Reply to “Need for updating safety recommendations on repetitive transcranial magnetic stimulation in stroke patients”

Publication date: Available online 3 June 2017
Source:Clinical Neurophysiology
Author(s): Ela B. Plow, Vishwanath Sankarasubramanian, Kelsey A. Potter-Baker, Yin-Liang Lin




http://ift.tt/2soOZM6

Need for updating safety recommendations on repetitive transcranial magnetic stimulation in stroke patients

Publication date: Available online 3 June 2017
Source:Clinical Neurophysiology
Author(s): Bertrand Glize, Dominique Guehl, Mélanie Cogné




http://ift.tt/2rPyfRa

Movat Pentachrom stain reveals unexpected high osteogenesis rate in aortic valves

Publication date: Available online 2 June 2017
Source:Acta Histochemica
Author(s): Claudia Dittfeld, Michael Haase, Maria Feilmeier, Anett Jannasch, Petra Büttner, Katrin Plötze, Thomas Waldow, Sems-Malte Tugtekin
Background and aim of the studyAortic valve (AV) stenosis is the most common valvular heart disease with an incidence of 3% for people ≥ 65years in the industrialized world with indication for a surgical or transcatheter valve replacement. Researchers suppose osteogenic processes as key mechanisms in calcific aortic valve stenosis. Recently, Torre et al. published impressive histological analyses and detected osseous and/or chondromatous metaplasia in 15.6% of 6685 native calcified aortic valves. Therefore one HE section per valve originated from the area with the greatest extent of calcification was analyzed. Aim of our experimental setup was to identify regions of neo-osteogenesis and to determine the rate of specimens with active mineralization in human aortic valve tissue by Movat Pentachrom staining of sections of lager tissue segments.MethodsOperational replaced aortic valves of 35 patients, 15 female and 20 male with an average age of 66.2 years were formalin fixed and decalcified using Osteosoft^®-solution. Tissue samples were cut and 2μm specimens were stained with Movat Pentachrom to visualize osteogenic regions. Instead of screening a large number of sections, tissue samples were cut up to five times with at least 100μm space each if no region of osseous and/or chondromatous metaplasia was visible.Results/ConclusionsUsing this setup, a region of osseous metaplasia was detected in 25 (71.4%) of 35 samples analyzed. In some cases, these regions were small sized and only visible due to the bright color of Movat Pentachrom stain. This leads to the suggestion that a higher rate of calcified aortic valve samples would be classified as cusps with areas of neo-osteogenesis after staining with Movat Pentachrom stain and by the systematic analysis of larger parts of the tissue blocks.



http://ift.tt/2rm0x4h

Particulate matter air pollution: individual choices for improving cardiometabolic well-being

Abstract

Exposure to small particulate matter (PM_2.5) has become the 5th highest ranking risk factor for death, responsible for 4.2 million deaths worldwide. PM pollution is also associated with cardiovascular disease and type 2 diabetes, and may contribute to deteriorate the already poor cardiometabolic outlook of the diabetic patient. Although most sources of outdoor air pollution are well beyond the control of individuals, there is still room for personal action. Health behaviors (smoking cessation, avoiding obesity, and increasing physical activity) may increase the poor life expectancy of individuals in the lowest income quartile of the Western population; moreover, a favorable lifestyle, (no current smoking, no obesity, physical activity at least once weekly, and a healthy diet pattern), may cut by nearly 50% the risk of coronary heart disease among people at high genetic risk. Things seem not immutable, as individual healthy choices do matter.

http://ift.tt/2ruLC64

Long lasting prophylaxis of iodine deficiency after a successful information campaign for iodized salt consumption

http://ift.tt/2rPy1cX

Five Operations that give the best results after brachial plexus injury.

Treatment of brachial plexus injuries has slowly improved over the last 45 years. Changes in strategy, techniques, microsurgical equipment and technology have expanded the surgical options to reconstruct these life altering, highly complex injuries. The surgical armamentarium includes neurolysis, nerve repair, nerve grafting, nerve transfers, tendon transfer, muscle transfer and other soft tissue and bony procedures. In this article we have selected five surgical procedures (Oberlin's procedure, Leechavengvongs' procedure, free functional muscle transfer, radial nerve tendon transfers and C5-C6 nerve grafting in obstetrical birth palsy) that have consistently given us good results in our patients who require surgical reconstruction. (C)2017American Society of Plastic Surgeons

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Single-artery human ear graft procurement: a simplified approach.

Background. In the field of experimental facial vascularized composite tissue allotransplantation (VCA), a human auricular subunit model, pedicled on both superficial temporal (STA) and posterior auricular (PAA) arteries was described. Clinical cases of extensive auricular replantation however, suggested that a single artery could perfuse the entire flap. In our study, variants of this single pedicle approach have been studied, aiming to develop a more versatile replantation technique, in which the question of venous drainage has also been addressed. Methods. For arterial perfusion study, we harvested 11 auricular grafts, either on a single STA pedicle (n=3) or a double STA-PAA pedicle (n=8). We then proceeded to selective barium injections, in STA, PAA or both PAA-STA. Arteriograms were acquired with a Micro-CT scan and analyzed on 3D-reconstructed images. Venous drainage was investigated in eight hemi-faces, carefully dissected after latex injection. Results. Observations showed a homogenous perfusion of the whole auricle in all arterial graft variants. Venous drainage was highly variable, with either a dominant superficial temporal vein (37.5%), dominant posterior auricular vein (12.5%) or co-dominant trunks (50%). Conclusions. We demonstrated that auricular subunit VCA can be performed on a single artery, relying on the dynamic intra-auricular anastomoses between STA and PAA branches. Potentially, this vascular versatility is prone to simplify the subunit harvest and allows various strategies for pedicle selection. Venous drainage, however, remains inconstant and thus the major issue when considering auricular transplantation. (C)2017American Society of Plastic Surgeons

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Free Diced Cartilage: A new application of diced cartilage grafts in primary and secondary Rhinoplasty.

Background: Irregularities or deformities of the nasal dorsum after hump reduction account for a significant number of revision rhinoplasties. We therefore developed a technique of meticulously dicing and exactly placing free diced cartilage grafts (fDC), harvested from septum, rib, or ear cartilage. The cartilage paste is used for smoothening, augmentation, or camouflaging of the nasal dorsum in primary or revision rhinoplasties. Methods: A retrospective analysis of multi-surgeon consecutive open approach rhinoplasties from January to December 2014 was conducted at a single center. We compared the outcome of three different techniques to augment or cover the nasal dorsum after an observation period of seven months: In Group I, 325 patients with fDC as the only onlay were included. In Group II, consisting of 73 patients, the dorsal onlay was either fascia alone, or in combination with fDC. 48 patients in Group III received a dorsal augmentation with the 'classical' diced cartilage in fascia (DCF) technique. Results: 446 patients with primary and secondary rhinoplasties in which one of the above-mentioned diced cartilage techniques was used were included in the study. We found revision rates for dorsal irregularities within the seven-month postoperative observation period of 5.2%, 8.2%, and 25% for Groups I-III, respectively. Conclusion: Our findings strongly support our clinical experience that the fDC technique presents an effective and easily reproducible method for camouflage and augmentation in aesthetic and reconstructive rhinosurgery. (C)2017American Society of Plastic Surgeons

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Dynamic Rheology for the Prediction of Surgical Outcomes in Autologous Fat Grafting.

Background: Due to the abundance and biocompatibility of fat, lipotransfer has become an attractive method for treating soft tissue deficits. However, it is limited by unpredictable graft survival and retention. Currently, little is known about the viscoelastic properties of fat after various injection methods. Here, we assess the effects of cannula diameter, length, and shape on the viscoelastic properties, structure, and retention of fat. Methods: Human lipoaspirate was harvested using suction-assisted liposuction and prepared for grafting. A syringe pump was used to inject fat at a controlled flow rate through cannulas of varying gauge, length, and shape. Processed samples were tested in triplicate on an oscillatory rheometer to measure their viscoelastic properties. Fat grafts from each group were placed into the scalps of immunocompromised mice. After 8 weeks, graft retention was measured using micro-CT and grafts were explanted for histological analysis. Results: Lipoaspirate injected through narrower, longer, and bent cannulas exhibited more shear thinning with diminished quality. The storage modulus (G') of fat processed with 18-gauge cannulas was significantly lower than when processed with 14-gauge or larger cannulas, which also corresponded with inferior in vivo histological structure. Similarly, the longer cannula group had a significantly lower G' than the shorter cannula, and was associated with decreased graft retention. Conclusions: Discrete modifications in the methods used for fat placement can have a significant impact on immediate graft integrity, and ultimately on graft survival and quality. Respecting these biomechanical influences during the placement phase of lipotransfer may allow surgeons to optimize outcomes. (C)2017American Society of Plastic Surgeons

http://ift.tt/2rBwXbt

Minor suture fusion in syndromic craniosynostosis.

Background: Infants with craniofacial dysostosis syndromes may present with midface abnormalities but without major (calvarial) suture synostosis and head shape anomalies. Delayed presentation of their calvarial phenotype is known as progressive postnatal craniosynostosis. Minor sutures/synchondroses are continuations of major sutures toward and within the skull base. We hypothesized that minor suture synostosis is present in infants with syndromic, progressive postnatal craniosynostosis, and is associated with major suture synostosis. Methods: A two-institution review of infants (

http://ift.tt/2rBYPfI

Prepectoral Breast Reconstruction: A Safe Alternative To Submuscular Prosthetic Reconstruction Following Nipple Sparing Mastectomy.

Background: Nipple sparing mastectomy (NSM) with immediate prosthetic reconstruction is routinely performed due to excellent aesthetic results, and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, due to pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major, by placing the prosthesis completely above the muscle with complete acellular dermal matrix (ADM) coverage. Methods: A single surgeon's experience with immediate prosthetic reconstruction following NSM from 2012 - 2016 was reviewed. Patient demographics, adjuvant treatment, length and characteristics of the expansion, and incidence of complications during the tissue expander stage were compared, between partial submuscular/partial ADM (dual-plane) cohort and prepectoral cohort. Results: Fifty-one patients (84 breasts) underwent immediate prepectoral tissue expander placement, compared to 115 patients (186 breasts) undergoing immediate partial submuscular expander placement. The groups had similar comorbidities and postoperative radiation exposure. There was no significant difference in overall complication rate between the two groups (17.9% vs 18.8%, p = 0.49). Conclusions: Prepectoral breast reconstruction provides a safe and effective alternative to partial submuscular reconstruction, that yields comparable aesthetic results with less operative morbidity. In the authors' experience, the incidence of acute and chronic postoperative pain, and animation deformity, is significantly lower following prepectoral breast reconstruction. This technique is now considered for all patients who are safe oncologic candidates, and are undergoing NSM and prosthetic reconstruction. (C)2017American Society of Plastic Surgeons

http://ift.tt/2sAaLMl

Berufskrankheiten: Die Verdachtsanzeige ist Pflicht

Unter den in der Berufskrankheiten-Verordnung insgesamt 77 gelisteten Krankheiten finden sich eine ganze Reihe von Gesundheitsstörungen, die in das Fachgebiet des HNO-Arztes fallen können. Kollegen zögern allerdings oft, den Verdacht auf eine Berufskrankheit anzuzeigen. Neben der Unsicherheit, ob es sich tatsächlich um eine Berufskrankheit handeln könnte, werden als Gründe Mehrarbeit, Verwaltungsaufwand und schlechte Vergütung genannt. Aber nichts davon trifft wirklich zu. Und: Die Anzeige bei Verdacht ist Pflicht!

http://ift.tt/2szVqez

Mehr Honorar für Ärzte

Ambulante Operationen bleiben für Vertragsärzte ein Wachstumsfeld: Die Fallzahlen steigen kontinuierlich, die Honorarumsätze etwas schneller. Anders sieht es bei belegärztlichen Operationen aus, wie der aktuelle Honorarbericht der KBV beweist.

http://ift.tt/2rv11U3

Arzthaftung: Auf der sicheren Seite bleiben

Kaum ein anderer Beruf lebt so sehr vom Vertrauen wie der Arztberuf. Vertrauen darauf, dass der Arzt alles weiß, alles gut kann und alles heilt. Wenn aber der Eindruck entsteht, dass die Erwartungen nicht erfüllt wurden, kann Vertrauen in Enttäuschung und Misstrauen umschlagen und die Situation sogar in einem Rechtsstreit enden. Wie kann man ein Verfahren vermeiden oder so vorbereitet sein, dass man ein Verfahren nicht fürchten muss?

http://ift.tt/2rusCVG

Sicherheit von SCIT und SLIT unter Real-Life-Bedingungen

Wie reagieren Patienten auf eine Allergen-Immuntherapie im Praxisalltag? Wie oft ereignen sich systemische Reaktionen nach subkutaner oder sublingualer Immuntherapie? Wie oft kommt es zu anaphylaktischen Notfallsituationen? Ein europäisches Team aus Allergologen ist diesen Fragen nachgegangen.

http://ift.tt/2sA44K4

Inhaltsverzeichnis

http://ift.tt/2szLKk4

Sind Tief- und Mitteltonhörverluste mit einer Lärmschwerhörigkeit vereinbar?

