Head and Neck Diseases by Alexandros G.Sfakianakis: 12/25/15

Παρασκευή 25 Δεκεμβρίου 2015

Effects of zinc sulfate supplementation on cell-mediated immune response in head and neck cancer patients treated with radiation therapy.

Effects of zinc sulfate supplementation on cell-mediated immune response in head and neck cancer patients treated with radiation therapy.

Nutr Cancer. 2015;67(3):449-56

Authors: Sangthawan D, Phungrassami T, Sinkitjarurnchai W

Abstract
Zinc deficiency is an important factor that impairs cellular immunity and contributes to low T lymphocyte counts in head and neck cancers. Persistent T lymphopenia is clinically relevant in terms of tumor persistence and/or recurrence. The primary objective was to evaluate the impact of zinc sulfate supplementation on the absolute numbers of circulating T lymphocytes and T lymphocyte subpopulations. The secondary objectives were to evaluate overall survival, progression-free survival, and the adverse events of zinc sulfate. Seventy-two head and neck cancer patients were enrolled in a randomized, double-blind, placebo-controlled trial. Zinc sulfate 50 mg in 10 cc and an identically appearing placebo were self-administered 3 times daily at meal times. Blood samples were obtained for complete blood count, total T lymphocytes and T lymphocyte subpopulations before radiation therapy as baselines, at the fifth week during radiation therapy, and at the first month after completion of radiation therapy. The baseline characteristics of patients, tumors, and treatments and the baseline lymphocyte parameters were not significantly different between the 2 groups. Zinc sulfate supplementation during head and neck radiation therapy showed no increase in absolute numbers of circulating T lymphocytes, T lymphocyte subpopulations, or survival with acceptable side effects.

PMID: 25803777 [PubMed - indexed for MEDLINE]

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upper respiratory tract infection; +24 new citations

24 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

upper respiratory tract infection

These pubmed results were generated on 2015/12/25

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Primary inverted papilloma of the middle ear with intracranial invasion.

Primary inverted papilloma of the middle ear with intracranial invasion.

Head Neck. 2015 Dec 24;

Authors: Coca-Pelaz A, Gómez-Martínez J, Vivanco-Allende B, Hermsen M, Llorente JL

Abstract
BACKGROUND: Primary inverted papillomas of the middle ear are extremely rare tumors, with only few cases published in the literature. They have a characteristic epithelium surface inversion to the inside of the stroma. Inverted papillomas are benign lesions but have a high propensity of recurrence, local aggressiveness, and association with malignancy.
METHODS: We present a patient with an inverted papilloma originating in the middle ear producing chronic otorrhea and facial nerve palsy treated with a subtotal petrosectomy.
RESULTS: During the follow-up, the patient developed an intracranial invasion of the tumor causing his death.
CONCLUSION: Primary inverted papillomas of the middle ear can have an extremely aggressive behavior despite their benign characteristics; therefore, an aggressive treatment must be performed in order to minimize the possibility of recurrence. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698908 [PubMed - as supplied by publisher]

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Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Head Neck. 2015 Dec 24;

Authors: Garzaro M, Zenga F, Raimondo L, Pacca P, Pennacchietti V, Riva G, Ducati A, Pecorari G

Abstract
BACKGROUND: The purpose of this prospective, observational study was to evaluate the management of skull base chordomas surgically resected via a 3D-endoscopic transnasal approach.
METHODS: Thirteen consecutive patients were observed and only 9 were surgically treated using a 3D-endoscopic transnasal approach assisted by a novel 3D visualization system.
RESULTS: Nine consecutive male patients (mean age, 57.4 years) underwent exclusive 3D-endoscopic transnasal transsphenoidal resection of clival chordomas; gross total resection was achieved in 66.6% of cases (6 of 9 patients), near-total resection in 11.2% (1 of 9 patients), and partial resection in 22.2% (2 of 9 patients). The complications observed were 2 cases of postoperative cerebrospinal fluid (CSF) leaks and 1 case of temporary VI cranial nerve palsy.
CONCLUSION: No discomfort was recorded; when a dura opening was required, 3D vision allowed an accurate intradural sharp dissection and a precise repair of the skull base. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698603 [PubMed - as supplied by publisher]

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Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Head Neck. 2015 Dec 24;

Authors: Lee DY, Park MW, Oh KH, Cho JG, Kwon SY, Woo JS, Jung KY, Baek SK

Abstract
BACKGROUND: The purpose of this study was to determine clinicopathological correlates of outcome among patients with parotid gland cancer.
METHODS: The medical records of 126 patients treated by surgery for localized parotid cancer were retrospectively reviewed to identify the clinicopathologic correlates of recurrence-free survival (RFS) according to histologic grade.
RESULTS: Multivariate analysis revealed that age and lymphovascular invasion were significant factors for recurrence in patients with low-grade cancer (p = .049 and p = .019, respectively), whereas perineural invasion was the only significant factor in patients with high-grade cancer (p = .001). The most frequent recurrence site tends to be different according to histologic grade: local recurrence at low-grade cancer (8.3%) and distant at high-grade cancer (13.6%). The duration of RFS was significantly longer in low-grade cancer than high-grade cancer in regional and distant recurrence (p = .044 and p = .016, respectively).
CONCLUSION: Consideration of different factors may be required for individual low-grade and high-grade parotid cancers when predicting the risk of recurrence. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698329 [PubMed - as supplied by publisher]

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Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Otolaryngol Head Neck Surg. 2015 Dec 23;

Authors: Marchiano E, Chin OY, Fang CH, Park RC, Baredes S, Eloy JA

Abstract
OBJECTIVE: Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents <1% of all laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome.
DATA SOURCES: PubMed, Web of Science, MEDLINE, and EMBASE databases.
METHODS: A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome.
RESULTS: A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively.
CONCLUSION: LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up.

PMID: 26701176 [PubMed - as supplied by publisher]

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Diffuse, encasing lymphangioma of the supraglottis.

Diffuse, encasing lymphangioma of the supraglottis.

Am J Otolaryngol. 2016 Jan-Feb;37(1):41-3

Authors: Thompson TL, Gungor A

Abstract
BACKGROUND: Lymphangioma of the head and neck is considered a rare congenital tumor with the vast majority presenting before two years of age. Surgical excision and sclerosing therapy using OK-432 are recognized as effective treatment options for the majority of these lesions; however, treatment options of laryngeal lesions are less straightforward due to the risk of airway compromise and the desire to maintain the integrity of a functional larynx. We present the case of a four month old male who presented with chief complaint of inspiratory stridor after a single episode of pneumonia. His clinical presentation, flexible fiberoptic laryngoscopic examination, and operative evaluation were consistent with a lymphangioma completely encasing the epiglottis and arytenoids and isolated to the supraglottis. This report outlines our approach to workup and treatment of this rare lesion.
METHOD: Case report of presentation, diagnosis and treatment is presented.
RESULTS: A four-month old male presented to ENT clinic with inspiratory stridor, worsened with crying, without frank respiratory distress. History and initial examination was consistent with airway obstruction. Flexible fiberoptic laryngoscopy showed laryngomalacia as well as diffuse and symmetric supraglottic edema. Surgical evaluation identified edema limited to the supraglottis, notably along the ventral surface of the epiglottis and dorsal surface of bilateral arytenoids. Biopsies were taken and immunohistochemical staining was performed with strong positivity for D2-40 and CD31, supporting the diagnosis of isolated lymphangioma of the supraglottis. Treatment was performed through multiple point spot welding with a fiber equipped CO2 LASER (OmniGuide TM) at 5 watt continuous power.
CONCLUSION: Isolated supraglottic lymphangioma was diagnosed via direct laryngoscopy, with pathologic and immunohistochemical confirmation. Carbon dioxide laser spot welding technique was used with excellent clinical improvement in stridor. Clinical improvement is sustained after 6months follow-up.

