Head and Neck Diseases by Alexandros G.Sfakianakis: 02/18/17

Σάββατο 18 Φεβρουαρίου 2017

Pharyngeal swallowing pressures in the base-of-tongue and hypopharynx regions identified with three-dimensional manometry

Objectives

This study aims to use three-dimensional (3D) high-resolution manometry to identify circumferential pressure patterns generated within the asymmetrical base-of-tongue and hypopharynx regions of the pharynx during deglutition.

Study Design

Case series.

Methods

Radial pressures in the regions of interest were evaluated during swallowing events in 12 healthy subjects using 3D high-resolution manometry.

Results

Repeated measures analysis of variance revealed asymmetrical pharyngeal clearance pressures in the base-of-tongue and hypopharynx regions during swallowing. A significant main effect of direction on pressure was found at the time point of average maximum pressure (P < 0.001) and for pressure integral (P < 0.001), with pressure primarily generated from the posterior direction. An interaction was noted between direction and location when comparing maximum directional pressures, regardless of time (P =0.045), highlighting the differences in anterior pressure production between regions. In contrast to the high posterior pressures produced in the base-of-tongue region, an anteroposterior dominant pressure pattern was observed in the hypopharynx. Pressure waveform complexity in the hypopharynx also is likely attributed to activity in the anterior and posterior directions. Symmetrical pressure generation was observed during intrabolus flow within the hypopharynx.

Conclusion

This study shows that pressure is asymmetrically generated in the base-of-tongue and hypopharynx regions during swallowing of a 10-mL bolus, reflecting the complex anatomy within the pharynx. Understanding of these complex pressure patterns aids in the interpretation of high-resolution manometry and can help guide further study in the clinical assessment and treatment of pharyngeal pathology.

Level of Evidence

4. Laryngoscope, 2016

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Racial disparities in preventable risk factors for head and neck cancer

Objectives/Hypothesis

To demonstrate racial differences in preventable risk behaviors/practices that contribute to head and neck cancer (HNCA).

Study Design

Cross-sectional analysis of large national risk factor survey.

Methods

The Behavioral Risk Factor Surveillance System for 2013 was analyzed. Demographic data were extracted, including age, sex, and race. Social habits considered risk factors for HNCA were also extracted, including alcohol consumption, smoking, and human papillomavirus (HPV) vaccination status. Statistical comparisons were conducted according to race for each risk factor, and additional comparisons were conducted within the American Indian population subgroup for risk factors according to sex.

Results

A total of 238.6 million Americans were surveyed. American Indians reported higher rates of binge drinking (19.0%) than whites (17.3%), blacks (12.4%), and Asian Americans (13.1%; P < .001). This rate was significantly higher for American Indian males (23.5%) versus females (13.7%; P < .001). Mean total drinks per month was higher for whites and American Indians (13.5 and 13.5; P < .001). American Indians reported the highest rates of current smoking (28.1%), followed by blacks (20.1%), whites (18.3%), and Asians (10.2%; P < .001). American Indians also reported the highest rates of every day smoking (18.2%), versus whites (13.3%), blacks (13.1%), and Asians (6.1%; P < .001). Rates of HPV vaccination were lowest for American Indians (11.7%), compared to whites (14.6%), blacks (13.6%), and Asians (12%; P = 0.618).

Conclusions

There are striking racial disparities in the prevalence of preventable risk factors for HNCA. These data highlight the need for targeted education and prevention programs in particular racial groups.

Level of Evidence

4. Laryngoscope, 2017

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Multi-resolution multi-object statistical shape models based on the locality assumption

Publication date: Available online 17 February 2017
Source:Medical Image Analysis
Author(s): Matthias Wilms, Heinz Handels, Jan Ehrhardt
Statistical shape models learned from a population of previously observed training shapes are nowadays widely used in medical image analysis to aid segmentation or classification. However, providing an appropriate and representative training population of preferably manual segmentations is typically either very labor-intensive or even impossible. Therefore, statistical shape models in practice frequently suffer from the high-dimension-low-sample-size (HDLSS) problem resulting in models with insufficient expressiveness.In this paper, a novel approach for learning representative multi-resolution multi-object statistical shape models from a small number of training samples that adequately model the variability of each individual object as well as their interrelations is presented. The method is based on the assumption of locality, which means that local shape variations have limited effects in distant areas and, therefore, can be modeled independently. This locality assumption is integrated into the standard statistical shape modeling framework by manipulating the sample covariance matrix (non-zero covariances between distant landmarks are set to zero). To allow for multi-object modeling, a method for computing distances between points located on different object shapes is proposed. Furthermore, different levels of locality are introduced by deriving a multi-resolution scheme, which is equipped with a method to combine variability information modeled at different levels into a single shape model. This combined representation of global and local variability in a single shape model allows the use of the classical active shape model strategy for model-based image segmentation.An extensive evaluation based on a public data base of 247 chest radiographs is performed to show the modeling and segmentation capabilities of the proposed approach in single- and multi-object HDLSS scenarios. The new approach is not only compared to the classical shape modeling method but also to three state-of-the-art shape modeling approaches specifically designed to cope with the HDLSS problem. The results show that the new approach significantly outperforms all other approaches in terms of generalization ability and model-based segmentation accuracy.

Graphical abstract

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Dendritic cell rehab: new strategies to unleash therapeutic immunity in ovarian cancer

Abstract

Immune-based therapies that induce remarkable and durable responses against melanoma and lung cancer have unfortunately demonstrated limited success in ovarian cancer patients. This is likely due to the exceptional immunoregulatory nature of ovarian tumors, which employ numerous strategies to effectively suppress anti-tumor immunity. Here, we summarize a decade of research indicating that ovarian cancers possess an exquisite capacity to subvert the activity of host dendritic cells (DCs) as a key mechanism to impede the development and maintenance of protective T cell-based immune responses. Identifying, understanding, and disabling the precise mechanisms promoting DC dysfunction in ovarian cancer are, therefore, fundamental requirements for devising the next generation of successful immunotherapies against this devastating malignancy.

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Myeloid cells as a target for oligonucleotide therapeutics: turning obstacles into opportunities

Abstract

Immunotherapies emerged as an alternative for cancer treatment, yet their clinical efficacies are still limited, especially in case of solid tumors. Myeloid immune cells, such as macrophages and myeloid-derived suppressor cells (MDSCs), are often hijacked by tumors and become pivotal inhibitors of antitumor immunity. Immunosuppressive functions of tumor-associated myeloid cells result from the activity of Signal Transducer and Activator of Transcription 3 (STAT3), a transcription factor with well-defined tumorigenic and tolerogenic roles in human cancers. To overcome challenges in the development of pharmacological STAT3 inhibitors, we recently developed oligonucleotide-based strategies for cell-selective, in vivo STAT3 targeting. Conjugation of a STAT3siRNA or decoy STAT3 inhibitors to synthetic Toll-like Receptor 9 (TLR9) agonists, CpG oligonucleotides, allowed for selective delivery into TLR9-positive cells. Cellular target for CpG-STAT3 inhibitors include non-malignant, tumor-associated myeloid cells, such as polymorphonuclear MDSCs, as well as cancer cells in acute myeloid leukemia, B cell lymphoma and in certain solid tumors. The chemically modified CpG-STAT3 inhibitors resist serum nucleases and thus can be administered intravenously. Their potency relies on the intracellular gain-of-function effect: release of the central immune checkpoint regulator (STAT3) to unleash proinflammatory signaling (CpG/TLR9) in the same antigen-presenting cell. At the cellular level, CpG-STAT3 inhibitors exert two-pronged effect by rescuing T cells from the immune checkpoint control while decreasing survival of cancer cells. In this article, we review the preclinical data on CpG-STAT3 inhibitors and discuss perspectives of using TLR9-targeted delivery of oligonucleotide therapeutics for the generation of novel, more effective and safer cancer immunotherapies.

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Accumulation of CD5(+)CD19(+) B lymphocytes expressing PD-1 and PD-1L in hypertrophied pharyngeal tonsils.

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Accumulation of CD5(+)CD19(+) B lymphocytes expressing PD-1 and PD-1L in hypertrophied pharyngeal tonsils.

Clin Exp Med. 2016 Nov;16(4):503-509

Authors: Wlasiuk P, Niedzielski A, Skorka K, Karczmarczyk A, Zaleska J, Zajac M, Putowski M, Pac-Kozuchowska E, Giannopoulos K

Abstract
Programmed death-1 (PD-1) is one of the most important inhibitory co-receptors expressed predominantly on activated T and B lymphocytes whose expression could be sustained by permanent antigenic stimulation accompanying chronic or recurrent tonsillitis. The expression of PD-1 and PD-1L was analyzed using flow cytometry on hypertrophied tonsils collected from 57 children. We observed high expression of PD-1 and PD-1L on certain lymphocytes subpopulations of hypertrophied tonsils; among T cells, the expression of PD-1 on protein level was higher on CD4(+) cells (70.3 %) than on CD8(+) cells (35 %). Interestingly, a limited expression of PD-1 was observed on CD19(+) B lymphocytes (6.5 %), while CD5(+)CD19(+) B cells overexpressed PD-1 (52.5 %). Moreover, the expression of PD-1L was also higher on CD5(+)CD19(+) B cells (16.5 %) than on CD19(+) B cells (3.5 %) and on CD4(+) T cells (20 %) than on CD8(+) T cells (10 %). PD-1 and PD-1L expressions correlated only on CD5(+)CD19(+) cells. In conclusion, high expression of PD-1 and PD-1L on T and B cells could represent hallmark of immune system adaptation to chronic antigenic exposition in patients with tonsillitis.

