Proximity as a predictor of social behavior in rats

Publication date: Available online 25 August 2017
Source:Journal of Neuroscience Methods
Author(s): Rafael Bonuti, Sílvio Morato
BackgroundIn studies that measure social behavior of a freely interacting pair rats social behavior of one rat is strongly influenced by the behavior of the other. This prevents evaluating social behavior of one single rat.New methodWe assessed the motivation to interact socially in a modified open-field, by measuring the time a rat attempted to interact with a co-specific separated by a grid in a birdcage outside of the apparatus. We propose time in front of the birdcage is an indicator of social behavior.ResultsWe showed that the focal rat allocates more time in front of the birdcage, interacting with another rat through the grid. Also, that the presence of the other rat that attracts the focal rat. Habituation to the apparatus, repeated testing and illumination condition did not alter the proximity measures of rats. Finally, treatment with chlordiazepoxide (3.0mg/kg) either increased the time spent in front of the cage by males and females or (5.6mg/kg) increased the proximity measure of females.Comparing with existing methodOur method prevents partners from influencing the target rat's social behavior; existing methods do not. Also, it is more sensitive to the effect of chlordiazepoxide than the broadly used method proposed by File and Hyde (1978).ConclusionsProximity is an advantageous measure: it allows the assessment of only one focal animal without the interference of a partner; it is simple to take; it requires little interpretation skills or training from the experimenter, no special equipment or conditions.



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A survey of herbal weeds that are used to treat gastrointestinal disorders from southern Thailand: Krabi and Songkhla provinces

Publication date: 14 September 2017
Source:Journal of Ethnopharmacology, Volume 209
Author(s): Oratai Neamsuvan, Thamakorn Ruangrit
Ethnopharmacological relevanceWeeds are plants grow naturally and are commonly seen. They are mostly used for feedstuff. However, their use as herbs for treating diseases, including gastrointestinal disorders, is rare. Therefore, the present study aimed to: (1) quantify the number of herbal weeds used for treating gastrointestinal disorders; (2) study local knowledge of weed utilization for treating gastrointestinal disorders in Songkhla and Krabi provinces; and (3) analyse quantitative data with the Informant Consensus Factor (ICF), Use Value (UV) and Fidelity Level (FL).Materials and methodsThe study was conducted from November 2014 to January 2016 through semi-structured interviews with 35 folk healers. The main questions were designed to obtain plant information, including the local name, method of use, preparation method and medicinal properties. The data were analysed by descriptive statistics, quantitative indexes (UV, ICF as well as FL) and interpretation.ResultsA total of 49 species in 46 genera and 28 families were found. The most common use of weeds was as herbs (80%). The preferred part used was the whole plant (76.27%). The preferred methods of drug preparation and use were decoction and drink, respectively. The highest UV was found for Acmella oleracea (0.83). The highest FLs (100%) were found for 12 species, including Amaranthus spinosus, Amaranthus viridis, Alternanthera sessilis, Sauropus androgynus, Plantago major, and others. The highest ICF (0.93) was found for treating toothache.ConclusionOverall, there are reports on the pharmacological activity of 31 species of weeds and reports on toxicity for 20 species of weeds. Therefore, awareness of the use of herbs is necessary to ensure that they are used safely and that benefits arise from the therapy. This study showed that medicinal weeds are still popularly used by folk healers. The pharmacological properties were consistent with the local uses, which supported a preliminary indication that the weed plants were effective for treating gastrointestinal diseases.



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IFC (Journal of Ethnopharmacology)

Publication date: 14 September 2017
Source:Journal of Ethnopharmacology, Volume 209





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Naoxintong inhibits myocardial infarction injury by VEGF/eNOS signaling-mediated neovascularization

Publication date: 14 September 2017
Source:Journal of Ethnopharmacology, Volume 209
Author(s): Hong Wang, Lizhen Qiu, Yake Ma, Lusha Zhang, Lu Chen, Chunxiao Li, Xiao Geng, Xingyu You, Xiumei Gao
Ethnopharmacological relevanceNaoxintong capsules (NXT), a traditional Chinese Medical preparation, are widely used for treatment of cardiovascular diseases, while the mechanism is still unclear.Materials and methodsMyocardial infarction (MI) was induced by ligation of the left coronary artery in mice. Echocardiographic measurements were performed to do physiological assessments of left ventricle (LV) function. Histological and immunohistochemical staining was used to determine infarct size, capillary density, tissue endothelial nitric oxide synthase (eNOS) expression. Bone Marrow Transplantation (BMT) model and flow cytometric (FCM) analyses were applied to assay endothelial progenitor cells (EPCs) mobilization. Quantitative Real-Time Reverse Transcription Polymerase Chain Reaction (qRT-PCR), Western blotting and enzyme-linked immunosorbent assay (ELISA) were performed to detect the expressions of vascular endothelial growth factor (VEGF), kinase domain region (KDR), phosphorylated-Akt (p-Akt), phosphorylated-eNOS (p-eNOS).ResultsNXT administration reduced myocardium fibrosis and increased myocardium capillary density in response to MI. NXT increased circulating Sca1⁺/ Fetal liver kinase 1 (Flk1)⁺ mononuclear cells (MNCs) and soluble Kit ligand (sKitL) of bone marrow (BM) in response to MI. In mice transplanted with green fluorescent protein (GFP) BM cells, NXT increased the numbers of GFP-positive cells at the border zone of the ischemic region in MI-induced mice. NXT increased the numbers of eNOS-expressing BM-derived cells in tissues, which was involved in increased the expressions of VEGF, KDR, p-eNOS, p-Akt in the myocardium.ConclusionNXT-mediated recovery in MI-induced mice was involved in mobilization and incorporation of bone marrow–derived EPCs/circulating angiogenic cells (CACs) leading to enhancement of neovascularization via VEGF/eNOS signaling.

Graphical abstract

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IFC (Journal of Ethnopharmacology)

Publication date: 17 August 2017
Source:Journal of Ethnopharmacology, Volume 208





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Corrigendum to A survey of herbal weeds that are used to treat gastrointestinal disorders from southern Thailand: Krabi and Songkhla provinces [Journal of Ethnopharmacology 196 (2017) 84–93]

Publication date: 14 September 2017
Source:Journal of Ethnopharmacology, Volume 209





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A novel mutation in the COL2A1 gene in a patient with Stickler syndrome type 1: a case report and review of the literature

Stickler syndrome is a group of collagenopathies characterized by ophthalmic, skeletal, and orofacial abnormalities, with the degree of symptoms varying among patients. Mutations in the COL2A1, COL11A1, and COL11...

http://ift.tt/2w6o6AB

Comment on: Impact of pneumococcal conjugate vaccine in children morbidity and mortality in Peru: Time series analysis

Publication date: 5 September 2017
Source:Vaccine, Volume 35, Issue 37
Author(s): Daniel Curcio, Alejandro Cané, Norka Napuri




http://ift.tt/2w5GIR0

Editorial Board/Aims and Scope

Publication date: 5 September 2017
Source:Vaccine, Volume 35, Issue 37





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Insulin-like growth factor binding protein-1 (IGFBP-1) upregulated by Helicobacter pylori and is associated with gastric cancer cells migration

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Caifeng Luo, Fengying Sun, Hong Zhu, Ying Ni, Jian Fang, Yun Liu, Shihe Shao, Hongxing Shen, Jianpeng Hu
Insulin-like growth factor binding protein-1 (IGFBP-1), a secreted protein, implicated of various cells in mediating the proliferation, migration, invasion, adhesion, survival and so on. In this study, we assessed the expression and release of IGFBP-1 from gastric cancer cells with H. pylori 26695 infection and the biological functions of IGFBP-1 in gastric cancer cells. The results showed that the expression and release of IGFBP-1 were increased in gastric cancer cells (MGC-803, BGC-823, SGC-7901) infected with H. pylori 26695. In addition, the upregulation of IGFBP-1 was dose-dependent in BGC-823 cells infected with H. pylori 26695 but not time-dependent. The upregulation of IGFBP-1 got to peak at 12h after H. pylori 26695 infection and then decreased over time. Subsequently, we measured its functions by silencing and overexpressing IGFBP1 which suggested that overexpression of IGFBP-1 could inhibit the migration of BGC-823 and SGC-7901 cells. However, knocking down the IGFBP-1 could increase the migration of BGC-823 and SGC-7901 cells. Functional findings illustrated that IGFBP-1 was implicated in H. pylori 26695-induced MMP-9 expression in BGC-823 cells. In addition, overexpressing IGFBP1 reduce the promoting effect of MMP-9 on the BGC-823 cells migration. In summary, we demonstrated that IGFBP-1 suppress the migration of BGC-823 cells and play a protective role in the process of H. pylori-induced gastric cancer.

Graphical abstract

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Acquisition of histologic diversity contributes to not only invasiveness but also lymph node metastasis in early gastric cancer

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Hyoun Wook Lee, Kyungeun Kim
BackgroundAs more endoscopic resections are performed in early gastric cancer, the pretreatment prediction of lymph node metastasis (LNM) becomes more important. Some tumor characteristics including histologic type, invasion depth, ulceration, size, and lymphovascular invasion have been used to determine the endoscopic resectability of early gastric cancer; however, a more detailed analysis between clinicopathologic factors and lymph node metastasis is needed.MethodsWe analyzed the correlation between the clinicopathological findings and LNM with 310 cases of early gastric cancer by dividing invasion depths in detail.ResultsLNM occurred in 3.2% and 16.2% of the T1a and T1b tumors, respectively. LNM was associated with invasion depth (p=0.002) and lymphatic (p<0.001) and perineural (p=0.013) invasion. Among them, lymphatic invasion was the most powerful factor associated with LNM and significantly constant in T1a and T1b. The rate of LNM increased gradually as the tumor invaded deeper, and invasion of the muscularis mucosae layer was associated with an increased mixed adenocarcinoma incidence, suggesting that histologic diversity was associated with tumor invasiveness.ConclusionsWe demonstrated that lymphatic invasion was the most important and powerful parameter for LNM in early gastric cancers. In addition, tumor invasiveness into the muscularis mucosae was accompanied by tumor histologic diversity.



http://ift.tt/2vfeO6n

Modulation of Galectin-3 and Galectin 9 in gastric mucosa of patients with chronic gastritis and positive Helicobacter pylori infection.

