Head and Neck Diseases by Alexandros G.Sfakianakis: 01/02/16

Σάββατο 2 Ιανουαρίου 2016

Surgical management of cervico-mediastinal goiters: OUR experience and REVIEW of the literature.

Surgical management of cervico-mediastinal goiters: OUR experience and REVIEW of the literature.

Int J Surg. 2015 Dec 22;

Authors: Di Crescenzo V, Vitale M, Valvano L, Napolitano F, Vatrella A, Zeppa P, De Rosa G, Amato B, Laperuta P

Abstract
AIM: We analyze and discuss the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and results in cervico-mediastinal thyroid masses admitted in Thoracic Surgery Unit of AOU Second University of Naples from 1991 to 2006 and in Thoracic Surgery Unit of AOU "S. Giovanni di Dio & Ruggi D'Aragona" of Salerno over a period of 3 years (2011-2014).
METHODS: We reviewed 97 patients who underwent surgical treatment for cervico-mediastinal goiters. 47 patients (49.2%) had cervico-mediastinal goiter, 40 patients (40%) had mediastino-cervical goiter and 10 patients (10.8%) had mediastinal goiter. 73 cases were prevascular goiters and 24 were retrovascular goiters. We performed total thyroidectomy in 40 patients, subtotal thyroidectomy in 46 patients and in 11 cases the resection of residual goiter. In 75 patients we used only a cervical approach, in 21 patients the cervical incision was combined with median sternotomy and in 1 patient with transverse sternotomy.
RESULTS: Three patients (3.1%) died in the postoperative period (2 cardio-respiratory failure and 1 pulmonary embolism). The histologic study revelead 8 (7.7%) carcinomas. Postoperative complications were: dyspnea in 9 cases (10.7%), transient vocal cord paralysis in 6 patients (9.2%), temporary hypoparathyroidism in 9 patients (9.2%) and kidney failure in 1 case (0.9%).
CONCLUSIONS: The presence of a cervico-mediastinal thyroid mass with or without respiratory distress requires a surgical excision as the only treatment option. Thyroid masses extending to the mediastinum can be excised successfully by cervical incision. Bipolar approach (cervical incision and sternotomy) has an excellent outcome, achieving a safe resection, especially in large thyroid masses extending to the mediastinum with close relations to mediastinal structures and in some limited cases (carcinoma, thyroiditis, retrovascular goiter, ectopic goiter). Postoperative mortality and morbidity is very low, independent of surgical techniques. Other surgical approaches for excision of a Posterior Mediastinal Thyroid Goiter reported in literature are: VATS techniques to remove an ectopic intrathoracic goiter, robot-assisted technique for the removal of a substernal thyroid goiter, with extension into the posterior. mediastinum.

PMID: 26721191 [PubMed - as supplied by publisher]

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Sialendoscopy: what is it and what is its awareness?

Sialendoscopy: what is it and what is its awareness?

Eur Arch Otorhinolaryngol. 2015 Dec 31;

Authors: Prasad S, Pezier T, Faure F, Marchal F

Abstract
In expanding the scope of sialendoscopy across the globe and assessing the impact of training activities at the European Sialendoscopy Training Centre, this study was conducted to find out the knowledge and attitude among respondents as well as identify potential obstacles to the initiation of the procedure. Delegates attending the 2011 International Federation of Otorhinolaryngological Societies meeting received a set of five questions. There were a total of 257 responses from 57 countries. Nearly all (238/257) were practising in the academic setting. A significant number of respondents had heard about sialendoscopy (231/257). An equal number found it interesting and were keen to learn more about the procedure (233/257). More than 85 % (219/257) respondents expressed their desire to start sialendoscopy. Hurdles to overcome included financial limitations (110) and "not enough knowledge" (100). Awareness about the existence of the procedure was rather high although the knowledge was limited. Several of the responders seemed keen on starting it, but had not done so due to financial limitations. However, there was a high rate of bias owing to the limited number of responders per country precluding a country-wise inference of awareness. Moreover, meetings of this nature tend to be attended by academics who in general seem to be more aware of new developments than their non-academic peers. Future surveys can address these issues as part of ensuring the universal adoption of sialendoscopy.

PMID: 26721245 [PubMed - as supplied by publisher]

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Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

Int Arch Otorhinolaryngol. 2016 Jan;20(1):61-8

Authors: Silva CN, Ribeiro KM, Freitas RV, Ferreira LM, Guerra RO

Abstract
Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p < 0.05 and p = 0.001, respectively). However, more than half of the elderly participants did not achieve negative Dix-Hallpike. Regarding static and dynamic balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p < 0.05). Conclusion Results reveal clinical and functional benefits in elderly people with Benign Paroxysmal Positional Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints.

PMID: 26722348 [PubMed]

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Neurophysiological assessment of auditory, peripheral nerve, somatosensory, and visual system function after developmental exposure to gasoline, E15, and E85 vapors.

Neurophysiological assessment of auditory, peripheral nerve, somatosensory, and visual system function after developmental exposure to gasoline, E15, and E85 vapors.

Neurotoxicol Teratol. 2015 Dec 22;

Authors: Herr DW, Freeborn DL, Degn L, Martin SA, Ortenzio J, Pantlin L, Hamm CW, Boyes WK

Abstract
The use of gasolines blended with a range of ethanol concentrations may result in inhalation of vapors containing a variable combination of ethanol with other volatile gasoline constituents. The possibility of exposure and potential interactions between vapor constituents suggests the need to evaluate the possible risks of this complex mixture. Previously we evaluated the effects of developmental exposure to ethanol vapors on neurophysiological measures of sensory function as a component of a larger project evaluating developmental ethanol toxicity. Here we report an evaluation using the same battery of sensory function testing in offspring of pregnant dams exposed during gestation to condensed vapors of gasoline (E0), gasoline blended with 15% ethanol (E15) or gasoline blended with 85% ethanol (E85). Pregnant Long-Evans rats were exposed to target concentrations 0, 3000, 6000, or 9000ppm total hydrocarbon vapors for 6.5h/day over GD9 - GD20. Sensory evaluations of male offspring began as adults. The electrophysiological testing battery included tests of: peripheral nerve (compound action potentials, nerve conduction velocity [NCV]), somatosensory (cortical and cerebellar evoked potentials), auditory (brainstem auditory evoked responses), and visual functions. Visual function assessment included pattern elicited visual evoked potentials (VEP), VEP contrast sensitivity, dark-adapted (scotopic) electroretinograms (ERGs), light-adapted (photopic) ERGs, and green flicker ERGs. The results included sporadic statistically significant effects, but the observations were not consistently concentration-related and appeared to be statistical Type 1 errors related to multiple dependent measures evaluated. The exposure concentrations were much higher than can be reasonably expected from typical exposures to the general population during refueling or other common exposure situations. Overall the results indicate that gestational exposure of male rats to ethanol/gasoline vapor combinations did not cause detectable changes in peripheral nerve, somatosensory, auditory, or visual function when the offspring were assessed as adults.

