Angioedema attacks related to endometrial hyperplasia in a case of estrogen-dependent factor XII hereditary angioedema

Hereditary angioedema (HAE) with normal C1-esterase inhibitor (C1-INH) is characterized by recurrent skin or mucosal angioedema attacks, lack of urticaria, and nonresponsiveness to antihistamines and corticosteroids, affecting mainly women with family history of angioedema and no C1-INH abnormalities.1–3 Missense mutations in the coagulation factor XII (FXII) gene (mainly Thr328Lys and Thr328Arg) have been associated with this type of HAE, causing an increase in FXII activity and leading to enhanced bradykinin production.

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Angioedema attacks related to endometrial hyperplasia in a case of estrogen-dependent factor XII hereditary angioedema

Hereditary angioedema (HAE) with normal C1-esterase inhibitor (C1-INH) is characterized by recurrent skin or mucosal angioedema attacks, lack of urticaria, and nonresponsiveness to antihistamines and corticosteroids, affecting mainly women with family history of angioedema and no C1-INH abnormalities.1–3 Missense mutations in the coagulation factor XII (FXII) gene (mainly Thr328Lys and Thr328Arg) have been associated with this type of HAE, causing an increase in FXII activity and leading to enhanced bradykinin production.

http://ift.tt/2qqko2H

Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1601884

The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16.4 ± 1.5 years) compared with patients without IR palsy (12.4 ±3.3 years), had significantly (p < 0.05) worse preoperative motility, and had significantly greater proportion developing postoperative hypertropia (100%) compared with patients without IR palsy (4.7%). Our series of pediatric blowout fractures demonstrated IR palsy prevalence and clinical features for IR palsy which may be distinct to the pediatric group.
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Surgical Anatomy of the Cervical Part of the Hypoglossal Nerve

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1601863

Iatrogenic injuries to cranial nerves, half of which affect the hypoglossal nerve, occur in up to 20% of surgical procedures involving the neck. The risk of injury could be minimized by in-depth knowledge of its positional and relational anatomy. Forty-one hypoglossal nerves were dissected from cadaveric specimens and positions described in relation to the internal carotid artery (ICA), external carotid artery (ECA), carotid bifurcation, mandible, hyoid bone, mastoid process, and the digastric tendon. The distance of the nerve from where it crossed the ICA and ECA to the carotid bifurcation was 29.93 (±5.99) mm and 15.19 (±6.68) mm, respectively. The point where it crossed the ICA was 12.24 (±3.71) mm superior to the greater horn of hyoid, 17.16 (±4.40) mm inferior to the angle of the mandible, and 39.08 (±5.69) mm from tip of the mastoid. The hypoglossal nerve loop was inferior to the digastric tendon in 73% of the cases. The hypoglossal nerves formed high loops in this study population. Caution should be exercised during surgical procedures in the neck. The study also revealed that the mastoid process is a reliable fixed landmark to locate the hypoglossal nerve.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

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Reenergizing T cell anti-tumor immunity by harnessing immunometabolic checkpoints and machineries

Ping-Chih Ho | Susan M Kaech

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The role of AMPK in T cell metabolism and function

Eric H Ma | Maya C Poffenberger | Alison H-T Wong | Russell G Jones

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Novel application of a rigid curved larygno-pharyngoscope for examination and treatment of hypopharyngeal lesions

Publication date: Available online 2 May 2017
Source:Auris Nasus Larynx
Author(s): Kenichi Watanabe, Daisuke Yamauchi, Yoshitaka Takanashi, Hiroshi Hidaka, Yukio Katori
In endoscopic laryngo-pharyngeal surgery (ELPS), a rigid curved laryngo-pharyngoscope, which was invented by Dr. Sato et al., is necessary to obtain excellent surgical view of both hypopharynx and even the entrance of the esophagus. We have used this instrument for the examination and treatment of several diseases other than cancer located in the hypopharynx, such as difficult-to-find buried fish bones, retropharyngeal abscess, and congenital pyriform sinus fistula. In the result, we could acquire better view of hypopharynx and completed the intended procedure safely, especially for uncovering difficult-to-find fish bone buried in the mucosa. Even in the cases hardly to operate under this instrument, just use for detailed observation of the lesion was available. A rigid curved laryngo-pharyngoscope provides a wide and clear view of a challenging space, the hypopharynx. We recommend using this technique in cases such as difficult-to-find buried fish bones or retropharyngeal abscesses while avoiding a neck incision.



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