Cognitive Functional Therapy (CFT) for chronic non-specific neck pain

Publication date: Available online 18 March 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Ney Meziat-Filho, Maicom Lima, Jessica Fernandez, Felipe J.J. Reis
This case report presents the effect of Cognitive Functional Therapy (CFT) in a patient with chronic non-specific neck pain. The patient believed that pain signified tissue damage, and demonstrated pain catastrophizing, hypervigilance, stress sensitivity, and movement impairment of the neck, during extension and rotation. The CFT intervention integrated a cognitive approach with manual therapy and active exercises to encourage the patient to trust her neck again. One month after the first appointment, the patient had recovered confidence, and the pain and disability had disappeared almost entirely.



http://ift.tt/2n2HvO2

Abnormal Trajectories in Cerebellum and Brainstem Volumes in Carriers of the Fragile X Premutation

Publication date: Available online 18 March 2017
Source:Neurobiology of Aging
Author(s): Jun Yi Wang, David Hessl, Randi J. Hagerman, Tony J. Simon, Flora Tassone, Emilio Ferrer, Susan M. Rivera
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disorder typically affecting male premutation carriers with 55-200 CGG repeat expansions in the FMR1 gene after age 50. The aim of this study was to examine whether cerebellar and brainstem changes emerge during development or aging in late life. We retrospectively analyzed MRI scans from 322 males (age 8-81 years). Volume changes in the cerebellum and brainstem were contrasted with those in the ventricles and whole brain. Compared to the controls, premutation carriers without FXTAS showed significantly accelerated volume decrease in the cerebellum and whole brain, flatter inverted U-shaped trajectory of the brainstem, and larger ventricles. Compared to both older controls and premutation carriers without FXTAS, carriers with FXTAS exhibited significant volume decrease in the cerebellum and whole brain and accelerated volume decrease in the brainstem. We therefore conclude that cerebellar and brainstem volumes were likely affected during both development and progression of neurodegeneration in premutation carriers, suggesting that interventions may need to start early in adulthood to be most effective.



http://ift.tt/2mWFGR8

N-type Ca2+ channels are affected by full-length mutant huntingtin expression in a mouse model of Huntington’s disease

Publication date: Available online 18 March 2017
Source:Neurobiology of Aging
Author(s): Flavia R. Silva, Artur S. Miranda, Rebeca P.M. Santos, Isabella G. Olmo, Gerald W. Zamponi, Tomas Dobransky, Jader S. Cruz, Luciene B. Vieira, Fabiola M. Ribeiro
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder caused by a polyglutamine expansion in the amino-terminal region of the huntingtin (htt) protein. In addition to facilitating neurodegeneration, mutant htt is implicated in HD-related alterations of neurotransmission. Previous data showed that htt can modulate N-type voltage-gated Ca²⁺ channels (Cav2.2), which are essential for presynaptic neurotransmitter release. Thus, to elucidate the mechanism underlying mutant htt-mediated alterations in neurotransmission, we investigated how Cav2.2 is affected by full-length mutant htt expression in a mouse model of HD (BACHD). Our data indicate that young BACHD mice exhibit increased striatal glutamate release, which is reduced to WT levels following Cav2.2 block. Cav2.2 Ca²⁺ current density and plasma membrane expression are increased in BACHD mice, which could account for increased glutamate release. Moreover, mutant htt affects the interaction between Cav2.2 and two major channel regulators, namely syntaxin 1A and Gβγ protein. Notably, 12 month old BACHD mice exhibit decreased Cav2.2 cell surface expression and glutamate release, suggesting that Cav2.2 alterations vary according to disease stage.



http://ift.tt/2nndjyp

Spatio-temporal patterns of event-related potentials related to audiovisual synchrony judgements in older adults

Publication date: Available online 18 March 2017
Source:Neurobiology of Aging
Author(s): Yu Man Chan, Michael Julian Pianta, Stefan Bode, Allison Maree McKendrick
Older adults have altered perception of the relative timing between auditory and visual stimuli, even when stimuli are scaled to equate detectability. To help understand why, this study investigated the neural correlates of audiovisual synchrony judgements in older adults using electroencephalography (EEG). Fourteen younger (18–32 years old) and sixteen older (61–74 years old) adults performed an audiovisual synchrony judgement task on flash-pip stimuli while EEG was recorded. All participants were assessed to have healthy vision and hearing for their age. Observers responded to whether audiovisual pairs were perceived as synchronous or asynchronous via a button press. The results showed that the onset of predictive sensory information for synchrony judgements was not different between groups. Channels over auditory areas contributed more to this predictive sensory information than visual areas. The spatial-temporal profile of the EEG activity also indicates that older adults utilised different resources to maintain a similar level of performance in audiovisual synchrony judgements compared to younger adults.



http://ift.tt/2mWKqq0

3T Hippocampal Glutamate-Glutamine Complex Reflects Verbal Memory Decline in Aging

Publication date: Available online 18 March 2017
Source:Neurobiology of Aging
Author(s): S. Nikolova, S.M. Stark, C.E.L. Stark
The hippocampus is a critical site for alterations that are responsible for age-related changes in memory. Here, we present a relatively novel approach of examining the relationship between memory performance and Glutamate-Glutamine levels using short echo time magnetic resonance spectroscopy (MRS). Specifically, we investigated the relationship between Glx (a composite of glutamate and glutamine) levels in the hippocampus, performance on a word recall task and resting state functional connectivity (RSFC). While there was no overall difference in Glx intensity between young and aging adults, we identified a positive correlation between delayed word-list recall and Glx, bilaterally in older adults, but not in young adults. Collapsed across age, we also discovered a negative relationship between Glx intensity and RSFC between the anterior hippocampus and regions in the subcallosal gyrus, replicating a recent finding by Wagner et al., (2016). These findings demonstrate the possibly utility of Glx in identifying age-related changes in the brain and behavior and provide encouragement that MRS can be useful in predicting age-related decline before any physical abnormalities are present.



http://ift.tt/2nnhVVc

Genetic or pharmacological activation of the Drosophila PGC-1α ortholog spargel rescues the disease phenotypes of genetic models of Parkinson’s disease

Publication date: Available online 18 March 2017
Source:Neurobiology of Aging
Author(s): Chee-Hoe Ng, Adeline H. Basil, Liting Hang, Royston Tan, Kian-Leong Goh, Sharon O'Neill, Xiaodong Zhang, Fengwei Yu, Kah-Leong Lim
Despite intensive research, the etiology of Parkinson's disease (PD) remains poorly understood and the disease remains incurable. However, compelling evidence gathered over decades of research strongly support a role for mitochondrial dysfunction in PD pathogenesis. Related to this, PGC-1α, a key regulator of mitochondrial biogenesis, has recently been proposed to be an attractive target for intervention in PD. Here, we showed that silencing of expression of the Drosophila PGC-1α ortholog spargel results in PD-related phenotypes in flies and also seem to negate the effects of AMPK activation, which we have previously demonstrated to be neuroprotective, i.e. AMPK-mediated neuroprotection appears to require PGC-1α. Importantly, we further showed that genetic or pharmacological activation of the Drosophila PGC-1α ortholog spargel is sufficient to rescue the disease phenotypes of Parkin and LRRK2 genetic fly models of PD, thus supporting the proposed use of PGC-1α-related strategies for neuroprotection in PD.



http://ift.tt/2mWB3qr

New concepts of personalized therapy in salivary gland carcinomas

During embryonal development, the primitive oropharynx epithelia form tubules which differentiate to adenoid tissues of salivary glands and lungs. Despite this similar ontogenetic origin, both tissues have different vulnerability to carcinogenic factors and may give rise to different adenoid cancer types. Most lung cancers can be grouped into neuroendocrine/small cell, adenocarcinomas and squamous carcinomas and the major risk factor is smoking. In contrast to lung cancer (smoking) but also in contrast to oral squamous carcinomas (smoking, alcohol, human papilloma virus), salivary gland carcinomas have no such common risk factors [1,2].

http://ift.tt/2nmXeZC

Dosimetric comparison between treatment plans of patients treated with low-dose–rate vs. high-dose–rate interstitial prostate brachytherapy as monotherapy: Initial findings of a randomized clinical trial

Publication date: Available online 18 March 2017
Source:Brachytherapy
Author(s): T. Major, C. Polgár, K. Jorgo, G. Stelczer, P. Ágoston
PurposeThe aim of this study was to compare the dosimetry of intraoperative dose plans of prostate cancer patients treated with low-dose–rate (LDR) and high-dose–rate (HDR) interstitial brachytherapy (BT).Methods and MaterialsA randomized clinical trial was initiated at our institution to compare the results and side effects of LDR and HDR BT as monotherapy in the treatment of early, organ-confined prostate cancer patients. Eighty-seven patients were randomly assigned to receive HDR afterloading BT with one fraction of 19 Gy or permanent LDR ¹²⁵I seed BT with 145 Gy. Inverse optimization algorithms were used for planning. Stranded seeds were implanted using live ultrasound imaging after preimplant treatment planning. Final dosimetry of HDR treatments was based on updated needle and contour positions. Statistical comparisons with nonparametric test were performed between the corresponding dose–volume parameters.ResultsThe V100 and V150 were 99% and 61%, respectively, for LDR, whereas 98% and 32% for HDR treatments. The D90 was less for HDR (122% vs. 110%). The dose distributions were more homogeneous and conformal with HDR technique (dose homogeneity index, 0.39 vs. 0.67; conformal index, 0.65 vs. 0.80). The urethra and rectum received significantly less dose with HDR. The D10 and D30 for urethra were 133% and 128%, respectively, for LDR and 114% and 111% for HDR treatments. The D2cm3 for rectum was 68% and 55% for LDR and HDR technique, respectively.ConclusionsBoth techniques provided acceptable target volume coverage with a slightly higher value with the LDR technique. The dose distributions were more homogeneous and conformal, and both urethra and rectum were better protected with the HDR technique.



http://ift.tt/2nneDRQ

A Modified Dual-plane Technique Using the Serratus Anterior Fascia in Primary Breast Augmentation

Background: Breast augmentations are commonly performed aesthetic surgical procedures. As the breast is a changeable structure, the ideal location of an implant would be a plane that can adjust to the dynamic changes of the breast. We present a modified dual-plane technique for breast augmentation using the fascia for thin patients. Methods: Between June 2014 and June 2015, 27 patients with small breasts underwent breast augmentation using the modified dual-plane technique. The average age was 29.4 years (range, 20–41 y). The mean body mass index was 18.9 kg/m2 (range, 17.6–20.4 kg/m2). Results: The mean size of the implant was 288.9 ml (range, 255–360 ml) on the right side and 281.6 ml (range, 255–360 ml) on the left side. All the patients returned to daily-life activities within 1 week. There have been no complications during minimum follow-up periods of 18 months. The mean follow-up was 25.6 months (range, 18–36 mo). Conclusions: Visible, palpable implants and rippling after breast augmentation with implants are relatively common problems. Our modified dual-plane technique with the serratus anterior fascia can reduce visible rippling and yields a natural-looking breast, especially in thin patients.