PMID: 26319791 [PubMed - indexed for MEDLINE]

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Visfatin correlates with hot flashes in postmenopausal women with metabolic syndrome: effects of genistein

Abstract

During menopause, an increased prevalence of metabolic syndrome (MetS) and central obesity seems to increase hot flashes (HFs). Visfatin is an inflammatory adipokine secreted by visceral fat. We investigated visfatin levels and its relationship with hot flash number and BMI, in postmenopausal women with MetS. We also evaluated the effect of genistein, an isoflavone effective in reducing HFs, on visfatin levels and HFs after 1 year of treatment. This was a randomized, double-blind, placebo-controlled trial. Postmenopausal women with MetS were randomly assigned to receive placebo (n = 60) or 54 mg genistein (n = 60), daily for 1 year. As main outcome measures, hot flashes number and circulating visfatin levels were evaluated. Visfatin significantly correlated with BMI and HFs number in women with MetS at basal. After 6 and 12 months, our results indicate a strong correlation and a significant effect of genistein in reducing both HFs and visfatin in women with MetS. The present study suggests that visfatin plays a role in the vasomotor symptoms, at least in postmenopausal women with metabolic syndrome. Genistein may reduce HFs decreasing the circulating levels of this inflammatory adipokine.

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Thyroid hormone levels in the cerebrospinal fluid correlate with disease severity in euthyroid patients with Alzheimer’s disease

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Chronic lymphocytic thyroiditis does not influence the risk of recurrence in patients with papillary thyroid carcinoma and excellent response to initial therapy

Abstract

Background

This study evaluated the recurrence in patients with papillary thyroid cancer and an excellent response to initial therapy, comparing those with and without chronic lymphocytic thyroiditis.

Methods

This was a prospective study. Patients who met the following criteria were selected: diagnosis of papillary thyroid cancer; submitted to total thyroidectomy followed or not by ablation with ¹³¹I; and neck ultrasonography without abnormalities, nonstimulated thyroglobulina (Tg) ≤0.2 ng/ml, and undetectable antithyroglobulin antibodies (TgAb) 12–18 months after initial therapy. The patients were divided into two groups: group A, with chronic lymphocytic thyroiditis on histology; group B, without chronic lymphocytic thyroiditis on histology.

Results

Groups A and B were similar in terms of sex and age of the patients, characteristics of the tumor, tumor-node-metastase stage and risk category. The time of follow-up ranged from 24 to 120 months (median 66 months). During follow-up, 5 patients of group A (2.6 %) and 9 patients of group B (2 %) developed recurrence (p = 0.77). Patients with chronic lymphocytic thyroiditis were more likely to progress to persistently borderline TgAb. No patient had positive TgAb (above the reference value) during follow-up. Recurrences occurred in 12/588 patients (2 %) with undetectable TgAb in all measurements, in 1/32 (3.1 %) with detectable TgAb on some occasion but that returned to undetectable spontaneously, and in 1/13 (7.7 %) with persistently borderline TgAb. These rates did not differ significantly (p = 0.25).

Conclusion

The results of the present study showed the absence of an association between chronic lymphocytic thyroiditis and recurrence risk at least in patients with an excellent response to initial therapy.

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Pituitary magnetic resonance imaging in Cushing’s disease

Abstract

Adrenocorticotropin-secreting pituitary tumor represents about 10 % of pituitary adenomas and at the time of diagnosis most of them are microadenomas. Transsphenoidal surgery is the first-line treatment of Cushing's disease and accurate localization of the tumor within the gland is essential for selectively removing the lesion and preserving normal pituitary function. Magnetic resonance imaging is the best imaging modality for the detection of pituitary tumors, but adrenocorticotropin-secreting pituitary microadenomas are not correctly identified in 30–50 % of cases, because of their size, location, and enhancing characteristics. Several recent studies were performed with the purpose of better localizing the adrenocorticotropin-secreting microadenomas through the use in magnetic resonance imaging of specific sequences, reduced contrast medium dose and high-field technology. Therefore, an improved imaging technique for pituitary disease is mandatory in the suspect of Cushing's disease. The aims of this paper are to present an overview of pituitary magnetic resonance imaging in the diagnosis of Cushing's disease and to provide a magnetic resonance imaging protocol to be followed in case of suspicion adrenocorticotropin-secreting pituitary adenoma.

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Proopiomelanocortin, glucocorticoid, and CRH receptor expression in human ACTH-secreting pituitary adenomas

Abstract

ACTH-secreting pituitary tumors are by definition partially autonomous, i.e., secrete ACTH independent of physiological control. However, only few, small-sized studies on proopiomelanocortin (POMC) and its regulation by corticotropin-releasing hormone (CRH) or glucocorticoids are available. Objective of the present study was to report on constitutive and CRH- and dexamethasone-regulated POMC, CRH (CRH-R1), and glucocorticoid receptor (NR3C1) gene expression in a large series of human corticotrope adenomas. Fifty-three ACTH-secreting adenomas were incubated with 10 nM CRH or 10 nM dexamethasone for 24 h. POMC, CRH-R1, NR3C1, and its alpha and beta isoforms were quantified and medium ACTH measured. Constitutive POMC expression proved extremely variable, with macroadenomas exhibiting higher levels than microadenomas. POMC increased during CRH in most specimens; conversely, changes induced by dexamethasone were varied, ranging from decrease to paradoxical increase. No correlation between POMC and ACTH was detected in any experimental condition. CRH-R1 expression was not linked to the response to CRH while NR3C1 was expressed at greater levels in specimens who failed to inhibit during dexamethasone; glucocorticoid receptor α was the more abundant isoform and subject to down-regulation by dexamethasone. Our results demonstrate a considerable variability in POMC expression among tumors and no correlation between POMC and ACTH, suggesting that POMC peptide processing/transport plays a major role in modulating ACTH secretion. Further, CRH-R1 and NR3C1 expression were not linked to the expected ligand-induced outcome, indicating that receptor signaling rather than abundance determines corticotrope responses. Our findings pave the way to new avenues of research into Cushing's disease pathophysiology.

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Selective determination of sulfonamides from environmental water based on magnetic surface molecularly imprinting technology

Abstract

In the study, a simple and selective method based on magnetic separation technology is presented for the extraction of sulfonamides (SAs) from environmental water, followed by liquid chromatography–tandem mass spectrometry. In this method, magnetic surface molecularly imprinted polymers (Fe₃O₄@SiO₂@MIPs) with super-paramagnetic property and high selectivity toward SAs were developed as magnetic adsorbents. The Fe₃O₄@SiO₂@MIPs were then applied to the selective extraction of SAs from environmental water. The extraction and enrichment were accomplished simultaneously in a single step by simply stirring the mixture of adsorbents and water samples. The Fe₃O₄@SiO₂@MIPs were characterized by scanning electron microscopy, Fourier-transform infrared spectrometry, and vibrating sample magnetometry. The adsorption thermodynamics and kinetics were employed to study the adsorption mechanism of the Fe₃O₄@SiO₂@MIPs. And the matrix effect of the method was evaluated. Calibration curves obtained by analyzing matrix-matched standards show excellent linear relationship (R = 0.9994–0.9999) in the concentration range of 10–1000 ng L⁻¹, and the limits of detection are in the range of 1.4–2.8 ng L⁻¹. The relative standard deviations of intra- and inter-day obtained are in the range of 2.8 to 7.8 and 3.1 to 7.9%, respectively. The proposed method was successfully applied to determine SAs in six environmental water samples, and SAs were detectable in four of them with the concentration from 10.5 to 120.2 ng L⁻¹.

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Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years

Abstract

Data from National Health and Nutrition Examination Survey for 1999–2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20–64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20–64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20–64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20–64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20–64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20–64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

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Baseline trace metals in Patella caerulea in a central Tyrrhenian ecosystem (Pontine Islands archipelago and Lazio region coastal sites, Italy)

Abstract

In this study, we tested the aptitude of the gastropod mollusk Patella caerulea as biomonitor of elemental pollution in seawater of a central Tyrrhenian ecosystem (Pontine Islands archipelago and Lazio region coastal sites, Italy). Concentrations of Cd, Cr, Cu, Ni, Pb, and Zn were measured in 120 individuals collected in six strategic locations in two sampling campaigns during 2011 and 2012. Samples of surrounding seawater were also collected in the same sites and tested for the same metals in order to obtain the respective concentration factors (CFs). Then, we analyzed the evolution of contamination in the selected sites and compared our results with the baseline levels (control charts) previously established for Tyrrhenian seas (Conti et al. Environ Sci Pollut R 22:3640–3651,2015). With this purpose, we defined six new variables (one for each metal) and then we applied multivariate statistics, i.e., cluster analysis and discriminant analysis on the principal component analysis factors in order to obtain more reliable results. Patella resulted to be a strong bioaccumulator of Cd (CFs = 8990) and a good accumulator of Cr, Pb, and Zn. The levels of the majority of metals (i.e., Cr, Cu, Ni, Pb, and Zn) in Patella decreased in the range from −13.06% of Zn to −42.51% of Ni in Fiumicino harbor, Anzio beach, and Ponza Harbor from 2011 to 2012. In general, the metal levels in these marine areas are low and within the previously established baseline ranges for Tyrrhenian Sea (control charts). Here, we found a not univocal trend of metal bioaccumulation patterns between the two sampling campaigns (2011–2012) in the selected sites. No one site resulted to be clearly more contaminated than another (i.e., harbor sites as expected). For instance, for Cd, we detected a relevant increase of its levels (+118%) in the harbors and Anzio beach sites from 2011 to 2012; however, they remained at lower levels of the lower limit (Q _2.5) of the control chart. Higher Pb levels with respect to the baseline values were observed for the majority of samples in the Ponza Cala Fonte site. Patella confirmed its usefulness as a cosmopolitan trace metal biomonitor in marine Mediterranean areas. The possibility of employing these results as a baseline level for comparative purposes in other marine areas is fully debated.

