Head and Neck Diseases by Alexandros G.Sfakianakis: 03/10/16

Πέμπτη 10 Μαρτίου 2016

Conditional IL-4/IL-13-deficient mice reveal a critical role of innate immune cells for protective immunity against gastrointestinal helminths.

Conditional IL-4/IL-13-deficient mice reveal a critical role of innate immune cells for protective immunity against gastrointestinal helminths.

Mucosal Immunol. 2015 May;8(3):672-82

Authors: Oeser K, Schwartz C, Voehringer D

Abstract
Approximately one-third of the world population is infected with gastrointestinal helminths. Studies in mouse models have demonstrated that the cytokines interleukin (IL)-4 and IL-13 are essential for worm expulsion, but the critical cellular source of these cytokines is poorly defined. Here, we compared the immune response to Nippostrongylus brasiliensis in wild-type, T cell-specific IL-4/IL-13-deficient and general IL-4/IL-13-deficient mice. We show that T cell-derived IL-4/IL-13 promoted T helper 2 (Th2) polarization in a paracrine manner, differentiation of alternatively activated macrophages, and tissue recruitment of innate effector cells. However, innate IL-4/IL-13 played the critical role for induction of goblet cell hyperplasia and secretion of effector molecules like Mucin5ac and RELMβ in the small intestine. Surprisingly, T cell-specific IL-4/IL-13-deficient and wild-type mice cleared the parasite with comparable efficiency, whereas IL-4/IL-13-deficient mice showed impaired expulsion. These findings demonstrate that IL-4/IL-13 produced by cells of the innate immune system is required and sufficient to initiate effective type 2 immune responses resulting in protective immunity against N. brasiliensis.

PMID: 25336167 [PubMed - indexed for MEDLINE]

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Different therapeutic mechanisms of rigid and semi-rigid mandibular repositioning devices in obstructive sleep apnea syndrome.

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

Different therapeutic mechanisms of rigid and semi-rigid mandibular repositioning devices in obstructive sleep apnea syndrome.

J Craniomaxillofac Surg. 2014 Dec;42(8):1650-4

Authors: Suga H, Mishima K, Nakano H, Nakano A, Matsumura M, Mano T, Yamasaki Y, Ueyama Y

Abstract
To clarify the mechanisms of rigid and semi-rigid mandibular repositioning devices (MRDs) in obstructive sleep apnea syndrome (OSAS), seven and 13 patients received rigid and semi-rigid MRDs, respectively. Each patient underwent polysomnographic and computed tomographic examinations at the initial consultation and after symptom improvement. Three-dimensional models of the upper airway (hard palate level to epiglottic base) were reconstructed by image processing software (Mimics version 14.2) to measure airway morphology. The mean age and body mass index were 58.1 years and 24.8 kg/m(2), respectively, in the rigid MRD group and 57.9 years and 23.2 kg/m(2), respectively, in the semi-rigid MRD group. The apnea-hypopnea index significantly improved (P < 0.05, Wilcoxon signed-rank test) from 22.0 to 8.9 and 20.5 to 11.5 events per hour of sleep in the respective groups. The cross-sectional areas measured at the epiglottic tip (from 2.0 to 2.6 cm(2)) and hard palate (from 2.6 to 3.3 cm(2)) levels also increased in the respective groups (P < 0.05). However, airway volume, cross-sectional area measured at the uvular tip level, and anteroposterior and transverse diameters of the airway were not significantly different. In conclusion, both types of MRDs improve respiratory status, but they affect different parts of the airway.

PMID: 24969766 [PubMed - indexed for MEDLINE]

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Management of arterial injury during endoscopic sinus and skull base surgery.

Management of arterial injury during endoscopic sinus and skull base surgery.

Curr Opin Otolaryngol Head Neck Surg. 2016 Apr;24(2):170-174

Authors: Valentine R, Padhye V, Wormald PJ

Abstract
PURPOSE OF REVIEW: The most feared complication during endonasal surgery is a carotid artery injury. The sheep model of carotid injury provides training for this event by giving a realistic endoscopic experience of major vascular injuries and tissue hemostasis.
RECENT FINDINGS: The sheep model of carotid artery injury recreates the narrow nasal confines and high-flow/high-pressure vascular injury accurately reproducing the endoscopic challenges seen in such vascular emergencies. This has led to the development of surgical techniques that quickly and effectively control the field of bleeding and achieve reliable hemostasis including the crushed muscle patch new direct vascular closure technologies. Vascular emergency simulation training is achieving better outcomes for our patients.
SUMMARY: All skull base surgeons are at risk of the unexpected carotid artery injury and recently, the sheep model not only effectively recreates this situation but has identified clinically tried and tested techniques at managing this situation and is improving patient outcomes.

PMID: 26959844 [PubMed - as supplied by publisher]

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Variability in the Cross-Sectional Area and Narrowing of the Internal Jugular Vein in Patients Without Multiple Sclerosis.

Variability in the Cross-Sectional Area and Narrowing of the Internal Jugular Vein in Patients Without Multiple Sclerosis.