PMID: 26721698 [PubMed - as supplied by publisher]

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Statistical context shapes stimulus-specific adaptation in human auditory cortex.

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

Statistical context shapes stimulus-specific adaptation in human auditory cortex.

J Neurophysiol. 2015 Apr 1;113(7):2582-91

Authors: Herrmann B, Henry MJ, Fromboluti EK, McAuley JD, Obleser J

Abstract
Stimulus-specific adaptation is the phenomenon whereby neural response magnitude decreases with repeated stimulation. Inconsistencies between recent nonhuman animal recordings and computational modeling suggest dynamic influences on stimulus-specific adaptation. The present human electroencephalography (EEG) study investigates the potential role of statistical context in dynamically modulating stimulus-specific adaptation by examining the auditory cortex-generated N1 and P2 components. As in previous studies of stimulus-specific adaptation, listeners were presented with oddball sequences in which the presentation of a repeated tone was infrequently interrupted by rare spectral changes taking on three different magnitudes. Critically, the statistical context varied with respect to the probability of small versus large spectral changes within oddball sequences (half of the time a small change was most probable; in the other half a large change was most probable). We observed larger N1 and P2 amplitudes (i.e., release from adaptation) for all spectral changes in the small-change compared with the large-change statistical context. The increase in response magnitude also held for responses to tones presented with high probability, indicating that statistical adaptation can overrule stimulus probability per se in its influence on neural responses. Computational modeling showed that the degree of coadaptation in auditory cortex changed depending on the statistical context, which in turn affected stimulus-specific adaptation. Thus the present data demonstrate that stimulus-specific adaptation in human auditory cortex critically depends on statistical context. Finally, the present results challenge the implicit assumption of stationarity of neural response magnitudes that governs the practice of isolating established deviant-detection responses such as the mismatch negativity.

PMID: 25652920 [PubMed - indexed for MEDLINE]

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Peroneal intraneural ganglia formation causing foot drop in children; clinical perspective.

Peroneal intraneural ganglia formation causing foot drop in children; clinical perspective.

World Neurosurg. 2015 Dec 22;

Authors: Jacques L

PMID: 26721618 [PubMed - as supplied by publisher]

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The Anterior Subcallosal Approach to Third Ventricular and Suprasellar Lesions: Anatomical Description and Technical Note.

The Anterior Subcallosal Approach to Third Ventricular and Suprasellar Lesions: Anatomical Description and Technical Note.

World Neurosurg. 2015 Dec 22;

Authors: Liebelt BD, Hooten KG, Britz GW

Abstract
BACKGROUND: Surgical access to the third ventricle is challenging given the depth of the operative field and close proximity of vital neural structures that must be traversed. For anterior third ventricular lesions approach options include anterior transcallosal or transcortical, subfrontal, frontotemporal, or endonasal. The subcallosal approach, a trans-lamina terminalis approach, is unique in that the surgical corridor is just below the corpus callosum, minimizes retraction, and preserves corpus callosum integrity. Case examples are provided and an anatomical study delineating the dimensions of the surgical corridor is performed.
METHODS: Two latex injected cadaver heads were utilized to describe the subcallosal corridor. An MRI was obtained and registered with neuronavigation for correlative anatomical illustration. Depth, dimensions, and cross-sectional area were measured for the subcommunicating and supracommunicating corridors.
RESULTS: The surgical depth for anterior transcallosal, subcallosal, and subfrontal approaches was 7.5 cm, 7.7 cm, and 7.6 cm respectively. The average corridor dimensions for the subcallosal approach was 14.75 x 6.63 mm compared to 8.88 x 5.38 mm for the subcommunicating corridor. Cross sectional area of the subcommunicating corridor was 30.62 mm(2) compared to 80.42 mm(2) for supracommunicating. This was easily enlarged to 156.62 mm(2) with gentle retraction.
CONCLUSIONS: The anterior subcallosal approach is a safe approach for lesions of the third ventricle that avoids splitting the corpus callosum, resecting unnecessary brain, and minimizes brain retraction. This corridor is superior to the traditional subfrontal approach in terms of working space and compares favorably to the anterior transcallosal approach without disrupting the corpus callosum.

PMID: 26721617 [PubMed - as supplied by publisher]

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Analysis of factors contributing to infections following cranioplasty: a single-institution retrospective chart review.

Analysis of factors contributing to infections following cranioplasty: a single-institution retrospective chart review.

World Neurosurg. 2015 Dec 22;

Authors: Riordan MA, Simpson VM, Hall WA

PMID: 26721616 [PubMed - as supplied by publisher]

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Predictors of Outcome in Traumatic Brain Injury.

Predictors of Outcome in Traumatic Brain Injury.

World Neurosurg. 2015 Dec 22;

Authors: Baum J, Entezami P, Shah K, Medhkour A

Abstract
INTRODUCTION: The purpose of this study was to retrospectively evaluate patients treated for traumatic brain injuries (TBI) to determine how multiple organ trauma (MOT) and lung injuries sustained at the time of initial injury affect outcome.
METHOD: A single institution retrospective review of all patients diagnosed with TBI at a level I trauma center from 2000-2014 was conducted. Clinical outcome was based on Glasgow Outcome Scale (GOS) at hospital discharge. Lung injury was defined as the presence of pulmonary contusions, pneumothorax, hemothorax, rib fractures, or diaphragmatic rupture proven by X-ray or CT scan. MOT was defined as trauma to one body region with an AIS score ≥ 3 plus trauma to two additional body regions with AIS scores ≥ 1.Regression analysis was conducted using SPSS 21.
RESULTS: There were 409 patients reviewed. Majority of patients were male (73%), average age was 46y (16-94), average GCS was 7, and 71% had a severe TBI (GCS≤8). Thirty percent of patients had poor outcome (GOS=1-2) Regression analysis indicated age (OR=1.03, p<0.001), initial GCS (OR=0.88, p<0.001), ISS (OR=1.03, p=0.021), and head AIS≥5 (OR=0.55, p=0.019) were significant independent predictors of poor outcome. Sex, MOT, lung injury, and lung injury severity were not significant predictors of outcome.
CONCLUSIONS: Age, GCS, ISS, and critical head injuries (AIS≥5) were significant tools in predicting outcome in this patient cohort. Multiple organ trauma and traumatic lung injury may cause significant damage to a patient suffering from a severe TBI, but these injuries do not predict mortality in this patient population.

PMID: 26721615 [PubMed - as supplied by publisher]

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Neuroendoscopy for Intraventricular Tumor Resection.

Neuroendoscopy for Intraventricular Tumor Resection.

World Neurosurg. 2015 Dec 22;

Authors: Rocque B

PMID: 26721614 [PubMed - as supplied by publisher]

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ALX1 promotes migration and invasion of lung cancer cells through increasing snail expression.

ALX1 promotes migration and invasion of lung cancer cells through increasing snail expression.