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Novel potential scaffold for periodontal tissue engineering

Abstract

Objective

The objective of the study is characterization of novel calcium and zinc-loaded electrospun matrices to be used for periodontal regeneration.

Materials and methods

A polymethylmetacrylate-based membrane was calcium or zinc loaded. Matrices were characterized morphologically by atomic force and scanning electron microscopy and mechanically probed by a nanoindenter. Biomimetic calcium phosphate precipitation on polymeric tissues was assessed. Cell viability tests were performed using oral mucosa fibroblasts. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests or by ANOVA and Student-Newman-Keuls multiple comparisons.

Results

Zinc and calcium loading on matrices did not modify their morphology but increased nanomechanical properties and decreased nanoroughness. Precipitation of calcium and phosphate on the matrix surfaces was observed in zinc-loaded specimens. Matrices were found to be non-toxic to cells in all the assays. Calcium- and zinc-loaded scaffolds presented a very low cytotoxic effect.

Conclusions

Zinc-loaded membranes permit cell viability and promoted mineral precipitation in physiological conditions. Based on the tested nanomechanical properties and scaffold architecture, the proposed membranes may be suitable for cell proliferation.

Clinical relevance

The ability of zinc-loaded matrices to promote precipitation of calcium phosphate deposits, together with their observed non-toxicity and its surface chemistry allowing covalent binding of proteins, may offer new strategies for periodontal regeneration.

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Platelet biology and the rationale of PRP therapy in chronic wounds

Abstract

For the past four decades, platelets have been thought to function only in hemostatic processes. With reference to recent research, today, it is known that platelets also play important roles in tissue regeneration and immunological processes. The keystone of the use of platelet-rich plasma (PRP) for the treatment of chronic wounds lays in the molecular composition of thrombocytes, which are rich in growth factors and other biologically active substances. PRP forms a matrix for cells and thus promotes wound healing processes. Harvesting PRP is relatively uncomplicated, minimally invasive, and potentially available for each patient. In this review, we provide an overview of the biology of the thrombocyte to better understand the effects of PRP. Additionally, we reviewed published studies, analyzing the effectiveness of PRP for the treatment of chronic wounds.

Level of evidence: Not ratable.

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Relationship between Sleep Disturbances and Multimorbidity among Community-dwelling Men and Women aged 65 to 93 years: Results from the KORA Age Study

/Objective: Although the association of disturbed sleep with specific chronic conditions is well known, the relationship between sleep disturbances and multiple diseases is less clear. Therefore, the objectives of this study were to examine the independent relationships of various sleep disturbances with 1) multimorbidity (≥2 chronic conditions) and 2) commonly co-occurring pairs of chronic conditions.

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A lateral cephalometry study of patients with neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant transmitted tumour suppressor syndrome and also a bone disease. Osseous dysplasia affecting the craniofacial region is characteristic of NF1. The aim of this study was to analyse the lateral cephalograms of NF1 patients in comparison to individuals who were not affected by this condition in order to describe the skeletal phenotype of NF1 in more detail.

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Fracture patterns after bilateral sagittal split osteotomy of the mandibular ramus according to the Obwegeser/Dal Pont and Hunsuck/Epker modifications

The aim of this study was to compare the fracture patterns after sagittal split osteotomy according to Obwegeser/Dal Pont (ODP) and Hunsuck/Epker (HE), as well as to investigate the relationship between lateral bone cut ending or angle and the incidence of unfavorable/bad splits. Postoperative cone-beam computed tomograms of 124 splits according to ODP and 60 according to HE were analyzed. ODP led to 75.8% and HE led to 60% lingual fractures with mandibular foramen contact. Horizontal fractures were found in 9.7% and 6.7%, respectively, and unfavorable/bad splits were found in 11.3% and 10%, respectively.

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The versatile use of revisited de-epithelialization concept in superficial circumflex iliac and anterolateral thigh perforator free flap for head and neck reconstructions

Although the perforator free flap is now a standard choice for head and neck reconstruction, problems such as microvascular complications, insufficient volume support for the defect, and fistula formation occur. We revisited a de-epithelialized concept for superficial circumflex iliac artery and anterolateral thigh perforator free flap to overcome these problems.

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The histological and histomorphometric changes in the mandible after radiotherapy: An animal model

Osteoradionecrosis (ORN) of the mandible is a severe complication after radiotherapy (RT) and develops in approximately 2%-22% of head and neck cancer patients and most often in the mandible (Teng and Futran, 2005). The most accepted definition for ORN is that 'irradiated bone becomes devitalized and is exposed through the overlying skin or mucosa, without tumor recurrence, and does not heal within 3 months' (Lyons and Ghazali, 2008). The current non-surgical treatment options for ORN, such as hyperbaric oxygen therapy and medical treatment, are based on controversial theories and on a limited number of studies (Delanian et al., 2005; Shaw and Dhanda, 2011).

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Visfatin correlates with hot flashes in postmenopausal women with metabolic syndrome: effects of genistein

Abstract

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Chronic lymphocytic thyroiditis does not influence the risk of recurrence in patients with papillary thyroid carcinoma and excellent response to initial therapy

Abstract

Background

This study evaluated the recurrence in patients with papillary thyroid cancer and an excellent response to initial therapy, comparing those with and without chronic lymphocytic thyroiditis.

Methods

Results

Conclusion

The results of the present study showed the absence of an association between chronic lymphocytic thyroiditis and recurrence risk at least in patients with an excellent response to initial therapy.

http://ift.tt/2lwMPJV

Pituitary magnetic resonance imaging in Cushing’s disease

Abstract

http://ift.tt/2magXXQ

Proopiomelanocortin, glucocorticoid, and CRH receptor expression in human ACTH-secreting pituitary adenomas

Abstract

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The effect of optimizing EABR parameters in artificial cochlear implantation for auditory rehabilitation

OBJECTIVE: The objective of the present study was to observe the relationship between V extraction rate and threshold value of electrically evoked auditory brainstem response (EABR) waves in artificial cochlear implantation, in order to optimize EABR parameters for improving auditory rehabilitation.

PATIENTS AND METHODS: Thirty patients without residual hearing and treated with artificial cochlear implants were selected. The experimental group included 17 cases with normal cochlear morphology, four with large vestibular aqueduct syndrome (LVAS), six with Mondini malformation, and three with internal auditory canal stenosis. Thirty patients with residual hearing and approximate conditions, treated with artificial cochlear implantation to conduct matching were taken as the control group. For artificial cochlear implantation, Remolded Cochlear Freedom artificial cochleas and platinum-iridium alloy spheroid electrodes were used to provide electric stimulation of different pulse widths (50 μs, 100 μs, and 200 μs) to patients in the two groups. A Bio-logic Navigator Pro auditory evoked potentiometer was used to record V extraction rate and threshold value of EABR waves under the different pulse widths.

RESULTS: There were no significant differences in V extraction rates of EABR waves at pulse widths of 50 μs, 100 μs, and 200 μs (p >0.05). All EABR threshold values in the experimental group were higher than those in the control group, and the differences were statistically significant (p <0.05).

CONCLUSIONS: The monopole stimulation within the cochlea can induce good EABR waves and EABR threshold values of patients without residual hearing were significantly higher than those of patients with residual hearing (p <0.05). Waveform differentiation of pulse width 100 μs was better, dynamic range was broader, and it was necessary to increase stimulation when the malformation was serious.

L'articolo The effect of optimizing EABR parameters in artificial cochlear implantation for auditory rehabilitation sembra essere il primo su European Review.

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The effect of optimizing EABR parameters in artificial cochlear implantation for auditory rehabilitation

L'articolo The effect of optimizing EABR parameters in artificial cochlear implantation for auditory rehabilitation sembra essere il primo su European Review.

http://ift.tt/2kz4Bwa

Determinants of Policy Decisions for Non-Commercial Drivers with OSA: An Integrative Review

Excessive daytime sleepiness and reduced cognitive funcitioning secondary to obstructive sleep apnea (OSA) have been identified as an important health-related risk in commercial transportation with, possibly, an increased chance of road accidents. This has resulted in a variety of policies and restrictions imposed on commercial drivers. Here we review current knowledge to assess whether available data are sufficient to guide policy decisions concerning restrictions for non-commercial drivers. The review shows that there is a lack of uniformity among different consensus conferences and guidelines as to how to deal with drivers with OSA.

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Thanks to Reviewers 2016

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New Developments in Imaging of Laryngeal Cancer

Abstract

Purpose of Review

To critically review the recent literature about laryngeal cancer imaging using a clinically oriented perspective and focusing on technical innovations.

Recent Findings

A number of articles have been recently published on cartilage invasion assessment. Inaccuracy of CT in assessing major cartilage invasion and extralaryngeal spread has emerged. Imaging of paraglottic and preepiglottic space invasion has been less investigated. MR can outperform CT, but optimization of MR protocols is crucial. Dual-energy/spectral CT and diffusion-weighted MR are promising techniques, but their clinical utility needs to be confirmed. Tumor volume is usually overestimated with CT and MR compared to that of histopathology. Follow-up, especially after (chemo) radiation, is challenging, and MR with diffusion-weighted sequences seems superior to CT in discriminating recurrence from inflammatory changes.

