidology May 2017, Vol. 29, No. 5: 198-199.


http://ift.tt/2qfeXAW

First -Degree Family Members of Patients with Hypothyroidism Due to Hashimoto's Thyroiditis Are at a Ninefold Increased Risk for the Same

Clinical Thyroidology May 2017, Vol. 29, No. 5: 180-182.


http://ift.tt/2puukIU

Surgery for Neck Recurrence of Thyroid Cancer Can Achieve Complete Remission in a Majority of Patients

Clinical Thyroidology May 2017, Vol. 29, No. 5: 169-172.


http://ift.tt/2qfejmV

Many Patients Who Become Hypothyroid After Lobectomy Will Recover Normal Thyroid Function Without Supplementation

Clinical Thyroidology May 2017, Vol. 29, No. 5: 183-185.


http://ift.tt/2puuj7O

124I PET–CT May Be Useful in Identifying Radioiodine-Avid Lesions in Differentiated Thyroid Cancer

Clinical Thyroidology May 2017, Vol. 29, No. 5: 195-197.


http://ift.tt/2qfASIs

A New Assessment of the Prevalence and Risk Factors of Liver Abnormalities in Hyperthyroidism

Clinical Thyroidology May 2017, Vol. 29, No. 5: 186-188.


http://ift.tt/2puC8tT

Case Report: The Utility of PTH Needle Washout in Distinguishing Recurrent Thyroid Bed Lesions in Thyroid Cancer Patients at Risk for Hyperparathyroidism

Clinical Thyroidology May 2017, Vol. 29, No. 5: 200-203.


http://ift.tt/2qfhjjo

Higher Preconception TSH Values Are Associated With Adverse Obstetric Outcomes

Clinical Thyroidology May 2017, Vol. 29, No. 5: 189-191.


http://ift.tt/2puGnG7

The Author Replies

Clinical Thyroidology May 2017, Vol. 29, No. 5: 206-207.


http://ift.tt/2qeTfx5

Characterization of the Anti-Bovine Podoplanin Monoclonal Antibody PMab-44

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


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Neuropathic and inflammatory antinociceptive effects and electrocortical changes produced by Salvia divinorum in rats

Publication date: Available online 11 May 2017
Source:Journal of Ethnopharmacology
Author(s): Karina Simón-Arceo, Ma. Eva González-Trujano, Ulises Coffeen, Rodrigo Fernández-Mas, Francisco Mercado, Angélica Almanza, Bernardo Contreras, Orlando Jaimes, Francisco Pellicer
Ethnopharmacological relevanceSalvia divinorum Epling et Játiva-M (SD, Lamiaceae) is a medicinal plant traditionally used in hallucinogenic ethnopharmacological practices and for its analgesic and antinflammatory properties. Its active compounds include diterpenes known as salvinorins which act as potent κ opioid receptor agonists.Aim of the studyGiven its effects in acute animal models of pain, as well as its antinflammatory attributes, we decided to investigate the analgesic effects of an SD extract in neuropathic (sciatic loose nerve ligature) and inflammatory (intra plantar carrageenan) pain models in rats. We also determined in this study the electrocorticographic changes to correlate similar hallucinogenic state and behavior as those produced in humans.Material and methodsMechanical and thermonociceptive responses, plantar test and von Frey assay, respectively, were measured in adult Wistar rats 30min, 3h and 24h after the intraperitoneal administration of saline or an hydroponic SD extract. We also evaluated carbamazepine and celecoxib, as gold reference drugs, to compare its antinociceptive effects.ResultsOur results showed that administration of SD extract induced antialgesic effects in both neuropathic and inflammatory pain models. All those effects were blocked by nor-binaltorphimine (a Kappa opioid receptor antagonist). Moreover, it was observed an increase of the anterior power spectral density and a decrease in the posterior region as electrocorticographic changes.ConclusionThe present investigation give evidence that SD is capable to reduce algesic response associated to neuropathic and inflammatory nociception. This study support therapeutic alternatives for a disabling health problem due to the long term pain with high impact on population and personal and social implications.

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Ethnozoological assessment of animals used by Mon traditional medicine vendors at Kyaiktiyo, Myanmar

Publication date: Available online 12 May 2017
Source:Journal of Ethnopharmacology
Author(s): Vincent Nijman, Chris R Shepherd
Ethnopharmacological relevanceWild animals are widely used in traditional Asian medicine but information from Myanmar is lacking. We show that a wide range of animals are used at a pilgrimage site, mostly for their rendered fats and oils to be used in mixed concoctions. The majority of species were sold to be used to treat aching joints, muscle ache and skin diseases.Aim of the studyTo assess wildlife for sale for medicinal purposes, and document their medicinal use at Kyaiktiyo, a pilgrimage site at a 1100m tall mountain, with many of the pilgrims climbing to the top. In addition we address legal issues relating to the production and sale of traditional medicine that contain legally protected animals.Material and methodsFour visits were made to Kyaiktiyo, Myanmar, between 2000 and 2017 to quantify animal parts on display and through discussions with vendors to obtain information on medicinal use of these parts.ResultsTwenty-three species, mostly mammals, were recorded to be used for traditional medicine. The most common were Chinese serow Capricornis milneedwardsii, Asian elephant Elephas maximus, and Asiatic black bear Ursus thibetanus. Over 600 bodies or body parts were present. Combined, these parts purportedly provided cures or relief for at least 15 ailments or diseases. The most commonly mentioned treatment was that of using rendered animal fats/oils externally to relieve/cure aching joints or muscles. This treatment allegedly provides instant relief to pilgrims after an arduous climb up the mountain. Purported cures for various skin diseases was the next common use for the animal species on offer. Purported cures for various skin diseases were the next common uses for animals. Ten of the species observed for sale at Kyaiktiyo are listed globally as threatened, and 15 are protected and cannot be legally traded. Ambiguities in Myanmar's legislation mean that protected animals or their body parts cannot be traded, however traditional medicines can be made out of them provided rules relating to the manufacturing of traditional medicines are adhered to.ConclusionThis study indicated that animals and their parts continue to be openly offered for sale at Kyaiktiyo to treat various illnesses. Despite these products potential medical, traditional or cultural importance, solutions have to been found on how to ensure that, in line with Myanmar's laws, use of traditional local medicine does not impede the conservation of imperilled species.

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Chinese Materia Medica Used in Medicinal Diets

