Head and Neck Diseases by Alexandros G.Sfakianakis: 04/30/17

Κυριακή 30 Απριλίου 2017

Tumor associated macrophage-targeted microRNA delivery with dual-responsive polypeptide nanovectors for anti-cancer therapy

Publication date: July 2017
Source:Biomaterials, Volume 134
Author(s): Lanlan Liu, Huqiang Yi, Huamei He, Hong Pan, Lintao Cai, Yifan Ma
Repolarizing Tumor-associated macrophages (TAMs) to anti-tumor M1 macrophages with microRNA (miR) is a plausible approach for cancer treatment. However, how to achieve TAM-targeted miR delivery remains a challenge. The present study generated redox/pH dual-responsive hybrid polypeptide nanovectors, which consisted of self-crosslinked redox-responsive nanoparticles based on galactose-functionalized n-butylamine-poly(l-lysine)-b-poly(l-cysteine) polypeptides (GLC) coated with DCA-grafted sheddable PEG-PLL (sPEG) copolymers. The ex vivo study showed that sPEG shielded cationic GLC core at physiological pH but quickly shed off to re-expose GLC due to it charge reversible property. Encapsulation with sPEG/GLC nanovectors effectively facilitated macrophage-targeted miR delivery at the acidic condition but diminished miR uptake at neutral pH. Administration of miR155-loaded sPEG/GLC (sPEG/GLC/155) nanocomplexes increased miR155 expression in TAMs about 100–400 folds both in vitro and in vivo. sPEG/GLC/155 also effectively repolarized immunosuppressive TAMs to anti-tumor M1 macrophages through elevating M1 macrophage markers (IL-12, iNOS, MHC II) and suppressing M2 macrophage markers (Msr2 and Arg1) in TAMs. Moreover, the treatment of sPEG/GLC/155 significantly increased activated T lymphocytes and NK cells in tumors, which consequently led to robust tumor regression. Hence, TAM-targeted delivery of miR with redox/pH dual-responsive sPEG/GLC nanovectors could be a promising approach to re-polarize TAMs to M1 macrophages in situ and induce tumor regression.

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A Study of Single Nucleotide Polymorphisms of Tumour Necrosis Factor α-1031 And Tumour Necrosis Factor β+ 252 in Chronic Rhinosinusitis.

A Study of Single Nucleotide Polymorphisms of Tumour Necrosis Factor α-1031 And Tumour Necrosis Factor β+ 252 in Chronic Rhinosinusitis.

Clin Exp Otorhinolaryngol. 2017 Apr 28;:

Authors: Misron K, Hamid SSA, Ahmad A, Ramli RR

Abstract
Objectives: This case-controlled study aimed to identify the association of tumor necrosis factor (TNF)α-1031 and TNFβ+252 gene polymorphisms between chronic rhinosinusitis (CRS) and healthy controls. Another purpose of this study was to investigate the associations of these gene polymorphisms with factors related to CRS.
Methods: All deoxyribonucleic acid (DNA) samples were genotyped for TNFα-1031 and TNFβ+252 genes by mean of polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP). The statistical analysis were carried out using chi-square test or Fisher exact test to determine the associations of these gene polymorphisms in CRS. Multiple logistic regression was performed to evaluate the associations of these gene polymorphisms in CRS and its related risk factors.
Results: The genotype and allele frequencies of TNFα-1031 and TNFβ+252 gene did not show any significant associations between CRS and healthy controls. However, a significantly statistical difference of TNFα-1031 was observed in CRS participants with atopy (P-value, 0.045; odds ratio, 3.66) but not in CRS with asthma or aspirin intolerance.
Conclusion: Although the presence of TNFα-1031 and TNFβ+252 gene polymorphisms did not render any significant associations between CRS and healthy control, this study suggests that TNFα-1031 gene polymorphisms in CRS patients with atopy may be associated with increase susceptibility towards CRS.

PMID: 28449554 [PubMed - as supplied by publisher]

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Changes in the Reflux Symptom Index After Multilevel Surgery for Obstructive Sleep Apnea.

Changes in the Reflux Symptom Index After Multilevel Surgery for Obstructive Sleep Apnea.

Clin Exp Otorhinolaryngol. 2017 Apr 28;:

Authors: Kim SJ, Kim HY, Jeong JI, Hong SD, Chung SK, Dhong HJ

Abstract
Objectives: This study evaluated whether the symptoms of laryngopharyngeal reflux (LPR) change after multilevel surgery for obstructive sleep apnea (OSA).
Methods: Patients who underwent multilevel surgery for OSA between April 2009 and September 2014 were enrolled in this study. All patients underwent preoperative polysomnography prior to surgery and were asked to complete the reflux symptom index (RSI) questionnaire before and after surgery.
Results: Of 73 enrolled patients, 24 (33%) reported an RSI score >13 and were thus classified as having reflux. The mean RSI score before surgery was 11.48±7.95; this number decreased to 4.95±6.19 after surgery (P<0.001). The rate of positive RSI responses was 33% before surgery and 9% after surgery. Each variable that comprised the RSI improved significantly after surgery, except for difficulty with swallowing. Regarding the degree of RSI improvement after surgery, there were no significant differences between subgroups according to sex, age, body mass index, OSA severity, or surgical outcome.
Conclusion: LPR symptoms are prevalent in OSA patients. Treatment for OSA using multilevel surgery potentially reduces the symptoms of LPR.

PMID: 28449553 [PubMed - as supplied by publisher]

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Effect of Proparacaine in a Mouse Model of Allergic Rhinitis.

Effect of Proparacaine in a Mouse Model of Allergic Rhinitis.

Clin Exp Otorhinolaryngol. 2017 Apr 28;:

Authors: Kim HS, Won S, Lee EK, Chun YH, Yoon JS, Kim JT, Kim HH

Abstract
Objectives: Lidocaine, a local anaesthetic is a treatment option in uncontrolled asthma due to its immunomodulatory effects. In the present study, proparacaine (PPC), a derivative of lidocaine was examined for its therapeutic application in a mouse model of allergic rhinitis.
Methods: The mice were grouped into 4 groups: control group, allergic rhinitis (AR) group, ciclesonide (CIC) group, and PPC group. Nasal symptom scores, eosinophil counts, goblet cell counts, and mast cells counts in the nasal mucosa were measured. Serum ovalbumin (OVA)-specific immunoglobulin (Ig) E, OVA-specific IgG1, OVA-specific IgG2a, interleukin (IL)-4, IL-5, and cortisol levels were measured.
Results: Intranasal administration of PPC significantly decreased nasal symptoms, number of eosinophils, goblet cells, and mast cells in the lamina propria of the nasal mucosa. Serum OVA-specific IgE, OVA-specific IgG1, OVA-specific IgG2a was significantly higher in the AR compared with the control group. Serum level of IL-4 was significantly lower in the CIC group and PPC group in comparison with AR group. Serum IL-5 showed no significant difference among all groups. No significant difference in serum cortisol levels was observed among the 4 groups.
Conclusion: PPC appears to have a therapeutic potential in treatment of allergic rhinitis in a mouse model by reducing eosinophil, goblet cell, and mast cell infiltration in the nasal mucosa.

PMID: 28449552 [PubMed - as supplied by publisher]

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A Survey of Korean Physicians' Prescription Patterns for Allergic Rhinitis.

A Survey of Korean Physicians' Prescription Patterns for Allergic Rhinitis.

Clin Exp Otorhinolaryngol. 2017 Apr 28;:

Authors: Seo MY, Kim DK, Jee HM, Ahn YM, Kim YM, Hong SD, Work Group for Allergic Rhinitis of the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI)

Abstract
Objectives: The aim of this study was to compare the prescription patterns according to characteristics of physicians using a survey distributed amongst physicians in Korea.
Methods: We surveyed the prescription patterns for allergic rhinitis (AR) of the members of the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) and the Korean Association of Otorhinolaryngologists (KAO). Questionnaire contained 4 categories with 28 queries. 448 physicians including 98 internal medicine (IM), 113 pediatrics (PED), and 237 otorhinolaryngology (ENT) were responded.
Results: Although the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines are most frequently used in all specialties, seasonal or perennial AR is the most frequent classification system. For the definitive diagnosis of AR, ENT physicians reported using multiple allergen simultaneous test (MAST)/radio allergy sorbent test (RAST) more than others (IM, 10.9%; PED, 20.6%; ENT, 44.2%; P<0.001). In treatment, most physicians reported that antihistamine medication is the initial treatment for AR. PED physicians prescribed fewer intranasal steroid to combinations with an antihistamine than other specialists (IM, 65.3%; PED, 42.5%; ENT, 63.3%), but preferred leukotriene antagonists (IM, 4.1%; PED, 23.0%; ENT, 3.9%; P=0.041). Overall, 53% (235/448) of the physicians performed allergen immunotherapy (AIT), and IM administers the most AIT (IM, 71.6%; PED, 42.0%; ENT, 39.5%; P=0.019). Furthermore, university and general hospital physicians prescribed more AIT than doctors at other hospital types (university hospital, 76.4%; general hospital, 64.3%; local hospital, 21.4%; private clinic, 20.2%; P<0.001).
Conclusion: The prescription patterns for AR were different according to the physicians' characteristics and general rate of prescribing AIT is just about 53% in Korea. Thus, the development of complementary Korean-specific guidelines is needed and proper clinical instruction of AIT would be necessary.

PMID: 28449551 [PubMed - as supplied by publisher]

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A fluorescent sensing for glycoproteins based on the FRET between quantum dots and Au nanoparticles

Publication date: October 2017
Source:Sensors and Actuators B: Chemical, Volume 250
Author(s): Lifang Chang, Xiwen He, Langxing Chen, Yukui Zhang
A simple fluorescent probe based on fluorescence resonance energy transfer (FRET) between the glucosamine-Mn-doped ZnS QDs and mercaptophenylboronic acid (MBA)-capped AuNPs was designed for the determination of glycoproteins such as immunoglobulin G (IgG), transferrin (Trf), α1-acid glycoprotein (AGP) and horseradish peroxidase (HRP). The FRET process took place via interaction between the glucosamine on the surface of QDs and boronic acid moieties on AuNPs surface, and resulted in the fluorescence quenched of the QDs. The FRET efficiency from QDs to AuNPs was calculated to be 75.4%. However, the FRET process would be inhibited after glycoproteins were introduced into the QDs-AuNPs system. The stronger interaction between the MBA on the surface of AuNPs and glycoproteins would keep the AuNPs far away from the QDs surface, leading to the fluorescence recovered of the QDs. The as-prepared sensor showed a high sensitivity and selectivity for glycoproteins. The dissociation constants and the detection limits of the selected standard glycoproteins (Trf, HRP, IgG and AGP) were estimated to be around 10⁻⁷M and 10⁻⁹M, respectively. Finally, this sensor has been successfully used for the determination of the AGP in serum samples without any complicated pretreatment and the recovery was in the range of 70%–105%.