Int J Clin Exp Pathol. 2015;8(10):12129-39

Authors: Yao W, Liu Y, Zhang Z, Li G, Xu X, Zou K, Xu Y, Zou L

Abstract
Lung cancer is one of the main causes in cancer-related death. Here we reported a novel functional role of Aristaless-like homeobox1 (ALX1) in lung carcinogenesis. Analysis of ALX1 in lung cancer specimens confirms upregulation of ALX1 in lung cancer, especially these with distant metastasis. Moreover, higher level of ALX1 expression is associated with poorer prognosis of lung cancer patients. Ectopic expression of ALX1 significantly promotes lung cancer cell proliferation, migration and invasion, while ALX1 silencing by siRNA significantly inhibits these abilities of lung cancer cells. The functional role of ALX1 is dependent on increasing Snail expression and knockdown of Snail could restrain the role of ALX1. Collectively, we identify critical roles of ALX1 in lung cancer development and progression. These findings may serve as a framework for future investigations designed to more comprehensive determination of ALX1 as a potential therapeutic target.

PMID: 26722397 [PubMed - in process]

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MicroRNA-34a-5p enhances sensitivity to chemotherapy by targeting AXL in hepatocellular carcinoma MHCC-97L cells.

MicroRNA-34a-5p enhances sensitivity to chemotherapy by targeting AXL in hepatocellular carcinoma MHCC-97L cells.

Oncol Lett. 2015 Nov;10(5):2691-2698

Authors: Li XY, Wen JY, Jia CC, Wang TT, Li X, Dong M, Lin QU, Chen ZH, Ma XK, Wei LI, Lin ZX, Ruan DY, Chen J, Wu DH, Liu W, Tai Y, Xiong ZY, Wu XY, Zhang QI

Abstract
Mature microRNA (miRNA) 34a-5p, which is a well-known tumor suppressor in hepatitis virus-associated hepatocellular carcinoma (HCC), plays an important role in cell processes, such as cell proliferation and apoptosis, and is therefore an optimal biomarker for future clinical use. However, the role of miRNA-34a-5p in chemoresistance has yet to be identified. In the present study, the expression of miRNA-34a-5p was assessed by an in situ hybridization assay in HCC tissues and was found to be significantly decreased compared with the pericarcinomatous areas of the tissue specimens, which consisted of samples obtained from 114 patients with HCC. High expression of miRNA-34a-5p was found to be associated with a favorable overall survival time in HCC patients. Functional tests performed by transfecting miRNA-34a-5p mimics or inhibitors into MHCC-97L cells illustrated that miRNA-34a-5p inhibited proliferation, elevated apoptosis and decreased chemoresistance to cisplatin in HCC cells. AXL is the direct target of miRNA-34a-5p, as confirmed by sequence analysis and luciferase assay. Transfection of the cells with small interfering RNA for AXL (siAXL) increased the apoptosis ratio of the MHCC-97L cell line. Transfection with siAXL led to similar biological behaviors in the MHCC-97L cells to those induced by ectopic expression of miRNA-34a-5p. Thus, it was concluded that miRNA-34a-5p enhanced the sensitivity of the cells to chemotherapy by targeting AXL in hepatocellular carcinoma. In addition, low expression of miRNA-34a-5p in HCC tissues yielded an unfavorable prognosis for patients with HCC that received radical surgery, due to the promotion of proliferation and an increase in chemoresistance in HCC cells.

PMID: 26722228 [PubMed - as supplied by publisher]

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PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response.

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response.

Cardiovasc Intervent Radiol. 2015 Dec 31;

Authors: Fowler KJ, Maughan NM, Laforest R, Saad NE, Sharma A, Olsen J, Speirs CK, Parikh PJ

Abstract
PURPOSE: The purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 ((90)Y) microsphere radioembolization.
MATERIALS AND METHODS: 26 patients undergoing lobar treatment with (90)Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.
RESULTS: A total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p < 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response.
CONCLUSIONS: PET/MRI of (90)Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of (90)Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.

PMID: 26721589 [PubMed - as supplied by publisher]

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Profiling Long Noncoding RNA Expression Using Custom-Designed Microarray.

Profiling Long Noncoding RNA Expression Using Custom-Designed Microarray.

Methods Mol Biol. 2016;1402:33-41

Authors: Zhang X, Lopez-Berestein G, Sood AK, Calin GA

Abstract
Long noncoding RNAs (lncRNAs) are an important class of pervasive genes involved in a variety of biological functions. The abnormal expression of lncRNAs has been implicated in a range of many human diseases, including cancer. But only a small number of functional lncRNAs have been well characterized to date. lncRNA expression profiling may help to identify useful molecular biomarkers and targets for novel therapeutic approaches in the future. In this chapter, we describe a highly efficient lncRNA expression profiling method using a custom-designed microarray.

PMID: 26721482 [PubMed - in process]

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METASTATIC RADIOIODINE AVID STRUMA OVARII ASSOCIATED WITH PSEUDO-MEIGS' SYNDROME.

METASTATIC RADIOIODINE AVID STRUMA OVARII ASSOCIATED WITH PSEUDO-MEIGS' SYNDROME.

J Ayub Med Coll Abbottabad. 2015 Jul-Sep;27(3):731-4

Authors: Riaz S, Bashir H, Hassan A, Syed AA, Hussain M, Imtiaz S

Abstract
We report a case of 21 years old lady who presented with ascites, left adnexal mass and elevated CA-125. With suspicion of ovarian malignancy, she underwent left salpingo-oophorectomy with omental biopsy. Histopathology revealed: 'follicular variant of papillary thyroid carcinoma arising in struma ovarii' with metastatic papillary thyroid carcinoma in omental and peritoneal nodules. Patient underwent total thyroidectomy followed by radioactive iodine therapy for metastatic omental and peritoneal disease. Post-therapy whole body scan, revealed extensive I-131 avid disease metastatic disease involving the chest, abdomen, pelvis and the musculoskeletal system. Patient was treated with multiple doses of high dose radioactive iodine. She became symptom free on supra-physiologic doses of oral thyroxin however her high thyroglobulin levels and residual radioiodine avid metastatic disease required further treatment. In literature a few cases of struma ovarii have been reported with elevated CA-125 and associated pseudo-Meigs' syndrome. The treatment for this rare disease is still not standardized and poses a therapeutic challenge. Our case emphasizes the need for a multidisciplinary approach for managing struma ovarii.

PMID: 26721055 [PubMed - in process]

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Radiolabeled BMIPP for imaging hepatic fatty acid metabolism: evaluation of hepatic distribution and metabolism in mice at various metabolic statuses induced by fasting in comparison with palmitic acid.

Radiolabeled BMIPP for imaging hepatic fatty acid metabolism: evaluation of hepatic distribution and metabolism in mice at various metabolic statuses induced by fasting in comparison with palmitic acid.