AJR Am J Roentgenol. 2016 Mar 9;:1-5

Authors: Buch K, Groller R, Nadgir RN, Fujita A, Qureshi MM, Sakai O

Abstract
OBJECTIVE: Chronic cerebrospinal vascular insufficiency is a proposed condition of intraluminal stenosis of the internal jugular vein (IJV) that impedes venous flow from the brain. Calculations of IJV stenosis are vague and described in veins with at least a 50% reduction in IJV caliber at a specific level. The purpose of this study was to assess normal changes in anatomic caliber of the course of the IJV in a generalized population.
MATERIALS AND METHODS: Images from 500 consecutive contrast-enhanced neck CT studies performed in January-July 2011 were reviewed. Cross-sectional areas of the IJV were calculated at the jugular foramen, C1-C7 levels, and jugular angles bilaterally. Patients were excluded if they had severely motion-limited studies; limited clinical data; a history of multiple sclerosis, neck mass, or neck dissection; or known IJV occlusion. Normalized IJV cross-sectional areas at each level were compared with an averaged normalized cross-sectional area from all patients at each level.
RESULTS: Greater than 50% narrowing compared with a normalized average was found in 133 of 363 patients (36.6%) and was seen at all IJV levels. In 36.1% of patients this narrowing occurred at the C1 level. Most of the areas of narrowing greater than 50% occurred above the C4 level.
CONCLUSION: The IJV has marked variability in its course in the neck. Areas of narrowing greater than 50% occur most commonly in the upper cervical and skull base regions. Given the normal anatomic variations in IJV caliber, caution should be used when making the diagnosis of and treating IJV stenosis.

PMID: 26958902 [PubMed - as supplied by publisher]

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Radiosensitization in esophageal squamous cell carcinoma

Radiosensitization in esophageal squamous cell carcinoma:

Abstract

Purpose

This study examined the efficacy of polo-like kinase 1 (PLK1) inhibition on radiosensitivity in vitro and in vivo by a pharmacologic approach using the highly potent PLK1 inhibitor volasertib.

Methods and materials

Human esophageal squamous cell carcinoma (ESCC) cell lines KYSE 70 and KYSE 150 were used to evaluate the synergistic effect of volasertib and irradiation in vitro using cell viability assay, colony formation assay, cell cycle phase analysis, and western blot, and in vivo using ectopic tumor models.

Results

Volasertib decreased ESCC cell proliferation in a dose- and time-dependent manner. Combination of volasertib and radiation caused G2/M cell cycle arrest, increased cyclin B levels, and induced apoptosis. Volasertib significantly enhanced radiation-induced death in ESCC cells by a mechanism involving the enhancement of histone H3 phosphorylation and significant cell cycle interruption. The combination of volasertib plus irradiation delayed the growth of ESCC tumor xenografts markedly compared with either treatment modality alone.

Conclusions

The in vitro results suggested that targeting PLK1 might be a viable approach to improve the effects of radiation in ESCC. In vivo studies showed that PLK1 inhibition with volasertib during irradiation significantly improved local tumor control when compared to irradiation or drug treatment alone.

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Middle Turbinate Mucosal Flap in Endoscopic Skull Base Reconstruction.

Middle Turbinate Mucosal Flap in Endoscopic Skull Base Reconstruction.

Turk Neurosurg. 2016;26(2):200-4

Authors: Wang X, Zhang X, Hu F, Yu Y, Gu Y, Xie T, Ge J

Abstract
AIM: To explore the indications, operation techniques and benefits of pedicled middle turbinate mucosal flap in endoscopic skull base reconstruction.
MATERIAL AND METHODS: The patients, who underwent endonasal endoscopic surgery from October 2009 to June 2010 in our department, were involved in this study. Multi-layer skull base reconstruction was performed in four cases by pedicled middle turbinate mucosal flap combined with fascia lata, artificial dura mater, fat and other reconstruction materials. The results of surgery were assessed in the follow-up period.
RESULTS: No reconstruction-associated complications, such as cerebrospinal fluid leakage or infection were observed in four cases during the follow-up period for more than one year. All patients showed excellent recovery.
CONCLUSION: Pedicled middle turbinate mucosal flap for skull base reconstruction has the advantages of fast healing and low incidence of cerebrospinal fluid leakage. It provides satisfactory skull base reconstruction.

PMID: 26956812 [PubMed - in process]

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Dyad of pain and depression in chronic rhinosinusitis.

Dyad of pain and depression in chronic rhinosinusitis.

Int Forum Allergy Rhinol. 2016 Mar;6(3):308-14

Authors: Cox DR, Ashby S, DeConde AS, Mace JC, Orlandi RR, Smith TL, Alt JA

Abstract
BACKGROUND: Pain and depression often coexist as comorbidities in patients with chronic disease and exert a major impact on quality of life (QOL). Little is known about the relationship between pain and depression in chronic rhinosinusitis (CRS). Our objective was to investigate this relationship and to analyze the effect of pain and depression on QOL in CRS.
METHODS: Patients with CRS were prospectively recruited as part of an observational cohort study. A total of 70 participants provided pain scores using both the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Patients at risk for depression were identified using the Patient Health Questionnaire-2 (PHQ-2). CRS-specific QOL was determined using the 22-item Sino-Nasal Outcome Test (SNOT-22).
RESULTS: Significant positive correlations were found between depression scores and all pain measures (R = 0.475 to 0.644, p < 0.001). Patients with a PHQ-2 score ≥1 had significantly higher scores on all reported pain measures. Significant positive correlations were found between all pain measures, the total SNOT-22 score, and 3 SNOT-22 subdomains (sleep, psychological dysfunction, and ear/facial symptoms; R = 0.323 to 0.608, p < 0.05).
CONCLUSION: Adult patients with CRS at risk for depression experience more pain and have overall worse disease-specific QOL. Further research investigating the complex interactions between depression and pain and the role it plays in CRS disease-specific QOL is warranted.