Graphical abstract

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Similar patterns of neural activity predict memory function during encoding and retrieval

Publication date: 15 July 2017
Source:NeuroImage, Volume 155
Author(s): James E. Kragel, Youssef Ezzyat, Michael R. Sperling, Richard Gorniak, Gregory A. Worrell, Brent M. Berry, Cory Inman, Jui-Jui Lin, Kathryn A. Davis, Sandhitsu R. Das, Joel M. Stein, Barbara C. Jobst, Kareem A. Zaghloul, Sameer A. Sheth, Daniel S. Rizzuto, Michael J. Kahana
Neural networks that span the medial temporal lobe (MTL), prefrontal cortex, and posterior cortical regions are essential to episodic memory function in humans. Encoding and retrieval are supported by the engagement of both distinct neural pathways across the cortex and common structures within the medial temporal lobes. However, the degree to which memory performance can be determined by neural processing that is common to encoding and retrieval remains to be determined. To identify neural signatures of successful memory function, we administered a delayed free-recall task to 187 neurosurgical patients implanted with subdural or intraparenchymal depth electrodes. We developed multivariate classifiers to identify patterns of spectral power across the brain that independently predicted successful episodic encoding and retrieval. During encoding and retrieval, patterns of increased high frequency activity in prefrontal, MTL, and inferior parietal cortices, accompanied by widespread decreases in low frequency power across the brain predicted successful memory function. Using a cross-decoding approach, we demonstrate the ability to predict memory function across distinct phases of the free-recall task. Furthermore, we demonstrate that classifiers that combine information from both encoding and retrieval states can outperform task-independent models. These findings suggest that the engagement of a core memory network during either encoding or retrieval shapes the ability to remember the past, despite distinct neural interactions that facilitate encoding and retrieval.

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Causal role of the posterior parietal cortex for two-digit mental subtraction and addition: A repetitive TMS study

Publication date: 15 July 2017
Source:NeuroImage, Volume 155
Author(s): Maria Montefinese, Cristina Turco, Francesco Piccione, Carlo Semenza
Although parietal areas of the left hemisphere are known to be involved in simple mental calculation, the possible role of the homologue areas of the right hemisphere in mental complex calculation remains debated. In the present study, we tested the causal role of the posterior parietal cortex of both hemispheres in two-digit mental addition and subtraction by means of neuronavigated repetitive TMS (rTMS), investigating possible hemispheric asymmetries in specific parietal areas. In particular, we performed two rTMS experiments, which differed only for the target sites stimulated, on independent samples of participants. rTMS was delivered over the horizontal and ventral portions of the intraparietal sulcus (HIPS and VIPS, respectively) of each hemisphere in Experiment 1, and over the angular and supramarginal gyri (ANG and SMG, respectively) of each hemisphere in Experiment 2. First, we found that each cerebral area of the posterior parietal cortex is involved to some degree in the two-digit addition and subtraction. Second, in Experiment 1, we found a stronger pattern of hemispheric asymmetry for the involvement of HIPS in addition compared to subtraction. In particular, results showed a greater involvement of the right HIPS than the left one for addition. Moreover, we found less asymmetry for the VIPS. Taken together, these results suggest that two-digit mental addition is more strongly associated with the use of a spatial mapping compared to subtraction. In support of this view, in Experiment 2, a greater role of left and right ANG was found for addition needed in verbal processing of numbers and in visuospatial attention processes, respectively. We also revealed a greater involvement of the bilateral SMG in two-digit mental subtraction, in response to greater working memory load required to solve this latter operation compared to addition.

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Robust and fast nonlinear optimization of diffusion MRI microstructure models

Publication date: 15 July 2017
Source:NeuroImage, Volume 155
Author(s): R.L. Harms, F.J. Fritz, A. Tobisch, R. Goebel, A. Roebroeck
Advances in biophysical multi-compartment modeling for diffusion MRI (dMRI) have gained popularity because of greater specificity than DTI in relating the dMRI signal to underlying cellular microstructure. A large range of these diffusion microstructure models have been developed and each of the popular models comes with its own, often different, optimization algorithm, noise model and initialization strategy to estimate its parameter maps. Since data fit, accuracy and precision is hard to verify, this creates additional challenges to comparability and generalization of results from diffusion microstructure models. In addition, non-linear optimization is computationally expensive leading to very long run times, which can be prohibitive in large group or population studies. In this technical note we investigate the performance of several optimization algorithms and initialization strategies over a few of the most popular diffusion microstructure models, including NODDI and CHARMED. We evaluate whether a single well performing optimization approach exists that could be applied to many models and would equate both run time and fit aspects. All models, algorithms and strategies were implemented on the Graphics Processing Unit (GPU) to remove run time constraints, with which we achieve whole brain dataset fits in seconds to minutes. We then evaluated fit, accuracy, precision and run time for different models of differing complexity against three common optimization algorithms and three parameter initialization strategies. Variability of the achieved quality of fit in actual data was evaluated on ten subjects of each of two population studies with a different acquisition protocol. We find that optimization algorithms and multi-step optimization approaches have a considerable influence on performance and stability over subjects and over acquisition protocols. The gradient-free Powell conjugate-direction algorithm was found to outperform other common algorithms in terms of run time, fit, accuracy and precision. Parameter initialization approaches were found to be relevant especially for more complex models, such as those involving several fiber orientations per voxel. For these, a fitting cascade initializing or fixing parameter values in a later optimization step from simpler models in an earlier optimization step further improved run time, fit, accuracy and precision compared to a single step fit. This establishes and makes available standards by which robust fit and accuracy can be achieved in shorter run times. This is especially relevant for the use of diffusion microstructure modeling in large group or population studies and in combining microstructure parameter maps with tractography results.

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Are the Insomnia Severity Index and Pittsburgh Sleep Quality Index valid outcome measures for Cognitive Behavioral Therapy for Insomnia? Inquiry from the perspective of response shifts and longitudinal measurement invariance in their Chinese versions

The purpose of this study was to examine whether the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) are valid outcome measures for Cognitive Behavioral Therapy for Insomnia (CBT-I). Specifically, we tested whether the factorial parameters of the ISI and the PSQI could remain invariant against CBT-I, which is a prerequisite to using their change scores as an unbiased measure of the treatment outcome of CBT-I.

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Tumores primarios del espacio parafaríngeo

Publication date: May–June 2017
Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
Author(s): Gianluigi Grilli, Vanessa Suarez, María Gabriela Muñoz, María Costales, José Luis Llorente
Introducción y objetivosEl objetivo de este estudio es presentar nuestra experiencia en el diagnóstico y tratamiento de los tumores parafaríngeos.Pacientes y métodoRealizamos un estudio retrospectivo de 90 pacientes, diagnosticados y tratados quirúrgicamente de una tumoración parafaríngea entre 1984 y 2015. Fueron excluidos los pacientes cuyos tumores no eran primarios, sino que invadían esta región por contigüidad, los tumores originados en el lóbulo profundo de la parótida y las metástasis de otros tumores de cabeza y cuello.ResultadosEl 74% de las neoplasias del espacio parafaríngeo fueron de naturaleza benigna y el 26% maligna. Los adenomas pleomorfos fueron los tumores más frecuentes (27%), seguido por los paragangliomas (25%), un grupo de tumores de origen misceláneo de naturaleza maligna (16%), los tumores de origen neurogénico (12%), un grupo de tumores de origen misceláneo de naturaleza benigna (10%) y los tumores malignos de glándulas salivales (10%). El tratamiento fue quirúrgico en todos los casos. Se realizó un abordaje transcervical en 56 pacientes, un abordaje cervical-transparotídeo en 15 pacientes, un abordaje infratemporal tipo A en 13 pacientes, un abordaje transmandibular en 4 pacientes y en 2 casos un abordaje transoral. Las complicaciones más frecuentes fueron las derivadas de lesiones de estructuras nerviosas.ConclusionesLa mayoría de los tumores localizados en el espacio parafaríngeo son subsidiarios de ser tratados de forma quirúrgica con una baja tasa de complicaciones y recurrencias. El abordaje transcervical es el más utilizado.Introduction and objectivesThe aim of this study is to present our experience with the diagnostic and therapeutic approaches for parapharyngeal space tumours.Patients and methodThis study is a retrospective review of 90 patients diagnosed with tumours of the parapharyngeal space and treated surgically between 1984 and 2015. Patients whose tumours were not primary but invaded the parapharyngeal space expanding from another region, tumours originating in the deep lobe of the parotid gland and head and neck metastasis were excluded from this study.Results74% percent of the parapharyngeal space neoplasms were benign and 26% were malignant. Pleomorphic adenoma was the most common neoplasm (27%), followed by paragangliomas (25%), miscellaneous malignant tumours (16%), neurogenic tumours (12%), miscellaneous benign tumours (10%), and malignant salivary gland tumours (10%). The transcervical approach was used in 56 cases, cervical-transparotid approach in 15 cases, type A infratemporal fossa approach in 13 cases, transmandibular approach in 4 cases and transoral approach in 2 cases. The most common complications were those deriving from nervous injuries.ConclusionsMost parapharyngeal space tumours can be removed surgically with a low rate of complications and recurrence. The transcervical approach is the most frequently used.