Publication date: Available online 12 May 2017
Source:Journal of Ethnopharmacology
Author(s): Fang Tan, Yalin Chen, Xiaolei Tan, Yunyun Ma, Yong Peng
Ethnopharmacological relevance:Medicinal diets have a history of more than 2000 years. Locally referred to as yaoshan (Chinese: 药膳), a medicinal diet is understood in China as a dietary product that combines herbs and food with the purpose of preventing and treating diseases or improving health under the guidance of traditional Chinese medicine theory. Medicinal diets are used in Chinese people's daily life and in specialized restaurants. Hundreds of Chinese materia medica (CMM) are used in medicinal diets; however, a comprehensive evaluation of medicinal diets is lacking.Aims of the study:This is an exploratory study that aims to identify the CMM that are most frequently used in medicinal diets and to provide an updated view of the current situation of medicinal diets in China.Materials and methods:A field study of 1221 people in 32 Chinese provinces was conducted over a period of approximately 6 months and included various types of interviews as well as a written questionnaire. Two approaches were used to analyse the data collected in the survey: (1) estimating the frequency of CMM consumed in daily diets; and (2) collecting CMM used in medicinal diet restaurants. Complementary information on the selected CMM was obtained from relevant databases, including PubMed, Google Scholar, Baidu Scholar, CNKI, and Web of Science.Results:Ten CMM were reported as commonly used by more than 50% of the participants. Among these 10 species, most medicinally used parts were seeds and fruits. Pharmacological data from the literature revealed that these species are associated with a wide spectrum of biological properties, including antitumour (80%), antioxidant (50%), anti-diabetic (40%), antilipemic (40%), anti-aging (40%), antimicrobial (40%) and cardioprotective (40%) activities. Our survey shows that most medicinal diet restaurants are located in the eastern part of China, with the greatest numbers being found in Beijing and Guangzhou. Only Dioscoreae Rhizoma, Lycii Fructus, Chrysanthemi Flos and Longan Arillus were frequently consumed both in daily diets and at medicinal diet restaurants. Some of the similarities shared by these 4 species include an extensive history of use (>2000 years); a sweet flavour; and antioxidant, antidiabetic, antilipemic and cardioprotective effects.Conclusions:The 10 most commonly consumed CMM possess various biological effects that are currently target the most frequent health problems for the majority of the population. The development of medicinal diet restaurants has certain regional restrictions and is associated with the local climate environment and dietary culture. The data revealed by this study provided useful information for commercial exploitation of medicinal diets and their components and serve as a basis for further studies on various aspects of medicinal diets.

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Src and Syk contribute to the anti-inflammatory activities of Achyranthes aspera ethanolic extract

Publication date: Available online 11 May 2017
Source:Journal of Ethnopharmacology
Author(s): Jeong-Ook Lee, Woo Seok Yang, Jae Gwang Park, Deok Jeong, Han Gyung Kim, Kee Dong Yoon, Adithan Aravinthan, Jong-Hoon Kim, Eunji Kim, Jae Youl Cho
Ethnopharmacological relevanceNuclear factor-kappa B (NF-κB) plays pivotal roles in inflammation. Src and Syk are two tyrosine kinases that act upstream of NF-κB signaling. Although Achyranthes aspera L. (A. aspera) has been used as a traditional medicine to treat fevers and inflammatory ailments and heal wounds, the molecular mechanisms of its anti-inflammatory actions are not yet fully understood.Materials and MethodsIn this study, we evaluated the anti-inflammatory effect of A. aspera ethanol extract (Aa-EE). To determine the mechanism by which Aa-EE dampens the inflammatory response, nitric oxide (NO) production and the mRNA expression levels of tumor necrosis factor (TNF)-α and inducible nitric oxide synthase (iNOS) were examined by Griess assay and RT-PCR. Luciferase assays and immunoblotting were also conducted to examine how Aa-EE regulates the NF-κB pathway.ResultsAa-EE reduced NO production up to 60% without any cytotoxicity. This extract was found to downregulate the mRNA expression levels of inflammatory genes. Aa-EE blocked NF-κB promoter activity induced by both TNF-α and adaptor molecule MyD88 (about 70% and 40%, respectively). Moreover, nuclear translocation of p65 and IκBα phosphorylation were also inhibited. Furthermore, Aa-EE inactivated two upstream signaling molecules, the Src and Syk kinases. In accordance with these data, the kinase activities of Src and Syk were decreased by 50% and 80%, respectively. The anti-inflammatory action of Aa-EE was also confirmed in a gastritis model.ConclusionOur data suggest that Aa-EE targets NF-κB to exert its anti-inflammatory properties by suppressing Src and Syk. Therefore, our study raises the possibility that this extract can be developed as a novel natural anti-inflammatory remedy.

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Protective effects of Cinnamomum cassia (Lamaceae) against gout and septic responses via attenuation of inflammasome activation in experimental models

Publication date: 9 June 2017
Source:Journal of Ethnopharmacology, Volume 205
Author(s): Woo-Young Shin, Do-Wan Shim, Myong-Ki Kim, Xiao Sun, Sushruta Koppula, Sang–Hyeun Yu, Han-Bi Kim, Tack-Joong Kim, Tae-Bong Kang, Kwang-Ho Lee
Ethnopharmacological relevanceCinnamomum cassia (C. cassia, Lauraceae family), commonly used for treating dyspepsia, gastritis, blood circulation, and inflammatory diseases is considered as one of the 50 fundamental herbs in traditional Chinese medicine.Aim of the studyThe anti-inflammatory action of an ethanol extract of C. cassia (CA), and its underlying mechanisms were explored in both in vitro cellular and in vivo murine models.Materials and methodsBone marrow-derived macrophages (BMDMs) were used to study the regulatory effect of CA on inflammasome activation. A lipopolysaccharide (LPS)-induced sepsis mouse model and a monosodium urate (MSU)-induced gout model were employed to study the effect of CA on in vivo efficacy.ResultsCA improved the survival rate in the LPS-induced septic shock mouse model and inhibited inflammasome activation including NLRP3, NLRC4, and AIM2, leading to suppression of interleukin-1β secretion. Further, ASC oligomerization and its speck formation in cytosol were attenuated by CA treatment. Furthermore, CA improved both survival rate of LPS-induced septic shock and gout murine model.ConclusionsCA treatment significantly attenuated danger signals-induced inflammatory responses via regulation of inflammasome activation, substantiating the traditional claims of its use in the treatment of inflammation-related disorders.

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Hepatoprotective activities of Antrodia camphorata and its triterpenoid compounds against CCl4-induced liver injury in mice

Publication date: Available online 12 May 2017
Source:Journal of Ethnopharmacology
Author(s): Zi-wei Li, Yi Kuang, Shu-nan Tang, Kai Li, Yun Huang, Xue Qiao, Si-wang Yu, Yew-min Tzeng, Jen-Yu Lo, Min Ye
Ethnopharmacology relevance:Antrodia camphorata (AC) is a rare and precious fungus indigenous to Taiwan used as a traditional medicine for the treatment of liver injury. Triterpenoids are the major bioactive constituents of A. camphorata and have been reported to possess hepatoprotective activities. To meet the increasing demand, artificial cultivation techniques have been developed.Aim of the studyThis study aims to evaluate the hepatoprotective activities of AC samples derived from different cultivation techniques and to dissect the main active triterpenoid compounds.Materials and methodsThe ethanol extracts of five batches of AC samples, including wild growing fruiting bodies, cutting wood culture fruiting bodies, dish cultures, cutting wood culture mycelia, and submerged fermentation mycelia were orally administered (50mg/kg or 200mg/kg) to ICR mice for 7 days. On the last day, CCl4 (0.2%, 7mL/kg, i.p.) was used to induce liver injury, and the activities of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined 24h after the injection. Moreover, a HepG2 cell model treated with CCl4 (0.35%) was used to screen the protective activities of 29 AC triterpenoids. After incubation for 6h, viabilities of the cells were tested using MTS assay. The in vivo hepatoprotective activities of antcin B and antcin K were further studied on the mice model by ALT and AST tests and histopathologic examinations. To elucidate the mechanisms, the mRNA levels of iNOS, COX2, TNF-α and IL-1β, and the protein levels of NF-κB (p65/p-p65), iNOS and COX2 in liver tissues were determined.ResultsThe wild growing or cutting wood culture fruiting bodies, and the dish cultures of AC showed more potent activities than the mycelia (P < 0.001). At 20μM, 16 of 29 triterpenoids showed significant protective activities, increasing HepG2 cell viability from 46% of the CCl4 group to >90%. Antcin B and antcin K could dose-dependently (10 or 50mg/kg, 7 days, i.g.) decrease the serum levels of ALT and AST, and decrease the incidence of liver necrosis. The effects of 50mg/kg of antcin K or antcin B were almost identical to those of 100mg/kg silymarin. Furthermore, qRT-PCR and Western blotting analyses revealed they could down-regulate IL-1β, TNF-α, iNOS, COX-2 and NF-κB in liver tissues at both transcriptional and translational levels.ConclusionThe results indicate that cultivation techniques remarkably affect the hepatoprotective activities of AC. Antcin K and antcin B are the major hepatoprotective compounds of A. camphorata, and the mechanism is related with anti-inflammation. Given its high natural abundance and good oral absorption, antcin K could be a promising drug candidate for liver injury.

