Principal component analysis of three-dimensional face shape: Identifying shape features that change with age

Abstract

Background

The types of shape feature that constitutes a face have not been comprehensively established, and most previous studies of age-related changes in facial shape have focused on individual characteristics, such as wrinkle, sagging skin, etc. In this study, we quantitatively measured differences in face shape between individuals and investigated how shape features changed with age.

Methods

We analyzed three-dimensionally the faces of 280 Japanese women aged 20-69 years and used principal component analysis to establish the shape features that characterized individual differences. We also evaluated the relationships between each feature and age, clarifying the shape features characteristic of different age groups.

Results

Changes in facial shape in middle age were a decreased volume of the upper face and increased volume of the whole cheeks and around the chin. Changes in older people were an increased volume of the lower cheeks and around the chin, sagging skin, and jaw distortion.

Conclusion

Principal component analysis was effective for identifying facial shape features that represent individual and age-related differences. This method allowed straightforward measurements, such as the increase or decrease in cheeks caused by soft tissue changes or skeletal-based changes to the forehead or jaw, simply by acquiring three-dimensional facial images.

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Glial control of neurogenesis

Publication date: December 2017
Source:Current Opinion in Neurobiology, Volume 47
Author(s): Sven Falk, Magdalena Götz
Glial cells are central components of all neurogenic niches in the embryonic as well as in the adult central nervous system. While neural stem cells (NSCs) themselves exhibit glial features the behavior of NSCs is also strongly influenced by niche glial cells. Recently, studies have begun to uncover a large variety of glial cell-extrinsic as well as intrinsic factors that play crucial roles in the control of NSCs and the regulation of the cellular output from the neurogenic niches. In this review, we focus on mechanisms underlying the formation of adult NSCs by embryonic radial glia cells, discuss the influence of niche glia cells on adult NSCs and examine how the neurogenic potential of glial cells is controlled.



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Case of alopecia induced by sorafenib, possible mechanism similar to alopecia areata

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Pigmented poroma on the temporal region dermoscopically mimicking basal cell carcinoma: A report of two cases

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Epstein–Barr virus-positive mucocutaneous ulcer in a patient with polycythemia vera treated with oral hydroxyurea

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Two cases of infundibular squamous cell carcinoma on the nose with aggressive clinical behavior: Case report and review of the published work

Abstract

Case 1 was a 75-year-old Japanese man who presented with a poorly demarcated, dark-red nodule with a destructive defect in the center, measuring 3 cm × 2 cm on the right wing of his nose. The histological diagnosis was a common form of infundibular squamous cell carcinoma. Atypical neoplastic cells radiated from the wall of a follicular infundibulum. The majority of neoplastic cells were positive for AE1/AE3 and 34βE12. Cytokeratin 17 expression was seen in the suprabasal cells of the deeply situated neoplastic components. Case 2 was a 73-year-old Japanese man who presented with a poorly demarcated, dark-red nodule with an irregularly shaped ulcer in the center, measuring 3 cm × 2 cm on the left wing of his nose. The histological diagnosis was a crater form of infundibular squamous cell carcinoma. Atypical neoplastic cells radiated from the broad base of the central keratin-filled crater, continuous with two infundibular canals. In both cases, some of the more deeply situated aggregations were composed of neoplastic keratinocytes with eosinophilic glassy or pale cytoplasm. In addition, no atypical keratinocytes could be seen in the interfollicular epidermis. In case 1, a hematogenous metastasis to the vocal cord and the forehead occurred in addition to a lymph node metastasis. In case 2, a local recurrence occurred with an intralymphatic dissemination. We describe two cases of infundibular squamous cell carcinoma on the nose with aggressive clinical behavior, one of which was accompanied by a hematogenous metastasis while another revealed a local recurrence.

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Digital pebbles without evidence of diabetes: A case report

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Outcomes following completion and salvage surgery for early rectal cancer: a systematic review

Publication date: Available online 14 November 2017
Source:European Journal of Surgical Oncology
Author(s): Helen JS. Jones, Chris Cunningham, Gary A. Nicholson, Roel Hompes
ObjectivesTo establish outcomes after completion and salvage surgery following local excision in literature published since 2005, to inform decision-making when offering local excision.BackgroundLocal excision of early rectal cancer aims to offer cure while maintaining quality of life through organ preservation. However, some patients will require radical surgery, prompted by unexpected poor pathology or local recurrence. Consistent definition and reporting of these scenarios is poor. We propose the term "salvage surgery" for recurrence after local excision and "completion surgery" for poor pathology.MethodsElectronic databases were searched in February 2016. Studies since 2005 describing outcomes for radical surgery following local excision of rectal cancer were included. Pooled and average values were obtained.ResultsA total of 23 studies included 262 completion and 165 salvage operations. Most completion operations were done within 4 weeks; local recurrence rate was 5% and overall disease recurrence rate was 14%.The majority of salvage operations for local recurrence were within 15 months of local excision, often following adjuvant treatment. Re-do local excision was used in 15%; APR was the most common radical procedure. Further local recurrence was uncommon (3%) but overall disease recurrence rate was 13%. Estimated 5-year survival was in the order of 50%. Heterogeneity was high among the studies.ConclusionsPatients undergoing local excision must be informed of risks and expected outcomes, but better data on completion and salvage surgery are required to achieve this.



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Breast Lesion Excision System in the diagnosis and treatment of intraductal papillomas – a feasibility study

Publication date: Available online 14 November 2017
Source:European Journal of Surgical Oncology
Author(s): Laura Niinikoski, Katja Hukkinen, Marjut H.K. Leidenius, Anders Ståhls, Tuomo J. Meretoja
ObjectivesThis study aims to evaluate the feasibility of Breast Lesion Excision System (BLES) in the treatment of intraductal papillomas.Material and methodsAll patients with a needle biopsy –based suspicion of an intraductal papilloma who consequently underwent a BLES procedure at Helsinki University Hospital between 2011 and 2016 were included in this retrospective study. The purpose of the BLES procedure was either to excise the entire lesion or in few cases to achieve better sampling.ResultsIn total, 74 patients underwent 80 BLES procedures. Pathological diagnosis after the BLES biopsy confirmed an intraductal papilloma without atypia in 43 lesions, whereas 10 lesions were upgraded to high-risk lesions (HRL) with either atypical ductal hyperplasia or lobular carcinoma in situ. Five cases were upgraded to malignancy, two were invasive ductal carcinomas and three were ductal carcinoma in situ. Additionally, 18 lesions were diagnosed as other benign lesions. Four procedures failed. Complete excision with BLES was achieved in 19 out of 43 intraductal papillomas, 6 out of 10 HRL and two out of five malignant lesions. No major complications occurred. The BLES procedure was adequate in the management of the 71 breast lesions.ConclusionThe BLES procedure is an acceptable method for the management of small benign and high-risk breast lesions such as intraductal papillomas in selected patients. Thus, a great amount of diagnostic surgical biopsies can be avoided.