PMID: 26700259 [PubMed - in process]

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Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Am J Otolaryngol. 2016 Jan-Feb;37(1):17-21

Authors: Feinstein AJ, Peng KA, Bhuta SM, Abemayor E, Mendelsohn AH

Abstract
OBJECTIVE: To describe an experience with laryngeal oncocytic cystadenomas and review the published literature regarding this uncommon diagnosis.
METHODS AND RESULTS: A clinical review of patients presenting with cystic laryngeal masses in an urban academic medical center between January and December 2013 was performed. Three patients, two female and one male, with a mean age of 68years, were diagnosed with oncocytic cystadenomata of the larynx. Major presenting symptoms included dysphonia, globus, and ipsilateral otalgia. Endoscopic examinations revealed a cystic structure arising from varied subsites of the larynx: laryngeal ventricle, aryepiglottic fold, and pre-epiglottic space. Cross-sectional radiographic imaging was obtained in each case. The patients were treated with transoral (CO2) laser microsurgery (TLM). In all three cases, pathological analysis revealed oncocytic cystadenoma with clear margins.
CONCLUSIONS: Oncocytic cystadenoma is a rare entity of the larynx predominantly affecting elderly patients. Clinical presentation and imaging may suggest the diagnosis of an internal laryngocele. Complete excision is both diagnostic and therapeutic, and typically can be achieved using TLM. When clear margins are obtained, no adjuvant therapy is indicated. Although laryngoceles and malignancies are more commonly encountered, oncocytic cystadenomas should remain in the differential of cystic laryngeal masses.

PMID: 26700253 [PubMed - in process]

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Cell-type and Tissue Context-dependent Nuclear Distribution of Human Ago2.

Cell-type and Tissue Context-dependent Nuclear Distribution of Human Ago2.

J Biol Chem. 2015 Dec 23;

Authors: Sharma NR, Wang X, Majerciak V, Ajiro M, Kruhlak M, Meyers C, Zheng ZM

Abstract
Argonaute-2 protein (Ago2), a major component of RISC, has been viewed as a cytoplasmic protein. In this report, we demonstrated by IFA confocal microscopy that Ago2 is distributed mainly as a nuclear protein in primary human foreskin keratinocytes in monolayer cultures and their derived organotypic (raft) cultures, although it exhibits only a minimal level of nuclear distribution in continuous cell lines such as HeLa and HaCaT cells. Oncogenic HPV16 or HPV18 infection of the keratinocytes does not affect the nuclear Ago2 distribution. Examination of human tissues reveals that Ago2 exhibits primarily as a nuclear protein in skin, normal cervix and cervical cancer tissues, but not in larynx. Together, our data provide the first convincing evidence that the subcellular distribution of Ago2 occurs in a cell-type and tissue context-dependent manner and may correlate with its various functions in regulation of gene expression.

PMID: 26699195 [PubMed - as supplied by publisher]

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Identification of vitamin C transporters in the human airways: a cross-sectional in vivo study.

http:--highwire.stanford.edu-icons-exter

Identification of vitamin C transporters in the human airways: a cross-sectional in vivo study.

BMJ Open. 2015;5(4):e006979

Authors: Larsson N, Rankin GD, Bicer EM, Roos-Engstrand E, Pourazar J, Blomberg A, Mudway IS, Behndig AF

Abstract
OBJECTIVES: Vitamin C is an important low-molecular weight antioxidant at the air-lung interface. Despite its critical role as a sacrificial antioxidant, little is known about its transport into the respiratory tract lining fluid (RTLF), or the underlying airway epithelial cells. While several vitamin C transporters have been identified, such as sodium-ascorbate cotransporters (SVCT1/2) and glucose transporters (GLUTs), the latter transporting dehydroascorbate, knowledge of their protein distribution within the human lung is limited, in the case of GLUTs or unknown for SVCTs.
SETTING AND PARTICIPANTS: Protein expression of vitamin C transporters (SVCT1/2 and GLUT1-4) was examined by immunohistochemistry in endobronchial biopsies, and by FACS in airway leucocytes from lavage fluid, obtained from 32 volunteers; 16 healthy and 16 mild asthmatic subjects. In addition, antioxidant concentrations were determined in RTLF. The study was performed at one Swedish centre.
PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was to establish the location of vitamin C transporters in the human airways. As secondary outcome measures, RTLF vitamin C concentration was measured and related to transporter expression, as well as bronchial epithelial inflammatory and goblet cells numbers.
RESULTS: Positive staining was identified for SVCT1 and 2 in the vascular endothelium. SVCT2 and GLUT2 were present in the apical bronchial epithelium, where SVCT2 staining was predominately localised to goblet cells and inversely related to RTLF vitamin C concentrations.
CONCLUSIONS: This experimental study is the first to demonstrate protein expression of GLUT2 and SVCT2 in the human bronchial epithelium. A negative correlation between SVCT2-positive goblet cells and bronchial RTLF vitamin C concentrations suggests a possible role for goblet cells in regulating the extracellular vitamin C pool.

PMID: 25854967 [PubMed - indexed for MEDLINE]

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Primary inverted papilloma of the middle ear with intracranial invasion.

Primary inverted papilloma of the middle ear with intracranial invasion.

Head Neck. 2015 Dec 24;

Authors: Coca-Pelaz A, Gómez-Martínez J, Vivanco-Allende B, Hermsen M, Llorente JL

PMID: 26698908 [PubMed - as supplied by publisher]

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Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Head Neck. 2015 Dec 24;

Authors: Garzaro M, Zenga F, Raimondo L, Pacca P, Pennacchietti V, Riva G, Ducati A, Pecorari G

PMID: 26698603 [PubMed - as supplied by publisher]

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Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Head Neck. 2015 Dec 24;

Authors: Lee DY, Park MW, Oh KH, Cho JG, Kwon SY, Woo JS, Jung KY, Baek SK

PMID: 26698329 [PubMed - as supplied by publisher]

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Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Otolaryngol Head Neck Surg. 2015 Dec 23;

Authors: Marchiano E, Chin OY, Fang CH, Park RC, Baredes S, Eloy JA

PMID: 26701176 [PubMed - as supplied by publisher]

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Diffuse, encasing lymphangioma of the supraglottis.

Diffuse, encasing lymphangioma of the supraglottis.