PMID: 26954903 [PubMed - in process]

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Long-term radiological findings after endonasal endoscopic approach to the skull base.

Long-term radiological findings after endonasal endoscopic approach to the skull base.

Am J Otolaryngol. 2016 Mar-Apr;37(2):103-7

Authors: Langdon C, Enseñat J, Rioja E, Jaume F, Berenguer J, Oleaga L, Bernal-Sprekelsen M, Alobid I

Abstract
OBJECTIVE: To study the long-term radiological findings after endonasal endoscopic approach to the skull base.
MATERIAL AND METHODS: Prospective study that included 55 patients who underwent advance endoscopic skull base surgery. All patients were evaluated with MRI before, 3months and 12months after surgery. We used the Lund-Mackay staging system for chronic rhinosinusitis to evaluate the paranasal cavities and the sinonasal scoring system to assess sinonasal symptoms.
RESULTS: Seventeen patients (30.9%) underwent extended endonasal approach that required a nasoseptal flap (NSF) for reconstruction of skull base. At baseline the mean total Lund-Mackay score was 0.63±1.2 (range 0-4), and at 3 and 12months postoperatively the mean scores were 3.5±3.8 (range 0-14) and 2.0±2.5 (range 0-8) respectively. Patients who needed an NSF for reconstruction had a greater Lund-Mackay score (p<0.05). Moreover, NSF is correlated with sinonasal mucosal thickening and fluid retention at 3months (r=0.45, p<0.01) and 12months (r=0.4, p<0.01). Total 5-symptom score (T5SS) was similar between both groups at baseline. Patients with extended endoscopic approach reported more smell loss (40.1±26.2; p<0.05) and posterior nasal discharge (49.3±30.1; p<0.05) than TTEA patients (21.6±30.9 and 22.5±27.5 respectively).
CONCLUSIONS: We observed that sinus opacity is still present after one year of advance endoscopic skull base surgery but symptoms seems to return to basal after 12months of follow-up.

PMID: 26954861 [PubMed - in process]

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Quantitative Analysis of Psychiatric Disorders in Intractable Peripheral Vertiginous Patients: A Prospective Study.

Quantitative Analysis of Psychiatric Disorders in Intractable Peripheral Vertiginous Patients: A Prospective Study.

Otol Neurotol. 2016 Mar 7;

Authors: Zhai F, Wang J, Zhang Y, Dai CF

Abstract
OBJECTIVE: To investigate the correlation between psychological disorder and vestibular dysfunction in patients suffering from intractable peripheral vertigo.
STUDY DESIGN: Prospective study.
SETTING: In-patients in a university hospital.
METHODS: Prospective design of 26 intractable peripheral vertiginous patients with peripheral vestibular dysfunction and 20 controls recruited from the EENT hospital. Hospital Anxiety and Depression scale, Self-rating Anxiety scale, Self-rating Depression scale, Symptom Checklist-90 were used in this study. All vertigo patients received intratympanic gentamicin/dexamethasone administration or endolymphatic sac decompression. Pre- and posttreatment scores were collected and compared. All the results were statistically analyzed using Stata 8.0. t test or rank-sum test and paired-sample t test or rank-sum test were performed.
RESULTS: The outcomes of Hospital Anxiety and Depression scale, Self-rating Anxiety scale, Self-rating Depression scale, Symptom Checklist-90 were significantly greater in vertiginous group than that in normal controls (p < 0.05). The pretreatment scores of these four scales were greater than the posttreatment scores in vertiginous patients, especially in Class A and B groups (p < 0.05). The scores of more scales were demonstrated to be statistically different in patients with over 5 years of the disorder and among patient in stages 1 to 3 than in stage 4 (p < 0.05). No significant difference was noted between male and female participants in all the questionnaires used (p > 0.05).
CONCLUSION: Increased anxiety/depression levels were noted in peripheral vertiginous patients compared with normal controls through psychiatric questionnaires, and then a significant decrease after the effective treatment of vertigo, suggesting that vertigo attack may contribute to psychological dysfunction. The intervention seemed to be more effective in lowering anxiety/depression levels among patients in earlier stage of Ménière's disease marked by pure-tone audiometry results.

PMID: 26954350 [PubMed - as supplied by publisher]

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Reconstruction of the denuded nasoseptal flap donor site with a free fascia lata graft: technical note.

Reconstruction of the denuded nasoseptal flap donor site with a free fascia lata graft: technical note.

Eur Arch Otorhinolaryngol. 2016 Mar 7;

Authors: Zeinalizadeh M, Sadrehosseini SM, Barkhoudarian G, Carrau RL

Abstract
The nasoseptal flap provides hearty vascularized tissue for the reconstruction of skull base defects subsequent to expanded endonasal approaches; however, it leads to exposure of the cartilage at the septal donor site producing crusting and discomfort while it remucosalizes. We report an alternative technique to reconstruct the denuded nasal septal donor site by means of a free fascia lata graft. Fascia lata grafting of the nasoseptal flap donor site showed evidence of revascularization 4 weeks after initial surgery. Re-epithelialization was complete 4-12 weeks postoperation. Although the nasoseptal flap provides a versatile reconstructive technique, its harvest results in significant donor site morbidity. A free fascia lata graft accelerates the rate of donor site remucosalization; thus, decreasing the nasal complications.