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High-throughput approaches for screening and analysis of cell behaviors

Publication date: January 2018
Source:Biomaterials, Volume 153
Author(s): Jungmok Seo, Jung-Youn Shin, Jeroen Leijten, Oju Jeon, Gulden Camci-Unal, Anna D. Dikina, Katelyn Brinegar, Amir M. Ghaemmaghami, Eben Alsberg, Ali Khademhosseini
The rapid development of new biomaterials and techniques to modify them challenge our capability to characterize them using conventional methods. In response, numerous high-throughput (HT) strategies are being developed to analyze biomaterials and their interactions with cells using combinatorial approaches. Moreover, these systematic analyses have the power to uncover effects of delivered soluble bioactive molecules on cell responses. In this review, we describe the recent developments in HT approaches that help identify cellular microenvironments affecting cell behaviors and highlight HT screening of biochemical libraries for gene delivery, drug discovery, and toxicological studies. We also discuss HT techniques for the analyses of cell secreted biomolecules and provide perspectives on the future utility of HT approaches in biomedical engineering.



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Bone mesenchymal stem cell secretion of sRANKL/OPG/M-CSF in response to macrophage-mediated inflammatory response influences osteogenesis on nanostructured Ti surfaces

Publication date: February 2018
Source:Biomaterials, Volume 154
Author(s): Qian-li Ma, Liang Fang, Nan Jiang, Liang Zhang, Ying Wang, Yu-mei Zhang, Li-hua Chen
Although it has been well established that osteogenic differentiation of bone mesenchymal stem cells (bMSCs) as well as osteoclastic differentiation of macrophages can be manipulated by the nanostructure of biomaterial surfaces, the interactions among the effects of the surface on immune cells and bMSCs remained unknown. Therefore, in this study, the osteogenic behaviors and secretion of osteoclastogenesis-related cytokines of human bMSCs on TiO2 nanotubular (NT) surfaces in conditioned medium (CM) generated by macrophages cultured on the respective NT surfaces (NT-CM) were analyzed. Although bMSCs showed consistent osteogenic behaviors on the NT5 and NT20 surfaces in both standard culture medium and both types of NT-CM, collagen synthesis and extracellular matrix mineralization were partially impeded on the NT20 surface in NT20-CM and bMSC cytokine secretions on the NT20 surface in NT20-CM elicited remarkable multinuclear giant cell and osteoclast formation compared with that observed on the NT5 surface in NT5-CM. After implantation in vivo, mineralized bone formation was significantly delayed around the NT20 implant compared with the NT5 implant, but both surfaces contributed to good bone formation after 12 weeks. The results obtained in this study advance our understanding of the confounding influence of the implant surface nanostructure, macrophage inflammatory response, and osteogenic differentiation of bMSCs as well as the retro-regulative effects of bMSCs on the osteoclastic differentiation of macrophages, and the culture system based on different NT surfaces and CM generated on the respective surfaces may provide a systematic research model for evaluating the performance of endosseous implants as well as a prospective approach for improving implant osseointegration via immune-regulation.



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Albumin-coordinated assembly of clearable platinum nanodots for photo-induced cancer theranostics

Publication date: February 2018
Source:Biomaterials, Volume 154
Author(s): Yong'an Tang, Tao Yang, Qiaoli Wang, Xiaoyan Lv, Xue Song, Hengte Ke, Zhengqing Guo, Xiaoqing Huang, Jun Hu, Zifu Li, Peng Yang, Xiangliang Yang, Huabing Chen
Photoactive noble metal nanoparticles are of increasing importance toward personalized cancer therapy in the field of precision nanomedicine. A critical challenge remains in the exploration of clinically potential noble metal nanoparticles for highly efficient cancer theranostics. Here, we introduce albumin-coordinated assembly of clearable Pt nanodots (Pt-NDs) with monodisperse nanostructure as high-performance theranostic agents for imaging-guided photothermal tumor ablation. We precisely manipulate the reduction and growth of tetravalent Pt ions into ultrasmall nanodots through albumin-directed growth kinetics, thereby leading to the synthesis of monodisperse 6.7 nm Pt-NDs with albumin molecules as the corona. Pt-NDs exhibit the surface plasmon resonance at 225 nm with enhanced near-infrared (NIR) absorbance, ideal resistance to photo-bleaching, distinct photoacoustic and X-ray signals, as well as remarkable photothermal effect through non-radiative relaxation under NIR light irradiation. In particular, Pt-NDs possess preferable tumor accumulation, and effective in vivo excretory capability. Thus, these nanodots promote preferable in vivo microscopic photoacoustics and spatially anatomic CT imaging with enhanced contrast, as well as potent hyperthermia-mediated tumor ablation. These findings represent a facile and general approach to fabricate high-performance noble metal nanostructures with clinical potential for cancer theranostics.