http://ift.tt/2m06lL0

Dual lanthanide-doped complexes: the development of a time-resolved ratiometric fluorescent probe for anthrax biomarker and a paper-based visual sensor

Publication date: 15 August 2017
Source:Biosensors and Bioelectronics, Volume 94
Author(s): Qi-Xian Wang, Shi-Fan Xue, Zi-Han Chen, Shi-Hui Ma, Shengqiang Zhang, Guoyue Shi, Min Zhang
In this work, a novel time-resolved ratiometric fluorescent probe based on dual lanthanide (Tb: terbium, and Eu: europium)-doped complexes (Tb/DPA@SiO2-Eu/GMP) has been designed for detecting anthrax biomarker (dipicolinic acid, DPA), a unique and major component of anthrax spores. In such complexes-based probe, Tb/DPA@SiO2 can serve as a stable reference signal with green fluorescence and Eu/GMP act as a sensitive response signal with red fluorescence for ratiometric fluorescent sensing DPA. Additionally, the probe exhibits long fluorescence lifetime, which can significantly reduce the autofluorescence interferences from biological samples by using time-resolved fluorescence measurement. More significantly, a paper-based visual sensor for DPA has been devised by using filter paper embedded with Tb/DPA@SiO2-Eu/GMP, and we have proved its utility for fluorescent detection of DPA, in which only a handheld UV lamp is used. In the presence of DPA, the paper-based visual sensor, illuminated by a handheld UV lamp, would result in an obvious fluorescence color change from green to red, which can be easily observed with naked eyes. The paper-based visual sensor is stable, portable, disposable, cost-effective and easy-to-use. The feasibility of using a smartphone with easy-to-access color-scanning APP as the detection platform for quantitative scanometric assays has been also demonstrated by coupled with our proposed paper-based visual sensor. This work unveils an effective method for accurate, sensitive and selective monitoring anthrax biomarker with backgroud-free and self-calibrating properties.

Graphical abstract

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Absence of functional fetal regulatory T cells in humans causes in utero organ-specific autoimmunity

Regulatory T cells play a critical role in preventing fetal organ-specific autoimmunity in humans. Autopsies of neonatal IPEX patients shortly after birth demonstrate chronic exocrine-dominant pancreatitis with tertiary lymphoid structures containing expanded oligoclonal T/B lymphocytes.

http://ift.tt/2mWBuRC

C3 nephritic factors: a changing landscape

http://ift.tt/2nmQQkR

Rape myth acceptance in convicted rapists: A systematic review of the literature

Publication date: Available online 18 March 2017
Source:Aggression and Violent Behavior
Author(s): Larissa Gabrielle Johnson, Anthony Beech
AimThe review examines studies on rape myth acceptance (RMA) within populations of convicted sexual offenders, changes in RMA due to interventions, comparisons between sexual offenders and community controls, comparisons within the offending population, and relationships between RMA and other psychological constructs linked to criminogenic need.MethodThe search employed electronic databases, OvidSP, Web of Science, and Proquest; hand searching reference lists; and contacting 35 experts in the field. Inclusion/exclusion and quality appraisal criteria were applied to each study.ResultsEight studies met the inclusion criteria. Results highlighted differences in subgroups of rapists for different aspects of RMA; while rapists can be distinguished from non-offenders and non-sexual offenders on measures of RMA, they cannot be significantly discriminated from child molesters; rapists and sexual murders cannot be distinguished using RMA scores; RMA was not found to be a significant predictor of sexual or violence recidivism; and significant positive change in RMA was reported after sex offenders completed treatment programs.ConclusionsDifferences in scores on RMA subscales amongst rapists' typologies were discovered, which may indicate differences in beliefs within each type. Implications for practice are discussed.



http://ift.tt/2mEU4f3

Alcohol abuse, personality disorders, and aggression: The quest for a common underlying mechanism

Publication date: Available online 18 March 2017
Source:Aggression and Violent Behavior
Author(s): Carlo Garofalo, Aidan G.C. Wright
Alcohol abuse and personality disorders are often comorbid, and their co-occurrence is associated with worse prognostic expectations, poor therapeutic outcomes, as well as deleterious behavioral and interpersonal consequences. The current review aims at untangling the association among alcohol abuse, personality disorders, and aggression. After reviewing the relevant literature on alcohol abuse, personality disorders, and related aggression, we propose that their association could be better understood by acknowledging common underlying mechanisms. Accordingly, we outline different potential avenues that can explain their association. In particular, we focus on impulsivity and emotion dysregulation as possible triggers of alcohol abuse and personality disorders, ultimately leading to self-harm and interpersonal violence. Also, the critical role of contextual influences in exacerbating both subjective and interpersonal dysfunctions is considered. Finally, we argue that emotion dysregulation and impulsivity could serve as useful intervention targets to treat clients with personality disorders and alcohol abuse who engage in aggressive behavior, by tackling these mechanisms underlying their complex pathology. Relevant implications for both clinical and research purposes are also highlighted.



http://ift.tt/2mEIMHG

Ventricular wall biomaterial injection therapy after myocardial infarction: Advances in material design, mechanistic insight and early clinical experiences

Publication date: June 2017
Source:Biomaterials, Volume 129
Author(s): Yang Zhu, Yasumoto Matsumura, William R. Wagner
Intramyocardial biomaterial injection therapy for myocardial infarction has made significant progress since concept initiation more than 10 years ago. The interim successes and progress in the first 5 years have been extensively reviewed. During the last 5 years, two phase II clinical trials have reported their long term follow up results and many additional biomaterial candidates have reached preclinical and clinical testing. Also in recent years deeper investigations into the mechanisms behind the beneficial effects associated with biomaterial injection therapy have been pursued, and a variety of process and material parameters have been evaluated for their impact on therapeutic outcomes. This review explores the advances made in this biomaterial-centered approach to ischemic cardiomyopathy and discusses potential future research directions as this therapy seeks to positively impact patients suffering from one of the world's most common sources of mortality.



http://ift.tt/2mU1OLW

Biomaterials for intervertebral disc regeneration and repair

Publication date: June 2017
Source:Biomaterials, Volume 129
Author(s): Robert D. Bowles, Lori A. Setton
The intervertebral disc contributes to motion, weight bearing, and flexibility of the spine, but is susceptible to damage and morphological changes that contribute to pathology with age and injury. Engineering strategies that rely upon synthetic materials or composite implants that do not interface with the biological components of the disc have not met with widespread use or desirable outcomes in the treatment of intervertebral disc pathology. Here we review bioengineering advances to treat disc disorders, using cell-supplemented materials, or acellular, biologically based materials, that provide opportunity for cell-material interactions and remodeling in the treatment of intervertebral disc disorders. While a field still in early development, bioengineering-based strategies employing novel biomaterials are emerging as promising alternatives for clinical treatment of intervertebral disc disorders.



http://ift.tt/2mg3e6I

Croconaine nanoparticles with enhanced tumor accumulation for multimodality cancer theranostics

Publication date: June 2017
Source:Biomaterials, Volume 129
Author(s): Longguang Tang, Fuwu Zhang, Fei Yu, Wenjing Sun, Menglin Song, Xiaoyuan Chen, Xianzhong Zhang, Xiaolian Sun
A novel nanoparticle self-assembled by polyethylene glycol (PEG) modified croconaine dye (CR780) is presented for photoacoustic (PA)/near-infrared (NIR) fluorescence imaging-guided photothermal therapy (PTT). The simple PEGylation made CR780 amphiphilic, and led to their self-assembly into well-defined and uniform nanostructures with size tunable by controlling the assembly conditions. The CR780-PEG5K not only displayed the strength of small molecules (including rapid distribution to different organs, fast renal clearance and minimal accumulation to normal tissues), but also demonstrated the advantages of nanomaterials (including high physiological stability, multimodal theranostic ability, high tumor accumulation and retention). These facilely synthesized molecular nanoprobes showed great clinical translation potential as a versatile theranostic agent.

Graphical abstract

http://ift.tt/2mWfki7

Long-term bioavailability of redox nanoparticles effectively reduces organ dysfunctions and death in whole-body irradiated mice

Publication date: June 2017
Source:Biomaterials, Volume 129
Author(s): Chitho P. Feliciano, Koji Tsuboi, Kenshi Suzuki, Hiroyuki Kimura, Yukio Nagasaki
Radioprotective agents have been developed to protect patients against the damaging and lethal effects of ionizing radiation. However, in addition to the intrinsic ability to target reactive oxygen species (ROS), the ability to retain a significant level of bioavailability is desirable in radioprotective agents because that would increase and prolong their radioprotective efficacy and improve its safety. Here, we report the development of a novel nanoparticle-based radioprotective agent with improved bioavailability, which suppressed the adverse effects typically associated with low-molecular-weight (LMW) antioxidants. We developed biocompatible and colloidally stable nanoparticles in which nitroxide radicals that were covalently conjugated (redox nanoparticles, RNP^N) effectively scavenged radiation-induced ROS with a characteristically prolonged bioavailability and tissue-residence time compared with that of conventional LMW antioxidants. The confinement of the nitroxide radicals in the RNP^N core prevented its rapid metabolism and excretion out of the body. The nano-sized formulation prevented internalization of RNP^N in healthy cells, thereby preserving the normal function of the redox reactions in the cell. This improved pharmacological performance dramatically reduced the radiation-induced organ dysfunctions and increased the survival time of the lethally irradiated mice when the nanoparticles were administered 3–24 h before whole-body irradiation.



http://ift.tt/2mWbhT9

Changes in health-related quality of life of oral cancer patients treated with curative intent: experience of a developing country

This study aimed to assess changes in oral cancer patients' health-related quality of life (HRQOL) and the impact of disease stage on HRQOL scores. HRQOL data were collected from seven hospital-based centres using the Functional Assessment of Cancer Therapy–Head and Neck (FACT-H&N) version 4.0 instrument. The independent samples t-test, χ2 test, and paired samples t-test were used to analyse the data. A total of 300 patients were recruited. The most common oral cancer sub-site was tongue and floor of mouth (42.6%).

http://ift.tt/2n2DFEV

Dexamethasone injection into the pterygomandibular space in lower third molar surgery

The objective of this study was to evaluate the effects of 8mg dexamethasone injection into the pterygomandibular space on the postoperative sequelae of lower third molar surgery. A prospective, randomized, controlled, split-mouth study was designed involving 62 lower third molar extractions (31 patients). Prior to surgery, the study group received 2ml of 4mg/ml (8mg) dexamethasone injection through the pterygomandibular space following local anaesthesia; the control group received 2ml normal saline injection.

http://ift.tt/2n2pqQl

Effect of passive smoking on auditory temporal resolution in children

To determine the effect of passive smoking on auditory temporal resolution in primary school children, based on the hypothesis that individuals who are exposed to smoking exhibit impaired performance.

http://ift.tt/2mgcJTk

Protective role of misoprostol in prevention of gentamicin ototoxicity

To demonstrate potential protective effect of misoprostol on cochlear toxicity caused by gentamicin with electrophysiological tests and histopathological studies.

http://ift.tt/2mWcQR5

Electromyographic ratio of masseter and anterior temporalis muscles in children with and without temporomandibular disorders

This study investigated differences in surface electromyography (sEMG) activity of the masseter and anterior temporalis muscles in children with and without temporomandibular disorders (TMD).

http://ift.tt/2mg51IM

Endoscopic management of bilateral vocal fold paralysis in newborns and infants

Stridor in the neonatal period may be a manifestation of multiple congenital anomalies of the respiratory tract. Due to the size and the shape of the airway of the newborn, stridor represents a warning sign that could be secondary to a potentially dangerous anomaly. Independent of its etiology, the approach is to ensure a stable and secure airway, and then develop a diagnostic approach1.

http://ift.tt/2mW6mBO

Anterior open bite correction by Le Fort I osteotomy with or without anterior segmentation: which is more stable?