PMID: 26951218 [PubMed - as supplied by publisher]

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Assessment of MRI image quality for various setup positions used in breast radiotherapy planning

Publication date: Available online 9 March 2016
Source:Radiotherapy and Oncology
Author(s): Vikneswary Batumalai, Gary Liney, Geoff P. Delaney, Robba Rai, Miriam Boxer, Myo Min, Megan Berry, Trang Pham, Penny Phan, Callie Choong, Melanie Rennie, Christine Chan, Lois Holloway
This study investigates breast magnetic resonance imaging (MRI) image quality for 3 different breast radiotherapy positions (prone, supine flat and supine inclined) and associated choice of breast coils. Supine breast MRI has comparable image quality to prone breast MRI for the purposes of radiotherapy delineation for T2-weighted sequences.

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Biological dosimetry to assess risks of health effects in victims of radiation accidents: Thirty years after Chernobyl

Publication date: Available online 9 March 2016
Source:Radiotherapy and Oncology
Author(s): Vitali Moiseenko, Igor K. Khvostunov, Jona A. Hattangadi-Gluth, Ludvig P. Muren, David C. Lloyd

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Histiocytosis with mixed cell populations

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Reflectance confocal microscopy features of mycosis fungoides and Sézary syndrome: correlation with histopathologic and T-cell receptor rearrangement studies

Abstract

Background

Mycosis fungoides/Sézary syndrome (MF/SS) often requires multiple skin biopsies for definitive diagnosis. In-vivo reflectance confocal microscopy (RCM) visualizes high-resolution cellular detail of the skin. The objective of this study is to evaluate the morphologic features of MF/SS using RCM and to correlate RCM features with histopathology and T-cell receptor (TCR) gene rearrangement studies.

Methods

A cohort of patients with active/recurrent or suspicious MF/SS disease was prospectively recruited for RCM imaging and histopathologic/RCM images were evaluated. Statistical analyses were performed to identify unique RCM features and to correlate RCM features to histopathologic findings and TCR rearrangement studies.

Results

Eighty-three lesions were evaluated. The correlation between RCM and histopathology was moderate for all relatable features (κ = 0.41, p<0.001), almost perfect for intraepidermal atypical lymphocytes (PABAK=0.90), and fair for Pautrier collections (κ = 0.32, p=0.03). Lesions with Pautrier collections identified by RCM were significantly more likely to demonstrate TCR clonality (p=0.04) and diagnostic features of MF/SS on histopathology (p=0.03).

Conclusions

Our study captures morphologic RCM criteria for a variety of skin lesions. Pautrier collections visualized by RCM are associated with improved histopathologic diagnosis and detection of TCR gene clonality. Although further studies are needed to validate the diagnostic implications of RCM for MF/SS, our study highlights the potential utility of RCM.

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Incidence of Atypical Nevi in Olmsted County: An Epidemiological Study

Abstract

Background

The association of atypical nevi with melanoma and other forms of skin cancer has not been clearly defined.

Methods

We studied 631 patients with first lifetime diagnosis of mild, moderate, or severely atypical nevus from 2000 through 2005, identified through a population-based approach.

Results

Age at first diagnosis differed significantly between men and women (P<.001). Incidence rates peaked in the second through fourth decades in women and in the third, sixth, and seventh decades in men. From 2000 through 2005, the overall age- and sex-adjusted incidence rate of all degrees of atypical nevi was 76.0 per 100,000 person-years. There were no statistically significant associations identified between the degree of atypia and the future development of basal cell carcinoma, squamous cell carcinoma, or MM (P=.51, P=.28, and P=.19, respectively).

Conclusion

There is no association between atypical nevi and the subsequent development of nonmelanoma skin cancer and MM. Incidence rates of atypical nevi are higher among younger women and older men. The association between degree of atypia and malignant melanoma warrants further study.

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A specific aptamer-cell penetrating peptides complex delivered siRNA efficiently and suppressed prostate tumor growth in vivo.

A specific aptamer-cell penetrating peptides complex delivered siRNA efficiently and suppressed prostate tumor growth in vivo.

Cancer Biol Ther. 2016 Mar 8;:0

Authors: Diao Y, Liu J, Ma Y, Su M, Zhang H, Hao X

Abstract
Specific and efficient delivery of siRNA into intended tumor cells remains as a challenge, even though RNAi has been exploited as a new strategy for prostate cancer therapy. This work aims to address both specificity and efficiency of SURVIVIN-siRNA delivery by constructing a therapeutic complex using combinatorial strategies. A fusion protein STD was first expressed to serve as a backbone, consisting of streptavidin, a cell-penetrating peptide called Trans-Activator of Transcription (TAT) and a double-stranded RNA binding domain. A biotinylated Prostate Specific Membrane Antigen (PSMA) specific aptamer A10 and SURVIVIN-siRNA were then linked to STD protein to form the therapeutic complex. This complex could specifically targeted PSMA(+) tumor cells. Compared to lipofectamine and A10-siRNA chimera, it demonstrated higher efficiency in delivering siRNA into target cells by 19.2% and 59.9%, and increased apoptosis by 16.8% and 26.1% respectively. Upon systemic administration, this complex also showed significant efficacy in suppressing tumor growth in athymic mice (p <0.001). We conclude that this therapeutic complex could specifically and efficiently deliver SURVIVIN-siRNA to target cells and suppressed tumor growth in vivo, which indicates its potential to be used as a new strategy in prostate cancer therapy.

