Functional characterization of two naturally occurring mutations V221G and T449N in the follicle stimulating hormone receptor

Publication date: 15 January 2017
Source:Molecular and Cellular Endocrinology, Volume 440
Author(s): Antara A. Banerjee, Swati K. Achrekar, Shaini Joseph, Bhakti R. Pathak, Smita D. Mahale
Naturally occurring mutations in follicle stimulating hormone receptor (FSHR) affect the receptor function. Here, we characterized two such previously reported mutations, V²²¹G and T⁴⁴⁹N, in the extracellular domain and transmembrane helix 3, of FSHR, respectively. Functional studies with the V²²¹G mutant demonstrated an impairment in FSH binding and signaling. Validation of X-ray crystallography data indicating the contribution of FSHR specific residues in the vicinity of V²²¹ to contribute to FSH-FSHR interaction was carried out. In vitro mutational studies showed that these residues are determinants of both FSH binding and FSH induced signaling. Analysis of the T⁴⁴⁹N mutation revealed that it results in an increase in FSH binding and high cAMP response at lower doses of FSH. A marginal hCG induced and no TSH induced cAMP production was also observed. These findings corroborated with the clinical manifestations of primary amenorrhea (V²²¹G) and spontaneous ovarian hyperstimulation syndrome (T⁴⁴⁹N) in women harbouring these mutations.



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I4, a synthetic anti-diabetes agent, attenuates atherosclerosis through its lipid-lowering, anti-inflammatory and anti-apoptosis properties

Publication date: 15 January 2017
Source:Molecular and Cellular Endocrinology, Volume 440
Author(s): Lingman Ma, Lifen Qian, Qidi Ying, Yan Zhang, Changlin Zhou, Guanzhong Wu
Here, we investigated whether I4, which was initially developed as a hypoglycemic agent, possesses anti-atherosclerotic activity and attempted to elucidate the probable mechanism of action underlying this activity. ApoE^−/− mice were fed a Western diet and simultaneously administered I4, glimepiride, or pioglitazone once daily for 12 weeks, and the atherosclerotic vascular lesions, lipid content, and expression levels of LOX-1, ICAM-1, VCAM-1 and Bax/Bcl-2 in mouse aortas were assessed. RAW264.7 macrophage-derived foam cells were obtained via ox-LDL stimulation to investigate the lipid-lowering, anti-atherosclerotic inflammation and anti-apoptotic effect of I4. The data indicated that I4 significantly decreased the lipid accumulation in the circulation and tissue, especially for TG and FFA levels (p < 0.05 vs model group), alleviating the arterial and liver lesions induced by lipotoxicity. Its lipid-reducing effects may due to LOX-1and CD36 expression suppression. I4, at doses of 20 mg/kg and 10 mg/kg, significantly decreased serum IL-6, IL-1β, and TNF-α production and suppressed the expression of p-ERK, p-p38, VCAM-1 and ICAM-1 protein. I4 attenuated atherosclerotic inflammation by blocking NF-κB nuclear translocation, suppressing MAPK/NF-κB signaling pathway and diminishing NF-κB-VCAM-1 promoter region binding. Additionally, I4 suppressed p-p53 and cleaved-caspase-3 expression to inhibit foam cell apoptosis induced by ox-LDL uptake. Overall, I4 exerts potent inhibitory effects on atherosclerosis onset and development.



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Brain and muscle aryl hydrocarbon receptor nuclear translocator-like protein-1 cooperates with glycogen synthase kinase-3β to regulate osteogenesis of bone-marrow mesenchymal stem cells in type 2 diabetes

Publication date: 15 January 2017
Source:Molecular and Cellular Endocrinology, Volume 440
Author(s): Xiaoguang Li, Na Liu, Yizhu Wang, Jinglong Liu, Haigang Shi, Zhenzhen Qu, Tingting Du, Bin Guo, Bin Gu
Type 2 diabetes mellitus (T2DM) is associated with inhibited osteogenesis of bone marrow mesenchymal stem cells (BMSCs). Brain and muscle ARNT-like protein 1 (BMAL1) has been linked to the T2DM-related bone remodeling, however, the specific mechanism is still unclear. Herein, we aimed to determine the role of BMAL1 in T2DM-induced suppression of BMSCs osteogenesis. Inhibited osteogenesis and BMAL1 expression were showed in diabetic BMSCs. And while β-catenin and T cell factor (TCF) expression were decreased, the glycogen synthase kinase-3β (GSK-3β) and nemo-like kinase (NLK) expression were increased in diabetic BMSCs. Moreover, over-expression of BMAL1 led to recovered osteogenesis ability and activation of Wnt/β-catenin pathway, which was partially due to inhibition of GSK-3β caused by over-expression of BMAL1. Taken together, our findings provide new insights into the role of BMAL1 in T2DM-induced suppression of BMSCs osteogenesis. Over-expressed BMAL1 could recover BMSCs osteogenesis in T2DM partially by decreasing GSK-3β expression to activate Wnt/β-catenin pathway. BMAL1 may have a potential use in repairing diabetic bone metabolic disorders.