A retrospective cohort study was conducted to analyze the relapse rate of anterior open bite (AOB) correction comparing Le Fort I osteotomy with and without anterior segmentation. The risk factors that might contribute to relapse were also assessed. Lateral cephalograms obtained at six different times were analyzed. A total of 81 patients with AOB were recruited. Thirty-five patients underwent Le Fort I osteotomy without anterior segmentation and 46 patients underwent anterior segmentation. Le Fort I osteotomy with anterior segmentation resulted in significantly more AOB relapse when compared to that without anterior segmentation at 7 weeks postoperative (15.2% vs.

http://ift.tt/2mI2sLM

Reply

The comments by Marlu et al1 regarding our article on plasminogen activator inhibitor 2 (PAI-2) deficiency in patients with hereditary angioedema with normal C1 inhibitor (HAE-N) is timely and interesting. The very low levels observed in 22 of 23 untreated patients with HAE-N (with or without a factor XII mutation, 4.5 ± 5) were similar to the levels in 11 patients reported in their commentary, but the PAI-2 mean values in normal controls (54 ± 24) and patients with HAE type I (84 ± 52) were over 10 times higher.

http://ift.tt/2nmX97Z

Normal PAI-2 level in French FXII-HAE patients

We read with interest the recent article by Joseph et al.1 Joseph et al explored plasminogen activator inhibitor (PAI)-1 and PAI-2 antigen levels in 23 patients with hereditary angioedema with normal C1 inhibitor (HAE-N) in remission; among them, 12 patients had FXII mutation. They observed a significant decrease in PAI-2 level in patients with HAE-N compared with control subjects; 11 out of 12 patients with HAE-N with FXII mutation had a marked decrease in PAI-2 levels. However, Joseph et al observed no statistically significant decrease in PAI-1 level compared with controls with a high interindividual variability.

http://ift.tt/2mEGybe

Relationship Between Laryngeal Electromyography and Video Laryngostroboscopy in Vocal Fold Paralysis

The objective of this study was to better define the relationship of laryngeal electromyography and video laryngostroboscopy in the diagnosis of vocal fold paralysis.

http://ift.tt/2nzwwgC

Improved Glottic Exposure for Robotic Microlaryngeal Surgery: A Case Series

Robotic surgery has become the standard of care for many procedures outside of otolaryngology and now is gaining momentum within our specialty. The da Vinci (Intuitive Surgical, Sunnyvale, CA) robot has several advantages to human hands, including removal of tremor and better access to lesions because of increased degree of movement of the articulated instruments. The glottis has rarely been addressed using robotic surgery because access was previously thought to be difficult because of the limitations of currently used retractors, which include poor base of tongue and oral commissure retraction resulting in lack of exposure of the glottis in many patients and lack of space for the robotic instruments to occupy.

http://ift.tt/2mEA0JR

Auditory-Perceptual Evaluation of Voice Quality of Cochlear-implanted and Normal-hearing Individuals: A Reliability Study

This study aimed to present an experience in rating voices of adults with normal hearing and adults with cochlear implants and critically examine the outcomes, discussing pros and cons of the methodology used.

http://ift.tt/2nzCw9m

Pitch Strength as an Outcome Measure for Treatment of Dysphonia

Measurement of treatment outcomes is critical for the spectrum of voice treatments (ie, surgical, behavioral, or pharmacological). Outcome measures typically include visual (eg, stroboscopic data), auditory (eg, Consensus Auditory-Perceptual Evaluation of Voice; Grade, Roughness, Breathiness, Asthenia, Strain), and objective correlates of vocal fold vibratory characteristics, such as acoustic signals (eg, harmonics-to-noise ratio, cepstral peak prominence) or patient self-reported questionnaires (eg, Voice Handicap Index, Voice-Related Quality of Life).

http://ift.tt/2mEvtai

Transcricothyroid Endoscopic Subglottic Surgery for Posterior Glottic Stenosis: A Case Report

Posterior glottic stenosis (PGS) is a rare but life-threatening condition mostly caused by damage to the interarytenoid mucosa by an endotracheal tube. In surgical treatment of PGS, airway patency is prioritized, and the laryngeal functions involved in swallowing and phonation are considerably sacrificed. In the majority of cases, lateralization of a vocal fold or partial excision of a vocal fold and arytenoid cartilage results in glottal closure insufficiency and deterioration of phonatory function.

http://ift.tt/2nzDn9M

Clinical Significance of Contralateral Reactive Lesion in Vocal Fold Polyp and Cyst

We investigated the clinical significance of contralateral reactive lesions in patients undergoing laryngeal microsurgery for benign vocal fold lesions such as vocal polyps and cysts.

http://ift.tt/2mEFrsn

Maximal Ambient Noise Levels and Type of Voice Material Required for Valid Use of Smartphones in Clinical Voice Research

Smartphone technology provides new opportunities for recording standardized voice samples of patients and transmitting the audio files to the voice laboratory. This drastically improves the achievement of baseline designs, used in research on efficiency of voice treatments. However, the basic requirement is the suitability of smartphones for recording and digitizing pathologic voices (mainly characterized by period perturbations and noise) without significant distortion. In a previous article, this was tested using realistic synthesized deviant voice samples (/a:/) with three precisely known levels of jitter and of noise in all combinations.

http://ift.tt/2nzAWnB

Relationships between potentially traumatic events, sleep disturbances, and symptoms of PTSD and alcohol use disorder in a young adult sample

Traumatic events, particularly those that are interpersonal in nature, are associated with increased risk for co-occurring sequelae, including sleep disturbances, posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD). However, the associations between these phenotypes have not been explored among college students.

http://ift.tt/2mWgSsw

Sleep Architecture in Patients with Juvenile Myoclonic Epilepsy

The aim is to analyze the sleep architecture using polysomnography (PSG)in patients with Juvenile Myoclonic Epilepsy (JME):(newly diagnosed and those on valproate drug) attending epilepsy clinic at Alexandria University Hospitals.

http://ift.tt/2mfRJMs

The reduction of central sleep apnoea severity in the left lateral position is not due to an improvement in cardiac haemodynamics in patients with chronic heart failure

The severity of central sleep apnoea (CSA), a common comorbidity in patients with chronic heart failure (CHF) and reduced ejection fraction, markedly decreases from the supine to the lateral sleeping position, with no difference between the left and right positions. The mechanisms responsible for this beneficial effect have not yet been elucidated.

http://ift.tt/2mWju9I

Study of association of severity of sleep disordered breathing and functional outcome in stroke patients

Sleep disordered breathing (SDB) is a prevalent yet underrecognized condition that may have major adverse consequences for those affected by it. We performed a prospective observational study to seek a correlation between the severity of SDB and the severity of stroke and its functional outcome.

http://ift.tt/2mg3YIT

Editorial “Sleep quality is associated with weight loss maintenance status: the MedWeight study”

Inadequate sleep is associated with a range of adverse outcomes, such as increased risk of cardiovascular metabolic and endocrine problems in addition to obesity and impaired cognition [1]. However, the existing literature has mostly used 'sleep duration' as the main measure of sleep adequacy. Emerging evidence from epidemiological studies indicates that other dimensions of sleep, ie, sleep quality and pattern, also play important roles in the biochemical pathways related to glucose metabolism [2].

http://ift.tt/2mfVod3

Sleep spindle density in narcolepsy

Patients with narcolepsy type 1 (NT1) show alterations in sleep stage transitions, rapid-eye-movement (REM) and non-REM sleep due to the loss of hypocretinergic signaling. However, the sleep microstructure has not yet been evaluated in these patients. We aimed to evaluate whether the sleep spindle (SS) density is altered in patients with NT1 compared to controls and patients with narcolepsy type 2 (NT2).

http://ift.tt/2mWiimW

Mazindol: a risk factor for pulmonary arterial hypertension?

Mazindol is an imidazo-isoindole derivative, tricyclic compound and a non-amphetamine central nervous system stimulant that blocks dopamine and norepinephrine reuptake. Mazindol was withdrawn from the US and European markets in 1999 for reasons unrelated to efficacy or safety around a time when other anorexic drugs were concluded to be associated with the development of pulmonary arterial hypertension (PAH). Despite decades of use, reports of PAH with mazindol have been extremely rare. Recent interest has emerged for mazindol for the treatment of narcolepsy and attention deficit hyperactivity disorder (ADHD).

http://ift.tt/2mg0gih

Sleep stage distribution in persons with mild traumatic brain injury: A polysomnographic study according to American Academy of Sleep Medicine Standards

/Background: Sleep stage disruption in persons with mild traumatic brain injury (mTBI) has received little research attention. We examined deviations in sleep stage distribution in persons with mTBI relative to population age and sex-specific normative data, as well as the relationships between such deviations and brain injury-related, medical/psychiatric, and extrinsic factors.

http://ift.tt/2mWdXzW

Emerging Roles of Coblation in Rhinology and Skull Base Surgery

Coblation is a technology that incorporates bipolar radiofrequency energy to ablate tissue at relatively low temperatures. Its use for sinonasal surgery is actively being investigated, including applications for turbinate reduction, sinus surgery, skull base surgery, and adenoidectomy. Potential benefits include reduction in blood loss, improved endoscopic surgical visualization, and reduction in postoperative pain. The main drawbacks are its relatively high cost, potential adverse effects on functional epithelium, and relative paucity of long-term outcomes.

http://ift.tt/2nmRxuk

Organism and Microbiome Analysis

Modern advances in DNA sequencing have allowed for the development of culture-independent techniques with application to infectious and inflammatory conditions, such as rhinosinusitis. Although paradigm-changing discoveries have resulted from molecular microbiologic methods for a number of diseases, insights provided into the role of bacteria in chronic rhinosinusitis have yet to be fully understood to the point of impacting clinical diagnosis and management. As culture-independent techniques continue to evolve and become more refined, it is likely that a better understanding will emerge of how the microbiome influences chronic rhinosinusitis pathogenesis and response to therapy.

http://ift.tt/2nEh5AL

Trends in the Use of Stents and Drug-Eluting Stents in Sinus Surgery

Stenting has long been used in the paranasal sinuses with the goals of maintaining a patent sinus cavity during the postoperative healing process and preventing restenosis from inflammation or scarring. More recently, drug-eluting stents have been introduced. Steroid-impregnated dressings and implants appear to be safe, although likely have increased systemic absorption compared with topical nasal steroid sprays and rinses. There is evidence to support the use of steroid-releasing implants in the ethmoid cavity in the postoperative period; however, more study is needed to truly define the role of these implants.