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SKI3301, a purified herbal extract from Sophora tonkinensis, inhibited airway inflammation and bronchospasm in allergic asthma animal models in vivo

Publication date: Available online 12 May 2017
Source:Journal of Ethnopharmacology
Author(s): Hunseung Yoo, Minseok Kang, Sungsoo Pyo, Hee-Sung Chae, Keun Ho Ryu, Jinwoong Kim, Young-Won Chin
Ethnopharmacological relevanceSophora tonkinensis (Leguminosae, ST) is a traditional herbal plant in Korea and China. Its roots and rhizomes have been used to dissipate heat, to clear toxic material and to treat acute pharyngolaryngeal infections and sore throats.Aim of studyIn this study, we tried to investigate the anti-inflammatory and anti-asthmatic effects of a purified extract (SKI3301) from Sophora tonkinensis using in vitro enzyme assay models and ovalbumin (OVA)-induced asthma animal models.Materials and methodsThe effect of SKI3301 on pro-inflammatory enzymes such as 5-lipoxygenase, phosphodiesterase 3 & 4, and thromboxane synthase was assayed in vitro. BALB/c mice were sensitized with OVA/Alum ip injection and nebulized with OVA to induce airway inflammation. Bronchoalveolar lavage (BAL) fluid was collected and analyzed for leukocytes infiltration and IL-5 production along with lung histopathology. Guinea pigs passively sensitized with anti-OVA antiserum were used to investigate the effect of SKI3301 on bronchospasm in vitro and in vivo.ResultsSKI3301 potently inhibited the activities of 5-lipoxygenase, phosphodiesterase 3 & 4, and thromboxane synthase. Orally administered SKI3301 attenuated the total leukocytes and eosinophil infiltration and IL-5 level in BAL fluids. Histopathological changes associated with lung inflammation were also reduced by SKI3301. SKI3301 inhibited OVA-induced contraction of isolated trachea from sensitized guinea pigs. SKI3301 also protected OVA-induced bronchoconstriction in the sensitized guinea pigs. Maackiain, one of 3 major components of SKI3301, was effective in inhibiting 5-lipoxygenase and OVA-induced airway inflammation.ConclusionIn this study, SKI3301 potently inhibited pro-inflammatory enzymes and attenuated OVA-induced bronchospasm in animal model of allergic asthma. These results suggest that SKI3301 may have therapeutic potential for allergic asthma.

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New Isoflavonoids from the Extract of Rhynchosia precatoria (Humb. & Bonpl. ex Willd.) DC. and their antimycobacterial activity

Publication date: Available online 12 May 2017
Source:Journal of Ethnopharmacology
Author(s): Enrique Wenceslao Coronado-Aceves, Giulia Gigliarelli, Adriana Garibay-Escobar, Ramón Enrique Robles Zepeda, Massimo Curini, Jaime López Cervantes, Clara Inés Espitia-Pinzón, Stefano Superchi, Stefania Vergura, Maria Carla Marcotullio
Ethnopharmacology relevanceThe evaluation of the antimycobacterial activity of extracts of medicinal plants used by Mayos against tuberculosis and respiratory problems, allowed the identification of Rhynchosia precatoria (Humb. & Bonpl. ex Willd.) DC (Fabaceae) as the best candidate to find new antimycobacterial compounds.Aim of the studyTo isolate and characterize the compounds of R. precatoria responsible for the inhibitory and bactericidal activity against Mycobacterium tuberculosis H37Rv and Mycobacterium smegmatis ATCC 700084. To determine antimycobacterial synergistic effect of pure compounds and their selectivity index towards Vero cells.Materials and MethodsA total of six flavonoids were purified by silica gel column chromatography. Structural elucidation of the isolated compounds was achieved by using 1D and 2D NMR spectroscopy techniques. The configuration at the C-3 chiral center was established by quantum mechanical calculation of the electronic circular dichroism (ECD) spectrum. In vitro inhibitory and bactericidal activity against M. tuberculosis and M. smegmatis were determined with the redox indicator Alamar Blue (resazurin). Synergy was determined by X/Y quotient. Cytotoxicity was measured by MTT assay.ResultsThe isolated compounds were identified as precatorin A (1), precatorin B (2), precatorin C (3), lupinifolin (4), cajanone (5) and lupinifolinol (6). Compounds 1–3 are new. Compounds 1 to 5 inhibited the growth of M. tuberculosis (MIC ≥31.25µg/mL); compounds 1, 2, 4 and 5 killed the bacteria (MBC ≥31.25µg/mL) and also inhibited M. smegmatis (MIC ≥125µg/mL), while 1 and 4 also resulted bactericidal (MBC ≥125µg/mL). Compounds 4 and 5 presented synergistic effect (X/Y quotient value <0.5) at a concentration of 1/2 MIC of each compound in the combination. Cytotoxicity in murine macrophages (RAW 264.7 cells) gave IC50 values of 13.3 to 46.98µM, for compounds 1–5.ConclusionsIn this work we isolated two new isoflavanones (1 and 2), and one new isoflavone (3) with a weak antimycobacterial activity. The (3R) absolute configuration was assigned to 1 by computational analysis of its ECD spectrum and to 2 and 5 by similarity of their ECD spectra with that of 1. We are also reporting by first time, activity against virulent strain of M. tuberculosis for compounds 4 and 5 and their antimycobacterial synergistic effect.

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Chronic administration of antioxidant resin from Virola oleifera attenuates atherogenesis in LDLr -/- mice