Am J Otolaryngol. 2016 Jan-Feb;37(1):41-3

Authors: Thompson TL, Gungor A

PMID: 26700259 [PubMed - in process]

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Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Am J Otolaryngol. 2016 Jan-Feb;37(1):17-21

Authors: Feinstein AJ, Peng KA, Bhuta SM, Abemayor E, Mendelsohn AH

PMID: 26700253 [PubMed - in process]

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Cell-type and Tissue Context-dependent Nuclear Distribution of Human Ago2.

Cell-type and Tissue Context-dependent Nuclear Distribution of Human Ago2.

J Biol Chem. 2015 Dec 23;

Authors: Sharma NR, Wang X, Majerciak V, Ajiro M, Kruhlak M, Meyers C, Zheng ZM

PMID: 26699195 [PubMed - as supplied by publisher]

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Identification of vitamin C transporters in the human airways: a cross-sectional in vivo study.

Identification of vitamin C transporters in the human airways: a cross-sectional in vivo study.

BMJ Open. 2015;5(4):e006979

Authors: Larsson N, Rankin GD, Bicer EM, Roos-Engstrand E, Pourazar J, Blomberg A, Mudway IS, Behndig AF

PMID: 25854967 [PubMed - indexed for MEDLINE]

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Hyoid and laryngeal excursion kinematics - magnitude, duration and velocity - changes following successful exercise-based dysphagia rehabilitation: MDTP.

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

Hyoid and laryngeal excursion kinematics - magnitude, duration and velocity - changes following successful exercise-based dysphagia rehabilitation: MDTP.

J Oral Rehabil. 2015 May;42(5):331-9

Authors: Sia I, Carvajal P, Lacy AA, Carnaby GD, Crary MA

Abstract
Variability in magnitude of deglutitional hyolaryngeal excursion in patients with dysphagia suggests that it does not adequately represent the kinematics of swallowing difficulties or recovery following rehabilitation. On the other hand, reduced hyolaryngeal excursion velocity has been reported in patients with dysphagia. While increased movement velocity often accompanies clinical and functional recovery in many diseases, velocity changes in swallowing-related movement following dysphagia therapy have not been well studied. This study evaluated changes in hyoid and laryngeal excursion (magnitude, duration and velocity) before and following successful dysphagia therapy to provide a more comprehensive representation of improvement to swallowing kinematics in patients who have experienced successful rehabilitation. A secondary analysis of case series data was completed. Eight patients with severe, chronic dysphagia completed a standard course of an exercise-based dysphagia treatment programme (McNeill dysphagia therapy program, MDTP). Pre- and post-treatment, kinematic aspects of swallowing were evaluated for thin liquid, thick liquid and pudding swallows. Maximum hyoid and laryngeal excursion magnitude and excursion duration were measured. Excursion velocities were calculated from excursion magnitude and duration measures. Successful treatment for dysphagia facilitated increased hyolaryngeal excursion magnitude, duration and velocity. These changes were most prominent for the hyoid and most often observed with thin liquids. By examining hyoid and laryngeal excursion velocity in patients who have experienced successful dysphagia rehabilitation, this study demonstrated the value of evaluating spatial and temporal aspects of swallowing kinematics in a single measure for a more comprehensive representation of positive changes underlying functional recovery.

PMID: 25488830 [PubMed - indexed for MEDLINE]

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Pomegranate exerts chemoprevention of experimentally induced mammary tumorigenesis by suppression of cell proliferation and induction of apoptosis.

Pomegranate exerts chemoprevention of experimentally induced mammary tumorigenesis by suppression of cell proliferation and induction of apoptosis.

Nutr Cancer. 2015 Dec 23;:1-11

Authors: Bishayee A, Mandal A, Bhattacharyya P, Bhatia D

Abstract
Breast cancer is the second leading cause of cancer-related death in women in the United States and discovery and development of safe chemopreventive drugs is urgently needed. The fruit pomegranate (Punica granatum) is gaining importance because of its various health benefits. This study was initiated to investigate chemopreventive potential of a pomegranate emulsion (PE) against 7,12-dimethylbenz(a)anthracene (DMBA) rat mammary carcinogenesis. The animals were orally administered with PE (0.2-5.0 g/kg), starting 2 wk before and 16 wk following DMBA treatment. PE exhibited a striking reduction of DMBA-induced mammary tumor incidence, total tumor burden, and reversed histopathological changes. PE dose-dependently suppressed cell proliferation and induced apoptosis in mammary tumors. Immunohistochemical studies showed that PE increased intratumor Bax, decreased Bcl2 and manifested a proapoptotic shift in Bax/Bcl2 ratio. In addition, our gene expression study showed PE-mediated upregulation of Bad, caspase-3, caspase-7, caspase-9, poly (ADP ribose) polymerase and cytochrome c in mammary tumors. Thus, PE exerts chemoprevention of mammary carcinogenesis by suppressing cell proliferation and inducing apoptosis mediated through upregulation of Bax and downregulation of Bcl2 in concert with caspase cascades. Pomegranate bioactive phytoconstituents could be developed as a chemopreventive drug to reduce the risk of breast cancer.

PMID: 26699876 [PubMed - as supplied by publisher]

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Rubus occidentalis: The black raspberry-its potential in the prevention of cancer.

Rubus occidentalis: The black raspberry-its potential in the prevention of cancer.

Nutr Cancer. 2015 Dec 23;:1-11

Authors: Kula M, Krauze-Baranowska M

Abstract
Rubus occidentalis is a black-fruited raspberry originating from North America. Its popularity and demand has been growing over the years, as studies outline its high anthocyanin and ellagitannin content and significance for human health. Interaction between chemical composition and pharmacological activity, mechanisms of action at cellular and molecular levels are all active areas of study. The vast majority of research concerning black raspberries is focused on chemoprevention and anticancer effects. This review summarizes the data on chemical composition and anticancer activity of black raspberry fruits throughout the years.

PMID: 26699735 [PubMed - as supplied by publisher]

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Suggestive evidence for the induction of colonic aberrant crypts in mice fed sodium nitrite.

Suggestive evidence for the induction of colonic aberrant crypts in mice fed sodium nitrite.