http://ift.tt/2nmFygy

Incomplete partition type III: A rare and difficult cochlear implant surgical indication

Presenting the clinical features and treatment options for incomplete partition type-III.

http://ift.tt/2mfSaGl

Japanese Clinical Practice Guideline for Head and Neck Cancer

The first revision of "Japanese Clinical Practice Guideline for Head and Neck Cancer" was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification.

http://ift.tt/2mWrgAJ

Emerging Roles of Coblation in Rhinology and Skull Base Surgery

Coblation is a technology that incorporates bipolar radiofrequency energy to ablate tissue at relatively low temperatures. Its use for sinonasal surgery is actively being investigated, including applications for turbinate reduction, sinus surgery, skull base surgery, and adenoidectomy. Potential benefits include reduction in blood loss, improved endoscopic surgical visualization, and reduction in postoperative pain. The main drawbacks are its relatively high cost, potential adverse effects on functional epithelium, and relative paucity of long-term outcomes.

http://ift.tt/2nmRxuk

Organism and Microbiome Analysis

Modern advances in DNA sequencing have allowed for the development of culture-independent techniques with application to infectious and inflammatory conditions, such as rhinosinusitis. Although paradigm-changing discoveries have resulted from molecular microbiologic methods for a number of diseases, insights provided into the role of bacteria in chronic rhinosinusitis have yet to be fully understood to the point of impacting clinical diagnosis and management. As culture-independent techniques continue to evolve and become more refined, it is likely that a better understanding will emerge of how the microbiome influences chronic rhinosinusitis pathogenesis and response to therapy.

http://ift.tt/2nEh5AL

Trends in the Use of Stents and Drug-Eluting Stents in Sinus Surgery

Stenting has long been used in the paranasal sinuses with the goals of maintaining a patent sinus cavity during the postoperative healing process and preventing restenosis from inflammation or scarring. More recently, drug-eluting stents have been introduced. Steroid-impregnated dressings and implants appear to be safe, although likely have increased systemic absorption compared with topical nasal steroid sprays and rinses. There is evidence to support the use of steroid-releasing implants in the ethmoid cavity in the postoperative period; however, more study is needed to truly define the role of these implants.

http://ift.tt/2nmFygy

Incomplete partition type III: A rare and difficult cochlear implant surgical indication

Presenting the clinical features and treatment options for incomplete partition type-III.

http://ift.tt/2mfSaGl

Japanese Clinical Practice Guideline for Head and Neck Cancer

The first revision of "Japanese Clinical Practice Guideline for Head and Neck Cancer" was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification.

http://ift.tt/2mWrgAJ

Thyroid Top-Cited Articles March 2017

FREE ACCESS through March 30, 2017.
Read now:

Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association

Impact of the Multi-Gene ThyroSeq Next-Generation Sequencing Assay on Cancer Diagnosis in Thyroid Nodules with Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Cytology
Yuri E. Nikiforov, Sally E. Carty, Simon I. Chiosea, Christopher Coyne, Umamaheswar Duvvuri, Robert L. Ferris, William E. Gooding, Shane O. LeBeau, N. Paul Ohori, Raja R. Seethala, Mitchell E. Tublin, Linwah Yip, Marina N. Nikiforova

BRAF Inhibitor Dabrafenib in Patients with Metastatic BRAF-Mutant Thyroid Cancer
Gerald S. Falchook, Michael Millward, David Hong, Aung Naing, Sarina Piha-Paul, Steven G. Waguespack, Maria E. Cabanillas, Steven I. Sherman, Bo Ma, Martin Curtis, Vicki Goodman, Razelle Kurzrock

Thyroid Ultrasound Features and Risk of Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies
Luciana Reck Remonti, Caroline Kaercher Kramer, Cristiane Bauermann Leitão, Lana Catani F. Pinto, Jorge Luiz Gross

The Impact of Noninvasive Follicular Variant of Papillary Thyroid Carcinoma on Rates of Malignancy for Fine-Needle Aspiration Diagnostic Categories
Kyle C. Strickland, Brooke E. Howitt, Ellen Marqusee, Erik K. Alexander, Edmund S. Cibas, Jeffrey F. Krane, Justine A. Barletta

Circadian and Circannual Rhythms in Thyroid Hormones: Determining the TSH and Free T4 Reference Intervals Based Upon Time of Day, Age, and Sex
Joel Ehrenkranz, Phillip R. Bach, Gregory L. Snow, Alison Schneider, Jo Lynn Lee, Sarah Ilstrup, Sterling T. Bennett, Salvatore Benvenga

The Impact of Subclinical Disease and Mechanism of Detection on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Olmsted County, Minnesota During 1935 Through 2012
Juan P. Brito, Alaa Al Nofal, Victor M. Montori, Ian D. Hay, John C. Morris

The post Thyroid Top-Cited Articles March 2017 appeared first on American Thyroid Association.

http://ift.tt/2mHUZw7

Thyroid Top-Cited Articles March 2017

FREE ACCESS through March 30, 2017.
Read now:

Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association

Impact of the Multi-Gene ThyroSeq Next-Generation Sequencing Assay on Cancer Diagnosis in Thyroid Nodules with Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Cytology
Yuri E. Nikiforov, Sally E. Carty, Simon I. Chiosea, Christopher Coyne, Umamaheswar Duvvuri, Robert L. Ferris, William E. Gooding, Shane O. LeBeau, N. Paul Ohori, Raja R. Seethala, Mitchell E. Tublin, Linwah Yip, Marina N. Nikiforova

BRAF Inhibitor Dabrafenib in Patients with Metastatic BRAF-Mutant Thyroid Cancer
Gerald S. Falchook, Michael Millward, David Hong, Aung Naing, Sarina Piha-Paul, Steven G. Waguespack, Maria E. Cabanillas, Steven I. Sherman, Bo Ma, Martin Curtis, Vicki Goodman, Razelle Kurzrock

Thyroid Ultrasound Features and Risk of Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies
Luciana Reck Remonti, Caroline Kaercher Kramer, Cristiane Bauermann Leitão, Lana Catani F. Pinto, Jorge Luiz Gross

The Impact of Noninvasive Follicular Variant of Papillary Thyroid Carcinoma on Rates of Malignancy for Fine-Needle Aspiration Diagnostic Categories
Kyle C. Strickland, Brooke E. Howitt, Ellen Marqusee, Erik K. Alexander, Edmund S. Cibas, Jeffrey F. Krane, Justine A. Barletta

Circadian and Circannual Rhythms in Thyroid Hormones: Determining the TSH and Free T4 Reference Intervals Based Upon Time of Day, Age, and Sex
Joel Ehrenkranz, Phillip R. Bach, Gregory L. Snow, Alison Schneider, Jo Lynn Lee, Sarah Ilstrup, Sterling T. Bennett, Salvatore Benvenga

The Impact of Subclinical Disease and Mechanism of Detection on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Olmsted County, Minnesota During 1935 Through 2012
Juan P. Brito, Alaa Al Nofal, Victor M. Montori, Ian D. Hay, John C. Morris

The post Thyroid Top-Cited Articles March 2017 appeared first on American Thyroid Association.

http://ift.tt/2mHUZw7

Ectopic Pelvic Kidney Mimicking Sacral Metastasis on Post-Therapy Iodine-131 Scan of a Thyroid Cancer Patient.

Related Articles

Ectopic Pelvic Kidney Mimicking Sacral Metastasis on Post-Therapy Iodine-131 Scan of a Thyroid Cancer Patient.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):43-46

Authors: Soyluoğlu Demir S, Ege Aktaş G, Polat A, Sarıkaya A

Abstract
A 25-year-old woman had total thyroidectomy and iodine-131 ablation therapy for papillary thyroid carcinoma. Whole body imaging on the 7(th) day of therapeutic activity demonstrated radioiodine uptake in the remnant tissue and intense heterogeneous uptake at the sacral region prominently in the posterior image. Initial interpretation was suspicious for sacral metastasis. Technetium-99m-methylene diphosphonate bone scan demonstrated normal bone uptake and the absence of left kidney. On blood-pool phase of bone scan, the absence of left renal activity and an extra area of uptake in the sacral region suggestive of pelvic kidney were noticed. Magnetic resonance imaging scan confirmed the ectopic pelvic kidney overlying the sacrum.

PMID: 28291010 [PubMed - in process]

http://ift.tt/2mMaBzC

The Correlation Between Pre-treatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters and Clinical Prognostic Factors in Pediatric Hodgkin Lymphoma.

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The Correlation Between Pre-treatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters and Clinical Prognostic Factors in Pediatric Hodgkin Lymphoma.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):9-16

Authors: Tatcı E, Uslu Biner İ, Emir S, Tanyıldız HG, Özmen Ö, Alagöz E, Gökçek A, Şahin G

Abstract
OBJECTIVE: To compare standardized uptake values (SUV) derived from pre-treatment (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging and clinical prognostic factors in pediatric patients with Hodgkin lymphoma (HL).
METHODS: Pre-treatment FDG PET/CT findings of 28 children with HL were evaluated in this retrospective study. Metabolic tumor volume (MTV), SUVmax normalized by weight (SUVweight), lean body mass (SUVlbm), body surface area (SUVbsa) and plasma glucose levels of tumors (SUVglucose) were calculated using pre-treatment FDG PET/CT scan images. These metabolic parameters were correlated with clinical factors [age, sex, number of lymph node groups, presence of splenic involvement, bulky mediastinal disease, Ann Arbor stage, serum white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum albumin and hemoglobin levels].
RESULTS: SUVbsa, SUVlbm, SUVweight, SUVglucose and MTV were higher in patients with stage III-IV disease, bulky tumor and ≥3 lymph node groups (p<0.05). SUVbsa and SUVglucose were higher in patients with splenic involvement (p<0.05). There was no significant correlation between these metabolic parameters and sex, ESR, levels of albumin and WBC (p>0.05). SUVbsa and SUVlbm were higher in patients with anemia (p<0.05). Additionally, significant increases were detected in SUVweight, MTV, and SUVglucose with increasing age (p=0.005, p=0.027, and p=0.009, respectively). SUVbsa and SUVlbm had no significant correlation with age (p>0.05).
CONCLUSION: Metabolic parameters derived from pre-treatment FDG PET/CT may have an important role in predicting high-risk disease in patients with HL. Also, SUVbsa and SUVlbm may be better markers than SUVweight in the quantitative evaluation of FDG PET/CT scans in pediatric patients.

PMID: 28291005 [PubMed - in process]

http://ift.tt/2n24b0S

A Family with Von Hippel-Lindau Syndrome: The Findings of Indium-111 Somatostatin Receptor Scintigraphy, Iodine-123 Metaiodobenzylguanidine Scintigraphy and Single Photon Emission Computerized Tomography.