Publication date: Available online 11 May 2017
Source:Journal of Ethnopharmacology
Author(s): Paola Nogueira Coutinho, Beatriz Peters Pereira, Ana Claudia Hertel Pereira, Marcella Leite Porto, Arícia Leone Evangelista Monteiro de Assis, Afrânio Côgo Destefani, Silvana Santos Meyrelles, Elisardo Corral Vasquez, Breno Valentim Nogueira, Tadeu Uggere de Andrade, Denise Coutinho Endringer, Marcio Fronza, Thiago Melo Costa Pereira
Ethnopharmacological relevance:Virola oleifera (Schott) A. C. Smith, Myristicaceae has been largely used in traditional folk medicine in Brazil as an anti-inflammatory agent and our previous data indicated the antioxidant properties in other oxidative stress-related models. However, its effects on atherosclerosis (AT) are not yet investigated.Aims of the study:To evaluate the influence of resin from Virola oleifera (RV) on progression of AT in LDLr-/- mice.Materials and methods:LDLr-/- mice were divided into 4 groups: 1) The ND group received a normal diet without treatment. 2) The HD group received a high-fat diet without treatment. 3) The HD-V50 received a high-fat diet and was orally treated with RV at 50mg/Kg. 4) The HD-V300 received a high-fat diet and was orally treated with RV at 300mg/Kg. After 4 weeks, blood was collected to quantify biochemical parameters and ROS total and the aorta was removed to measure the lipid deposition by en face analysis. The liver was also collected to determine total lipids and lipid and protein oxidation. In order to investigate in more detail the contributions of RV in the vascular structure, we carried out the in vitro tests using four cellular types: macrophages, fibroblasts, vascular smooth muscle and endothelial cells.Results:We showed that the chronic treatment of RV at both doses reduced vascular lipid accumulation (~50%, p<0.05), probably through systemic and hepatic antioxidant effects, independent of dyslipidemia. Moreover, the in vitro assay results demonstrated that RV develops antioxidant properties on the vascular smooth muscle and endothelial cells, reinforcing the protective role of RV in progression of AT. LPS-stimulated macrophages treated with RV resulted in a significant reduction of NO production in a concentration-dependent manner.Conclusions:Chronic treatment with RV diminishes lipid deposition in atherosclerotic mice, which may be justified, at least in part, by antioxidant systemic and local mechanisms, reinforcing the protective role this resin in the setting of vascular lipid deposition, independent of hypercholesterolemia.

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Inhibition of proinflammatory mediators by coumaroyl lupendioic acid, a new lupane-type triterpene from Careya arborea, on inflammation-induced animal model

Publication date: Available online 11 May 2017
Source:Journal of Ethnopharmacology
Author(s): Rayhana Begum, Manjur Ali Sheliya, Showkat R. Mir, Ekta Singh, Manju Sharma
Ethnopharmacological relevanceCareya arborea Roxb. (Lecythidaceae) is a large tree found throughout India in deciduous forests and grasslands. C. arborea is traditionally used in tumors, inflammation, anthelmintic, bronchitis, epileptic fits, astringents, antidote to snake-venom, skin disease, diarrhea, dysentery with bloody stools, dyspepsia, ulcer, tooth ache, and ear pain.Aim of the studyIn our previous work, the methanolic extract of Careya arborea stem bark showed significant anti-inflammatory activity. As a continuity of that work, this study aimed at the isolation and evaluation of the anti-inflammatory effect of coumaroyl lupendioic acid, a new lupane-type triterpene from Careya arborea stem bark. Further, to give an insight into the underlying mechanism of action of the compound on the modulation of proinflammatory mediators.Materials and methodsMethanolic extract of Careya arborea stem bark was suspended in water, and sequentially fractionated with n-hexane and ethyl acetate. Further ethyl acetate fraction was subjected to medium pressure liquid chromatography (MPLC) to isolate the active molecules. The isolated compounds were characterized by the various spectral techniques namely UV, IR, 1H NMR, 13C NMR, DEPT, 1H - 1H COSY, HMBC and Mass spectral techniques. In vitro COX-1 and COX-2 enzyme inhibition assays using human whole blood was performed to investigate the inhibitory effect of the isolated compounds. The resulted potent COX-2 inhibitor of the isolated constituents compound 5, designated as coumaroyl lupendioic acid (CLA), was investigated in carrageenan induced inflammation and its effect was also compared with betulinic acid (BA) at the doses of 10 and 20mg/kg, p.o. using indomethacin and celecoxib (10 and 20mg/kg, p.o., respectively) as reference drugs. The effect of CLA on the production of NO, MPO, PGE2, TNF-α, IL-1β and IL-6 were assessed. In addition, the histopathology and immunohistochemistry (NF-ҡB, COX-2 and TNF-α protein expression) in paw tissues were also carried out.ResultsThe chromatographic fractionation of the methanolic extract resulted in isolation of six new derivatives of lupane type triterpenes for the first time from the stem bark of C. arborea; 3β-hydroxy-lup-5,20 (29),21-trien-28-oic acid (Compound 1), 1, 3, 13, 16-tetrahydroxy-lup-9(11), 20(29)-diene-28-oic acid (Compound 2), 1, 7-di hydroxy betulinic acid (Compound 3), 3β-O-dihydrocinnamyl betulinic acid (Compound 4), 3β-O-trans-coumaryl-lup-6, 9(11), 20(29)-triene-27, 28-olioic acid (Compound 5), 16β-hydroxy-2, 3-seco-lup-5, 20(29)-dien-2, 3, 28-trioic acid (Compound 6). Among the all isolated compounds 3β-O-trans-coumaryl-lup-6, 9(11), 20(29)-triene-27, 28-olioic acid designated as coumaroyl lupendioic acid (CLA) showed higher COX-2 selectivity which is comparable to reference drug (celecoxib). CLA significantly reduced carrageenan induced inflammation whereas CLA revealed greater effect as compared to BA at the similar corresponding doses. Moreover, CLA significantly inhibited pro-inflammatory mediators elevated by carrageenan. CLA also preserved the tissue architecture as evidenced by the histopathology. Furthermore, immunohistochemical studies revealed that CLA significantly down regulated NF-ҡB, COX-2 and TNF-α protein expression.ConclusionThe study gives an insight into the molecular mechanisms of coumaroyl lupendioic acid and suggests that the down-regulations of proinflammatory mediators provide credence to the ethno botanical use of the plant in the management of inflammation.

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Editorial

Publication date: June 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology, Volume 170
Author(s): Kristy A. Brown, Wah Chin Boon, Colin D. Clyne




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Editorial board

Publication date: June 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology, Volume 170





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Acetaminophen and Asthma in Children: Association or Causality?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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Acetaminophen and Asthma in Children: Association or Causality?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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Hepatic thyroid signaling of heat-stressed late pregnant and early lactating cows

During the transition between late gestation and early lactation dairy cows experience severe metabolic stress due to the high energy and nutrient requirements of the fetus and the mammary gland. Additional thermal stress as occurring with rising temperatures during the ongoing climate change has further adverse implications on energy intake, metabolism and welfare. The thyroid hormone (TH)-mediated cellular signaling has a pivotal role in regulation of body temperature, energy intake and metabolic adaptation to heat. To distinguish between energy intake and heat stress-related effects, Holstein cows were first kept at thermoneutrality at 15°C followed by exposure to heat stress (HS) at 28°C or pair-feeding (PF) at 15°C for 6 days, in late pregnancy and again in early lactation. Herein we focused on hepatic metabolic changes associated with alterations in the hypothalamic-pituitary-thyroid axis in HS and PF animals. T3 and T4 levels dropped with HS or PF; however, in HS animals this decline was more pronounced. Thyroid-stimulating hormone (TSH) levels remain unaffected while plasma cholesterol concentrations were lower in HS than PF animals. Hepatic marker genes for TH action (THRA, DIO1 and PPARGC1) decreased after HS and were lower compared to PF cows but only post-partum. Proteomics data revealed reduced hepatic amino acid catabolism ante-partum and a shift towards activated beta-oxidation and gluconeogenesis but declined oxidative stress defense post-partum. Thus, liver metabolism of HS and PF cows adapts differently to diminished energy intake both ante-partum and post-partum, and a different TH sensitivity is involved in the regulation of catabolic processes.