Graphical abstract

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Biological safety and tissue distribution of (16-mercaptohexadecyl)trimethylammonium bromide-modified cationic gold nanorods

Publication date: February 2018
Source:Biomaterials, Volume 154
Author(s): Monika Zarska, Michal Sramek, Filip Novotny, Filip Havel, Andrea Babelova, Blanka Mrazkova, Oldrich Benada, Milan Reinis, Ivan Stepanek, Kamil Musilek, Jiri Bartek, Monika Ursinyova, Ondrej Novak, Rastislav Dzijak, Kamil Kuca, Jan Proska, Zdenek Hodny
The exceptionally high cellular uptake of gold nanorods (GNRs) bearing cationic surfactants makes them a promising tool for biomedical applications. Given the known specific toxic and stress effects of some preparations of cationic nanoparticles, the purpose of this study was to evaluate, in an in vitro and in vivo in mouse, the potential harmful effects of GNRs coated with (16-mercaptohexadecyl)trimethylammonium bromide (^MTABGNRs). Interestingly, even after cellular accumulation of high amounts of ^MTABGNRs sufficient for induction of photothermal effect, no genotoxicity (even after longer-term accumulation), induction of autophagy, destabilization of lysosomes (dominant organelles of their cellular destination), alterations of actin cytoskeleton, or in cell migration could be detected in vitro. In vivo, after intravenous administration, the majority of GNRs accumulated in mouse spleen followed by lungs and liver. Microscopic examination of the blood and spleen showed that GNRs interacted with white blood cells (mononuclear and polymorphonuclear leukocytes) and thrombocytes, and were delivered to the spleen red pulp mainly as GNR-thrombocyte complexes. Importantly, no acute toxic effects of ^MTABGNRs administered as 10 or 50 μg of gold per mice, as well as no pathological changes after their high accumulation in the spleen were observed, indicating good tolerance of ^MTABGNRs by living systems.

Graphical abstract

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A robust strategy for preparation of sequential stimuli-responsive block copolymer prodrugs via thiolactone chemistry to overcome multiple anticancer drug delivery barriers

Publication date: February 2018
Source:Biomaterials, Volume 154
Author(s): Wendong Ke, Wei Yin, Zengshi Zha, Jean Felix Mukerabigwi, Weijian Chen, Yuheng Wang, Chuanxin He, Zhishen Ge
Block copolymer prodrugs (BCPs) have attracted considerable attentions in clinical translation of nanomedicine owing to their self-assembly into well-defined core-shell nanoparticles for improved pharmacokinetics, stability in blood circulation without drug leakage, and optimized biodistribution. However, a cascade of physiological barriers against specific delivery of drugs into tumor cells limit the final therapeutic efficacy. Herein, we report a robust and facile strategy based on thiolactone chemistry to fabricate well-defined BCPs with sequential tumor pH-promoted cellular internalization and intracellular stimuli-responsive drug release. A series of BCPs were prepared through one-pot synthesis from clinically used small molecule anticancer drugs. The ring-opening reaction of drug-conjugated thiolactones releases mercapto groups via aminolysis by N-(3-aminopropyl)-imidazole, which further react with poly(ethylene glycol)-block-poly(pyridyldisulfide ethylmethacrylate) (PEG-PDSEMA) to produce imidazole and disulfide bonds-incorporated BCPs. Taking paclitaxel (PTX) for example, PTX BCPs exhibited high drug-loading content (>50%) and low critical micellization concentration (5 × 10⁻³ g/L), which can self-assemble into micellar nanoparticles in aqueous solution with a small size (∼40 nm). The nanoparticles showed high tumor accumulation and uniform distribution in hypopermeable tumors via systemic administration. Meanwhile, imidazole moieties endow nanoparticles tumor pH-sensitive charge transition from nearly neutral to positive, which promoted cellular internalization. Disulfide bonds can be cleaved by intracellular glutathione (GSH) of cancer cells, which accelerate the release of active PTX drug inside cells. Finally, highly aggressive murine breast cancer 4T1 tumor and hypopermeable human pancreatic adenocarcinoma BxPC3 tumor were completely ablated after treatment by PTX BCP nanoparticles. Consequently, the robust and facile preparation strategy based on thiolactone chemistry represents an efficient approach to construct multifunctional BCPs for better therapeutic efficacy via addressing multiple physiological barriers.

Graphical abstract

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Editorial board

Publication date: January 2018
Source:Biomaterials, Volume 153





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Neonatal airway anomaly: vallecular cyst

Description

Neonatal laryngeal cysts are an uncommon but recognised cause of inspiratory stridor and respiratory distress in infants. Although a small cyst may be asymptomatic, due to the anatomical location and the small size of an infant's respiratory tract, larger cysts may cause acute airway obstruction.1 Affected infants typically display symptoms within the first week of life, which include inspiratory stridor, respiratory distress or feeding difficulties. Congenital vallecular cysts, also known as mucus retention cysts, may arise from the mucosal surface of the true vocal fold, epiglottis or vallecula.2 Vallecular cysts are particularly dangerous as they may cause posterior displacement of the supraglottis, causing collapse of the airway during inspiration leading to respiratory compromise. Additionally, several reports have documented an association between laryngomalacia and vallecular cysts.3 Diagnosis is typically obtained through flexible nasopharyngolaryngoscopy, and endoscopic marsupialisation is the recommended surgical approach in...

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Pyoderma gangrenosum: combination therapy with excellent results in a patient with underlying hepatitis C

Description

Pyoderma gangrenosum (PG) is defined as a neutrophilic dermatosis, not related to any infections or gangrenous causes.1 It usually appears with an underlying systemic disease. We report a 55-year-old man who presented with painful bilateral skin lesions on legs with no associated constitutional symptoms. Patient had a history of untreated hepatitis C infection with negative cryoglobulinaemia screen. Surgical debridement was performed in the emergency department, at that time without a diagnosis and a biopsy plus culture of the skin was done which disclosed no evidence of microorganism, vasculitis findings and perivascular lymphoplasmacytic infiltrate. A repeat biopsy showed neutrophilic infiltrate. Clinical and histopathological diagnosis of PG was made and patient was started on intravenous steroids with some improvement,2 followed with clinical deterioration that prompted intravenous immunoglobulin therapy with excellent results.3 Patient continues to get weekly wound care and was being seen by infectious disease and rheumatology...

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Septic arthritis of knee joint due to Parvimonas micra

Parvimonas species are anaerobic, Gram-positive cocci that are a constituent of normal oral and gastrointestinal flora. We present a case of right knee joint septic arthritis due to Parvimonas micra in an immunocompromised patient. A 61-year-old male renal and pancreatic transplant recipient on immunosuppressive therapy was admitted to our hospital due to intense pain, joint swelling and inability to move his right knee over the past 9 months. After synovial fluid was drawn, cultures were positive for P. micra, an anaerobic pathogen that is part of the flora of the oral cavity. We report a rare causative pathogen for septic arthritis in an immunocompromised patient.