Graphical abstract

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Polymorphisms in MIR499A and MIR125A gene are associated with autoimmune thyroid diseases

Publication date: 15 January 2017
Source:Molecular and Cellular Endocrinology, Volume 440
Author(s): TianTian Cai, Jie Li, Xiaofei An, Ni Yan, Danfeng Li, Yanfei Jiang, Wen Wang, Liangfeng Shi, Qiu Qin, Ronghua Song, Guofei Wang, Wenjuan Jiang, Jin-an Zhang
BackgroundSingle nucleotide polymorphisms (SNPs) of the miR-146a, miR-499a and miR-125a have been shown to be associated with the susceptibility to several autoimmune diseases. This study was conducted to identify the association of SNPs rs2910164, rs57095329, rs3746444 and rs12976445 with autoimmune thyroid diseases (AITDs) in a Chinese Han population.MethodsWe enrolled 1061 patients with AITDs, including 701 patients with Graves' disease (GD) and 360 patients with Hashimoto's thyroiditis (HT), and 938 healthy individuals for a case-control genetic association study. Four SNPs were selected for genotyping by multiplex polymerase chain reaction and ligase detection reaction.ResultsThe frequencies of rs3746444 genotypes in patients with AITD and GD differed significantly from those in the controls. The frequencies of rs12976445 genotypes in patients with HT differed significantly from those in the controls. The frequencies of allele C in HT groups were significantly higher than those in control group. For the rs3746444 polymorphism, genetic associations between the combinational genotype and AITD/GD risk were observed in the dominant model, recessive model, and overdominant model. For the rs12976445 polymorphism, genetic associations between the combinational genotype and HT risk were also found in the dominant model and overdominant model. Moreover, gene-sex interactions were identified by GMDR and 2 × 2 crossover analysis.ConclusionsOur results suggest rs3746444 (miR-499a) and rs12976445 (miR-125a) associated with AITD susceptibility and potential gene-sex interactions between the four polymorphisms and AITD.



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Factors associated to post-operative nausea and vomiting following oral and maxillofacial surgery: a prospective study

Abstract

Aim

This study aims to address and assess possible factors associated with nausea and vomiting (NV) following oral and maxillofacial surgery.

Material and methods

A prospective study was carried out in the period from December 2013 to January 2016 targeting all attended cases in that period. For statistical analysis, Pearson chi-square and Fisher tests were used to verify association and ANOVA and Student's t tests to test for significant difference, p was defined as ≤0.05. The sample group consisted of 207 patients with an average age of 33.56 years (±13.23), and 70.5% of subjects were male.

Results

Calculations based on the predictive model showed that a female patient with prior history of nausea and vomiting who used opioids and had intra-oral surgical access would have a 96% chance of experiencing a nausea and vomiting episode.

Other factors like age, being overweight, anesthesia, surgery duration, and duration of hospital stay also contribute so that these aspects must be paid careful attention prior to surgery to ensure a suitably orientated treatment that will avoid disturbances caused by post-operative nausea and vomiting.

Conclusion

The occurrence of post-operative nausea and vomiting after oral and maxillofacial surgery was found to be more higher incidence associated to female patients who used opioids, who had a prior history of NV, whose surgery involved intra-oral access, who were in the second or third decades of their lives, who have above average weight, and who have long anesthesia when undergoing surgery, resulting in a long hospital stays.

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Gene delivery nanoparticles to modulate angiogenesis

Publication date: Available online 30 November 2016
Source:Advanced Drug Delivery Reviews
Author(s): Jayoung Kim, Adam C. Mirando, Aleksander S. Popel, Jordan J. Green
Angiogenesis is naturally balanced by many pro- and anti-angiogenic factors while an imbalance of these factors leads to aberrant angiogenesis, which is closely associated with many diseases. Gene therapy has become a promising strategy for the treatment of such a disordered state through the introduction of exogenous nucleic acids that express or silence the target agents, thereby engineering neovascularization in both directions. Numerous non-viral gene delivery nanoparticles have been investigated towards this goal, but their clinical translation has been hampered by issues associated with safety, delivery efficiency, and therapeutic effect. This review summarizes key factors targeted for therapeutic angiogenesis and anti-angiogenesis gene therapy, non-viral nanoparticle-mediated approaches to gene delivery, and recent gene therapy applications in pre-clinical and clinical trials for ischemia, tissue regeneration, cancer, and wet age-related macular degeneration. Enhanced nanoparticle design strategies are also proposed to further improve the efficacy of gene delivery nanoparticles to modulate angiogenesis.

Graphical abstract

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Neck Pain and Acute Dysphagia

Abstract

The acute tendinitis of the longus colli muscle is an unusual diagnosis in the cases of acute dysphagia with cervical pain. Is a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the prevertebral space and can cause pharyngeal swelling with impaired swallow. It is absolutely critical to make the differential diagnosis with deep cervical infections in order to avoid invasive treatments.

http://ift.tt/2gGAb8E

Associations among oral health-related quality of life, subjective symptoms, clinical status, and self-rated oral health in Japanese university students: a cross-sectional study

Abstract

Background

The present study aimed to elucidate the associations among self-rated oral health, clinical oral health status, oral health behaviors, subjective oral symptoms, and oral health-related quality of life (OHRQoL) in a group of Japanese university students.

Methods

Of 2051 participants, 2027 (98.83%) students received an optional oral examination and answered a questionnaire including items regarding age, sex, self-rated oral health, oral health behaviors, subjective oral symptoms, and OHRQoL [The Oral Health Impact Profile (OHIP)-14]. On oral examination, the decayed, missing, and filled teeth (DMFT) score, Community Periodontal Index (CPI), the percentage of teeth showing bleeding on probing (%BOP), and malocclusion were recorded. Structural equation modelling (SEM) analysis was used to test associations.

Results

The mean score (± SD) of OHIP-14 was 1.92 ± 5.47. In the SEM analysis, the final model showed that self-rated oral health, oral pain, malocclusion, and the DMFT score were directly associated with the OHRQoL, and subjective symptoms of temporomandibular disorders (TMD) and recurrent aphthous stomatitis were both directly and indirectly associated (p < 0.05). CPI, %BOP, and oral health behaviors were excluded from the final model.

Conclusions

OHRQoL was associated with self-related oral health, subjective symptoms of TMD, oral pain and stomatitis, DMFT, and malocclusion in this group of Japanese university students.

http://ift.tt/2fLZLV8

Effectiveness of bovine-derived xenograft versus bioactive glass with periodontally accelerated osteogenic orthodontics in adults: a randomized, controlled clinical trial

Abstract

Background

Periodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth.