Bei Lärmschwerhörigkeitsverfahren ist es häufig strittig, ob Hörverluste im Tieftonbereich und Mitteltonbereich neben einer Hochtonsenke auf die berufliche Lärmbelastung zurückgeführt werden können oder nicht. Zur Beantwortung dieser Frage sind verschiedene Kriterien zu berücksichtigen, die im Folgenden erläutert werden.

http://ift.tt/2rBJVGg

Fahrverbot auch Tage nach THC-Konsum

Per Gesetz ist seit März 2017 der Einsatz von Cannabisarzneimitteln als Therapiealternative zugelassen. Autofahrer sollten ärztlicherseits auf die Eigenschaften des Cannabiswirkstoffs hingewiesen werden.

http://ift.tt/2rBWUrw

Wischen statt blättern!

Was Sie gerade auf Papier gedruckt in den Händen halten, könnten Sie auch online auf Ihrem Tablet lesen, denn ab sofort gibt es Ihre „HNO-Nachrichten" auch als ePaper: Es steht auf SpringerMedizin.de, dem Fachportal für Ärzte, kostenlos zum Download bereit. Dort finden Sie auch das Archiv der Zeitschrift und noch vieles mehr ...

http://ift.tt/2rBFkns

Nasopharynxkarzinom: Man kann noch mehr tun

Beim fortgeschrittenen, aber nicht metastasierten Nasopharynxkarzinom hat sich die zeitgleiche Gabe von Strahlen- und Chemotherapie (CRT) etabliert. Wäre eine zusätzliche adjuvante oder Induktions-CT hilfreich?

http://ift.tt/2qM2iZK

Editorial Board

http://ift.tt/2soxV9b

Intergenerational preferences for radio loudness during automobile driving

The comparative contribution to human noise exposure from the vehicular radio is unknown, as are the radio volume preferences of different generations when driving an automobile.

http://ift.tt/2rPs4wu

Mehr Effizienz durch Apps & Co im Praxisalltag

Bei einer Fortbildungsveranstaltung der Deutschen Apotheker- und Ärztebank Anfang April in Magdeburg gab es für die Teilnehmer eine Orientierung, wie die Nutzung moderner Medien den Praxisalltag verändern könnte.

http://ift.tt/2rBFo6G

Immer wieder Tonsillitis: OP oder erstmal abwarten?

Werden Kindern mit rezidivierenden Tonsillitiden die Rachenmandeln entfernt, erkranken sie offenbar im darauffolgenden Jahr seltener an Racheninfektionen als ohne Operation.

http://ift.tt/2rC1Tbs

Von Joseph-Ignace Guillotin zu Greenfield Sluder

Beide Erfinder waren Ärzte, und von der technischen Seite der Erfindung stimmt alles überein: Eine scharfe Metallschneide wird in einem stabilen Rahmen geführt. Nur die Öffnung des Rahmens musste dem abzutrennenden Objekt angepasst sein: Bei Joseph-Ignace Guillotin (1738–1814 ) war es der ganze Kopf bei Greenfield Sluder (1865–1928) eben „nur" die Tonsille.

http://ift.tt/2sA0VtE

BIBB-Bericht 2017: Ausbildung in Praxen ist beliebt

http://ift.tt/2szDWPp

Mauscheleien und kein Ende

http://ift.tt/2qLoX8R

Arbeiten im Spannungsfeld zwischen Medizin und Recht

Begutachtungsfragen sind seit jeher immanenter Bestandteil der ärztlichen Tätigkeit. In der Musterweiterbildungsordnung und in der Musterberufsordnung der Bundesärztekammer (BÄK) [1] sind die Begutachtung bzw. Ärztliche Gutachten und Zeugnisse aufgeführt. Sowohl im Medizinstudium als auch in der Weiter- und Fortbildung wird dieses Thema bisher allerdings zu wenig berücksichtigt [2]. Der folgende Beitrag wendet sich vor allem an diejenigen Kolleginnen und Kollegen, die am Anfang einer gutachterlichen Tätigkeit stehen.

http://ift.tt/2ruFwTk

Ist nach einer Mononukleose eine Tonsillektomie generell anzuraten?

http://ift.tt/2qLX7Je

Ernährungsberatung bei Krebs

Für den möglichst günstigen Verlauf einer Tumorerkrankung ist es wichtig, häufig auftretende Ernährungsstörungen fortlaufend im Blick zu haben. Eine der jeweiligen Situation angepasste Ernährungstherapie gilt als Bestandteil der Supportivbetreuung jedes Krebspatienten.

http://ift.tt/2ruAia6

Studie: Studium der Medizin ist lukrativ

Je höher der Bildungsabschluss, desto größer ist im Schnitt das Einkommen, so das Ergebnis einer kürzlich durchgeführten Analyse des Ifo-Institutes in Frankfurt. Wie hoch sind da heutzutage die Differenzen?

http://ift.tt/2qLJCtl

Quantitative profiling of 19 bile acids in rat plasma, liver, bile and different intestinal section contents to investigate bile acid homeostasis and the application of temporal variation of endogenous bile acids

Publication date: Available online 3 June 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Tingting Yang, Ting Shu, Guanlan Liu, Huifang Mei, Xiaoyu Zhu, Xin Huang, Luyong Zhang, Zhenzhou Jiang
Bile acid homeostasis is maintained by liver synthesis, bile duct secretion, microbial metabolism and intestinal reabsorption into the blood. When drug insults result in liver damage, the variances of bile acids (BAs) are related to the physiological status of the liver. Here, we established a method to simultaneously quantify 19 BAs in rat plasma, liver, bile and different intestinal section contents (duodenum, jejunum, ileum, cecum and colon) using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) to reveal the pattern of bile acid homeostasis in the enterohepatic circulation of bile acids in physiological situations. Dynamic changes in bile acid composition appeared throughout the enterohepatic circulation of the BAs; taurine- and glycine-conjugated BAs and free BAs had different dynamic homeostasis levels in the circulatory system. cholic acid (CA), beta-muricholic acid (beta-MCA), lithocholic acid (LCA), glycocholic acid (GCA) and taurocholic acid (TCA) greatly fluctuated in the bile acid pool under physiological conditions. Taurine- and glycine-conjugated bile acids constituted more than 90% in the bile and liver, whereas GCA and TCA accounted for more than half of the total bile acids and the secretion of bile mainly via conjugating with taurine. While over 80% of BAs in plasma were unconjugated bile acids, CA and HDCA were the most abundant elements. Unconjugated bile acids constituted more than 90% in the intestine, and CA, beta-MCA and HDCA were the top three bile acids in the duodenum, jejunum and ileum content, but LCA and HDCA were highest in the cecum and colon content. As the main secondary bile acid converted by microflora in the intestine, LCA was enriched in the cecum and DCA mostly in the colon. As endogenous substances, the concentrations of plasma BAs were closely related to time rhythm and diet. In conclusion, analyzing detailed BA profiles in the enterohepatic circulation of bile acids in a single run is possible using LC-MS/MS. Based on the physiological characteristics of the metabolic profiling of 19 BAs in the total bile acid pool and the time rhythm variation of the endogenous bile acids, this study provided a new valuable method and theoretical basis for the clinical research of bile acid homeostasis.



http://ift.tt/2rlVUqS

Arbeiten im Spannungsfeld zwischen Medizin und Recht

Begutachtungsfragen sind seit jeher immanenter Bestandteil der ärztlichen Tätigkeit. In der Musterweiterbildungsordnung und in der Musterberufsordnung der Bundesärztekammer (BÄK) [1] sind die Begutachtung bzw. Ärztliche Gutachten und Zeugnisse aufgeführt. Sowohl im Medizinstudium als auch in der Weiter- und Fortbildung wird dieses Thema bisher allerdings zu wenig berücksichtigt [2]. Der folgende Beitrag wendet sich vor allem an diejenigen Kolleginnen und Kollegen, die am Anfang einer gutachterlichen Tätigkeit stehen.

http://ift.tt/2ruFwTk

Ernährungsberatung bei Krebs

Für den möglichst günstigen Verlauf einer Tumorerkrankung ist es wichtig, häufig auftretende Ernährungsstörungen fortlaufend im Blick zu haben. Eine der jeweiligen Situation angepasste Ernährungstherapie gilt als Bestandteil der Supportivbetreuung jedes Krebspatienten.

http://ift.tt/2ruAia6

Mehr Honorar für Ärzte

Ambulante Operationen bleiben für Vertragsärzte ein Wachstumsfeld: Die Fallzahlen steigen kontinuierlich, die Honorarumsätze etwas schneller. Anders sieht es bei belegärztlichen Operationen aus, wie der aktuelle Honorarbericht der KBV beweist.

http://ift.tt/2rv11U3

Nasopharynxkarzinom: Man kann noch mehr tun

Beim fortgeschrittenen, aber nicht metastasierten Nasopharynxkarzinom hat sich die zeitgleiche Gabe von Strahlen- und Chemotherapie (CRT) etabliert. Wäre eine zusätzliche adjuvante oder Induktions-CT hilfreich?

http://ift.tt/2qM2iZK

Ist nach einer Mononukleose eine Tonsillektomie generell anzuraten?

http://ift.tt/2qLX7Je

Studie: Studium der Medizin ist lukrativ

Je höher der Bildungsabschluss, desto größer ist im Schnitt das Einkommen, so das Ergebnis einer kürzlich durchgeführten Analyse des Ifo-Institutes in Frankfurt. Wie hoch sind da heutzutage die Differenzen?

http://ift.tt/2qLJCtl

Arzthaftung: Auf der sicheren Seite bleiben

Kaum ein anderer Beruf lebt so sehr vom Vertrauen wie der Arztberuf. Vertrauen darauf, dass der Arzt alles weiß, alles gut kann und alles heilt. Wenn aber der Eindruck entsteht, dass die Erwartungen nicht erfüllt wurden, kann Vertrauen in Enttäuschung und Misstrauen umschlagen und die Situation sogar in einem Rechtsstreit enden. Wie kann man ein Verfahren vermeiden oder so vorbereitet sein, dass man ein Verfahren nicht fürchten muss?

http://ift.tt/2rusCVG

Step by step zum ePaper

http://ift.tt/2qLIBkS

Gezielte Muskeldehnung gegen den Kloß im Hals

Zusammenfassung

Bei Patienten mit Globusgefühl, bei denen alle „gängigen" Differenzialdiagnosen ausgeschlossen sind, lohnt es sich, neue Therapieansätze in Betracht zu ziehen. Denn eine nach unserer Erfahrung häufige Ursache für das Globusgefühl ist eine vermehrte Anspannung der paralaryngealen Muskulatur mit nach-weisbarer Überanstrengung. Hier hilft das manuelle „Entspannen" und Dehnen der Muskulatur. Die bekannteste Technik ist die laryngeale osteopathische Manipulation nach Jacob Lieberman.

http://ift.tt/2ruFB9A

Fahrverbot auch Tage nach THC-Konsum

Per Gesetz ist seit März 2017 der Einsatz von Cannabisarzneimitteln als Therapiealternative zugelassen. Autofahrer sollten ärztlicherseits auf die Eigenschaften des Cannabiswirkstoffs hingewiesen werden.

http://ift.tt/2rBWUrw

Inhaltsverzeichnis

http://ift.tt/2szLKk4

Sind Tief- und Mitteltonhörverluste mit einer Lärmschwerhörigkeit vereinbar?