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Carcinoma en cuirasse in a young female

Description

Cancer or carcinoma en cuirasse is an infrequent clinical presentation of metastatic cutaneous carcinoma.1 In this condition, the skin of the chest wall is studded with carcinomatous indurated plaques. It is often seen after a patient of breast cancer undergoes mastectomy operation and develops local recurrence. The patient usually presents after a few months or years after the surgery2 (figure 1). This patient, a 22-year-old woman, had already undergone right modified radical mastectomy for infiltrating ductal carcinoma (IDC) Not Otherwise Specified (NOS) grade II with triple-negative receptor status, 1 year ago. She had now presented with a lump in the left breast and multiple cutaneous lesions on the chest wall on the right side and on the left breast since the past 5 months (figure 2). Cutaneous metastasis or carcinoma en cuirasse has occurred on the right side after mastectomy, whereas they are...

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Isolated azygos vein thrombosis: a rare phenomenon

Description

A 57-year-old man with diabetes mellitus and liver cirrhosis was electively admitted for endoscopic retrograde cholangiopancreatography (ERCP). He had history of obstructive jaundice secondary to choledocholithiasis in the preceding month, during which a biliary stent was inserted. During ERCP, he developed acute chest pain and shortness of breath. ECG, cardiac enzymes, coagulation profile and chest radiograph were normal. He was then suspected to have acute pulmonary embolism.

CT pulmonary angiography (CTPA) showed a central tubular filling defect within the azygos vein (AV). This filling defect has a small attachment at the roof of the vessel, forming acute angle with the vessel wall (figures 1 and 2). The rest of the pulmonary vasculature was fully opacified. Lung fields were normal.

Figure 1

Selected axial (A) and coronal (B) sections of CT pulmonary angiography showing tubular filling defect within the azygos vein (arrows).

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Umbilical artery perforation: a potentially life-threatening complication of umbilical artery catheterisation

Umbilical artery catheterisation is frequently performed in preterm or critically ill newborn infants for invasive monitoring of blood pressure and blood sampling for laboratory tests. It is associated with well-known complications like catheter-related infections, thromboembolic events and aneurysmal formation of the aorta. In this report, we present another major complication of umbilical artery catheterisation: umbilical artery perforation. This complication occurred in a prematurely born infant and resulted in severe haemorrhagic shock, subsequent renal failure and severe periventricular leukomalacia. Ultimately, the patient deceased 3 weeks after birth. Review of the literature identified only a few case reports and retrospective postmortem studies describing this complication. Neonatologists and paediatricians performing umbilical artery catheterisation should be aware of this rare, but potentially life-threatening complication.

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Orbitonasal metallic foreign body

Description

A 23-year-old male patient presented with the history of metallic wire injury following a burst of an instrument. The duration of injury was 2 hours. Clinical examination revealed a visual acuity of 20/20 in each eye, right brow showed a superficial skin laceration. Medial side of the right orbit had an impacted curved metallic wire. Extraocular motility in the right eye was within normal limits (figure 1). Anterior segment and posterior segment examination was unremarkable in both the eyes. B-scan ultrasound revealed a high amplitude spike along the side of the right globe but without any penetration; however, it showed curvilinear course along the medial orbital wall (figure 2A).

Figure 1

Front and lateral clinical profile showing a curvilinear metallic foreign body impacted along the superior and nasal aspect of the right upper eyelid. Extraocular motilities were unaffected.

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Norethisterone enanthate-induced cerebral venous sinus thrombosis (CVST)

A 23-year-old East Indian woman with no significant medical history, except a depot-norethisterone enanthate injection taken 3 weeks prior to admission, presented with a gradually worsening headache for the past 5 days. She had no fever, vomiting, neck stiffness, focal weakness or rash, and examination was unremarkable with no focal neurological deficits. Vasculitic, thrombophilia and sepsis screens were normal. A brain CT scan showed a left parietal lobe venous infarct, secondary to a venous dural sinus thrombosis, with MRI and Magnetic Resonance Venogram (MRV) confirming a signal void. She was diagnosed to have multiple cerebral venous sinus thrombosis due to norethisterone enanthate. She made a complete recovery following treatment with mannitol, dexamethasone and anticoagulants. A follow-up brain MRI done at 6 months was normal.

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Reversible brain lesion following growth hormone replacement therapy in an adolescent

A 12.6-year-old girl presented with a 2-month history of headache, recurrent vomiting and 5 kg weight loss. She had been receiving recombinant human growth hormone (rhGH) replacement therapy at a dose of 0.035 mg/kg for the past 10 months, due to short stature. Investigations before initiating rhGH, including brain MRI, had been normal. Physical examination revealed a nystagmus and a mildly elevated arterial blood pressure. Brain MRI revealed a lesion in the posterior aspect of the medulla oblongata, adjacent to the foramen of Magendie. rhGH therapy was discontinued, followed by a gradual resolution of the symptoms. At follow-up 3 months later, she was asymptomatic and physical examination was unremarkable. A subsequent repeat brain MRI showed complete resolution of the lesion, supporting the diagnosis of a variant of reversible posterior leucoencephalopathy syndrome. This is the first case report of a reversible brain lesion linked to rhGH replacement therapy.

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Peripheral arterial disease as seen on X-ray and arteriography

Description

An 80-year-old woman was admitted for a 2months history of non-healing ulcers on both feet. She is known to have type 2 diabetes, dyslipidaemia and hypertension for 30 years. She has a history of a femoral fracture on the left incurred after a fall 2 years ago for which she underwent open reduction and internal fixation.

On physical examination, there were ulcers on the lateral aspect of both feet and on the right malleolar area. Dorsalis pedis pulses were absent bilaterally.

An X-ray of both femurs was requested to check if the fracture healed properly and to rule out a new fracture since the patient remained bedridden despite surgery to correct the fracture. The X-ray revealed a metal implant on the left femur and with no new fracture. Incidentally, the femoral arteries were noted to be calcified along their entire length indicative of atherosclerosis (figure 1).

...

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Unusual Salmonella typhi periprosthetic joint infection involving bilateral knees: management options and literature review

A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports. Considering her underlying immunosuppression, a bilateral two-stage revision TKA was done with complete remission of symptoms and good functional recovery at last follow-up after 18 months. S. typhi infection of prosthetic joint has not been reported in the literature. Patients presenting with gastrointestinal complaints and PJI should alert the clinician to the possibility of infection with such atypical organisms endemic to the region.

