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

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Κυριακή 4 Ιουλίου 2021

MiR-181a-5p Regulates NIS Expression in Papillary Thyroid Carcinoma

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Int J Mol Sci. 2021 Jun 4;22(11):6067. doi: 10.3390/ijms22116067.

ABSTRACT

NIS is a potent iodide transporter encoded by the SLC5A5 gene. Its expression is reduced in papillary thyroid carcinoma (PTC). In this study we analyzed the impact of miR-181a-5p on NIS expression in the context of PTC. We used real-time PCR to analyze the expression of SLC5A5 and miR-181a-5p in 49 PTC/normal tissue pairs. Luciferase assays and mutagenesis were performed to confirm direct bindi ng of miR-181a-5p to the 3'UTR of SLC5A5 and identify the binding site. The impact of modulation of miR-181a-5p using appropriate plasmids on endogenous NIS and radioactive iodine accumulation was verified. We confirmed downregulation of SLC5A5 and concomitant upregulation of miR-181a-5p in PTC. Broadly used algorithms did not predict the binding site of miR-181a-5p in 3'UTR of SLC5A5, but we identified and confirmed the binding site through mutagenesis using luciferase assays. In MCF7 and HEK293-flhNIS cell lines, transfection with mir-181a-expressing plasmid decreased endogenous SLC5A5, whereas silencing of miR-181a-5p increased it. We observed similar tendencies in protein expression and radioactive iodine accumulation. This study shows for the first time that miR-181a-5p directly regulates SLC5A5 expression in the context of PTC and may decrease efficacy of radioiodine treatment. Accordingly, miR-181a-5p may serve as an emerging target to enhan ce the efficacy of radioactive iodine therapy.

PMID:34199867 | DOI:10.3390/ijms22116067

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Oncocytic Papillary Carcinoma in an Autonomous Thyroid Nodule

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Am J Case Rep. 2021 Jul 2;22:e931757. doi: 10.12659/AJCR.931757.

ABSTRACT

BACKGROUND Thyroid nodules are a common cause of neck swelling in clinical practice, even in iodine-sufficient communities. Most nodules are benign, but malignancy cannot be excluded. The majority of thyroid cancers occur in nonfunctioning nodules, but in rare cases they can present as an autonomous nodule. Papillary carcinoma, the most common type of thyroid malignancy, typically spreads quickly to local lym ph nodes; however, current guidelines do not recommend biopsy of autonomous thyroid nodules. Early detection and surgical intervention can be curative in many of these cases. CASE REPORT This present case involved a woman in her early 30s who presented with an enlarging neck mass. Ultrasound demonstrated a unilateral right thyroid mass, and blood work showed triiodothyronine thyrotoxicosis. Thyroid scintigraphy was performed and showed unilateral increased uptake on the right side. The patient was treated initially with a thyroid lobectomy. Intraoperative frozen sectioning of the removed specimen showed papillary thyroid carcinoma, and a total thyroidectomy was performed. Radioactive iodine ablation therapy was not done, but given the patient's history and risk factors, recurrence of her disease is unlikely. CONCLUSIONS The vast majority of autonomous thyroid nodules are noncancerous. However, patients should be informed of the possibility of malignancy, and cancer should be ruled o ut clinically. Papillary thyroid carcinoma accounts for the majority of tumors in both hot and cold nodules. However, the oncocytic subtype seen in the patient in this report is less common, presents a higher risk of recurrence, and typically occurs in older patients. Thyroidectomy is usually curative for patients with papillary thyroid carcinoma.

PMID:34210951 | DOI:10.12659/AJCR.931757

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Oral secretory leukocyte protease inhibitor (SLPI): Associations with oropharyngeal cancer and treatment outcome

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by Brittney L. Dickey, Bradley Sirak, Laura Martin-Gomez, Richard R. Reich, Martha Abrahamsen, Kimberly Isaacs-Soriano, Christine H. Chung, Anna R. Giuliano

Background

Rates of oropharyngeal cancer (OPC) associated with alcohol & tobacco use have decreased, while human papillomavirus (HPV) associated OPC has increased among men in the US. Secretory leukocyte protease inhibitor (SLPI), detectable in a variety of secretions, has been implicated in cancers of the head and neck, associated with tumor progression and anti-viral activity. Using the recently verified oral gargle specimen, this study aimed to assess the association of salivary SLPI expression with risk of OPC and response to treatment.