Bei Lärmschwerhörigkeitsverfahren ist es häufig strittig, ob Hörverluste im Tieftonbereich und Mitteltonbereich neben einer Hochtonsenke auf die berufliche Lärmbelastung zurückgeführt werden können oder nicht. Zur Beantwortung dieser Frage sind verschiedene Kriterien zu berücksichtigen, die im Folgenden erläutert werden.

http://ift.tt/2rBJVGg

Mehr Effizienz durch Apps & Co im Praxisalltag

Bei einer Fortbildungsveranstaltung der Deutschen Apotheker- und Ärztebank Anfang April in Magdeburg gab es für die Teilnehmer eine Orientierung, wie die Nutzung moderner Medien den Praxisalltag verändern könnte.

http://ift.tt/2rBFo6G

Berufskrankheiten: Die Verdachtsanzeige ist Pflicht

Unter den in der Berufskrankheiten-Verordnung insgesamt 77 gelisteten Krankheiten finden sich eine ganze Reihe von Gesundheitsstörungen, die in das Fachgebiet des HNO-Arztes fallen können. Kollegen zögern allerdings oft, den Verdacht auf eine Berufskrankheit anzuzeigen. Neben der Unsicherheit, ob es sich tatsächlich um eine Berufskrankheit handeln könnte, werden als Gründe Mehrarbeit, Verwaltungsaufwand und schlechte Vergütung genannt. Aber nichts davon trifft wirklich zu. Und: Die Anzeige bei Verdacht ist Pflicht!

http://ift.tt/2szVqez

Immer wieder Tonsillitis: OP oder erstmal abwarten?

Werden Kindern mit rezidivierenden Tonsillitiden die Rachenmandeln entfernt, erkranken sie offenbar im darauffolgenden Jahr seltener an Racheninfektionen als ohne Operation.

http://ift.tt/2rC1Tbs

Sicherheit von SCIT und SLIT unter Real-Life-Bedingungen

Wie reagieren Patienten auf eine Allergen-Immuntherapie im Praxisalltag? Wie oft ereignen sich systemische Reaktionen nach subkutaner oder sublingualer Immuntherapie? Wie oft kommt es zu anaphylaktischen Notfallsituationen? Ein europäisches Team aus Allergologen ist diesen Fragen nachgegangen.

http://ift.tt/2sA44K4

Von Joseph-Ignace Guillotin zu Greenfield Sluder

Beide Erfinder waren Ärzte, und von der technischen Seite der Erfindung stimmt alles überein: Eine scharfe Metallschneide wird in einem stabilen Rahmen geführt. Nur die Öffnung des Rahmens musste dem abzutrennenden Objekt angepasst sein: Bei Joseph-Ignace Guillotin (1738–1814 ) war es der ganze Kopf bei Greenfield Sluder (1865–1928) eben „nur" die Tonsille.

http://ift.tt/2sA0VtE

Wischen statt blättern!

Was Sie gerade auf Papier gedruckt in den Händen halten, könnten Sie auch online auf Ihrem Tablet lesen, denn ab sofort gibt es Ihre „HNO-Nachrichten" auch als ePaper: Es steht auf SpringerMedizin.de, dem Fachportal für Ärzte, kostenlos zum Download bereit. Dort finden Sie auch das Archiv der Zeitschrift und noch vieles mehr ...

http://ift.tt/2rBFkns

BIBB-Bericht 2017: Ausbildung in Praxen ist beliebt

http://ift.tt/2szDWPp

Absolute venomics: Absolute quantification of intact venom proteins through elemental mass spectrometry

Publication date: Available online 2 June 2017
Source:Journal of Proteomics
Author(s): Francisco Calderón-Celis, Laura Cid-Barrio, Jorge Ruiz Encinar, Alfredo Sanz-Medel, Juan J. Calvete
We report the application of a hybrid element and molecular MS configuration for the parallel absolute quantification of μHPLC-separated intact sulfur-containing venom proteins, via ICP triple quadrupole MS and ³²S/³⁴S isotope dilution analysis, and identification by ESI-QToF-MS of the toxins of the medically important African black-necked spitting cobra, Naja nigricollis (Tanzania); New Guinea small-eyed snake, Micropechis ikaheka; and Papuan black snake, Pseudechis papuanus. The main advantage of this approach is that only one generic sulfur-containing standard is required to quantify each and all intact Cys- and/or Met-containing toxins of the venom proteome. The results of absolute quantification are in reasonably good agreement with previously reported relative quantification of the most abundant protein families. However, both datasets depart in the quantification of the minor ones, showing a tendency for this set of proteins to be underestimated in standard peptide-centric venomics approaches. The molecular identity, specific toxic activity, and concentration in the venom, are the pillars on which the toxicovenomics-aimed discovery of the most medically-relevant venom toxins, e.g. those that need to be neutralized by an effective therapeutic antivenom, should be based. The pioneering venom proteome-wide absolute quantification shown in this paper represents thus a significant advance towards this goal. The potential of ICP triple quadrupole MS in proteomics in general, and venomics in particular, is critically discussed.Biological significanceAnimal venoms provide excellent model systems for investigating interactions between predators and prey, and the molecular mechanisms that contribute to adaptive protein evolution. On the other hand, numerous cases of snake bites occur yearly by encounters of humans and snakes in their shared natural environment. Snakebite envenoming is a serious global public health issue that affects the most impoverished and geopolitically disadvantaged rural communities in many tropical and subtropical countries. Unveiling the temporal and spatial patterns of venom variability is of fundamental importance to understand the molecular basis of envenoming, a prerequisite for developing therapeutic strategies against snakebite envenoming. Research on venoms has been continuously enhanced by advances in technology. The combined application of next-generation transcriptomic and venomic workflows has demonstrated unparalleled capabilities for venom characterization in unprecedented detail. However, mass spectrometry is not inherently quantitative, and this analytical limitation has sparked the development of methods to determine absolute abundance of proteins in biological samples. Here we show the potential of a hybrid element and molecular MS configuration for the parallel ESI-QToF-MS and ICP-QQQ detection and absolute quantification of intact sulfur-containing venom proteins via ³²S/³⁴S isotope dilution analysis. This configuration has been applied to quantify the toxins of the medically important African snake Naja nigricollis (Tanzania), and the Papuan species Micropechis ikaheka and Pseudechis papuanus.

Graphical abstract

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Hydrocarbon-induced changes in proteins and fatty acids profiles of Raoultella ornithinolytica M03

Publication date: Available online 2 June 2017
Source:Journal of Proteomics
Author(s): A. Zdarta, J. Tracz, M. Łuczak, U. Guzik, E. Kaczorek
Microorganisms can support environmental restoration by biodegradation of hydrocarbons but the mechanism of this process has been not described in detail yet. We present the effect of benzene derivatives on Raoultella ornithinolytica M03 cell composition. Comparison of the cell response after short-term and long-term stress revealed significant differences in surface properties, fatty acid composition and proteins profile. R. ornithinolytica M03 after long-term stress was characterized by lower cell surface hydrophobicity and much higher inner membrane permeability. Also decrease in the content of branched and unsaturated fatty acids was observed. Cells after short- and long-term stress were characterized by analyses of changes related to thirty-nine proteins participating in various metabolic pathways. The presence of benzene derivatives resulted in modifications in the abundance of proteins involved in determination of cell shape and ability to ion transport, lipid biosynthesis, amino-acid biosynthesis, tRNA ligases, chaperone and TCA cycleproteins, gluconeogenesis, transcription and nucleotide synthesis. Uptake and transport associated proteins, cell properties and membrane stability were also found to differ in the cells after short- and long-term stress suggesting the use of different mechanisms for transport and biodegradation of benzene derivatives and modification of cell response depending on the length of exposure to the stressor.Biological significanceThis is the first comprehensive study whose results may contribute to a better understanding of the changes occurring during short- and long-term contact with benzene derivatives. R. ornithinolytica M03 after long-term stress was characterized by lower cell surface hydrophobicity and much higher inner membrane permeability. Also decrease in the content of branched and unsaturated fatty acids was observed. Cells after short- and long-term stress were characterized by analyses of changes related to thirty-nine proteins participating in various metabolic pathways. The presence of benzene derivatives resulted in modifications in the abundance of proteins involved in determination of cell shape and ability to ion transport, lipid biosynthesis, amino-acid biosynthesis, tRNA ligases, chaperone and TCA cycleproteins, gluconeogenesis, transcription and nucleotide synthesis. Uptake and transport associated proteins, cell properties and membrane stability were also found to differ in the cells after short- and long-term stress suggesting the use of different mechanisms for transport and biodegradation of benzene derivatives and modification of cell response depending on the length of exposure to the stressor. The provided results seem to constitute an important aspect of remediation techniques, and the present article shall be of great interest to the Journal's readership.

Graphical abstract

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Clinical significance of epithelial-to-mesenchymal transition in laryngeal carcinoma: its role in the different subsites.

Clinical significance of epithelial-to-mesenchymal transition in laryngeal carcinoma: its role in the different subsites.

Head Neck. 2017 May 31;:

Authors: Mezi S, Chiappetta C, Carletti R, Nardini A, Cortesi E, Orsi E, Piesco G, Di Gioia C

Abstract
BACKGROUND: During epithelial-to-mesenchymal transition, cancer cells lose adhesion capacity gaining migratory properties. The role of the process on prognosis has been evaluated in 50 cases of laryngeal carcinoma.
METHODS: E-cadherin, N-cadherin, β-catenin, α-catenin, γ-catenin, caveolin-1, and vimentin immunohistochemical expression were evaluated using a double score based on staining intensity and cellular localization.
RESULTS: Cytoplasmic E-cadherin and α/γ catenin staining were associated with a decrease in survival, cytoplasmic β-catenin was associated with advanced stage, and N-cadherin and vimentin expression were associated with poor differentiation and tumor relapse. On the basis of cancer cells, epithelial or mesenchymal morphological and immunophenotypic similarity we identified 4 main subgroups correlated with a transition to a more undifferentiated phenotype, which have a different pattern of relapse and survival.
CONCLUSION: The negative prognostic role of epithelial-to-mesenchymal transition has been confirmed and a predictive role in glottic tumors has been suggested, leading us to propose epithelial-to-mesenchymal transition as an additional adverse feature in laryngeal carcinoma.