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The most common vices of men can damage fertility and the health of the next generation

There is growing evidence from animal and human studies that demonstrate that acquired paternal traits can impair both a male's fertility and the health of his offspring, including advanced age, smoking, stress, trauma, under-nutrition, infection, toxin exposure, and obesity. Curiously, many of these factors manifest as impaired neurological, behavioural, and/or metabolic functioning in offspring. The underlying molecular mechanisms that respond to the paternal environment and act as vectors of intergenerational transmission are beginning to emerge. This review focuses on three vices of men (alcohol consumption, overweight/obesity, and tobacco smoking) that damage fertility and pose risks to offspring health. These vices are not only the three most prevalent but are also leading risk factors for death and disability adjusted life years (DALYs) worldwide.

Clearly, any epigenetic/genetic alterations induced by the paternal exposures responsible for transmission need to escape/bypass the substantial post-fertilisation reprogramming that occurs during embryo development. For example paternal obesity alters the molecular composition of sperm, alters the developmental trajectory of resultant embryos, and increase the incidence of obesity and metabolic disorders in offspring. Mechanistic candidates of paternal programming include changes to the sperm epigenome (eg DNA methylation, histone/protamine modifications, and sperm borne small non-coding RNAs), increased sperm DNA damage, aberrant sperm DNA chromatin structure, and components of seminal plasma. Understanding the molecular mechanisms underpinning paternal programming may lead to the development of interventions designed to reduce the disease burden in future generations, who were born to fathers exposed to these initiating factors. Given that these vices are predominantly self-inflicted, interventions aimed at mitigating their consequences are readily identified.



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Bisphenol A promotes hepatic lipid deposition involving Kupffer cell M1 polarization in male mice

Bisphenol A (BPA), as one of the most common environmental endocrine disruptors, is considered to promote hepatic lipid deposition, but the mechanisms has not been fully elucidated. The polarization of Kupffer cells (KCs) plays an important role in hepatic inflammation by promoting pro-inflammatory M1 phenotype (M1KCs), which contributes to dysregulated lipid metabolism. The purpose of this study is to investigate the role of KC polarization in BPA-induced hepatosteatosis in male mice. In this study, we examined hepatic lipid contents and quantified M1KC in BPA-treated CD1 mice, and further explored the interaction between KCs and hepatocytes by using conditional HepG2 cell culture. BPA treatment significantly increased hepatic fat contents in CD1 mice, accompanied by increased number of pro-inflammatory M1KCs and enhanced secretion of inflammatory cytokines. Increased lipid contents were also observed in HepG2 cells treated with BPA. Interestingly, higher TG contents were observed in HepaG2 cells treated with conditional media from BPA-treated KCs, compared with that treated with BPA directly. Incubation of KCs with BPA promoted the polarization of KCs to pro-inflammatory M1 dominant subtypes, which was blocked by estrogen antagonist ICI182780. Taken together, our results revealed that M1KCs polarization is involved in BPA-induced hepatic fat deposition, which is possibly associated with the estrogen receptor signaling pathway.



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Novel concepts for initiating multitargeted kinase inhibitors in radioactive iodine refractory differentiated thyroid cancer

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Publication date: Available online 12 May 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): R.Michael Tuttle, Marcia S. Brose, Enrique Grande, Sun Wook Kim, Makoto Tahara, Mona M. Sabra
Multitargeted kinase inhibitors have been shown to improve progression-free survival in patients with structurally progressive, radioactive-iodine refractory differentiated thyroid cancer. While the inclusion criteria for phase 3 clinical trials and clinical practice guidelines provide guidance with regard to the minimal requirements that need to be met prior to initiation of a multitargeted kinase inhibitor, a better way to integrate the rate of structural disease progression with the size of the metastatic foci to more precisely define the optimal time to recommend initiation of therapy for individual patients is needed. In this manuscript we describe how to use assessments of tumor size and growth rates (structural disease doubling times) to define the critical point in time when the volume and rate of progression of metastatic structural disease merits consideration for initiation of systemic therapy (the inflection point).



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Oral Lichen Sclerosus: A Rare Case Report and Review of the Literature

Abstract

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area and causes significant discomfort and morbidity. Oral mucosal lesions in LS are extremely rare and might be associated with genital and/or skin manifestations. As a unique manifestation of LS, oral lesions are even more rare, with only 20 cases reported in English-language literature. In reviewing that literature in this paper, we present the case of a 44-year-old white man who sought dental assistance with a complaint of a white spot on his upper lip. Extraoral clinical examination revealed a slight white macule on the left upper lip vermilion next to the labial commissure. Intraoral examination revealed that the macule was approximately 3.5 × 2.0 cm, extended to the upper left labial mucosa, and presented an ivory-white color. Following an incisional biopsy and microscopy, the lesion was shown to be covered by a stratified squamous epithelium showing hyperkeratosis and atrophy. The superficial lamina propria revealed a well-marked band of subepithelial hyalinization and, below it, a band-like mononuclear inflammatory infiltrate. Sections stained by Verhoeff's technique revealed a scantiness of elastic fibers in the superficial lamina propria. The diagnosis of LS was then established. The patient was referred for dermatologic evaluation, which identified no skin or genital lesions, and no treatment was employed. After 6 years, no significant changes in clinical features were observed. Altogether, this rare case makes an important contribution to knowledge on this uncommon condition.



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Well-Differentiated Laryngeal/Hypopharyngeal Liposarcoma in the MDM2 Era Report of Three Cases and Literature Review

Abstract

Laryngeal/hypopharyngeal liposarcomas are very rare, fewer than 40 cases have been reported. These tumors are polypoid, with a male predisposition, and usually cause hoarseness and difficulty breathing. Their clinical course is characterized by multiple local recurrences. No distant metastasis has been reported, and dedifferentiation is extremely rare. In sum, the prognosis of these tumors is excellent; the 5-year survival rate is essentially 100 %. Pathologic diagnosis of these well-differentiated liposarcomas can be challenging. Many of them were initially diagnosed as benign lipoma, fibrovascular polyp, or "inflammatory polyp". The correct diagnosis is usually made after multiple recurrences. On the other hand, the literature bears out that these incorrect diagnoses do not impact disease-specific survival. Here, we report three patients with laryngeal/hypopharyngeal well-differentiated liposarcomas; this is the first documentation of MDM2 amplification in liposarcomas at this site.



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Orthokeratinized Odontogenic Cyst with an Associated Keratocystic Odontogenic Tumor Component and Ghost Cell Keratinization and Calcifications in a Patient with Gardner Syndrome

Abstract

Gardner syndrome (GS) is caused by mutations in the APC and besides adenomatous colorectal polyps includes such manifestations as osteomas, epidermoid cysts (ECs) and occasionally multiple pilomatricomas. More than 50 % of ECs in patients with GS exhibit pilomatricoma-like ghost cell keratinization. The latter may be explained by the fact that the development of both GS and pilomatricoma is driven by activation of the Wnt/β-catenin signaling pathway. A 62-year-old, Caucasian male with history of GS presented with a unilocular, mixed radiopaque/radiolucent mandibular lesion causing divergence and external root resorption of involved teeth. Histopathologically, the lesion was composed of two cystic components, an orthokeratinized odontogenic cyst (OOC) and a smaller one with characteristics of keratocystic odontogenic tumor (KCOT) featuring, focally, ghost cells and an epithelial morule-like structure. Dystrophic calcifications essentially similar to those seen in pilomatricomas were observed in the fibrous connective tissue wall. The KCOT and OOC epithelia revealed strong and diffuse cytokeratin (AE1/AE3) and β-catenin immunoreactivity. CD10 positive immunostaining was seen in the keratin and superficial spinous cell layers in both OOC and KCOT. The intraepithelial and mural ghost cells showed a cytokeratin (+), β-catenin and CD10 (−) immunophenotype. The diagnosis of OOC with ghost cell calcifications in association with KCOT was rendered. The patient was lost to follow-up. Although a coincidental co-existence cannot be excluded, ghost cell calcifications mimicking pilomatricoma-like changes in an unusual odontogenic cyst combining OOC and KCOT features as seen in this patient with GS may be explained by the common molecular mechanisms underlying the pathogenesis of cutaneous pilomatricomas and GS.