Nutr Cancer. 2015 Dec 23;:1-8

Authors: Zhou L, Zahid M, Anwar MM, Pennington KL, Cohen SM, Wisecarver JL, Shostrom V, Mirvish SS

Abstract
A reported linkage between processed (nitrite-treated) meat products and the incidence of colon cancer could be due to sodium nitrite (NaNO2) itself or to N-nitroso compounds produced from the nitrite. Exposure to nitrite occurs due to residual nitrite in processed meat and to salivary nitrite arising by reduction of nitrate in vegetables and drinking water. Here we tested whether NaNO2 could induce colonic aberrant crypts (ABC) or ABC foci (ACF), which are putative precursors of colon cancer. We fed NaNO2 in drinking water for 20-25 wk to groups of 8-20 adult female mice. After sacrifice, ABC and ACF were counted in 2-cm distal colonic segments. In Experiment 1, no significant differences in ABC/ACF induction were seen between groups of 13-14 A/J mice fed 0, 0.5, or 1.0 g NaNO2/l drinking water. NaNO2 also did not affect fasting blood glucose levels. In Experiment 2, we fed 0, 1.0, 1.25, or 1.5 g NaNO2/l water to groups of 15 CF-1 mice. Five of the mice fed 1.5 g NaNO2/l showed ABC, whereas all other groups showed only 0-2 ABC/group, including 0 ABC for the group fed 1.25 g NaNO2/l. Overall statistical analysis indicated a dose-response p trends of 0.04. Pairwise comparison of ABC between groups fed 1.25 and 1.5 g NaNO2/l showed p 0.02 for both ABC and ACF, but a similar comparison between the untreated and 1.5 g/l groups showed no significant effects. In Experiment 3, hot dogs (18% of diet), which were fed to CF-1 mice previously treated with azoxymethane, inhibited ABC and ACF induction, but this effect was not significant (P = 0.10-0.12). In conclusion, these results support the view that NaNO2 may be a risk factor for colon carcinogenesis.

PMID: 26699517 [PubMed - as supplied by publisher]

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Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Laryngeal oncocytic cystadenomas masquerading as laryngoceles.

Am J Otolaryngol. 2016 Jan-Feb;37(1):17-21

Authors: Feinstein AJ, Peng KA, Bhuta SM, Abemayor E, Mendelsohn AH

PMID: 26700253 [PubMed - in process]

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[Pharyngeal-cervical-brachial syndrome: A rare form of Guillain-Barré syndrome with severe acute bulbar palsy].

[Pharyngeal-cervical-brachial syndrome: A rare form of Guillain-Barré syndrome with severe acute bulbar palsy].

Arch Pediatr. 2015 Dec 14;

Authors: Lametery E, Dubois-Teklali F, Millet A, Manel V

Abstract
The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome is rare in children. It is characterized by oropharyngeal, neck, and upper limb muscle involvement, without ataxia and disturbed consciousness. Although associated with anti-GT1a antibodies, there is no single clinical or serological marker of PCB syndrome. We report on two cases in a 14-year-old and a 15-year-old females. The first symptom was acute dysphonia followed by severe bulbar palsy with deglutition disorders, associated with involvement of other cranial nerves and arm and leg weakness. One of the girls had normal deep tendon reflexes. Both had normal cerebral imaging and normal cerebrospinal fluid. No sign of neuropathy was found on nerve conduction studies. The diagnosis of PCB syndrome was established based on the presence of antiganglioside antibodies. Both adolescents had IgG anti-GT1a antibodies. Anti-GQ1b and anti-GT1b antibodies were associated in the first case, anti-GM1 and anti-GD1a in the second case. Clinical improvement was fast after treatment with intravenous immunoglobulin therapy. Recovery was complete. Only a few cases of children and adolescents with PCB syndrome have been reported. The main differential diagnoses were excluded with brain MRI. The neurophysiological findings in PCB syndrome are axonal neuropathy rather than demyelinating neuropathy, which might be normal in the early stages of the disease. Positivity of anti-GT1a IgG antibodies is very helpful for the diagnosis of PCB syndrome. In atypical cases of bulbar palsy with other cranial nerve involvement and normal brain MRI, diagnosis of PCB syndrome should be considered. Recognizing the atypical cases of Guillain-Barré syndrome enables anticipatory monitoring for disease complications and identifies therapeutic options. The short- and long-term outcome of the PCB syndrome after intravenous immunoglobulin treatment seems favorable.

PMID: 26697812 [PubMed - as supplied by publisher]

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Effect of TRIAC Treatment in Mct8-deficiency: a Word of Caution.

Effect of TRIAC Treatment in Mct8-deficiency: a Word of Caution.

Thyroid. 2015 Dec 23;

Authors: Bárez-López S, Obregon MJ, Martínez-de-Mena R, Bernal J, Guadaño-Ferraz A, Morte B

Abstract
BACKGROUND: Monocarboxylate transporter 8 (MCT8) is a thyroid hormone-specific cell membrane transporter. Mutations in the MCT8 gene lead to profound psychomotor retardation and abnormal thyroid hormone serum levels with low thyroxine (T4) and high triiodothyronine (T3). Currently, therapeutic options for patients are limited. Triiodothyroacetic acid (TRIAC) has potential therapeutic value. The aim of this study was to evaluate the effects and efficacy of therapeutic doses of TRIAC on Mct8-deficient mice (Mct8KO).
METHODS: Wild-type (Wt) and Mct8KO mice were treated with 30 ng TRIAC/g BW/day, given in drinking water, from postnatal day 21 to 30. TRIAC, T4 and T3 levels in plasma, as well as T3 and TRIAC content in the cerebral cortex and striatum were measured by specific radioimmunoassays. The activities of deiodinases 1 and 2 were measured in liver and cortex. The effect of TRIAC treatment in the expression of T3-dependent genes was measured in the heart, cerebral cortex and striatum.
RESULTS: Plasma TRIAC concentration were the same in Wt and Mct8KO animals after treatment. TRIAC treatment greatly decreased plasma T4 in Wt and Mct8KO mice, and reduced T3 to normal levels in the Mct8KO. Deiodinase 1 activity and gene expression in the liver increased while it did not have any effect on the expression of Serca2a in the heart. TRIAC treatment did not induce the expression of T3-dependent genes in the cerebral cortex or striatum but further decreased expression of Flywch2 in the cortex and Aldh1a1 and Flywch2 in the striatum. Direct measurements of TRIAC and T3 content in the cortex and striatum revealed a decrease in T3 after treatment with no significant increase in the level of endogenous TRIAC. Conclusions Therapeutic doses of TRIAC in Mct8KO mice restored plasma T3 levels but severely decreased T4 levels. TRIAC has a direct effect on deiodinase 1 in the liver and does not have an effect on gene expression in the heart. The increase in the plasma TRIAC levels after treatment is not sufficient to increase TRIAC levels in the brain and to promote the expression of T3-dependent genes in brain cells. Instead, it leads to a state of brain hypothyroidism with reduced T3 content.

PMID: 26701289 [PubMed - as supplied by publisher]

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Sorafenib for the treatment of Progressive Metastatic Medullary Thyroid Cancer: Efficacy and Safety Analysis.

Sorafenib for the treatment of Progressive Metastatic Medullary Thyroid Cancer: Efficacy and Safety Analysis.