PMID: 28561907 [PubMed - as supplied by publisher]

http://ift.tt/2sqUGZ8

Particulate matter air pollution: individual choices for improving cardiometabolic well-being

Abstract

Exposure to small particulate matter (PM_2.5) has become the 5th highest ranking risk factor for death, responsible for 4.2 million deaths worldwide. PM pollution is also associated with cardiovascular disease and type 2 diabetes, and may contribute to deteriorate the already poor cardiometabolic outlook of the diabetic patient. Although most sources of outdoor air pollution are well beyond the control of individuals, there is still room for personal action. Health behaviors (smoking cessation, avoiding obesity, and increasing physical activity) may increase the poor life expectancy of individuals in the lowest income quartile of the Western population; moreover, a favorable lifestyle, (no current smoking, no obesity, physical activity at least once weekly, and a healthy diet pattern), may cut by nearly 50% the risk of coronary heart disease among people at high genetic risk. Things seem not immutable, as individual healthy choices do matter.

http://ift.tt/2ruLC64

Social Representation of “Loud Music” in Young Adults: A Cross-Cultural Study

http://ift.tt/2qLY9VG

Be a Teacher

http://ift.tt/2qLY2JK

Acoustic Reflexes in Normal-Hearing Adults, Typically Developing Children, and Children with Suspected Auditory Processing Disorder: Thresholds, Real-Ear Corrections, and the Role of Static Compliance on Estimates

http://ift.tt/2ruEua4

Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients

http://ift.tt/2qLFrOb

A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient‐Clinician Interactions

http://ift.tt/2ruoqFq

Cortical Auditory-Evoked Potential and Behavioral Evidence for Differences in Auditory Processing between Good and Poor Readers

http://ift.tt/2ruEsis

Tinnitus Management: Randomized Controlled Trial Comparing Extended-Wear Hearing Aids, Conventional Hearing Aids, and Combination Instruments

http://ift.tt/2ruukGo

The Potential in Preparing Community Health Workers to Address Hearing Loss

http://ift.tt/2qLzGjA

The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review

http://ift.tt/2ruOlfZ

JAAA CEU Program

http://ift.tt/2qM1Cnb

Multiple laser pulses in conjunction with an optical clearing agent to improve the curative effect of cutaneous vascular lesions

Abstract

Port-wine stains (PWSs) usually respond poorly to pulsed dye laser treatment because of the shallow penetration and light absorption of melanin in the epidermis. Multiple laser pulses (MLPs) Nd:YAG laser in conjunction with an optical clearing agent can help to reduce the total laser energy required for blood coagulation. The quantitative optical clearing effect (OCE) of glycerol was investigated by using a tissue-like phantom. Thereafter, an in vitro capillary tube experimental system and an in vivo hamster dorsal skin chamber experiment for the laser treatment of PWSs were established to visually obtain the quantitative relationship between the OCE and the blood coagulation properties under the irradiation of 1064 nm MLPs. Diffuse reflection coefficient decreases by 36.69% and transmission coefficient increases by 38.73% at 1064 nm, after applying 0.5 mL anhydrous glycerol for 10 min on the surface of the tissue-like phantom. The number of laser pulses required for blood coagulation decreases by 25% after the application of 0.5 mL anhydrous glycerol for 4 min, thrombosis appears after 10 min, and the 0.0854 clotting area completely blocks the capillary tubes in 6 pulses. For 10 min, the incident energy can be reduced by 35.09 and 29.82%. When the 0.3-mm vessel's buried depths are 1 and 0.5 mm, the pulse number can be reduced from 11 to 8 and from 6 to 4, respectively. Adding anhydrous glycerol directly on the hamster dorsal skin is an effective way to reduce the number of laser pulses from 4∼5 to 2∼3 for similar capillary tube diameter. Therefore, the MLPs of 1064 nm Nd:YAG demonstrates a substantial curative effect for large capillary tubes. In conjunction with glycerol, this approach may treat deeply buried cutaneous capillary tubes and prevent the unwanted thermal damage of normal dermal tissue.

http://ift.tt/2ruKxeG

pH-responsive unimolecular micelle-gold nanoparticles-drug nanohybrid system for cancer theranostics

Publication date: Available online 3 June 2017
Source:Acta Biomaterialia
Author(s): Wenjing Lin, Na Yao, Long Qian, Xiaofang Zhang, Quan Chen, Jufang Wang, Lijuan Zhang
The development of an in situ formed pH-responsive theranostic nanocomposite for anticancer drug delivery and computed tomography (CT) imaging was reported. β-cyclodextrin-{poly(lactide)-poly(2-(dimethylamino) ethyl methacrylate)-poly[oligo(2-ethyl-2-oxazoline)methacrylate]}21 [β-CD-(PLA-PDMAEMA-PEtOxMA)21] unimolecular micelles served as a template for the in situ formation of gold nanoparticles (GNPs) and the subsequent encapsulation of doxorubicin (DOX). The formation of unimolecular micelles, microstructures and the distributions of GNPs and DOX were investigated through the combination of experiments and dissipative particle dynamics (DPD) simulations. β-CD-(PLA-PDMAEMA-PEtOxMA)21 formed spherical unimolecular micelles in aqueous solution within a certain range of polymer concentrations. GNPs preferentially distributed in the PDMAEMA area. The maximum wavelength (λmax) and the size of GNPs increased with increasing concentration of HAuCl4. DOX preferentially distributed in the PDMAEMA mesosphere, but penetrated the inner PLA core with increasing DOX concentration. DOX-loaded micelles with 41-61% entrapment efficiency showed fast release (88% after 102 h) under acidic tumor conditions. Both in vitro and in vivo experiments revealed superior anticancer efficacy and effective CT imaging properties for β-CD-(PLA-PDMAEMA-PEtOxMA)21/Au/DOX. We conclude that the reported unimolecular micelles represent a class of versatile smart nanocarriers for theranostic application.Statement of SignificanceDeveloping polymeric nanoplatforms as integrated theranostic vehicles for improving cancer diagnostics and therapy is an emerging field of much importance. This article aims to develop an in situ formed pH-responsive theranostic nanocomposite for anticancer drug delivery and computed tomography (CT) imaging. Specific emphases is on structure-properties relationship. There is a sea of literature on polymeric drug nanocarriers, and a couple of polymer-stablized gold nanoparticles (GNPs) systems for cancer diagnosis are also known. However, to our knowledge, there has been no report on polymeric unimolecualr micelles capable of dual loading of GNPs without external reducing agents and anticancer drugs for cancer diagnosis and treatment. To this end, the target of the current work was to develop an in situ formed nanocarrier, which actively dual wrapped CT contrast agent GNPs and hydrophobic anticancer drug doxorubicin (DOX), achieving high CT imaging and antitumor efficacy under in vitro and in vivo acid tumor condition. Meanwhile, by taking advantage of dissipative particle dynamics (DPD) simulation, we further obtained the formation process and mechanism of unimolecular micelles, and detailed distributions and microstructures of GNPs and DOX on unimolecular micelles. Taken together, our results here provide insight and guidance for the design of more effective nanocarriers for cancer theranostic application.

Graphical abstract

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Highly efficient delivery of potent anticancer iminoquinone derivative by multilayer hydrogel cubes

Publication date: Available online 3 June 2017
Source:Acta Biomaterialia
Author(s): Bing Xue, Wei Wang, Jiang-Jiang Qin, Bhavitavya Nijampatnam, Srinivasan Murugesan, Veronika Kozlovskaya, Ruiwen Zhang, Sadanandan E. Velu, Eugenia Kharlampieva
We report a novel delivery platform for a highly potent anticancer drug, 7-(benzylamino)-3,4-dihydro-pyrrolo[4,3,2-de]quinolin-8(1H)-one (BA-TPQ), using pH- and redox-sensitive poly(methacrylic acid) (PMAA) hydrogel cubes of micrometer size as the encapsulating matrix. The hydrogels are obtained upon cross-linking PMAA with cystamine in PMAA/poly(N-vinylpyrrolidone) multilayers assembled within mesoporous sacrificial templates. The BA-TPQ-loaded hydrogels maintain their cubical shape and pH-sensitivity after lyophilization, which is advantageous for long-term storage. Conversely, the particles degrade in vitro in the presence of glutathione (5 mM) providing 80% drug release within 24 h. Encapsulating BA-TPQ into hydrogels significantly increases its transport via Caco-2 cell monolayers used as a model for oral delivery where the apparent permeability of BA-TPQ-hydrogel cubes was ∼2-fold higher than that of BA-TPQ. BA-TPQ-hydrogel cubes exhibit better anticancer activity against HepG2 (IC50=0.52 µg/mL) and Huh7 (IC50=0.29 µg/mL) hepatoma cells with a 40% decrease in the IC50 compared to the non-encapsulated drug. Remarkably, non-malignant liver cells have a lower sensitivity to BA-TPQ-hydrogel cubes with 2-fold increased IC50 values compared to those of cancer cells. In addition, encapsulating BA-TPQ in the hydrogels amplifies the potency of the drug via down-regulation of MDM2 oncogenic protein and upregulation of p53 (a tumor suppressor) and p21 (cell proliferation suppressor) expression in HepG2 liver cancer cells. Moreover, enhanced inhibition of MDM2 protein expression by BA-TPQ-hydrogel cubes is independent of p53-status in Huh7 cells. This drug delivery platform of non-spherical shape provides a facile method for encapsulation of hydrophobic drugs and can facilitate the enhanced efficacy of BA-TPQ for liver cancer therapy.Statement of SignificanceMany potent anticancer drugs are hydrophobic and lack tumor selectivity, which limits their application in cancer therapy. Although cubical hydrogels of poly(methacrylic acid) exhibit excellent biocompatibility and versatility, they have not been investigated for hydrophobic drug delivery due to poor mechanical stability and incompatibility between hydrophobic drugs and a hydrophilic hydrogel network. In this study, we provide a facile method to prepare a multilayer hydrogel-based platform with controlled nanostructure, cubical shape and redox-responsiveness for delivery of highly potent anticancer therapeutics, hydrophobic BA-TPQ. The BA-TPQ-hydrogel cubes have exceptional structural stability upon lyophilization which is advantageous for a long-term storage. The greatly enhanced trans-epithelial permeability and amplified anti-tumor activity of BA-TPQ are achieved by encapsulation in these hydrogel cubes. Furthermore, the anticancer BA-TPQ-hydrogel platform retains the selective activity of BA-TPQ to hepatocellular carcinoma cells. Overall, the produced BA-TPQ-hydrogel cubes demonstrate a high potential for clinical liver cancer therapy.

Graphical abstract

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pH-responsive self-healing injectable hydrogel based on N-carboxyethyl chitosan for hepatocellular carcinoma therapy

Publication date: Available online 2 June 2017
Source:Acta Biomaterialia
Author(s): Jin Qu, Xin Zhao, Peter X. Ma, Baolin Guo
Injectable hydrogels with pH-responsiveness and self-healing ability have great potential for anti-cancer drug delivery. Herein, we developed a series of polysaccharide-based self-healing hydrogels with pH-sensitivity as drug delivery vehicles for hepatocellular carcinoma therapy. The hydrogels were prepared by using N-carboxyethyl chitosan (CEC) synthesized via Michael reaction in aqueous solution and dibenzaldehyde-terminated poly(ethylene glycol) (PEGDA). Doxorubicin (Dox), as a model of water-soluble small molecule anti-cancer drug was encapsulated into the hydrogel in situ. Self-healing behavior of the hydrogels was investigated at microscopic and macroscopic levels, and the hydrogels showed rapid self-healing performance without any external stimulus owing to the dynamic covalent Schiff-base linkage between amine groups from CEC and benzaldehyde groups from PEGDA. The chemical structures, rheological property, in vitro gel degradation, morphology, gelation time and in vitro Dox release behavior from the hydrogels were characterized. Injectability was verified by in vitro injection and in vivo subcutaneous injection in a rat. pH-responsive behavior was verified by in vitro Dox release from hydrogels in PBS solutions with different pH values. Furthermore, the activity of Dox released from hydrogel matrix was evaluated by employing human hepatocellular liver carcinoma (HepG2). Cytotoxicity test of the hydrogels using L929 cells confirmed their good cytocompatibility. Together, these pH-responsive self-healing injectable hydrogels are excellent candidates as drug delivery vehicles for liver cancer treatment.Statement of SignificancepH-responsive drug delivery system could release drug efficiently in targeted acid environment and minimalize the amount of drug release in normal physiological environment. pH-sensitive injectable hydrogels as smart anti-cancer drug delivery carriers show great potential application for cancer therapy. The hydrogels with self-healing property could prolong their lifetime during implantation and provide the advantage of minimally invasive surgery and high drug-loading ratio. This work reported the design of a series of pH-responsive self-healing injectable hydrogels based on N-carboxyethyl chitosan synthesized in aqueous solution and dibenzaldehyde-terminated poly(ethylene glycol) via a green approach, and demonstrated their potential as intelligent delivery vehicle of doxorubicin for hepatocellular carcinoma therapy via the pH-responsive nature of dynamic Schiff base.