Mol Imaging. 2015;14

Authors: Yamasaki K, Zhao S, Nishimura M, Zhao Y, Yu W, Shimizu Y, Nishijima K, Tamaki N, Takeda H, Kuge Y

Abstract
Abnormalities in hepatic fatty acid metabolism are involved in various diseases. In order to clarify the use of 123I-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid ([123I]BMIPP) for imaging hepatic fatty acid metabolism, we determined the hepatic distribution/metabolism of [125I]BMIPP in mice at various metabolic statuses induced by fasting, and compared the results with those of [1-(14)C]palmitic acid ([1-(14)C]PA). Fed or fasted (6, 12, and 24 hour-fasted) mice were intravenously injected with [125I]BMIPP or [1-(14)C]PA. Hepatic radioactivity was measured at 1 to 120 minutes after the injection (n = 5 to 15/time points), and radioactive lipid metabolites were analyzed by thin-layer chromatography (n = 3/time points). The areas under the curves (AUCs) were calculated. In mice given [125I]BMIPP, the hepatic radioactivity was increased with the fasting time (AUC: 35.1, 45.5, 57.6, and 59.0 [% injected dose (ID)/g/kg]▪min for fed, 6, 12, and 24 hour-fasted). Similar characteristic changes were observed in mice given [1-(14)C]PA (100.6, 101.0, 116.5, and 121.5 [%ID/g/kg]▪min). Metabolite analysis showed that the triglyceride-fraction was increased by fasting in both groups (5.7, 12.8, 32.0, and 37.9 [%ID/g/kg]▪min for [125I]BMIPP groups; 20.6, 39.2, 66.0, and 67.9 [%ID/g/kg]▪min for [1-(14)C]PA groups). Thus, [125I]BMIPP demonstrated the changes in hepatic fatty acid metabolism induced by fasting, indicating the potential of [123I]BMIPP for imaging hepatic fatty acid metabolism.

PMID: 25744134 [PubMed - indexed for MEDLINE]

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Pathological analysis of collision (double primary) cancer in the upper digestive tract concomitant with gastric stromal tumor: a case report.

Pathological analysis of collision (double primary) cancer in the upper digestive tract concomitant with gastric stromal tumor: a case report.

Int J Clin Exp Pathol. 2015;8(10):13523-7

Authors: Sun X, Zou Y, Hao Y, Cheng H, Zhou C, Meng X

Abstract
Carcinoma of the esophagus and cardiac cancer are common malignancies, while multiple primary cancers in the esophagus and cardia is rarely encountered and easily misdiagnosed. Multiple primary cancers mean the same organs (tissues) or different organs (tissues) have two or more than two primary malignant tumors at the same time or in sequence in the same individual. The case below of two independent primary lesions is double primary carcinoma which meets the diagnosis standard of multiple primary cancers. Gastrointestinal stromal tumor is the most common stromal tumor, which is usually considered as originating from Cajal cells in the gastrointestinal tract or mesenchymal stem cells with the mutation of KIT or PDGFRA gene. Study on stromal tumor with digestive tract cancer is less both at home and abroad, while double primary carcinoma with stromal tumor is rare, which has not been reported at present. Although scholars have different viewpoints on the prognosis, but the full understanding of this disease can be as a warning for the future work and to avoid misdiagnosis.

PMID: 26722567 [PubMed - in process]

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Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

Int Arch Otorhinolaryngol. 2016 Jan;20(1):61-8

Authors: Silva CN, Ribeiro KM, Freitas RV, Ferreira LM, Guerra RO

PMID: 26722348 [PubMed]

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IJERPH, Vol. 13, Pages 88: Cadmium Chloride Induces DNA Damage and Apoptosis of Human Liver Carcinoma Cells via Oxidative Stress

Cadmium is a heavy metal that has been shown to cause its toxicity in humans and animals. Many documented studies have shown that cadmium produces various genotoxic effects such as DNA damage and chromosomal aberrations. Ailments such as bone disease, renal damage, and several forms of cancer are attributed to overexposure to cadmium. Although there have been numerous studies examining the effects of cadmium in animal models and a few case studies involving communities where cadmium contamination has occurred, its molecular mechanisms of action are not fully elucidated. In this research, we hypothesized that oxidative stress plays a key role in cadmium chloride-induced toxicity, DNA damage, and apoptosis of human liver carcinoma (HepG2) cells. To test our hypothesis, cell viability was determined by MTT assay. Lipid hydroperoxide content stress was estimated by lipid peroxidation assay. Genotoxic damage was tested by the means of alkaline single cell gel electrophoresis (Comet) assay. Cell apoptosis was measured by flow cytometry assessment (Annexin-V/PI assay). The result of MTT assay indicated that cadmium chloride induces toxicity to HepG2 cells in a concentration-dependent manner, showing a 48 hr-LD50 of 3.6 µg/mL. Data generated from lipid peroxidation assay resulted in a significant (p < 0.05) increase of hydroperoxide production, specifically at the highest concentration tested. Data obtained from the Comet assay indicated that cadmium chloride causes DNA damage in HepG2 cells in a concentration-dependent manner. A strong concentration-response relationship (p < 0.05) was recorded between annexin V positive cells and cadmium chloride exposure. In summary, these in vitro studies provide clear evidence that cadmium chloride induces oxidative stress, DNA damage, and programmed cell death in human liver carcinoma (HepG2) cells.

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IJMS, Vol. 17, Pages 58: Effect of Chromatin Structure on the Extent and Distribution of DNA Double Strand Breaks Produced by Ionizing Radiation; Comparative Study of hESC and Differentiated Cells Lines

Chromatin structure affects the extent of DNA damage and repair. Thus, it has been shown that heterochromatin is more protective against DNA double strand breaks (DSB) formation by ionizing radiation (IR); and that DNA DSB repair may proceed differently in hetero- and euchromatin regions. Human embryonic stem cells (hESC) have a more open chromatin structure than differentiated cells. Here, we study the effect of chromatin structure in hESC on initial DSB formation and subsequent DSB repair. DSB were scored by comet assay; and DSB repair was assessed by repair foci formation via 53BP1 antibody staining. We found that in hESC, heterochromatin is confined to distinct regions, while in differentiated cells it is distributed more evenly within the nuclei. The same dose of ionizing radiation produced considerably more DSB in hESC than in differentiated derivatives, normal human fibroblasts; and one cancer cell line. At the same time, the number of DNA repair foci were not statistically different among these cells. We showed that in hESC, DNA repair foci localized almost exclusively outside the heterochromatin regions. We also noticed that exposure to ionizing radiation resulted in an increase in heterochromatin marker H3K9me3 in cancer HT1080 cells, and to a lesser extent in IMR90 normal fibroblasts, but not in hESCs. These results demonstrate the importance of chromatin conformation for DNA protection and DNA damage repair; and indicate the difference of these processes in hESC.

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A new breakable stent for recoarctation in early infancy: Preliminary Clinical Experience

Objectives

Transcatheter treatment of aortic coarctation (CoA) via stent implantation has become an established treatment option depending on the patient's age and CoA type.