Summary

CT is a well-established technique, with known limitations. MR potential needs to be exploited using a state-of-the-art technique. Specific relevant issues for planning mini invasive surgery need to be further investigated.

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Current Philosophy in the Surgery for Chronic Rhinosinusitis

Abstract

Purpose of Review

Despite the paucity of level I evidence from meta-analysis of randomized, controlled trials, physicians have to make decisions regarding the surgical management of chronic rhinosinusitis (CRS). In this review we attempt to summarize the current state of knowledge regarding surgery for CRS.

Recent Findings

A well known, often repeated adage is that the extent of surgery must be tailored to the extent of disease. At the same time, there is an increasing body of evidence that more extended procedures are associated with better overall outcomes. Adverse predictive factors include the presence of acetylsalicylic acid (ASA) intolerance, cystic fibrosis (CF), biofilms, osteitis, and immunodeficiency. Overall, about 10–20% of patients submitted to sinus surgery with simultaneous medical therapy will not avoid a revision procedure. The use of balloon catheters as a valid alternative to standard ESS techniques is not supported by current evidence.

Summary

Advantages of endoscopic sinus surgery include safety and the capacity to improve both symptom scores (especially nasal obstruction) and objective measures. Improvement in distribution of topical therapy is a major method of action.

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New Developments in Imaging of Laryngeal Cancer

Abstract

Purpose of Review

To critically review the recent literature about laryngeal cancer imaging using a clinically oriented perspective and focusing on technical innovations.

Recent Findings

Summary

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Current Philosophy in the Surgery for Chronic Rhinosinusitis

Abstract

Purpose of Review

Recent Findings

Summary

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Classical Hodgkin lymphoma masquerading as chronic recurrent multifocal osteomyelitis: a case report

Hodgkin lymphoma is a hematologic malignancy usually confined to lymphatic structures and commonly associated with constitutional symptoms. Bony involvement and musculoskeletal symptoms are uncommon and typica...

http://ift.tt/2l6Wx4t

A systematic review of known interventions for the treatment of chronic non-hypovolaemic hypotonic hyponatraemia and a meta-analysis of the vaptans

Abstract

International and national guidelines on the treatment of chronic non-hypovolaemic hypotonic hyponatraemia differ; therefore we have undertaken this systematic review and meta-analysis to investigate the efficacy and safety of interventions for the treatment of chronic non-hypovolaemic hypotonic hyponatraemia.

Following registration of the review protocol with PROSPERO, systematic literature searches were conducted to identify randomised and quasi-randomised controlled trials assessing any degree of fluid restriction or any drug treatment with the aim of increasing serum sodium concentration in patients with chronic non-hypovolaemic hypotonic hyponatraemia. Where appropriate, outcome data were synthesised in a meta-analysis.

45,716 bibliographic records were identified from the searches and 18 trials (assessing conivaptan, lixivaptan, tolvaptan and satavaptan) met the eligibility criteria. Results suggest that all four vasopressin receptor agonists ("vaptans"), significantly improve serum sodium concentration. Lixivaptan, satavaptan and tolvaptan were associated with greater rates of response versus placebo. There was no evidence of a difference between each of the vaptans compared with placebo for mortality, discontinuation and rates of hypernatraemia. No RCT evidence of treatments other than the vaptans for hyponatraemia such as oral urea, salt tablets, mannitol, loop diuretics demeclocycline or lithium was identified.

Vaptans demonstrated superiority over placebo for outcomes relating to serum sodium correction. Few trials documented the potential benefit of vaptans on change in health-related quality of life as a result of treatment. There was also a lack of high-quality RCT evidence on the comparative efficacy of the vaptans and other treatment strategies for the treatment of chronic non-hypovolaemic hypotonic hyponatraemia.

http://ift.tt/2lwh8QU

Skeletal and dental effects of Class III orthopaedic treatment: a systematic review and meta-analysis

Summary

Aim

To summarise the skeletal, dental and soft tissue effects of orthopaedic treatment on growing skeletal class III patients compared with a concurrent untreated similar control group; and to evaluate if the design of the primary studies may affect the results.

Materials And Method

A literature search was performed up to the end of February 2016. No restrictions were applied concerning language and appliances. Once the quality score was assessed, a meta-analysis was performed for the appliances used in more than three studies. A moderator analysis for study design was performed. The level of evidence was evaluated by means of the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool.

Results

The search resulted in 21 papers. The quality of most of the studies was medium. Each study reported skeletal sagittal improvement and overjet correction. Fourteen studies reported a significant increase in lower facial height. Follow-up data showed slight relapses in about 15% of patients. Meta-analyses were performed for the facemask and chin cup. The two appliances were efficient for correcting the sagittal discrepancy, increasing the divergence. In the analysis for study design, the retrospective studies showed a more efficient appliance than RCTs for 6 out of 13 variables. The level of evidence was between very low and moderate.

Conclusion

There is very low to low evidence that orthopaedic treatment is effective in the correction of Class III skeletal discrepancies and moderate evidence for the correction of the overjet. A common side effect is mandibular clockwise rotation in older subjects.

http://ift.tt/2m9nzpq

Is there an association between verbal school bullying and possible sleep bruxism in adolescents?

Abstract

The aim of this study was to determine the association between verbal school bullying and possible sleep bruxism (SB) in adolescents. A case-control study was carried out at the population level by recruiting 13- to 15-year old participants among the attendants of schools of Itabira, Brazil. The case group was composed of 103 adolescents with possible SB (i.e., self- or parental-reported), while the control group included 206 adolescents without possible SB. All participants answered a questionnaire on the occurrence of their involvement in verbal school bullying episodes, based on the National School of Health Research (PeNSE) as well as an evaluation of their economic class according to the criteria of the Brazilian Association of Research Companies. Pearson's chi-square, McNemar test and conditional logistic regression were performed to assess the association between possible SB, verbal school bullying, and economic class. There were 134 (43.3%) participants who reported involvement in verbal school bullying episodes as a victim, bully, or both. The majority of them were males (90.3%). Adolescents with possible SB were more likely to have been involved in episodes of verbal school bullying (OR:6.20; 95%CI: 3.67-10.48). Based on these findings, it can be suggested that possible SB in young teenagers is associated with a history of episodes of verbal school bullying.

http://ift.tt/2m9sWVT

Classical Hodgkin lymphoma masquerading as chronic recurrent multifocal osteomyelitis: a case report

The risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis

Abstract

Background

Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS) patients.

Objective

To estimate risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, PsA, and AS, respectively, compared with the general population.

Methods

This population-based cohort study analyzed 36,214 psoriasis patients, 5,138 PsA patients, and 1,878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation, and suicide attempt was calculated separately for psoriasis, PsA and AS.

Results

There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA, or AS patients.

Limitations

Patients were not excluded if previously diagnosed with depression, suicidal ideation, or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

Conclusion

The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA, and AS.

http://ift.tt/2m9iRrM

The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study

Abstract

Background

Flat pigmented facial lesions are difficult to diagnose even with dermatoscopy. It is controversial how additional information obtained by in vivo reflectance confocal microscopy (RCM) impacts the diagnosis and management.

Objective

To examine what in vivo reflectance confocal microscopy of flat pigmented facial lesions adds to clinical examination using dermatoscopy including digital dermatoscopic monitoring.

Methods

We prospectively collected 70 cases of flat pigmented facial lesions and recorded diagnoses and management decisions by experts based on direct clinical examination aided by dermatoscopy including digital dermatoscopic monitoring and by remote experts who reviewed the corresponding confocal images. The expert confocal readers were blinded to the clinical and dermatoscopic appearance of the lesion.

Results

The sensitivity of dermatoscopy plus digital dermatoscopic monitoring was 95.0% (95% CI 75.13% to 99.87%) and the specificity 84.0% (95% CI 70.89% to 92.83%). The sensitivity of RCM was 95.0% (95% CI 75.13% to 99.87%) and the specificity 82.0% (95% CI 68.56% to 91.42%).

Conclusion

Although most flat pigmented facial lesions can be managed by clinical examination and dermatoscopy alone, confocal microscopy is a useful adjunct in selected lesions. If RCM is not correlated with clinical and dermatoscopic information there is risk of overdiagnosis of actinic keratosis, however.

http://ift.tt/2lwc9j4

Allergic contact cheilitis from anethole-containing toothpastes: a practical solution

Abstract

In patients presenting with therapy-resistant cheilitis, especially when extending to the perioral skin, patch tests should be performed, even in longstanding cases^1-2. A 55-year-old woman suffered from an oozing cheilitis for three months with erythema, edema and crusting of the lips and perioral skin (Fig. 1). An intra-oral burning sensation, loss of taste and a dry mouth were also present. Microbiological swabs and a blood analysis did not reveal any abnormalities, and the application of topical corticosteroids brought only temporary relief.

http://ift.tt/2m9DZhH

CD49a Expression Defines Tissue-Resident CD8+ T Cells Poised for Cytotoxic Function in Human Skin

Publication date: Available online 14 February 2017
Source:Immunity
Author(s): Stanley Cheuk, Heinrich Schlums, Irène Gallais Sérézal, Elisa Martini, Samuel C. Chiang, Nicole Marquardt, Anna Gibbs, Ebba Detlofsson, Andrea Introini, Marianne Forkel, Charlotte Höög, Annelie Tjernlund, Jakob Michaëlsson, Lasse Folkersen, Jenny Mjösberg, Lennart Blomqvist, Marcus Ehrström, Mona Ståhle, Yenan T. Bryceson, Liv Eidsmo
Tissue-resident memory T (Trm) cells form a heterogeneous population that provides localized protection against pathogens. Here, we identify CD49a as a marker that differentiates CD8⁺ Trm cells on a compartmental and functional basis. In human skin epithelia, CD8⁺CD49a⁺ Trm cells produced interferon-γ, whereas CD8⁺CD49a⁻ Trm cells produced interleukin-17 (IL-17). In addition, CD8⁺CD49a⁺ Trm cells from healthy skin rapidly induced the expression of the effector molecules perforin and granzyme B when stimulated with IL-15, thereby promoting a strong cytotoxic response. In skin from patients with vitiligo, where melanocytes are eradicated locally, CD8⁺CD49a⁺ Trm cells that constitutively expressed perforin and granzyme B accumulated both in the epidermis and dermis. Conversely, CD8⁺CD49a^– Trm cells from psoriasis lesions predominantly generated IL-17 responses that promote local inflammation in this skin disease. Overall, CD49a expression delineates CD8⁺ Trm cell specialization in human epithelial barriers and correlates with the effector cell balance found in distinct inflammatory skin diseases.