Graphical abstract

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Interleukin-13 conjugated quantum dots for identification of glioma initiating cells and their extracellular vesicles

Publication date: Available online 3 June 2017
Source:Acta Biomaterialia
Author(s): A.B. Madhankumar, Oliver Mrowczynski, Suhag Patel, Cody Weston, Brad Zacharia, Michael Glantz, Christopher Siedlecki, Lichong Xu, James R. Connor
Cadmium selenide (CdSe) based quantum dots modified with polyethylene glycol and chemically linked to interleukin-13 (IL13) were prepared with the aim of identifying the high affinity receptor (IL13Rα2) which is expressed in glioma stem cells and exosomes secreted by these cancer stem cells. IL13 conjugated quantum dots (IL13QD) were thoroughly characterized for their physicochemical properties including particle size and surface morphology. Furthermore, the specific binding of the IL13QD to glioma cells and to glioma stem cells (GSC) was verified using a competitive binding study. The exosomes were isolated from the GSC conditioned medium and the expression of IL13Rα2 in the GSC and exosomes was verified. The binding property of IL13QD to the tumor associated exosomes was initially confirmed by transmission electron microscopy. The force of attraction between the quantum dots and U251 glioma cells and the exosomes was investigated by atomic force microscopy, which indicated a higher force of binding interaction between the IL13QD and IL13Rα2 expressing glioma cells and exosomes secreted by glioma stem cells. Flow cytometry of the IL13QD and exosomes from the culture media and cerebrospinal fluid (CSF) of patients with glioma tumors indicated a distinctly populated complex pattern different from that of non-targeted quantum dots and bovine serum albumin (BSA) conjugated quantum dots confirming specific binding potential of the IL13QD to the tumor associated exosomes. The results of this study demonstrate that IL13QD can serve as an ex vivo marker for glioma stem cells and exosomes that can inform diagnosis and prognosis of patients harboring malignant disease.Statement of significanceFunctionalized quantum dots are flexible semiconductor nanomaterials which have an immense application in biomedical research. In particular, when they are functionalized with biomolecules like proteins or antibodies, they have the specialized ability to detect the expression of receptors and antigens in cells and tissues. In this study we designed a cytokine (interleukin-13) functionalized quantum dot to detect a cancer associated receptor expressed in cancer stem cells and the extracellular vesicles (exosomes) secreted by the cancer cells themselves. The binding pattern of these cytokine modified quantum dots to the cancer stem cells and exosomes alters the physical properties of the complex in the fixed and suspended form. This altered binding pattern can be monitored by a variety of techniques, including transmission electron microscopy, atomic force microscopy and flow cytometry, and subsequent characterization of this quantum dot binding profile provides useful data that can be utilized as a fingerprint to detect cancer disease progression. This type of functionalized quantum dot fingerprint is especially useful for invasive cancers including brain and other metastatic cancers and may allow for earlier detection of disease progression or recurrence, thus saving the lives of patients suffering from this devastating disease.

Graphical abstract

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Comparison of dimensional accuracy of conventionally and digitally manufactured intracoronal restorations

Publication date: Available online 2 June 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Reza Eftekhar Ashtiani, Leila Nasiri Khanlar, Minoo Mahshid, Alireza Moshaverinia
Statement of problemAdvances have been made in digital dentistry for the fabrication of dental prostheses, but evidence regarding the efficacy of digital techniques for the fabrication of intracoronal restorations is lacking.PurposeThe purpose of this in vitro study was to compare the dimensional accuracy of intracoronal restorations fabricated with digital and conventional techniques.Material and methodsA sound mandibular molar tooth received a standard onlay preparation, and onlays were fabricated with 1 of 3 fabrication techniques. In group CC, the onlays were made after conventional impression and conventional fabrication of a resin pattern. In group CP, the onlays were made after conventional impression and 3-dimensional (3D) printing of the pattern. In group IP, the onlays were made after intraoral scanning, and 3D printing produced the resin pattern. Ten specimens in each group (N=30) were evaluated. Glass-ceramic restorations were fabricated using the press technique. The replica technique was used to assess the marginal fit. Each replica was assessed at 8 points. One-way ANOVA was used to compare the marginal discrepancy among the 3 groups. The Tukey honest significant differences test was applied for pairwise comparisons of the groups (α=.05).ResultsNo significant differences were noted in the marginal discrepancy at the gingival margin among the 3 groups (P=.342), but significant differences were noted among the 3 groups in the pulpal (P=.025) and lingual (P=.031) areas. Comparison of the absolute discrepancy among the 3 groups revealed that only groups CC and CP were significantly different (P=.020) from each other.ConclusionsWithin the limitations of this in vitro study, the conventional method yielded more accuracy than the 3D printing method, and no differences were found between the methods which used the 3D printer (groups CP and IP).



http://ift.tt/2s3rzyC

Toward Defining “Vocal Constriction”: Practitioner Perspectives

This research investigated the terminology used in relation to constriction of the singing voice from a range of practitioner perspectives. It focused on the locality, causes, consequences, management, trends, identification, and vocabulary of constriction. The research aimed to develop a holistic understanding of the term "vocal constriction" from participant experiences and perceptions (N = 10).

http://ift.tt/2rlGuD0

Retrieval as a Fast Route to Memory Consolidation

Publication date: Available online 2 June 2017
Source:Trends in Cognitive Sciences
Author(s): James W. Antony, Catarina S. Ferreira, Kenneth A. Norman, Maria Wimber
Retrieval-mediated learning is a powerful way to make memories last, but its neurocognitive mechanisms remain unclear. We propose that retrieval acts as a rapid consolidation event, supporting the creation of adaptive hippocampal–neocortical representations via the 'online' reactivation of associative information. We describe parallels between online retrieval and offline consolidation and offer testable predictions for future research.



http://ift.tt/2qQuxSe

Intraoperative 1-Hour Electrical Nerve Stimulation Enhances Outcomes of Nerve–Muscle-Endplate Band Grafting Technique for Muscle Reinnervation

J reconstr Microsurg
DOI: 10.1055/s-0037-1602824

Background Increasing evidence suggests that 1-hour electrical nerve stimulation during surgery improves nerve regeneration and functional recovery. However, it remains unknown if this approach has beneficial effects on the outcomes of our recently developed nerve–muscle-endplate band grafting-native motor zone (NMEG-NMZ) technique for muscle reinnervation. Methods In this study, NMEG-NMZ transplantation was performed in a rat model. The right sternomastoid muscle was experimentally denervated and immediately reinnervated by implanting a NMEG harvested from the ipsilateral sternohyoid (SH) muscle into the NMZ of the target muscle. Before implantation of the NMEG, the SH nerve branch innervating the NMEG was subjected to intraoperative 1-hour continuous electrical stimulation (20 Hz). Three months after surgery, the degree of functional recovery was evaluated with muscle force measurement and the extent of nerve regeneration and endplate reinnervation was examined using histological and immunohistochemical methods. Results A combination of NMEG-NMZ with electrical nerve stimulation resulted in a greater degree of functional recovery than the NMEG-NMZ alone. The mean muscle force of the treated muscles was 90% of the contralateral control. The muscle mass was recovered up to 90% of the control. The mean number and percentage of area of the regenerated axons in the treated muscles was computed to be 81 and 84% of the control muscles, respectively. On average, 83% of the denervated endplates in the treated muscles were reinnervated by regenerated axons. Conclusion Intraoperative brief nerve stimulation promotes nerve regeneration, endplate reinnervation, and functional recovery of the muscles reinnervated with NMEG-NMZ technique.
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Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Enhancement of sorption capacity of cocoa shell biomass modified with non-thermal plasma for removal of both cationic and anionic dyes from aqueous solution

Abstract

Removal of cationic dye, Azur II, and anionic dye, Reactive Red 2 (RR-2) from aqueous solutions, has been successfully achieved by using a modified agricultural biomaterial waste: cocoa shell husk (Theobroma cacao) treated by gliding arc plasma (CPHP). The biomass in its natural form CPHN and modified form CPHP was characterized by infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), and point of zero charge (pH_pzc). Experimental variables such as initial pH, contact time, and temperature were optimized for adsorptive characteristics of CPHN and CPHP. The results show that the removal of the Azur II dye was favorable in the basic pH region (pH 10) while the Reactive Red 2 dye was favorable in the acidic pH region (pH 2). The minimum equilibrium time for Azur II and RR-2 dye was obtained after 40 and 240 min, respectively. The adsorption kinetics and isotherm data obtained were best described by a pseudo-second-order kinetic rate model and a combination of Langmuir-Freundlich isotherm models. This work indicates that the plasma-treated raw materials are good alternative multi-purpose sorbents for the removal of many coexisting pollutants from aqueous solutions.

http://ift.tt/2sokPsh

Assessing energy efficiencies, economy, and global warming potential (GWP) effects of major crop production systems in Iran: a case study in East Azerbaijan province

Abstract

Efficient use of energy in farming systems is one of the most important implications for decreasing greenhouse gas (GHG) emissions and mitigating global warming (GW). This paper describes the energy use patterns, analyze the economics, and report global warming potential effects of major crop production systems in East Azerbaijan province, Iran. For this purpose, 110 farmers whose main activity was major crop production in the region, including wheat, barley, carrot, tomato, onion, potato, alfalfa, corn silage, canola, and saffron, were surveyed. Some other data was obtained from the Ministry of Agriculture Jihad of Iran. Results showed that, in terms of total energy input, onion (87,556 Mj ha⁻¹) and potato (80,869 Mj ha⁻¹) production systems were more energy-intensive than other crops. Among the studied crops, the highest values of net return (6563.8 $ ha⁻¹) and benefit/cost ratio (1.95) were related to carrot and corn silage production systems, respectively. Studies have also shown that onion and saffron production systems emit the highest (5332.6 kg CO2eq ha⁻¹) and lowest (646.24 kg CO₂eq ha⁻¹) CO₂ eq. emission, respectively. When it was averaged across crops, diesel fuel accounted for the greatest GHG contribution with 43% of the total, followed by electric power (28%) and nitrogen fertilizer (21%). In the present study, eco-efficiency was calculated as a ratio of the gross production value and global warming potential effect for the studied crops. Out of all the studied crops, the highest values of eco-efficiency were calculated to be 8.65 $ kg CO₂eq⁻¹ for the saffron production system followed by the carrot (3.65 $ kg CO₂eq⁻¹) production. Generally, from the aspect of energy balance and use efficiency, the alfalfa production system was the best; however, from an economical point of view, the carrot production system was better than the other crops.

http://ift.tt/2rP5zI0

Pseudocontingencies and Choice Behavior in Probabilistic Environments With Context-Dependent Outcomes.

Author: Meiser, Thorsten; Rummel, Jan; Fleig, Hanna

DOI: 10.1037/xlm0000432

Publication Date: POST AUTHOR CORRECTIONS, 1 June 2017

http://ift.tt/2qJRoj5

In sickness and in health: The many roles of the minichromosome maintenance proteins

Publication date: Available online 1 June 2017
Source:Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Author(s): Henrique Neves, Hang Fai Kwok
Cell division is a tightly-regulated process that involves the contribution of a large number of proteins. Before they are able to undergo mitosis, cells must first synthesize new DNA, effectively duplicating their genome. This occurs during what is called the S-phase and requires a fine control in order to avoid replication errors.The synthesis of new DNA takes place in origin sites, specific locations in the genome where the double strands of DNA are unwound and separated, allowing for the binding of proteins and complexes that will build new strands of the genomic material, using the existent ones as molds, in what is referred to as semi-conservative process.While the overall flow of the DNA synthesis process has been elucidated, its regulation and the exact role of its contributors are not yet entirely understood. It is believed that the Minichromosome Maintenance (MCM) proteins occupy a central role in DNA synthesis. While the functions of each protein in this family vary, they are believed to have helicase and proofreading activity.Given their contribution to a central aspect in the conservation of life, further studies have been launched to understand how the MCM proteins may affect or be affected by pathologies involving cell division, namely neoplasia.In this review, we aim to give an overview on the members of the MCM family, what their functions are in a healthy environment and how they are altered in a variety of pathologies.