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Antenatal Bartter syndrome presenting with vomiting and constipation mimicking subacute intestinal obstruction in a 20-day-old neonate

Antenatal Bartter syndrome is a rare condition that can present with different clinical features. These features include early onset maternal polyhydramnios, failure to thrive, prematurity and nephrocalcinosis.

We are presenting this 20-day-old girl who had an antenatal history of polyhydramnios. She developed persistent non-bilious vomiting that was associated with constipation soon after birth. She presented with failure to thrive and features suggestive of intestinal obstruction. On the initial evaluation, she was noted to have hypokalaemic, hyponatraemic metabolic alkalosis. The initial work-up was done to exclude surgical and renal causes of her presentation, and the diagnosis was confirmed by gene analysis to be type III—classic Bartter syndrome. She was closely monitored for her growth and development with the appropriate salt replacement therapy.

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Ectopic ACTH syndrome complicated by multiple opportunistic infections treated with percutaneous ablation of the adrenal glands

Ectopic adrenocorticotropic hormone (ACTH)-related Cushing's syndrome can lead to multiple complications including severe immunosuppression. If the ACTH-secreting tumour cannot be found, definitive treatment is surgical adrenalectomy, typically followed by glucocorticoid replacement. Here, we present a case of fulminant respiratory failure secondary to coinfection with Pneumocystis jirovecii and cytomegalovirus in a patient with ectopic ACTH-dependent Cushing's syndrome with occult primary. Due to significant deconditioning, she was unable to undergo definitive adrenalectomy and instead underwent percutaneous microwave ablation of the adrenal glands.

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Barrier dysfunction in the nasal allergy

Publication date: Available online 14 November 2017
Source:Allergology International
Author(s): Ayumi Fukuoka, Tomohiro Yoshimoto
Epithelial cells form the first physiological barrier against invasion by pathogens and the infiltration of allergens. Tight junctions (TJ), a cell–cell junctional complex located on the apical side of epithelial cells, have a critical role in the maintenance of epithelial barrier function. Impaired TJ structures are observed in patients with asthma, atopic dermatitis and nasal allergy; therefore, the dysfunction of epithelial barriers might be involved in the initiation or progression of allergic diseases. Protease-containing allergens and environmental pollutants enhance paracellular transport in epithelial cells through disruption of epithelial barrier function. This suggests that the disruption of TJ leads to the promotion of allergen delivery into the subepithelia, resulting in the progression of allergic diseases. Thus, protection of the epithelial barrier function might prevent or inhibit the development or exacerbation of allergic diseases. Recently, we reported that diesel exhaust particles (DEP), the main component of particulate patter 2.5, exacerbated allergic rhinitis (AR) in a mouse model through TJ disruption. In addition, we revealed that the oxidative stress-mediated pathway is involved in the effects caused by DEP and that nasal treatment with a reactive oxygen species (ROS) scavenger suppressed DEP-induced TJ disruption and exacerbation of AR. In this review, we focus on the relationship between TJ disruption and allergic disease. Furthermore, we discuss our recent findings regarding TJ disruption and the exacerbation of AR.



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Parenting and family adjustment scales (PAFAS): validation of a brief parent-report measure for use with families who have a child with a developmental disability

Publication date: January 2018
Source:Research in Developmental Disabilities, Volume 72
Author(s): Trevor G. Mazzucchelli, Julie Hodges, Robert T. Kane, Kate Sofronoff, Matthew R. Sanders, Stewart Einfeld, Bruce Tonge, Kylie M. Gray
BackgroundChildren with a developmental disability are three to four times more likely than their typically developing peers of developing significant emotional and behavioural problems. There is strong evidence to suggest that individual biological and psychological factors interact with family functioning to precipitate and perpetuate these problems.AimsThis study examined the psychometric properties of a brief measure, the Parent and Family Adjustment Scales (PAFAS) for use with parents of children with a developmental disability.MethodsA sample of 914 parents of children (M=6.27years) with a developmental disability participated in the study. Disabilities included Autism Spectrum Disorder and Intellectual DisabilityResultsA confirmatory factor analysis supported a 16-item, four factor model of PAFAS Parenting, and an 11-item, three factor model of PAFAS Family Adjustment. The Parenting Scale measures parental consistency, coercive practices, use of encouragement and the quality of parent-child relationship. The Family Adjustment Scale measures parental emotional adjustment and partner and family support in parenting.ConclusionsThe current study indicated that the PAFAS demonstrates promise as a brief measure of multiple domains of family functioning important for families who have a child with a developmental disability.



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Editorial Board

Publication date: January 2018
Source:Microbiological Research, Volume 206





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Functional characterization of murB-potABCD operon for polyamine uptake and peptidoglycan synthesis in Streptococcus suis

Publication date: Available online 14 November 2017
Source:Microbiological Research
Author(s): Wanquan Liu, Meifang Tan, Chunyan Zhang, Zhuofei Xu, Lu Li, Rui Zhou
Spermidine (Spd), spermine (Spm), and putrescine (Put), which are the most widely distributed cellular polyamines, are essential for normal growth and multiplication of both eukaryotic and prokaryotic cells. In this study, we identified the only putative polyamine transport system PotABCD in Streptococcus suis, a worldwide zoonotic Gram-positive pathogen causing lethal infections in humans and pigs. It was discovered that S. suis could uptake polyamines preferably Spd and Spm. By constructing a potA deleted mutant, we confirmed that PotABCD was responsible for polyamine uptake, and PotD bound to the protein of polyamines. The four PotABCD genes were co-transcribed with murB, a gene involved in peptidoglycan (PG) synthesis. Furthermore the roles of polyamine transport system in maintaining the PG structure were detected to understand the biological significance of this co-transcription. In contrast to the wild type, the mutant ΔpotA exhibited elongated chain length and abnormal cell division morphology. Phenotypic changes were attributed to be the up-regulation of genes involved in PG synthesis and hydrolysis in ΔpotA. Additionally, polyamines functioned not only as feedback regulators of PotA by inhibiting PotA activity but also as regulators on potABCD and genes involved in PG synthesis. This study reveals the functions of PotABCD in polyamine transport and the regulatory roles of polyamines in PG synthesis.Results provide new insights into the machineries contributing to normal growth and cell division of S. suis.