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Rayane Bernardes Estevam, Natalia Maria Jacom Wood da Silva, Emerson Abdulmassih Wood da Silva, Fernanda Machado Fonseca, Adriana Gonçalves de Oliveira, Ruchele Dias Nogueira Geraldo Martins, Sanívia Aparecida de Lima Pereira, Thiago Lima Pereira, Sheila Jorge Adad, Virmondes Rodrigues Júnior, Denise Bertulucci Rocha Rodrigues
OBJECTIVESGalectins are mediators that play an important role in the inflammatory response and in this study we analyzed the expression of Galectins (Gal) −1, −3 and −9 in biopsies of the gastric antrum of patients with upper gastrointestinal symptoms. Methodology: 44 patients with upper digestive tract symptoms were evaluated, and underwent Upper Digestive Endoscopy examination. Sections of the gastric antrum were fixed in buffered formaldehyde at 4% in order to perform the anatomopathological examination and immunohistochemical analysis for Galectins-1, −3 and −9 expression. Fresh sections of gastric antrum were used for DNA extraction and evaluation of Helicobacter pylori (H. pylori). P values<0.05 were considered statistically significant.RESULTSGal-1 was significantly more expressed on stroma than epithelium (p<0.0001), whereas Gal-3 and Gal-9 were more expressed on epithelium (p<0.0001). Gal-3 was found to be significantly higher in the stroma of patients with H. pylori infection, mainly on Cag-A positive H. pylori (p<0.0001). Gal-9 was down modulated in stroma of patients with chronic gastritis.CONCLUSIONUp modulation of Gal-3 expression was associated with H. pylori infection and down modulation of Gal-9 with the inflammatory process of chronic gastritis.



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Prognostic relevance of tripartite motif containing 24 expression in colorectal cancer

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Feng-Qin Wang, Yan Han, WenJuan Yao, Jing Yu
Colorectal cancer is one of the most frequent malignancies in the world. Tripartite motif containing 24 (TRIM24) is a member of the TRIM protein family and a coregulator for multiple nuclear receptors. Altered expression of TRIM24 has been shown in a spectrum of human cancers. However, the clinical role of TRIM24 in colorectal cancer remains unknown. Here, gene expression data in colorectal cancer and normal tissues were downloaded from Gene Expression Omnibus (GEO). Western blotting analysis was conducted to compare TRIM24 expression between colorectal cancer and non-cancerous tissues. Immunohistochemistry staining were performed to assess TRIM24 expression in colorectal cancer tissues, and statistical analyses were employed to evaluate the associations of TRIM24 expression with clinicopathologic features and overall survival. TRIM24 mRNA and protein levels were higher in colorectal cancer tissues than that in the normal controls. TRIM24 protein expression was positively correlated with tumor size (P=0.0269), clinical stage (P=0.0061), vital status (P=0.0110) and serum carcinoembryonic antigen levels (P=0.0176). Kaplan-Meier survival analysis indicated that patients with higher TRIM24 expression had shorter survival time than those with lower TRIM24 expression. Multivariate analyses revealed TRIM24 expression was an independent prognostic factor (P<0.001). In conclusion, our study suggests that TRIM24 may play a role in colorectal carcinogens and serve as a potential prognostic marker of human colorectal cancer.



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Melanotic MiT family translocation neoplasms: Expanding the clinical and molecular spectrum of this unique entity of tumors

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Rola M. Saleeb, John R. Srigley, Joan Sweet, Cedric Doucet, Virginie Royal, Ying-Bei Chen, Fadi Brimo, Andrew Evans
MiT family translocation tumors are a group of neoplasms characterized by translocations involving MiT family transcription factors. The translocation renal cell carcinomas, TFE3 (Xp11.2) and TFEB (t6;11) are known members of this family. Melanotic Xp11 translocation renal cancer is a more recently described entity. To date only 14 cases have been described. It is characterized by a distinct set of features including a nested epithelioid morphology, melanin pigmentation, labeling for markers of melanocytic differentiation, lack of labeling for markers of renal tubular differentiation, predominance in a younger age population and association with aggressive clinical behavior. There are noted similarities between that entity and TFE3 associated PEComas. There are no cases reported of equivalent melanotic TFEB translocation renal cancer. We report 2 rare cases of melanotic translocation renal neoplasms. The first is a melanotic TFE3 translocation renal cancer with an indolent clinical course, occurring in a patient more than 3-decades older than the usual average age in which such tumors have been described. The other case is, to our knowledge, the first reported melanotic TFEB translocation cancer of the kidney. Both cases exhibit the same H&E morphology as previously reported in melanotic translocation renal cancers and label accordingly with HMB45 and Melan-A. While the TFE3 melanotic tumor lacked any evidence of renal tubular differentiation, the TFEB melanotic cancer exhibited some staining for renal tubular markers. Based on the unique features noted above, these two cases expand the clinical and molecular spectrum of the melanotic translocation renal cancers.



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Expression of STIM1 is associated with tumor aggressiveness and poor prognosis in breast cancer

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Yanfang Yang, Zhansheng MM Jiang, Bin MM Wang, Lili Chang, Jun Liu, Lina Zhang, Lin Gu
STIM1 has been confirmed a key role involving in breast cancer proliferation and metastasis in vitro studies and its value in breast cancer patients is still to be defined. In this study, we investigate the correlation between STIM1 expressions with clinicopathologic features and prognosis quantified by disease-free survival (DFS) and overall survival (OS). To assess STIM1 expression, we conducted immunohistochemistry assays using breast cancer tissues encompassing a total of 165 breast cancer cases with detailed follow-up data and 40 cases of matched samples including cancer and adjacent normal tissues. STIM1 expression was present in 66.1% (109/165) of breast cancer cases which was significantly higher than adjacent non-tumor tissues. Larger tumors, lymphnode metastasis and negative estrogen receptor were positively associated with STIM1 overexpression. Furthermore, STIM1 expression was significantly associated with worse DFS (P=0.03) rather than OS in breast cancer patients.



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Immunohistochemical analysis of NKX2.2, ETV4, and BCOR in a large series of genetically confirmed Ewing sarcoma family of tumors

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Isidro Machado, Akihiko Yoshida, José Antonio López-Guerrero, María Gema Nieto, Samuel Navarro, Piero Picci, Antonio Llombart-Bosch
Ewing sarcoma is an aggressive neoplasm of pediatric and adolescent patients. Immunohistochemistry (IHC) can be used to support the morphologic diagnosis of Ewing sarcoma family of tumors (ESFT) in a convincing clinical/radiological context. Although neither NKX2.2 nor CD99 alone are entirely specific, when combined, the diagnostic specificity is high. The aim of the present study was to investigate the IHC expression of NKX2.2, ETV4 and BCOR in a large series of genetically confirmed ESFT. The results for CD99 and CAV-1 immunoreactivity, and the histological and fusion gene subtypes were retrieved from our previous study. NKX2.2 demonstrated moderate or strong nuclear positivity in 91.2% of the tumors. The staining intensity was heterogeneous. Many of the ESFT with negative NKX2.2 immunoreactivity were in bone. Strong/moderate ETV4 nuclear expression was detected in two small round cell tumors, both were negative for NKX2.2. No relationships could be found between expression of NKX2.2 and the histological subgroups or ESFT gene fusion subtypes. BCOR was negative in all ESFT. In conclusion, NKX2.2, ETV4 and BCOR IHC may be helpful in daily practice for distinguishing ESFT from CIC or BCOR-associated sarcomas, especially in hospitals without access to molecular assays. In addition, the combination of strong CD99 membranous positivity and nuclear NKX2.2 positivity seems to be very reliable for ESFT diagnosis in an appropriate clinicoradiological setting. So far no antibody is entirely specific for ESFT diagnosis, and the IHC or molecular results in round cell tumors of bone may be strongly influenced by decalcification processes.



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Correlation between HBV protein preS2 and tumor markers of hepatocellular carcinoma

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Fang Luan, Bin Liu, Junguo Zhang, Shiqing Cheng, Bingchang Zhang, Yong Wang
BackgroundAlpha-fetoprotein (AFP) and Glypican 3 (GPC3) are both oncogenes and reactivated in hepatocellular carcinoma (HCC). PreS2 has been proved to be an important transactivator in HCC. In this study, we aim to provide evidence that HBV protein preS2 is responsible for AFP and GPC3's reactivation in HCC.MethodsTotally Sixty-three cases of HCC, aged 34-79, who were surgically treated and pathologically confirmed were enrolled. The levels of AFP in peripheral serum were detected with electrochemical luminescence method before surgery. Levels of GPC3 in HCC samples were evaluated by immunohistochemistry. Luciferase reporter assays were used to measure the effect of preS2 on AFP and GPC3 promoters.ResultsAFP level and GPC3 but not albumin were significantly higher in preS2-positive HCC samples than preS2-negative HCC samples. And the preS2 protein expression was positively related with serum AFP level and GPC3 expression. Furtherly, dual luciferase assay showed that preS2 activated AFP and GPC3 promoter activity.ConclusionThe expression of preS2 protein relates closely to HCC markers AFP and GPC3.



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miR-155 targets Est-1 and induces ulcerative colitis via the IL-23/17/6-mediated Th17 pathway

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Jiangtao Hou, Bin Chen, Xueying Hu, Xu Chen, Lina Zhao, Zhuoqun Chen, Fengbin Liu, Zhihui Liu
BackgroundUlcerative colitis (UC) is a type of inflammatory bowel disease (IBD) affecting millions of people worldwide. miR-155 has been reported to be upregulated in various inflammatory diseases and is a positive regulator of the T-cell response. IL-17 secreting helper T (Th17) cells have been heavily implicated in tissue-specific immune pathology, including UC.Methods and resultsTherefore, we targeted miR-155 and investigated its expression levels in a DSS-induced UC mouse model, revealing increased expression. Est-1 expression was found to have decreased, but the levels of IL-23/17/6 were raised significantly and Th17 had experienced an obvious increase. We overexpressed miR-155 using a lentiviral treatment. Increased miR-155 expression induced a more severe damage to colon tissues. In this case, the level of Est-1 decreased even further, thereby enhancing IL-23/17/6-mediated Th17 differentiation.ConclusionmiR-155 seems to target Est-1 and induces UC via the IL-23/17/6-mediated Th17 pathway.