Methods

In this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1.43 [18 − 27] years), were randomly allocated to one of three groups. Group 1 underwent a modified corticotomy technique on the labial side only, whereas group 2 was treated with the same technique combined with PAOO using a bovine-derived xenograft and group 3 was treated in the same way but combining PAOO with bioactive glass. The total treatment duration was recorded from the start of active orthodontic treatment, immediately after corticotomy, and at the time of debonding. Probing depth was evaluated clinically and bone density and root length were evaluated radiographically on the day of surgery (baseline, T1), post-treatment at debonding (T2), and 9 months post-treatment (T3).

Results

The duration of orthodontic treatment was markedly reduced to an average of 11.4 ± 0.14 weeks in all groups. All probing depths were < 3 mm, the interdental papillae were well preserved, there was no loss of tooth vitality, and there was no evidence of significant apical root resorption at any time interval. All groups showed a decrease in mean bone density at T2 followed by an increase at T3. The net percentage change that occurred between baseline and 9 months post-treatment was significantly different between the three groups. Groups 2 and 3, where grafts were incorporated, demonstrated a statistically significant greater increase in bone density than group 1 at T3.

Conclusion

Combination of orthodontic treatment and periodontal surgery is an effective treatment for adult patients that decreases the duration of active treatment and reduces the risk of root resorption. Use of a bovine-derived xenograft with modified corticotomy provided superior benefits in terms of increased bone density than did the use of bioactive glass.

Trial registration

The study was retrospectively registered at ClinicalTrials.gov under Clinical Trial Registration Number: NCT02796911.

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Botulinum Toxin Type A Block of the Sphenopalatine Ganglion in Chronic Rhinosinusitis With Nasal Polyposis

Conditions:   Chronic Disease;   Nasal Polyposis;   Rhinitis
Intervention:   Drug: botox injection Multiguide
Sponsors:   Norwegian University of Science and Technology;   St. Olavs Hospital
Recruiting - verified November 2016

http://ift.tt/2gy9tw6

Botulinum Toxin Type A Block of the Sphenopalatine Ganglion in Chronic Rhinosinusitis With Nasal Polyposis

Conditions:   Chronic Disease;   Nasal Polyposis;   Rhinitis
Intervention:   Drug: botox injection Multiguide
Sponsors:   Norwegian University of Science and Technology;   St. Olavs Hospital
Recruiting - verified November 2016

http://ift.tt/2gy9tw6

Hematopoietic Stem Cell Niches Produce Lineage-Instructive Signals to Control Multipotent Progenitor Differentiation

Publication date: Available online 29 November 2016
Source:Immunity
Author(s): Ana Cordeiro Gomes, Takahiro Hara, Vivian Y. Lim, Dietmar Herndler-Brandstetter, Erin Nevius, Tatsuki Sugiyama, Shizue Tani-ichi, Susan Schlenner, Ellen Richie, Hans-Reimer Rodewald, Richard A. Flavell, Takashi Nagasawa, Koichi Ikuta, João Pedro Pereira
Hematopoietic stem cells (HSCs) self-renew in bone marrow niches formed by mesenchymal progenitors and endothelial cells expressing the chemokine CXCL12, but whether a separate niche instructs multipotent progenitor (MPP) differentiation remains unclear. We show that MPPs resided in HSC niches, where they encountered lineage-instructive differentiation signals. Conditional deletion of the chemokine receptor CXCR4 in MPPs reduced differentiation into common lymphoid progenitors (CLPs), which decreased lymphopoiesis. CXCR4 was required for CLP positioning near Interleukin-7⁺ (IL-7) cells and for optimal IL-7 receptor signaling. IL-7⁺ cells expressed CXCL12 and the cytokine SCF, were mesenchymal progenitors capable of differentiation into osteoblasts and adipocytes, and comprised a minor subset of sinusoidal endothelial cells. Conditional Il7 deletion in mesenchymal progenitors reduced B-lineage committed CLPs, while conditional Cxcl12 or Scf deletion from IL-7⁺ cells reduced HSC and MPP numbers. Thus, HSC maintenance and multilineage differentiation are distinct cell lineage decisions that are both controlled by HSC niches.

Graphical abstract

Teaser

Hematopoietic stem cells reside in rare niches in bone marrow, where they are maintained throughout life, but where these cells differentiate remains unclear. Cordeiro Gomes et al. find that hematopoietic multipotent progenitor cells localize to hematopoietic stem cell niches in bone marrow, where they receive lineage-instructive differentiation signals.


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Adrenal Cushing syndrome with detectable ACTH from an unexpected source

Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging. After induction of anaesthesia for laparoscopic adrenalectomy, the patient developed resistant hypertension with stress-dose hydrocortisone administration. Surgery was cancelled and repeat testing revealed elevated plasma metanephrines. α-Blockade was administered for a presumed coexisting pheochromocytoma, and the patient underwent adrenalectomy. Pathology revealed an MCMT. This case highlights the importance of a thorough biochemical evaluation in patients with adrenal masses to rule out multiple hormone producing tumours.

http://ift.tt/2gGnVou

Medium-chain acyl-Coenzyme A dehydrogenase deficiency (MCADD): a cause of severe hypoglycaemia in an apparently well child

Medium-chain acyl-Coenzyme A dehydrogenase deficiency (MCADD) is a disorder of fatty acid β oxidation inherited in an autosomal recessive manner. The enzyme is useful in hepatic ketogenesis, a major source of energy once hepatic glycogen stores become depleted during prolonged fasting. It is a cause of hypoketotic hypoglycaemia in a previously well child. MCADD is not part of newborn screening in Ireland; children are likely to be missed if routine hypoglycaemic screen is not instituted when blood glucose level is below 2.6 mmol/L. This is a case of an otherwise healthy 23-month-old baby girl who presented with severe hypoglycaemia with some initial diagnostic dilemma.