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Präoperative Evaluation erwachsener Patienten vor elektiven, nicht herz-thoraxchirurgischen Eingriffen1*

Anästhesiol Intensivmed Notfallmed Schmerzther
DOI: 10.1055/s-0043-111784

Die präoperative Anamnese und körperliche Untersuchung sind anerkannter Standard bei der Risikoevaluation von Patienten vor elektiven chirurgischen Eingriffen. Ob und unter welchen Umständen technische Voruntersuchungen dazu beitragen können, das perioperative Risiko zu reduzieren, ist bislang nur unzureichend untersucht. Auch besteht unter Anästhesisten, Chirurgen und Internisten vielfach Unsicherheit im perioperativen Umgang mit der Dauermedikation. Die deutschen wissenschaftlichen Fachgesellschaften für Anästhesiologie und Intensivmedizin (DGAI), Chirurgie (DGCH) und Innere Medizin (DGIM) haben daher eine gemeinsame Empfehlung zur präoperativen Evaluation erwachsener Patienten vor elektiven, nicht herz-thoraxchirurgischen Eingriffen erarbeitet und erstmals im Jahr 2010 publiziert. Die vorliegende Fassung ist eine Überarbeitung der Stellungnahme von 2010 unter Einbeziehung der seither publizierten Literatur sowie von aktuellen Leitlinien internationaler Fachgesellschaften. Zunächst werden die allgemeinen Prinzipien der präoperativen Evaluation dargestellt (Teil A). Das Vorgehen bei Patienten mit bekannten oder vermuteten kardiovaskulären Vorerkrankungen wird gesondert betrachtet (Teil B: „Erweiterte kardiale Diagnostik"). Abschließend wird der perioperative Umgang mit der Dauermedikation diskutiert (Teil C). Die vorgestellten Konzepte stellen fachübergreifende Empfehlungen dar, die ein strukturiertes und gemeinsames Vorgehen ermöglichen sollen. Ihr Ziel ist es, durch transparente und verbindliche Absprachen eine hohe Patientenorientierung unter Vermeidung unnötiger Voruntersuchungen zu gewährleisten, präoperative Untersuchungsabläufe zu verkürzen sowie letztlich Kosten zu reduzieren. Die gemeinsamen Empfehlungen von DGAI, DGCH und DGIM spiegeln den gegenwärtigen Kenntnisstand, aber auch die Meinungen von Experten wider, da nicht für jede Fragestellung wissenschaftliche Evidenz besteht. Daher werden eine regelmäßige Überprüfung und Aktualisierung der Empfehlungen erfolgen, sobald gesicherte neue Erkenntnisse vorliegen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2sztXd5

Light-emitting diode modulates carbohydrate metabolism by pancreatic duct regeneration

Abstract

Pancreatic lesions can produce metabolic disorders. Light-emitting diode (LED) has been used as a safe and effective phototherapy for cell proliferation and regeneration. We investigate the effects of phototherapy using LED irradiation on the pancreas after the injection of streptozotocin (STZ) to induce experimental diabetes and evaluate that the β cells can regenerate in the pancreas in an in vivo model and observe its implications on the control of carbohydrate metabolism. Twenty Wistar rats were randomized into three groups: non-diabetic control, diabetic control, and diabetic treated with LED. Except for the non-diabetic control group, all were induced to diabetes type I by streptozotocin injection. Treated groups were irradiated by LED: λ = 805 nm; 40 mW, 22 s; spot diameter 5 mm, spot area 0.196 cm², 0.88 J that it was applied on pancreas projection area for 5 consecutive days and monitored for 30 days. Diabetic group treated with LED showed regeneration of islets and ducts (p = 0.001) on the pancreas. Intraperitoneal insulin tolerance test showed differences between the diabetic control and diabetic treated groups (p = 0.03). In diabetic control group, the hepatic glycogen content was 296% lower when compared with diabetic treated with LED. Furthermore, in the diabetic control group, the glycogen content of the gastrocnemius muscle was 706% smaller when compared with diabetic treated with LED. This study shows that LED was able to modify morphological and metabolic features and also altered carbohydrate metabolism on irradiated pancreas in experimental model of diabetes.

http://ift.tt/2rP0rn9

AFF-1 fusogen can rejuvenate the regenerative potential of adult dendritic trees via self-fusion [RESEARCH ARTICLE]

Veronika Kravtsov, Meital Oren-Suissa, and Benjamin Podbilewicz

The aging brain undergoes structural changes, affecting brain homeostasis, neuronal function and consequently cognition. The complex architecture of dendritic arbors poses a challenge to understanding age-dependent morphological alterations, behavioral plasticity and remodeling following brain injury. Here, we use the PVD polymodal neurons of C. elegans as a model to study how aging affects neuronal plasticity. Using confocal live imaging of C. elegans PVD neurons, we demonstrate age-related progressive morphological alterations of intricate dendritic arbors. We show that insulin/IGF-1 receptor mutations (daf-2) fail to inhibit the progressive morphological aging of dendrites and do not prevent the minor decline in response to harsh touch during aging. We uncovered that PVD aging is characterized by a major decline in regenerative potential of dendrites following experimental laser dendrotomy. Furthermore, the remodeling of transected dendritic trees via AFF-1-mediated self-fusion can be restored in old animals by DAF-2 insulin/IGF-1 receptor mutations, and can be differentially reestablished by ectopic expression of AFF-1 fusion protein (fusogen). Thus, AFF-1 fusogen ectopically expressed in the PVD and mutations in DAF-2/IGF-1R, differentially rejuvenate some aspects of dendritic regeneration following injury.

http://ift.tt/2rum49g

Distinct roles for the mTOR pathway in postnatal morphogenesis, maturation and function of pancreatic islets [RESEARCH ARTICLE]

Katie L. Sinagoga, William J. Stone, Jacqueline V. Schiesser, Jamie I. Schweitzer, Leesa Sampson, Yi Zheng, and James M. Wells

While much is known about the molecular pathways that regulate embryonic development and adult homeostasis of the endocrine pancreas, little is known about what regulates early postnatal development and maturation of islets. Given that birth marks the first exposure to enteral nutrition, we investigated how nutrient-regulated signaling pathways influence postnatal islet development. To do this we performed loss-of-function studies of mechanistic target of rapamycin (mTOR), a highly conserved kinase within a nutrient-sensing pathway known to regulate cellular growth, morphogenesis and metabolism. Deletion of mTOR in pancreatic endocrine cells had no significant effect on their embryonic development. However, within the first 2 weeks after birth, mTOR-deficient islets became dysmorphic, β–cell maturation and function was impaired, and animals lost islet mass. Moreover, we discovered these distinct functions of mTOR are mediated by separate downstream branches of the pathway, in that mTORC1 (Raptor) is the main complex mediating maturation and function of islets, whereas mTORC2 (Rictor) impacts islet mass and architecture. Taken together, these findings suggest that nutrient-sensing may be a trigger for postnatal β cell maturation and islet development.

http://ift.tt/2qLOui3

Incompatibility between mitochondrial and nuclear genomes during oogenesis results in ovarian failure and embryonic lethality [RESEARCH ARTICLE]

Chunyang Zhang, Kristi L. Montooth, and Brian R. Calvi

Mitochondrial dysfunction can cause female infertility. An important remaining question is the extent to which incompatibility between mitochondrial and nuclear genomes contributes to female infertility. It was previously shown that a mitochondrial haplotype from D. simulans (simw⁵⁰¹) is incompatible with a nuclear genome from the D. melanogaster strain Oregon-R (OreR), resulting in impaired development, which was enhanced at higher temperature. This mito-nuclear incompatibility is between alleles of the nuclear-encoded mitochondrial tyrosyl- tRNA synthetase (Aatm) and the mitochondrial-encoded tyrosyl-tRNA that it aminoacylates. Here, we show that this mito-nuclear incompatibility causes a severe temperature-sensitive female infertility. The OreR nuclear genome contributed to death of ovarian germline stem cells and reduced egg production, which was further enhanced by the incompatibility with simw⁵⁰¹ mitochondria. Mito-nuclear incompatibility also resulted in aberrant egg morphology and a maternal-effect on embryonic chromosome segregation and survival, which was completely dependent on the temperature and mito-nuclear genotype of the mother. Our findings show that maternal mito-nuclear incompatibility during Drosophila oogenesis has severe consequences for egg production and embryonic survival, with important broader relevance to human female infertility and mitochondrial replacement therapy.

http://ift.tt/2ruc9jX

BMP signaling orchestrates a transcriptional network to control the fate of mesenchymal stem cells in mice [RESEARCH ARTICLE]

Jifan Feng, Junjun Jing, Jingyuan Li, Hu Zhao, Vasu Punj, Tingwei Zhang, Jian Xu, and Yang Chai

Signaling pathways are used reiteratively in different developmental processes yet produce distinct cell fates through specific downstream transcription factors. In this study, we used tooth root development as a model to investigate how the BMP signaling pathway regulates transcriptional complexes to direct the fate determination of multipotent mesenchymal stem cells (MSCs). We first identified the MSC population supporting mouse molar root growth as Gli1+ cells. Using a Gli1-mediated transgenic animal model, our results provide the first in vivo evidence that BMP signaling activity is required for the odontogenic differentiation of MSCs. Specifically, we identified transcription factors, Pax9, Klf4, Satb2, and Lhx8, that are downstream of BMP signaling and are expressed in a spatially restricted pattern potentially involved in determining distinct cellular identities within the dental mesenchyme. Finally, we found that overactivation of one key transcription factor, Klf4, associated with the odontogenic region, promotes odontogenic differentiation of MSCs. Collectively, our results demonstrate the functional significance of BMP signaling in regulating MSC fate during root development and shed light on how BMP signaling can achieve functional specificity in regulating diverse organ development.

http://ift.tt/2ru9ze8

Placental labyrinth formation in mice requires endothelial FLRT2-UNC5B signaling [RESEARCH ARTICLE]

Ikue Tai-Nagara, Yusuke Yoshikawa, Naoko Numata, Tomofumi Ando, Keisuke Okabe, Yuki Sugiura, Masaki Ieda, Nobuyuki Takakura, Osamu Nakagawa, Bin Zhou, Koji Okabayashi, Makoto Suematsu, Yuko Kitagawa, Martin Bastmeyer, Kohji Sato, Rüdiger Klein, Sutip Navankasattusas, Dean Y. Li, Satoru Yamagishi, and Yoshiaki Kubota

The placental labyrinth is the interface for gas and nutrient exchange between the embryo and the mother; hence its proper development is essential for embryogenesis. However, the molecular mechanism underlying development of the placental labyrinth, particularly in terms of its endothelial organization, is not well understood. Here, we determined that fibronectin leucine-rich transmembrane protein 2 (FLRT2), a repulsive ligand of the UNC5 receptor family for neurons, is unexpectedly expressed in endothelial cells specifically in the placental labyrinth. Mice lacking FLRT2 in endothelial cells exhibited embryonic lethality at mid-gestation, with systemic congestion and hypoxia. Although they lacked apparent deformities in the embryonic vasculature and heart, the placental labyrinths of these embryos exhibited aberrant alignment of endothelial cells, which disturbed the feto-maternal circulation. Interestingly, this vascular deformity was related to endothelial repulsion through binding to the UNC5B receptor. Our results suggest that the proper organization of the placental labyrinth depends on coordinated inter-endothelial repulsion, which prevents uncontrolled layering of the endothelium.

http://ift.tt/2qL6Dg5

Defining epithelial cell dynamics and lineage relationships in the developing lacrimal gland [RESEARCH ARTICLE]

D'Juan Farmer, Sara Nathan, Jennifer Finley, Kevin Shengyang Yu, Elaine Emmerson, Lauren Byrnes, Julie Sneddon, Michael McManus, Aaron Tward, and Sarah Knox

The tear producing lacrimal gland is a tubular organ that protects and lubricates the ocular surface. While the lacrimal gland possesses many features that make it an excellent model to understand tubulogenesis, the cell types and lineage relationships that drive lacrimal gland formation are unclear. Using single cell sequencing and other molecular tools, we reveal novel cell identities and epithelial lineage dynamics that underlie lacrimal gland development. We show that the lacrimal gland from its earliest developmental stages is composed of multiple subpopulations of immune, epithelial, and mesenchymal cell lineages. The epithelial lineage exhibits the most substantiative cellular changes, transitioning through a series of unique transcriptional states to become terminally differentiated acinar, ductal and myoepithelial cells. Furthermore, lineage tracing in postnatal and adult glands provides the first direct evidence of unipotent KRT5+ epithelial cells in the lacrimal gland. Finally, we show conservation of developmental markers between the developing mouse and human lacrimal gland, supporting the use of mice to understand human development. Together, our data reveal critical features of lacrimal gland development that have broad implications for understanding epithelial organogenesis.