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DNA sequence-specific dimeric bisbenzimidazoles DBP(n) and DBPA(n) as inhibitors of H-NS silencing in bacterial cells

Publication date: Available online 14 November 2017
Source:Microbiological Research
Author(s): Olga E. Melkina, Vasilii S. Koval, Alexander A. Ivanov, Alexei L. Zhuze, Gennadii B. Zavilgelsky
DNA sequence-specific fluorescent dimeric bisbenzimidazoles DBP(n) and DBPA(n), noncovalently interacting with A-T pairs in the minor groove of double-stranded DNA were used for studying and monitoring the expression of histone-like H-NS-dependent promoters. Histone-like H-NS selectively binds to AT-rich segments of DNA and silences a large number of genes in bacterial chromosomes. The H-NS-dependent promoters of Quorum Sensing (QS)-regulated lux operons of the marine bacteria mesophilic Aliivibrio fischeri, psychrophilic Aliivibrio logei were used. Escherichia coli lux biosensors were constructed by cloning fragments bearing QS-regulated promoters into the vector, thereby placing each fragment upstream of the promoterless Photorhabdus luminescens luxCDABE genes. It was shown that the dimeric bisbenzimidazoles DBP(n) and DBPA(n) counteract the H-NS silencing activity. Thus, the presence of DBP(n) or DBPA(n) in the medium leads to an approximately 10-100-fold increase in the level of transcription of QS promoters in E. coli hns⁺. The largest decrease in the level of H-NS repression was observed using ligands containing a linker with a length of ca. 18Å, such as DBP(2) and DBPA(2). Ligands containing linkers with n=1 and 3 are an order of magnitude less active; ligands with n=4 are inactive. DBPA(2) exhibits activity starting with a concentration of 0.5μM; the minimum concentration of DBP(2) is 5–7 times higher. It is suggested that A-T pairs located at five nucleotide pair intervals, which correspond to the linker length in highly active ligands with n=2, play a key role in the structure of H-NS-binding sites in QS-regulated promoters.



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J. Gail Neely, M.D.: Obituary

No abstract available

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The Growing—and Now Alarming—Burden of Hearing Loss Worldwide

No abstract available

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Letter to the Editor: Regarding Deep N, Besch-Stokes J, Lane J, Driscoll C, Carlson M, “Paget's Disease of the Temporal Bone: A Single-Institution Contemporary Review of 27 Patients”

No abstract available

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Implantable Hearing Devices. Chris de Souza, Peter Roland, Debara L. Tucci, ed.; San Diego, CA: Plural Publishing Inc., 2017

No abstract available

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High Incidence of Bell's Palsy After Mastoidectomy: A Longitudinal Follow-up Study

Objective: The objective of this study was to compare the prevalence of Bell's palsy in participants who underwent mastoidectomy (to treat chronic otitis media) and nonmastoidectomy participants (control). Methods: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, mastoidectomy patients (2,045) and control participants (8,180) were matched 1:4 for age, sex, income, and region of residence. The prevalence of Bell's palsy in both the groups was measured from 0 to 10 years postoperation. Results: In a sample of 1,025,340 Korean individuals, 7,070 were diagnosed or treated with Bell's palsy between 2002 and 2013; the annual incidence of Bell's palsy was 0.057%. The overall prevalence of Bell's palsy was three times higher in the mastoidectomy group (1.27%) than control group (0.49%) (p 

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Management of Sigmoid Sinus Associated Pulsatile Tinnitus: A Systematic Review of the Literature

Objectives: Although studies demonstrate 4 to 20% of patients with pulsatile tinnitus (PT) have associated sigmoid sinus anomalies, no consensus exists regarding optimal management. Our objective was to perform a systematic review exploring surgical and endovascular intervention of PT caused by sigmoid sinus anomalies. Data Sources/Extraction: A systematic review was performed using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines for reporting of results, with a target population encompassing patients with PT and either sigmoid sinus diverticulum or sigmoid wall dehiscence. From an initial search yielding 74 articles, 21 manuscripts met inclusion criteria. Data Synthesis: Of 139 patients, 90.4% were female. Mean age was 39.0 years. Diagnosis was sigmoid sinus diverticulum/aneurysm in 47.5% of patients, sigmoid sinus dehiscence in 35.3% of patients, and both in 17.3%. Sigmoid sinus wall reconstruction/resurfacing (SSW R/R) was used in 91.4% and endovascular procedures in 7.9% of patients. Postoperative recurrence was 3.5% (mean follow-up 21.1 m). Although there was no association between resolution rate and age or sex, right-sided PT resolved at a higher rate. For every increase in body mass index by 1 kg/m2, the odds of PT resolution increased 9.2%. Conclusion: PT as a result of sigmoid sinus diverticula, aneurysms, and dehiscence is a rare, but largely treatable condition. Available interventions include SSW R/R, endovascular intervention, and cardiac U-clip techniques. In SSW R/R, bone pate, unspecified soft-tissue graft, and bone cement had the highest rates of PT resolution. While temporalis fascia and autologous bone chips were the materials most commonly used, they had significantly lower rates of PT resolution compared with the other materials, with the exception of auricular cartilage and bone cement. Most episodes of recurrence are resolved with medical management or a revision procedure. This study serves to summarize the current state of knowledge on the treatment of pulsatile tinnitus across disciplines.

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The Role of Auditory Evoked Potentials in the Context of Cochlear Implant Provision

Auditory evoked potentials (AEP) are highly demanded during the whole process of equipping patients with cochlear implants (CI). They play an essential role in preoperative diagnostics, intraoperative testing, and postoperative monitoring of auditory performance and success. The versatility of AEP's is essentially enhanced by their property to be evokable by acoustic as well as electric stimuli. Thus, the electric responses of the auditory system following acoustic stimulation and recorded by the conventional surface technique as well as by transtympanic derivation from the promontory (Electrocochleography [ECochG]) are used for the quantitative determination of hearing loss and, additionally, electrically evoked compound actions potentials (ECAP) can be recorded with the intracochlear electrodes of the implant just adjacent to the stimulation electrode to check the functional integrity of the device and its coupling to the auditory system. The profile of ECAP thresholds is used as basis for speech processor fitting, the spread of excitation (SOE) allows the identification of electrode mislocations such as array foldover, and recovery functions may serve to optimize stimulus pulse rate. These techniques as well as those relying on scalp surface activity originating in the brainstem or the auditory cortex accompany the CI recipient during its whole life span and they offer valuable insights into functioning and possible adverse effects of the CI for clinical and scientific purposes.