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Intracellular B Lymphocyte Signalling and the Regulation of Humoral Immunity and Autoimmunity

Abstract

B lymphocytes are critical for effective immunity; they produce antibodies and cytokines, present antigens to T lymphocytes and regulate immune responses. However, because of the inherent randomness in the process of generating their vast repertoire of antigen-specific receptors, B cells can also cause diseases through recognizing and reacting to self. Therefore, B lymphocyte selection and responses require tight regulation at multiple levels and at all stages of their development and activation to avoid diseases. Indeed, newly generated B lymphocytes undergo rigorous tolerance mechanisms in the bone marrow and, subsequently, in the periphery after their migration. Furthermore, activation of mature B cells is regulated through controlled expression of co-stimulatory receptors and intracellular signalling thresholds. All these regulatory events determine whether and how B lymphocytes respond to antigens, by undergoing apoptosis or proliferation. However, defects that alter regulated co-stimulatory receptor expression or intracellular signalling thresholds can lead to diseases. For example, autoimmune diseases can result from altered regulation of B cell responses leading to the emergence of high-affinity autoreactive B cells, autoantibody production and tissue damage. The exact cause(s) of defective B cell responses in autoimmune diseases remains unknown. However, there is evidence that defects or mutations in genes that encode individual intracellular signalling proteins lead to autoimmune diseases, thus confirming that defects in intracellular pathways mediate autoimmune diseases. This review provides a synopsis of current knowledge of signalling proteins and pathways that regulate B lymphocyte responses and how defects in these could promote autoimmune diseases. Most of the evidence comes from studies of mouse models of disease and from genetically engineered mice. Some, however, also come from studying B lymphocytes from patients and from genome-wide association studies. Defining proteins and signalling pathways that underpin atypical B cell response in diseases will help in understanding disease mechanisms and provide new therapeutic avenues for precision therapy.

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Gluteus medius muscle metastasis of squamous cell carcinoma of larynx: a rare case

Publication date: Available online 29 April 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Alperen Vural, Deniz Avcı, Sedat Çağlı, İmdat Yüce, Turan Arlı

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Temporal patterns of patient-reported trismus and associated mouth-opening distances in radiotherapy for head and neck cancer: A prospective cohort study

Abstract

Objectives

To identify temporal patterns of patient-reported trismus during the first year post-radiotherapy, and to study their associations with maximal interincisal opening distances (MIOs).

Design

Single institution case series.

Setting

University hospital ENT clinic.

Participants

One hundred ninety six subjects who received radiotherapy (RT) for head and neck cancer (HNC) with or without chemotherapy in 2007-2012 to total dose of 64.6/68 Gy in 38/34 fractions, respectively. All subjects were prospectively assessed for mouth-opening ability (Gothenburg Trismus Questionnaire (GTQ), and MIO) pre-RT and at 3, 6, and 12 months after RT.

Main outcome measures

Correlations between temporally robust GTQ-symptoms and MIO as given by Pearson's correlation coefficients (P_r); temporally robust GTQ-symptom domains as given by factor analysis; rates of trismus with respect to baseline by risk ratios (RRs).

Results

Four temporally robust domains were identified: Eating (3-7 symptoms), Jaw (3-7), Pain (2-5), and Quality of Life (QoL, 2-5), and included 2-3 persistent symptoms across all post- RT assessments. The median RR for a moderate/severe (>2/>3) cut-off was the highest for Jaw (3.7/3.6) and QoL (3.2/2.9). The median P_r between temporally robust symptoms and MIO post-radiotherapy was 0.25-0.35/0.34-0.43/0.24-0.31/0.34-0.50 for Eating/Jaw/Pain/QoL, respectively.

Conclusions

Mouth-opening distances in HNC patients post-RT can be understood in terms of associated patient-reported outcomes on trismus-related difficulties. Our data suggest that a reduction in MIO can be expected as patients communicate their mouth-opening status to interfere with private/social life, a clinical warning signal for emerging or worsening trismus as patients are being followed after RT.

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Patient injuries in operative rhinology during a ten-year period: Review of National Patient Insurance Charts

Abstract

Objectives

To assess factors contributing to patient injuries in operative rhinology.

Design

Data of the accepted patient injury claims involving operative rhinology, between the years 2001 and 2011, were obtained from the Finnish Patient Insurance Centre registry. Two senior otolaryngologists analysed and evaluated the injury mechanisms.

Main outcome measures

Analysis and classification of factors contributing to patient injuries.

Results

During the ten-year study period, there were 67 patient injuries in operative rhinology, comprising 36% of all patient injuries in otorhinolaryngologic surgery. The majority (78%) of patients were treated in university or central hospitals and almost all (90%) by fully trained otolaryngology specialists. The factors contributing to the injuries were errors in surgical technique, like lesions to the orbit, skull base and meninges, and adjacent nerves, as well as mistakes with removable packings left in situ. Nearly half of the patients had undergone endoscopic sinus surgery. One patient died because of bleeding from the intracranial artery. Fourteen patients (21%) needed a re-operation due to the injury.

Conclusions

Patient injuries in rhinology were caused by typical complications of common operations performed by otorhinolaryngology specialists. The increased volume of endoscopic sinus surgery was evident also in patient injuries.

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Temporal patterns of patient-reported trismus and associated mouth-opening distances in radiotherapy for head and neck cancer: A prospective cohort study

Abstract

Objectives

To identify temporal patterns of patient-reported trismus during the first year post-radiotherapy, and to study their associations with maximal interincisal opening distances (MIOs).

Design

Single institution case series.

Setting

University hospital ENT clinic.

Participants

Main outcome measures

Results

Conclusions

http://ift.tt/2pM424A

Patient injuries in operative rhinology during a ten-year period: Review of National Patient Insurance Charts

Abstract

Objectives

To assess factors contributing to patient injuries in operative rhinology.

Design

Main outcome measures

Analysis and classification of factors contributing to patient injuries.

Results

Conclusions

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The influence of children's exposure to language from two to six years: The case of nonword repetition.

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The influence of children's exposure to language from two to six years: The case of nonword repetition.

Cognition. 2016 08;153:79-88

Authors: Jones G

Abstract
Nonword repetition (NWR) is highly predictive of vocabulary size, has strong links to language and reading ability, and is a clinical marker of language impairment. However, it is unclear what processes provide major contributions to NWR performance. This paper presents a computational model of NWR based on Chunking Lexical and Sub-lexical Sequences in Children (CLASSIC) that focuses on the child's exposure to language when learning lexical phonological knowledge. Based on language input aimed at 2-6year old children, CLASSIC shows a substantial fit to children's NWR performance for 6 different types of NWR test across 6 different NWR studies that use children of various ages from 2;1 to 6;1. Furthermore, CLASSIC's repetitions of individual nonwords correlate significantly with children's repetitions of the same nonwords, NWR performance shows strong correlations to vocabulary size, and interaction effects seen in the model are consistent with those found in children. Such a fit to the data is achieved without any need for developmental parameters, suggesting that between the ages of two and six years, NWR performance measures the child's current level of linguistic knowledge that arises from their exposure to language over time and their ability to extract lexical phonological knowledge from that exposure.

PMID: 27155560 [PubMed - indexed for MEDLINE]

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Frontmatter

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: i-iv

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Imaging methods for bone mass evaluation during childhood and adolescence: an update

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 485-497

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Risk factors for overweight and obesity in children aged 2–6 years

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 499-505

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Copy number variations in “classical” obesity candidate genes are not frequently associated with severe early-onset obesity in children

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 507-515

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Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 517-523

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Plasma but not serum brain-derived neurotrophic factor concentration is decreased by oral glucose tolerance test-induced hyperglycemia in children

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 525-530

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Environmental and genetic determinants of two vitamin D metabolites in healthy Australian children

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 531-541

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Evaluation of vitamin D prophylaxis in 3–36-month-old infants and children

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 543-549

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Possible effects of neonatal vitamin B12 status on TSH-screening program: a cross-sectional study from Turkey

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 551-555

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Plasma kisspeptin and ghrelin levels in puberty variant cases

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 569-573

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Effects of L-thyroxine treatment on heart functions in infants with congenital hypothyroidism

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 557-560

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Hyperandrogenism in adolescent girls: relationship with the somatotrophic axis

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 561-568

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Genotype-phenotype correlation in paediatric pheochromocytoma and paraganglioma: a single centre experience from India

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 575-581

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Provider variability in the initial diagnosis and treatment of congenital hypothyroidism

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 583-586

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Giant parathyroid adenoma associated with severe hypercalcemia in an adolescent patient

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 587-592

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Personalized precision medicine in extreme preterm infants with transient neonatal diabetes mellitus

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 593-596

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Pseudohypoaldosteronism types I and II: little more than a name in common

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 597-601

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Primary pigmented nodular adrenocortical disease: literature review and case report of a 6-year-old boy

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 30
Issue: 5
Pages: 603-609

http://ift.tt/2qsXzYq

Studying the association between methylene tetrahdrofolate reductase (MTHFR) 677 gene polymorphism, cardiovascular risk and lichen planus

Abstract

Background

There is a reported relation between hyperhomocysteinemia and lichen planus (LP). An increase in homocysteine (Hcy) and the risk of cardiovascular disease (CVD) in patients with methylenetetrahydrofolate reductase (MTHFR) mutation has been described

Objective

To detect MTHFR (C677T) gene polymorphism, and to find its association with CVD risk, Hcy and folic acid levels in patients with LP

Methods

This hospital-based case-control study included 110 patients with LP; 70 with cutaneous LP (CLP) and 40 with oral LP (OLP). 120 age and sex matched healthy subjects were used as controls. Three ml venous blood sample was taken for detection of MTHFR gene polymorphism by PCR-RFLP technique and for measurement of the lipid profile. Hcy and folic acid were measured by ELISA. Hypertension was evaluated

Results

There were significantly higher prevalence of hypertension with higher Hcy, triglycerides and cholesterol levels and lower folic acid and HDL levels among patients' groups. Hypertension with higher Hcy and cholesterol levels together with lower folic acid and HDL levels have been found in OLP when compared to CLP. Patients showed a significant higher percentage of the MTHFR 677 TT genotype (P=0.003) and of the MTHFR 677 T allele (P=0.042) compared to controls. Moreover, there was higher a prevalence of MTHFR 677 T allele in patients with CLP.