Graphical abstract

Teaser

Tissue-resident memory T (Trm) cells provide localized adaptive immunity in peripheral tissues. Cheuk et al. identify cytotoxic CD49a⁺CD8⁺ Trm cells and IL-17-producing CD49a⁻CD8⁺ Trm cells in healthy human skin. The functional dichotomy of pathogenic Trm cells based on CD49a expression is preserved in focal skin diseases vitiligo and psoriasis.

http://ift.tt/2kK5xt2

A Relay Pathway between Arginine and Tryptophan Metabolism Confers Immunosuppressive Properties on Dendritic Cells

Publication date: Available online 14 February 2017
Source:Immunity
Author(s): Giada Mondanelli, Roberta Bianchi, Maria Teresa Pallotta, Ciriana Orabona, Elisa Albini, Alberta Iacono, Maria Laura Belladonna, Carmine Vacca, Francesca Fallarino, Antonio Macchiarulo, Stefano Ugel, Vincenzo Bronte, Federica Gevi, Lello Zolla, Auke Verhaar, Maikel Peppelenbosch, Emilia Maria Cristina Mazza, Silvio Bicciato, Yasmina Laouar, Laura Santambrogio, Paolo Puccetti, Claudia Volpi, Ursula Grohmann
Arginase 1 (Arg1) and indoleamine 2,3-dioxygenase 1 (IDO1) are immunoregulatory enzymes catalyzing the degradation of l-arginine and l-tryptophan, respectively, resulting in local amino acid deprivation. In addition, unlike Arg1, IDO1 is also endowed with non-enzymatic signaling activity in dendritic cells (DCs). Despite considerable knowledge of their individual biology, no integrated functions of Arg1 and IDO1 have been reported yet. We found that IDO1 phosphorylation and consequent activation of IDO1 signaling in DCs was strictly dependent on prior expression of Arg1 and Arg1-dependent production of polyamines. Polyamines, either produced by DCs or released by bystander Arg1⁺ myeloid-derived suppressor cells, conditioned DCs toward an IDO1-dependent, immunosuppressive phenotype via activation of the Src kinase, which has IDO1-phosphorylating activity. Thus our data indicate that Arg1 and IDO1 are linked by an entwined pathway in immunometabolism and that their joint modulation could represent an important target for effective immunotherapy in several disease settings.

Teaser

Arginase 1 (Arg1) and indoleamine 2,3-dioxygenase 1 (IDO1) are immunosuppressive enzymes known to operate in distinct immune cells. Mondanelli and colleagues demonstrate that Arg1 and IDO1 cooperate in conferring long-term, immunosuppressive effects to dendritic cells.

http://ift.tt/2kKeSRE

Palliation of malignant gastroduodenal obstruction: fluoroscopic metallic stent placement with different approaches.

Palliation of malignant gastroduodenal obstruction: fluoroscopic metallic stent placement with different approaches.

Diagn Interv Radiol. 2017 Feb 17;:

Authors: Bulut E, Çiftçi T, Akhan O, Akıncı D

Abstract
PURPOSE: We aimed to evaluate the safety and effectiveness of fluoroscopy-guided gastroduodenal metallic stent placement with different approaches in malignant obstruction.
METHODS: We retrospectively assessed 53 patients (33 men and 20 women; mean age, 58.7±15 years) who underwent stent placement between February 2004 and April 2014. All patients had unresectable tumors. The most common causes of obstruction were gastric (38%) and pancreatic cancers (36%). Uncovered self-expandable metallic stents (SEMS) were placed under fluoroscopic guidance. In addition to transoral approach in 46 patients (86.7%), transgastric and transhepatic approaches were used in six patients (11.3%) and one patient (1.8%), respectively. Gastric outlet obstruction scoring system (GOOSS) was used to evaluate oral intake before and after stenting. Patients were followed until death or the end of the study.
RESULTS: Technical and clinical success rates were 100% and 92%, respectively. The median stent patency was 76 days (range, 4-985 days). Mean preprocedural GOOSS score of 0.1 increased to postprocedural GOOSS score of 2.42 (P < 0.001). Afferent loop decompression was achieved in one symptomatic patient. Neither mortality nor major complications occurred due to stenting. Stent migration occurred in one patient (2%) and stent obstruction occurred in two patients (4%). Combined biliary and duodenal stenting were performed in 21 patients (40%). Post-stenting GOOSS scores were predictive of survival (P = 0.003).
CONCLUSION: Fluoroscopic metallic stent placement for palliation of malignant gastroduodenal obstruction is safe and effective with high technical and clinical success rates and minimal complications. High technical success rates can be achieved using different approaches.

PMID: 28209556 [PubMed - as supplied by publisher]

http://ift.tt/2kJHyKs

White Matter Tract Pathology in Pediatric Anoxic Brain Injury from Drowning.

White Matter Tract Pathology in Pediatric Anoxic Brain Injury from Drowning.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Ishaque M, Manning JH, Woolsey MD, Franklin CG, Salinas FS, Fox PT

Abstract
BACKGROUND AND PURPOSE: Although drowning is a leading cause of mortality and morbidity in young children, the neuropathologic consequences have not been fully determined. The purpose of this article was to quantitatively characterize white matter microstructural abnormalities in pediatric anoxic brain injury from nonfatal drowning and investigate the correlation with motor function.
MATERIALS AND METHODS: Whole-brain T1-weighted and diffusion-weighted MR imaging datasets were acquired in 11 children with chronic anoxic brain injury and 11 age- and sex-matched neurotypical controls (4-12 years of age). A systematic evaluation form and scoring system were created to assess motor function. Tract-Based Spatial Statistics was used to quantify between-group alterations in the diffusion tensor imaging indices of fractional anisotropy and mean diffusivity and to correlate with per-subject functional motor scores.
RESULTS: Group-wise Tract-Based Spatial Statistics analyses demonstrated reduced fractional anisotropy in the bilateral posterior limbs of the internal capsule and the splenium of the corpus callosum (P < .001). Mean diffusivity was more diffusely increased, affecting the bilateral superior corona radiata, anterior and posterior limbs of the internal capsule, and external capsules (P < .001). Individual-subject fractional anisotropy and mean diffusivity values derived from the ROIs of the bilateral posterior limbs of the internal capsule strongly correlated with motor scores and demonstrated more potent between-group effects than with ROIs of the entire corticospinal tract.
CONCLUSIONS: These data particularly implicate the deep white matter, predominantly the posterior limbs of the internal capsule, as targets of damage in pediatric anoxic brain injury with drowning. The substantial involvement of motor-system tracts with relative sparing elsewhere is notable. These results localize white matter pathology and inform future diagnostic and prognostic markers.

PMID: 28209580 [PubMed - as supplied by publisher]

http://ift.tt/2kJspsz

Regarding "MR Imaging of the Cervical Spine in Nonaccidental Trauma: A Tertiary Institution Experience".

Regarding "MR Imaging of the Cervical Spine in Nonaccidental Trauma: A Tertiary Institution Experience".

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Wu X, Durand D, Rao B, Malhotra A

PMID: 28209585 [PubMed - as supplied by publisher]

http://ift.tt/2ltYzfM

REPLY.

REPLY.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Booth TN, Jacob R, Greenwell C, Reeder K, Koral K

PMID: 28209584 [PubMed - as supplied by publisher]

http://ift.tt/2ltTZy0

Combining Diffusion Tensor Metrics and DSC Perfusion Imaging: Can It Improve the Diagnostic Accuracy in Differentiating Tumefactive Demyelination from High-Grade Glioma?

Combining Diffusion Tensor Metrics and DSC Perfusion Imaging: Can It Improve the Diagnostic Accuracy in Differentiating Tumefactive Demyelination from High-Grade Glioma?