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p38MAPK family isoform p38α and activating transcription factor 2 are associated with the malignant phenotypes and poor prognosis of patients with ovarian adenocarcinoma

Publication date: Available online 25 August 2017
Source:Pathology - Research and Practice
Author(s): Wan-Juan Song, Yu Dong, Cheng Luo, Yuan-Yuan Chen
This study was to identify the biomarkers for the malignancy and poor prognosis in patients with ovarian cancer. The protein expression of p38MAPK family isoform p38α (p38α) and activating transcription factor 2 (ATF2) was measured in 120 ovarian serous adenocarcinomas and 34 normal fallopian tubes using immunohistochemistry. Stable OV-90 cells expressing p38α and ATF2 inhibitor were established using shRNA lentivirus. Cell proliferation, invasion, and migration were analyzed in vitro. Tumor growth and chemosensitivity were investigated in xenograft tumor models. The percentage of positive p38α and ATF2 expression was significantly higher in ovarian serous adenocarcinomas than that in normal fallopian tubes. Positive p38α and ATF2 expression were significantly associated with high clinical stage (III/IV), lymph node metastasis, and shorter overall survival. Silencing of p38α and ATF2 gene expression in OV-90 cells significantly inhibited cell proliferation, migration, and invasion in vitro. OV-90 cells with p38α and ATF2 gene being silenced grew significantly slow and were significantly sensitive to the chemotherapy compared to cells with high p38α and ATF2 expression. p38α and ATF2 expression play a crucial role in the malignant phenotypes of ovarian tumor cells and are a marker for the poor prognosis of patients with ovarian serous adenocarcinomas.



http://ift.tt/2vf9sIm

Extra-ocular movement restriction and diplopia following orbital fracture repair

To report a series of patients with extra-ocular movement restriction and diplopia after orbital fracture repair, and determine the effect of timing of repair and the type of implant used.

http://ift.tt/2gdCv8w

Comment on: “The outcomes of overlay myringoplasty: Endoscopic versus microscopic approach”

We would like to comment on the manuscript titled "The outcomes of overlay myringoplasty: Endoscopic versus microscopic approach" by Plodpai and Paje [1]. Endoscopic techniques have developed rapidly, as has surgical proficiency, and endoscopes are now widely used to perform myringoplasty, replacing traditional operating microscopes. The indications for endoscopic ear surgery have also increased in recent years. The authors compared the outcomes of overlay myringoplasty in patients treated via the endoscopic and microscopic approaches.

http://ift.tt/2w5XT4R

Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

Cutaneous angiosarcoma is a rare, but aggressive malignant vascular neoplasm arising from endothelial cells. Although it only accounts for less than 2% of soft tissue sarcomas and less than 1% of all head and neck malignancies [1], it is often seen in head and neck regions particularly of the scalp and face in individuals over 60years old. Its clinical presentation varies widely and typically deceiving, from bruise-like macule to benign capillary malformation and hemangioma-like lesion. Prognosis is poor due to its high rate of local recurrence and distant metastasis, with reported 5-year survival rate of approximately 10–34% [2].

http://ift.tt/2gdChhG

Survival trends in patients with tracheal carcinoma from 1973 to 2011

The prognosis for primary tracheal cancer is dismal. We investigated whether there has been improvement in survival in tracheal cancer patients and how treatment modality affected overall and cancer-specific survival.

http://ift.tt/2w6gJcp

Extra-ocular movement restriction and diplopia following orbital fracture repair

To report a series of patients with extra-ocular movement restriction and diplopia after orbital fracture repair, and determine the effect of timing of repair and the type of implant used.

http://ift.tt/2gdCv8w

Comment on: “The outcomes of overlay myringoplasty: Endoscopic versus microscopic approach”

We would like to comment on the manuscript titled "The outcomes of overlay myringoplasty: Endoscopic versus microscopic approach" by Plodpai and Paje [1]. Endoscopic techniques have developed rapidly, as has surgical proficiency, and endoscopes are now widely used to perform myringoplasty, replacing traditional operating microscopes. The indications for endoscopic ear surgery have also increased in recent years. The authors compared the outcomes of overlay myringoplasty in patients treated via the endoscopic and microscopic approaches.

http://ift.tt/2w5XT4R

Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

Cutaneous angiosarcoma is a rare, but aggressive malignant vascular neoplasm arising from endothelial cells. Although it only accounts for less than 2% of soft tissue sarcomas and less than 1% of all head and neck malignancies [1], it is often seen in head and neck regions particularly of the scalp and face in individuals over 60years old. Its clinical presentation varies widely and typically deceiving, from bruise-like macule to benign capillary malformation and hemangioma-like lesion. Prognosis is poor due to its high rate of local recurrence and distant metastasis, with reported 5-year survival rate of approximately 10–34% [2].

http://ift.tt/2gdChhG

Survival trends in patients with tracheal carcinoma from 1973 to 2011

The prognosis for primary tracheal cancer is dismal. We investigated whether there has been improvement in survival in tracheal cancer patients and how treatment modality affected overall and cancer-specific survival.

http://ift.tt/2w6gJcp

Calculation of 15N NMR chemical shifts: recent advances and perspectives

Publication date: Available online 24 August 2017
Source:Progress in Nuclear Magnetic Resonance Spectroscopy
Author(s): Leonid B. Krivdin
Recent advances in computation of ¹⁵N NMR chemical shifts are reviewed, concentrating mainly on practical aspects of computational protocols and accuracy factors. The review includes the discussion of the level of theory, the choice of density functionals and basis sets together with taking into account solvent effects, rovibrational corrections and relativistic effects. Computational aspects of ¹⁵N NMR are illustrated for the series of neutral and protonated open-chain nitrogen-containing compounds and nitrogen heterocycles, coordination and intermolecular complexes.

Graphical abstract

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Short communication: Delayed erythematous SKIN reaction with SERI(R)-ASSISTED Direct to implant breast reconstruction

Direct to implant reconstruction (DTI) using meshes following mastectomy is a safe and viable option for patients who require an alternative to autologous techniques (1). The surgical support scaffold, SERI (R) (Allergan Inc., USA) was designed to bridge the gap between synthetic and biological meshes in this field (2). It is made of the bioprotein, BIOSILK (C), purified from silk fibres and knitted into a 3D-scaffold. We present our short-term results for SERI(R)-assisted DTI reconstruction from a retrospective multi-centre case series.

http://ift.tt/2vxeMSy

Apelin attenuates TGF-β1-induced epithelial to mesenchymal transition via activation of PKC-ε in human renal tubular epithelial cells

Publication date: Available online 25 August 2017
Source:Peptides
Author(s): Li-Yan Wang, Zong-Li Diao, Jun-Fang Zheng, Yi-Ru Wu, Qi-Dong Zhang, Wen-Hu Liu
Epithelial to mesenchymal transition (EMT), a process whereby fully differentiated epithelial cells transition to a mesenchymal phenotype, has been implicated in the pathogenesis of renal fibrosis. Apelin, a bioactive peptide, has recently been recognized to protect against renal profibrotic activity, but the underlying mechanism has not yet been elucidated. In this study, we investigated the regulation of EMT in the presence of apelin-13 in vitro. Expression of the mesenchymal marker alpha-smooth muscle actin (α-SMA) and the epithelial marker E-cadherin was examined by immunofluorescence and western blotting in transforming growth factor beta 1 (TGF-β1)-stimulated human proximal tubular epithelial cells. Expression of extracellular matrix, fibronectin and collagen-I was examined by quantitative real-time PCR and ELISA. F13A, an antagonist of the apelin receptor APJ, and small interfering RNA targeting protein kinase C epsilon (PKC-ε) were used to explore the relevant signaling pathways. Apelin attenuated TGF-β1-induced EMT, and inhibited the EMT-associated increase in α-SMA, loss of E-cadherin, and secretion of extracellular matrix. Moreover, apelin activated PKC-ε in tubular epithelial cells, which in turn decreased phospho-Smad2/3 levels and increased Smad-7 levels. APJ inhibition or PKC-ε deletion diminished apelin-induced modulation of Smad signaling and suppression of tubular EMT. Our findings identify a novel PKC-ε-dependent mechanism in which apelin suppresses TGF-β1-mediated activation of Smad signaling pathways and thereby inhibits tubular EMT. These results suggest that apelin may be a new agent that can suppress renal fibrosis and retard chronic kidney disease progression.



http://ift.tt/2wGnEKI

Postoperative objective detecting techniques for cochlear implant children with inner ear malformation

This study aims to investigate the changing characteristics and rules of electrically-evoked auditory brainstem response (EABR), electrically-evoked stapedius reflex threshold (ESRT) and neural response telemetry (NRT) after cochlear implant in children with inner ear malformation, and guide postoperative equipment debug.

http://ift.tt/2xAptFF

Light-emitting diode aspiration: Distinct radiographic features and approach to management

Foreign body aspiration is a potentially life threatening problem. The successful removal of airway foreign bodies is dependent on positively identifying the object and developing a solution to its extraction prior to attempts at retrieval. Thus, pre-operative radiographic evaluation is essential in the diagnosis and management of foreign body aspiration. The current case report describes the unique challenges in the evaluation and management of an unusual foreign body within the airway. The distinctive radiographic appearance of this foreign body allows it to be easily identified pre-operatively, and this may decrease the likelihood of operative complications and patient morbidity.

http://ift.tt/2wGxzjk

Pediatric tympanic membrane cholesteatoma: Systematic review and meta-analysis

Tympanic membrane cholesteatoma (TMC) is a rare anomaly found in pediatric patients with no significant otologic history. Its pathogenesis appears distinct from congenital mesotympanic cholesteatoma. This systematic review and meta-analysis evaluates the management of TMC.

http://ift.tt/2xAKBLA

Sequential pediatric bilateral cochlear implantation: The effect of time interval between implants

To examine speech intelligibility in children subjected to sequential bilateral cochlear implants (CI) surgery and to assess the influence of the inter-stage interval duration.

http://ift.tt/2wGiAG4

Salivary cotinine levels in children with otolaryngological disorders

To determine if salivary cotinine, a biomarker for tobacco smoke exposure, is elevated more often or to a higher degree in children meeting criteria for tonsillectomy or tympanostomy tube insertion.

http://ift.tt/2xAHxPU

MOSAIC: a web-interface for statistical analyses in ecotoxicology

Abstract

In ecotoxicology, bioassays are standardly conducted in order to measure acute or chronic effects of potentially toxic substances on reproduction, growth, and/or survival of living animals. MOSAIC, standing for MOdeling and StAtistical tools for ecotoxICology, is a user-friendly web interface dedicated to the mathematical and statistical modelling of such standard bioassay data. Its simple use makes MOSAIC a turnkey decision-making tool for ecotoxicologists and regulators. Without wasting time on extensive mathematical and statistical technicalities, users are provided with advanced and innovative methods for a valuable quantitative environmental risk assessment. MOSAIC is available at http://ift.tt/2ixmY3Y.

http://ift.tt/2gcEYQk

FDA Approves Second Humira Biosimilar, Cyltezo

Adalimumab-adbm Cyltezo, from Boehringer Ingelheim, is approved for multiple indications including treatment of adults with moderate-to-severe active rheumatoid arthritis.
FDA Approvals

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Analysis of the Changing Patterns of Midface Fractures Using 3D Computed Tomography: An Observational Study

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1606250

This article aims to analyze the changing Le Fort fracture patterns using computed tomography (CT) scans with three-dimensional (3D) reconstruction. A prospective observational study was conducted on 60 patients with midface trauma, who had reported to MS Ramaiah Group of Hospitals, Bangalore, between January 2015 and October 2016. CT scans using 1.6 mm axial, sagittal, coronal sections were taken and their 3D reconstruction was made. The images were studied and compared with the standard Le Fort lines. The deviations from the classical Le Fort lines were analyzed and recorded. A note was also made of any additional fixation that was required for these deviations. Descriptive analysis was done and the results expressed in numbers and percentages. Study revealed that the most common cause for the midface fractures was found to be road traffic accidents (81.7%) with a male preponderance (88.3%) and peak incidence in 21 to 30 years of age (40%). Among the 60 patients, 18 (30%) patients had fracture patterns similar to the ideal Le Fort lines, 4 (6.6%) had a combination of Le Fort patterns, and 38 (66.3%) patients had deviations seen from the ideal Le Fort lines. Four types of deviations were recorded, namely, D1(60%), D2(5.4%), D3(10.9%), and D4(23.6%). It was observed that D1 and D3 required additional fixation. Majority of the cases presented as a deviation from ideal Le Fort fractures. CT was a valuable tool in the assessment of these fracture patterns. Deviations, if any, could be better analyzed using the 3D reconstruction images. Proper diagnosis and detection of these deviations make the planning for fixation easier. Repetition of these deviations could propose a newer or modified classification system for Le Fort fractures.
[...]