Thyroid. 2015 Dec 23;

Authors: Castroneves LA, Negrao MV, Freitas RM, Papadia C, Lima Junior JV, Fukushima J, Simao EF, Kulcsar MA, Tavares M, Jorge AA, Castro G, Hoff PM, Hoff AO

Abstract
BACKGROUND: Treatment of advanced medullary thyroid carcinoma (MTC) was recently improved with the approval of vandetanib and cabozantinib. However, there is still a need to explore sequential therapy with more than one tyrosine kinase inhibitor (TKI) and to explore alternative therapies when vandetanib and cabozantinib are not available. In this paper, we report our experience with sorafenib as a treatment for advanced medullary thyroid cancer.
METHODS: This is a retrospective longitudinal study of thirteen patients with progressive metastatic MTC treated with sorafenib 400 mg twice daily between December 2011 and January 2015. The primary endpoints were to evaluate response and progression free survival (PFS) in patients treated with sorafenib outside a clinical trial. Secondary endpoint was assessment of toxicity profile. One patient was excluded because of a serious allergic skin rash after 1 week of starting sorafenib.
RESULTS: The analysis included 12 patients with metastatic MTC (median age 48 years), 10 with sporadic and 2 with hereditary disease. The median duration of treatment was 11 months and the median follow-up was 15.5 months. At data cutoff, 2 (16%) of 12 patients were still on treatment for 16 and 34 months. According to RECIST analysis, 10 patients (83.3%) showed stable disease and 2 (16.6%) had progression of disease, no partial response was observed. The median PFS was 9 months; however, three patients with extensive and rapidly progressive disease died within 3 months of sorafenib treatment. The median PFS excluding these 3 patients was 12 months. Adverse events (AE) occurred in 9 patients (75%). The main AEs were skin toxicity, weight loss and fatigue. Five (41.6%) patients needed dose reduction, and one patient discontinued treatment for toxicity.
CONCLUSIONS: Treatment with sorafenib in progressive metastatic MTC is well tolerated and resulted in disease control and durable clinical benefit in 75% of patients. Sorafenib treatment could be considered when vandetanib and cabozantinib are not available or after failing these drugs.

PMID: 26701095 [PubMed - as supplied by publisher]

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Ensuring effective prevention of iodine-deficiency disorders.

Ensuring effective prevention of iodine-deficiency disorders.

Thyroid. 2015 Dec 23;

Authors: Völzke H, Caron PJ, Dahl L, de Castro J, Erlund I, Gaberšček S, Gunnarsdottir I, Hubalewska-Dydejczyk A, Ittermann T, Ivanova L, Karanfilski B, Khattak RM, Kusic Z, Laurberg P, Lazarus J, Markou K, Moreno-Reyes R, Nagy EV, Peeters R, Pīrāgs V, Podoba J, Rayman MP, Rochau U, Siebert U, Smyth PP, Thuesen BH, Troen A, Vila L, Vitti P, Zamrazil V, Zimmermann M

Abstract
Background Programs initiated to prevent iodine-deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors and human behaviour that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies are needed to optimize the effectiveness of IDD prevention. Summary Although the need for monitoring is compelling, the current reality in Europe is less than optimal. Regular and systematic monitoring surveys have only been established in a few countries and comparability across the studies is hampered by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency. Conclusion Monitoring studies can be optimized by including centralized standardization procedures that improve the comparison between studies. No study of iodine consumption can replace the direct measurement of health outcomes and the evaluation of the costs and benefits of the program. It is particularly important that health-economic evaluation should be conducted in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic and cultural backgrounds.

PMID: 26700864 [PubMed - as supplied by publisher]

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PRENATAL VITAMIN COMPOUNDS AVAILABLE IN BRAZIL ARE NOT SUITABLE FOR ADEQUATE IODINE SUPPLEMENTATION OF PREGNANT WOMEN.

PRENATAL VITAMIN COMPOUNDS AVAILABLE IN BRAZIL ARE NOT SUITABLE FOR ADEQUATE IODINE SUPPLEMENTATION OF PREGNANT WOMEN.

Thyroid. 2015 Dec 23;

Authors: Villagelin D, Romaldini JH, Comarella AP, Azevedo GG, Zolio SC, Tiago DB, Ward LS

Abstract
Maternal intake iodine deficiency, results in altered maternal and fetal hormone synthesis, which is proportional to the degree and duration of the iodine deprivation. A recent meta-analysis demonstrated difference in the prevalence of iodine deficiency disorders in individuals of different ages living in different regions of Brazil. Worryingly, the Brazilian National Health Surveillance (ANVISA) recently reduced the amount of iodine added to salt. Here we aimed to: 1) identify the availability of dietary supplements for pregnant women in Brazil; 2) verify the amount of iodine present in these supplements; and 3) correlate these levels with the new global recommendations of the American Thyroid Association (1). We obtained nutritional information from available dietary supplements used by pregnant women and analyzed these data based on information on their package insert using the federal agency (ANVISA) system of drug control and regulation; the Anvisa's Eletronic Label. We identified 25 dietary supplements for pregnant women currently in use in Brazil. Based on the minimal daily supplementation of 150 µg of iodine recommended by the ATA, the ETA and the WHO, 48% of these supplements contained no iodine (12 out of the 25 products), 16% (4) contained 1 to 149 µg of iodine, and only 9 products (36%) had the recommended amount of iodine. In fact, despite a mandatory program of salt iodization in Brazil, available studies have found iodine insufficiency in 30 to 57% of brazilian pregnant women. On the other hand, less than half of dietary supplements commercially available and used by pregnant women in Brazil contain iodine at the amounts recommended by international guidelines. Based on our findings, we propose that urgent measures are needed to protect both pregnant women and their offspring from the severe consequences associated with iodine deficiency.

PMID: 26700644 [PubMed - as supplied by publisher]

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Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition.

Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition.

Thyroid. 2015 Dec 23;

Authors: Samuels M, Kolobova I, Smeraglio A, Peters D, Purnell J, Schuff KG

Abstract
BACKGROUND: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether metabolic function is also affected. The objective of this study was to determine whether women receiving TSH-suppressive L-T4 doses have alterations in energy expenditure or body composition.
METHODS: This study was a cross-sectional comparison among three groups of women: 26 women receiving chronic TSH-suppressive L-T4 doses, 80 women receiving chronic replacement L-T4 doses, and 16 untreated euthyroid control women. Subjects underwent measurements of resting energy expenditure (REE), substrate oxidation, and thermic effect of food by indirect calorimetry; physical activity energy expenditure by accelerometer; caloric intake by 24-hour diet recall; and body composition by dual x-ray absorptiometry.
RESULTS: REE per kilogram lean body mass in the L-T4 euthyroid women was 6% lower than the L-T4 suppressed group and 4% lower than the healthy control group (P=0.04). Free T3 levels were directly correlated with REE, and were 10% lower in the L-T4 euthyroid women compared to the other two groups (P=0.007). The groups of subjects did not differ in other measures of energy expenditure, caloric intake, or body composition.
CONCLUSIONS: L-T4 suppression therapy does not adversely affect energy expenditure or body composition in women. However, L-T4 replacement therapy is associated with a lower REE despite TSH levels within the reference range. This may be due to lower fT3 levels, suggesting relative tissue hypothyroidism may contribute to impaired energy expenditure in L-T4 therapy.

PMID: 26700485 [PubMed - as supplied by publisher]

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Reactive oxygen species and anti-proteinases.

Reactive oxygen species and anti-proteinases.