http://ift.tt/2ruCI8M

Defective Hand1 phosphoregulation uncovers essential roles for Hand1 in limb morphogenesis [RESEARCH ARTICLE]

Beth A. Firulli, Hannah Milliar, Kevin P. Toolan, Jade Harkin, Robyn K. Fuchs, Alex G. Robling, and Anthony B. Firulli

The morphogenesis of the vertebrate limbs is a complex process where cell signaling and transcriptional regulation coordinate diverse structural adaptations across species. In this study, we examine the consequences of altering Hand1 dimer choice regulation within the developing vertebrate limbs. Although Hand1 deletion via the limb-specific Prx1-Cre reveals a non-essential role for Hand1 in limb morphogenesis, altering Hand1 phosphoregulation, and consequently Hand1 dimerization affinities, results in a severe truncation of anterior-proximal limb elements. Molecular analysis reveals a non-cell autonomous mechanism that causes widespread cell death within embryonic limb bud. In addition, we observe changes in proximal anterior gene regulation including a reduction in the expression of Irx3&5, Gli3, and Alx4, all of which are upregulated in Hand2 limb conditional knockouts. A reduction of Hand2 and Shh gene dosage improves the integrity of anterior limb structures validating this proposed mechanism.

http://ift.tt/2qLBWae

Immunization of Tg-APPswe/PSEN1dE9 mice with Aβ3-10-KLH vaccine prevents synaptic deficits of Alzheimer’s disease

Publication date: 14 August 2017
Source:Behavioural Brain Research, Volume 332
Author(s): Yuan Meng, Li Ding, HuiYi Zhang, WenChao Yin, Yi Yan, YunPeng Cao
The amyloid cascade hypothesis is widely accepted by researchers as the mechanism of Alzheimer's disease. Active immunization to eliminate Aβ depositions has been used in preclinical and clinical studies. Aβ3-10-KLH is a vaccine of the Aβ3-10 peptide combined with keyhole limpet hemocyanin (KLH). We immunized 2.5-month-old Tg-APPswe/PSEN1dE9 mice with Aβ3-10-KLH peptide and Aβ1-42 peptide to eliminate Aβ deposits in the brains of these transgenic mice. The results of immunohistochemical staining and transmission electron microscopy detection indicated that our new vaccine was more advantageous in protecting synaptic function and structure than the Aβ1-42 peptide. Aβ3-10-KLH peptide is an effective vaccine in the treatment of Alzheimer's disease.



http://ift.tt/2rPdncF

BRAF Mutations as Predictive Biomarker for Response to Anti-EGFR Monoclonal Antibodies

Recently, the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) recommended that patients with epidermal growth factor receptor (EGFR)-expressing metastatic colorectal cancer could be treated with anti-EGFR monoclonal antibodies (mAbs) cetuximab and panitumumab only in absence of Rat-Sarcoma (RAS) mutations. In addition to the previously established biomarker Kirsten rat sarcoma viral oncogene homolog (KRAS) exon 2, cumulative evidence also shows that patients whose tumors harbor KRAS exons 3 or 4 and neuroblastoma rat-sarcoma viral oncogene homolog (NRAS) exons 2, 3, and 4 mutations are found unlikely to benefit from anti-EGFR treatment.

In line with the resistance of RAS mutated (mt) tumors, treatment response in BRAFmt tumors may also be altered given their important role in the EGFR signaling pathway. However, BRAF is not recommended as predictive biomarker yet because the evidence for the impact of BRAF mutations on treatment outcome is considered insufficient.

This article summarizes the evidence for the impact of BRAF mutations on treatment outcome of anti-EGFR mAbs. Based on a review of literature, eight meta-analyses were included that consistently show that patients with BRAF mutations have a lack of treatment benefit of anti-EGFR mAbs. After discussing the quality and quantity of available evidence, we conclude that evidence is stronger than suggested by ESMO and ASCO. Additionally, we highlight that the quality of evidence for BRAF is even higher than for extended RAS as a biomarker. We therefore advise ESMO and ASCO to reconsider BRAF status as a predictive biomarker for response. The Oncologist 2017;22:1–9

Implications for Practice.

In metastatic colorectal cancer (mCRC), therapy with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies cetuximab and panitumumab is indicated in absence of RAS mutations. Cumulative evidence shows that patients with BRAF mutations, who comprise 10% of the mCRC population, do not benefit from anti-EGFR-antibody treatment. Although guidelines state that evidence for BRAF as a predictive marker is insufficient, we highlight that the quality and quantity of evidence is higher than suggested. We therefore encourage the use of BRAF as a predictive marker in order to exclude patients from therapy for whom limited treatment benefit is expected.

http://ift.tt/2qKc4Yq

Präoperative Evaluation erwachsener Patienten vor elektiven, nicht herz-thoraxchirurgischen Eingriffen1*

Anästhesiol Intensivmed Notfallmed Schmerzther
DOI: 10.1055/s-0043-111784

Die präoperative Anamnese und körperliche Untersuchung sind anerkannter Standard bei der Risikoevaluation von Patienten vor elektiven chirurgischen Eingriffen. Ob und unter welchen Umständen technische Voruntersuchungen dazu beitragen können, das perioperative Risiko zu reduzieren, ist bislang nur unzureichend untersucht. Auch besteht unter Anästhesisten, Chirurgen und Internisten vielfach Unsicherheit im perioperativen Umgang mit der Dauermedikation. Die deutschen wissenschaftlichen Fachgesellschaften für Anästhesiologie und Intensivmedizin (DGAI), Chirurgie (DGCH) und Innere Medizin (DGIM) haben daher eine gemeinsame Empfehlung zur präoperativen Evaluation erwachsener Patienten vor elektiven, nicht herz-thoraxchirurgischen Eingriffen erarbeitet und erstmals im Jahr 2010 publiziert. Die vorliegende Fassung ist eine Überarbeitung der Stellungnahme von 2010 unter Einbeziehung der seither publizierten Literatur sowie von aktuellen Leitlinien internationaler Fachgesellschaften. Zunächst werden die allgemeinen Prinzipien der präoperativen Evaluation dargestellt (Teil A). Das Vorgehen bei Patienten mit bekannten oder vermuteten kardiovaskulären Vorerkrankungen wird gesondert betrachtet (Teil B: „Erweiterte kardiale Diagnostik"). Abschließend wird der perioperative Umgang mit der Dauermedikation diskutiert (Teil C). Die vorgestellten Konzepte stellen fachübergreifende Empfehlungen dar, die ein strukturiertes und gemeinsames Vorgehen ermöglichen sollen. Ihr Ziel ist es, durch transparente und verbindliche Absprachen eine hohe Patientenorientierung unter Vermeidung unnötiger Voruntersuchungen zu gewährleisten, präoperative Untersuchungsabläufe zu verkürzen sowie letztlich Kosten zu reduzieren. Die gemeinsamen Empfehlungen von DGAI, DGCH und DGIM spiegeln den gegenwärtigen Kenntnisstand, aber auch die Meinungen von Experten wider, da nicht für jede Fragestellung wissenschaftliche Evidenz besteht. Daher werden eine regelmäßige Überprüfung und Aktualisierung der Empfehlungen erfolgen, sobald gesicherte neue Erkenntnisse vorliegen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2sztXd5

Oncology Drug Approvals: Evaluating Endpoints and Evidence in an Era of Breakthrough Therapies

http://ift.tt/2s3n4Ec

Inflammatory Arthritis: A Newly Recognized Adverse Event of Immune Checkpoint Blockade

http://ift.tt/2qJB9CY

Regarding "Oncology Drug Approvals: Evaluating Endpoints and Evidence in an Era of Breakthrough Therapies"

http://ift.tt/2s3xvr9

Congratulations to SLHS’ student NSSLHA chapter for receiving National Silver Chapter Honors!

Congratulations to SLHS' student NSSLHA chapter for receiving National Silver Chapter Honors!

 

http://ift.tt/2szsq6P

Thoracic Outlet Syndrome after the Nuss Procedure for Pectus Excavatum―Is It a Rare Complication?

The present study aims to elucidate the frequency of thoracic outlet syndrome after the Nuss procedure for pectus excavatum and the conditions in which thoracic outlet syndrome is likely to develop.

http://ift.tt/2qJChX6

Reliability and validity of Mamma Balance®: Novel software to assess the symmetry of the nipple-areola-complex position

It is important to achieve as much symmetry in the breasts as possible during breast reconstruction. The nipple-areola complex (NAC) position is an important component of a breast appearance, and it critically affects the aesthetic outcome of surgery. Mamma Balance® (MB) (Medic Engineering K.K, ver. 1.0.3) can automatically calculate and assess the degree of the NAC position's symmetry with one continuous variable. The purpose of this study was to evaluate the reliability and validity of this software to assess the NAC's symmetry.

http://ift.tt/2s3cwF8

An objective assessment of Botulinum toxin type A injection in the treatment of post facial palsy synkinesis and hyperkinesis using the Synkinesis Assessment Questionnaire (SAQ)

The aim of this study is to provide reliable and valid evidence that Botulinum toxin (BTX-A) is a successful treatment for facial synkinesis in facial palsy using the synkinesis assessment questionnaire tool (SAQ). 51 patients completed questionnaires pre and post BTX-A treatment over 103 cycles of treatment. Each patient was individually assessed and then treated according to their presenting symptoms with a dosage in each injection site of between 0.5 to 5 U of BTX-A. A two-tailed, paired samples t-test was used to compare the scores for each question before and after treatment.

http://ift.tt/2qJYvrO

Impact of adjuvant anti-estrogen therapies (tamoxifen and aromatase inhibitors) on perioperative outcomes of breast reconstruction

Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend adjuvant treatment duration from 5 to 10 years. The link between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. However, while estrogens play a crucial role in skin healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative complications, including wound healing complications.

http://ift.tt/2s306gm

Refining the Extended Circumflex Scapular Flap for Neck Burn Reconstruction: A 30-Year Experience

Neck burn sequelae remain a major challenge for the reconstructive surgeon. To achieve satisfactory functional and aesthetic results, the anterior neck aesthetic unit must be covered as a single unit. In cases where free flaps are required, harvesting a flap of sufficient size can cause major donor site morbidity. In 1994, we published our favorable 6-year experience reconstructing neck burn sequelae with an Extended Circumflex Scapular Flap (ECSF). We have since made several modifications to the technique that improve long-term functional and aesthetic results.

http://ift.tt/2s3tKC3

Donor Site Morbidity in DIEP Free Flap Breast Reconstructions: A Comparison of Unilateral, Bilateral, and Bipedicled Surgical Procedure Types

The use of abdominal tissue in post-mastectomy autologous breast reconstruction is a popular choice among reconstructive surgeons. This is the first study to evaluate donor complications comparing unilateral, bilateral and bipedicled DIEP breast reconstructions.

http://ift.tt/2qKantO

The Indian Nose: An anthropometric analysis

Anthropometric measurements of nose are of great importance in planning aesthetic nasal surgery. Abundant literature is available on anthropometric analysis of Caucasians and Orientals, without similar references on Indian nose and its regional differences. Thus, we conducted a descriptive cross sectional epidemiological study of one thousand volunteers, with equal number of subjects derived from five geographic groups namely North; Central; West; South; and Himalayan region to determine differences in nasal morphology of Indian population and amongst its various regions.

http://ift.tt/2s2XnDO

Incidence and Risk Factors for Venous Thromboembolism in Bilateral Breast Reduction Surgery: An Analysis of the National Surgical Quality Improvement Program

Risk of venous thromboembolism (VTE) in patients undergoing bilateral breast reduction surgery remains unknown. Aim of this study was to determine VTE incidence and risk factors in this patient cohort.

http://ift.tt/2qK7b1o

STEAP4: its emerging role in metabolism and homeostasis of cellular iron and copper