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Maxillomandibular Syngnathia: 3D Planning and Review of the Literature

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1606248

Congenital maxillomandibular fusion or syngnathia is a rare craniofacial disorder with only 26 cases reported in the literature. We present a case of a congenital complex zygomatico-mandibular syngnathia associated with a palatal cleft, posterior maxilla and turbinate agenesia, mild hemifacial microsomia, and a disordered dental eruption. The patient has the highest age (15 years) at diagnosis described in the literature. 3D planning of the surgery was performed to study the patient's anatomy and design the necessary osteotomies to separate the jaws. En bloc removal of the fused fragment with bilateral coronoidectomy and aggressive long-term physiotherapy for 3 months led to a stable increase in mouth opening from 0 to 21 mm inter-incisor distance. The patient reported an improvement in speech, was able to eat without restriction regarding food consistency, and could maintain a good oral hygiene.
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Temporoparietal Fascia Free Flap for Nasoseptal Perforation Repair

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1604425

Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard. We present a unique case of a 37-year-old woman with a 3.0 cm × 3.5 cm nasoseptal perforation secondary to cocaine use successfully reconstructed with a temporoparietal fascia free flap anastomosed to the facial artery and vein. Postoperatively, the patient had a well-healed septal defect from the free flap reconstruction This new technique shows promise as a feasible option for patients with large defects and for those with limited local reconstructive options. The ease of harvest and low donor-site morbidity make the temporoparietal fascia flap a suitable option for repair of complex nasoseptal defects.
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Comparison of Imaging Softwares for Upper Airway Evaluation: Preliminary Study

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1606247

The interest about upper airway evaluation has increased lately. Therefore, many softwares have been developed aiming to improve and facilitate the analysis of airway volume. The objective of this study was to compare two different softwares packages, Mimics and Dolphin, in their accuracy and precision in upper airway space measurements. Preoperative cone beam computed tomography scans of nine nonsyndromic patients submitted to surgically assisted rapid maxillary expansion were included in this study. The imaging exams were converted to DICOM (digital imaging and communications in medicine) files and imported to the softwares. The mean volume for the Dolphin group (G1) was 10.791 cm3 (SD = 4.269 cm3) and for the Mimics group (G2) was 10.553 cm3 (SD = 4.564 cm3). There was no statistically significant difference between the two groups (p = 0.105).
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Glossopharyngeal Nerve Block: The Premolar Approach

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1606249

This is a technical note describing hard tissue landmarks to simplify the intraoral glossopharyngeal nerve block. Our literature review revealed no specific mention of the same procedure in documented data.
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Strategy to identify the causes and to solve a sludge granulation problem in methanogenic reactors: application to a full-scale plant treating cheese wastewater

Abstract

Granulation of biomass is at the basis of the operation of the most successful anaerobic systems (UASB, EGSB and IC reactors) applied worldwide for wastewater treatment. Despite of decades of studies of the biomass granulation process, it is still not fully understood and controlled. "Degranulation/lack of granulation" is a problem that occurs sometimes in anaerobic systems resulting often in heavy loss of biomass and poor treatment efficiencies or even complete reactor failure. Such a problem occurred in Mexico in two full-scale UASB reactors treating cheese wastewater. A close follow-up of the plant was performed to try to identify the factors responsible for the phenomenon. Basically, the list of possible causes to a granulation problem that were investigated can be classified amongst nutritional, i.e. related to wastewater composition (e.g. deficiency or excess of macronutrients or micronutrients, too high COD proportion due to proteins or volatile fatty acids, high ammonium, sulphate or fat concentrations), operational (excessive loading rate, sub- or over-optimal water upflow velocity) and structural (poor hydraulic design of the plant). Despite of an intensive search, the causes of the granulation problems could not be identified. The present case remains however an example of the strategy that must be followed to identify these causes and could be used as a guide for plant operators or consultants who are confronted with a similar situation independently of the type of wastewater. According to a large literature based on successful experiments at lab scale, an attempt to artificially granulate the industrial reactor biomass through the dosage of a cationic polymer was also tested but equally failed. Instead of promoting granulation, the dosage caused a heavy sludge flotation. This shows that the scaling of such a procedure from lab to real scale cannot be advised right away unless its operability at such a scale can be demonstrated.

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Microvascular reactivity monitored with near-infrared spectroscopy is impaired after induction of anaesthesia in cardiac surgery patients: An observational study.

BACKGROUND: Induction of anaesthesia causes significant macrohaemodynamic changes, but little is known about its effects on the microcirculation. However, alterations in microvascular perfusion are known to be associated with impaired tissue oxygenation and organ dysfunction. Microvascular reactivity can be assessed with vascular occlusion testing, which evaluates the response of tissue oxygen saturation to transient ischaemia and reperfusion. OBJECTIVE: The aim of the current study was to evaluate the effects of an opioid-based anaesthesia induction on microvascular reactivity. We hypothesised that despite minimal blood pressure changes, microvascular function would be impaired. DESIGN: Prospective, observational study. SETTING: Single-centre, tertiary university teaching hospital, Belgium. PATIENTS: Thirty-five adult patients scheduled for elective coronary artery bypass grafting surgery. INTERVENTION: Microvascular reactivity was assessed before and 30 min after anaesthesia induction by means of vascular occlusion testing and near-infrared spectroscopy. MAIN OUTCOME MEASURES: Tissue oxygen saturations, desaturation rate, recovery time (time from release of cuff to the maximum value) and rate of recovery were determined. RESULTS: Data are expressed as median (minimum to maximum). Tissue oxygen saturation was higher after induction of anaesthesia [70 (54 to 78) vs. 73 (55 to 94)%, P = 0.015]. Oxygen consumption decreased after induction, appreciable by the higher minimum tissue oxygen saturation [45 (29 to 69) vs. 53 (28 to 81)%, P

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Research ethics committee approval as reported for abstracts submitted to the annual Euroanaesthesia meeting.

BACKGROUND: The annual congress of the European Society of Anaesthesiology (ESA) is one of the largest anaesthesia congresses in the world and exhibits more than 1200 abstracts annually. OBJECTIVES: The aims of this study were to quantify the frequency of inadequate evidence of ethical approval for abstracts submitted to the ESA congress and to examine whether abstracts without appropriate ethical approval were subsequently accepted. DESIGN AND SETTING: All abstracts submitted in 2015 were adjudicated according to European ethical criteria. MAIN OUTCOME MEASURE: The proportion of submitted abstracts that lacked evidence of appropriate ethics committee approval. Secondary outcomes included the proportion of accepted abstract that lacked evidence of appropriate ethical approval; the proportion of correctly identified case reports; the proportion of accepted abstracts that lacked evidence of appropriate ethics committee approvals corresponding to location (within/outside Europe); and the proportion of accepted abstracts that lacked evidence of appropriate ethics committee approvals corresponding to a specific area of research. RESULTS: In total, 1792 abstracts were reviewed and 1572 (87.7%) involved humans. In 527 (29.4%), the authors failed to demonstrate adequate ethical approval with higher rates in abstracts submitted from Europe (32.1%) than the rest of the world (23.5%), P

http://ift.tt/2xAugGO

Microvascular reactivity monitored with near-infrared spectroscopy is impaired after induction of anaesthesia in cardiac surgery patients: An observational study.

BACKGROUND: Induction of anaesthesia causes significant macrohaemodynamic changes, but little is known about its effects on the microcirculation. However, alterations in microvascular perfusion are known to be associated with impaired tissue oxygenation and organ dysfunction. Microvascular reactivity can be assessed with vascular occlusion testing, which evaluates the response of tissue oxygen saturation to transient ischaemia and reperfusion. OBJECTIVE: The aim of the current study was to evaluate the effects of an opioid-based anaesthesia induction on microvascular reactivity. We hypothesised that despite minimal blood pressure changes, microvascular function would be impaired. DESIGN: Prospective, observational study. SETTING: Single-centre, tertiary university teaching hospital, Belgium. PATIENTS: Thirty-five adult patients scheduled for elective coronary artery bypass grafting surgery. INTERVENTION: Microvascular reactivity was assessed before and 30 min after anaesthesia induction by means of vascular occlusion testing and near-infrared spectroscopy. MAIN OUTCOME MEASURES: Tissue oxygen saturations, desaturation rate, recovery time (time from release of cuff to the maximum value) and rate of recovery were determined. RESULTS: Data are expressed as median (minimum to maximum). Tissue oxygen saturation was higher after induction of anaesthesia [70 (54 to 78) vs. 73 (55 to 94)%, P = 0.015]. Oxygen consumption decreased after induction, appreciable by the higher minimum tissue oxygen saturation [45 (29 to 69) vs. 53 (28 to 81)%, P

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Research ethics committee approval as reported for abstracts submitted to the annual Euroanaesthesia meeting.