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Hiremath SB, Muraleedharan A, Kumar S, Nagesh C, Kesavadas C, Abraham M, Kapilamoorthy TR, Thomas B

Abstract
BACKGROUND AND PURPOSE: Tumefactive demyelinating lesions with atypical features can mimic high-grade gliomas on conventional imaging sequences. The aim of this study was to assess the role of conventional imaging, DTI metrics (p:q tensor decomposition), and DSC perfusion in differentiating tumefactive demyelinating lesions and high-grade gliomas.
MATERIALS AND METHODS: Fourteen patients with tumefactive demyelinating lesions and 21 patients with high-grade gliomas underwent brain MR imaging with conventional, DTI, and DSC perfusion imaging. Imaging sequences were assessed for differentiation of the lesions. DTI metrics in the enhancing areas and perilesional hyperintensity were obtained by ROI analysis, and the relative CBV values in enhancing areas were calculated on DSC perfusion imaging.
RESULTS: Conventional imaging sequences had a sensitivity of 80.9% and specificity of 57.1% in differentiating high-grade gliomas (P = .049) from tumefactive demyelinating lesions. DTI metrics (p:q tensor decomposition) and DSC perfusion demonstrated a statistically significant difference in the mean values of ADC, the isotropic component of the diffusion tensor, the anisotropic component of the diffusion tensor, the total magnitude of the diffusion tensor, and rCBV among enhancing portions in tumefactive demyelinating lesions and high-grade gliomas (P ≤ .02), with the highest specificity for ADC, the anisotropic component of the diffusion tensor, and relative CBV (92.9%). Mean fractional anisotropy values showed no significant statistical difference between tumefactive demyelinating lesions and high-grade gliomas. The combination of DTI and DSC parameters improved the diagnostic accuracy (area under the curve = 0.901). Addition of a heterogeneous enhancement pattern to DTI and DSC parameters improved it further (area under the curve = 0.966). The sensitivity increased from 71.4% to 85.7% after the addition of the enhancement pattern.
CONCLUSIONS: DTI and DSC perfusion add profoundly to conventional imaging in differentiating tumefactive demyelinating lesions and high-grade gliomas. The combination of DTI metrics and DSC perfusion markedly improved diagnostic accuracy.

PMID: 28209583 [PubMed - as supplied by publisher]

http://ift.tt/2m7x8FF

Noninvasive Evaluation of CBF and Perfusion Delay of Moyamoya Disease Using Arterial Spin-Labeling MRI with Multiple Postlabeling Delays: Comparison with (15)O-Gas PET and DSC-MRI.

Noninvasive Evaluation of CBF and Perfusion Delay of Moyamoya Disease Using Arterial Spin-Labeling MRI with Multiple Postlabeling Delays: Comparison with (15)O-Gas PET and DSC-MRI.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Hara S, Tanaka Y, Ueda Y, Hayashi S, Inaji M, Ishiwata K, Ishii K, Maehara T, Nariai T

Abstract
BACKGROUND AND PURPOSE: Arterial spin-labeling MR imaging with multiple postlabeling delays has a potential to evaluate various hemodynamic parameters. To clarify whether arterial spin-labeling MR imaging can identify CBF and perfusion delay in patients with Moyamoya disease, we compared arterial spin-labeling, DSC, and (15)O-gas PET in terms of their ability to identify these parameters.
MATERIALS AND METHODS: Eighteen patients with Moyamoya disease (5 men, 13 women; ages, 21-55 years) were retrospectively analyzed. CBF values of pulsed continuous arterial spin-labeling using 2 postlabeling delays (short arterial spin-labeling, 1525 ms; delayed arterial spin-labeling, 2525 ms) were compared with CBF values measured by (15)O-gas PET. All plots were divided into 2 groups by the cutoff of time-based parameters (the time of the maximum observed concentration, TTP, MTT, delay of MTT to cerebellum, and disease severity [symptomatic or not]). The ratio of 2 arterial spin-labeling CBFs (delayed arterial spin-labeling CBF to short arterial spin-labeling CBF) was compared with time-based parameters: time of the maximum observed concentration, TTP, and MTT.
RESULTS: The short arterial spin-labeling-CBF values were significantly correlated with the PET-CBF values (r = 0.63; P = .01). However, the short arterial spin-labeling-CBF value dropped in the regions with severe perfusion delay. The delayed arterial spin-labeling CBF overestimated PET-CBF regardless of the degree of perfusion delay. Delayed arterial spin-labeling CBF/short arterial spin-labeling CBF was well correlated with the time of the maximum observed concentration, TTP, and MTT (ρ = 0.71, 0.64, and 0.47, respectively).
CONCLUSIONS: Arterial spin-labeling using 2 postlabeling delays may detect PET-measured true CBF and perfusion delay in patients with Moyamoya disease. Provided its theoretic basis and limitations are considered, noninvasive arterial spin-labeling could be a useful alternative for evaluating the hemodynamics of Moyamoya disease.

PMID: 28209582 [PubMed - as supplied by publisher]

http://ift.tt/2kJzgSL

Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain.

Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Vedantam A, Hou P, Chi TL, Hess KR, Dougherty PM, Bruera E, Viswanathan A

Abstract
BACKGROUND AND PURPOSE: There are limited data on the use of postoperative imaging to evaluate the cordotomy lesion. We aimed to describe the cordotomy lesion by using postoperative MR imaging in patients after percutaneous cordotomy for intractable cancer pain.
MATERIALS AND METHODS: Postoperative MR imaging and clinical outcomes were prospectively obtained for 10 patients after percutaneous cordotomy for intractable cancer pain. Area, signal intensity, and location of the lesion were recorded. Clinical outcomes were measured by using the Visual Analog Scale and the Brief Pain Inventory-Short Form, and correlations with MR imaging metrics were evaluated.
RESULTS: Ten patients (5 men, 5 women; mean age, 58.5 ± 9.6 years) were included in this study. The cordotomy lesion was hyperintense with central hypointense foci on T2-weighted MR imaging, and it was centered in the anterolateral quadrant at the C1-C2 level. The mean percentage of total cord area lesioned was 24.9% ± 7.9%, and most lesions were centered in the dorsolateral region of the anterolateral quadrant (66% of the anterolateral quadrant). The number of pial penetrations correlated with the percentage of total cord area that was lesioned (r = 0.78; 95% CI, 0.44-0.89; P = .008) and the length of T2-weighted hyperintensity (r = 0.85; 95% CI, 0.54-0.89; P = .002). No significant correlations were found between early clinical outcomes and quantitative MR imaging metrics.
CONCLUSIONS: We describe qualitative and quantitative characteristics of a cordotomy lesion on early postoperative MR imaging. The size and length of the lesion on MR imaging correlate with the number of pial penetrations. Larger studies are needed to further investigate the clinical correlates of MR imaging metrics after percutaneous cordotomy.

PMID: 28209581 [PubMed - as supplied by publisher]

http://ift.tt/2kJElut

Patterns of Brain Injury in Newborns Treated with Extracorporeal Membrane Oxygenation.

Patterns of Brain Injury in Newborns Treated with Extracorporeal Membrane Oxygenation.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Wien MA, Whitehead MT, Bulas D, Ridore M, Melbourne L, Oldenburg G, Short BL, Massaro AN

Abstract
BACKGROUND AND PURPOSE: Neonates treated with extracorporeal membrane oxygenation are at risk for brain injury and subsequent neurodevelopmental compromise. Advances in MR imaging and improved accessibility have led to the increased use of routine MR imaging after extracorporeal membrane oxygenation. Our objective was to describe the frequency and patterns of extracorporeal membrane oxygenation-related brain injury based on MR imaging findings in a large contemporary cohort of neonates treated with extracorporeal membrane oxygenation.
MATERIALS AND METHODS: This was a retrospective study of neonatal patients treated with extracorporeal membrane oxygenation from 2005-2015 who underwent MR imaging before discharge. MR imaging and ultrasound studies were reviewed for location and type of parenchymal injury, ventricular abnormalities, and increased subarachnoid spaces. Parenchymal injury frequencies between patients treated with venoarterial and venovenous extracorporeal membrane oxygenation were compared by χ(2) tests.
RESULTS: Of 81 neonates studied, 46% demonstrated parenchymal injury; 6% showed infarction, mostly in vascular territories (5% anterior cerebral artery, 5% MCA, 1% posterior cerebral artery); and 20% had hemorrhagic lesions. The highest frequency of injury occurred in the frontal (right, 24%; left, 25%) and temporoparietal (right, 14%; left, 19%) white matter. Sonography had low sensitivity for these lesions. Other MR imaging findings included volume loss (35%), increased subarachnoid spaces (44%), and ventriculomegaly (17% mild, 5% moderate, 1% severe). There were more parenchymal injuries in neonates treated with venoarterial (49%) versus venovenous extracorporeal membrane oxygenation (29%, P = .13), but the pattern of injury was consistent between both modes.
CONCLUSIONS: MR imaging identifies brain injury in nearly half of neonates after treatment with extracorporeal membrane oxygenation. The frontal and temporoparietal white matter are most commonly affected, without statistically significant laterality. This pattern of injury is similar between venovenous and venoarterial extracorporeal membrane oxygenation, though the frequency of injury may be higher after venoarterial extracorporeal membrane oxygenation.

PMID: 28209579 [PubMed - as supplied by publisher]

http://ift.tt/2kJJylJ

Intraforaminal Location of Thoracolumbar Radicular Arteries Providing an Anterior Radiculomedullary Artery Using Flat Panel Catheter Angiotomography.