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Do Measurements of Inner Ear Structures Help in the Diagnosis of Inner Ear Malformations? A Review of Literature

Objective: We conducted an extensive review of the literature relevant to inner ear measurements in normal and malformative conditions to select reproducible methods and normative ranges that may be used in clinical practice. Data Sources and Study Selection: A review of the published literature was performed in the English language using PubMed with appropriate keywords. We selected only those articles containing normative values of inner ear structures. Data Extraction and Data Synthesis: The following measurements were identified as reproducible and sensitive for the diagnosis of inner malformations: cochlear height in coronal plane; maximal diameter of bony island of lateral semicircular canal; width of vestibular aqueduct: 1) at midpoint; 2) at operculum in axial plane; cochlear canal and cochlear width in multiplanar reconstructions (MPR)/axial; cochlear length. The following cutoffs for normal inner ears are proposed based on the comparative analysis of the literature: cochlea height: >4.3 mm; lateral semicircular canal bony island: >3 mm; vestibular aqueduct: 1.4 mm and 5.4 mm. Conclusion: Measurements of inner ear structures can help in the interpretation of computed tomography images. They increase the sensitivity in detecting inner ear malformations, especially cochlear hypoplasia now considered more common than previously thought.

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Assessing Readability and Reliability of Online Patient Information Regarding Vestibular Schwannoma

Hypothesis: The aim of this study is to objectively assess the quality and readability of websites related to vestibular schwannomas. Background: Patients are increasingly seeking information on confirmed or suspected diagnoses through the Internet. Clinicians are often concerned regarding the accuracy, quality, and readability of web-based sites. Methods: Online information relating to vestibular schwannoma was searched using the three most popular search engines. The terms "acoustic neuroma" and "vestibular schwannoma" were used. The top 50 results from each site were assessed for readability using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Gunning-Fog Index. Quality of website information was scored using the DISCERN tool. Results: Of 300 search results analyzed, 58 separate appropriate websites were identified. The mean readability score using Flesch-Kincaid Grade Level was 10.27 (95% confidence interval [CI] 9.84–10.70). The mean Flesch Reading Ease Score was 48.75 (95% CI 46.57–50.92). The Gunning-Fog Index was 13.40 (95% CI 12.92–13.89). These scores equate to someone finishing secondary school/first year university student. DISCERN scores were highly variable but consistently demonstrated great variability in quality of information. Conclusion: Online patient information on vestibular schwannoma is highly variable in quality. Although there are a wide range of different websites easily available to patients on their condition and its treatment options, the information is written at a difficult level which may exceed the understanding level of many patients as it is written at a higher than average level of expected reading ability.

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Effectiveness in Rehabilitation of Current Wireless CROS Technology in Experienced Bone-Anchored Implant Users

Objective: To compare the effectiveness of current contralateral routing of signal technology (CROS) to bone-anchored implants in experienced bone-anchored implant users with unilateral severe-profound sensorineural hearing loss. Design: Prospective, within-subject repeated-measures comparison study. Setting: Tertiary referral center. Patients: Adult, English-speaking patients (n = 12) with severe-profound unilateral sensorineural hearing loss implanted with a bone-anchored implant for the indication of single-sided deafness. Intervention: Subjects were fitted with contralateral routing of signal amplification and tested for speech in noise performance and localization error. Outcome Measures: Speech perception in noise was assessed using the BKB-SIN test materials. Localization was assessed using narrow band noises centered at 500 and 4000 Hz, as well as a broadband speech stimulus presented at random to the front hemifield by 19 speakers spatially separated by 10 degrees. Results: There was no improvement in localization ability in the aided condition and no significant difference in performance with CROS versus bone-anchored implants (BAI). There was a significant improvement in speech in noise performance for monaural listeners in the aided condition for speech poorer ear/noise better ear, speech front/noise front, and speech front/noise back. No significant difference was observed on performance with CROS versus BAI subjects. Conclusion: Contrary to earlier studies suggesting improved performance of BAIs over CROS, the current study found no difference in performance in BAI over CROS devices. Both CROS and BAI provide significant benefit for monaural listeners. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

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Changes in Serum Prestin Concentration After Exposure to Cisplatin

Hypothesis: There are temporal changes in the outer-hair-cell-specific protein, prestin, in the blood after administration of low-dose cisplatin. Methods: Two rodent models of ototoxicity were used. After control and baseline data collection, mice (n = 30) and guinea pigs (n = 10), respectively, were treated with cisplatin at 8 mg/kg. Auditory brainstem responses were recorded on Days 1, 3, 7, and 14 after treatment. Five mice were sacrificed at each time point and serum samples were obtained. A group of 10 guinea pigs were tested and serum samples were collected at each time point. Serum prestin concentrations were measured using separate enzyme-linked immunosorbent assays for each species. Results: Auditory brainstem responses thresholds changed relatively little in mice, but gradually increased in guinea pigs, as a function of time after cisplatin exposure. In contrast, serum prestin concentrations rose, reaching a peak on Days 3 and 7 after cisplatin treatment in mouse and guinea pig, respectively, before declining back to or below baseline/control levels 14 days after treatment. Conclusion: There was a time-dependent pattern of change in serum prestin after exposure to low-dose cisplatin in a resistant (mouse) and sensitive (guinea pig) rodent models. These comparative results suggest prestin may serve as a biomarker for cisplatin ototoxicity.

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Patterns of Extended High-frequency Hearing Loss Following Stapes Surgery

Objective: Thresholds in the extended high-frequency (EHF) range (> 8 kHz) often worsen after otherwise successful stapedectomy. The aims of this study were to document the prevalence of hearing loss from 0.25 to 16 kHz after stapedectomy and the relative rates of transient and permanent EHF hearing loss. Study Design: Prospective, observational, longitudinal. Setting: Tertiary referral center. Patients: Thirty-nine patients who underwent 44 primary or revision stapes surgeries. Intervention: Hearing thresholds were measured at 0.25 to 16 kHz preoperatively, and at approximately 1 week, 1, 3, 6, and 12 months postoperatively. Main Outcome Measures: Average threshold changes in bands of frequencies (0.25–1, 2–8, 9–11.2, 12.5–16 kHz) and the percentage of patients with a change in the highest frequency at which a hearing threshold could be measured were evaluated at each assessment. Results: A mean hearing loss was documented in the EHF range at all postoperative assessments. There was a decrease in the highest frequency at which a hearing threshold was measureable in 77% of patients at the first postoperative assessment, and despite some improvement over time, in 50% of patients 12 months postoperatively. Conclusion: There is a significant incidence of EHF loss after stapedectomy. Although partial recovery often occurs, more than half of patients retain an EHF hearing loss 12 months postoperatively. As hearing loss in the EHF range is more common than loss at 4 kHz, EHF measurements may be a more sensitive model to compare surgical factors and evaluate pharmacologic interventions.