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First reported case of peroneal tenosynovitis caused by Coccidioides immitis successfully treated with fluconazole

Coccidioidomycosis is an insidious infection caused by Coccidioides spp (C. immitis and C. posadasii). Disseminated disease occasionally involves tendon sheaths and synovium of the joints leading to tenosynovitis. Here, we describe the case of a 72-year-old woman from southern Arizona, who presented with right ankle pain, redness and swelling for 2 months. Her serum IgG was positive for C. immitis on complement fixation, and her MRI of the right ankle joint showed extensive tenosynovitis of the right peroneal tendons, and subtalar joint effusions with associated synovitis. The purpose of this case is to report an extremely rare manifestation of disseminated C. immitis, that is, peroneal tenosynovitis and challenges involved with diagnosis and treatment. We also document that azole therapy is an effective treatment option for peroneal tenosynovitis caused by C. immitis, and we had to double the dose for slow symptom resolution with 4-week trial with usual 400 mg oral dose of fluconazole.

http://ift.tt/2gGgoGn

Acute promyelocytic leukaemia: looking through 'gums

Description

Examination of the oral cavity provides valuable clues to a large number of systemic disorders. Gum hypertrophy is usually associated with myelomonocytic and monocytic subtypes of acute myeloid leukaemia.1 Its occurrence in a case of acute promyelocytic leukaemia (APL) is unusual.1

We describe a 28-year-old man from India who presented to our hospital with a 2-week history of easy fatiguability and gum bleeding. Examination revealed pallor and marked gum hypertrophy (figure 1). Blood investigations showed haemoglobin 50 g/L, white cell count 5.4x10⁹/L, differential counts 95% promyelocytes, 3% myelocytes, 1% metamyelocytes and 1% neutrophils, platelets 30x10⁹/L, prothrombin time 18 s (control 14 s), activated partial thromboplastin time 42 s (control 34–36 s) and fibrinogen 1.5 g/L (2–4 g/L). Examination of the bone marrow aspirate smears revealed typical Faggot cells (figure 2A, B). Conventional karyotyping revealed t(15;17). PML-RARα was detected in the bone marrow aspirate by reverse...

http://ift.tt/2fLIQ4W

Course of membranous nephropathy during multiple gestations

Description

The physiological adaptations in pregnancy can unmask underlying occult proteinuric renal disease. However, the effect of multiple pregnancies on the course of the disease is variable. We report the clinical course of a case of idiopathic membranous nephropathy through multiple pregnancies.

A 25-year-old Hispanic woman was referred to our institution for worsening generalised swelling of the body, uncontrolled hypertension and 21 g/day of proteinuria at 34 weeks' gestation during her third pregnancy. There were no stigmata suggestive of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome. She was previously seen at our institution 5 years ago during her 1st pregnancy when 13 g/day of proteinuria was recorded at 25 weeks of gestation. At that time, she was treated with oral steroids and delivery was induced at 35 weeks due to intrauterine growth restriction. Placental biopsy revealed focal, tightly adherent blood clot, consistent with possible abruption. Renal biopsy performed in the postpartum period...

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Early severe coronary artery disease and aortic coarctation in a child with familial hypercholesterolaemia

An 11-year-old boy presented with easy fatigability, multiple xanthomas, and absent pedal pulsations. Laboratory workup showed severe hypercholesterolaemia and non-invasive imaging revealed 'normally functioning' bicuspid aortic valve and tight aortic coarctation. Coronary angiography showed severe right coronary artery (RCA) stenosis. Medical treatment resulted in significant improvement of dyslipidaemia. We successfully performed balloon dilation and stenting of his coarctation, as well as percutaneous coronary intervention for RCA lesion.

http://ift.tt/2gGeDsG

Fundamental insight into the effect of carbodiimide crosslinking on cellular recognition of collagen-based scaffolds.

Publication date: Available online 30 November 2016
Source:Acta Biomaterialia
Author(s): Daniel V. Bax, Natalia Davidenko, Donald Gullberg, Samir W. Hamaia, Richard W. Farndale, Serena M. Best, Ruth E. Cameron
Research on the development of collagen constructs is extremely important in the field of tissue engineering. Collagen scaffolds for numerous tissue engineering applications are frequently crosslinked with 1-ethyl-3-(3-dimethylaminopropyl-carbodiimide hydrochloride (EDC) in the presence of N-hydroxy-succinimide (NHS). Despite producing scaffolds with good biocompatibility and low cellular toxicity the influence of EDC/NHS crosslinking on the cell interactive properties of collagen has been overlooked. Here we have extensively studied the interaction of model cell lines with collagen I-based materials after crosslinking with different ratios of EDC in relation to the number of carboxylic acid residues on collagen. Divalent cation-dependent cell adhesion, via integrins α1β1, α2β1, α10β1 and α11β1, were sensitive to EDC crosslinking. With increasing EDC concentration, this was replaced with cation-independent adhesion. These results were replicated using purified recombinant I domains derived from integrin α1 and α2 subunits. Integrin α2β1-mediated cell spreading, apoptosis and proliferation were all heavily influenced by EDC crosslinking of collagen. Data from this rigorous study provides an exciting new insight that EDC/NHS crosslinking is utilising the same carboxylic side chain chemistry that is vital for native-like integrin-mediated cell interactions. Due to the ubiquitous usage of EDC/NHS crosslinked collagen for biomaterials fabrication this data is essential to have a full understanding in order to ensure optimized collagen-based material performance.

Graphical abstract

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To the Editor: Combined immunodeficiency and hypoglycemia associated with mutations in hypoxia up-regulated 1

Publication date: Available online 29 November 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Emma M. Haapaniemi, Christopher L. Fogarty, Salla Keskitalo, Shintaro Katayama, Helena Vihinen, Mette Ilander, Satu Mustjoki, Kaarel Krjutškov, Markku Lehto, Timo Hautala, Ove Eriksson, Eija Jokitalo, Vidya Velagapudi, Markku Varjosalo, Mikko Seppänen, Juha Kere

Teaser

We describe recessive mutations in hypoxia up-regulated 1 (HYOU1) in a patient that presented with generalized susceptibility to bacterial and herpetic infections as well as hypoglycemic episodes.