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A Family with Von Hippel-Lindau Syndrome: The Findings of Indium-111 Somatostatin Receptor Scintigraphy, Iodine-123 Metaiodobenzylguanidine Scintigraphy and Single Photon Emission Computerized Tomography.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):38-42

Authors: Arıcan P, Okudan Tekin B, Naldöken S, Şefizade R, Berker D

Abstract
Von Hippel-Lindau syndrome (VHLS) is an autosomal dominant hereditary familial disorder characterized by development of malignant and benign neoplasms. Differential diagnosis of the adrenal and pancreatic masses are difficult in patients with VHLS. Iodine-123 metaiodobenzylguanidine (I-123 MIBG) and indium-111 somatostatin receptor scintigraphies (In-111 SRS) have important roles in the differential diagnosis of adrenal and pancreatic masses in those patients. In this case report, we present the findings of I-123 MIBG single-photon emission computerized tomography (SPECT/CT) and In-111 SRS SPECT/CT in three members of a family with VHLS. In case 1, a residual neuroendocrine tumor (NET) was detected in the head of pancreas on In-111 SRS SPECT/CT images. In case 2 and 3, I-123 MIBG SPECT/CT confirmed the adrenal masses as pheochromocytoma, and the extra-adrenal mass as NET, before surgery. We thought that In-111 SRS and I-123 MIBG scan might be helpful in the routine work up of VHLS patients for diagnostic and therapeutic purposes. Hybrid SPECT/CT system may improve diagnostic accuracy of planar images since it assesses morphologic and functional information together.

PMID: 28291009 [PubMed - in process]

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The Efficacy of Yttrium-90 Radiosynovectomy in Patients with Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome.

Related Articles

The Efficacy of Yttrium-90 Radiosynovectomy in Patients with Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):33-37

Authors: Al-Mayouf SM, Almutairi N, Alismail K

Abstract
OBJECTIVE: Camptodactyly-arthropathy-coxa-vara-pericarditis (CACP) syndrome is an autosomal recessive disorder caused by mutations in PRG4 gene that encodes for proteoglycan 4, the main lubricant for joints and tendon surfaces. It is a non-inflammatory arthropathy, characterized by joint effusions and synovial hypertrophy. So far, there is no effective treatment for this disorder. To evaluate the effectiveness of yttrium-90 radiosynovectomy in arthropathy of patients with CACP syndrome.
METHODS: Consecutive patients with CACP syndrome were prospectively evaluated at the enrollment and 3 months after the right knee injection with yttrium-90. The outcome variables were patient/parent and physician's global assessment measured by a 3-point scale, right knee swelling and range of motion on a 3-point scale, in addition to magnetic resonance imaging (MRI) assessment of the right knee for bone, cartilage, fluid, synovial hypertrophy and soft tissue changes.
RESULTS: Six (three boys, three girls) patients with a mean age of 12 years and mean follow-up duration of 8.5 years completed a single right knee intra-articular yttrium-90 injection with 5 mCi. The procedure was well tolerated without adverse events apart from mild and transient joint pain in two patients. There was a minimal radioisotope leakage to soft tissue in two patients. During the 3-month follow-up interval, there was no improvement in the outcome variables. Patients and parents did not notice favorable therapeutic effects and global physician assessment was unsatisfactory. There was no difference in knee joint swelling or range of motion. Furthermore, MRI findings were unchanged. However, there was a minimal increase in synovial fluid post injection.
CONCLUSION: Yttrium-90 radiosynovectomy seems to be a safe and well tolerated procedure, however, it did not show a beneficial therapeutic effect in arthropathy of CACP syndrome with the given dosage and interval. Studies including a larger number of patients and probably repeated injections are needed to derive satisfactory results about the effectiveness of yttrium-90 in CACP syndrome patients.

PMID: 28291008 [PubMed - in process]

http://ift.tt/2n2ip1V

Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer.

Related Articles

Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):24-32

Authors: Sürer Budak E, Toptaş T, Aydın F, Öner AO, Çevikol C, Şimşek T

Abstract
OBJECTIVE: To explore the correlation of the primary tumor's maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin) with clinicopathologic features, and to determine their predictive power in endometrial cancer (EC).
METHODS: A total of 45 patients who had undergone staging surgery after a preoperative evaluation with (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) were included in a prospective case-series study with planned data collection. Multiple linear regression analysis was used to determine the correlations between the study variables.
RESULTS: The mean ADCmin and SUVmax values were determined as 0.72±0.22 and 16.54±8.73, respectively. A univariate analysis identified age, myometrial invasion (MI) and lymphovascular space involvement (LVSI) as the potential factors associated with ADCmin while it identified age, stage, tumor size, MI, LVSI and number of metastatic lymph nodes as the potential variables correlated to SUVmax. In multivariate analysis, on the other hand, MI was the only significant variable that correlated with ADCmin (p=0.007) and SUVmax (p=0.024). Deep MI was best predicted by an ADCmin cutoff value of ≤0.77 [93.7% sensitivity, 48.2% specificity, and 93.0% negative predictive value (NPV)] and SUVmax cutoff value of >20.5 (62.5% sensitivity, 86.2% specificity, and 81.0% NPV); however, the two diagnostic tests were not significantly different (p=0.266).
CONCLUSION: Among clinicopathologic features, only MI was independently correlated with SUVmax and ADCmin. However, the routine use of (18)F-FDG PET/CT or DW-MRI cannot be recommended at the moment due to less than ideal predictive performances of both parameters.

PMID: 28291007 [PubMed - in process]

http://ift.tt/2n2imTN

Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis.

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Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):17-23

Authors: Alipour Z, Khatib F, Tabib SM, Javadi H, Jafari E, Aghaghazvini L, Mahmoud-Pashazadeh A, Nabipour I, Assadi M

Abstract
OBJECTIVE: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia.
METHODS: Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of (99m)Tc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired.
RESULTS: The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups.
CONCLUSION: According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons.

PMID: 28291006 [PubMed - in process]

http://ift.tt/2n2vI2r

(18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Other Thyroid Cancers: Medullary, Anaplastic, Lymphoma and So Forth.

Related Articles

(18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Other Thyroid Cancers: Medullary, Anaplastic, Lymphoma and So Forth.

Mol Imaging Radionucl Ther. 2017 Feb 05;26(1):1-8

Authors: Araz M, Çayır D

Abstract
Positron emission tomography/computed tomography (PET/CT) with (18)F-fluorodeoxyglucose (FDG) is used in staging, restaging, and evaluation of therapy response in many cancers as well as differentiated thyroid carcinomas especially in non-iodine avid variants. Its potential in less frequent thyroid tumors like medullary, anaplastic thyroid cancers, thyroid lymphoma and metastatic tumors of the thyroid however, is not well established yet. The aim of this review is to provide an overview on the recent applications and indications of (18)F-FDG PET/CT in these tumors and to focus on the controversies in the clinical setting.

PMID: 28291004 [PubMed - in process]

http://ift.tt/2nzfy26

Editorial Board

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3





http://ift.tt/2mfMGeU

Endoscopic versus microscopic stapes surgery

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Ozgur Surmelioglu, Suleyman Ozdemir, Ozgur Tarkan, Ulku Tuncer, Muhammed Dagkiran, Fikret Cetik
ObjectiveThe aim of this study to compare the outcomes and complications of endoscopic stapes surgery versus microscopic stapes surgery.MethodsThis study involved patients who underwent stapedotomy at the Department of Otorhinolaryngology, Faculty of Medicine, Cukurova University between January 2012 and July 2014. The patients were divided into two groups. Patients in group I were operated with endoscope and patients in group II were operated with microscope. Pure tone audiometry was carried out in all patients preoperatively. Peroperative surgical findings, complications, and duration of surgery were noted and compared between the two groups. Air conduction and bone conduction thresholds were measured at frequencies of 500, 1000, 2000, and 4000Hz, and the mean (±SD) air-bone gap was noted.ResultsMean preoperative air-bone gap was 36.9±6.8dB (23.3–50dB) in group I and 35.1±6dB (26.6–50dB) in group II. Mean postoperative air-bone gap was 9.3±7.1dB (0–30dB) in group I and 13.5±9.7dB (1.6–35dB) in group II. The difference in preoperative and postoperative air-bone gap between the two groups was statistically significant (p=0.023). Patients in group I did not complain of postoperative pain but this was felt in four patients in group II. The difference was statistically significant (p=0.045).ConclusionEndoscopic stapes surgery has many benefits such as good visualization, and easy accessibility to the stapes, oval window niche, and facial nerve. Removal of the scutum and manipulation of the chorda tympani nerve are less frequent with the endoscopic technique.



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Difference of Type 3 secretion system (T3SS) effector gene genotypes (exoU and exoS) and its implication to antibiotics resistances in isolates of Pseudomonas aeruginosa from chronic otitis media

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Min-Hyun Park, So Young Kim, Eun Yun Roh, Ho Sun Lee
ObjectiveType 3 secretion system (T3SS) is the most important virulence factor in Pseudomonas aeruginosa infection. Of the various T3SS effector genes, exoS and exoU showed mutually exclusive distributions, and these two genes showed varied virulence. In many pseudomonal infections, the distribution of these genes showed different pattern and it influenced severity of infection. This study was aimed to evaluate differences of virulence factors and antibiotics resistance between chronic otitis media and other body infection caused by P. aeruginosa.MethodsTo estimate the prevalence of effector genes of T3SS, especially the distributions of exoS and exoU genes and their association with antibiotic resistance in COM, we compared the prevalence of T3SS genes in isolates from COM with those from lower respiratory infection and bacteremia. Other virulence genes, including groEL, pilA, ndvB, lasB, rhlI, and apr, were also studied to evaluate prevalence. These isolates were tested for antibiotic susceptibility, and we examined the association between antibiotic susceptibility and the prevalence of T3SS effector genes.ResultsThe COM group showed a significantly higher exoU-positive rate than the control group (70.6% vs. 6.7%; P<0.01). Furthermore, COM patients with exoU showed significant antibiotic resistance to ciprofloxacin and tobramycin (P=0.035), whereas there was no significant difference in the control group.ConclusionsThe high incidence of exoU-positive P. aeruginosa and ciprofloxacin resistance can explain the chronicity and intractability of infection in COM. Elucidation of this pathogenicity will facilitate the development of new treatment options for COM patients.



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Editorial Board

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Optimal use of CT imaging in pediatric congenital cholesteatoma

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): So Young Kim, Hyo-Sang Kim, Min Hyun Park, Jun Ho Lee, Seung Ha Oh, Sun O Chang, Chong Sun Kim, Ah Young Jung, Young Ho Kim
ObjectiveThis study aimed to determine the radiation dose of temporal bone computed tomography (TBCT) to detect pediatric congenital cholesteatoma (CC), and suggests strategy for lowering perioperative radiation dose.MethodsFifty-three CC patients followed up for more than 12 months after surgery. Perioperative clinical findings and the effective radiation dose (ERD) of TBCT were investigated. Patients' mean age at initial TBCT was 60 months; the mean follow-up period was 43 months.ResultsIn 33 (62.3%) of 53 patients, only one TBCT was performed postoperatively. Postoperative CT imaging was performed to evaluate before second-stage ossiculoplasty, due to suspicion of CC recurrence on examinations, or as part of follow-up. When TBCT was performed on more than two occasions after surgery as a part of follow-up, there was no difference in the distribution of stage or type of CC compared to patients subjected to TBCT on less than three occasions (p=0.093 and p=0.744, respectively). During the most-recent follow-up of these 53 cases, there was no CC recurrence. The mean ERD of a single TBCT was 1.2mSv, and the mean cumulative ERD of TBCT was 2mSv per patient.ConclusionMean and cumulative ERD of TBCT performed in CC cases was not too high to consider radiation hazard. However, efforts to minimize the number of CT scans should be taken basically.