PMID: 26954374 [PubMed - as supplied by publisher]

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An uncommon cause of dysuria solved by “boom-boom” radiotherapy

Publication date: Available online 9 March 2016
Source:Cancer/Radiothérapie
Author(s): R. Mazeron, J. Bosq, E. Rivin del Campo, J. Arfi-Rouche, A. Boros, D. Ghez
BackgroundChronic lymphocytic leukaemia is a common disease affecting the hematopoietic organs. The disease remains classically indolent for years preceding a blast crisis. However, the disease can affect all parts of the body. We report here an unusual localization.Case presentationA 72-year-old man was followed for 2 years for an indolent chronic lymphocytic leukaemia while he presented a rapidly progressive dysuria. Prostate biopsies were performed concluding to a prostate involvement by the chronic lymphocytic leukaemia. In the absence of progression according to RAI staging system and Binet's classification, he was treated with local low-dose radiotherapy, twice 2Gy, allowing for a rapid resolution of the symptoms. No systemic treatment was introduced, and 1 year after the completion of his treatment, he is still under watchful waiting strategy for his chronic lymphocytic leukaemia.ConclusionLow-dose radiotherapy is an underused effective strategy in indolent lymphoma. In this case, urinary symptoms from a prostate involvement were relieved non-invasively at low cost.

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Anaesthesia and Sedation For Electrocochleography.

Anaesthesia and Sedation For Electrocochleography.

Acta Otolaryngol. 1974 Jan;77 Suppl 316:37-8

Authors: Zvonar M, Zvonar-Kuhndl B, Odenthal DW

Abstract
Anaesthesia and sedation in electrocochleo-graphy are of paramount importance for the whole procedure, since restlessness of the patient during the measurements can invalidate the results of the test. The time needed for extensive electrocochleography amounts on average to two hours. The only pain experienced during the procedure is associated with the placement of the transtympanic electrode. A relatively long-lasting, light level of anaesthesia has to be achieved to obtain the desired relative or absolute immobility of the patient. For the psychologically normal adult, local anaesthesia and additional sedation will meet the requirements for electrocochleography, but for children and mentally disturbed or anxious patients general anaesthesia is necessary. Tor children under the age of 8 years, two types of anaesthesia are available, i.e. dissociative anaesthesia and inhalation anaesthesia. After relatively extensive experience with dissociative anaesthesia, we abandoned this method because the above-mentioned requirements for ECoG could not be adequately satisfied during the entire duration (two hours) of the procedure. Inhalation anaesthesia, using the semi-closed-circle technique, has proved to be the optimal available procedure in these cases.

PMID: 26950680 [PubMed]

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Methods for assessing high frequency hearing loss in every-day listening situations.

Methods for assessing high frequency hearing loss in every-day listening situations.

Acta Otolaryngol. 1974 Jan;77(320):1-50

Authors: Gunnar A

PMID: 26947520 [PubMed]

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Scanning Electron Microscopy of the Inner Structure of the Organ of Corti and its Neural Pathways.

Scanning Electron Microscopy of the Inner Structure of the Organ of Corti and its Neural Pathways.

Acta Otolaryngol. 1974 Jan;77(319):57-66

Authors: Engström B

Abstract
Scanning electron microscopy has been used by the author since 1968 and has become an important tool in the study of inner ear structures. By the combination of good preparation and microdissection, light and electron microscopy, we can better visualize the structure of the normal and pathologically altered organ of Corti and also the vestibular sensory regions. In the present publication it is shown that good preparation permits a study of the inner of the organ of Corti and also of the neural pathways not only in the organ of Corti but also in the osseous spiral lamina and in the modiolus.

PMID: 26947362 [PubMed]

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The Tympanic Covering Layer. An Electron Microscopic Study in Guinea Pig.

The Tympanic Covering Layer. An Electron Microscopic Study in Guinea Pig.

Acta Otolaryngol. 1974 Jan;77(319):43-56

Authors: Angelborg C, Engström B

Abstract
The tympanic covering layer in guinea pig was studied with transmission and scanning electron microscopy. The tympanic border cells looked like bipolar ganglion cells with long processes. There was often a kinocilium on the cell body. The cells were rather similar structurally but their arrangement varied in the different coils. In the basal coil the cells were lying close together and oriented strictly longitudinally. In the upper coils both longitudinally and radially oriented cells were seen. There were fewer cells in the apical coils and the perilymphatic space between the cells, as well as the area of contact between the perilymph and the basilar membrane, became larger. On every level in the cochlea the tympanic covering layer was thinnest under the tunnel of Corti. The significance of the appearance of the cells and their arrangement are discussed. The tissue on the lower side of the basilar membrane is called the tympanic lamella or the tympanic covering layer and its cells have been called tympanic border cells, basilar membrane cells or cells of the tympanic covering layer. They are of mesothelial origin and were already noticed by Claudius (1856), Hensen (1863), Boettcher (1869) and Retzius (1884). Little interest was paid to them until Iurato (1962) described their submicroscopic anatomy in detail in his investigations of the rat's inner ear. In the studies of the cochlea using tracer substance it has been observed that these cells in the guinea pig have a high phagocytic ability (Angelborg & Engström, 1973; Angelborg, in press). Further studies of the tympanic border cells showed some new features in their anatomy which had not been described earlier. In this investigation their ultrastructure in guinea pig will be presented.