BACKGROUND: The annual congress of the European Society of Anaesthesiology (ESA) is one of the largest anaesthesia congresses in the world and exhibits more than 1200 abstracts annually. OBJECTIVES: The aims of this study were to quantify the frequency of inadequate evidence of ethical approval for abstracts submitted to the ESA congress and to examine whether abstracts without appropriate ethical approval were subsequently accepted. DESIGN AND SETTING: All abstracts submitted in 2015 were adjudicated according to European ethical criteria. MAIN OUTCOME MEASURE: The proportion of submitted abstracts that lacked evidence of appropriate ethics committee approval. Secondary outcomes included the proportion of accepted abstract that lacked evidence of appropriate ethical approval; the proportion of correctly identified case reports; the proportion of accepted abstracts that lacked evidence of appropriate ethics committee approvals corresponding to location (within/outside Europe); and the proportion of accepted abstracts that lacked evidence of appropriate ethics committee approvals corresponding to a specific area of research. RESULTS: In total, 1792 abstracts were reviewed and 1572 (87.7%) involved humans. In 527 (29.4%), the authors failed to demonstrate adequate ethical approval with higher rates in abstracts submitted from Europe (32.1%) than the rest of the world (23.5%), P

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Proteomic analysis reveals strong mitochondrial involvement in cytoplasmic male sterility of pepper (Capsicum annuum L.)

Publication date: Available online 25 August 2017
Source:Journal of Proteomics
Author(s): Jinju Guo, Peng Wang, Qing Cheng, Limin Sun, Hongyu Wang, Yutong Wang, Lina Kao, Yanan Li, Tuoyu Qiu, Wencai Yang, Huolin Shen
Although cytoplasmic male sterility (CMS) is widely used for developing pepper hybrids, its molecular mechanism remains unclear. In this study, we used a high-throughput proteomics method called label-free to compare protein abundance across a pepper CMS line (A-line) and its isogenic maintainer line (B-line). Data are available via ProteomeXchange with identifier PXD006104. Approximately 324 differentially abundant protein species were identified and quantified; among which, 47 were up-accumulated and 140 were down-accumulated in the A-line; additionally, 75 and 62 protein species were specifically accumulated in the A-line and B-line, respectively. Protein species involved in pollen exine formation, pyruvate metabolic processes, the tricarboxylic acid cycle, the mitochondrial electron transport chain, and oxidative stress response were observed to be differentially accumulated between A-line and B-line, suggesting their potential roles in the regulation of pepper pollen abortion. Based on our data, we proposed a potential regulatory network for pepper CMS that unifies these processes.Biological significanceArtificial emasculation is a major obstacle in pepper hybrid breeding for its high labor cost and poor seed purity. While the use of cytoplasmic male sterility (CMS) in hybrid system is seriously frustrated because a long time is needed to cultivate male sterility line and its isogenic restore line. Transgenic technology is an effective and rapid method to obtain male sterility lines and its widely application has very important significance in speeding up breeding process in pepper. Although numerous studies have been conducted to select the genes related to male sterility, the molecular mechanism of cytoplasmic male sterility in pepper remains unknown. In this study, we used the high-throughput proteomic method called "label-free", coupled with liquid chromatography-quadrupole mass spectrometry (LC–MS/MS), to perform a novel comparison of expression profiles in a CMS pepper line and its maintainer line. Based on our results, we proposed a potential regulated protein network involved in pollen development as a novel mechanism of pepper CMS.

Graphical abstract

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Calendar

Publication date: September 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 9





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Preoperative biliary drainage in hilar cholangiocarcinoma: Systematic review and meta-analysis

Publication date: September 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 9
Author(s): A. Celotti, L. Solaini, G. Montori, F. Coccolini, D. Tognali, G. Baiocchi
BackgroundThe role of preoperative biliary drainage (PBD) for hilar cholangiocarcinoma (HCC) remains unclear. The aim of this meta-analysis is to investigate the role of PBD in the treatment of potentially resectable HCC.MethodsAll studies reporting outcomes on patients with PBD vs without PBD were included. A systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies published between 1980 and 2016.ResultsInitial search identified 667 articles. Only 9 studies met the inclusion criteria and were included in this analysis. No significant differences in mortality were observed between the two groups (RR = 0,935; 95% CI = 0,612 to 1429; p = 0,463). Overall morbidity was significantly higher in PBD group (RR = 1266; 95% CI = 1039 to 1543; p = 0,011). No significant differences in transfusion rate, hospital stay, anastomotic leaks, abdominal collections and operative time, were found. Wound infections were significantly higher in PBD group.ConclusionsPBD seems to be associated with higher postoperative morbidity and increases the risk of wound infections. Further prospective studies are needed to better define the impact of PBD in outcomes after surgery for hilar cholangiocarcinoma.



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Editorial Board

Publication date: September 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 9





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Announcements

Publication date: September 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 9





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In vitro toxicity of perfluorooctane sulfonate on rat liver hepatocytes: probability of distructive binding to CYP 2E1 and involvement of cellular proteolysis

Abstract

Perfluorooctanesulfonate (PFOS), an anthropogenic fluorosurfactant, is one of the most common global pollutants. PFOS is used in various consumer products to provide soil, oil, and water resistance to materials used in clothing, upholstery, and food packaging. PFOS is persistent, bioaccumulative, and toxic to mammalian species. In this study, the cellular mechanisms involved in PFOS hepatotoxicity were evaluated. For this purpose, we determined oxidative stress markers including cell lysis, ROS generation, lipid peroxidation, glutathione depletion, mitochondrial membrane potential decrease, lysosomal membrane leakiness, and cellular proteolysis. Our results demonstrated that PFOS liver cytotoxicity was associated with reactive oxygen species (ROS) formation and lipid peroxidation in isolated rat hepatocytes. Incubation of hepatocytes with PFOS caused rapid depletion of hepatocyte glutathione (GSH), an important marker of cellular oxidative stress. Most of the PFOS-induced GSH depletion could be attributed to the expulsion of glutathione disulfide (GSSG). PFOS hepatotoxicity was inhibited by antioxidants and ROS scavengers, mitochondrial permeability transition (MPT) pore sealing agents, and endocytosis inhibitors. Our results suggest that PFOS hepatotoxicity might be the result of oxidative stress-induced lysosomal membrane leakiness and cellular proteolysis in rat hepatocytes.

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Agreement between Perometry and Sequential Arm Circumference Measurements in Objective Determination of Arm Volume

J reconstr Microsurg
DOI: 10.1055/s-0037-1606267

Background Limb circumference measurements (CM) and perometry are the preferred methods for objectively measuring arm volume in lymphedema surgery research. Understanding the measurement bias involved in these measuring systems is important to properly interpret and compare studies and their results. Methods Arm volumes from 91 patients were measured using sequential girths and the truncated cone formula (CM) and with the use of an automated perometer (perometry). The absolute volume of the largest arm (V), the volume difference between the arms (VD), and the relative difference between them (percentage of excess volume [PEV]) were calculated with both methods. The agreement between methods was assessed by the Pearson's correlation test and the Bland–Altman's method. Results Correlations were strong for V (r = 0.99), VD (r = 88), and PEV (r = 0.86). Volumes measured by perometry were, on average, 10.6 mL smaller than volumes calculated from CM, while their limits of agreement (LOA) ranged from −202 to 181 mL. The LOA represents the range we could expect the arm volumes measured with the two methods to differ by chance alone, 95% of the times. For VD, LOA was −101 to 141 mL, with a mean difference of 19.9 mL, while PEV had a mean difference of 0.9%, with LOA ranging from −5 to 6.8%. Conclusion There is considerable measurement error between arm volume estimated by perometry and by CM. Volumes calculated with these methods should be compared with caution. Furthermore, we observed an increasingly relevant measurement bias in outcomes that are mathematically derived from arm volumes.
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Repair of Craniomaxillofacial Traumatic Soft Tissue Defects With Tissue Expansion in the Early Stage.

Background: Craniomaxillofacial traumatic soft tissue defects severely affect the function and appearance of the patients. The traditional skin grafting or free flap transplantation can only close the defects in the early stage of operation but cannot ensure similar color, texture, and relative aesthetic contour. In the present study, the authors have explored a novel strategy to repair craniomaxillofacial traumatic soft tissue defects by tissue expansion in the early stage and have obtained satisfactory results. Methods: Eighteen patients suffering large craniomaxillofacial traumatic soft tissue defects were treated by thorough debridement leaving the wounds unclosed or simply closed with thin split-thickness scalp grafts, adjacent expander implantation in the first stage, and expanded flap transposition in the second stage. Results: There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years (mean, 19.4 +/- 12.2 years), with average 15 months follow-up (range, 3-67 months). The average expansion time was 74.3 days (range, 53-96 days). The 18 patients with a total of 22 expanders were treated with satisfactory results. All the flaps survived and the skin color, texture, and contour well matched those of the peripheral tissue. Only 1 complication of infection happened in the 18 cases (5.56%) and the 22 expanders (4.55%), which was similar to the rate reported in the literature. No other complications related to the expanders occurred. Conclusion: Debridement and tissue expansion in the early stage has been proved to be a more effective strategy to repair craniomaxillofacial traumatic soft tissue defects. This strategy can not only achieve satisfactory color, unbulky and well-matched texture similar to normal, but also avoid unnecessary donor site injuries. (C) 2017 by Mutaz B. Habal, MD.

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Myocutaneous Gracilis Free Flaps in Microsurgical Breast Reconstruction: A Systematic Review Comparing Variations of the Upper Gracilis Flap

J reconstr Microsurg
DOI: 10.1055/s-0037-1604439

Background The transverse upper gracilis (TUG) flap has gained increasing acceptance as a reliable option for breast reconstruction, specifically in patients without adequate abdominal tissue. Three major flap designs of the upper gracilis flap have been proposed to balance volume needs with flap vascularity. A systematic review was performed to identify outcomes of the major gracilis flaps: TUG, vertical-transverse upper gracilis (V-TUG), and longitudinal gracilis myocutaneous (LGM) flaps. This study is the first and only systematic review to date reviewing the variations of the upper gracilis flap in microsurgical breast reconstruction. Methods A systematic review of the literature was conducted using PubMed database from 1966 through 2015. Inclusion and exclusion criteria were applied. Outcomes assessed included total flap volumes, additional breast procedures to achieve intended breast volume, and complication rates. Results A total of 485 gracilis-type flaps were performed in 335 patients. V-TUG flaps provided the largest mean flap weights and did not require additional lipofilling or implant placement, whereas the majority of TUG flaps (50.6%) required additional fat grafting or implant placements. All flap types demonstrated a low incidence of donor-site morbidity. Overall flap loss rate was low; TUG flaps reported 2.3% total and 2.0% partial flap losses, while V-TUG and LGM flaps reported no flap losses. Conclusion This review found V-TUG yielded highest mean flap weights and did not require additional breast augmentation procedures as compared with the TUG. Also, the V-TUG was a safer donor-site option with fewer flap and donor-site morbidities.
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Comprehensive Treatment of Primary Orbital Arteriovenous Malformation.