Arch Physiol Biochem. 2015 Dec 23;:1-7

Authors: Siddiqui T, Zia MK, Ali SS, Rehman AA, Ahsan H, Khan FH

Abstract
Reactive oxygen species (ROS) cause damage to macromolecules such as proteins, lipids and DNA and alters their structure and function. When generated outside the cell, ROS can induce damage to anti-proteinases. Anti-proteinases are proteins that are involved in the control and regulation of proteolytic enzymes. The damage caused to anti-proteinase barrier disturbs the proteinase-anti-proteinases balance and uncontrolled proteolysis at the site of injury promotes tissue damage. Studies have shown that ROS damages anti-proteinase shield of the body by inactivating key members such as alpha-2-macroglobulin, alpha-1-antitrypsin. Hypochlorous acid inactivates α-1-antitrypsin by oxidizing a critical reactive methionine residue. Superoxide and hypochlorous acid are physiological inactivators of alpha-2-macroglobulin. The damage to anti-proteinase barrier induced by ROS is a hallmark of diseases such as atherosclerosis, emphysema and rheumatoid arthritis. Thus, understanding the behaviour of ROS-induced damage to anti-proteinases may helps us in development of strategies that could control these inflammatory reactions and diseases.

PMID: 26699123 [PubMed - as supplied by publisher]

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Standard or accelerated methotrexate, vinblastine, doxorubicin and cisplatin as neoadjuvant chemotherapy for locally advanced urothelial bladder cancer: Does dose intensity matter?

Publication date: February 2016
Source:European Journal of Cancer, Volume 54
Author(s): Damien Pouessel, Sylvie Chevret, Frédéric Rolland, Gwenaelle Gravis, Lionel Geoffrois, Guilhem Roubaud, Safae Terrisse, Helen Boyle, Christine Chevreau, Jérôme Dauba, Guillaume Moriceau, Ingrid Alexandre, Gaël Deplanque, Angélique Chapelle, Elodie Vauleon, Alexandre Colau, François Audenet, Thomas Grellety, Stéphane Culine
BackgroundThere is continuing controversy regarding the optimal regimen for neoadjuvant chemotherapy (NAC) in bladder cancer.Patients and methodsWe performed a retrospective analysis of 241 consecutive bladder cancer patients who received a combination of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) using a standard (52 patients) or an accelerated schedule (189 patients) as NAC before radical cystectomy in 17 centres of the French GEnito-urinary TUmour Group from March 2004–May 2013.ResultsThe median age was 62 years. As expected, the median number of cycles, the median total dose of cisplatin and the median cisplatin dose intensity were higher in patients treated with the accelerated regimen. Conversely, the median duration of chemotherapy was shorter. Regarding toxicity, grade III/IV neutropenia, grade III thrombocytopenia and grade III anaemia as well were more frequently observed in patients treated with the standard regimen. Among 211 (88%) patients who proceeded to cystectomy, 75 (35%) patients achieved an ypT0 pN0 status (no pathologic residual tumour cells) with no significant difference according to the MVAC schedule. Three-year overall survival rates were 66.5% (95% confidence interval [CI], 56–79) and 72% (95% CI, 59.5–88) in the standard and accelerated cohorts, respectively. In the multivariate analysis, two independent prognostic parameters were retained: the ypT0 stage and the ypN0 stage. Heterogeneity test did not show any interaction with NAC regimens.ConclusionSimilar pathological response and survival rates were observed whatever the chemotherapy regimen used. Haematological toxicity was greater in patients who received standard MVAC.

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A European Organisation for Research and Treatment of Cancer randomized, double-blind, placebo-controlled, multicentre phase II trial of anastrozole in combination with gefitinib or placebo in hormone receptor-positive advanced breast cancer (NCT00066378)

Publication date: January 2016
Source:European Journal of Cancer, Volume 53
Author(s): Konstantinos Tryfonidis, Gul Basaran, Jan Bogaerts, Marc Debled, Luc Dirix, Jean-Christophe Thery, Vivianne C.G. Tjan-Heijnen, Danielle Van den Weyngaert, Tanja Cufer, Martine Piccart, David Cameron
BackgroundPreclinical data suggest that epidermal growth factor receptor (EGFR) inhibitors (e.g. gefitinib) can delay endocrine resistance in breast cancer. A double-blind, placebo-controlled, phase II trial investigated whether adding gefitinib (G) to anastrozole (A) would improve outcome in advanced breast cancer (ABC).MethodsPostmenopausal pre-treated hormone receptor-positive ABC patients (locally recurrent or metastatic) were 1:1 randomized to A (1 mg/d) plus G 250 mg/d or plus placebo (P). Patients who had prior treatment with an aromatase inhibitor in metastatic setting or with trastuzumab, anti-EGFR or anti-VEGF agents were excluded. Treatment was given until disease progression, unacceptable toxicity or patient withdrawal. Progression-free survival (PFS) rate at 1 year was assessed according to Response Evaluation Criteria in Solid Tumours, version 1.0.ResultsOf 108 planned patients, 71 were recruited (36 in A/G and 35 in A/P). The trial closed prematurely due to slow recruitment; 31 patients had prior chemotherapy and 53 prior endocrine therapy (all except one received tamoxifen); 60% in adjuvant and 16% in metastatic setting received tamoxifen; 59 patients had visceral disease. Median follow-up was 18 months. PFS rate at 1 year was 35% for A/G and 32% for A/P arm. Objective responses were six (22%) in the A/G and nine (28%) in the A/P arm. Median duration of response was 13.8 and 18.6 months in the A/G and A/P arms, respectively. Fatigue (35%), diarrhoea (31%), rash (32%), dry skin (27%), and arthralgia/myalgia (27%) were the commonest adverse events in the A/G arm.ConclusionsThis phase II study, although prematurely closed, did not show a signal that adding G to A improves PFS at 1 year and its use is not supported. Gastrointestinal and skin toxicities were more pronounced with G resulting in premature therapy interruption in almost 1 in 3 patients (ClinicalTrials.gov number, NCT00066378).

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Publisher’s Note

Publication date: January 2016
Source:European Journal of Cancer, Volume 52

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Reviewers 2015

Publication date: January 2016
Source:European Journal of Cancer, Volume 52

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Risk factors for bone pain among patients with cancer receiving myelosuppressive chemotherapy and pegfilgrastim

Conclusions Potential risk factors for bone pain in patients receiving myelosuppressive chemotherapy and primary prophylactic pegfilgrastim identified in this study are younger age and history of bone pain. No other association with clinical factors and risk of bone pain was detected. Better understanding of risk factors for bone pain would be useful in identifying patients who may benefit from pain prevention strategies. (Source: Supportive Care in Cancer)

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Standard or accelerated methotrexate, vinblastine, doxorubicin and cisplatin as neoadjuvant chemotherapy for locally advanced urothelial bladder cancer: Does dose intensity matter?