Conclusion

MTHFR 677 gene polymorphism may be a risk factor for the development of the LP, and to predispose these patients to higher risk of CVD.

http://ift.tt/2pkfh2L

Bacterial adhesion not inhibited by ion-releasing bioactive glass filler

Publication date: Available online 29 April 2017
Source:Dental Materials
Author(s): Kumiko Yoshihara, Noriyuki Nagaoka, Yukinori Maruo, Hidehiko Sano, Yasuhiro Yoshida, Bart Van Meerbeek
ObjectiveBioactive glasses and surface pre-reacted glass-ionomer (sPRG) filler possess cariostatic properties owing to ion release. Many studies investigated potential cariostatic effects; few studies evaluated the surface stability and the structural changes their surfaces undergo in acidic conditions.MethodsThe surface resistance against acid attack and the surface receptiveness for bacterial adhesion and biofilm formation of a sPRG-filled (Beautifil ll, Shofu) and conventional glass-filled (Herculite XRV Ultra, Kerr) resin-based composite (RBC), and a conventional glass-ionomer cement (GIC; Fuji IX GP Extra, GC) were examined. Specimens (n=3) were immersed in distilled water or lactic acid (pH 4.0) for 3 days. Bacterial growth and biofilm formation were recorded using optical density and SEM.ResultsUpon 3-day immersion in lactic acid, the surface of the sPRG-filled RBC revealed multiple holes, while virtually no change in surface integrity was observed for the conventional RBC and GIC. Bacterial growth measurements revealed that none of the materials inhibited Streptococcus mutans (p<0.05). Remarkably, cross-sectional SEM revealed that S. mutans had penetrated the etch pits induced by lactic acid in/around the sPRG filler. Ion-release measurements revealed that sPRG-filled RBC released boron and fluoride, while GIC only released fluoride. However, the concentration of ions released by both materials appeared not sufficient to inhibit bacterial growth. Moreover, the structural surface change and resultant increased surface roughness appeared to have promoted biofilm formation.SignificanceWhile having bioactive potential through ion release, the stability of surface integrity of bioactive materials is a key-parameter to be assessed with regard to their cariostatic potential.

http://ift.tt/2pkdqL7

Unbound monomers do diffuse through the dentin barrier

Publication date: Available online 29 April 2017
Source:Dental Materials
Author(s): Kods Mahdhaoui, Benjamin Fournier, Mathieu A. Derbanne
ObjectivesAssessing the role of dentinal fluid proteins in trans-dentinal diffusion of free monomers in vitro.MethodsAn artificial pulp chamber (APC) topped human dentin disks was used. A simplified two-step etch-and-rinse adhesive was formulated with 2-hydroethyl-methacrylate (HEMA), Bisphenol-A-diglycidyl-methacrylate (BisGMA), using Camphorquinone/tertiary amine as initiators. Two extraction media were used: buffered saline (Control), buffered saline with 1% bovine serum albumin (BSA). Samples were acid-etched, rinsed, air dried. Simplified primer was used, adhesive applied then light cured with a LED curing. Monomer diffusion was assessed by reverse phase HPLC.ResultsQuantifiable amounts of HEMA were detected in both extraction media while BisGMA was present in quantifiable amounts in BSA medium only. Diffused monomers concentrations were significantly higher for both monomers in BSA extraction medium.SignificanceAlbumin is sometimes referred to as taxi protein for its ability to bind and transport hydrophobic ligands. From our results, we hypothesized that albumin can also transport unbound monomers released from dental adhesive through the dentin barrier. However, dentinal fluid proteins like albumin could have significant effect on monomer diffusion through dentin to the dental pulp transporting highly hydrophobic molecules like BisGMA and enhancing diffusion of more hydrophilic ones like HEMA. These results demonstrate a new possible mechanism for cytotoxicity of resin monomers.

http://ift.tt/2qlXo1M

Spinal activation of the NPY Y1 receptor reduces mechanical and cold allodynia in rats with chronic constriction injury

Publication date: Available online 29 April 2017
Source:Peptides
Author(s): Mariana Malet, Candelaria Leiguarda, Guillermo Gastón, Carly McCarthy, Pablo Brumovsky
Neuropeptide tyrosine (NPY) and its associated receptors Y1R and Y2R have been previously implicated in the spinal modulation of neuropathic pain induced by total or partial sectioning of the sciatic nerve. However, their role in chronic constrictive injuries of the sciatic nerve has not yet been described. In the present study, we analyzed the consequences of pharmacological activation of spinal Y1R, by using the specific Y1R agonist Leu³¹Pro³⁴-NPY, in rats with chronic constriction injury (CCI). CCI and sham-injury rats were implanted with a permanent intrathecal catheter (at day 7 after injury), and their response to the administration of different doses (2.5, 5, 7, 10 or 20μg) of Leu³¹Pro³⁴-NPY (at a volume of 10μl) through the implanted catheter, recorded 14days after injury. Mechanical allodynia was tested by means of the up-and-down method, using von Frey filaments. Cold allodynia was tested by application of an acetone drop to the affected hindpaw. Intrathecal Leu³¹Pro³⁴-NPY induced an increase of mechanical thresholds in rats with CCI, starting at doses of 5μg and becoming stronger with higher doses. Intrathecal Leu³¹Pro³⁴ also resulted in reductions in the frequency of withdrawal to cold stimuli, although the effect was somewhat more moderate and mostly observed for doses of 7μg and higher. We thus show that spinal activation of the Y1R is able to reduce neuropathic pain due to a chronic constrictive injury and, together with other studies, support the use of a spinal Y1R agonist as a therapeutic agent against chronic pain induced by peripheral neuropathy.

http://ift.tt/2qsHF0f

Assessing the spatiotemporal dynamic of global grassland carbon use efficiency in response to climate change from 2000 to 2013

Publication date: May 2017
Source:Acta Oecologica, Volume 81
Author(s): Yue Yang, Zhaoqi Wang, Jianlong Li, Chencheng Gang, Yanzhen Zhang, Inakwu Odeh, Jiaguo Qi
The carbon use efficiency (CUE) of grassland, a ratio of net primary production (NPP) to gross primary productivity (GPP), is an important index representing the capacity of plants to transfer carbon from the atmosphere to terrestrial biomass. In this study, we used the Moderate Resolution Imaging Spectroradiometer (MODIS) data to calculate the global grassland CUE, and explore the spatiotemporal dynamic of global grassland CUE from 2000 to 2013 to discuss the response to climate variations. The results showed that the average annual CUE of different grassland types follows an order of: open shrublands > non-woody grasslands > closed shrublands > woody savannas > savannas. The higher grassland CUE mainly occurred in the regions with cold and dry climate. By contrast, the regions with the lower grassland CUE were mostly in warm and wet environments. Moreover, the CUE exhibited a globally positive correlation with precipitation and a negative correlation with temperature. Therefore, the grassland CUE has considerable spatial variation associated with grassland type, geographical location and climate change.

http://ift.tt/2qidZq7

Anti-inflammatory action of 2-carbomethoxy-2,3-epoxy-3-prenyl-1,4-naphthoquinone (CMEP-NQ) suppresses both the MyD88-dependent and TRIF-dependent pathways of TLR4 signaling in LPS-stimulated RAW264.7 cells

Publication date: Available online 30 April 2017
Source:Journal of Ethnopharmacology
Author(s): Hyun Ju Woo, Do Youn Jun, Ji Young Lee, Hae Sun Park, Mi Hee Woo, Sook Jahr Park, Sang Chan Kim, Chae Ha Yang, Young Ho Kim
Ethnopharmacological relevanceThe roots of Rubia cordifolia L. have been widely used as a traditional herbal medicine in Northeast Asia for treatment of inflammatory diseases.Aim of the studyTo elucidate the anti-inflammatory mechanism of 2-carbomethoxy-2,3-epoxy-3- prenyl-1,4-naphthoquinone (CMEP-NQ), purified from the roots of R. cordifolia L. as the major anti-inflammatory component, in LPS-treated RAW264.7 murine macrophage cells.Materials and methodsAnti-inflammatory activity of CMEP-NQ was investigated in LPS-treated RAW264.7 cells by measuring the levels of NO, PGE2, and cytokines (IL1β, IL-6, TNF-α) in the culture supernatants and the TLR4-mediated intracellular events including association of MyD88 with IRAK1, activation of IRAK1, TAK1, MAPKs, NF-κB/AP-1, and IRF3, and generation of ROS.ResultsPretreatment of RAW264.7 cells with CMEP-NQ reduced LPS-induced production of NO and PGE2 by suppressing iNOS and COX-2 gene expression. CMEP-NQ also reduced the secretion of IL-1β, IL-6, and TNF-α by down-regulating mRNA levels. Under these conditions, TLR4-mediated MyD88-dependent events were inhibited by CMEP-NQ, including the association of MyD88 with IRAK1, phosphorylation of IRAK1, TAK1, and MAPKs (ERK, JNK and p38 MAPK), and activation of NF-κB and AP-1. As TRIF-dependent events of TLR4 signaling, phosphorylation of IRF3 and induction of iNOS protein expression were also inhibited by CMEP-NQ. However, the binding of FITC-conjugated LPS to cell surface TLR4 was not influenced by CMEP-NQ. Following LPS stimulation, intracellular ROS production was first detected by DCFH-DA staining at 1h; thereafter, it continuously increased until 16h. Although CMEP-NQ failed to exhibit DPPH radical- or ABTS radical-scavenging activity in vitro, LPS-induced ROS production in RAW264.7 cells was more efficiently blocked by CMEP-NQ than by NAC.ConclusionsThese results demonstrate that the suppressive effect of CMEP-NQ on LPS-induced inflammatory responses in RAW264.7 cells was mainly exerted via its inhibitory function toward TLR4-mediated proximal events, such as MyD88-dependent NF-κB/AP-1 activation and ROS production, and TRIF-dependent IRF3 activation.