PMID: 26947361 [PubMed]

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Distribution of Macromolecular Tracer Particles (Thorotrast(R)) in the Cochlea. An Electron Microscopic Study in Guinea Pig: Part I. The organ of Corti, the basilar membrane and the tympanic covering layer.

Distribution of Macromolecular Tracer Particles (Thorotrast(R)) in the Cochlea. An Electron Microscopic Study in Guinea Pig: Part I. The organ of Corti, the basilar membrane and the tympanic covering layer.

Acta Otolaryngol. 1974 Jan;77(319):19-41

Authors: Angelborg C

Abstract
Thorotrast(R) containing thorium dioxide particles with diameters of around 100 Å was introduced in perilymph or endolymph using various methods and concentrations. The location of the tracer particles in the cochleas was determined using the transmission electron microscope. Injection of tracer into the cerebrospinal fluid (CSF) was considered to be the least unphysiological way to bring the tracer to the cochlea, and therefore most of the experiments were performed in that way. The distribution of tracer was very dependent on the mode of injection and the concentration of tracer in the cochlea. With very high concentrations it appeared that every kind of cell had a capacity of phagocytizing. No significant tracer uptake was noted in the cells of the organ of Corti after direct injection of small amounts of tracer in the cochlear duct. After tracer administration in the cerebrospinal fluid, the tracer rapidly reached the scala tympani. The tympanic border cells contained large numbers of tracer particles, while lesser amounts were found in the homogenous parts of the basilar membrane. No tracer was seen in the cells of the organ of Corti. After perfusion of the cochlear perilymph, some tracer was seen in the cells of the organ of Corti. The limited passage of tracer to the organ of Corti was not regarded as proof of free communication between perilymph and cortilymph. Glycerol administration to the animals did not change the propagation of tracer in the cochlea. After injection of tracer into dead animals, tracer inclusions could be seen in the tympanic border cells, indicating the possibility of a cell phagocytizing ability, also some time after death.

PMID: 26947360 [PubMed]

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Surface Structures of the Human Vestibular Sensory Regions.

Surface Structures of the Human Vestibular Sensory Regions.

Acta Otolaryngol. 1974 Jan;77(319):3-18

Authors: Rosenhall U, Engström B

Abstract
The hair bundles and other surface organelles of the human vestibular sensory regions have been studied with SEM and TEM. The material was taken from individuals of different ages, from the fetal period to old age. The hair bundles have a remarkably mature appearance in fetuses three to four months old. Each hair bundle consists of one kinocilium and of many stereocilia of different length. Some hair bundles are shorter than the majority. There are indications that these short hair bundles, which are especially numerous at the edges of the maculae, belong to type II sensory cells. In old individuals, laminated inclusions are often seen in the cytoplasm close to the cuticular plate. Each supporting cell is equipped with microvilli and a solitary kinocilium in the fetal period. In adults these microvilli are shorter and more scanty, and the kinocilium is usually missing.

PMID: 26947359 [PubMed]

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Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.

Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.

J Voice. 2016 Mar 4;

Authors: Moore J, Greenberg C, Thibeault SL

Abstract
OBJECTIVE: To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI).
STUDY DESIGN: Prospective, survey study.
METHODS: Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database with voice, concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. The VHI was sent to patients 6 months post clinic visit to determine change in voice handicap from baseline. General health was screened using the 12-item Short Form Health Survey, using physical component summary and mental component summary scores. Predictor variables included treatment (medical and/or behavioral); dysphonia sub-diagnosis; grade, roughness, breathiness, asthenia, and strain rating; age; sex; socioeconomic factors; smoking history; and comorbidity score.
RESULTS: Two hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned 6-month surveys. The VHI was significantly correlated with mental component summary scores. Patients with a higher grade in baseline grade, roughness, breathiness, asthenia, and strain score were more likely to receive voice intervention (P = 0.04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher educational level in both univariate (P < 0.01, P = 0.04) and multivariate analyses (P < 0.01, P = 0.02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI score.
CONCLUSIONS: Our results suggest that it is important to consider baseline self-perceived voice impact measures and educational level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted.

PMID: 26952321 [PubMed - as supplied by publisher]

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Alcohol responsiveness in laryngeal dystonia: a survey study.

http:--production.springer.de-OnlineReso

Alcohol responsiveness in laryngeal dystonia: a survey study.