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Effect of bradykinin receptor antagonism on ACE inhibitor-associated angioedema

Publication date: Available online 29 November 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Brittany T. Straka, Claudia E. Ramirez, James B. Byrd, Elizabeth Stone, Alencia Woodard-Grice, Hui Nian, Chang Yu, Aleena Banerji, Nancy J. Brown
BackgroundThe B2 receptor antagonist icatibant is approved for treatment of attacks of hereditary angioedema. Icatibant has been reported to decrease time-to-resolution of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema in one study of European patients.MethodsPatients with ACE inhibitor-associated angioedema (defined as swelling of lips, tongue, pharynx or face during ACE inhibitor use and no swelling in the absence of ACE inhibitor use) were enrolled at Vanderbilt University Medical Center from October 2007 through September 2015 and at Massachusetts General Hospital in 2012. C1 inhibitor deficiency and patients with bowel edema only were excluded. Patients were randomized within six hours of presentation to subcutaneous icatibant 30 mg or placebo at zero and six hours later. Patients assessed severity of swelling using a visual analog scale serially following study drug administration or until discharge.ResultsThirty-three patients were randomized and 31 received treatment, with 13 receiving icatibant and 18 receiving placebo. One patient randomized to icatibant did not complete the visual analog scale and was excluded from analyses. Two-thirds of patients were African American and two-thirds were women. Time-to-resolution of symptoms was similar in placebo and icatibant treatment groups (p=0.19 for the primary symptom and p>0.16 for individual symptoms of face, lip, tongue, or eyelid swelling). Frequency of administration of H1 and H2 blockers, corticosteroids, and epinephrine was similar in the two treatment groups. Time-to-resolution of symptoms was similar in black and white patients.ConclusionsThis study does not support clinical efficacy of a bradykinin B2 receptor antagonist in ACE inhibitor-associated angioedema.

Teaser

This randomized, placebo-controlled double-blind study does not shown any benefit of administration of the bradykinin B2 receptor antagonist icatibant in patients presenting with angiotensin-converting enzyme inhibitor-associated angioedema. This contrasts studies in hereditary angioedema.


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An mTORC1/AKT1/Cathepsin H axis controls filaggrin expression and processing in skin, a novel mechanism for skin barrier disruption in Atopic Dermatitis

Publication date: Available online 29 November 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Aishath S. Naeem, Cristina Tommasi, Christian Cole, Stuart J. Brown, Yanan Zhu, Benjamin Way, Saffron AG. Willis Owen, Miriam Moffatt, William O. Cookson, John I. Harper, Di WL, Sara J. Brown, Thomas Reinheckel, Ryan F.L. O'Shaughnessy
BackgroundFilaggrin, encoded by the FLG gene, is an important component of the skin's barrier to the external environment and genetic defects in FLG strongly associate with Atopic Dermatitis (AD). However, not all AD patients have FLG mutations.ObjectiveWe hypothesised that these patients may possess other defects in filaggrin expression and processing, contributing to barrier disruption and AD, and therefore present novel therapeutic targets for this disease.ResultsWe describe the relationship between the mTORC1 protein subunit RAPTOR, the serine/threonine kinase AKT1 and the protease cathepsin H, for which we establish a role in filaggrin expression and processing. Increased RAPTOR levels correlated with decreased filaggrin expression in AD. In keratinocyte cell culture, RAPTOR up-regulation or AKT1 shRNA knockdown reduced the expression of the protease cathepsin H. Skin of cathepsin H-deficient mice and CTSH shRNA knockdown keratinocytes showed reduced filaggrin processing and the mouse showed both impaired skin barrier function and a mild proinflammatory phenotype.ConclusionOur findings highlight a novel, potentially treatable, signalling axis controlling filaggrin expression and processing which is defective in AD.

Graphical abstract

Teaser

Capsule:FLG mutations strongly associate with Atopic Dermatitis (AD). However, not all AD patients have FLG mutations. An mTORC/AKT1 signalling axis controls both filaggrin expression and processing by controlling expression of the protease Cathepsin H.


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Oral Immunotherapy–Induced Gastrointestinal Symptoms and Peripheral Blood Eosinophil Responses

Publication date: Available online 29 November 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Michael R. Goldberg, Arnon Elizur, Liat Nachshon, Michael Y. Appel, Michael B. Levy, Keren Golobov, Robert Goldberg, Miguel Stein, Marc E. Rothenberg, Yitzhak Katz

Teaser

Capsule Summary: Oral immunotherapy-induced gastrointestinal and eosinophilic responses (OITIGER) is an adverse response to OIT in ∼8% of patients and is typically reversible by decreasing dosage administration. The peripheral blood eosinophil count serves as a biomarker marker for susceptibility and the medical course.


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Effects of nongenetic factors on immune cell dynamics in early childhood: The Generation R Study

Publication date: Available online 29 November 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Diana van den Heuvel, Michelle A.E. Jansen, Kazem Nasserinejad, Willem A. Dik, Ellen G. van Lochem, Liesbeth E. Bakker-Jonges, Halima Bouallouch-Charif, Vincent W.V. Jaddoe, Herbert Hooijkaas, Jacques J.M. van Dongen, Henriëtte A. Moll, Menno C. van Zelm
Background. Numbers of blood leukocyte subsets are highly dynamic in childhood and differ greatly between individuals. Inter-individual variation is only partly accounted for by genetic factors.ObjectiveDetermine which nongenetic factors affect the dynamics of innate leukocytes, and naive and memory lymphocyte subsets.Methods. We performed six-color flow cytometry and linear mixed effect modeling to define the dynamics of 62 leukocyte subsets from birth to 6 years of age in 1,182 children with one to five measurements per individual. Subsequently, we defined the impact of prenatal maternal lifestyle-related or immune-mediated determinants, birth characteristics and bacterial/viral exposure-related determinants on leukocyte subset dynamics.Results. Functionally similar leukocyte populations were grouped by unbiased hierarchical clustering of patterns of age-related leukocyte dynamics. Innate leukocyte numbers were high at birth and were predominantly affected by maternal low education level. Naive lymphocytes peaked around 1 year, while most memory lymphocyte subsets more gradually increased during the first 4 years of life. Dynamics of CD4⁺ T cells were predominantly associated with gender, birth characteristics, and persistent infections with cytomegalovirus (CMV) or Epstein Barr virus (EBV). CD8⁺ T cells were predominantly associated with CMV and EBV infections, and TCRγδ⁺ T cells with premature rupture of membranes and CMV infection. B-cell subsets were predominantly associated with gender, breastfeeding and Helicobacter pylori carriership.Conclusions. Our study identifies specific dynamic patterns of leukocyte subset numbers, as well as nongenetic determinants that affect these patterns, thereby providing new insights into the shaping of the childhood immune system.