Graphical abstract

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Dalbergia odorifera extract promotes angiogenesis through upregulation of VEGFRs and PI3K/MAPK signaling pathways

Publication date: 23 May 2017
Source:Journal of Ethnopharmacology, Volume 204
Author(s): Zhu-Ming Fan, Da-Ying Wang, Jian-Mei Yang, Zhi-Xiu Lin, Yun-Xiao Lin, Ai-Lin Yang, Hua Fan, Min Cao, Su-yun Yuan, Zong-jun Liu, Xin Zhou, You-Hua Wang
Ethnopharmacological relevanceThe heart wood of Dalbergia odorifera is a Chinese herbal medicine commonly used for the treatment of various ischemic diseases in Chinese medicine practice.Aim of the studyIn this study, therapeutic angiogenesis effects of the Dalbergia odorifera extract (DOE) were investigated on transgenic zebrafish in vivo and human umbilical vein endothelial cells (HUVECs) in vitro.Materials and methodsThe pro-angiogenic effects of DOE on zebrafish were examined by subintestinal vessels (SIVs) sprouting assay and intersegmental vessels (ISVs) injury assay. And the pro-angiogenic effects of DOE on HUVECs were examined by MTT, scratch assay, protein chip and western blot.ResultsIn the in vivo studies, we found that DOE was able to dose-dependently promote angiogenesis in zebrafish SIVs area. In addition, DOE could also restore the injury in zebrafish ISVs area and upregulate the reduced mRNA expression of VEGFRs including kdr, kdrl and flt-1 induced by VEGF receptor kinase inhibitor II (VRI). In the in vitro studies, we observed that DOE promoted the proliferation, migration of HUVECs and also restored the injury induced by VRI. Moreover, protein chip and western blot experiments showed the PI3K/MAPK cell proliferation/migration pathway were activated by DOE.ConclusionsDOE has a therapeutic effects on angiogenesis, and its mechanism may be related to adjusting the VEGFRs mRNA and activation of PI3K/MAPK signaling pathway. These results suggest a strong potential for Dalbergia odorifera to be developed as an angiogenesis-promoting therapeutic.

Graphical abstract

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Danshen Injection Prevents Heart Failure by Attenuating Post-infarct Remodeling

Publication date: Available online 30 April 2017
Source:Journal of Ethnopharmacology
Author(s): Lingyan Wang, Jiahui Yu, Patrick Asare Fordjour, Xiaoxue Xing, Hui Gao, Yanyan Li, Lingyan Li, Yan Zhu, Xiumei Gao, Guanwei Fan
Ethnopharmacological relevanceDanshen Injection (DSI) is a traditional Chinese medicine extracted from Danshen, prepared from the dried root and rhizome of Salvia miltiorrhiza Bunge. Danshen is an ancient antipyretic traditional Chinese medicine which is mostly used to improve blood circulation and dispel blood stasis. Danshen decoction or liquor-fried Danshen (with grain-based liquor) which is cool in nature is traditionally used to 'cool the blood' and reduce the swelling of sores and abscesses.Aim of studyThe present study aimed to examine the effect and mechanism of DSI in LAD induced heart injury.Materials and methodsOne day after LAD surgery, adult male Sprague-Dawley rats were randomized to 3 groups: MI group; DSI group (1.5ml/kg/d, intramuscular); and Valsartan group (10mg/kg/d, intragastric). Echocardiography and hemodynamic measurements (Pressure-Volume loop) were performed to evaluate cardiac function. Pathological methods (Masson, and Sirus red staining) were used to check myocardial fibrosis. Western blotting assay was used to detect the protein expression of MMP-2. RT-PCR was used to detect the gene expression of MMP-9, MPO, iNOS, Bcl-2 and Bax.ResultsDSI administration to LAD rats resulted in improved cardiac functions, hemodynamic parameters and normalized ventricular mass. Furthermore, DSI-treated group demonstrated potential regulation of myocardial collagen I and III deposition associated with MMP-2 expression. Also, DSI administration decreased gene expression of iNOS, MPO and MMP-9, and increased Bcl-2/Bax ratio.ConclusionMyocardial fibrosis, cardiac hypertrophy, hemodynamic deterioration as well as systolic and diastolic dysfunctions which characterize a failing hearts were significantly prevented by DSI. Our study may provide future directions to focus on the anti-hypertrophic mechanisms of DSI and pathological roles played by MMP-2 in myocardial hypertrophy. Meanwhile, DSI also performed the effect of anti-inflammation by the way of decreasing iNOS and MPO. The way Danshen Injection increasing Bcl-2/Bax presented the possibility that it may has the effect of inhibiting cell death.

Graphical abstract

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Antioxidant and anti-inflammatory activities of the major phenolics from Zygophyllum simplex L

Publication date: Available online 29 April 2017
Source:Journal of Ethnopharmacology
Author(s): Hossam M. Abdallah, Ahmed Esmat
Ethnopharmacological relevanceZygophyllum simplex L. is a halophyte plant that follows Zygophyllaceae. The plant is growing in arid and semiarid regions. It has been used traditionally in Arabic region to treat gout, asthma and inflammation.Aim of studyAlthough ant-inflammatory activity has been reported for this plant, this study aimed to isolate and identify the major constituents of Zygophyllum simplex L., as well as assessing their antioxidant and anti-inflammatory activities in-vitro. In this study, the mechanism of anti-inflammatory activity of the isolated compounds was assessed.Materials and methodsDefatted fraction of the total methanol extract of the aerial parts of Z. simplex was repeatedly chromatographed on Diaion HP-20, polyamide, and RP18 columns to give five major phenolic compounds. The identity of the purified compounds was established by NMR experiments and comparing with previously known analogs. Moreover, the antioxidant and anti-inflammatory activities of the purified phenolics were investigated in-vitro through measuring of NFκB, PGE2, IL-6, IL-1β and TNF-α levels in human peripheral blood mononuclear cells (PBMC) stimulated with phytohaemagglutinin (PHA).ResultsPhytochemical investigation of the flowering aerial parts of Z. simplex resulted in isolation of five major metabolites identified as isorhamnetin-3-O-β-D-rutinoside (1), myricitrin (2), luteolin-7- O-β-D-glucoside (3), isorhamnetin-3-O-β-D-glucoside(4), and isorhamnetin (5). It is noteworthy to report that compounds 1–3 were isolated from the plant for the first time. It was reported that NFκB represents an important linkage between oxidative stress and inflammation. Compounds 2 and 3 have exhibited the highest antioxidant activity and showed the most efficient in decreasing NFκB p65 at the lowest concentration (1µM). Moreover; at 1µM concentrations, only compounds 2 and 3 significantly decreased IL-6, IL-1β and TNF-α levels from PHA treatment. Nevertheless, at 100µM, all isolated metabolites significantly decreased IL-6 compared to PHA treatment.ConclusionFive major phenolic compounds were isolated from Z. simplex. Anti-inflammatory activity exhibited by the isolated compounds augment the traditional use of this plant as anti-inflammatory. The effect was mediated via inhibition of NFκB through antioxidant mechanism and subsequent inhibition to other inflammatory mediators like TNF-α, IL-1β and IL-6.

Graphical abstract

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Developing a stable point: Evaluating the temporal and geographic consistency of Late Prehistoric unnotched triangular point functional design in Midwestern North America

Publication date: September 2017
Source:Journal of Anthropological Archaeology, Volume 47
Author(s): Michelle Rae Bebber, Stephen J. Lycett, Metin I. Eren
The occurrence of unnotched triangular points is exceptional in the North American archaeological record. The study of these items can shed light on selective forces that influence the evolution of prehistoric weaponry, especially that which involves small stone tipped projectiles, which is itself a global phenomenon during the late Pleistocene and continuing throughout the Holocene. Following Engelbrecht's (2015) analysis of points from the Eaton site (1550 CE) in western New York, we assessed potential functional–design characteristics of a large sample of complete and broken unnotched-triangular points from Blain Village, Ohio, an archaeological context several centuries older than, and approximately 550km southwest of, the Eaton site. We compared our archaeological results to patterns of both experimental point breakage and practical morphometric thresholds for successfully hunting deer. Our results showed that the complete Blain points possessed on average significantly lower length-to-width ratios and significantly higher thickness-to-length ratios relative to the broken ones. Moreover, all points – complete and broken – possessed basal widths under 5cm and maximum thicknesses under 1.1cm. These results are consistent with the hypothesis that Late Prehistoric points were designed to effectively penetrate the thoracic cavity of a deer, as well as potentially cause greater trauma during warfare through breakage. Moreover, given that these results are fully consistent with Engelbrecht's (2015) analysis from the Eaton site, our results indicate that there was a broad, strong selective pressure (i.e., functionally related biases) driving the design stability of unnotched triangular points across the Midwest for an extended period. The principles and methods we use are broadly applicable, especially in terms of using quantitative information derived from experiments to guide our understanding of factors influencing morphometric variation in archaeological points.

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Shellfish, water, and entanglements: Inter-community interaction and exchange in the Huanangue Valley, Peru

Publication date: September 2017
Source:Journal of Anthropological Archaeology, Volume 47
Author(s): Kasia Szremski
Though there is a wide and diverse body of literature on interaction theory in the social sciences, it is only recently that the economic, political, and cultural implications of interaction have been studied in ancient Andean societies. This paper explores the outcomes of interaction between Chancay settlers and local chaupiyunginos in the Huanangue Valley, Peru, during the Late Intermediate Period (1100–1470 CE). Drawing from entanglement theory—which explores the complex types of relationships that develop between groups when exotic goods are inserted into local systems of value (Dietler, 1998, 2010; Hodder, 2012)—I argue that intergroup exchange and resource sharing could draw small scale groups living on the western slopes of the Andes into webs of interdependency. Using a combination of ethnohistoric and archaeological data, I argue that Chancay colonists became entangled with local chaupiyunginos due to the Chancay's need for irrigation water and the chaupiyungino's desire for marine goods. Furthermore, though many cases of entanglement lead to one group being subjugated by the other, the Chancay's economic power and the chaupiyungino's tactical power may have prevented this from happening.

http://ift.tt/2pjMVFK

Pain-motor integration in the primary motor cortex in Parkinson’s disease

Publication date: Available online 30 April 2017
Source:Brain Stimulation
Author(s): A. Suppa, C. Leone, F. Di Stasio, L. Marsili, A. Di Santo, A. Biasiotta, S. La Cesa, A. Truini, G. Cruccu, A. Berardelli
BackgroundIn Parkinson's disease (PD), the influence of chronic pain on motor features has never been investigated. We have recently designed a technique that combines nociceptive system activation by laser stimuli and primary motor cortex (M1) activation through transcranial magnetic stimulation (TMS), in a laser-paired associative stimulation design (Laser-PAS). In controls, Laser-PAS induces long-term changes in motor evoked potentials reflecting M1 long-term potentiation-like plasticity, arising from pain-motor integration.ObjectiveWe here examined the possible influence of chronic pain on motor responses to Laser-PAS in patients with PD, with and without chronic pain.MethodsWe compared motor responses to Laser-PAS in healthy subjects and in patients with PD, with and without chronic pain.ResultsUnlike controls, we found reduced responses to Laser-PAS in patients with PD, with and without pain. Patients off and on dopaminergic therapy had similar responses to Laser-PAS. When comparing responses to Laser-PAS in patients with and without pain, the two patients' subgroups had similar abnormalities. When we compared patients with pain in the body region investigated with Laser-PAS, with those with pain in other body regions, we found prominent changes in patients with homotopic pain. Finally, when comparing Laser-PAS with the original PAS protocol, which combines electric peripheral nerve stimuli and TMS, in patients without pain and those with homotopic pain, we found similar responses to both techniques in patients without pain, whereas Laser-PAS induced greater abnormalities than PAS in patients with pain.ConclusionsIn PD, chronic pain degrades response to Laser-PAS through abnormal pain-motor integration.