Primary orbital arteriovenous malformations are a rare kind of vascular malformation lesions. The authors present a 17-year-old man presented with swelling and pulsation in the left upper eyelid. The angiogram of the left internal carotid artery showed that arteriovenous malformations at the left upper eyelid area were supplied with one of the branches of ophthalmic artery. In this report, the authors elaborated the comprehensive treatments of primary arteriovenous malformation. (C) 2017 by Mutaz B. Habal, MD.

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Evaluation of Palatal Bone thickness for Insertion of Orthodontic Mini-Implants in Adults and Adolescents.

Objective: The aim of this study was to measure palatal bone thickness and select relatively safe regions for mini-implant insertion, and to determine the effect of age and sex on palatal bone thickness and whether there is any difference between right and left sides. Materials and Methods: Cone beam computed tomographic (CBCT) evaluation was used on 107 healthy orthodontic patients, including 51 adolescents (12.90 +/- 1.71 years) and 56 adults (26.09 +/- 4.35 years), who were selected from the Zhongshan Hospital, Fudan University (Shanghai, China). Seventy-two sites of bone thickness were measured in the palate. Intragroup, intergroup, and sex differences were analyzed by repeated measures analysis of variance. Results: Palatal bone thickness exhibited significant differences in 3 anteroposterior areas of the 2 groups. From anterior to posterior region, palatal bone thickness gradually decreased. Meanwhile, on the sagittal plane, palatal bone thickness decreased gradually from reference line 0 to 9 mm among adults, and from reference line 0 to 12 mm among adolescents posterior to the level of the posterior rim of the incisive foramen. However, on the coronal plane, no significant differences were found in the palatal bone thickness among reference lines 2, 4, 6, and 8 mm lateral to the midpalatal suture. Nor were there differences between right and left sides, between adults and adolescents or between males and females. Conclusions: In terms of bone thickness, the anterior region is relatively safe for orthodontic mini-implant insertion. However, since subjects vary greatly, CBCT scans are needed before undertaking mini-implant insertion. (C) 2017 by Mutaz B. Habal, MD.

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Neurotization of the Superficial Sensory Branch of Ulnar Nerve by the Distal Posterior Interosseous Nerve: Cadaveric Feasibility Study

J reconstr Microsurg
DOI: 10.1055/s-0037-1605365

Background In 2014, Delclaux et al described a case wherein the Battiston and Lanzetta's technique, modified by utilization of the posterior interosseus nerve (PIN), was used to perform double neurotization of the ulnar nerve (UN). This study evaluates the feasibility of transfer of proprioceptive fascicles of the PIN to the superficial sensory branch of the UN (SSBUN). Methods The surgeries were performed on 16 fresh cadaveric wrist specimens. PIN transfer was performed through the interosseous membrane and sutured to the SSBUN. The diameter for each nerve, number of fascicles, and the percentage of fascicles without axons, under ×10, ×40, and ×100 magnifications were performed by two observers. Results Neurotization of the SSBUN by the PIN was successful in all cases. The median diameter of the SSBUN and PIN was 3.5 (3–4) and 2.3 mm (1.6–3), respectively. The SSBUN contained 5.5 fascicles (4–7), while the PIN contained 2 fascicles (0–4). The 16 PIN had limited (10 cases) or no axonal reserve (6 cases). Conclusion This study supports the surgical and anatomical feasibility of neurotization of the SSBUN by the PIN. However, the PIN's limited axonal reserve may partially or totally compromise recovery.
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Global Medical Cooperation With the East and West: Achieve Excellence in Craniofacial Surgery.

No abstract available

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Intracranial Enterogenous Cysts Close to the Brainstem Treated Through the Nerve Endoscope.

Enterogenous cysts (ECs) are rare, inborn lesions of central nervous system, which mostly occurred in the ventral side of the spinal cord as well as common in children; adult intracranial cysts are rare. Although the morbidity of intracranial ECs is quite low, we also can make a preliminary diagnosis of those patients with the help of imaging examination. In this article, we introduced 1 case of ECs ventral to the brainstem, which present images on magnetic resonance imaging as hypointense lesions on T1-weighted and high-intensity mass on T2-weighted image. In consideration of the difficulty of the surgical approach and the surgical visual field exposure, we use microscope and nerve endoscope to design personalized surgical approach to minimize the surgical injury. Pathologic examination showed that it was typical EC. Not only is the location extremely rare, but also the surgical method is uncommon in this disease. We not only study the intracranial ECs' manifestations, but also discuss the surgical approach and the application of nerve endoscope of our choice,which aims to provides a new surgical therapeutic approach for these lesions. (C) 2017 by Mutaz B. Habal, MD.

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Comment on Chlorhexidine Keratitis

No abstract available

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Commentary on The Clinical and Histological Effect of a Low-Fluence Q-Switched 1,064-nm Neodymium: Yttrium-Aluminum-Garnet Laser for the Treatment of Melasma and Solar Lentigenes in Asians

No abstract available

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A Two-Phase Pilot Study to Evaluate the Safety and Tolerability of an In Situ Polymerizing Collagen

BACKGROUND: Demand for collagen-based fillers has declined primarily because of limited long-term clinical benefit and the introduction of hyaluronic acid compositions. In situ polymerizing collagen is a noncrosslinked solution of porcine collagen containing a collagenase shield that undergoes fibrillogenesis on injected into tissues forming a natural matrix. OBJECTIVE: Conduct a prospective, single-center, dual-phase open-label study in 8 subjects to evaluate the safety, tolerability, and efficacy of the porcine collagen composition. METHODS: In Phase I, potential hypersensitivity of the collagen composition was evaluated after skin testing in the back (men) or forearms of subjects (women). In Phase II, subjects showing no signs of hypersensitivity received collagen injections into the nasolabial area followed by evaluation at 1, 4, 8, and 12 weeks using the Global Aesthetic Improvement Scale. RESULTS: None of the subjects had signs of hypersensitivity and all continued in Phase II. The treating physician(s) reported no post-treatment adverse events. Improvement of the nasolabial fold was observed by the physicians and confirmed by assessment of high-resolution photographs and Global Aesthetic Improvement Scale scores over the 12-week treatment were maintained. CONCLUSION: In this pilot clinical study in situ polymerizing collagen was shown to be safe and effective throughout the 3-month study period.

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Treatment of Facial Acne Scarring With Fractional Carbon Dioxide Laser in Asians, a Retrospective Analysis of Efficacy and Complications

BACKGROUND: Fractional carbon dioxide (CO2) laser resurfacing unites the idea of fractional photothermolysis with an ablative 10,600-nm wavelength. This technology permits effective treatment of acne scarring, with shorter recovery and a decreased side effect profile as compared to traditional CO2 laser resurfacing. OBJECTIVE: The aims of this study were to study the efficacy and safety of fractional CO2 laser for acne scars in Asian patients. METHODS: This was a retrospective study of all patients treated with the fractional CO2 laser for facial acne scarring between January 2, 2008, and December 31, 2010, at the National Skin Centre, Singapore. Data reviewed included sex, age, and severity of acne, type of scarring, previous treatment history, frequency of treatments, adverse events, and efficacy. RESULTS: Two hundred and ten fractional CO2 laser treatments for facial acne scars were performed on 107 patients (65 men and 42 women, Fitzpatrick skin Types II to V) during the study period. Sixteen of 107 patients experienced (15.0%) adverse events. The adverse events include hyperpigmentation (6.4%), blistering (4.0%), crusting (2.9%), aggravation of inflammatory acne lesions (1.7%), and scarring (0.6%). There were no reported side effects of hypopigmentation, bacterial or viral infection. Follow-up results after final laser treatment showed that 66.4% of patients reported Grade 1 skin texture improvement, that is, 75% improvement (n = 1). CONCLUSION: The study demonstrated the efficacy and safety of a fractional CO2 laser in the treatment of acne scars in Asian. Future studies are required to establish optimum treatment parameters and achieve better clinical results.

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Sebaceous Carcinoma Arising Within a Nevus Sebaceus Excised by Mohs Micrographic Surgery

No abstract available

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A 30-Minute, Monthly, Live, Webinar-Based Journal Club Activity Alters the Self-Reported Behaviors of Dermatologic Surgeons

BACKGROUND: Journal clubs provide a way to communicate advances in recent literature. In outpatient surgical subspecialties, such as dermatologic surgery, physicians may face challenges in finding or attending meetings pertinent to their practice. OBJECTIVE: To assess the utility of a live web-based journal club in dermatologic surgery. MATERIALS AND METHODS: Monthly 30-minute journal club sessions covering 5 to 6 scholarly articles. Anonymous surveys were used to evaluate the utility and self-reported learning associated with each meeting. RESULTS: From December 2012 to February 2015, 117 articles were reviewed. Survey data were acquired monthly, apart from 5 months of missing data. On average, the survey response rate was 37% (range: 7%–82%), with an average of 17 participants per monthly session (range: 9–25). The mean monthly usefulness score was 83.7 (101-point scale), with participants scoring their likelihood of returning in the future as 96.2 (0 = not likely, 100 = extremely likely). At each session, a mean of 68% of participants felt that at least one article would change their practice of medicine. CONCLUSION: A monthly online and telephonic journal club may be a practical and effective way to inform dermatologic surgeons of new developments in high impact literature and may influence improvements in individual practice.