Methods

A case-control study design compared levels of salivary SLPI among OPC cases to age and tobacco smoking matched healthy controls. Oral HPV DNA and SLPI was quantified from oral gargle specimens. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations of oral SLPI and risk of OPC and treatment outcomes.

Results

In crude and adjusted analyses of 96 OPC cases and 97 age- and smoki ng-matched controls, OPC was not significantly associated with oral gargle SLPI levels. Among cases, oral SLPI was associated with tonsillectomy (p = 0.018) and among controls oral SLPI was associated with HPV in the oral gargle (p = 0.008). Higher concentrations of SLPI was significantly associated with increased odds of incomplete treatment response (T2: OR: 12.39; 95% CI: 1.44–106.72; T3: OR: 9.86; 95% CI: 1.13–85.90) among all cases, but not among P16+ cases.

Conclusions

Salivary SLPI was not associated with OPC risk but was associated with higher odds of an incomplete treatment response.

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A Novel Combined Transorbital Transnasal Endoscopic Approach for Reconstruction of Posttraumatic Complex Anterior Cranial Fossa Defect

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Asian J Neurosurg. 2021 Mar 20;16(1):136-140. doi: 10.4103/ajns.AJNS_363_20. eCollection 2021 Jan-Mar.

ABSTRACT

The transorbital neuroendoscopic surgery (TONES), endoscopic transnasal skull base procedures, and the concept of multiportal minimal access neurosurgery are novel, rapidly evolving approaches in the management of complex skull base lesions. A 27-year-old male presented with a history of road traffic accident with nasal bleed, cerebrospinal fluid (CSF) rhinorrhea, and left eye deformity. There was left upper eyelid ecchymosis, orbital dystopia, left pupil was dilated, and fixed with no extraocular movements. The computed tomography scan showed basifrontal contusion and complex comminuted anterior cranial fossa (ACF) fracture involving left cribriform plate and left orbital roof with fracture fragment impinging on the superior rectus muscle with suspicious orbital CSF leak. There was no improvement with conservative management. Hence , a novel combined TONES, transnasal endoscopic multiportal surgery was undertaken for the removal of fracture fragments and multi-layered closure of the complex ACF defect. The patient had a complete resolution of orbital dystopia and visual loss with no evidence of CSF leak postoperatively.

PMID:34211881 | PMC:PMC8202373 | DOI:10.4103/ajns.AJNS_363_20

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Olfactory Fossa Evaluation as a Maxillary Sinus Development Using Cone Beam Computed Tomography

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Abstract

In our study, we aimed to evaluate the risk of skull base perforation during endoscopic sinus surgery in individuals with hypoplasic maxillary sinuses using Cone Beam Computed Tomography (CBCT). We included 52 patients with bilateral maxillary sinus hypoplasia and 52 patients with normal maxillary sinus in the study. Reviewing paranasal CBCT scans, we noted the olfactory fossa depths and lateral lamella lengths of all the groups and compared between the hypoplasia groups and the control group. Compared the maxillary hypoplasia sinus individuals with the control group, both the olfactory fossa depths and the lateral lamina length were different in the maxillary hypoplasic individuals. In individuals with hypoplasic maxillary sinus, the olfactory fossa depth and the lateral lamina length values are higher, which increases the risk of complications in endoscopic sinus surgery.