Graphical abstract

Teaser

Capsule Summary: Human inter-individual immunological diversity can only partly be explained by genetic factors, indicating an important contribution of nongenetic factors. We here analyzed leukocyte dynamics in 1,182 children of the Generation R Study and determined the effect of 26 nongenetic factors on inter-individual immunological diversity.


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Copyright

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1





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Contributors

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1





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Contents

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1





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Forthcoming Issues

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1





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Evolving Treatment Options for Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Daniel Morgensztern, Roy S. Herbst




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Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Daniel Morgensztern, Roy S. Herbst




http://ift.tt/2fDv0Xj

Next-Generation Sequencing of Lung Cancers

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Siddhartha Devarakonda, Ashiq Masood, Ramaswamy Govindan

Teaser

Targeted therapies and immune checkpoint inhibitors have significantly improved outcomes in a sizable fraction of patients with metastatic non-small cell lung cancer. Nevertheless, a majority of patients with lung cancer continue to have poor outcomes. The ability to comprehensively characterize the genomic alterations in various subtypes of lung cancer has the potential to transform cancer care by facilitating the identification of novel treatment strategies. The objective of this review is to summarize key findings from recent studies that have sequenced a large number of lung cancer samples and discuss the diagnostic, prognostic, and therapeutic relevance of these findings.


http://ift.tt/2gK93C4

Lung Cancer Biomarkers

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Pamela Villalobos, Ignacio I. Wistuba

Teaser

The molecular characterization of lung cancer has changed the classification and treatment of these tumors, becoming an essential component of pathologic diagnosis and oncologic therapy decisions. Through the recognition of novel biomarkers, such as epidermal growth factor receptor mutations and anaplastic lymphoma kinase translocations, it is possible to identify subsets of patients who benefit from targeted molecular therapies. The success of targeted anticancer therapies and new immunotherapy approaches has created a new paradigm of personalized therapy and has led to accelerated development of new drugs for lung cancer treatment. This article focuses on clinically relevant cancer biomarkers as targets for therapy and potential new targets for drug development.


http://ift.tt/2fDA1Pq

Neoadjuvant and Adjuvant Therapy for Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Jody C. Chuang, Ying Liang, Heather A. Wakelee

Teaser

The use of 4 cycles of cisplatin-based adjuvant chemotherapy is now the standard of care for patients with resected stage II and IIIA non–small cell lung cancer. Neoadjuvant chemotherapy lacks the same level of data as adjuvant treatment, but meta-analyses of this approach support its use. Selection of patients who are most likely to benefit from chemotherapy remain elusive. Ongoing adjuvant trials are exploring biomarkers, molecularly targeted agents, postoperative radiation therapy, and immunotherapy.


http://ift.tt/2gK78xl

Treatment of Locally Advanced Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Kit Tam, Megan Daly, Karen Kelly

Teaser

Locally advanced non–small cell lung cancer is a heterogeneous disease with typically poor outcomes. Select patients may benefit from the integration of surgery, whereas patients with bulky, multistation, or contralateral (N3) mediastinal involvement are managed with definitive chemoradiation. Attempts to improve outcomes through induction, consolidation, or maintenance chemotherapy or radiation dose escalation have not demonstrated a survival benefit. Current research efforts focus on the integration of novel systemic agents that exploit tumor-specific driver mutations, augment antitumor immune response, or enhance radiation sensitivity.


http://ift.tt/2fDv0qh

First-Line Systemic Therapy for Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Rebecca S. Heist

Teaser

Major advances in the treatment of metastatic non–small cell lung cancer have led to significant incremental improvements in patient outcomes. Platinum-based combination therapy remains the cornerstone of first-line therapy. The addition of biologic agents, such as bevacizumab or necitumumab, in selected populations has shown benefit over chemotherapy alone. The advent of maintenance therapy has also improved overall survival outcomes in selected populations of patients. Ongoing studies will further refine optimal treatment in the first-line setting and further advance first-line treatment options.


http://ift.tt/2gK91Ks

Second-Line Chemotherapy and Beyond for Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Greg Durm, Nasser Hanna

Teaser

The landscape for the second- and third-line treatment of advanced non–small cell lung cancer has changed dramatically over the last two decades. Immunotherapeutic agents have become a preferred choice following progression on platinum-based first-line chemotherapy. However, there remains a role for cytotoxic chemotherapy and pemetrexed and docetaxel (with or without ramucirumab) are approved for single-agent use in the second-line setting. With the discovery of new genetic alterations and the development of novel targeted drugs, the treatment of advanced non–small cell lung cancer following progression on first-line therapy continues to become more complicated as new treatment algorithms evolve.


http://ift.tt/2fDvDQw

Epidermal Growth Factor Receptor Mutated Advanced Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Suchita Pakkala, Suresh S. Ramalingam