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Neuropraxia of the Spinal Accessory Nerve After Mohs Micrographic Surgery

No abstract available

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Commentary on A 30-Minute, Monthly, Live, Webinar-Based Journal Club Activity Alters the Self-Reported Behaviors of Dermatologic Surgeons

No abstract available

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Repair of a Large, Full-Thickness Defect of the Lower Lip Under Local Anesthesia

No abstract available

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The Use of a Fresh-Tissue Cadaver Model for the Instruction of Dermatological Procedures: A Laboratory Study for Training Medical Students

BACKGROUND: A realistic model for the instruction of basic dermatologic procedural skills was developed, while simultaneously increasing medical student exposure to the field of dermatology. OBJECTIVE: The primary purpose of the authors' study was to evaluate the utilization of a fresh-tissue cadaver model (FTCM) as a method for the instruction of common dermatologic procedures. The authors' secondary aim was to assess students' perceived clinical skills and overall perception of the field of dermatology after the lab. METHODS: Nineteen first- and second-year medical students were pre- and post-tested on their ability to perform punch and excisional biopsies on a fresh-tissue cadaver. Students were then surveyed on their experience. RESULTS: Assessment of the cognitive knowledge gain and technical skills revealed a statistically significant improvement in all categories (p

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Commentary on Chlorhexidine Keratitis

No abstract available

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Toenail Bracing Complicated With Group-A Beta-Haemolytic Streptococcus Infection

No abstract available

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Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids

BACKGROUND/OBJECTIVE: Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing. MATERIALS AND METHODS: Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects. RESULTS: Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence. CONCLUSION: Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.

http://ift.tt/2gd95al

Large Elliptical Specimens and the Single Section Method

No abstract available

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Treatment of Actinic Keratoses: A Randomized Split-Site Approach Comparison of Sequential 5-Fluorouracil and 5-Aminolevulinic Acid Photodynamic Therapy to 5-Aminolevulinic Acid Photodynamic Monotherapy

BACKGROUND: Actinic keratoses (AKs) are skin lesions resulting from sun exposure and carry a risk of developing into squamous cell carcinoma. Current therapies for AK eradication include topical 5-fluorouracil (5-FU) and photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA). However, sequential therapy with 5-FU-ALA-PDT may offer improved outcome compared to ALA-PDT alone. OBJECTIVE: The purpose of this study is to compare the long-term efficacy of AK clearance by sequential therapy with 5-FU-ALA-PDT versus ALA-PDT alone. MATERIALS AND METHODS: This is a single center, randomized split-site approach study on equivalent anatomical and clinical sites. Seventeen patients were enrolled with one half of the site randomized to receive sequential 5-FU-ALA-PDT and the other side with ALA-PDT monotherapy. Total AKs were counted at baseline, 6 and 12 months. RESULTS: Median percentage reduction in AK number at 6 months for 5-FU-ALA-PDT versus ALA-PDT was 100% for 5-FU-ALA-PDT (N = 21) and 66.7% for ALA-PDT (N = 21), p = .001. Median percentage reduction in AK number at 12 months for 5-FU-ALA-PDT versus ALA-PDT was 100% for 5-FU-ALA-PDT (N = 22) and 82.6% for ALA-PDT (N = 22), p = .0002. CONCLUSION: Sequential therapy with 5-FU-ALA-PDT is more effective at AK clearance at 6 and 12 months compared to ALA-PDT monotherapy.

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Novel Camera Mounting Technique for Dermatologic Surgeries

No abstract available

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A prodrug design for improved oral absorption and reduced hepatic interaction

Publication date: Available online 24 August 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Gulzar Ahmed, Walter Elger, Frederick Meece, Hareesh B. Nair, Birgitt Schneider, Ralf Wyrwa, Klaus Nickisch
A series of estradiol-17-β esters of N-(p-sulfomylbenzamide)-amino acids were prepared and evaluated for systemic and hepatic estrogenic activity after oral administration in ovariectomized rats. The alkyl substitution at nitrogen of amino acids such as proline or N-methyl-alanine produced compounds that exhibit potent oral activity. The proline analog (EC508) was further evaluated along with 17 β -estradiol (E2) and ethinyl-estradiol (EE) and compared their effects on the uterus, angiotensin and HDL-cholesterol after oral administration to ovariectomized female rats. Orally administered EC508 produced systemic estrogenic activity 10 times greater than EE and a 100 times higher activity than E2 with no influence on levels of angiotensin and HDL-cholesterol, whereas EE and E2 reduced the HDL-cholesterol and increased the angiotensine plasma levels. EC 508 might offer significant advantages in indications like fertility control and HRT based on its high oral bioavailability and lack of hepatic estrogenicity.

Graphical abstract

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Endogenous spatial attention directed to intracutaneous electrical stimuli on the forearms involves an external reference frame

Publication date: Available online 25 August 2017
Source:International Journal of Psychophysiology
Author(s): Jorian H.G. Blom, Rob H.J. Van der Lubbe
In the present study, we examined whether the direction of attention while anticipating intracutaneous electrical stimuli on the left or right forearm occurs within an internal somatotopic or an external body-based reference frame. Participants placed their hands on a table in front of them in a normal position or in a crossed-hands position. A symbolic cue with a validity of 80% instructed participants to attend to either the left or the right side, which varied from trial to trial. Crossing the hands induces a conflict of internal and external reference frames which allows to determine the dominating reference frame(s). Analyses of the electroencephalogram (EEG) during the orienting phase revealed that crossing the arms did not induce a reversal of neural activity over central sites as a late direction attention-related positivity and increased ipsilateral alpha power over occipital and central sites was observed in both conditions. Hand position influenced the processing of the electrical stimuli as no effect of cue validity was observed on the P3a component in the crossed-hands position. Our results indicate that endogenous spatial attention to intracutaneous electrical stimuli primarily occurs within an external reference frame.



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Ultrasensitive electrochemical detection of tumor cells based on multiple layer CdS quantum dots-functionalized polystyrene microspheres and graphene oxide – polyaniline composite

Publication date: 15 February 2018
Source:Biosensors and Bioelectronics, Volume 100
Author(s): Jidong Wang, Xiaoyu Wang, Hengshan Tang, Zehua Gao, Shengquan He, Jian Li, Shumin Han
In this work, a novel ultrasensitive electrochemical biosensor was developed for the detection of K562 cell by a signal amplification strategy based on multiple layer CdS QDs functionalized polystyrene microspheres(PS) as bioprobe and graphene oxide(GO) -polyaniline(PANI) composite as modified materials of capture electrode. Due to electrostatic force of different charge, CdS QDs were decorated on the surface of PS by PDDA (poly(diallyldimethyl-ammonium chloride)) through a layer-by-layer(LBL) assemble technology, in which the structure of multiple layer CdS QDs increased the detection signal intensity. Moreover, GO-PANI composite not only enhanced the electron transfer rate, but also increased tumor cells load ratio. The resulting electrochemical biosensor was used to detect K562 cells with a lower detection limit of 3 cellsmL⁻¹ (S/N = 3) and a wider linear range from 10 to 1.0 × 10⁷ cellsmL⁻¹. This sensor was also used for mannosyl groups on HeLa cells and Hct116 cells, which showed high specificity and sensitivity. This signal amplification strategy would provide a novel approach for detection, diagnosis and treatment for tumor cells.



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Funnel-like Intima After Blunt Aortic Injury

Publication date: Available online 25 August 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): R. Zhang, R. Zeng




http://ift.tt/2vwXc18

Human Frequency Following Responses to Vocoded Speech

Objectives: Vocoders offer an effective platform to simulate the effects of cochlear implant speech processing strategies in normal-hearing listeners. Several behavioral studies have examined the effects of varying spectral and temporal cues on vocoded speech perception; however, little is known about the neural indices of vocoded speech perception. Here, the scalp-recorded frequency following response (FFR) was used to study the effects of varying spectral and temporal cues on brainstem neural representation of specific acoustic cues, the temporal envelope periodicity related to fundamental frequency (F0) and temporal fine structure (TFS) related to formant and formant-related frequencies, as reflected in the phase-locked neural activity in response to vocoded speech. Design: In experiment 1, FFRs were measured in 12 normal-hearing, adult listeners in response to a steady state English back vowel /u/ presented in an unaltered, unprocessed condition and six sine-vocoder conditions with varying numbers of channels (1, 2, 4, 8, 16, and 32), while the temporal envelope cutoff frequency was fixed at 500 Hz. In experiment 2, FFRs were obtained from 14 normal-hearing, adult listeners in response to the same English vowel /u/, presented in an unprocessed condition and four vocoded conditions where both the temporal envelope cutoff frequency (50 versus 500 Hz) and carrier type (sine wave versus noise band) were varied separately with the number of channels fixed at 8. Fast Fourier Transform was applied to the time waveforms of FFR to analyze the strength of brainstem neural representation of temporal envelope periodicity (F0) and TFS-related peaks (formant structure). Results: Brainstem neural representation of both temporal envelope and TFS cues improved when the number of channels increased from 1 to 4, followed by a plateau with 8 and 16 channels, and a reduction in phase-locking strength with 32 channels. For the sine vocoders, peaks in the FFRTFS spectra corresponded with the low-frequency sine-wave carriers and side band frequencies in the stimulus spectra. When the temporal envelope cutoff frequency increased from 50 to 500 Hz, an improvement was observed in brainstem F0 representation with no change in brainstem representation of spectral peaks proximal to the first formant frequency (F1). There was no significant effect of carrier type (sine- versus noise-vocoder) on brainstem neural representation of F0 cues when the temporal envelope cutoff frequency was 500 Hz. Conclusions: While the improvement in neural representation of temporal envelope and TFS cues with up to 4 vocoder channels is consistent with the behavioral literature, the reduced neural phase-locking strength noted with even more channels may be because of the narrow bandwidth of each channel as the number of channels increases. Stronger neural representation of temporal envelope cues with higher temporal envelope cutoff frequencies is likely a reflection of brainstem neural phase-locking to F0-related periodicity fluctuations preserved in the 500-Hz temporal envelopes, which are unavailable in the 50-Hz temporal envelopes. No effect of temporal envelope cutoff frequency was seen for neural representation of TFS cues, suggesting that spectral side band frequencies created by the 500-Hz temporal envelopes did not improve neural representation of F1 cues over the 50-Hz temporal envelopes. Finally, brainstem F0 representation was not significantly affected by carrier type with a temporal envelope cutoff frequency of 500 Hz, which is inconsistent with previous results of behavioral studies examining pitch perception of vocoded stimuli.

http://ift.tt/2wOknbs

Hearing Threshold Shifts Among 11- to 35-Year-Olds With Early Hearing Impairment

Objectives: Data obtained from the clinical records of selected 11- to 35-year-olds with preadult onset hearing impairment were analyzed with 2 primary aims: (1) to determine the incidence of hearing threshold level (HTL) shift in this cohort and, (2) to examine the relationship between HTL shift, whole-of-life noise exposure, and other factors. Design: Cross-sectional cohort study. Retrospective HTL + survey data for a sample of 237 young Australians receiving hearing (re)habilitation services were obtained. From these data, two subsets, (A) n = 127 and (B) n = 79, were analyzed. Participants with risk factors for progressive hearing loss (other than noise exposure) were excluded from both subsets. Subset (A) additionally excluded cochlear implant recipients, and subset (B) excluded cases with diagnosis of hearing loss after age 5 years. Using subset (A) data, the differences between final (recent) and specified baseline (initial) HTLs at 250, 500, 1000, 2000, and 4000 Hz were calculated and three criteria for HTL shift were applied. Correlations between reported noise exposure and HTL shift were calculated (Mann–Whitney U test). Using subset (B) data, relationships between high frequency (HF) HTL shift and exposure, and other personal and extrinsic factors were examined (Cox Regression model). Survival analyses (Kaplan–Meier) were performed to reveal the temporal pattern of HF shift. The magnitude of HF shifts at 5, 10, and 15 years post initial (i.e., specified baseline) audiogram were also calculated. Results: For subset (A), HTL shift (≥15 dB any frequency, and/or ≥10 dB* at two adjacent frequencies) was observed in 46.5% of cases examined. HF shift (≥15 dB at 2000 and/or 4000 Hz; one or both ears) was observed in 33.1% of cases. There was no relationship between HTL shift and reported whole-of-life exposure. For subset (B), no relationship was found between HF shift and noise exposure, nor 9 of 10 personal or extrinsic covariates tested. HF shift was significantly associated with HTL ≥ 70 dB at 2000 and/or 4000 Hz at initial audiogram. Survival analysis also illustrated that HF shift was more frequent, and occurred earlier, when HF hearing loss was ≥70 dB at initial audiogram. Median HF shifts at 15 years after initial audiogram were in the magnitude of 5 to 10 dB, and at the 90th percentile were 25 to 30 dB. Conclusions: HTL shift was observed in almost 50% of cases without predisposing factors for progressive hearing loss. The magnitude of HF shift increased gradually over time. While no relationship was found between HTL shift and noise exposure, the interpretation of this finding is restrained by the small spread of whole-of-life noise exposures, within a relatively conservative range. Nevertheless, this is the first direct examination of the relationship between HTL shift and noise exposure in young people with preadult hearing impairment.