J Neurol. 2015 Jun;262(6):1548-56

Authors: Kirke DN, Frucht SJ, Simonyan K

Abstract
Laryngeal dystonia (LD) is a task-specific focal dystonia of unknown pathophysiology affecting speech production. We examined the demographics of anecdotally reported alcohol use and its effects on LD symptoms using an online survey based on Research Electronic Data Capture (REDCap™) and National Spasmodic Dysphonia Association's patient registry. From 641 participants, 531 were selected for data analysis, and 110 were excluded because of unconfirmed diagnosis. A total of 406 patients (76.5 %) had LD and 125 (23.5 %) had LD and voice tremor (LD/VT). The consumption of alcohol was reported by 374 LD (92.1 %) and 109 LD/VT (87.2 %) patients. Improvement of voice symptoms after alcohol ingestion was noted by 227 LD (55.9 % of all patients) and 73 LD/VT (58.4 %), which paralleled the improvement observed by patient's family and/or friends in 214 LD (57.2 %) and 69 LD/VT (63.3 %) patients. The benefits lasted 1-3 h in both groups with the maximum effect after 2 drinks in LD patients (p = 0.002), whereas LD/VT symptoms improved independent of the consumed amount (p = 0.48). Our data suggest that isolated dystonic symptoms, such as in LD, are responsive to alcohol intake and this responsiveness is not attributed to the presence of VT, which is known to have significant benefits from alcohol ingestion. Alcohol may modulate the pathophysiological mechanisms underlying abnormal neurotransmission of γ-aminobutyric acid (GABA) in dystonia and as such provide new avenues for novel therapeutic options in these patients.

PMID: 25929664 [PubMed - indexed for MEDLINE]

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Tinnitus: Is there a place for brain stimulation?

Tinnitus: Is there a place for brain stimulation?

Surg Neurol Int. 2016;7(Suppl 4):S125-9

Authors: van Zwieten G, Smit JV, Jahanshahi A, Temel Y, Stokroos RJ

Abstract
Tinnitus is the perception of a "phantom sound" and has a high prevalence. Although many therapies have been investigated within the last decades, there is still no effective standard therapy. Animal studies and human functional imaging studies revealed that tinnitus perception is associated with many complex changes in multiple brain structures. There is growing evidence that brain stimulation might be able to interrupt the local altered neuronal activity and hereby inhibit tinnitus perception. In this editorial review, an update is given on the most promising targets for brain stimulation. Promising structures for stimulation are the dorsal cochlear nucleus, the inferior colliculus and the medial geniculate body of the thalamus. For cortical stimulation, the auditory cortex is considered as a target. Nevertheless, the field is waiting for evidence from well-designed clinical trials, based on supporting evidence from experimental/mechanistic research, to support or discourage the application of brain stimulation in tinnitus.

PMID: 26958429 [PubMed]

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Disability evaluation in acoustic blast trauma.

Disability evaluation in acoustic blast trauma.

Indian J Occup Environ Med. 2015 Sep-Dec;19(3):138-40

Authors: Raju G

Abstract
INTRODUCTION: Acoustic blast trauma is different from Noise induced hearing loss. Blast trauma can damage the tympanic membrane, ossicles and cochlea singly or in combination. It produces immediate severe hearing loss and may be associated with tinnitus and vestibular symptoms. Hearing loss recovers spontaneously in many cases but may be permanent in 30-55% cases. Thirteen patients working in an explosive manufacturing unit in Andhra Pradesh were exposed to blast trauma at work place. All these workers complained of immediate hearing loss and were subjected to audiological investigations.
METHODS: Initial evaluation showed a severe sensorineural type of hearing loss 10 of the 13 cases (77%). They were referred to our Medical board for disability evaluation after 2-3 years of initial injury. Pure tone audiometry indicated severe hearing loss in 12 of 13 cases (92%) that was not correlating clinically. Re-evaluation with Acoustic reflex and ABR (BERA) tests were done and permanent disability was evaluated with the results of these investigations.
OBSERVATIONS: No significant hearing loss was found in most patients and these patients had minimal disability.
CONCLUSION: Objective hearing tests should be carried out after one year or more before evaluation of permanent disability.

PMID: 26957811 [PubMed]

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Emerging hubs in phantom perception connectomics.

Emerging hubs in phantom perception connectomics.

Neuroimage Clin. 2016;11:181-94

Authors: Mohan A, De Ridder D, Vanneste S

Abstract
Brain networks are small-world networks typically characterized by the presence of hubs, i.e. nodes that have significantly greater number of links in comparison to other nodes in the network. These hubs act as short cuts in the network and promote long-distance connectivity. Long-distance connections increase the efficiency of information transfer but also increase the cost of the network. Brain disorders are associated with an altered brain connectome which reflects either as a complete change in the network topology, as in, the replacement of hubs or as an alteration in the connectivity between the hubs while retaining network structure. The current study compares the network topology of binary and weighted networks in tinnitus patients and healthy controls by studying the hubs of the two networks in different oscillatory bands. The EEG of 311 tinnitus patients and 256 control subjects are recorded, pre-processed and source-localized using sLORETA. The hubs of the different binary and weighted networks are identified using different measures of network centrality. The results suggest that the tinnitus and control networks are distinct in all the frequency bands but substantially overlap in the gamma frequency band. The differences in network topology in the tinnitus and control groups in the delta, theta and the higher beta bands are driven by a change in hubs as well as network connectivity; in the alpha band by changes in hubs alone and in the gamma band by changes in network connectivity. Thus the brain seems to employ different frequency band-dependent adaptive mechanisms trying to compensate for auditory deafferentation.

PMID: 26955514 [PubMed - in process]

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Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: One year follow-up study.

Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: One year follow-up study.

Am J Otolaryngol. 2016 Mar-Apr;37(2):99-102

Authors: Xiong H, Liang M, Zhang Z, Xu Y, Ou Y, Chen S, Yang H, Zheng Y

Abstract
PURPOSE: Eustachian tube balloon dilation (ETBD) has been recently described as feasible treatment for patients with refractory Eustachian tube dysfunction (ETD). The aim of this study was to evaluate the efficacy of ETBD in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis.
MATERIALS AND METHODS: Forty patients who underwent ETBD were included in the study. Subjects' inclusion criteria were as follows: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) at three pressure measurements (30, 40, and 50mbar), Eustachian Tube Score (ETS) and the ability to perform a Valsalva maneuver were assessed preoperatively, 1week, 3months and 12months postoperatively.
RESULTS: All cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM, ETS and the ability to perform a Valsalva maneuver 1week, 3months and 12month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%.
CONCLUSIONS: ETBD can provide both short- and long-term benefits to those who are diagnosed SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.

PMID: 26954860 [PubMed - in process]

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SENP1 but not fetal hemoglobin differentiates chronic mountain sickness from healthy Andean highlanders.

SENP1 but not fetal hemoglobin differentiates chronic mountain sickness from healthy Andean highlanders.

Exp Hematol. 2016 Mar 4;

Authors: Hsieh MM, Callacondo D, Rojas-Camayo J, Quesada-Olarte J, Wang X, Uchida N, Maric I, Remaley AT, Leon-Velarde F, Villafuerte FC, Tisdale JF

Abstract
Chronic mountain sickness (CMS) results from chronic hypoxia. It is unclear why certain highlanders develop CMS. We hypothesized modest increases in fetal hemoglobin (HbF) is associated with lower CMS severity. In this cross-sectional study, we showed that normal HbF levels (median 0.4%) were found in all 153 adult Andean natives in Cerro de Pasco, Peru. Compared to healthy adults, the borderline elevated hemoglobin group frequently had symptoms (headaches, tinnitus, cyanosis, dilatation of veins) of CMS. Although the mean hemoglobin levels differed between healthy (17.1) and CMS (22.3 g/dL) groups, mean plasma erythropoietin (EPO) levels were similar (healthy, 17.7; CMS, 12.02 mIU/mL). Sanger sequencing showed SNPs in endothelial PAS domain 1 (EPAS1) and egl nine homolog 1 (EGLN1), associated with lower hemoglobin in Tibetans, were not identified in Andeans. Sanger sequencing of sentrin-specific protease 1 (SENP1) and acidic nuclear phosphoprotein 32 family, member D (ANP32D), in healthy and CMS individuals showed that non-G/G genotypes were associated with higher CMS score. No JAK2 V617F mutation was detected in CMS individuals. Thus HbF or other classic erythropoietic parameters were not different between healthy and CMS individuals. However, the non-G/G genotypes of SENP1 appeared to differentiate CMS from healthy Andean highlanders.

PMID: 26952840 [PubMed - as supplied by publisher]

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DNA Damage in CD133-Positive Cells in Barrett’s Esophagus and Esophageal Adenocarcinoma

Barrett's esophagus (BE) caused by gastroesophageal reflux is a major risk factor of Barrett's esophageal adenocarcinoma (BEA), an inflammation-related cancer. Chronic inflammation and following tissue damage may activate progenitor cells under reactive oxygen/nitrogen species-rich environment. We previously reported the formation of oxidative/nitrative stress-mediated mutagenic DNA lesions, 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) and 8-nitroguanine, in columnar epithelial cells of BE tissues and cancer cells of BEA tissues. We investigated the mechanisms of BEA development in relation to oxidative/nitrative DNA damage and stem cell hypothesis. We examined 8-nitroguanine and 8-oxodG formation and the expression of stem cell marker (CD133) in biopsy specimens of patients with BE and BEA by immunohistochemical analysis in comparison with those of normal subjects. CD133 was detected at apical surface of columnar epithelial cells of BE and BEA tissues, and the cytoplasm and cell membrane of cancer cells in BEA tissues. DNA lesions and CD133 were colocalized in columnar epithelial cells and cancer cells. Their relative staining intensities in these tissues were significantly higher than those in normal subjects. Our results suggest that BE columnar epithelial cells with CD133 expression in apical surface undergo inflammation-mediated DNA damage, and mutated cells acquire the property of cancer stem cells with cytoplasmic CD133 expression.

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Tuberculosis of the Breast: An Initial Presentation of the Metabolic Syndrome with Type 2 Diabetes Mellitus in a Young Nigerian Woman

Breast tuberculosis is an uncommon presentation of extra pulmonary tuberculosis. A 40-year-old obese woman presented with a right breast abscess which had failed to heal after surgical drainage. There was no family history of breast disease. Biopsy and histology of the lesion showed chronic granulomatous inflammation with positive stains for acid fast bacilli compatible with tuberculosis. Further evaluation confirmed metabolic syndrome with type 2 diabetes mellitus. She was placed on antituberculosis chemotherapy and appropriate therapy for diabetes mellitus with complete resolution of the lesion. We report this case because of its rarity and to highlight the association between tuberculosis an infectious disease and overnutrition in diabetes mellitus, a noncommunicable disease.

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