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Congenital malrotation of atlas with unilateral hypertrophy of atlanto-ocipital joint – A rare anomaly of cranio-vertebral junction and its management: A case report

Publication date: Available online 24 December 2015
Source:World Neurosurgery
Author(s): Pratap Chandra Nath, Sudhansu Sekhar Mishra, Rama Chandra Deo, Itibrata Mahanta
Congenital anomalies are commonly encountered in cranio-vertebral junction (CVJ) due to its unique embryological development. CVJ usually comprises occiput, atlas and axis. However malrotation of atlas (C1) in between occiput (C0) and axis (C2) with Chiari -1 malformation as well as hypertrophy of unilateral atlanto-ocipital joint and lateral mass manifesting features of high cervical myelopathy is hardly reported anomaly. Here we report a case of successfully managed 22 years old female who presented to us with high cervical compressive myelopathy. Imaging revealed rotation of C1 vertebra around 20 degrees towards left side with right atlanto-ocipital joint dislocation and hypertrophy. It also revealed hypertrophy of right lateral mass of C1, Chiari -1 malformation and right atlanto axial dislocation exposing right C2 superior facet. She underwent right extreme far lateral approach comprising right C1 posterior arch excision and medialization of right vertebral artery with excision of hypertrophied atlanto -occipital joint extradurally and posteromedial excision of superior articular facet of C1. The patient's compressive myelopathy features improved post operatively. We report the management of this rare congenital anomaly with review of literatures.

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Associations of health behaviours with return to work outcomes after colorectal cancer

Conclusions Further research into how excessive sleep might be related to return to work amongst colorectal cancer survivors is warranted. Interventions focused on achieving optimal sleep patterns may assist colorectal cancer survivors to return to work and should be tested in future studies. (Source: Supportive Care in Cancer)

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A European Organisation for Research and Treatment of Cancer randomized, double-blind, placebo-controlled, multicentre phase II trial of anastrozole in combination with gefitinib or placebo in hormone receptor-positive advanced breast cancer (NCT00066378)

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Comparison of Complications and Clinical and Radiographic Outcomes Between Non-Obese and Obese Patients With Adult Spinal Deformity Undergoing Minimally Invasive Surgery

Publication date: Available online 25 December 2015
Source:World Neurosurgery
Author(s): Paul Park, Michael Y. Wang, Stacie Nguyen, Gregory M. Mundis, Frank La Marca, Juan S. Uribe, Neel Anand, David O. Okonkwo, Adam S. Kanter, Richard Fessler, Robert K. Eastlack, Dean Chou, Vedat Deviren, Pierce D. Nunley, Christopher I. Shaffrey, Praveen V. Mummaneni
ObjectiveObesity can be associated with increased complications and potentially worse outcomes. We aimed to evaluate the impact of obesity on complications and outcomes in patients with adult spinal deformity (ASD) who underwent minimally invasive surgery (MIS).MethodsMulticenter database of patients with ASD treated via MIS was queried. Of 190 patients in the database, 77 fit the inclusion criteria of 3 or more spinal levels treated minimally invasively. Patients were divided by body mass index (BMI) < 30 (non-obese; n = 59), and BMI ≥ 30 (obese; n = 18).ResultsMean BMI was 24.6 non-obese, and 35.0 obese (p < 0.001). There were mean 3.8 interbody fusions non-obese, and 4.7 obese (p = 0.065). Levels treated posteriorly averaged 5.8 non-obese, and 5.9 obese (p = 0.502). Mean follow-up was 34.4 months non-obese, and 35.3 months obese (p = 0.976). Baseline radiographic parameters were similar between groups. Postoperatively, SVA averaged 83.9 mm obese and 20.4 mm non-obese (p = 0.002). Postoperative lumbar lordosis-pelvic incidence mismatch averaged 17.9° obese and 9.9° non-obese (p = 0.028). Both groups had improvement in ODI scores with no difference in postoperative ODI scores between groups (p = 0.090). Similarly, both groups had decreased VAS scores for back and leg pain with no difference between groups postoperatively. Twenty (33.9%) non-obese patients versus 7 (38.9%) obese patients had complications (p = 0.452).ConclusionsOur results suggest that obesity does not negatively impact complication rate or clinical outcomes in patients with ASD treated via MIS approaches.

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miR-126 promotes angiogenesis and attenuates inflammation after contusion spinal cord injury in rats.

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miR-126 promotes angiogenesis and attenuates inflammation after contusion spinal cord injury in rats.

Brain Res. 2015 May 22;1608:191-202

Authors: Hu J, Zeng L, Huang J, Wang G, Lu H

Abstract
MicroRNAs are a class of small RNAs that regulate the expression of target mRNAs by inhibiting translation or destabilizing target mRNAs. miR-126 is a microRNA that is highly enriched in endothelial cells. miR-126 has been found to promote angiogenesis and inhibit vascular inflammation in endothelial cells by repressing three target genes Sprouty-related EVH1 domain-containing protein 1 (SPRED1), phosphoinositol-3 kinase regulatory subunit 2 (PIK3R2), and vascular cell adhesion molecule 1 (VCAM1). Our previous study showed that the expression of miR-126 was downregulated after spinal cord injury (SCI). Therefore, we wanted to examine whether upregulation of miR-126 could promote angiogenesis, inhibit inflammation, and exert a positive effect on recovery after contusion SCI. In this study, we found that increased levels of miR-126 promoted angiogenesis, and inhibited leukocyte extravasation into the injured spinal cord, which was concurrent with downregulation of mRNA and protein expression of three validated miR-126 target genes, SPRED1, PIK3R2, and VCAM1. Moreover, a dose-dependent effect of miR-126 was observed in rescuing tissue damage and improving the functional deficit after SCI. Thus, the present study indicated that miR-126 played an important role in angiogenesis and inflammation after SCI.

PMID: 25724143 [PubMed - indexed for MEDLINE]

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Are we there yet? Evaluating commercial grade brain-computer interface for control of computer applications by individuals with cerebral palsy.

Are we there yet? Evaluating commercial grade brain-computer interface for control of computer applications by individuals with cerebral palsy.

Disabil Rehabil Assist Technol. 2015 Dec 23;:1-10

Authors: Taherian S, Selitskiy D, Pau J, Claire Davies T

Abstract
PURPOSE: Using a commercial electroencephalography (EEG)-based brain-computer interface (BCI), the training and testing protocol for six individuals with spastic quadriplegic cerebral palsy (GMFCS and MACS IV and V) was evaluated.
METHOD: A customised, gamified training paradigm was employed. Over three weeks, the participants spent two sessions exploring the system, and up to six sessions playing the game which focussed on EEG feedback of left and right arm motor imagery.
RESULTS: The participants showed variable inconclusive results in the ability to produce two distinct EEG patterns. Participant performance was influenced by physical illness, motivation, fatigue and concentration.
CONCLUSIONS: The results from this case study highlight the infancy of BCIs as a form of assistive technology for people with cerebral palsy. Existing commercial BCIs are not designed according to the needs of end-users. Implications for Rehabilitation Mood, fatigue, physical illness and motivation influence the usability of a brain-computer interface. Commercial brain-computer interfaces are not designed for practical assistive technology use for people with cerebral palsy. Practical brain-computer interface assistive technologies may need to be flexible to suit individual needs.

PMID: 26699697 [PubMed - as supplied by publisher]

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A basic technology-aided programme for leisure and communication of persons with advanced amyotrophic lateral sclerosis: performance and social rating.