http://ift.tt/2wO1Yvp

Combined Electric and Acoustic Stimulation With Hearing Preservation: Effect of Cochlear Implant Low-Frequency Cutoff on Speech Understanding and Perceived Listening Difficulty

Objective: The primary objective of this study was to assess the effect of electric and acoustic overlap for speech understanding in typical listening conditions using semidiffuse noise. Design: This study used a within-subjects, repeated measures design including 11 experienced adult implant recipients (13 ears) with functional residual hearing in the implanted and nonimplanted ear. The aided acoustic bandwidth was fixed and the low-frequency cutoff for the cochlear implant (CI) was varied systematically. Assessments were completed in the R-SPACE sound-simulation system which includes a semidiffuse restaurant noise originating from eight loudspeakers placed circumferentially about the subject's head. AzBio sentences were presented at 67 dBA with signal to noise ratio varying between +10 and 0 dB determined individually to yield approximately 50 to 60% correct for the CI-alone condition with full CI bandwidth. Listening conditions for all subjects included CI alone, bimodal (CI + contralateral hearing aid), and bilateral-aided electric and acoustic stimulation (EAS; CI + bilateral hearing aid). Low-frequency cutoffs both below and above the original "clinical software recommendation" frequency were tested for all patients, in all conditions. Subjects estimated listening difficulty for all conditions using listener ratings based on a visual analog scale. Results: Three primary findings were that (1) there was statistically significant benefit of preserved acoustic hearing in the implanted ear for most overlap conditions, (2) the default clinical software recommendation rarely yielded the highest level of speech recognition (1 of 13 ears), and (3) greater EAS overlap than that provided by the clinical recommendation yielded significant improvements in speech understanding. Conclusions: For standard-electrode CI recipients with preserved hearing, spectral overlap of acoustic and electric stimuli yielded significantly better speech understanding and less listening effort in a laboratory-based, restaurant-noise simulation. In conclusion, EAS patients may derive more benefit from greater acoustic and electric overlap than given in current software fitting recommendations, which are based solely on audiometric threshold. These data have larger scientific implications, as previous studies may not have assessed outcomes with optimized EAS parameters, thereby underestimating the benefit afforded by hearing preservation.

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Binaural Interaction Effects of 30–50 Hz Auditory Steady State Responses

Objectives: Auditory stimuli modulated by modulation frequencies within the 30 to 50 Hz region evoke auditory steady state responses (ASSRs) with high signal to noise ratios in adults, and can be used to determine the frequency-specific hearing thresholds of adults who are unable to give behavioral feedback reliably. To measure ASSRs as efficiently as possible a multiple stimulus paradigm can be used, stimulating both ears simultaneously. The response strength of 30 to 50Hz ASSRs is, however, affected when both ears are stimulated simultaneously. The aim of the present study is to gain insight in the measurement efficiency of 30 to 50 Hz ASSRs evoked with a 2-ear stimulation paradigm, by systematically investigating the binaural interaction effects of 30 to 50 Hz ASSRs in normal-hearing adults. Design: ASSRs were obtained with a 64-channel EEG system in 23 normal-hearing adults. All participants participated in one diotic, multiple dichotic, and multiple monaural conditions. Stimuli consisted of a modulated one-octave noise band, centered at 1 kHz, and presented at 70 dB SPL. The diotic condition contained 40 Hz modulated stimuli presented to both ears. In the dichotic conditions, the modulation frequency of the left ear stimulus was kept constant at 40 Hz, while the stimulus at the right ear was either the unmodulated or modulated carrier. In case of the modulated carrier, the modulation frequency varied between 30 and 50 Hz in steps of 2 Hz across conditions. The monaural conditions consisted of all stimuli included in the diotic and dichotic conditions. Results: Modulation frequencies ≥36 Hz resulted in prominent ASSRs in all participants for the monaural conditions. A significant enhancement effect was observed (average: ~3 dB) in the diotic condition, whereas a significant reduction effect was observed in the dichotic conditions. There was no distinct effect of the temporal characteristics of the stimuli on the amount of reduction. The attenuation was in 33% of the cases >3 dB for ASSRs evoked with modulation frequencies ≥40 Hz and 50% for ASSRs evoked with modulation frequencies ≤36 Hz. Conclusions: Binaural interaction effects as observed in the diotic condition are similar to the binaural interaction effects of middle latency responses as reported in the literature, suggesting that these responses share a same underlying mechanism. Our data also indicated that 30 to 50 Hz ASSRs are attenuated when presented dichotically and that this attenuation is independent of the stimulus characteristics as used in the present study. These findings are important as they give insight in how binaural interaction affects the measurement efficiency. The 2-ear stimulation paradigm of the present study was, for the most optimal modulation frequencies (i.e., ≥40 Hz), more efficient than a 1-ear sequential stimulation paradigm in 66% of the cases.

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Pre- and Postoperative Binaural Unmasking for Bimodal Cochlear Implant Listeners

Objectives: Cochlear implants (CIs) are increasingly recommended to individuals with residual bilateral acoustic hearing. Although new hearing-preserving electrode designs and surgical approaches show great promise, CI recipients are still at risk to lose acoustic hearing in the implanted ear, which could prevent the ability to take advantage of binaural unmasking to aid speech recognition in noise. This study examined the tradeoff between the benefits of a CI for speech understanding in noise and the potential loss of binaural unmasking for CI recipients with some bilateral preoperative acoustic hearing. Design: Binaural unmasking is difficult to evaluate in CI candidates because speech perception in noise is generally too poor to measure reliably in the range of signal to noise ratios (SNRs) where binaural intelligibility level differences (BILDs) are typically observed (

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Comment on Ohlenforst et al. (2016) Exploring the Relationship Between Working Memory, Compressor Speed, and Background Noise Characteristics, Ear Hear 37, 137–143

No abstract available

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Listening Effort Through Depth of Processing in School-Age Children

Objectives: A reliable and practical measure of listening effort is crucial in the aural rehabilitation of children with communication disorders. In this article, we propose a novel behavioral paradigm designed to measure listening effort in school-age children based on different depths and levels of verbal processing. The paradigm consists of a classic word recognition task performed in quiet and in noise coupled to one of three additional tasks asking the children to judge the color of simple pictures or a certain semantic category of the presented words. The response time (RT) from the categorization tasks is considered the primary indicator of listening effort. Design: The listening effort paradigm was evaluated in a group of 31 normal-hearing, normal-developing children 7 to 12 years of age. A total of 146 Dutch nouns were selected for the experiment after surveying 14 local Dutch-speaking children. Windows-based custom software was developed to administer the behavioral paradigm from a conventional laptop computer. A separate touch screen was used as a response interface to gather the RT data from the participants. Verbal repetition of each presented word was scored by the tester and a percentage-correct word recognition score (WRS) was calculated for each condition. Randomized lists of target words were presented in one of three signal to noise ratios (SNR) to examine the effect of background noise on the two outcome measures of WRS and RT. Three novel categorization tasks, each corresponding to a different depth or elaboration level of semantic processing, were developed to examine the effect of processing level on either WRS or RT. It was hypothesized that, while listening effort as measured by RT would be affected by both noise and processing level, WRS performance would be affected by changes in noise level only. The RT measure was also hypothesized to increase more from an increase in noise level in categorization conditions demanding a deeper or more elaborate form of semantic processing. Results: There was a significant effect of SNR level on school-age children's WRS: their word recognition performance tended to decrease with increasing background noise level. However, depth of processing did not seem to affect WRS. Moreover, a repeated-measure analysis of variance fitted to transformed RT data revealed that this measure of listening effort in normal-hearing school-age children was significantly affected by both SNR level and the depth of semantic processing. There was no significant interaction between noise level and the type of categorization task with regard to RT. Conclusions: The observed patterns of WRS and RT supported the hypotheses regarding the effects of background noise and depth of processing on word recognition performance and a behavioral measure of listening effort. The magnitude of noise-induced change in RT did not differ between categorization tasks, however. Our findings point to future research directions regarding the potential effects of age, working memory capacity, and cross-modality interaction when measuring listening effort in different levels of semantic processing.

http://ift.tt/2wO7Yo4

Burden of Hearing Loss on Communication Partners and Its Influence on Pursuit of Hearing Evaluation

Objective: Describe how the burden on the communication partner (CP) from the patient's hearing loss, as perceived by both the patient and their CP, influences a patient's pursuit of hearing evaluation. Design: Cross-sectional design. Demographics, perception of patient's hearing loss, and associated burden on the CP were collected from both patient and CP via online questionnaires. Patients and their CPs from Duke University Medical Center Otolaryngology Clinic, 55 to 75 years of age, being seen for any reason, who indicated a CP has expressed concern about their hearing. Final sample was 245 matched pairs. Results: Based on completed questionnaires, on average, patients perceived their own hearing loss as more burdensome to the CP than the CP did. However, CPs of patients who believed themselves to have no hearing handicap scored the patient's hearing loss 54.3% higher than the patient. The patient's perspective about the amount of burden their hearing loss placed on the CP predicted patients seeking a hearing evaluation. Conclusions: Recognition of early stage hearing loss and associated burden on CPs may be delayed in patients; CPs may help elucidate unrecognized concerns. Educational approaches that raise awareness of burden of hearing loss on CPs along with hearing loss indications could be a feasible, multidimensional strategy to promote help seeking behaviors.

http://ift.tt/2wOGAWQ