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On the effectiveness of event-related beta tACS on episodic memory formation and motor cortex excitability

Publication date: Available online 30 April 2017
Source:Brain Stimulation
Author(s): Verena Braun, Rodika Sokoliuk, Simon Hanslmayr
BackgroundTranscranial alternating current stimulation (tACS) is widely used to entrain or modulate brain oscillations in order to investigate causal relationships between oscillations and cognition.ObjectiveIn a series of experiments we here addressed the question of whether event-related, transient tACS in the beta frequency range can be used to entrain beta oscillations in two different domains: episodic memory formation and motor cortex excitability.MethodsIn experiments 1 and 2, 72 healthy human participants engaged in an incidental encoding task of verbal and non-verbal material while receiving tACS to the left and right inferior frontal gyrus (IFG) at 6.8Hz, 10.7Hz, 18.5Hz, 30Hz, 48Hz and sham stimulation for 2s during stimulus presentation.In experiment 3, tACS was administered for 10s to M1 at the individual motor beta frequency of eight subjects. We investigated the relationship between the size of TMS induced MEPs and tACS phase.ResultsBeta tACS did not affect memory performance compared to sham stimulation in experiments 1 and 2. Likewise, in experiment 3, MEP size was not modulated by the tACS phase.ConclusionsOur findings suggest that event-related, transient tACS in the beta frequency range cannot be used to modulate the formation of episodic memories or motor cortex excitability. These null-results question the effectiveness of event-related tACS to entrain beta oscillations and modulate cognition.

http://ift.tt/2oY4Q2c

Comparison and evaluation of risk factors for meningeal, pleural, and extrapleural solitary fibrous tumors: A clinicopathological study of 92 cases confirmed by STAT6 immunohistochemical staining

Publication date: Available online 29 April 2017
Source:Pathology - Research and Practice
Author(s): Ji Min Kima, Yoon-La Choia, Hyung Kyu Parka
Solitary fibrous tumors (SFTs) are an uncommon type of mesenchymal tumors that are presumably fibroblastic in nature. SFTs are translocation-associated neoplasms that can be consistently diagnosed through the evaluation of NAB2/STAT6 gene fusion. Currently, SFTs have a different grading system and criteria according to their primary sites, and the differences and similarities in SFTs according to their primary sites are still poorly understood. Therefore, we compared SFTs according to their primary sites and histologic appearance, and validated the current grading system of SFTs.A total of 92 patients (with 15 meningeal, 30 pleural, and 37 extrapleural SFTs) were evaluated. The patients with pleural SFTs (mean age: 60.2 years) showed a significantly increased age at diagnosis. Tumors with hemangiopericytoma-predominant morphology had significantly higher grades in the evaluation of several risk factors such as cellularity (P<0.001), pleomorphism (P=0.001), and mitotic activity (P<0.001). Consequently, hemangiopericytoma (HPC)-predominant tumors had a significantly higher recurrence rate. The meningeal SFT group had significantly higher proportion of the HPC-predominant histologic phenotype compared with pleural or extrapleural SFTs (66.67% vs. 5.00% or 18.92%, respectively; P<0.001). Consequently, meningeal SFTs showed significantly higher recurrence rates compared with pleural or extrapleural SFTs (33.33% vs. 12.50% or 2.70%, respectively; P=0.009). Regarding the evaluation of risk factors, a tumor size ≥10cm (P=0.017), a mitotic index ≥4/10 high power fields (HPFs) (P=0.001), high tumor cellularity (P=0.003), high nuclear pleomorphism (P=0.005), and tumor necrosis (P=0.004) were associated with both recurrence and disease-specific mortality. Upon evaluation of the usefulness of the criteria using previously described factors, the predictive model was on the borderline of validation. Of the five factors indicated in the log rank test, only a mitotic index ≥4/10 HPFs remained a significant factor in the multivariate Cox model.

Graphical abstract

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High temporal resolution modelling of environmentally-dependent seabird ammonia emissions: Description and testing of the GUANO model

Publication date: July 2017
Source:Atmospheric Environment, Volume 161
Author(s): S.N. Riddick, T.D. Blackall, U. Dragosits, Y.S. Tang, A. Moring, F. Daunt, S. Wanless, K.C. Hamer, M.A. Sutton
Many studies in recent years have highlighted the ecological implications of adding reactive nitrogen (Nr) to terrestrial ecosystems. Seabird colonies represent a situation with concentrated sources of Nr, through excreted and accumulated guano, often occurring in otherwise nutrient-poor areas. To date, there has been little attention given to modelling N flows in this context, and particularly to quantifying the relationship between ammonia (NH3) emissions and meteorology. This paper presents a dynamic mass-flow model (GUANO) that simulates temporal variations in NH3 emissions from seabird guano. While the focus is on NH3 emissions, the model necessarily also treats the interaction with wash-off as far as this affects NH3. The model is validated using NH3 emissions measurements from seabird colonies across a range of climates, from sub-polar to tropical. In simulations for hourly time-resolved data, the model is able to capture the observed dependence of NH3 emission on environmental variables. With temperature and wind speed having the greatest effects on emission for the cases considered. In comparison with empirical data, the percentage of excreted nitrogen that volatilizes as NH3 is found to range from 2% to 67% (based on measurements), with the GUANO model providing a range of 2%–82%. The model provides a tool that can be used to investigate the meteorological dependence of NH3 emissions from seabird guano and provides a starting point to refine models of NH3 emissions from other sources.

http://ift.tt/2pjsVD0

Inflammatory Disequilibrium in Stroke.

Inflammatory Disequilibrium in Stroke.

Circ Res. 2016 Jun 24;119(1):142-58

Authors: Petrovic-Djergovic D, Goonewardena SN, Pinsky DJ

Abstract
Over the past several decades, there have been substantial advances in our knowledge of the pathophysiology of stroke. Understanding the benefits of timely reperfusion has led to the development of thrombolytic therapy as the cornerstone of current management of ischemic stroke, but there remains much to be learned about mechanisms of neuronal ischemic and reperfusion injury and associated inflammation. For ischemic stroke, novel therapeutic targets have continued to remain elusive. When considering modern molecular biological techniques, advanced translational stroke models, and clinical studies, a consistent pattern emerges, implicating perturbation of the immune equilibrium by stroke in both central nervous system injury and repair responses. Stroke triggers activation of the neuroimmune axis, comprised of multiple cellular constituents of the immune system resident within the parenchyma of the brain, leptomeninges, and vascular beds, as well as through secretion of biological response modifiers and recruitment of immune effector cells. This neuroimmune activation can directly impact the initiation, propagation, and resolution phases of ischemic brain injury. To leverage a potential opportunity to modulate local and systemic immune responses to favorably affect the stroke disease curve, it is necessary to expand our mechanistic understanding of the neuroimmune axis in ischemic stroke. This review explores the frontiers of current knowledge of innate and adaptive immune responses in the brain and how these responses together shape the course of ischemic stroke.

PMID: 27340273 [PubMed - indexed for MEDLINE]

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"Oncol Lett"[jour]; +267 new citations

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[PET-CT in head and neck cancer].

[PET-CT in head and neck cancer].

HNO. 2017 Apr 27;:

Authors: Send T, Kreppel B, Gaertner FC, Bundschuh RA, Strunk H, Bootz F, Essler M

Abstract
The importance of (18)F-fluorodesoxyglucose positron-emission tomography (FDG-PET) for the diagnosis of malignant disease is increasing. On one hand, this is due to the high sensitivity of this method, on the other, because the entire body can be examined. FDG-PET can be particularly advantageous for the diagnosis of head and neck tumors, where tumor staging is an important prognostic parameter and essentially determines the therapeutic regimen. This article presents the different possibilities for combined evaluation with PET and computed tomography (CT) for the diagnosis of patients with head and neck cancer. Special focus is placed on primary staging and tumor follow-up, as well as on the role of PET-CT in the diagnosis of patients with cancer of unknown primary origin (CUP). The use of PET-CT for radiotherapy planning and new aspects of PET technology are also discussed.

PMID: 28451717 [PubMed - as supplied by publisher]

http://ift.tt/2oXL9at

[88th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery : With good hearing and without vertigo through everyday life-but how?]

[88th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery : With good hearing and without vertigo through everyday life-but how?]

HNO. 2017 May;65(5):360-361

Authors: Eßer D, Rosahl S, Plontke S

PMID: 28455592 [PubMed - in process]

http://ift.tt/2oXL9qZ

Corrigendum.

Corrigendum.

Minim Invasive Ther Allied Technol. 2017 Apr 28;:1

Authors:

PMID: 28452239 [PubMed - as supplied by publisher]

http://ift.tt/2pL73SH

Update HNO.

Update HNO.

HNO. 2017 May;65(5):358-359

Authors:

PMID: 28455593 [PubMed - in process]

http://ift.tt/2pjoKqI

[APHAB scores for individual assessment of the benefit of hearing aid fitting].

[APHAB scores for individual assessment of the benefit of hearing aid fitting].