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Mammary Analogue Secretory Carcinoma of Submandibular Gland: A Case Report with Review of the Literature

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Abstract

Secretory carcinoma (SC) is a rare salivary gland tumor and has been recently included in the fourth edition of the World Health Organization classification of head and neck tumors. To understand the histopathologic findings and clinical behavior of mammary analogue secretory carcinoma (MASC) of the submandibular gland in a 23 year old female. MASC is an intriguing and rare malignant salivary gland tumor first described in 2010. It shares histologic, immunohistochemical and genetic features with secretory carcinoma of the breast. The clinical behavior of MASC ranges from slowly growing tumors to aggressive tumors that can cause widespread metastasis. Many cases of MASC were discovered in archived cases previously classified as pleomorphic adenoma, acinic cell carcinoma, mucoepidermoid carcinoma, and adenocarcinoma. They are only a few reported in submandibular gland. MASC is a newly recognized variant of salivary gland malignancy. Further research is needed to better delineate its overall prevalence and to define an appropriate treatment algorithm for this new clinical entity.

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Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB)

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Eur Arch Otorhinolaryngol. 2021 Jul 1. doi: 10.1007/s00405-021-06959-3. Online ahead of print.

ABSTRACT

PURPOSE: Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fine-needle aspiration biopsy (FNAB) showing WT.

METHODS: We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach-immediate surgery, follow-up or surgery and follow-up.

RESULTS: 323 patients were diagnosed with WT and met the study's inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their first detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range - 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and definitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic findings at their next control. The mean observation time was 44.7 months (range 12-138 months) in patients followed exclusively at our institution and 50.9 months (range 12-110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients' place of residence.

CONCLUSION: Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT.

PMID:34212241 | DOI:10.1007/s00405-021-06959-3

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Effect of cisplatin chemotherapy on the inner ear function and serum prestin concentration

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Eur Arch Otorhinolaryngol. 2021 Jul 2. doi: 10.1007/s00405-021-06967-3. Online ahead of print.

ABSTRACT

PURPOSE: One of the main side effects of chemotherapy with cisplatin is irreversible sensorineural hearing loss. This study was conducted to assess the correlation between the serum prestin concentration as a potential cochlear biomarker and audiologic findings in patients after cisplatin chemotherapy.

METHODS: A total of 52 patients aged 18-75 years were included in this prospective study. All the subjects were recruited from the radiotherapy and oncology center of a tertiary hospital in Rasht, Iran. Audiologic parameters evaluations and serum prestin concentrations were measured at baseline and after 1-3 weeks of chemotherapy. The inner ear function was evaluated by pure-tone audiometry (PTA) and distortion product of otoacoustic emission (DPOAE). A repeated-measure analysis of variance was performed to evaluate the relations hip between the PTA, DPOAE, serum prestin concentration and cumulative cisplatin dose.

RESULTS: Fifty-two patients (36 females) participated in this study. The PTA results showed that ototoxicity was more frequent among the patients with a high cumulative dose of cisplatin (χ2 trend = 15.25; P < 0.001). DPOAE responses revealed that 38.5% of the patients had ototoxicity change after 40-80 mg of cisplatin administration. After receiving 40-80 mg of cisplatin, serum prestin concentration increased from 130 to 230 pg/ml. There is a significant positive correlation between prestin concentration after receiving more than 80 mg of cisplatin and the ototoxic changes in the DPOAE response.

CONCLUSION: The present study showed correlations between prestin concentrations and ototoxicity diagnosis by DPOAE findings. An early rise in prestin concentration is particularly important and an early sign of hearing loss. Future studies are recommended to investigate the effect of vary ing doses of cisplatin on prestin concentration and any association between ototoxicity and clinicopathological features.

PMID:34213608 | DOI:10.1007/s00405-021-06967-3

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Discrepancies between UICC and AJCC TNM classifications for oral cavity tumors in the 8th editions and following versions

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Eur Arch Otorhinolaryngol. 2021 Jul 2. doi: 10.1007/s00405-021-06964-6. Online ahead of print.

ABSTRACT

PURPOSE: To underline discrepancies between the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) classifications in oral cavity cancer.

METHODS: Comparison between the UICC and AJCC TNM classifications of oral cavity cancer in their 8th editions and following versions.