Intraforaminal Location of Thoracolumbar Radicular Arteries Providing an Anterior Radiculomedullary Artery Using Flat Panel Catheter Angiotomography.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Gregg L, Sorte DE, Gailloud P

Abstract
BACKGROUND AND PURPOSE: Flat panel catheter angiotomography performed during the selective injection of intersegmental arteries offers a multiplanar assessment of the intraforaminal course of the radicular arteries providing an anterior radiculomedullary artery. Injury of anterior radiculomedullary arteries during transforaminal epidural steroid injections can result in spinal cord damage. Evaluations of the intraforaminal location of these arteries have so far been limited to anteroposterior views or the examination of cadaveric material. This study documents the in vivo intraforaminal location of thoracolumbar arteries providing an anterior radiculomedullary artery with flat panel catheter angiotomography.
MATERIALS AND METHODS: Ninety-four flat panel catheter angiotomography acquisitions obtained during the selective injection of intersegmental arteries providing an anterior radiculomedullary artery were reviewed. Measurements obtained from sagittal reconstructions were converted into a scatterplot visualization. Patients' age, sex, and side and level of the injection were recorded.
RESULTS: The location of radicular arteries could be ascertained in 78 of 94 flat panel catheter angiotomography acquisitions (33 women and 45 men, 22-82 years of age). Fifty-three acquisitions (67.9%) were on the left side, and 25 (32.1%), on the right, between T2 and L3. The arteries were found in the anterosuperior quadrant of the neural foramen in 75 cases (96.2%), in the posterosuperior quadrant in 2 cases (2.6%), and in the anteroinferior quadrant in 1 case (1.3%). None were located in the posteroinferior quadrant. No differences in location were observed with age, sex, side of injection, or vertebral level.
CONCLUSIONS: Avoiding needle placement in the superior half of the neural foramen, specifically the anterosuperior quadrant, can reduce the risk of spinal cord injury during transforaminal epidural steroid injection.

PMID: 28209578 [PubMed - as supplied by publisher]

http://ift.tt/2lvcgvc

Feasibility of Flat Panel Detector CT in Perfusion Assessment of Brain Arteriovenous Malformations: Initial Clinical Experience.

Feasibility of Flat Panel Detector CT in Perfusion Assessment of Brain Arteriovenous Malformations: Initial Clinical Experience.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Garcia M, Okell TW, Gloor M, Chappell MA, Jezzard P, Bieri O, Byrne JV

Abstract
The different results from flat panel detector CT in various pathologies have provoked some discussion. Our aim was to assess the role of flat panel detector CT in brain arteriovenous malformations, which has not yet been assessed. Five patients with brain arteriovenous malformations were studied with flat panel detector CT, DSC-MR imaging, and vessel-encoded pseudocontinuous arterial spin-labeling. In glomerular brain arteriovenous malformations, perfusion was highest next to the brain arteriovenous malformation with decreasing values with increasing distance from the lesion. An inverse tendency was observed in the proliferative brain arteriovenous malformation. Flat panel detector CT, originally thought to measure blood volume, correlated more closely with arterial spin-labeling-CBF and DSC-CBF than with DSC-CBV. We conclude that flat panel detector CT perfusion depends on the time point chosen for data collection, which is triggered too early in these patients (ie, when contrast agent appears in the superior sagittal sinus after rapid shunting through the brain arteriovenous malformation). This finding, in combination with high data variability, makes flat panel detector CT inappropriate for perfusion assessment in brain arteriovenous malformations.

PMID: 28209577 [PubMed - as supplied by publisher]

http://ift.tt/2lvj5Nm

Differences in Hemodynamics and Rupture Rate of Aneurysms at the Bifurcation of the Basilar and Internal Carotid Arteries.

Differences in Hemodynamics and Rupture Rate of Aneurysms at the Bifurcation of the Basilar and Internal Carotid Arteries.

AJNR Am J Neuroradiol. 2017 Feb 16;:

Authors: Doddasomayajula R, Chung B, Hamzei-Sichani F, Putman CM, Cebral JR

Abstract
BACKGROUND AND PURPOSE: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates.
MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate = 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate = 20%) were analyzed with image-based computational fluid dynamics. Several hemodynamic variables were compared among aneurysms at each location and between ruptured and unruptured aneurysms at each location.
RESULTS: On average, aneurysms at the basilar tip had more concentrated inflow (P < .001), a larger inflow rate (P < .001), a larger maximum oscillatory shear index (P = .003), more complex flows (P = .033), and smaller areas under low wall shear stress (P < .001) than aneurysms at the bifurcation of the internal carotid artery. In general, ruptured aneurysms had larger inflow concentration (P = .02), larger shear concentration (P = .02), more complex flows (P < .001), and smaller minimum wall shear stress (P = .003) than unruptured aneurysms.
CONCLUSIONS: High flow conditions, characterized by large and concentrated inflow jets, complex and oscillatory flow patterns, and wall shear stress distributions with focalized regions of high shear and large regions of low shear, are associated with aneurysm rupture, especially for basilar tip aneurysms. The higher flow conditions in basilar tip aneurysms could explain their increased rupture risk compared with internal carotid bifurcation aneurysms.

PMID: 28209576 [PubMed - as supplied by publisher]

http://ift.tt/2lvj0Jx

mGluR1 enhances efferent inhibition of inner hair cells in the developing rat cochlea.

mGluR1 enhances efferent inhibition of inner hair cells in the developing rat cochlea.

J Physiol. 2017 Feb 17;:

Authors: Ye Z, Goutman JD, Pyott SJ, Glowatzki E

Abstract
Just before the onset of hearing, the inner hair cells (IHCs) receive inhibitory efferent input from cholinergic medial olivocochlear (MOC) neurons originating in the brainstem. This input may serve a role in the maturation of the ascending (afferent) auditory system by inhibiting spontaneous activity of the IHCs. To investigate the molecular mechanisms regulating these IHC efferent synapses, we combined electrical stimulation of the efferent fibres with patch clamp recordings from the IHCs to measure efferent synaptic strength. By examining evoked responses, we show that activation of mGluRs by general and group I specific mGluR agonists enhances IHC efferent inhibition. This enhancement is blocked by application of a group I mGluR1-specific antagonist, indicating that enhancement of IHC efferent inhibition is mediated by group I mGluRs and specifically by mGluR1s. By comparing spontaneous and evoked responses, we show that group I mGluR agonists act presynaptically to increase neurotransmitter release without affecting postsynaptic responsiveness. Moreover, endogenous glutamate released from the IHCs also enhances IHC efferent inhibition via the activation of group I mGluRs. Finally, immunofluorescent analysis indicates that the efferent terminals are sufficiently close to IHC glutamate release sites to allow activation of mGluRs on the efferent terminals by glutamate spillover. Together, these results suggest that glutamate released from the IHCs activates group I mGluRs (mGluR1s), likely present on the efferent terminals, which, in turn, enhances release of acetylcholine and inhibition of the IHCs. Thus, mGluRs establish a local negative feedback loop positioned to regulate IHC activity and maturation of the ascending auditory system in the developing cochlea. This article is protected by copyright. All rights reserved.

PMID: 28211069 [PubMed - as supplied by publisher]

http://ift.tt/2l59D2i

Imaging evaluating of the implant/bone interface - an in vitro radiographic study.

Imaging evaluating of the implant/bone interface - an in vitro radiographic study.

Dentomaxillofac Radiol. 2017 Feb 17;:20160296

Authors: Vidor MM, Liedke GS, Vizzotto MB, da Silveira H, da Silveira PF, Araujo CW, da Silveira H

Abstract
OBJECTIVES: To analyze the diagnostic accuracy of conventional and digital radiographic images and the impact of digital filters in evaluating the bone/implant interface.
METHODS: Titanium implants were inserted into 74 fresh bovine ribs blocks, 37 fitting tight to the bone walls (simulating the existence of osseointegration), and 37 with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film and two phosphor-plate systems (Vista Scan and Express). Digital radiographs were investigated with and without enhancement filters. Three blinded examiners assessed the images for the presence of juxtaposition in the bone/implant interface using a five-point Likert scale. Sensitivity, specificity, and the area under the ROC curve (AUC) and its 95% confidence interval (CI) were calculated for each variable. Intra- and inter-examiner agreements were analyzed using Kendall´s concordance test.
RESULTS: Intra- and inter-examiner agreements were higher than 0.80 for both digital and conventional images. Conventional radiographs (AUC = 0.963 / CI = 0.891 to 0.993) and digital images with high enhancement filters such as Caries2 (AUC = 0.964 / CI = 0.892 to 0.993), Endo (AUC = 0.952 / CI = 0.875 to 0.988), and Sharpen3 (AUC = 0.894 / CI = 0.801 to 0.954) showed the greatest accuracy for evaluating the bone/implant interface. Original images from both digital systems, and the further enhancement filters tested showed low sensitivity for the diagnosis task tested.
CONCLUSION: Conventional radiographs or digital radiographs with high-enhancement filters should be used for evaluating the bone/implant interface.

PMID: 28211288 [PubMed - as supplied by publisher]

http://ift.tt/2lvh4Ri

In reply

I would like to thank Dr. Marcelo S. Ramos et al. for their valuable comments and the interest shown in our article recently published in JCA [1].

http://ift.tt/2kJCeqy

A murine model of a novel surgical architecture for proprioceptive muscle feedback and its potential application to control of advanced limb prostheses.

A murine model of a novel surgical architecture for proprioceptive muscle feedback and its potential application to control of advanced limb prostheses.