Background

The Osypka BabyStent® is a low-profiled, balloon-expandable cobalt-chrome stent to treat aortic CoA in infants, which is breakable to permit unrestricted growth. We hereby evaluated our initial clinical experience to demonstrate the feasibility and efficacy of this new nonlicensed device, which we have occasionally implanted in critically ill patients or when redo-surgery would entail an excessively high risk.

Methods

Retrospective single-center analysis of all available data during and after treatment with a BabyStent implanted in infants with considerable re-CoA or reobstruction of the aortic arch after former surgery. All interventions took place under fluoroscopy and conscious sedation with local anesthesia or general anesthesia.

Results

Five BabyStents were implanted in four infants with technical success in all of them—median age 10 weeks (range 5–21), median bodyweight 3.8 kg (range 2.7–4.5). Aortic diameters enlarged from median 2.25 mm (range 1.5–3.3) to median 5.3 mm (range 4.6–6.0). The follow-up period lasting up to 26 months (median 8.5, range 2–26) was uneventful concerning stent-related complications.

Conclusions

BabyStent® implantation for recoarctation was effective. However, our initial experience with the device is limited to short- and midterm follow-up only. None of the stents was subsequently overdilated with the intention to break due to our patients' limited somatic growth so far. A multicenter survey has been initiated to justify device approval. © 2016 Wiley Periodicals, Inc.

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We already know the best way to win the conflict on medicine – The Times (subscription)

We already know the best way to win the conflict on medicine
The Times (subscription)
In January 1964, the Beatles first broke onto the Billboard chart with I Want to Hold Your Hand; by June, Ringo Starr had collapsed from tonsillitis and pharyngitis. In January, the US surgeon-general announced that scientists had found conclusive …

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IJMS, Vol. 17, Pages 53: Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of drugs targeted at reducing aspects of the post-burn hypermetabolic response such as heart rate and cardiac work, there is still a paucity of knowledge regarding the underlying mechanisms that induce cardiac dysfunction in the severely burned. There are many animal models of burn injury, from rodents, to sheep or swine, but the majority of burn related cardiovascular investigations have occurred in rat and mouse models. This literature review consolidates the data supporting the prevalent role that β-adrenergic receptors play in mediating post-burn cardiac dysfunction and the idea that pharmacological modulation of this receptor family is a viable therapeutic target for resolving burn-induced cardiac deficits.

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Cancers, Vol. 8, Pages 6: Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer

Background: Elderly patients receiving anticancer drugs may have an increased risk to develop treatment-related toxicities compared to their younger peers. However, a potential pharmacokinetic (PK) basis for this increased risk has not consistently been established yet. Therefore, the objective of this study was to systematically review the influence of age on the PK of anticancer agents frequently administered to elderly breast cancer patients. Methods: A literature search was performed using the PubMed electronic database, Summary of Product Characteristics (SmPC) and available drug approval reviews, as published by EMA and FDA. Publications that describe age-related PK profiles of selected anticancer drugs against breast cancer, excluding endocrine compounds, were selected and included. Results: This review presents an overview of the available data that describe the influence of increasing age on the PK of selected anticancer drugs used for the treatment of breast cancer. Conclusions: Selected published data revealed differences in the effect and magnitude of increasing age on the PK of several anticancer drugs. There may be clinically-relevant, age-related PK differences for anthracyclines and platina agents. In the majority of cases, age is not a good surrogate marker for anticancer drug PK, and the physiological state of the individual patient may better be approached by looking at organ function, Charlson Comorbidity Score or geriatric functional assessment.

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Ichthyosis

Ichthyosis: Dry, rectangular scales on the skin. Like fish scales. From the Greek «ichthys» meaning fish.

Ichthyosis is not one but rather a group of skin disorders characterized by scaling of the skin. Many different metaphors have been used to describe the appearance and texture of the skin in the various types and stages of ichthyosis, for example alligator skin, crocodile skin, collodion skin, porcupine skin and, of course, fish skin.

Most ichthyoses are genetic (inherited). Some ichthyoses develop in association with various systemic diseases or be a prominent feature in certain genetic syndromes. The term «ichthyosis» is commonly used alone to refer to ichthyosis vulgaris.

Ichthyosis vulgaris, also known as ichthyosis simplex, is inherited as an autosomal (nonsex-linked) trait and is characterized by scaly (fishlike) areas of skin. The first scaly skin problems usually appear after 3 months of age. The palms and soles are often affected. Areas that tend to be spared include the axillae (the armpits), the antecubital fossa (the inside area at the bend of the elbow) and the popliteal fossa (behind the knee).

The gene responsible for ichthyosis vulgaris has been mapped to chromosome band 1q21. The product of this gene is thought to be a substance called filaggrin (abbreviated FLG) which may act as the «keratin matrix protein» in cells of the stratum corneum, one of the layers of the skin.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
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International Journal of Stroke

International Journal of Stroke, published by SAGE Publications, last updated on 2015-12-31, available at http://wso.sagepub.com

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Kopfschmerz im Alter kann viele Ursachen haben

Migräne & Co.
Inzidenz und Symptomatik von Kopfschmerzerkrankungen ändern sich mit dem Alter. Wie gehen Sie bei alten Kopfschmerzpatienten am besten diagnostisch vor und welche Differenzialdiagnosen sind auszuschließen?

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Materials, Vol. 9, Pages 18: Influence of Blended Cements with Calcareous Fly Ash on Chloride Ion Migration and Carbonation Resistance of Concrete for Durable Structures

The objective of this paper is to examine the possible use of new blended cements containing calcareous fly ash in structural concrete, potentially adequate for structural elements of nuclear power plants. The investigation included five new cements made with different contents of non-clinker constituents: calcareous fly ash, siliceous fly ash, ground granulated blastfurnace slag, and a reference cement—ordinary Portland cement. The influence of innovative cements on the resistance of concrete to chloride and carbonation exposure was studied. Additionally, an evaluation of the microstructure was performed using optical microscopy on concrete thin sections. Test results revealed a substantial improvement of the resistance to chloride ion penetration into concrete containing blended cements. The resistance was higher for increased clinker replacement levels and increased with curing time. However, concrete made with blended cements exhibited higher depth of carbonation than the Portland cement concrete, except the Portland-fly ash cement with 14.3% of calcareous fly ash. The thin sections analysis confirmed the values of the carbonation depth obtained from the phenolphthalein test. Test results indicate the possible range of application for new cements containing calcareous fly ash.

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METASTATIC RADIOIODINE AVID STRUMA OVARII ASSOCIATED WITH PSEUDO-MEIGS' SYNDROME.

METASTATIC RADIOIODINE AVID STRUMA OVARII ASSOCIATED WITH PSEUDO-MEIGS' SYNDROME.