A basic technology-aided programme for leisure and communication of persons with advanced amyotrophic lateral sclerosis: performance and social rating.

Disabil Rehabil Assist Technol. 2015 Dec 23;:1-8

Authors: Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Ferlisi G, Zullo V, Denitto F, Lauta E, Abbinante C, Pesce CV

Abstract
PURPOSE: This study assessed (a) the impact of a technology-aided programme on the leisure and communication engagement of persons with advanced amyotrophic lateral sclerosis (ALS) and (b) the opinion of rehabilitation and care personnel regarding the programme.
METHOD: The programme's impact was assessed with four participants who were allowed to activate leisure and communication options through basic responses (e.g. knee, finger or lip movements) and microswitches. Forty-two care and health professionals rated the programme after watching video clips of persons with ALS (three of the four involved in this study and three involved in previous studies) during and outside of the programme.
RESULTS: The programme was effective with all participants. Their mean percentages of session time with independently initiated leisure and communication engagements were zero during baseline and increased to between nearly 70 and 80 during the intervention. The care and health professionals rated the technology-aided programme as beneficial for the participants' positive engagement and social image, fairly practical for daily contexts and interesting from a personal standpoint.
CONCLUSIONS: The programme might be viewed as a viable resource for persons with advanced ALS. Implications for Rehabilitation A programme characterised by versatility, simplicity and relatively low cost could be considered practically relevant for persons with ALS and their contexts. A programme that is effective in fostering participants' independent leisure and communication engagement and is positively rated by care and rehabilitation personnel is more likely to be accepted and used with consistency. Any programme directed at persons affected by ALS needs to be adapted to the persons' progressive deterioration, starting from the response and microswitch used for accessing the programme's options.

PMID: 26699449 [PubMed - as supplied by publisher]

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Changes in cochlear function related to acoustic stimulation of cervical vestibular evoked myogenic potential stimulation

Publication date: Available online 25 December 2015
Source:Hearing Research
Author(s): Anna-Karin Strömberg, Åke Olofsson, Magnus Westin, Maoli Duan, Stefan Stenfelt
Evaluation of cervical evoked myogenic potentials (c-VEMP) is commonly applied in clinical investigations of patients with suspected neurotological symptoms. Short intense acoustic stimulation of peak levels close to 130 dB SPL is required to elicit the responses. A recent publication on bilateral significant sensorineural hearing loss related to extensive VEMP stimulation motivates evaluations of immediate effects on hearing acuity related to the intense acoustic stimulation required to elicit c-VEMP responses. The aim of the current study was to investigate changes in DPOAE-levels and hearing thresholds in relation to c-VEMP testing in humans. More specifically, the current focus is on immediate changes in hearing thresholds and changes in DPOAE-levels at frequencies 0.5 octaves above the acoustic stimulation when applying shorter tone bursts than previously used. Hearing acuity before and immediately after exposure to c-VEMP stimulation was examined in 24 patients with normal hearing and referred for neurotologic testing. The stimulation consisted of 192 tonebursts of 6 milliseconds and was presented at 500 Hz and 130 dB peSPL. Békésy thresholds at 0.125 to 8 kHz and DPOAE I/O growth functions with stimulation at 0.75 and 3 kHz were used to assess c-VEMP related changes in hearing status. No significant deterioration in Békésy thresholds was detected. Significant reduction in DPOAE levels at 0.75 (0.5-1.35 dB) and 3 kHz (1.6-2.1 dB) was observed after c-VEMP stimulation without concomitant changes in cochlear compression. The results indicated that there was no immediate audiometric loss related to c-VEMP stimulation in the current group of patients. The significant reduction of DPOAE levels at a wider frequency range than previously described after the c-VEMP test could be related to the stimulation with shorter tone bursts. The results show that c-VEMP stimulation causes reduction in DPOAE-levels at several frequencies that corresponds to half the reductions in DPOAE levels reported after exposure to the maximally allowed occupational noise for an eight hours working day. Consequently, extended stimuli intensity or stimulation repetition with c-VEMP testing should be avoided to reduce the risk for noise-induced cochlear injury.

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Influence of the paraflocculus on normal and abnormal spontaneous firing rates in the inferior colliculus

Publication date: Available online 25 December 2015
Source:Hearing Research
Author(s): Darryl P. Vogler, Donald Robertson, Wilhelmina H.A.M. Mulders
Spontaneous firing rates of neurons in the central auditory pathway, such as in the inferior colliculus, are known to be increased after cochlear trauma. This so-called hyperactivity is thought to be involved in the generation of tinnitus, a phantom auditory perception. Recent research in an animal model suggests behavioural signs of tinnitus can be significantly reduced by silencing or removal of the paraflocculus (PF) of the cerebellum. The current study investigated the effects of acute PF removal on spontaneous firing rates recorded from single neurons in the right inferior colliculus of guinea pigs with normal hearing (which did not receive acoustic trauma) or with hearing loss caused by acoustic trauma. Spontaneous firing rates were obtained at either 2 or 13 weeks after initial surgery on the left side. In half of the animals in each group the left PF was removed immediately prior to the spontaneous firing rates recordings. In the acoustic trauma groups, spontaneous firing rates in the inferior colliculus were higher when the PF was removed compared to animals with an intact PF. This effect of PF removal was not observed in animals that did not receive acoustic trauma. These results suggest that the PF has a tonic inhibitory effect on hyperactivity in the inferior colliculus in animals with hearing loss, but not on normal spontaneous firing rates in normal hearing animals.

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Cortical and thalamic connectivity of the auditory anterior ectosylvian cortex of early-deaf cats: Implications for neural mechanisms of crossmodal plasticity

Publication date: Available online 24 December 2015
Source:Hearing Research
Author(s): M. Alex Meredith, H. Ruth Clemo, Sarah B. Corley, Nicole Chabot, Stephen G. Lomber
Early hearing loss leads to crossmodal plasticity in regions of the cerebrum that are dominated by acoustical processing in hearing subjects. Until recently, little has been known of the connectional basis of this phenomenon. One region whose crossmodal properties are well-established is the auditory field of the anterior ectosylvian sulcus (FAES) in the cat, where neurons are normally responsive to acoustic stimulation and its deactivation leads to the behavioral loss of accurate orienting toward auditory stimuli. However, in early-deaf cats, visual responsiveness predominates in the FAES and its deactivation blocks accurate orienting behavior toward visual stimuli. For such crossmodal reorganization to occur, it has been presumed that novel inputs or increased projections from non-auditory cortical areas must be generated, or that existing non-auditory connections were 'unmasked.' These possibilities were tested using tracer injections into the FAES of adult cats deafened early in life (and hearing controls), followed by light microscopy to localize retrogradely labeled neurons. Surprisingly, the distribution of cortical and thalamic afferents to the FAES was very similar among early-deaf and hearing animals. No new visual projection sources were identified and visual cortical connections to the FAES were comparable in projection proportions. These results support an alternate theory for the connectional basis for cross-modal plasticity that involves enhanced local branching of existing projection terminals that originate in non-auditory as well as auditory cortices.

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