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Japanese Clinical Practice Guideline for Head and Neck Cancer

Publication date: Available online 18 March 2017
Source:Auris Nasus Larynx
Author(s): Ken-ichi Nibu, Ryuichi Hayashi, Takahiro Asakage, Hiroya Ojiri, Yoshihiro Kimata, Takeshi Kodaira, Toshitaka Nagao, Torahiko Nakashima, Takashi Fujii, Hirofumi Fujii, Akihiro Homma, Kazuto Matsuura, Nobuya Monden, Takeshi Beppu, Nobuhiro Hanai, Tadaaki Kirita, Yuzuru Kamei, Naoki Otsuki, Naomi Kiyota, Sadamoto Zenda, Ken Omura, Koichi Omori, Tetsuo Akimoto, Kazuyoshi Kawabata, Seiji Kishimoto, Hiroya Kitano, Iwai Tohnai, Takashi Nakatsuka
ObjectiveThe first revision of "Japanese Clinical Practice Guideline for Head and Neck Cancer" was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification.Methods34 CQs (Clinical Questions) were newly adopted to describe the diagnosis and treatment methods currently considered most appropriate, and offered recommendation grade made by the consensus of the committee. A comprehensive literature search was performed for studies published between 2001 and 2012 using PubMed. Qualified studies were analyzed and the results were evaluated, consolidated and codified by all the committee members.ResultsElective neck dissection (ND) does contribute to improvement in survival and should be performed for patients with high-risk tongue cancer. At present, no research has clearly demonstrated the utility of superselective arterial infusion chemotherapy. However, depending on the site and stage of the cancer, combination with radiotherapy may be useful for preserving organ function or improving survival rate. Concurrent CDDP chemotherapy and adjuvant radiotherapy contributes to improvement of survival rate as an adjuvant therapy for advanced squamous cell carcinoma of the head and neck in patients at high risk of recurrence. The anti-EGFR antibody cetuximab (Cmab) has an additive effect with radiotherapy. However, the indication must be carefully considered since this treatment has not been compared with the standard treatment of chemoradiotherapy. Cmab has been shown to have an additive effect with chemotherapy (CDDP/5-FU) in patients with unresectable metastatic or recurrent cancer. Preoperative and postoperative oral care may reduce the risk of postoperative complications such as surgical wound infection and pneumonia in head and neck cancers. Rehabilitation soon after ND for cervical lymph node metastasis is recommended for maintaining and restoring shoulder function.ConclusionsIn this article, we described most relevant guidelines and CQs for the diagnosis and treatment of head and neck cancer in Japan. These guidelines are not intended to govern therapies that are not shown here, but rather aim to be used as a guide in searching for the most appropriate treatment for individual patient.



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The prognostic value of pretreatment platelet count in patients with head and neck squamous cell carcinoma

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Laura Pardo, Cristina Valero, Montserrat López, Jacinto García, Mercedes Camacho, Miquel Quer, Xavier León
ObjectiveThrombocytosis is commonly observed in patients with solid tumors. This study aimed to evaluate the prognostic role of circulating pretreatment platelet count in a large series of patients with head and neck squamous cell carcinoma (HNSCC).MethodsWe retrospectively studied 824 patients with HNSCC treated at a single institution from 2000 to 2012. Disease-specific survival and local, regional, and distant recurrence-free survival were analyzed according to the distribution of the platelet count.ResultsBy defining the platelet count 250.05×10⁹/L as a cut-off point with the best predictive capacity, we classified the patients into two groups: those with a high platelet count (n=378, 45.9%), and those with a low platelet count (n=446, 54.1%). On univariate analysis, there were significant differences in disease-specific survival depending on pretreatment platelet count (P=0.001). The 5-year specific survival rates were 74.1% (CI 95%: 69.8–78.4%) and 61.6% (CI 95%: 56.4–66.8%) for patients with a low and high platelet count, respectively. According to the results of a multivariate analysis, patients with a high count of platelets had a tendency to a lower disease-specific survival, but the hazard ratio did not reach statistically significant differences (HR 1.24, CI 95%: 0.97–1.61, P=0.085).ConclusionPlatelet count was significantly associated with survival in univariate analysis. However, in a multivariate analysis it lost its prognostic capacity, limiting its utility as a prognostic marker in patients with HNSCC. Considering separately each primary tumor location, patients with hypopharyngeal cancer and a high platelet count had a significant decrease of disease-specific survival.



http://ift.tt/2mfPvNb

Transposition of lingual thyroid gland to the submandibular region by transoral approach

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Ercan Akbay, Gokce Simsek, Rahmi Kilic
The purpose of this case report is to demonstrate surgical technique of only functional but symptomatic lingual thyroid gland transposition to submandibular region by transoral approach without mandibulotomy and tongue-splitting.A 37-year-old female patient was admitted to our hospital with dysphagia and apnea symptoms. Physical examination revealed 3cm×3cm lingual thyroid gland was detected at the tongue base. The patient was euthyroid and thyroid gland was not detected in the neck. Under general anesthesia, right submandibular gland excision and transposition of lingual thyroid tissue to submandibular region with dorsal lingual artery axis flap were performed by transoral approach. Thyroid hormones remained normal in the postoperative period.In conclusion transoral transposition of lingual thyroid to submandibular region as a flap without mandibulotomy is a minimally invasive and function preserving alternative approach. Besides preserving thyroid functions, this transoral surgical technique can be preferred by patients who avoid skin incision for esthetic concerns.



http://ift.tt/2mW01WR

Rupture of the extracranial carotid artery caused by misdiagnosed infected pseudoaneurysm during deep cervical abscess drainage: A case report

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Davide Di Santo, Leone Giordano, Giacomo Bertazzoni, Andrea Galli, Michele Tulli, Mario Bussi
Infected aneurysms or pseudoaneurysms of the extracranial carotid artery are extremely rare, but they can lead to lethal complications. In some cases, infected pseudoaneurysms can be masked by the excessive inflammation of surrounding tissues. Here we describe the case of a 69-year-old woman with several comorbidities, who presented with a rapidly enlarging left neck bulge. CT was suggestive of an abscess involving the left common carotid artery. Colour Doppler ultrasound did not document intralesional flow. Abscess drainage under ultrasonographic assistance was attempted unsuccessfully, with collection of creamy, purple material. Surgical drainage of the abscess was, therefore, decided. As soon as necrotic tissue debridement was started, a massive haemorrhage originating from the common carotid artery invaded the surgical field. The carotid artery was then repaired with a bovine pericardial patch and covered with a pectoralis major muscle flap. The patient recovered without any neurological consequences. Revision of CT imaging revealed a very small misdiagnosed infected pseudoaneurysm. With better preoperative surgical planning and a good suspicion index, such a life-threatening emergency could have been avoided.



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Sinus pericranii, petrosquamosal sinus and extracranial sigmoid sinus: Anatomical variations to consider during a retroauricular approach

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Juan Carlos Cisneros, Paula Tardim Lopes, Ricardo Ferreira Bento, Robinson Koji Tsuji
Lateral and sigmoid sinus malformations are uncommon and dangerous anatomical variations that surgeons may encounter when performing a retroauricular approach. We report three cases of rare temporal bone venous sinus anomalies seen in patients who underwent cochlear implant surgery. The first patient had a diagnosis of CHARGE syndrome and presented a bilateral persistent petrosquamosal sinus with sigmoid sinus agenesis, which made mastoidectomy for cochlear implantation difficult. The second patient presented an anomalous venous lake in the occipital region, which communicated the left dural venous sinuses with a conglomerate of pericranial vessels in the left nuchal region, also consistent with left sinus pericranii. The third patient presented with an extracranial sigmoid sinus that produced a troublesome bleeding immediately after the muscular-periosteal flap incision was performed.



http://ift.tt/2mVSMy2

A case of desmoid tumor co-existing with recurrent squamous cell carcinoma in the larynx

Publication date: June 2017
Source:Auris Nasus Larynx, Volume 44, Issue 3
Author(s): Shogo Shinohara, Atsushi Suehiro, Masahiro Kikuchi, Hiroyuki Harada, Ippei Kishimoto, Yukihiro Imai
Extra-abdominal desmoid tumor, also known as aggressive fibromatosis, has aggressive behavior with local infiltration and tendency for recurrence. Though head and neck is reported to be one of the most common sites, a desmoid tumor in the larynx is extremely rare. A 67-year-old male visited our hospital with prolonged hoarseness and received laryngo-microsurgery with the diagnosis of laryngeal polyp. After the operation, he eventually developed a laryngeal squamous cell carcinoma with papilloma, confirmed by second laryngo-microsurgery and received radiation therapy. After the third laryngo-microsurgery to remove residual papilloma, white irregular mass appeared on the right vocal cord and grew rapidly beneath the glottis, causing dyspnea. After 2 additional laryngo-microsurgeries, he was diagnosed having the dermoid tumor co-existing with recurrent squamous cell carcinoma. He underwent near-total laryngectomy and is currently alive without disease, speaking using a vocal shunt. Only five cases of the desmoid tumors arising in the adult larynx have been reported in the English literature. In this case, repeated surgery and radiation were suspected as the causes. Also, the present report is the first to describe desmoid tumor co-existing with recurrent squamous cell carcinoma in the larynx.