J Ayub Med Coll Abbottabad. 2015 Jul-Sep;27(3):731-4

Authors: Riaz S, Bashir H, Hassan A, Syed AA, Hussain M, Imtiaz S

PMID: 26721055 [PubMed - in process]

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Radiolabeled BMIPP for imaging hepatic fatty acid metabolism: evaluation of hepatic distribution and metabolism in mice at various metabolic statuses induced by fasting in comparison with palmitic acid.

Mol Imaging. 2015;14

Authors: Yamasaki K, Zhao S, Nishimura M, Zhao Y, Yu W, Shimizu Y, Nishijima K, Tamaki N, Takeda H, Kuge Y

PMID: 25744134 [PubMed - indexed for MEDLINE]

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Lang anhaltender Erfolg gegen Myelofibrose?

Mit Tyrosinkinaseinhibitor
Vor allem die Splenomegalie führt bei Myelofibrose, einer potenziell tödlichen Bluterkrankung, zu erheblichen Einbußen der Lebensqualität. Mit Ruxolitinib lassen sich die belastende Milzvergrößerung und andere assoziierte Symptome rasch reduzieren. Doch hält der Erfolg auch an?

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Welche Ärzte trinken den meisten Kaffee?

Forschung mit Augenzwinkern
Kaffeetrinken ist beliebt – auch bei Ärzten. Doch welche Fachrichtung konsumiert während der Arbeit die größte Menge des Heißgetränks? Dieser Frage ging ein Schweizer Krankenhaus in einer eigenen Studie nach.

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Changes in the Distribution of Capsular Serotypes of Streptococcus pneumoniae Isolated from Adult Respiratory Specimens in Japan.

Changes in the Distribution of Capsular Serotypes of Streptococcus pneumoniae Isolated from Adult Respiratory Specimens in Japan.

Intern Med. 2015;54(11):1337-41

Authors: Shoji H, Maeda M, Shirakura T, Takuma T, Hanaki H, Niki Y

Abstract
OBJECTIVE: The objective of this study was to assess whether the distribution of pneumococcal capsular types has been changed, while also providing basic data on changes in the distribution after the introduction of Pneumococcal conjugated vaccine (PCV)13 in adult medical practice.
METHODS: We analyzed 431 Streptococcus pneumoniae strains (200 in 2006 and 231 in 2012) that had been isolated from respiratory infection specimens from adult patients. Capsular typing was performed by the Quellung reaction and multiplex polymerase chain reaction.
RESULTS: A comparison of the 2006 and 2012 strains revealed that the number and proportion of strains by serotype increased from 30 (15%) to 46 (20%) for serotype 3, from 4 (2%) to 14 (6%) for serotype 6A, and from 4 (2%) to 13 (6%) for serotype 6C, whereas the number and proportion of strains by serotype decreased from 8 (4%) to 0 (0%) for serotype 4 and from 24 (12%) to 17 (7%) for serotype 6B. From 2006 to 2012, the coverage rate significantly decreased from 39 to 28.1% for PCV7 (p=0.017).
CONCLUSION: Our study showed a decrease in the vaccine coverage of PCV7. However, PCV13 covered serotypes 3 and 6A, which are prevalent, as well as penicillin-resistant S. pneumoniae strains. At present, PCV13 in adult clinical practice seems to be highly significant. However, there is a possibility that the distribution has changed, and careful screening should be continued in the future.

PMID: 26027983 [PubMed – indexed for MEDLINE]

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SYNOVIAL SARCOMA OF THE LARYNX.

SYNOVIAL SARCOMA OF THE LARYNX.

J Ayub Med Coll Abbottabad. 2015 Jul-Sep;27(3):729-30

Authors: Javed N, Iqbal J

Abstract
Synovial sarcoma is a mesenchymal spindle cell tumour that displays variable epithelial differentiation. It most commonly occurs in lower extremities. Head and neck is a rare site for synovial sarcoma accounting for less than 10%. Larynx is an extremely rare site and only 16 cases with laryngeal location have been reported. Immunohistochemistry is important for correct diagnosis. Surgical excision of the tumour with clear margins and local radiotherapy is effective in local control. Chemotherapy is indicated in the presence of distant metastasis. Case of a 16 years old female is presented with hoarseness of voice and mass in supraglottic region. Lateral pharangotomy and excision of mass revealed synovial sarcoma. She had been treated with adjuvant radiotherapy in September 2012. She was fine and coming for regular follow up.

PMID: 26721054 [PubMed – in process]

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Autophagy mediates tolerance to Staphylococcus aureus alpha-toxin.

http:--linkinghub.elsevier.com-ihub-imag

Autophagy mediates tolerance to Staphylococcus aureus alpha-toxin.

Cell Host Microbe. 2015 Apr 8;17(4):429-40

Authors: Maurer K, Reyes-Robles T, Alonzo F, Durbin J, Torres VJ, Cadwell K

Abstract
Resistance and tolerance are two defense strategies employed by the host against microbial threats. Autophagy-mediated degradation of bacteria has been extensively described as a major resistance mechanism. Here we find that the dominant function of autophagy proteins during infections with the epidemic community-associated methicillin-resistant Staphylococcus aureus USA300 is to mediate tolerance rather than resistance. Atg16L1 hypomorphic mice (Atg16L1(HM)), which have reduced autophagy, were highly susceptible to lethality in both sepsis and pneumonia models of USA300 infection. Autophagy confers protection by limiting the damage caused by α-toxin, particularly to endothelial cells. Remarkably, Atg16L1(HM) mice display enhanced survival rather than susceptibility upon infection with α-toxin-deficient S. aureus. These results identify an essential role for autophagy in tolerance to Staphylococcal disease and highlight how a single virulence factor encoded by a pathogen can determine whether a given host factor promotes tolerance or resistance.

PMID: 25816775 [PubMed – indexed for MEDLINE]

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Long-term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery.

Long-term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery.

Otolaryngol Head Neck Surg. 2015 Dec 31;

Authors: Sarcu D, Isaacson G

Abstract
OBJECTIVE: Routine endoscopic examination during primary surgery decreased the rate of residual cholesteatoma to 18% in our early experience. Based on this, we stopped performing routine second-look surgery in children who were endoscopically free of cholesteatoma at the end of primary surgery. We sought to investigate if second-look procedures after endoscopic-assisted surgery could safely be performed only in children at a high risk of residual disease (extensive inflammation, spontaneously ruptured or fragmented cholesteatoma, residual disease intentionally left).
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary pediatric otolaryngology practice.
SUBJECTS AND METHODS: Children aged 1 to 16 years who were treated for cholesteatoma over 15-year period by a single surgeon. Extent of disease and endoscopic findings were compared with rates of residual disease. Time to diagnosis of residual disease and prognostic factors were analyzed.
RESULTS: Forty-two children underwent endoscopically assisted middle ear surgery for cholesteatoma. Of 42 children, 7 (17%) had additional disease found by endoscopy that was missed by microscopy alone. Twelve children at high risk had second looks; 5 (42%) had residual disease. Of 30 children, 2 (7%) presented with macroscopically evident residual cholesteatoma after no planned second look on office follow-up and subsequently underwent reoperation and were cured.
CONCLUSIONS: Selective second-look surgery in high-risk children did not adversely affect outcome as compared with the low-risk group. Cholesteatoma was identified endoscopically in 7 of 42 (17%) children thought to be microscopically free of disease at initial surgery. The endoscope may aid in visualization of difficult middle ear recesses when used to complement microscopy. Further investigation with multicenter data is needed.