HNO. 2017 Apr 28;:

Authors: Löhler J, Wollenberg B, Schönweiler R

Abstract
OBJECTIVE: The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment on four different subscales pertaining to different listening situations. Using a very large patient cohort, this study aims to show how answers are distributed within the four subscales before and after hearing aid fitting, and what benefit the patients experience. The results are discussed on the basis of the available literature.
PATIENTS AND METHODS: Between April 2013 and March 2016, 35,000 APHAB questionnaires from nine German statutory health insurance providers were evaluated. The average values before and after hearing aid fitting, as well as the benefit, were determined for all four APHAB subscales and analyzed graphically.
RESULTS: The results of the subjective evaluation of hearing impairment before and after hearing aid fitting and the resultant benefit were plotted by percentile distribution graphs and boxplots. The data were analyzed statistically. There was no overlap of the interquartile ranges before and after hearing aid fitting in any of the APHAB subscales. In three scales (EC, BN and RV), the median improvement after hearing aid fitting was nearly 30 percentage points. In the AV subscale, this value was slightly negative.
DISCUSSION: The percentile distribution graphs used in this study allow individual evaluation of subjective hearing impairment before and after hearing aid fitting, as well as of the resultant benefit, on the background of a huge database. Additionally, it is demonstrated why presentation as boxplots and the average benefit values calculated from these is problematic.

PMID: 28455538 [PubMed - as supplied by publisher]

http://ift.tt/2oXOGFZ

[Interventional radiology in the head and neck region].

[Interventional radiology in the head and neck region].

HNO. 2017 Apr 27;:

Authors: Mayer C, Hattingen E, Schild H, Bootz F, Schröck A

Abstract
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material. Indications for endovascular embolization are i. otherwise unmanageable bleeding (caused by e. g., trauma, vascular malformation, or tumor), ii. reduction of perioperative bleeding by preoperative embolization in case of a hypervascularized tumor, iii. selective induction of tumor necrosis by palliative embolization to enhance local tumor control. Major complications such as stroke, loss of vision, and cranial nerve palsy are mostly due to a lack of preinterventional evaluation. Regarding neurological deficits, interventions within the supply region of the external carotid artery have a complication rate below 1%.

PMID: 28451716 [PubMed - as supplied by publisher]

http://ift.tt/2ql8fsH

[Imaging in otorhinolaryngology].

[Imaging in otorhinolaryngology].

HNO. 2017 Apr 27;:

Authors: Bootz F

PMID: 28451715 [PubMed - as supplied by publisher]

http://ift.tt/2pjkqrM

Asymptomatic medial vocal fold hemorrhagic polyp.

Asymptomatic medial vocal fold hemorrhagic polyp.

Ear Nose Throat J. 2016 Jun;95(6):210

Authors: Kantarcioglu OE, Rutt AL, Sataloff RT

PMID: 27304436 [PubMed - indexed for MEDLINE]

http://ift.tt/2qs0sJ1

Low 22-Item Sinonasal Outcome Test Scores in Chronic Rhinosinusitis: Why Do Patients Seek Treatment?

Low 22-Item Sinonasal Outcome Test Scores in Chronic Rhinosinusitis: Why Do Patients Seek Treatment?

Am J Rhinol Allergy. 2017 Mar 01;31(2):142

Authors: Amedee RG

PMID: 28452712 [PubMed - in process]

http://ift.tt/2pupQ1i

Expression and clinical significance of YAP in laryngeal squamous cell carcinoma patients.

Expression and clinical significance of YAP in laryngeal squamous cell carcinoma patients.

Oncol Lett. 2017 Mar;13(3):1311-1314

Authors: Qiu S, Xia Z, Li Q, Ye D, Huang Q, Shen Z

Abstract
The aim of the present study was to investigate the expression levels of Yes-associated protein (YAP) in different grades of laryngeal squamous cell carcinoma (LSCC) tissues and vocal cord polyps tissues, and to investigate any correlations with clinical factors. The expression of YAP in 128 cases of LSCC and 10 cases of vocal cord polyps tissues was tested using immunohistochemistry. YAP was primarily present in the nucleus of LSCC and controls, whereas phosphorylated YAP expression was present in the cytoplasm. The results indicated that YAP expression was upregulated in LSCC samples compared with vocal cord polyps tissues. YAP expression was positively correlated with the malignant degree of LSCC (P<0.01) and a high level of YAP expression in LSCC tissues was correlated with pathological type, lymphatic metastasis and clinical stage. The present study provided evidence for the expression and localization of YAP in LSCC and vocal cord polyps tissues. Thus, YAP may be involved in the occurrence and development of LSCC as an oncogene.

PMID: 28454253 [PubMed - in process]

http://ift.tt/2pu606t

Distinct Actions of Voltage-Activated Ca(2+) Channel Block on Spontaneous Release at Excitatory and Inhibitory Central Synapses.

Distinct Actions of Voltage-Activated Ca(2+) Channel Block on Spontaneous Release at Excitatory and Inhibitory Central Synapses.

J Neurosci. 2017 Apr 19;37(16):4301-4310

Authors: Tsintsadze T, Williams CL, Weingarten DJ, von Gersdorff H, Smith SM

Abstract
At chemical synapses, voltage-activated calcium channels (VACCs) mediate Ca(2+) influx to trigger action potential-evoked neurotransmitter release. However, the mechanisms by which Ca(2+) regulates spontaneous transmission have not been fully determined. We have shown that VACCs are a major trigger of spontaneous release at neocortical inhibitory synapses but not at excitatory synapses, suggesting fundamental differences in spontaneous neurotransmission at GABAergic and glutamatergic synapses. Recently, VACC blockers were reported to reduce spontaneous release of glutamate and it was proposed that there was conservation of underlying mechanisms of neurotransmission at excitatory and inhibitory synapses. Furthermore, it was hypothesized that the different effects on excitatory and inhibitory synapses may have resulted from off-target actions of Cd(2+), a nonselective VACC blocker, or other variations in experimental conditions. Here we report that in mouse neocortical neurons, selective and nonselective VACC blockers inhibit spontaneous release at inhibitory but not at excitatory terminals, and that this pattern is observed in culture and slice preparations as well as in synapses from acute slices of the auditory brainstem. The voltage dependence of Cd(2+) block of VACCs accounts for the apparent lower potency of Cd(2+) on spontaneous release of GABA than on VACC current amplitudes. Our findings indicate fundamental differences in the regulation of spontaneous release at inhibitory and excitatory synapses by stochastic VACC activity that extend beyond the cortex to the brainstem.SIGNIFICANCE STATEMENT Presynaptic Ca(2+) entry via voltage-activated calcium channels (VACCs) is the major trigger of action potential-evoked synaptic release. However, the role of VACCs in the regulation of spontaneous neurotransmitter release (in the absence of a synchronizing action potential) remains controversial. We show that spontaneous release is affected differently by VACCs at excitatory and inhibitory synapses. At inhibitory synapses, stochastic openings of VACCs trigger the majority of spontaneous release, whereas they do not affect spontaneous release at excitatory synapses. We find this pattern to be wide ranging, holding for large and small synapses in the neocortex and brainstem. These findings indicate fundamental differences of the Ca(2+) dependence of spontaneous release at excitatory and inhibitory synapses and heterogeneity of the mechanisms of release across the CNS.

PMID: 28320843 [PubMed - indexed for MEDLINE]

http://ift.tt/2qrXQe7

Gain Control in the Auditory Cortex Evoked by Changing Temporal Correlation of Sounds.

https:--academic.oup.com-images-oup_pubm

Gain Control in the Auditory Cortex Evoked by Changing Temporal Correlation of Sounds.

Cereb Cortex. 2017 Mar 01;27(3):2385-2402

Authors: Natan RG, Carruthers IM, Mwilambwe-Tshilobo L, Geffen MN

Abstract
Natural sounds exhibit statistical variation in their spectrotemporal structure. This variation is central to identification of unique environmental sounds and to vocal communication. Using limited resources, the auditory system must create a faithful representation of sounds across the full range of variation in temporal statistics. Imaging studies in humans demonstrated that the auditory cortex is sensitive to temporal correlations. However, the mechanisms by which the auditory cortex represents the spectrotemporal structure of sounds and how neuronal activity adjusts to vastly different statistics remain poorly understood. In this study, we recorded responses of neurons in the primary auditory cortex of awake rats to sounds with systematically varied temporal correlation, to determine whether and how this feature alters sound encoding. Neuronal responses adapted to changing stimulus temporal correlation. This adaptation was mediated by a change in the firing rate gain of neuronal responses rather than their spectrotemporal properties. This gain adaptation allowed neurons to maintain similar firing rates across stimuli with different statistics, preserving their ability to efficiently encode temporal modulation. This dynamic gain control mechanism may underlie comprehension of vocalizations and other natural sounds under different contexts, subject to distortions in temporal correlation structure via stretching or compression.

PMID: 27095823 [PubMed - indexed for MEDLINE]

http://ift.tt/2pxieNA

Office-based rhinologic surgery: A modern experience with operative techniques under local anesthetic.

Office-based rhinologic surgery: A modern experience with operative techniques under local anesthetic.

Am J Rhinol Allergy. 2017 Mar 01;31(2):135-138

Authors: Scott JR, Sowerby LJ, Rotenberg BW

Abstract
BACKGROUND: Office-based rhinologic procedures have become popularized in recent years with the advent of several minimally invasive techniques. There is a paucity of literature, however, that supports more robust in-clinic procedures, e.g., true endoscopic sinus surgery (ESS). There is a high volume of this work being done at our center, and the objective of this article was to review the safety and tolerability of in-clinic surgeries.
METHODS: A retrospective chart review was conducted. All the adult patients who underwent in-clinic sinonasal procedures and surgery with a minimum of 3 months of follow-up were included. Information regarding intra- and postoperative complications and revision procedures were recorded. For the ESS procedures, the indication, sinuses operated on, and type of revision were also collected.
RESULTS: A total of 315 patients met the inclusion criteria. There were 166 turbinoplasties, 118 ESS, 35 septoplasties, 34 rhinoplasties, and 4 septorhinoplasties performed. For the ESS procedures, 74 (62.7%) were bilateral, and experience was had operating in all paranasal sinuses. All ESS work involved opening diseased ostia and was more than just polypectomies. The mean follow-up for the ESS cases was 13.4 months (range, 12-65 months). Complication rates and tolerability measures were comparable with those of other reported in-office sinonasal procedures performed with the patient under local anesthetic.
CONCLUSION: Office-based rhinologic surgery was safe and well tolerated by the patients. The need for revision ESS in our series was low when considering the extent of surgery that was performed. An in-clinic procedure may avoid a general anesthetic in the operating room for appropriately selected patients.

PMID: 28452711 [PubMed - in process]

http://ift.tt/2pupEiR

Excavating meningoencephaloceles: A newly recognized entity.

Excavating meningoencephaloceles: A newly recognized entity.