J Neural Eng. 2017 Feb 17;:

Authors: Clites TR, Carty M, Srinivasan S, Zorzos A, Herr H

Abstract
Objective: Proprioceptive mechanisms play a critical role in both reflexive and volitional lower extremity control. Significant strides have been made in the development of bionic limbs that are capable of bi-directional communication with the peripheral nervous system, but none of these systems have been capable of providing physiologically-relevant muscle-based proprioceptive feedback through natural neural pathways. In this study, we present the Agonist-antagonist Myoplastic Interface (AMI), a surgical approach with the capacity to provide graded kinesthetic feedback from a prosthesis through mechanical activation of native mechanoreceptors within residual agonist-antagonist muscle pairs. Approach: (1) Sonomicrometery and electroneurography measurement systems were validated using a servo-based muscle tensioning system. (2) A heuristic controller was implemented to modulate functional electrical stimulation (FES) of an agonist muscle, using sonomicrometric measurements of stretch from a mechanically-coupled antagonist muscle as feedback. (3) One AMI was surgically constructed in the hindlimb of each rat. (4) The gastrocnemius-soleus complex (GSC) of the rat was cycled through a series of ramp-and-hold stretches in two different muscle architectures: native (physiologically-intact) and AMI (modified). Integrated electroneurography (iENG) from the tibial nerve was compared across the two architectures. Main results: Correlation between stretch and afferent signal demonstrated that the AMI is capable of provoking graded afferent signals in response to ramp-and-hold stretches, in a manner similar to the native muscle architecture. The response magnitude in the AMI was reduced when compared to the native architecture, likely due to lower stretch amplitudes. The closed-loop control system showed robustness at high stretch magnitudes, with some oscillation at low stretch magnitudes. Significance: These results indicate that the AMI has the potential to communicate meaningful kinesthetic feedback from a prosthetic limb by replicating the agonist-antagonist relationships that are fundamental to physiological proprioception.

PMID: 28211795 [PubMed - as supplied by publisher]

http://ift.tt/2lv4DVz

Development and Validation of an ERCC1 Immunohistochemistry Assay for Solid Tumors.

http:--allenpress.com-system-files-image

Development and Validation of an ERCC1 Immunohistochemistry Assay for Solid Tumors.

Arch Pathol Lab Med. 2016 Dec;140(12):1397-1403

Authors: Bahamon BN, Gao F, Danaee H

Abstract
CONTEXT: - Excision repair cross-complementation 1 (ERCC1) is a key enzyme in nuclear excision repair pathway and has a critical role in helping remove DNA adducts caused by cross-linking agents, such as platinum-containing cancer chemotherapies and other DNA-damaging therapeutic modalities. ERCC1 expression, evaluated by techniques such as immunohistochemistry, has been associated with clinical response; ERCC1(+) tumors are more resistant to cisplatin treatment than are ERCC1(-) tumors. Although several immunohistochemistry, anti-ERCC1 antibodies are available, the 8F1 clone, in particular, has been used in many studies. Recent evidence has suggested that the 8F1 antibody cross-reacts with at least one other protein, raising concerns about the specificity of this clone.
OBJECTIVE: - To design an immunohistochemistry assay to detect ERCC1 levels that show dynamic range and consistent analytic performance.
DESIGN: - Two different primary antibodies to ERCC1, clones 4F9 and D6G6, were evaluated on formalin-fixed, paraffin-embedded tissue. We then performed a fit-for-purpose assay validation with the 4F9 clone, which included sensitivity assessment across several solid tumor types and evaluation of analytic parameters, such as precision and reproducibility.
RESULTS: - The 4F9 clone was consistently superior to the D6G6 clone in the optimization phase. A range of expression was seen in ovarian, head and neck, non-small cell lung, and esophageal cancer samples when tested with the 4F9 clone. The antibody showed acceptable reproducibility (31.02%) and precision (16.06%).
CONCLUSIONS: - This assay can be used to assess ERCC1 levels during clinical studies of patient tumors from a variety of tumor types.

PMID: 27610644 [PubMed - indexed for MEDLINE]

http://ift.tt/2ltlUOo

Proliferative verrucous leukoplakia: diagnosis, management and current advances.

Proliferative verrucous leukoplakia: diagnosis, management and current advances.

Braz J Otorhinolaryngol. 2017 Jan 24;:

Authors: Capella DL, Gonçalves JM, Abrantes AA, Grando LJ, Daniel FI

Abstract
INTRODUCTION: Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. It is characterized by a high rate of oral squamous cell carcinoma and verrucou carcinoma transformations.
OBJECTIVE: To analyze the studies about Proliferative verrucous leukoplakia and develop a concise update.
METHODS: A Pubmed search identifying studies (laboratory research, case series and reviews of literature) that examined patients with Proliferative verrucous leukoplakia was realized.
RESULTS: There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. Although several treatment strategies have been proposed, most of them still show a high recurrence rate.
CONCLUSION: More research about Proliferative verrucous leukoplakia is necessary to understand and treat this disease.

PMID: 28209441 [PubMed - as supplied by publisher]

http://ift.tt/2lhaUlk

The maturation state of the auditory nerve and brainstem in rats exposed to lead acetate and supplemented with ferrous sulfate.

The maturation state of the auditory nerve and brainstem in rats exposed to lead acetate and supplemented with ferrous sulfate.

Braz J Otorhinolaryngol. 2017 Jan 23;:

Authors: Zucki F, Morata TC, Duarte JL, Ferreira MC, Salgado MH, Alvarenga KF

Abstract
INTRODUCTION: The literature has reported the association between lead and auditory effects, based on clinical and experimental studies. However, there is no consensus regarding the effects of lead in the auditory system, or its correlation with the concentration of the metal in the blood.
OBJECTIVE: To investigate the maturation state of the auditory system, specifically the auditory nerve and brainstem, in rats exposed to lead acetate and supplemented with ferrous sulfate.
METHODS: 30 weanling male rats (Rattus norvegicus, Wistar) were distributed into six groups of five animals each and exposed to one of two concentrations of lead acetate (100 or 400mg/L) and supplemented with ferrous sulfate (20mg/kg). The maturation state of the auditory nerve and brainstem was analyzed using Brainstem Auditory Evoked Potential before and after lead exposure. The concentration of lead in blood and brainstem was analyzed using Inductively Coupled Plasma-Mass Spectrometry.
RESULTS: We verified that the concentration of Pb in blood and in brainstem presented a high correlation (r=0.951; p<0.0001). Both concentrations of lead acetate affected the maturation state of the auditory system, being the maturation slower in the regions corresponding to portion of the auditory nerve (wave I) and cochlear nuclei (wave II). The ferrous sulfate supplementation reduced significantly the concentration of lead in blood and brainstem for the group exposed to the lowest concentration of lead (100mg/L), but not for the group exposed to the higher concentration (400mg/L).
CONCLUSION: This study indicate that the lead acetate can have deleterious effects on the maturation of the auditory nerve and brainstem (cochlear nucleus region), as detected by the Brainstem Auditory Evoked Potentials, and the ferrous sulphate can partially amend this effect.

PMID: 28209442 [PubMed - as supplied by publisher]

http://ift.tt/2lhgQKU

Stem Cell Reviews and Reports: Cell Trafficking, Stem Cell Mobilization and Homing, and Hematopoiesis Section.

Stem Cell Reviews and Reports: Cell Trafficking, Stem Cell Mobilization and Homing, and Hematopoiesis Section.

Stem Cell Rev. 2017 Feb 16;:

Authors: Pelus LM

PMID: 28210846 [PubMed - as supplied by publisher]

http://ift.tt/2kTGwMA

Epitranscriptomic regulation of viral replication

Publication date: Available online 17 February 2017
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Camila Pereira-Montecinos, Fernando Valiente-Echeverría, Ricardo Soto-Rifo
RNA plays central roles in biology and novel functions and regulation mechanisms are constantly emerging. To accomplish some of their functions within the cell, RNA molecules undergo hundreds of chemical modifications from which N6-methyladenosine (m⁶A), inosine (I), pseudouridine (ψ) and 5-methylcytosine (5mC) have been described in eukaryotic mRNA. Interestingly, the m⁶A modification was shown to be reversible, adding novel layers of regulation of gene expression through what is now recognized as epitranscriptomics. The development of molecular mapping strategies coupled to next generation sequencing allowed the identification of thousand of modified transcripts in different tissues and under different physiological conditions such as viral infections. As intracellular parasites, viruses are confronted to cellular RNA modifying enzymes and, as a consequence, viral RNA can be chemically modified at some stages of the replication cycle. This review focuses on the chemical modifications of viral RNA and the impact that these modifications have on viral gene expression and the output of infection. A special emphasis is given to m⁶A, which was recently shown to play important yet controversial roles in different steps of the HIV-1, HCV and ZIKV replication cycles.

http://ift.tt/2ltCTjG

MRI findings of optic pathway involvement in Miller Fisher syndrome in 3 pediatric patients and a review of the literature.

MRI findings of optic pathway involvement in Miller Fisher syndrome in 3 pediatric patients and a review of the literature.

J Clin Neurosci. 2017 Feb 10;:

Authors: Malhotra A, Zhang M, Wu X, Jindal S, Durand D, Makhani N

Abstract
BACKGROUND: Miller Fisher syndrome (MFS) is a rare demyelinating condition which may have involvement of cranial nerves. There are a few case reports of optic pathway involvement in children. We describe 3 patients with optic pathway enhancement in pediatric patients with MFS.
CASE SERIES: We retrospectively reviewed brain imaging findings in 17 pediatric patients with of Guillain-Barré syndrome (GBS) meeting Brighton criteria who had brain MRIs performed during their acute illness. Cranial nerve enhancement was seen in 6/17 patients and optic nerve/chiasm enhancement was seen in 3 patients.
CONCLUSION: Cranial nerve enhancement and optic pathway in particular, can be seen in patients with MFS. Imaging findings do not always correlate with clinical manifestations of cranial nerve involvement.

PMID: 28209311 [PubMed - as supplied by publisher]

http://ift.tt/2luV35g

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 18 Φεβρουαρίου 2017

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