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Editorial Board

http://ift.tt/2mW35lJ

"J Drugs Dermatol"[jour]; +29 new citations

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

"J Drugs Dermatol"[jour]

These pubmed results were generated on 2017/03/17

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

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The Neandertal vertebral column 2: The lumbar spine

Publication date: May 2017
Source:Journal of Human Evolution, Volume 106
Author(s): Asier Gómez-Olivencia, Mikel Arlegi, Alon Barash, Jay T. Stock, Ella Been
Here we provide the most extensive metric and morphological analysis performed to date on the Neandertal lumbar spine. Neandertal lumbar vertebrae show differences from modern humans in both the vertebral body and in the neural arch, although not all Neandertal lumbar vertebrae differ from modern humans in the same way. Differences in the vertebral foramen are restricted to the lowermost lumbar vertebrae (L4 and L5), differences in the orientation of the upper articular facets appear in the uppermost lumbar vertebrae (probably in L1 and L2–L3), and differences in the horizontal angle of the transverse process appear in L2–L4. Neandertals, when compared to modern humans, show a smaller degree of lumbar lordosis. Based on a still limited fossil sample, early hominins (australopiths and Homo erectus) had a lumbar lordosis that was similar to but below the mean of modern humans. Here, we hypothesize that from this ancestral degree of lumbar lordosis, the Neandertal lineage decreased their lumbar lordosis and Homo sapiens slightly increased theirs. From a postural point of view, the lower degree of lordosis is related to a more vertical position of the sacrum, which is also positioned more ventrally with respect to the dorsal end of the pelvis. This results in a spino-pelvic alignment that, though different from modern humans, maintained an economic postural equilibrium. Some features, such as a lower degree of lumbar lordosis, were already present in the middle Pleistocene populations ancestral to Neandertals. However, these middle Pleistocene populations do not show the full suite of Neandertal lumbar morphologies, which probably means that the characteristic features of the Neandertal lumbar spine did not arise all at once.



http://ift.tt/2nm9NnT

A comparative analysis of infraorbital foramen size in Paleogene euarchontans

Publication date: April 2017
Source:Journal of Human Evolution, Volume 105
Author(s): Magdalena N. Muchlinski, E. Christopher Kirk
The size of the infraorbital foramen (IOF) is correlated with the size of the infraorbital nerve and number of mystacial vibrissae in mammals. Accordingly, IOF cross-sectional area has been used to infer both the rostral mechanoreceptive acuity and phylogenetic relationships of extinct crown primates and plesiadapiforms. Among living mammals, extant primates, scandentians, and dermopterans (Euarchonta) exhibit smaller IOF cross-sectional areas than most other mammals. Here we assess whether fossil adapoids, omomyoids, and plesiadapiforms show a reduction in relative IOF area similar to that characterizing extant euarchontans. The IOFs of 12 adapoid, 7 omomyoid, 15 plesiadapiform, and 3 fossil gliran species were measured and compared to a diverse extant mammalian sample. These data demonstrate that adapoids and omomyoids have IOFs that are similar in relative size to those of extant euarchontans. Conversely, IOFs of plesiadapiforms are on average about twice as large as those of extant euarchontans and are more comparable in size to those of extant non-euarchontan mammals. These results indicate that crown primates share a derived reduction in relative IOF size with treeshrews and colugos. Accordingly, a decreased reliance on the muzzle and an increased reliance on the hands for environmental exploration may have first evolved in the euarchontan stem lineage. However, the relatively large IOFs of plesiadapiforms imply a continued reliance on the muzzle for close exploration of objects. This finding may indicate that either parallel evolutionary decreases in IOF size occurred within Euarchonta or that plesiadapiforms lie outside the euarchontan crown group.



http://ift.tt/2nm97yG

Favorable ecological circumstances promote life expectancy in chimpanzees similar to that of human hunter-gatherers

Publication date: April 2017
Source:Journal of Human Evolution, Volume 105
Author(s): Brian M. Wood, David P. Watts, John C. Mitani, Kevin E. Langergraber
Demographic data on wild chimpanzees are crucial for understanding the evolution of chimpanzee and hominin life histories, but most data come from populations affected by disease outbreaks and anthropogenic disturbance. We present survivorship data from a relatively undisturbed and exceptionally large community of eastern chimpanzees (Pan troglodytes schweinfurthii) at Ngogo, Kibale National Park, Uganda. We monitored births, deaths, immigrations, and emigrations in the community between 1995 and 2016. Using known and estimated ages, we calculated survivorship curves for the whole community, for males and females separately, and for individuals ≤2 years old when identified. We used a novel method to address age estimation error by calculating stochastic survivorship curves. We compared Ngogo life expectancy, survivorship, and mortality rates to those from other chimpanzee communities and human hunter-gatherers. Life expectancy at birth for both sexes combined was 32.8 years, far exceeding estimates of chimpanzee life expectancy in other communities, and falling within the range of human hunter-gatherers (i.e., 27–37 years). Overall, the pattern of survivorship at Ngogo was more similar to that of human hunter-gatherers than to other chimpanzee communities. Maximum lifespan for the Ngogo chimpanzees, however, was similar to that reported at other chimpanzee research sites and was less than that of human-hunter gatherers. The absence of predation by large carnivores may contribute to some of the higher survivorship at Ngogo, but this cannot explain the much higher survivorship at Ngogo than at Kanyawara, another chimpanzee community in the same forest, which also lacks large carnivores. Higher survivorship at Ngogo appears to be an adaptive response to a food supply that is more abundant and varies less than that of Kanyawara. Future analyses of hominin life history evolution should take these results into account.



http://ift.tt/2nQGZAB

The chronostratigraphy of the Haua Fteah cave (Cyrenaica, northeast Libya) — Optical dating of early human occupation during Marine Isotope Stages 4, 5 and 6

Publication date: April 2017
Source:Journal of Human Evolution, Volume 105
Author(s): Zenobia Jacobs, Bo Li, Lucy Farr, Evan Hill, Chris Hunt, Sacha Jones, Ryan Rabett, Tim Reynolds, Richard G. Roberts, David Simpson, Graeme Barker
The paper presents the results of optical dating of potassium-rich feldspar grains obtained from the Haua Fteah cave in Cyrenaica, northeast Libya, focussing on the chronology of the Deep Sounding excavated by Charles McBurney in the 1950s and re-excavated recently. Samples were also collected from a 1.25 m-deep trench (Trench S) excavated during the present project below the basal level of the Deep Sounding. Optically stimulated luminescence (OSL) data sets for multi-grain, single aliquots of quartz for samples from the Middle Trench were previously published. Re-analyses of these OSL data confirm significant variation in the dose saturation levels of the quartz signal, but allow the most robust OSL ages to be determined for comparison with previous age estimates and with those obtained in this study for potassium-rich feldspars from the Deep Sounding. The latter indicate that humans may have started to visit the cave as early as ∼150 ka ago, but that major use of the cave occurred during MIS 5, with the accumulation of the Deep Sounding sediments. Correlations between optical ages and episodes of "Pre-Aurignacian" artefact discard indicate that human use of the cave during MIS 5 was highly intermittent. The earliest phases of human activity appear to have occurred during interstadial conditions (5e and 5c), with a later phase of lithic discard associated with more stadial conditions, possibly MIS 5b. We argue that the "Pre-Aurignacian" assemblage can probably be linked with modern humans, like the succeeding "Levalloiso-Mousterian" assemblage; two modern human mandibles associated with the latter are associated with a modelled age of 73–65 ka. If this attribution is correct, then the new chronology implies that modern humans using "Pre-Aurignacian" technologies were in Cyrenaica as early as modern humans equipped with "Aterian" technologies were in the Maghreb, raising new questions about variability among lithic technologies during the initial phases of modern human dispersals into North Africa.



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Economic and outcome following severe head injury

Somsri Wiwanitkit, Viroj Wiwanitkit

Asian Journal of Neurosurgery 2017 12(1):147-147



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Excision of hypoglossal neurinoma by condyle sparing suboccipital keyhole approach

Harjinder Bhatoe

Asian Journal of Neurosurgery 2017 12(1):120-122

Hypoglossal neurinomas are rare tumors that present with gradually worsening unilateral wasting of the tongue. The tumors often attain large size prior to detection and often extend into the hypoglossal canal. Large tumors can distort the brainstem and cerebellum. Preoperative diagnosis can often be made by magnetic resonance imaging (MRI) with contrast enhancement. Traditionally, surgery for these tumors has entailed large transcondylar approaches, often necessitating occipitocervical stabilization. We managed one 23-year-old female patient with a large hypoglossal neurinoma. The tumor could be excised completely by a condyle-sparing minimally invasive suboccipital keyhole approach.

http://ift.tt/2mHEPCR

Bilateral cervico-dorsal gossypiboma presenting as discharging sinus

Sushil Kumar, Pooja Abbey, Amit Handa

Asian Journal of Neurosurgery 2017 12(1):92-94

Retained surgical sponge is an uncommon complication after laminectomy. A 67-year-old male presented with a discharging sinus in the cervical region following cervical laminectomy. Magnetic resonance imaging (MRI) revealed bilateral symmetrical lesions in the paraspinal area. Re-exploration revealed gauze pieces on either side under the muscle. Persistent discharging wound after surgery should arouse the possibility of a foreign body. Because of the rarity of bilateral lesions, the present case is being reported.

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Perioperative complications in endovascular neurosurgery: Anesthesiologist's perspective

Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia

Asian Journal of Neurosurgery 2017 12(1):6-12

Background: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. Methods: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications. Information regarding hemodynamic alterations, temperature variability, fluid-electrolyte imbalance, coagulation abnormalities and alterations in the anesthesia course was specifically noted. Results: Among the important complications observed were aneurysm rupture (2.5%), vasospasm (6.67%), thromboembolism (4.16%), contrast reactions, hemodynamic alterations, electrolyte abnormalities, hypothermia, delayed emergence from anesthesia, groin hematomas and early postoperative mortality (5.14%). Conclusion: Awareness of the unique challenges of endovascular neurosurgery and prompt and appropriate management of the associated complications by an experienced neuroanesthesiologist is vital to the outcome of these procedures.

http://ift.tt/2mHQgKO

C2 Primary leiomyoma in an immunocompetent woman: A case report and review of literature

Mohana Rao Patibandla, Madhukar T Nayak, AK Purohit, Megha Uppin, Sundaram Challa, Gokul Chowdary Addagada, Manisha Nukavarapu

Asian Journal of Neurosurgery 2017 12(1):134-138

Clinical case report and review of the literature. This is the first case of primary leiomyoma in an immunocompetent woman without previous history of uterine leiomyoma being reported in the literature to the best of our knowledge.Leiomyoma, a type of smooth muscle cell tumor, involving the vertebra is extremely rare. There were very few primary leiomyoma in patients with AIDS or in the immune-suppressed patients.This 48-year-old female came with H/o neck pain, weakness and bladder retention. On examination, tone increased in all four limbs, power on the right side of the limbs 4/5, power on the left upper limb 0/5, lower limb 3/5, left plantar was up going, decreased sensation over the left second cervical vertebra (C2) dermatome and all modalities decreased below C2. X-ray and magnetic resonance imaging (MRI) of the cervical spine showed kyphosis of the cervical spine with destruction of the C2 vertebral body along with pathological fracture. The patient underwent decompression of the C2 lesion through the C2 right pedicle with occipito-C1-C3 lateral mass screws fixation. Lesion anterior to the cord was reached by a transpedicular approach and decompression was performed.The lesion was pinkish grey, firm and moderately vascular and was destroying the C2 vertebral body. The patient improved symptomatically in power in the left upper limb and lower limb over the next 1 week duration from 0/5 to 4+/5. Histopathology revealed primary leiomyoma. The patient was evaluated with ultrasound abdomen and contrast tomogram of the chest, abdomen and pelvis to rule out other possible lesions in the lung, intestines and uterus.We suggest that leiomyoma should be included in the differential diagnosis of destructive lytic lesions involving the C2 vertebra. Histopathological examination with immunohistochemistry is necessary for the definitive diagnosis. Treatment of choice is surgery with complete removal.