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Programmed Death-Ligand 1 Expression, Microsatellite Instability, Epstein–Barr Virus, and Human Papillomavirus in Nasopharyngeal Carcinomas of Patients from the Philippines

Abstract

Most nasopharyngeal carcinomas (NPCs) in a high-incidence population are driven by Epstein–Barr virus (EBV) infection. EBV-associated malignancies have increased expression of the programmed death-ligand 1 (PD-L1). Immunotherapy agents targeting the PD-1/PD-L1 pathway have achieved durable treatment effects in patients with various cancer types including EBV-associated malignancies. In this study, we sought to investigate PD-L1 expression in a cohort of patients with NPCs from the Philippines. Fifty-six NPCs were studied for PD-L1, p16, and DNA mismatch repair (MMR) deficiency by immunohistochemistry. One case with MMR deficiency was also assessed for microsatellite instability (MSI) by polymerase chain reaction. EBV and human papillomavirus (HPV) status were tested by in situ hybridization. All NPCs were p16 negative. Three of the 56 NPCs (5%) were EBV negative (EBV−) and HPV negative, while one NPC (1/56, 2%) was EBV positive and showed MSI (EBV+/MSI). Positive PD-L1 expression (PD-L1+), defined as membranous staining in ≥1% tumor cells, was seen in 64% (36/56) of NPCs. All three EBV− NPCs were PD-L1+ as was the EBV+/MSI NPC. PD-L1+ was seen significantly more often in NPCs from non-smokers than those from smokers (23/28, 82% vs 9/18, 50%; P = 0.047). PD-L1+ was not associated with pT, pN, distant metastasis, or clinical stage (P > 0.05). PD-L1+ was not associated with overall survival (P = 0.473). In summary, our results show frequent PD-L1 expression in NPCs regardless of EBV status and a preferential PD-L1 expression in non-smokers. MSI and HPV positivity are exceedingly rare in NPCs.



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Anaplastic Transformation of Papillary Thyroid Carcinoma Only Seen in Pleural Metastasis: A Case Report with Review of the Literature

Abstract

Anaplastic transformation of papillary thyroid carcinoma (PTC) at distant metastatic sites is extremely rare, and there have been fewer than 20 reported cases in the literature. A 61-year-old woman presented with 1-week history of dyspnea. Her past medical history was remarkable because, 19 years ago, she underwent nearly total thyroidectomy and radical neck dissection due to PTC. Computed tomography of the chest revealed a 1.7 cm nodule in the lung and diffuse pleural thickening. Gun biopsy of the lung nodule revealed metastatic PTC with typical histology. However, the pleural biopsy predominantly showed anaplastic pleomorphic and spindle sarcomatoid carcinoma with microscopic focus of PTC. Immunohistochemical results showed both anaplastic sarcomatoid and PTC components positive for TTF-1, galectin-3 and PAX-8, thus supporting anaplastic transformation of PTC at the metastatic site. Subsequently the patient received 1 cycle of cisplatin-based chemotherapy but died from the disease 4 months after diagnosis. Although it is rare, anaplastic transformation of PTC should be considered during differential diagnosis of patients who present with exclusive sarcomatoid morphology at metastatic sites and have a history of PTC. We report another case of anaplastic transformation of PTC, found at pleural metastasis, together with the immunohistochemical profile and a literature review.



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Mucinous Carcinoma with Neuroendocrine Differentiation of Salivary Gland Origin

Abstract

Primary mucinous adenocarcinomas of the salivary gland are rare malignancies defined by aggregates of epithelial cells suspended in large pools of extracellular mucin. We report a case of a giant mucinous adenocarcinoma of salivary gland origin, with low-grade cytoarchitectural features and neuroendocrine differentiation arising in the submental region. Grossly, the tumor measured 12.5 × 13.4 × 8.2 cm and replaced the bone and soft tissues of the anterior oral cavity. Microscopically, the neoplasm was composed of large extracellular pools of mucin, which contained papillary and acinar aggregates, and small nodules of ductal type epithelium with minimal nuclear enlargement, powdery chromatin and little pleomorphism. The nodules comprised 20 % of the tumor and showed morphologic and immunohistochemical evidence of neuroendocrine differentiation. Examination revealed histologic features comparable to mammary gland analogues in mucin predominance, ductal type morphology, expression of estrogen and progesterone receptors, and GATA-3 positivity. This is the first case reported of mucin-rich carcinoma of salivary gland origin exhibiting neuroendocrine differentiation.



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Diskitis, Osteomyelitis, Spinal Epidural Abscess, Meningitis, and Endocarditis Following Sacroiliac Joint Injection for the Treatment of Low-Back Pain in a Patient on Therapy for Hepatitis C Virus.

Objective: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. Case Report: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection. The patient was on treatment for hepatitis C virus, and the resulting immunocompromised state likely contributed to the outcome. Conclusions: Immunocompromised patients should be identified prior to treatment, and the small possibility of devastating complications should be thoughtfully weighed against the potential benefit of the procedure. Conservative management should be maximized initially, and if a procedure is done, strict asepsis must be maintained. Prophylaxis for S. aureus should be considered for immunocompromised patients undergoing interventional spine procedures. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Continuous Regional Anesthesia and Inpatient Rehabilitation for Pediatric Complex Regional Pain Syndrome.

Background: Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy and cognitive-behavioral therapy. Some patients have persistent pain and/or limb dysfunction despite these treatments. We performed a retrospective study of pediatric patients with CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along with inpatient rehabilitation at Boston Children's Hospital. Methods: After approval from the institutional review board, electronic medical records were reviewed for patients treated between September 2003 and September 2014. Primary outcomes were pain and functional scores. Data were collected at the first encounter, at follow-up visits between 4 months before and after admission, and daily while inpatient. Changes over time were assessed using Wilcoxon tests with Dunn corrections. Clinical significance of benefit or harm was assessed by the method of Jacobson and Truax. Response predictors were analyzed using linear mixed models and exploratory logarithmic regression analyses. Results: Pain, function, and disability scores improved during hospitalization and in follow-up over a 4-month period. Seventy percent of patients achieved clinically significant benefit (56% for pain reduction and 40% increased functionality, respectively). Univariate and adjusted predictors of favorable outcome included preadmission resting Numeric Pain Rating Scale score of less than 6 (odds ratio, 5.0; P = 0.0164 and subsequent attendance at the Pediatric Pain Rehabilitation Center at Boston Children's Hospital (odds ratio, 5.0; P = 0.0206). Mean pain scores greater than 3 during the regional anesthesia infusion predicted less favorable outcome. Conclusions: Continuous regional anesthesia may be an option to facilitate intensive rehabilitation for selected pediatric patients with CRPS. Further research should help clarify the role of regional anesthesia in a comprehensive management program. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Continuous Intrathecal Infusion of Cannabinoid Receptor Agonists Attenuates Nerve Ligation-Induced Pain in Rats.