PMID: 26721891 [PubMed – as supplied by publisher]

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The polysaccharide capsule of Streptococcus pneumonia partially impedes MyD88-mediated immunity during pneumonia in mice.

The polysaccharide capsule of Streptococcus pneumonia partially impedes MyD88-mediated immunity during pneumonia in mice.

PLoS One. 2015;10(2):e0118181

Authors: de Vos AF, Dessing MC, Lammers AJ, de Porto AP, Florquin S, de Boer OJ, de Beer R, Terpstra S, Bootsma HJ, Hermans PW, van 't Veer C, van der Poll T

Abstract
Toll-like receptors (TLR) and the downstream adaptor protein MyD88 are considered crucial for protective immunity during bacterial infections. Streptococcus (S.) pneumoniae is a human respiratory pathogen and a large majority of clinical pneumococcal isolates expresses an external polysaccharide capsule. We here sought to determine the role of pneumococcal capsule in MyD88-mediated antibacterial defense during S. pneumonia pneumonia. Wild type (WT) and Myd88(-/-) mice were inoculated intranasally with serotype 2 S. pneumoniae D39 or with an isogenic capsule locus deletion mutant (D39∆cps), and analysed for bacterial outgrowth and inflammatory responses in the lung. As compared to WT mice, Myd88(-/-) mice infected with D39 demonstrated a modestly impaired bacterial clearance accompanied by decreased inflammatory responses in the lung. Strikingly, while WT mice rapidly cleared D39∆cps, Myd88(-/-) mice showed 105-fold higher bacterial burdens in their lungs and dissemination to blood 24 hours after infection. These data suggest that the pneumococcal capsule impairs recognition of TLR ligands expressed by S. pneumoniae and thereby partially impedes MyD88-mediated antibacterial defense.

PMID: 25700108 [PubMed – indexed for MEDLINE]

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Inflammatory myofibroblastic tumor of the larynx: report of a case and review of the literature.

Inflammatory myofibroblastic tumor of the larynx: report of a case and review of the literature.

Int J Clin Exp Pathol. 2015;8(10):13557-60

Authors: Yan Q, Hu XL

Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm, most commonly seen in children and adolescents. It can occur in nearly every part of the body. Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm mostly seen in the lungs, but also in extrapulmonary sites. But it may rarely be seen in the vical cord. We report a case of a 73-year-old men presented with hoarseness and cough. Laryngoscopy reveals a large non-ulcerated, red subepithelial mass arising from the right vical cord. Magnetic resonance imaging (MRI) scan revealed a mass in the right vical cord, and magnetic resonance imaging (MRI) enhanced scan showed the mass of the right vical cord inhomogeneous enhancement. The patient underwent right cordectomy with KTP laser, and further assessment of the tissue demonstrated a pathologic diagnosis of IMT.

PMID: 26722573 [PubMed – in process]

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Preoperative external tissue expansion for complex cranial reconstructions.

Preoperative external tissue expansion for complex cranial reconstructions.

J Neurosurg. 2016 Jan 1;:1-8

Authors: Reinard KA, Zakaria HM, Qatanani A, Lee IY, Rock JP, Houin HP

Abstract
OBJECTIVE Reconstruction of large solitary cranial defects after multiple craniotomies is challenging because scalp contraction generally requires more than simple subcutaneous undermining to ensure effective and cosmetically appealing closure. In plastic and reconstructive surgery, soft tissue expansion is considered the gold standard for reconstructing scalp defects; however, these techniques are not well known nor are they routinely practiced among neurosurgeons. The authors here describe a simple external tissue expansion technique that is associated with low morbidity and results in high cosmetic satisfaction among patients. METHODS The authors reviewed the medical records of patients with large cranial defects (> 5 cm) following multiple complicated craniotomies who had undergone reconstructive cranioplasty with preoperative tissue expansion using the DermaClose RC device. In addition to gathering data on patient age, sex, primary pathology, number of craniotomies and/or craniectomies, history of radiation therapy, and duration of external scalp tissue expansion, the authors screened patient charts for cerebrospinal fluid (CSF) leak, meningitis, intracranial abscess formation, dermatitis, and patient satisfaction rates. RESULTS The 6 identified patients (5 female, 1 male) had an age range from 36 to 70 years. All patients had complicating factors such as recalcitrant scalp infections after multiple craniotomies or cranial radiation, which led to secondary scalp tissue scarring and retraction. All patients were deemed to be potential candidates for rotational flaps with or without skin grafts. All patients underwent the same preoperative tissue expansion followed by standard cranial bone reconstruction. None of the patients developed CSF leak, meningitis, intracranial abscess, dermatitis, or permanent cosmetic defects. None of the patients required a reoperation. Mean follow-up was 117 days. CONCLUSIONS Preoperative scalp tissue expansion with the DermaClose RC device allows for simple and reliable completion of complicated cranial reconstruction with low morbidity rates and high cosmetic satisfaction among patients.

PMID: 26722853 [PubMed - as supplied by publisher]

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MICROVASCULAR DECOMPRESSION FOR TRIGEMINAL NEURALGIA.

MICROVASCULAR DECOMPRESSION FOR TRIGEMINAL NEURALGIA.

J Ayub Med Coll Abbottabad. 2015 Jul-Sep;27(3):539-42

Authors: Khan SA, Khan B, Khan AA, Afridi EA, Mehmood S, Muhammad G, Hussain I, Zadran KK, Bhatti SN

Abstract
BACKGROUND: Trigeminal Neuralgia (TGN) is the most frequently diagnosed type of facial pain. In idiopathic type of TGN it is caused by the neuro-vascular conflict involving trigeminal nerve. Microvascular decompression (MVD) aims at addressing this basic pathology in the idiopathic type of TGN. This study was conducted to determine the outcome and complications of patients with idiopathic TGN undergoing MVD.
METHODS: In a descriptive case series patients with idiopathic TGN undergoing MVD were included in consecutive manner. Patients were diagnosed on the basis of detailed history and clinical examination. Retromastoid approach with craniectomy was used to access cerebellopontine angle (CP-angle) and microsurgical decompression was done. Patients were followed up for 6 months.
RESULTS: A total of 53 patients underwent MVD with mean age of 51.6±4.2 years and male predominance. In majority of cases (58.4%) both Maxillary and Mandibular divisions were involved. Per-operatively superior cerebellar artery (SCA) was causing the neuro-vascular conflict in 33 (62.2%) of the cases, anterior inferior cerebellar artery (AICA) in 6 (11.3%) cases, both CSA and AICA in 3 (5.6%) cases, venous compressions in only 1 (1.8%) patient and thick arachnoid adhesions were seen in 10 (18.9%) patients. Postoperatively, 33 (68%) patients were pain free, in 14 (26.45%) patients pain was significantly improved whereas in 3 (5.6%) patients there was mild improvement in symptoms. Three (5.6%) patients did not improve after the primary surgery. Cerebrospinal fluid (CSF) leak was encountered in 7 (13.2%) patients post-operatively, 4 (7.5%) patients developed wound infection and 1 (1.8%) patient developed aseptic meningitis. Three (5.6%) patients had transient VII nerve palsy while one patient developed permanent VII nerve palsy.
CONCLUSION: MVD is a safe and effective surgical option for treating patients with idiopathic TGN with better surgical outcome and fewer complications.