Teaser

Activating mutations in the epidermal growth factor receptor (EGFR) are present in approximately 15% of US patients with lung adenocarcinoma. EGFR tyrosine kinase inhibitors are associated with high response rate and progression-free survival for patients with non–small cell lung cancer with this genotype. Gefitinib, erlotinib, and afatinib are the EGFR tyrosine kinase inhibitors that are presently in clinical use. Understanding resistance mechanisms has led to the identification of a secondary mutational target, T790M, in more than half of patients, for which osimertinib has been approved. This article reviews the current treatments, resistance mechanisms, and strategies to overcome resistance.


http://ift.tt/2gJZMK6

Diagnosis and Treatment of Anaplastic Lymphoma Kinase–Positive Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Kathryn C. Arbour, Gregory J. Riely

Teaser

Anaplastic lymphoma kinase (ALK) gene rearrangements occur in a small portion of patients with non–small cell lung cancer (NSCLC). These gene rearrangements lead to constitutive activation of the ALK kinase and subsequent ALK-driven tumor formation. Patients with tumors harboring such rearrangements are highly sensitive to ALK inhibitors, such as crizotinib, ceritinib, and alectinib. Resistance to these kinase inhibitors occurs through several mechanisms, resulting in ongoing clinical challenges. This review summarizes the biology of ALK-positive lung cancer, methods for diagnosing ALK-positive NSCLC, current FDA-approved ALK inhibitors, mechanisms of resistance to ALK inhibition, and potential strategies to combat resistance.


http://ift.tt/2fDvFIb

New Targets in Non–Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Soo J. Park, Soham More, Ayesha Murtuza, Brian D. Woodward, Hatim Husain

Teaser

With the implementation of genomic technologies into clinical practice, we have examples of the predictive benefit of targeted therapy for oncogene-addicted cancer and identified molecular dependencies in non–small cell lung cancer. The clinical success of tyrosine kinase inhibitors against epidermal growth factor receptor and anaplastic lymphoma kinase activation has shifted treatment emphasize the separation of subsets of lung cancer and genotype-directed therapy. Advances have validated oncogenic driver genes and led to the development of targeted agents. This review highlights treatment options, including clinical trials for ROS1 rearrangement, RET fusions, NTRK1 fusions, MET exon skipping, BRAF mutations, and KRAS mutations.


http://ift.tt/2gK3DqK

Immunotherapy in Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Lingling Du, Roy S. Herbst, Daniel Morgensztern

Teaser

The treatment of patients with good performance status and advanced stage non–small cell lung cancer has been based on the use of first-line platinum-based doublet and second-line docetaxel. Immunotherapy represents a new therapeutic approach with the potential for prolonged benefit. Although the vaccines studied have not shown benefit in patients with non–small cell lung cancer, immune checkpoint inhibitors against the PD-1/PD-L1 axis showed increased overall survival compared with docetaxel in randomized clinical trials, which led to the approval of nivolumab and pembrolizumab. Because only a minority of patients benefit from this class of drugs, there has been an intense search for biomarkers.


http://ift.tt/2fDxB3H

Advances in Small Cell Lung Cancer

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Gregory P. Kalemkerian, Bryan J. Schneider

Teaser

Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor characterized by early metastatic spread and responsiveness to initial therapy. The incidence of SCLC has been declining in the United States in parallel with the decreasing prevalence of cigarette smoking. Limited stage disease is potentially curable with chemoradiotherapy followed by cranial irradiation. Extensive stage disease is incurable, but systemic chemotherapy can improve quality of life and prolong survival. Nearly all patients relapse with chemoresistant disease. Molecularly targeted therapy has failed to yield convincing clinical benefits. Nevertheless, many biologically rational strategies, including immune checkpoint inhibition, show promise in ongoing clinical trials.


http://ift.tt/2gJZLpw

Systemic Treatment of Brain Metastases

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1
Author(s): Saiama N. Waqar, Daniel Morgensztern, Ramaswamy Govindan

Teaser

Lung cancer continues to be the leading cause of cancer-related mortality in the United States. Brain metastases are a significant problem in patients with lung cancer and have conventionally been treated with whole-brain radiation. This article reviews the data for systemic chemotherapy to treat brain metastasis from lung cancer and examines the activity of small molecule tyrosine kinase inhibitors for the targeted therapy for brain metastases from EGFR-mutant and ALK-rearranged non–small cell lung cancer. Future directions for evaluating the role of immunotherapy in treating brain metastasis are also discussed.


http://ift.tt/2fDwmkV

Index

Publication date: February 2017
Source:Hematology/Oncology Clinics of North America, Volume 31, Issue 1





http://ift.tt/2gKcnwQ

Depression in cancer: The many biobehavioral pathways driving tumor progression.

Depression in cancer: The many biobehavioral pathways driving tumor progression.

Cancer Treat Rev. 2016 Nov 16;52:58-70

Authors: Bortolato B, Hyphantis TN, Valpione S, Perini G, Maes M, Morris G, Kubera M, Köhler CA, Fernandes BS, Stubbs B, Pavlidis N, Carvalho AF

Abstract
Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote: (1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitaryadrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioral pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed.

PMID: 27894012 [PubMed - as supplied by publisher]

http://ift.tt/2gxvCub

Cell membrane modulation as adjuvant in cancer therapy.

Related Articles

Cell membrane modulation as adjuvant in cancer therapy.

Cancer Treat Rev. 2016 Nov 9;52:48-57

Authors: Zalba S, Ten Hagen TL

Abstract
Cancer is a complex disease involving numerous biological processes, which can exist in parallel, can be complementary, or are engaged when needed and as such can replace each other. This redundancy in possibilities cancer cells have, are fundamental to failure of therapy. However, intrinsic features of tumor cells and tumors as a whole provide also opportunities for therapy. Here we discuss the unique and specific makeup and arrangement of cell membranes of tumor cells and how these may help treatment. Interestingly, knowledge on cell membranes and associated structures is present already for decades, while application of membrane modification and manipulation as part of cancer therapy is lagging. Recent developments of scientific tools concerning lipids and lipid metabolism, opened new and previously unknown aspects of tumor cells and indicate possible differences in lipid composition and membrane function of tumor cells compared to healthy cells. This field, coined Lipidomics, demonstrates the importance of lipid components in cell membrane in several illnesses. Important alterations in cancer, and specially in resistant cancer cells compared to normal cells, opened the door to new therapeutic strategies. Moreover, the ability to modulate membrane components and/or properties has become a reality. Here, developments in cancer-related Lipidomics and strategies to interfere specifically with cancer cell membranes and how these affect cancer treatment are discussed. We hypothesize that combination of lipid or membrane targeted strategies with available care to improve chemotherapy, radiotherapy and immunotherapy will bring the much needed change in treatment in the years to come.