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Alveolar soft part sarcoma with brain metastases

Vinodh Vayara Perumall, Rahmat Harun, Pulivendhan Sellamuthu, Mohd Shariman Md Shah

Asian Journal of Neurosurgery 2017 12(1):112-115

Metastatic tumors are the most common mass lesions in the brain. This case reports a rare form of sarcoma with metastasis to the brain. The appropriate management of a patient with metastatic alveolar soft part sarcoma to the brain is discussed. Author describes a 32-year-old gentleman diagnosed with primary tumor at gluteus and distant metastases at lower lobe of right lung and the brain. Histopathology proves diagnosis as alveolar soft part sarcoma. Craniotomy with excision of brain lesion was done. Repeated magnetic resonance imaging of the brain after 2 months showed rapidly growing new lesions. The next step of management was made by the oncology team as recurrence rate was high and due to multi-systemic involvement. Patient was planned for palliative chemotherapy and to be reassessed later. This case report discusses the appropriate approach to any form of brain metastases and the role of early follow-up especially after surgery for better outcome and choice of post operative management such as radiotherapy or chemotherapy or both for malignant tumors. Based on this report, it was concluded that every brain tumor patient should be frequently monitored even in the outpatient setting as most of them are metastatic and rapidly spreading. The patient should be considered for radiotherapy or chemotherapy or both after surgery if the histopathology result is suggestive of malignancy.

http://ift.tt/2mHQT7e

Severe hypotension in transforaminal lumbar interbody fusion surgery: Is it vasovagal or?

Tumul Chowdhury, Harsh Sapra, Sudhir Dubey

Asian Journal of Neurosurgery 2017 12(1):149-150



http://ift.tt/2mHEv7f

Post ventriculoperitoneal shunt abdominal pseudocyst: Challenges posed in management

Raashid Hamid, Aejaz A Baba, Nisar A Bhat, Gowhar Mufti, Younis A Mir, Wani Sajad

Asian Journal of Neurosurgery 2017 12(1):13-16

Background: In patients with hydrocephalus, the abdominal cavity has been used for absorption of cerebrospinal fluid (CSF) since 1905. Ventriculoperitoneal (VP) shunt operation is followed by abdominal complications in about 5-47% cases. Abdominal CSF pseudo cyst is an uncommon, but well described complication. Aim: This survey was conducted to study the clinical profile and management of this entity. We present our experience with cases of CSF pseudo cyst in children. Materials and Methods: Retrospective analysis of 4 cases diagnosed to have abdominal pseudo cyst following VP shunt between 2008 and 2013. All the four cases were suspected clinically and diagnosis was confirmed by abdominal ultrasonography. Results: In three patients, the cyst was multilocular and of varying size. Fourth one had a unilocular cyst at the lower end of VP shunt. All the four patients had features of varying degree raised intracranial pressure and a two patients had abdominal signs also. All the patients needed open exploration. Cyst fluid was drained and partial to complete excision of the cyst was done along with the repositioning of the shunt in abdominal cavity in three patients and exteriorization of shunt in one patient. Patients were followed for any further complication over a period of 1-year. Conclusion: Abdominal pseudo cyst is a rare complication after VP Shunt and could result in shunt malfunction or abdominal symptoms and signs. Whenever suspected it should be confirmed by imaging, followed by open exploration and repositioning of the shunt.

http://ift.tt/2mHMfWV

Challenges in a case of ophthalmic artery aneurysm associated with abnormal internal carotid arteries

Eduard B Dinca, Felix Brehar, Andrei Giovani, Alexandru V Ciurea

Asian Journal of Neurosurgery 2017 12(1):106-108

Ophthalmic artery aneurysms account for 5% of all cerebral aneurysms and are an important cause of morbidity and mortality related to subarachnoid hemorrhage. The diagnosis is often made only when the aneurysm is large enough to become symptomatic. They remain technically challenging for both neurosurgeon and interventional radiologist. We present the case of a 62-year-old woman admitted for transient loss of consciousness, followed by generalized tonic-clonic seizures. Computed tomography (CT) showed a subarachnoid hemorrhage (SAH), clinically graded as Hunt and Hess III. Magnetic resonance imaging (angioMR) and the four-vessel digital subtraction angiography (DSA) identified a ruptured, 8 mm left ophthalmic artery aneurysm. Embolization was the first therapeutic choice. Nevertheless, the attempt had to be aborted due to a combination of a hypoplastic right internal carotid artery (ICA) and an irregular atheromatous plaque on the left ICA, rendering the procedure unduly hazardous. Therefore, microsurgical clipping of the aneurysm became the procedure of choice. Postoperatively, the patient was in good condition, with no visual and neurological deficits. At 6 months follow up, she was assigned maximum scores of 5 and 8 on the Glasgow Outcome Scale (GOS) and Extended GOS (GOS-E), respectively. Aneurysm rupture represents a neurosurgical emergency and an early intervention (less than 48 h) is recommended to maximize the chances of deficit-free survival. The peculiarities of this case consisted in the combination between the size and the location of the aneurysm, abrupt presentation, and the impossibility of embolization due to bilateral ICA abnormalities, congenital (hypoplastic right ICA) and acquired (extensively atherosclerotic left ICA).

http://ift.tt/2n1Yyjn

Neuroendoscopy - Is it safe?

Manas Panigrahi, Bharat Gupta, Rajesh Reddy

Asian Journal of Neurosurgery 2017 12(1):17-21

Background: The effect of heat in endoscopic instruments used for laparoscopy and hysteroscopy has been well-studied. Reports of thermal injury from nasal endoscopes have also been reported. However, there are no experimental studies, which have objectively documented and provided recommendations for safe use of endoscopes in neurosurgery. Objectives: To study the heat generated at the tip of the endoscope and the subsequent thermal damage caused to a cotton drape placed in proximity, by varying the intensity of light delivered through different optical cables, ambient (operating room) temperatures and working distances. Materials and Methods: The study was carried out in the operation theater using a 300 watt xenon light source connected to the endoscope with 3.5 mm and 4.8 mm optical cables. A digital thermometer was used to record the heat generated at the tip of the endoscope. Results: The heat generated at the tip of the endoscope reached its peak in the first 6 min and attained a plateau at 15 min after turning on a light source of 60% intensity. Thermal injury to the cotton drape took a longer time with a 3.8 mm cable compared with 4.8 mm cable. The heat generated at the tip of the endoscope, and thereby the thermal injury caused was found to be lower when the ambient temperature was close to 20°C. Conclusions: Complications related to thermal injuries caused by heat generated at the tip of an endoscope can be reduced by using a smaller diameter cable, light intensity of 60%, increasing the working distance (as permissible), reducing the time spent for dissection while keeping the endoscope very close to the target and lowering the ambient temperature to 20°C.

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First report of important causal relationship between the Adamkiewicz artery vasospasm and dorsal root ganglion cell degeneration in spinal subarachnoid hemorrhage: An experimental study using a rabbit model

Osman N Turkmenoglu, Ayhan Kanat, Coskun Yolas, Mehmet Dumlu Aydin, Naci Ezirmik, Cemal Gundogdu

Asian Journal of Neurosurgery 2017 12(1):22-27

Background: The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz. The goal of this study was to elucidate the effects of lumbar subarachnoid hemorrhage (SAH) on the lumbar 4 dorsal root ganglion (L4DRG) cells secondary to Adamkiewicz artery (AKA) vasospasm. Materials and Methods: This study was conducted on 20 rabbits, which were randomly divided into three groups: Spinal SAH (n = 8), serum saline (SS) (SS; n = 6) and control (n = 6) groups. Experimental spinal SAH was performed. After 20 days, volume values of AKA and neuron density of L4DRG were analyzed. Results: The mean alive neuron density of the L4DRG was 15420 ± 1240/mm3 and degenerated neuron density was 1045 ± 260/mm3 in the control group. Whereas, the density of living and degenerated neurons density were 12930 ± 1060/mm3 and 1365 ± 480/mm3 in serum saline (SS), 9845 ± 1028/mm3 and 4560 ± 1340/mm3 in the SAH group. The mean volume of imaginary AKAs was estimated as 1,250 ± 0,310 mm3 in the control group and 1,030 ± 0,240 mm3 in the SF group and 0,910 ± 0,170 mm3 in SAH group. Volume reduction of the AKAs and neuron density L4DRG were significantly different between the SAH and other two groups (P < 0.05). Conclusion: Decreased volume of the lumen of the artery of Adamkiewicz was observed in animals with SAH compared with controls. Increased degeneration the L4 dorsal root ganglion in animals with SAH was also noted. Our findings will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

http://ift.tt/2mHIVen

Predictors of visual outcome with transsphenoidal excision of pituitary adenomas having suprasellar extension: A prospective series of 100 cases and brief review of the literature

Amit Kumar Thotakura, Mohana Rao Patibandla, Manas K Panigrahi, Gokul Chowdary Addagada

Asian Journal of Neurosurgery 2017 12(1):1-5

Objective: The aim was to assess the factors influencing the visual outcome following trans-sphenoidal excision of pituitary adenomas. Materials and Methods: One hundred consecutive patients of pituitary adenomas with suprasellar extension (SSE) were operated by trans-sphenoidal approach from July 2003 to December 2006. There were 52 male and 48 female patients with a mean age of 42.47 years. The visual impairment score, which was used to evaluate the visual outcome was produced by adding the scores for visual acuity and visual field defects of each patient (from the tables of the German Ophthalmological Society). The mean diameter, the SSE and the parasellar extension of the lesion were noted in the magnetic resonance imaging study. The average follow-up was 43.5 months. Results: The mean diameter of the tumor was 32.97 mm, and the mean SSE was 14.95 mm. The parasellar extension was present in 27 patients. The vision improved in 61 of the 71 patients (85.91%). The shorter the duration of visual symptoms and smaller the size of the lesion resulted in better visual outcome. The age and the preoperative visual impairment did not show any correlation with the visual outcome. Conclusions: Patients with visual symptoms of <1-year duration (P < 0.01) and adenomas of <36.5 mm diameter (P < 0.009) have better visual outcome.

http://ift.tt/2n29m1b

Clinical predictors for survival and treatment outcome of high-grade glioma in Prasat Neurological Institute

Raywat Noiphithak, Kullapat Veerasarn

Asian Journal of Neurosurgery 2017 12(1):28-33

Objective: The aim was to identify clinical predictors for survival and examine treatment outcome in patients with high-grade glioma (HGG). Materials and Methods: The authors retrospectively reviewed medical records of patients who was diagnosed HGG between January 2007 and December 2009. Demographic data, radiological data and treatment data of patients were reviewed and analyzed. Results: A total of 100 patients were analyzed. There was no difference in demographic data between Grade III and IV glioma. Patients with HGG had median survival time (MST) 18 months, The MST of patients with Grade III and IV glioma were 26 and 13 months, respectively. In this study, only anaplastic oligoastrocytoma and radiotherapy did impact strongly on survival of patients with HGG. In patients with Grade III and IV glioma, radiotherapy found to have influence on survival. Conclusion: Patients with HGG in Prasat Neurological Institute had short survival resemble to other previous study. The clinical predictors for survival of patients were identified on multivariate analysis.

http://ift.tt/2mHmZQM