PMID: 26721002 [PubMed - in process]

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Inflammatory myofibroblastic tumor of the larynx: report of a case and review of the literature.

Inflammatory myofibroblastic tumor of the larynx: report of a case and review of the literature.

Int J Clin Exp Pathol. 2015;8(10):13557-60

Authors: Yan Q, Hu XL

PMID: 26722573 [PubMed - in process]

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Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience.

Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience.

Int Arch Otorhinolaryngol. 2016 Jan;20(1):30-3

Authors: Oishi M, Okamoto S, Teranishi Y, Yokota C, Takano S, Iguchi H

Abstract
Introduction Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB. Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB) diagnosed in our department. Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB) or history of TB, tuberculin skin test (TST) results, interferon-gamma release assay (IGRA) results, and duration from the first visit to the final diagnosis of EPTB. Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients), with the supraclavicular nodes being the most commonly affected (60%). Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days. Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.

PMID: 26722342 [PubMed]

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Leptomeningeal metastasis from early glottic laryngeal cancer: A case report.

Leptomeningeal metastasis from early glottic laryngeal cancer: A case report.

Oncol Lett. 2015 Nov;10(5):2915-2918

Authors: Pan Z, Yang G, Qu L, Yuan T, Pang X, Wang Y, Shi W, Dong L

Abstract
The present study reports the case of a 53-year-old man with leptomeningeal metastasis from early glottic laryngeal cancer. The patient had been diagnosed with squamous cell carcinoma of the glottic larynx 9 years previously. The current symptoms included a recurring headache that had persisted for 1 month and vomiting for 1 week. A magnetic resonance imaging scan of the head revealed multiple enhancing lesions in the brain and multiple line-like enhancements in the brain fold. Computed tomography scans of the head, neck, chest and abdomen showed no nodular lesions. Cytological examination of the cerebral spinal fluid (CSF) revealed malignant cells with a scattered distribution pattern. The patient received intra-CSF methotrexate chemotherapy concurrent with whole-brain radiotherapy, which relieved the neurological symptoms. To the best of our knowledge, this is the first case of cytologically-confirmed LM from early glottic laryngeal cancer.

PMID: 26722263 [PubMed - as supplied by publisher]

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Changes in the Distribution of Capsular Serotypes of Streptococcus pneumoniae Isolated from Adult Respiratory Specimens in Japan.

Changes in the Distribution of Capsular Serotypes of Streptococcus pneumoniae Isolated from Adult Respiratory Specimens in Japan.

Intern Med. 2015;54(11):1337-41

Authors: Shoji H, Maeda M, Shirakura T, Takuma T, Hanaki H, Niki Y

PMID: 26027983 [PubMed - indexed for MEDLINE]

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SYNOVIAL SARCOMA OF THE LARYNX.

SYNOVIAL SARCOMA OF THE LARYNX.

J Ayub Med Coll Abbottabad. 2015 Jul-Sep;27(3):729-30

Authors: Javed N, Iqbal J

PMID: 26721054 [PubMed - in process]

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Long-term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery.

Long-term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery.

Otolaryngol Head Neck Surg. 2015 Dec 31;

Authors: Sarcu D, Isaacson G

PMID: 26721891 [PubMed - as supplied by publisher]

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Autophagy mediates tolerance to Staphylococcus aureus alpha-toxin.

Autophagy mediates tolerance to Staphylococcus aureus alpha-toxin.

Cell Host Microbe. 2015 Apr 8;17(4):429-40

Authors: Maurer K, Reyes-Robles T, Alonzo F, Durbin J, Torres VJ, Cadwell K

PMID: 25816775 [PubMed - indexed for MEDLINE]

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The polysaccharide capsule of Streptococcus pneumonia partially impedes MyD88-mediated immunity during pneumonia in mice.

The polysaccharide capsule of Streptococcus pneumonia partially impedes MyD88-mediated immunity during pneumonia in mice.

PLoS One. 2015;10(2):e0118181

Authors: de Vos AF, Dessing MC, Lammers AJ, de Porto AP, Florquin S, de Boer OJ, de Beer R, Terpstra S, Bootsma HJ, Hermans PW, van 't Veer C, van der Poll T

PMID: 25700108 [PubMed - indexed for MEDLINE]

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Sensors, Vol. 16, Pages 57: Self-Powered WSN for Distributed Data Center Monitoring

Monitoring environmental parameters in data centers is gathering nowadays increasing attention from industry, due to the need of high energy efficiency of cloud services. We present the design and the characterization of an energy neutral embedded wireless system, prototyped to monitor perpetually environmental parameters in servers and racks. It is powered by an energy harvesting module based on Thermoelectric Generators, which converts the heat dissipation from the servers. Starting from the empirical characterization of the energy harvester, we present a power conditioning circuit optimized for the specific application. The whole system has been enhanced with several sensors. An ultra-low-power micro-controller stacked over the energy harvesting provides an efficient power management. Performance have been assessed and compared with the analytical model for validation.

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Materials, Vol. 9, Pages 21: Towards Lead-Free Piezoceramics: Facing a Synthesis Challenge

The search for electroceramic materials with enhanced ferro-pyro-piezoelectric properties and revealing the perovskite type structure has been the objective of a significant number of manuscripts reported in the literature. This has been usually carried out by proposing the synthesis and processing of new compounds and solid solution series. In this work, several methods to obtain ferro-pyro-piezoelectric families of materials featuring the well-known ABO3 perovskite structure (or related) such as BaTiO3, Ba1–xCaxTi1–yZryO3, (Bi0.5Na0.5)TiO3, (K0.5Na0.5)NbO3 and their solid solutions with different cations either in the A or B positions, are presented. For this kind of materials, the challenge for obtaining a single phase compound with a specific grain size and morphology and, most importantly, with the adequate stoichiometry, will also be discussed. The results reviewed herein will be discussed in terms of the tendency of working with softer conditions, i.e., lower temperature and shorter reaction times, also referred to as soft-chemistry.

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Αρχειοθήκη ιστολογίου

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Η λίστα ιστολογίων μου

Σάββατο 2 Ιανουαρίου 2016

Objectives

Background

Methods

Results

Conclusions

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