PMID: 27889637 [PubMed - as supplied by publisher]

http://ift.tt/2gBffNZ

Multiple myeloma treatment at relapse after autologous stem cell transplantation: A practical analysis.

Related Articles

Multiple myeloma treatment at relapse after autologous stem cell transplantation: A practical analysis.

Cancer Treat Rev. 2016 Nov 15;52:41-47

Authors: Malard F, Harousseau JL, Mohty M

Abstract
Over the past decade, significant advances have been made in the field of multiple myeloma. Introduction of the so-called novel agents, proteasome inhibitors (PI) and immunomodulatory drugs (IMiD), and improved supportive care have resulted in significantly better outcome. Standard first line treatment in fit patients include PI and IMiD based induction, high dose melphalan with autologous hematopoietic stem cell transplantation (ASCT) and consolidation/maintenance. However, despite these progresses MM remains incurable for the majority of patients and most patients will relapse. Next generation PI (carfilzomib, ixazomib) and IMiD (pomalidomide) and new therapeutic classes: monoclonal antibody (elotuzumab, daratumumab) and pan-deacetylase inhibitors (panobinostat) have been successfully evaluated in relapse multiple myeloma. Some of these new agents are now approved for multiple myeloma treatment at relapse. However choosing the most appropriate treatment at relapse may be difficult. This review sum up the most important studies and provide evidence to choose the most relevant therapeutic strategy for relapse after ASCT, based on disease, patient and previous treatment related parameters.

PMID: 27888768 [PubMed - as supplied by publisher]

http://ift.tt/2gxwNtX

Predictive factors and treatment outcome of laryngeal carcinoma recurrence

Abstract

Background

Up to 30% of patients with laryngeal squamous cell carcinoma (SCC) present with recurrence after treatment. We analyzed factors associated with the risk of cancer recurrence and prognosis after recurrence.

Methods

A nationwide laryngeal SCC cohort from Finnish university hospitals during 2001 to 2005 with initial successful therapy (n = 316) was analyzed.

Results

Laryngeal SCC recurred in 22% of patients. The median time to recurrence was 9 months, with 90% occurring within 36 months after treatment. The World Health Organization (WHO) performance status >0, neck metastasis at presentation, and nonsurgical treatment were independent prognostic factors for recurrence. Patients with local recurrence had a 5-year overall survival (OS) of 53% compared with 5% in patients with regional/distant recurrences. OS for glottic and nonglottic laryngeal SCC recurrence was 45% and 0%, respectively.

Conclusion

The type of treatment affected the risk of recurrence in this retrospective series. Local recurrences carried a chance for successful salvage treatment. Routine follow-up beyond 36 months remains controversial. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

http://ift.tt/2gJLucE

Predictive factors and treatment outcome of laryngeal carcinoma recurrence

Abstract

Background

Up to 30% of patients with laryngeal squamous cell carcinoma (SCC) present with recurrence after treatment. We analyzed factors associated with the risk of cancer recurrence and prognosis after recurrence.

Methods

A nationwide laryngeal SCC cohort from Finnish university hospitals during 2001 to 2005 with initial successful therapy (n = 316) was analyzed.

Results

Laryngeal SCC recurred in 22% of patients. The median time to recurrence was 9 months, with 90% occurring within 36 months after treatment. The World Health Organization (WHO) performance status >0, neck metastasis at presentation, and nonsurgical treatment were independent prognostic factors for recurrence. Patients with local recurrence had a 5-year overall survival (OS) of 53% compared with 5% in patients with regional/distant recurrences. OS for glottic and nonglottic laryngeal SCC recurrence was 45% and 0%, respectively.

Conclusion

The type of treatment affected the risk of recurrence in this retrospective series. Local recurrences carried a chance for successful salvage treatment. Routine follow-up beyond 36 months remains controversial. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

http://ift.tt/2gJLucE

Rhinosporidiosis: A Rare Cause of Proptosis and an Imaging Dilemma for Sinonasal Masses

Background. Rhinosporidiosis is a common disease entity in tropical countries; however, it can be encountered in other parts of the world as well due to increasing medical tourism. It may mimic other more malignant and vigorous pathologies of the involved part. Case Report. We present a case of a 36-year-old male presenting with proptosis due to involvement of nasolacrimal duct which is rare. We will discuss typical CT and MRI features of the disease which were present in the case. Conclusion. For a surgeon and a radiologist, this is a necessary differential to be kept in mind for sinonasal masses. CT and MRI are invaluable investigations. However, FNAC is confirmatory. Both clinical and radiological aspects are required to reach correct diagnosis.

http://ift.tt/2g6dh76

Rhinosporidiosis: A Rare Cause of Proptosis and an Imaging Dilemma for Sinonasal Masses

Background. Rhinosporidiosis is a common disease entity in tropical countries; however, it can be encountered in other parts of the world as well due to increasing medical tourism. It may mimic other more malignant and vigorous pathologies of the involved part. Case Report. We present a case of a 36-year-old male presenting with proptosis due to involvement of nasolacrimal duct which is rare. We will discuss typical CT and MRI features of the disease which were present in the case. Conclusion. For a surgeon and a radiologist, this is a necessary differential to be kept in mind for sinonasal masses. CT and MRI are invaluable investigations. However, FNAC is confirmatory. Both clinical and radiological aspects are required to reach correct diagnosis.

http://ift.tt/2g6dh76