Preserving energy homeostasis in the presence of stressors such as proinflammatory cytokines and nutrient overload is crucial to maintaining normal cellular function. Six-transmembrane epithelial antigen of the prostate 4 (STEAP4), a metalloreductase involved in iron and copper homeostasis, is thought to play a potentially important role in the cellular response to inflammatory stress. Genome-wide association studies have linked various mutations in STEAP4 with the development of metabolic disorders such as obesity, metabolic syndrome, and type 2 diabetes. Several studies have shown that expression of Steap4 is modulated by inflammatory cytokines, hormones, and other indicators of cellular stress, and that STEAP4 may protect cells from damage, helping to maintain normal metabolic function. STEAP4 appears to be particularly relevant in metabolically oriented cells, such as adipocytes, hepatocytes, and pancreatic islet cells. These cells struggle to maintain their function in iron or copper overloaded states, presumably due to increased oxidative stress, suggesting STEAP4's role in metal homeostasis is critical to the maintenance of cellular homeostasis in general, and in preventing the onset of metabolic disease. In this review, we explore genetic associations of STEAP4 with metabolic disorders, and we examine STEAP4 tissue expression, subcellular localization, regulation, structure, and function as it relates to metabolic diseases. We then examine how STEAP4's role as a regulator of cellular iron and copper may relate to type 2 diabetes.

http://ift.tt/2ruB0En

Origin of a rapidly evolving homeostatic control system programming testis function

Mammals share common strategies for regulating reproduction, including a conserved hypothalamic-pituitary-gonadal axis yet individual species exhibit differences in reproductive performance. In this report, we describe the discovery of a species-restricted homeostatic control system programming testis growth and function. Prl3c1 is a member of the prolactin gene family and its protein product (PLP-J) was discovered as a uterine cytokine contributing to the establishment of pregnancy. We utilized mouse mutagenesis of Prl3c1 and revealed its involvement in the regulation of the male reproductive axis. The Prl3c1 null male reproductive phenotype was characterized by testiculomegaly and hyperandrogenism. The larger testes in the Prl3c1 null mice were associated with an expansion of the Leydig cell compartment. Prl3c1 locus is a template for two transcripts (Prl3c1-v1 and Prl3c1-v2) expressed in a tissue specific pattern. Prl3c1-v1 is expressed in uterine decidua, while Prl3c1-v2 is expressed in Leydig cells of the testis. 5'RACE, chromatin immunoprecipitation, and DNA methylation analyses were used to define cell-specific promoter usage and alternative transcript expression. We examined the Prl3c1 locus in five murid rodents and showed that the testicular transcript and encoded protein are the result of a recent retrotransposition event at the Mus musculus Prl3c1 locus. Prl3c1-v1 encodes PLP-J V1 and Prl3c1-v2 encodes PLP-J V2. Each protein exhibits distinct intracellular targeting and actions. PLP-J V2 possesses Leydig cell static actions consistent with the Prl3c1 null testicular phenotype. Analysis of the biology of the Prl3c1 gene has provided insight into a previously unappreciated homeostatic setpoint control system programming testicular growth and function.

http://ift.tt/2qLGz4j

Predictive validity of the GOSLON Yardstick index in patients with unilateral cleft lip and palate: A systematic review

by Cindy Buj-Acosta, Vanessa Paredes-Gallardo, José María Montiel-Company, Alberto Albaladejo, Carlos Bellot-Arcís

Among the various indices developed for measuring the results of treatment in patients born with unilateral cleft lip and palate (UCLP), the GOSLON Yardstick index is the most widely used to assess the efficacy of treatment and treatment outcomes, which in UCLP cases are closely linked to jaw growth. The aim of this study was to conduct a systematic review to validate the predictability of growth using the GOSLON Yardstick in patients born with UCLP. A systematic literature review was conducted in four Internet databases: Medline, Cochrane Library, Scopus and Embase, complemented by a manual search and a further search in the databases of the leading journals that focus on this topic. An electronic search was also conducted among grey literature. The search identified a total of 131 articles. Duplicated articles were excluded and after reading titles and abstracts, any articles not related to the research objective were excluded, leaving a total of 21 texts. After reading the complete text, only three articles fulfilled the inclusion criteria. The results showed a predictive validity of between 42.2% and 64.7%, which points to a lack of evidence in the literature for the predictive validity of the GOSLON Yardstick index used in children born with UCLP.

http://ift.tt/2rpFYT2

Letter to the editor

http://ift.tt/2rBcBPF

The effect of training level on complications after free flap surgery of the head and neck

Analyze postoperative complications after free flap surgery based on PGY training level.

http://ift.tt/2ruzanf

The effect of training level on complications after free flap surgery of the head and neck

Analyze postoperative complications after free flap surgery based on PGY training level.

http://ift.tt/2ruzanf

Innate mechanism of pollen and cat dander-induced oxidative stress and DNA damage in airways

Specific allergenic extracts induce TLR4-dependent oxidative stress and DNA damage.

http://ift.tt/2szoiDI

Prostaglandin E2 stimulates adaptive IL-22 production and promotes allergic contact dermatitis

Prostaglandin E2 promotes IL-22 production from T cells that mediates IL-22-driven development of allergic contact dermatitis.

http://ift.tt/2rBprNP

Historical and future emission of hazardous air pollutants (HAPs) from gas-fired combustion in Beijing, China

Abstract

The consumption of natural gas in Beijing has increased in the past decade due to energy structure adjustments and air pollution abatement. In this study, an integrated emission inventory of hazardous air pollutants (HAPs) emitted from gas-fired combustion in Beijing was developed for the period from 2000 to 2014 using a technology-based approach. Future emission trends were projected through 2030 based on current energy-related and emission control policies. We found that emissions of primary HAPs exhibited an increasing trend with the rapid increase in natural gas consumption. Our estimates indicated that the total emissions of NO_X , particulate matter (PM)₁₀, PM_2.5, CO, VOCs, SO₂, black carbon, Pb, Cd, Hg, As, Cr, Cu, Ni, Zn, polychlorinated dibenzo-p-dioxins and dibenzofurans, and benzo[a]pyrene from gas-fired combustion in Beijing were approximately 22,422 t, 1042 t, 781 t, 19,097 t, 653 t, 82 t, 19 t, 0.6 kg, 0.1 kg, 43 kg, 52 kg, 0.3 kg, 0.03 kg, 4.3 kg, 0.6 kg, 216 μg, and 242 g, respectively, in 2014. To mitigate the associated air pollution and health risks caused by gas-fired combustion, stricter emission standards must be established. Additionally, combustion optimization and flue gas purification system could be used for lowering NO_X emissions from gas-fired combustion, and gas-fired facilities should be continuously monitored based on emission limits.

Graphical abstract

Spatial distribution and typical live photos of gas-fired boiler in Beijing

http://ift.tt/2rOtW8G

Phosphaturic mesenchymal tumor of the nasal cavity and paranasal sinuses: A clinical curiosity presenting a diagnostic challenge

Publication date: Available online 1 June 2017
Source:Auris Nasus Larynx
Author(s): Shubhada V. Kane, Aanchal Kakkar, Nikita Oza, Epari Sridhar, Prathamesh S. Pai
Phosphaturic mesenchymal tumor (PMT) is a rare mesenchymal neoplasm associated with tumor-induced osteomalacia (TIO) and elevated serum FGF-23. Common in extremities, PMT rarely occurs in sinonasal region. We report a series of sinonasal PMT diagnosed at our institute over a 6-year period.Six cases of sinonasal PMT were identified during this period, of which five presented with features of TIO. Median age of patients was 45.5 years. All six tumors were composed of stellate to spindled cells, with prominent staghorn vasculature in four cases. Typical smudgy matrix was seen in all cases, but only focally; grungy calcification was absent.Accurate diagnosis of PMTs is imperative, as complete excision leads to dramatic resolution of TIO symptoms. Lack of knowledge of this entity prevents clinicians from ordering relevant investigations. Absence of specific morphological features, like grungy calcification, and presentation at atypical locations makes the diagnosis challenging. Awareness of this entity is essential in order to suspect PMT in patients presenting with a soft tissue mass and features of TIO, however unusual the location may be.



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The pesticide chlordecone is trapped in the tortuous mesoporosity of allophane clays

Abstract

Some volcanic soils like andosols contain short-range order nanoclays (allophane) which build aggregates with a tortuous and fractal microstructure. The aim of the work was to study the influence of the microstructure and mesoporosity of the allophane aggregates on the pesticide chlordecone retention in soils. Our study shows that the allophane microstructure favors pollutants accumulation and sequestration in soils. We put forth the importance of the mesoporous microstructure of the allophane aggregates for pollutant trapping in andosols. We show that the soil contamination increases with the allophane content but also with the mesopore volume, the tortuosity, and the size of the fractal aggregate. Moreover, the pore structure of the allophane aggregates at nanoscale favors the pesticide retention. The fractal and tortuous aggregates of nanoparticles play the role of nanolabyrinths. It is suggested that chlordecone storage in allophanic soils could be the result of the low transport properties (permeability and diffusion) in the allophane aggregates. The poor accessibility to the pesticide trapped in the mesopore of allophane aggregates could explain the lower pollutant release in the environment.

http://ift.tt/2rtQPuV

Resource recovery of food waste through continuous thermophilic in-vessel composting

Abstract

In the Kingdom of Saudi Arabia (KSA) and Gulf region, a very small amount of municipal solid waste (MSW) is treated for compost production. The produced compost through traditional methods of compost piles and trenches does not coincide with the international standards of compost quality. Therefore, in this study, a continuous thermophilic composting (CTC) method is introduced as a novel and efficient technique for treating food waste into a quality compost in a short period of time. The quality of the compost was examined by degradation rates of organic matter (OM), changes in total carbon (TC), ash contents, pH, dynamics in ammonium nitrogen (NH₄-N) and nitrate nitrogen (NO₃-N), and nitrification index (NI). The results showed that thermophilic treatment at 60 °C increased the pH of the substrate and promoted degradation and mineralization process. After 30 days of composting, the degree of OM degradation was increased by 43.26 and 19.66%, NH₄-N by 65.22 and 25.23%, and NO₃-N by 44.76 and 40.05% as compared to runs treated at 25 and 40 °C, respectively. The stability of the compost was attained after 30 to 45 days with quality better than the compost that was stabilized after 60 days of the experiment under mesophilic treatment (25 °C). The final compost also showed stability at room temperature, confirming the rapid degradation and maturation of food waste after thermophilic treatment. Moreover, the quality of produced compost is in line with the compost quality standard of United States (US), California, Germany, and Austria. Hence, CTC can be implemented as a novel method for rapid decomposition of food waste into a stable organic fertilizer in the given hot climatic conditions of KSA and other Gulf countries with a total net saving of around US $70.72 million per year.

http://ift.tt/2qLbaPf

A novel mutation in the MYO7A gene is associated with Usher syndrome type 1 in a Chinese family

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Xiaoguang He, Qi Peng, Siping Li, Pengyuan Zhu, Chunqiu Wu, Chunbao Rao, Jingqi Lin, Xiaomei Lu
ObjectivesWe aimed to investigate the genetic causes of hearing loss in a Chinese proband with autosomal recessive congenital deafness.MethodsThe targeted capture of 159 known deafness genes and next-generation sequencing were performed to study the genetic causes of hearing loss in the Chinese family. Sanger sequencing was employed to verify the variant mutations in members of this family.ResultsThe proband harbored two mutations in the MYO7A gene in the form of compound heterozygosity. She was found to be heterozygous for a novel insertion mutation c.3847_3848 ins TCTG (p.N1285LfsX24) in exon 30 and for the known mutation c.2239_2240delAG (p.R747S fsX16)in exon 19. The novel mutation was absent in the 1000 Genomes Project. These variants were carried in the heterozygous state by the parents and were therefore co-segregated with the genetic disease. Clinical re-assessment, including detailed audiologic and ocular examinations, revealed congenital deafness and retinitis pigmentosa in the proband. Collectively, the combination of audiometric, ophthalmologic and genetic examinations successfully confirmed the phenotype of Usher syndrome type 1 (USH1).ConclusionThis study demonstrates that the novel mutation c.3847_3848insTCTG (p. N1285LfsX24) in compound heterozygosity with c.2239_2240delAG in the MYO7A gene is the main cause of USH1 in the proband. Our study expands the mutational spectrum of MYO7A and provides a foundation for further investigations elucidating the MYO7A-related mechanisms of USH1.



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