Background and Objectives: Cannabinoid receptors (CB1R/CB2R) are known to play important roles in pain transmission. In this study, we investigated the effects of continuous intrathecal infusion of CB1/2R agonists in the L5/6 spinal nerve ligation pain model. Methods: Under isoflurane anesthesia, rats received nerve ligation and intrathecal catheter connected to an infusion pump. After surgery, saline (1 [mu]L/h), CB1/2R agonist WIN55,212-2, CB1R agonist ACEA, or CB2R agonist AM1241 (1 [mu]mol/h) was given intrathecally for 7 days. The mechanical and thermal sensitivities of rat hindpaw were determined by von Frey hair and radiant heat tests. The expression of CB1/2R and protein levels of CB1/2R, Iba1, glial fibrillary acidic protein, and tumor necrosis factor [alpha] were examined by immunofluorescence study and Western blotting. Results: On postligation day 7, rats that received WIN55,212-2, ACEA or AM1241 had significantly higher mean withdrawal thresholds (6.8, 8.4, and 10.2 g) and latencies (6.3, 7.3, and 9.1 seconds) than did saline-treated rats (1.7 g, 2.2 seconds). Cannabinoid receptors were expressed not only in IB4+ (isolectin B4) and CGRP+ (calcitonin gene-related peptide) dorsal root ganglion neurons, their central terminals, and peripheral axons, but also in neurons, microglia, and astrocytes in spinal cord. Cannabinoid receptor agonists enhanced nerve ligation-induced up-regulation of cannabinoid receptor in spinal cord and dorsal root ganglion. Treatment with WIN55,212-2 or AM1241, but not ACEA, markedly reduced nerve ligation-induced up-regulation of Iba1, glial fibrillary acidic protein, and tumor necrosis factor [alpha] in spinal cord. Conclusions: Continuous intrathecal infusion of CB1/2R agonists elicits antinociception in the pain model. The mechanisms might involve their actions on neurons and glial cells. CB2R, but not CB1R, seems to play an important role in the regulation of nerve injury-induced neuroinflammation. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Advancing Safety in Intrathecal Analgesia: A Novel Web-Based Pharmacologic Requisition Platform and Data Repository for Intrathecal Drug Delivery Devices.

No abstract available

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Retrobulbar Block in Pediatric Vitreoretinal Surgery Eliminates the Need for Intraoperative Fentanyl and Postoperative Analgesia: A Randomized Controlled Study.

Background and Objectives: Pediatric ophthalmologic surgery is traditionally accomplished by general anesthesia with opioids, but respiratory depression remains a major concern. Our study compared the efficacy of retrobulbar block with systemic fentanyl on pain, hemodynamic, and stress response in pediatric vitreoretinal surgery. Methods: A prospective double-blind, randomized controlled study was performed comparing retrobulbar block with intravenously administered fentanyl in 28 children aged 1 to 6 years undergoing vitreoretinal surgery. After general anesthesia was induced, retrobulbar block with 0.5% ropivacaine was accomplished in group RB (general anesthesia plus retrobulbar block) (n = 13), and normal saline was injected into retrobulbar space in group F (general anesthesia alone) (n = 15). Fentanyl 0.5 [mu]g/kg was administered when signs of inadequate anesthesia were observed. Results: Respiratory depression (defined as a persistent respiratory rate

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Residual Enoxaparin Activity, Anti-Xa Levels, and Concerns About the American Society of Regional Anesthesia and Pain Medicine Anticoagulation Guidelines.

Currently, the American Society of Regional Anesthesia and Pain Medicine (ASRA) anticoagulation guidelines recommend that before the performance of a neuraxial procedure a minimum of 24 hours should elapse following a treatment dose of enoxaparin (1 mg/kg twice daily or 1.5 mg/kg once daily). The guidelines have since their inception also consistently recommended against the routine use of anti-Xa level monitoring for patients receiving enoxaparin. However, we noted in our clinical practice that anti-Xa levels were frequently still elevated despite patients meeting the time-based recommendation for treatment dose enoxaparin. To further investigate the possibility that residual anticoagulant activity may persist longer than 24 hours after a treatment dose of enoxaparin, we assessed anti-Xa level activity in patients presenting for elective surgery. Despite nearly universal compliance with ASRA's anticoagulation guidelines (1 sample was drawn at 23.25 hours), anti-Xa activity was found to be elevated in 11 of 19 patients. While 10 patients had an anti-Xa level within the peak prophylactic range (0.2-0.5 IU/mL), 1 patient's level was found to still be in the peak therapeutic range (0.5-1.0 IU/mL). These findings suggest that significant anticoagulant activity may persist longer than previously appreciated after the last treatment dose of enoxaparin and that the current time-based ASRA recommendation may not be conservative enough. Further research is needed to delineate the level of anti-Xa activity below which it is likely safe to proceed with a neuraxial procedure, but it may be time to reconsider the utility of anti-Xa level monitoring when it is available. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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The New Opt-Out Dutch National Breast Implant Registry – Lessons learnt from the road to implementation

An estimated 1-3% of all women in the Netherlands carry breast implants. Since the introduction five decades ago, problems with a variety of breast implants have emerged with direct consequences for the patients' health. Plastic surgeons worldwide reacted through campaigning for auditing on long-term implant quality surgeon performance and institutional outcomes in implant registries. Especially the PIP implant scandal of 2010 demonstrated the paucity of epidemiological data and uncovered a weakness in our ability to even 'track and trace' patients.

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Guidelines for allergen immunotherapy in India: 2017-An update

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SN Gaur

Indian Journal of Allergy, Asthma and Immunology 2017 31(1):1-2



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Guidelines for practice of allergen immunotherapy in India: 2017-An update

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SN Gaur, Raj Kumar, AB Singh, MK Agarwal, Naveen Arora

Indian Journal of Allergy, Asthma and Immunology 2017 31(1):3-33

The practice of Allergy and Immunotherapy is not streamlined in our country and there were no guidelines till we published in 2009 in IJAAI. The guidelines are updated now incorporating the additional information after 2009. The purpose of bringing out these guidelines was to maintain the uniformity in the methods of diagnosis and management i.e. Immunotherapy in the country. Because of different soil conditions, temperature, different allergens, different seasonal variations etc, it was the felt the need to have separate guidelines for India, although such guidelines are available from other organisations. These guidelines are based on available guidelines with modifications/alterations at appropriate places keeping in mind the situation in our country.