RESULTS: The most important update was the introduction of the depth of infiltration (DOI), which reflects the proximity of the tumor to the underlying lymphovascular tissues and was associated to the presence of nodal metastases. Since the first publication of the 8th edition of the AJCC Cancer Staging Manual on March 30, 2017, two further versions have been published, while the UICC TNM classification was left unchanged until a document containing modifications to the 8th edition o f the UICC TNM Classification of Malignant Tumours was published online on October 6, 2020.

CONCLUSION: Different versions of the TNM classification can be confounding for the scientific community. Citing the 8th edition of the UICC TNM Classification of Malignant Tumours or the AJCC Cancer Staging Manual without specifying the precise version used for classification may be insufficient. Clinicians and researchers are invited to always refer to the latest update of each classification.

PMID:34213607 | DOI:10.1007/s00405-021-06964-6

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Evaluation of a non-personalized optopalatographic device for prospective use in functional post-stroke dysphagia therapy

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IEEE Trans Biomed Eng. 2021 Jul 2;PP. doi: 10.1109/TBME.2021.3094415. Online ahead of print.

ABSTRACT

OBJECTIVE: Stroke survivors commonly suffer from dysphagia, originating from oro-facial impairments which affect swallowing function. Functional therapy often employs tongue exercises that require the patient to perform short motion sequences. Evaluating the patients performance on those exercises is difficult, because there is no reliable form of visual feedback.

METHODS: We propose an optopalatographic device that does not require a personalized dental retainer and is capable of measuring tongue movement trajectories intraorally. The device features nine optical proximity sensors at 100 Hz and is fixated against the hard palate with a specifically developed palatal adhesive. The sensing capabilities of the device were evaluated on a tongue gesture corpus recorded from nine healthy individuals, containing eight different tongue exercises commonly used in functional dysphagia therapy.

RESULTS: The measured tongue trajectories contained temporally and spatially resolved information about the tongue movement and location during each exercise. Furthermore, a simple DTW-kNN classifier was able to distinguish the exercises from one another with an average classification accuracy of 97.9 % and 61.4 % (cross-validation and inter-speaker test accuracy, respectively).

CONCLUSION: the device can provide real-time feedback for tongue motion and we obta ined promising gesture recognition results with relatively few sensors, even in the absence of a personalized dental retainer.

SIGNIFICANCE: Non-personalized optopalatography is readily available and could aid in improving functional dysphagia therapy by providing visual feedback to both the physician and patient.

PMID:34214033 | DOI:10.1109/TBME.2021.3094415

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Noninvasive, objective evaluation of lower extremity lymphedema severity using shear wave elastography: A preliminary study

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J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00265-5. doi: 10.1016/j.bjps.2021.05.013. Online ahead of print.

ABSTRACT

BACKGROUND: Increased skin and subcutaneous tissue stiffness in patients with early-stage lymphedema has been reported. The purpose of this study was to examine the use of shear wave elastography (SWE) for evaluating lower extremity lymphedema (LEL).

METHODS: For 10 lower extremities of normal controls and 72 limbs of patients with gynecological cancer whose lymphatic function was categorized into six stages based on the range of dermal backflow (DBF) observed in indocyanine green (ICG) lymphography, SWE was performed and shear wave velocity (SWV) of the dermis and three layers of subcutaneous tissue at the thigh and calf were recorded. Twenty-five patients underwent thigh tissue histological and dermal thickness examinations.

RESULTS: The strongest correlation between the ICG DBF stage and SWV d uring SWE was observed on the dermal layer of the thigh (p < 0.01, R = 0.67). There was a significant correlation between the dermal thickness of the thigh and the ICG DBF stage (p < 0.01, R = 0.87) and also between the dermal thickness of the thigh and SWV (p < 0.01, R = 0.73).

CONCLUSION: Noninvasive, objective evaluation of LEL severity using SWE was well correlated with lymphatic function as determined by ICG lymphography. The DBF changes in the dermis of the thigh best reflected the changes in lymphatic function. Dermal thickness variations may partially account for differences in SWV.

PMID:34215544 | DOI:10.1016/j.bjps.2021.05.013

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