Am J Rhinol Allergy. 2017 Mar 01;31(2):127-134

Authors: Loftus PA, Wise SK, Daraei P, Baugnon K, DelGaudio JM

Abstract
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner.
OBJECTIVE: To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence.
METHODS: A retrospective review was performed at a tertiary care rhinology practice to identify a subset of CSF leak patients with an excavating/canal-like skull base defect visualized radiographically on computed tomography (CT) scan or magnetic resonance imaging and/or endoscopically in the operating room.
RESULTS: The cohort of patients consisted of 7 females and 1 male with an average age of 53.6 years and a self-reported race of 4:3:1 African-American:Caucasian:Indian. All patients presented with CSF rhinorrhea. The most common leak site was the cribriform and upper septum. Six of the 8 patients had multiple defects and/or progression of their skull base defects, and 5 patients required multiple and/or repeat repairs in the operating room. Seven of the 8 patients underwent a cisternogram because the excavating nature of the leaks made it difficult to identify the specific leak site on high-resolution CT scan alone.
CONCLUSION: In spontaneous CSF leaks that are difficult to identify or recur soon after a proper repair, an excavating pattern should be considered. Failure to recognize this type of leak and all of its tributaries, to fully unroof the excavated bone to completely resect the meningocele, and to visualize and close the site of origin will likely result in failure and recurrence of CSF leak.

PMID: 28452710 [PubMed - in process]

http://ift.tt/2oUO17h

Effect of doxycycline on epithelial-mesenchymal transition via the p38/Smad pathway in respiratory epithelial cells.

Effect of doxycycline on epithelial-mesenchymal transition via the p38/Smad pathway in respiratory epithelial cells.

Am J Rhinol Allergy. 2017 Mar 01;31(2):71-77

Authors: Shin JM, Kang JH, Lee SA, Park IH, Lee HM

Abstract
PURPOSE: Doxycycline has antibacterial and anti-inflammatory effects, and it also suppresses collagen biosynthesis. This study aimed to confirm the effects and mechanism of doxycycline on transforming growth factor (TGF) beta 1 induced epithelial-mesenchymal transition and cell migration in A549 and primary nasal epithelial cells.
METHODS: A 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide assay and phalloidin-fluorescein isothiocyanate staining were used to evaluate cytotoxicity and cellular morphologic changes. Western blot and immunofluorescence staining were used to determine the expression levels of E-cadherin, vimentin, alpha-smooth muscle actin, fibronectin, phosphorylated Smad2/3, and mitogen-activated protein kinases. Scratch and transwell migration assays were used to assess cellular migration ability.
RESULTS: Doxycycline (0-10 μg/mL) had no significant cytotoxic effects in A549 and primary nasal epithelial cells. Increased expression of mesenchymal markers, including vimentin, alpha-smooth muscle actin, and fibronectin in TGF beta 1 induced A549 cells were downregulated by doxycycline treatment. In contrast, E-cadherin expression was upregulated in TGF beta 1 induced A549 cells. An in vitro cell migration assay showed that doxycycline also inhibited the ability of TGF beta 1 induced migration. Doxycycline treatment suppressed the activation of Smad2/3 and p38, whereas its inhibitory effects were similar to each element-specific inhibitor in A549 and primary nasal epithelial cells.
CONCLUSION: Doxycycline inhibited TGF beta 1 induced epithelial-to-mesenchymal transition and migration by targeting Smad2/3 and p38 signal pathways in respiratory epithelial cells.

PMID: 28452702 [PubMed - in process]

http://ift.tt/2pufVJf

21st century rhinology.

21st century rhinology.

Am J Rhinol Allergy. 2017 Mar 01;31(2):69-70

Authors: Citardi MJ

PMID: 28452701 [PubMed - in process]

http://ift.tt/2pu2eu4

The use of polydioxanone plates for endoscopic skull base repair.

The use of polydioxanone plates for endoscopic skull base repair.

Am J Rhinol Allergy. 2017 Mar 01;31(2):122-126

Authors: Al-Asousi F, Okpaleke C, Dadgostar A, Javer A

Abstract
BACKGROUND: Many reconstructive techniques and materials have been reported for repair of skull base defects after sinonasal tumor excision, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone. Synthetic materials have been developed for endoscopic skull base repair to avoid donor-site morbidity. Polydioxanone plate is a bioabsorbable implant designed for nasal septal reconstruction and has the ability to retain strength for at least 10 weeks and absorbs in 6 months.
OBJECTIVES: This study aimed to describe the use of polydioxanone plates in endoscopic skull base defect and CSF leak repair, and to describe our experience with the surgical technique and postoperative management.
METHODS: This was a retrospective case series of patients who, between May 2013 and December 2015, underwent endoscopic sinus surgery and skull base repair for CSF leak or after excision of a skull base tumor by using polydioxanone plates. Patients who presented with sinonasal inflammatory disease or skull base tumors underwent endoscopic skull base repair by using polydioxanone plates in an underlay fashion and mucosal membrane grafts with or without adjuvant materials in an overlay fashion. The patients were reviewed at 6 days, 6 weeks, and 3 months after surgery. Postoperative adverse events, including CSF leak, infection, bleeding, headache, and graft failure, were recorded.
RESULTS: The cases of seven patients (five women, two men; mean age, 53.9 years) were reviewed. Five patients underwent sinonasal tumor resection and two underwent repair for CSF leak. The mean (standard deviation) defect size was 16.4 ± 11.4 mm. There was no evidence of postoperative CSF leak, and lumbar drains were not used. One patient reported transient headache and facial pressure at the 6-week follow-up visit. The surgeons' experience with polydioxanone plate placement, postoperative healing, and follow-up was satisfactory.
CONCLUSION: Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.

PMID: 28452709 [PubMed - in process]

http://ift.tt/2oUDuJp

Evolution of sinonasal symptoms and mucosal healing after minimally invasive pituitary surgery.

Evolution of sinonasal symptoms and mucosal healing after minimally invasive pituitary surgery.

Am J Rhinol Allergy. 2017 Mar 01;31(2):117-121

Authors: Chaudhry S, Chaudhry S, Qureshi T, Batra PS

Abstract
BACKGROUND: Minimally invasive pituitary surgery (MIPS) via endoscopy has become widely accepted as the surgical paradigm of choice for pituitary pathology. The objective of the current study was to analyze the evolution of symptom scores and mucosal healing after MIPS.
METHODS: The 22-item Sino-Nasal Outcome Test (SNOT-22) scores and objective endoscopic data of 52 patients were reviewed in a longitudinal manner. Scaled averages of the SNOT-22 and endoscopic scores from different time points were compared with baseline scores by using nonparametric testing. The time to baseline for endoscopic examinations was also analyzed by using Kaplan-Meier curves.
RESULTS: The rhinologic symptoms subdomain of the SNOT-22 scores showed statistically significant worsening between baseline and 2 weeks after surgery (p = 0.03). Follow-up SNOT-22 scores after 2 weeks showed no significant differences compared with baseline scores, with an overall trend toward improvement in patient symptoms during the subsequent period. Similar analysis for the endoscopic data illustrated statistically significant differences from the baseline scores up to 16 weeks after surgery. The overall trend showed a worsened endoscopic examination, initially with a spike at ∼8 to 10 weeks (p = 0.03) and with a subsequent return to baseline. The Kaplan-Meier estimate curve demonstrated a median time to return to baseline endoscopy at 18.9 weeks (95% confidence interval, 14.9-38.3 weeks).
CONCLUSION: The longitudinal data exhibited subjective improvement of patient outcomes based on SNOT-22 scores within 2-4 weeks after MIPS. However, the objective endoscopic data revealed a lag in improvement of the examination, typically at 16-20 weeks, which underscores ongoing careful endoscopic assessment and management to ensure proper mucosal healing beyond just subjective symptoms as the gauge to postoperative recovery.

PMID: 28452708 [PubMed - in process]

http://ift.tt/2pudnuP

Complete surgical resection and short-term survival in acute invasive fungal rhinosinusitis.

Complete surgical resection and short-term survival in acute invasive fungal rhinosinusitis.

Am J Rhinol Allergy. 2017 Mar 01;31(2):109-116

Authors: Roxbury CR, Smith DF, Higgins TS, Lee SE, Gallia GL, Ishii M, Lane AP, Reh DD

Abstract
BACKGROUND: Acute invasive fungal rhinosinusitis (AIFR) is a fulminant fungal infection seen in patients who are immunocompromised. Due to its rarity, there is little evidence regarding the appropriate antifungal treatment regimen, especially the degree of surgical intervention.
OBJECTIVE: To assess factors that impact short-term survival in AIFR as defined by survival to hospital discharge and to develop a staging system to predict survival and complete surgical resection.
METHODS: Fifty-four patients with histopathologically diagnosed AIFR who met inclusion criteria were identified between 1984 and 2014. Patient characteristics, disease extent, treatment modality, and short-term survival data were collected. Univariate analysis was performed to assess for factors associated with survival and increased likelihood of surgical resection.
RESULTS: Of 52 patients with adequate documentation, 36 (69.2%) survived their hospital stay. Complete surgical resection was the only factor associated with improved survival (survival, 95.5%; p < 0.01). A surgical staging system was proposed to guide probability of complete resection and overall prognosis, with stage I disease limited to the nasal cavity, stage II involving the paranasal sinuses, stage III involving the orbit, and stage IV with skull base or intracranial extension. The χ2 analyses showed a decreased likelihood of complete surgical resection with stage III or IV disease compared with stage I (resection, 90.9%) (stage III resection, 37.5% [p = 0.01]; stage IV resection, 16.7% [p = 0.002]). There was a decreased likelihood of survival associated with increasing disease stage compared with stage I (survival, 100%) (stage II survival, 60% [p = 0.009]; stage III survival, 62.5% [p = 0.02]; stage IV survival, 54.6%, [p = 0.006]).
CONCLUSION: Although further studies are needed to define specific treatment protocols, analysis of these data indicated that endoscopic sinus surgery with the goal of complete surgical resection may provide the best survival outcomes in select patients when complete surgical resection can be performed. Our staging system represents the first attempt to predict surgical success and prognosis in patients with AIFR.

PMID: 28452707 [PubMed - in process]

http://ift.tt/2oUKqpJ

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 30 Απριλίου 2017

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