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Utility of early postoperative imaging after combined endoscopic and open ventral skull base surgery

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Effects of changes in nasal volume on voice in patients after endoscopic endonasal transsphenoidal surgery

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Causes of dacryocystorhinostomy failure: External versus endoscopic approach

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The microscope and the endoscope



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International Frontal Sinus Anatomy Classification and anatomic predictors of low-lying anterior ethmoidal arteries

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T-helper type 1‐T-helper type 2 shift and nasal remodeling after fine particulate matter exposure in a rat model of allergic rhinitis

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Specific immunoglobulin E and immunoglobulin G4 toward major allergens of house-dust mite during allergen-specific immunotherapy

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Association of pediatric allergic rhinitis with the ratings of attention-deficit/hyperactivity disorder

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Immunopathologic characteristics of nasal polyps in adult Koreans: A single-center study

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Closure of nasal septal perforations with a polydioxanone plate and temporoparietal fascia in a closed approach

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The application of a free nasal floor mucoperiosteal graft in endoscopic sinus surgery

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Endoscopic resection of sinonasal mucosal melanoma has comparable outcomes to open approaches



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Endoscopic-guided coblation treatment of nasal telangiectasias in hereditary hemorrhagic telangiectasia: “How I do it”

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Recurrence of Sinonasal Inverted Papilloma Following Surgical Approach: A Meta-Analysis



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Overcoming immunosuppression in bone metastases

Publication date: Available online 12 May 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Zachary Reinstein, Sahithi Pamarthy, Vinay Sagar, Ricardo Costa, Sarki A. Abdulkadir, Francis J. Giles, Benedito A. Carneiro
Bone metastases are present in up to 70% of advanced prostate and breast cancers and occur at significant rates in a variety of other cancers. Bone metastases can be associated with significant morbidity. The establishment of bone metastasis activates several immunosuppressive mechanisms. Hence, understanding the tumor-bone microenvironment is crucial to inform the development of novel therapies. This review describes the current standard of care for patients with bone metastatic disease and novel treatment options targeting the microenvironment. Treatments reviewed include immunotherapies, cryoablation, and targeted therapies. Combinatorial treatment strategies including targeted therapies and immunotherapies shows promise in pre-clinical and clinical studies to overcome the suppressive environment and improve treatment of bone metastases.



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5 things to know about endotracheal intubation

If you've ever wondered why the little hole near the tip of an endotracheal tube is called the Murphy Eye, or who Macintosh was, or even who performed the first intubatio, this quick trip through the history of endotracheal tubes and laryngoscopy is for you. Here are five things to know about the invention, indications and use of an endotracheal tube. 1. Endotracheal tube history There is debate ...

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Thick tumor capsule is a valuable risk factor for distant metastasis in follicular thyroid carcinoma

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Publication date: Available online 12 May 2017
Source:Auris Nasus Larynx
Author(s): Wataru Shimbashi, Iwao Sugitani, Kazuyoshi Kawabata, Hiroki Mitani, Kazuhisa Toda, Keiko Yamada, Yukiko Sato
ObjectiveWhile the biological behavior of follicular thyroid carcinoma (FTC) has been studied in great detail using clinical experience, few studies have investigated pre- or intraoperative factors related to the risk of distant metastasis (DM) among patients with FTC. The aim of this study was to analyze the characteristics of FTC with DM.MethodsThis study retrospectively investigated 102 patients with FTC who underwent surgery between 1988 and 2013. We compared clinicopathological characteristics between FTC with and without DM.ResultsUnivariate analysis revealed nodal metastasis (p=0.045), serum thyroglobulin (Tg) at initial operation (≥1000ng/ml; p<0.0001), widely invasive appearance according to macroscopic findings (p<0.0001), thick tumor capsule (≥1mm; p<0.0001), vascular invasion (p=0.0003), extrathyroidal invasion (p=0.047), and venous tumor embolism (p=0.045) as significant risk factors for DM. Multivariate analysis conducted using pre- and intraoperative factors identified thick tumor capsule (≥1mm), serum Tg at initial operation (≥1000ng/ml), and macroscopically widely invasive appearance as risk factors independently associated with development of DM.ConclusionPatients with these risk factors should undergo total thyroidectomy and radioactive iodine ablation.



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5 things to know about endotracheal intubation

If you've ever wondered why the little hole near the tip of an endotracheal tube is called the Murphy Eye, or who Macintosh was, or even who performed the first intubatio, this quick trip through the history of endotracheal tubes and laryngoscopy is for you. Here are five things to know about the invention, indications and use of an endotracheal tube. 1. Endotracheal tube history There is debate ...

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Dental practice: Loyal and caring staff

British Dental Journal 222, 643 (2017). doi:10.1038/sj.bdj.2017.381

Author: S. Waters



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Remineralisation now starts in the clinic

British Dental Journal 222, 734 (2017). doi:10.1038/sj.bdj.2017.418



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OMFS: Dental fitness prior to cardiac surgery

British Dental Journal 222, 643 (2017). doi:10.1038/sj.bdj.2017.382

Author: A. Pantiora



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Using a situational judgement test for selection into dental core training: a preliminary analysis

British Dental Journal 222, 715 (2017). doi:10.1038/sj.bdj.2017.410

Authors: E. Rowett, F. Patterson, F. Cousans & K. Elley



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Oral cancer: Early/delayed diagnosis

British Dental Journal 222, 643 (2017). doi:10.1038/sj.bdj.2017.380

Authors: P. Varela-Centelles, P. Castelo-Baz & J. Seoane-Romero



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Make a real difference to your patients

British Dental Journal 222, 737 (2017). doi:10.1038/sj.bdj.2017.425



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Survey on the use of CAD-CAM technology by UK and Irish dental technicians

British Dental Journal 222, 689 (2017). doi:10.1038/sj.bdj.2017.407

Authors: E. Blackwell, M. Nesbit & H. Petridis



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Water fluoridation: It really is this simple

British Dental Journal 222, 644 (2017). doi:10.1038/sj.bdj.2017.383

Author:



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Digital dentistry made easy

British Dental Journal 222, 734 (2017). doi:10.1038/sj.bdj.2017.416



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Whitening toothpaste with charcoal

British Dental Journal 222, 733 (2017). doi:10.1038/sj.bdj.2017.414



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Mystery object: Denture drop

British Dental Journal 222, 644 (2017). doi:10.1038/sj.bdj.2017.384

Author: C. Wallis



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EFP launch European Gum Health Day 2017 in Spain

British Dental Journal 222, 647 (2017). doi:10.1038/sj.bdj.2017.388



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Accelerated healing of traumatised oral tissue

British Dental Journal 222, 735 (2017). doi:10.1038/sj.bdj.2017.422



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Case report: Giant cell arteritis warning

British Dental Journal 222, 644 (2017). doi:10.1038/sj.bdj.2017.385

Author: T. Lynn



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Invasive cervical resorption and the oro-facial cleft patient: a review and case series

British Dental Journal 222, 677 (2017). doi:10.1038/sj.bdj.2017.405

Authors: A. O'Mahony, C. McNamara, A. Ireland, J. Sandy & J. Puryer



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Case report: Odontalgia and facial pain

British Dental Journal 222, 645 (2017). doi:10.1038/sj.bdj.2017.386

Authors: M. Davies & C. J. Mannion



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Enhanced skills in periodontology: evaluation of a pilot scheme for general dental practitioners and dental care professionals in London

British Dental Journal 222, 700 (2017). doi:10.1038/sj.bdj.2017.404

Authors: S. G. Ghotane, V. Harrison, E. Radcliffe, E. Jones & J. E. Gallagher



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Case report: Osteonecrosis as a complication of GA

British Dental Journal 222, 645 (2017). doi:10.1038/sj.bdj.2017.387

Authors: M. Kharazmi, U. Nilsson & P. Hallberg



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Beyond ONJ – A review of the potential uses of bisphosphonates in dentistry

British Dental Journal 222, 727 (2017). doi:10.1038/sj.bdj.2017.412

Authors: N. P. Shah, S. Nayee, M. Pazianas & C. Sproat



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Dentists fully support HPV jabs for boys

British Dental Journal 222, 648 (2017). doi:10.1038/sj.bdj.2017.389



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