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Response to Letter to the Editor: “Comparison of Acyclovir and Famciclovir for Ramsay Hunt Syndrome”

No abstract available

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The Etiological Relationship Between Migraine and Sudden Hearing Loss

Objectives: To investigate the relationship between sudden sensorineural hearing loss (SSNHL) and migraine, assess the prevalence of migraine in patients with idiopathic SSNHL, and determine a possible common vascular etiopathogenesis for migraine and SSNHL. Study Design: Prospective cohort study. Setting: Tertiary referral center. Patients: This study initially assessed 178 SSNHL cases obtained from the Head and Neck Surgery Clinic patient database at a tertiary hospital in Turkey between January 2011 and March 2016. Ultimately, a total of 61 idiopathic SSNHL patients participated in the present study. İnterventions: Diagnostic. Main Outcome Measures: Cases with inflammation in the middle or inner ear; a retro cochlear tumor; autoimmune, infectious, functional, metabolic, neoplastic, traumatic, toxic, or vascular causes; Meniere's disease; otosclerosis; multiple sclerosis; and/or cerebrovascular diseases were excluded. Results: Of the 61 idiopathic SSHNL patients, 34 were women (55.74%); and 24 (39.34%) had migraine, according to the criteria of the International Headache Society (IHS). The mean age of the migraine patients (Group 1) was 43.83 ± 13.16 years, and that of those without migraine (Group 2) was 51.05 ± 16.49 years. The groups did not significantly differ in terms of age, sex, or SSNHL recovery rates according to the Siegel criteria (p > 0.05). Ten of the migraine patients experienced visual aura, and the recovery rates of this group were higher. Additionally, the rate of total hearing loss was lower in Group 1 (n = 3, 12.5%) than in Group 2 (n = 10, 27%). Conclusion: SSNHL patients had a higher prevalence of migraine. Although those with migraine had higher recovery rates, the differences were not statistically significant.

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Effectiveness of Directional Microphones in Bilateral/Bimodal Cochlear Implant Users—Impact of Spatial and Temporal Noise Characteristics

Objective: To measure speech reception thresholds (SRTs) in co-located (S0N0) and diffuse noise conditions (multi-source noise field, MSNF) and to assess the impact of beamforming algorithms in MSNF in cochlear implant (CI) users. Study Design: Non-randomized, open, prospective study. Setting: Tertiary referral cochlear implantation center. Patients: Participants included 14 CI users (7 bimodal, 7 bilateral) and 14 normal hearing young adults. Interventions: Cochlear implantation. Main Outcome Measures: SRTs were assessed by means of a German matrix sentence test in either continuous or modulated noise. Loudspeakers were configured in two different conditions: S0N0 and MSNF (speech source in front, four speakers distributed at ±28.6 and ±151.4 degrees). In MSNF, the CI speech processor microphone was set in different directional sensitivity settings: standard (sub-cardioid), fixed (super-cardioid), and adaptive. Results: In continuous noise, SRTs of both CI groups were comparable. In modulated noise, bimodal CI users showed lower SRTs than bilateral CI group, but significant benefit from glimpsing was only demonstrated in normal hearing participants. All subject groups showed significant spatial release from masking (i.e., SRT improvement in MSNF compared with S0N0 condition) in continuous noise. A tendency of improved SRT (1 dB bimodal, 2 dB bilateral) with fixed and adaptive directional sensitivity was found which could not be statistically confirmed due to large between-subject variations. Conclusions: The absence of the glimpsing effect in CI users was reaffirmed in the present study. Although very effective in single noise source conditions, the beneficial impact of beamforming algorithms in multiple noise source conditions is poor.

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STRC Deletion is a Frequent Cause of Slight to Moderate Congenital Hearing Impairment in the Czech Republic

Objective: This study aimed to clarify the molecular epidemiology of hearing loss by identifying the responsible genes in patients without GJB2 mutations. Study Design: Prospective genetic study. Setting: Tertiary referral hospital. Patients: Fifty one patients with bilateral sensorineural hearing loss, 20 men, and 31 women, mean age 24.9 years, range 3 to 64 years, from 49 families. GJB2 and deltaGJB6-D13S1830 mutations were excluded previously. Intervention: Diagnostic. Sixty-nine genes reported to be causative of hearing loss were analyzed. Sequence capture technology, next-generation sequencing, and multiplex ligation-dependent probe amplification (MLPA) were used. Coverage of STRC was screened in Integrative Genomics Viewer software. Main Outcome Measure: Identification of causal pathogenic mutations in genes related to deafness. Results: Five families (10%) had recessive STRC deletions or mutations. Five unrelated patients (10%) had recessive mutations in TMPRSS3, USH2A, PCDH15, LOXHD1, and MYO15A. Three families (6%) had autosomal dominant mutations in MYO6A, KCNQ4, and SIX1. One family (2%) had an X-linked POU3F4 mutation. Thus, we identified the cause of hearing loss in 28% of the families studied. Conclusions: Following GJB2, STRC was the second most frequently mutated gene in patients from the Czech Republic with hearing loss. To decrease the cost of testing, we recommend STRC deletion screening with MLPA before next-generation sequencing. The existence of a pseudogene and polymorphic STRC regions can lead to false-positive or false-negative results when copy number variation analysis is based on next-generation sequencing data.

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Long-term Hearing Preservation After Resection of Vestibular Schwannoma: A Systematic Review and Meta-analysis

Objective: The objective is to perform a systematic review and meta-analysis of the literature on the long-term results of hearing preservation after vestibular schwannoma resection. Data Sources: Ovid/Medline, PubMed, Embase, and the Cochrane library from January 1980 to January 2015. Study Selection: Inclusion criteria: age ≥18 years, minimum 10 patients in the treatment group, hearing preserving microsurgery, no previous radiation treatment, serviceable hearing at immediate postop follow-up, hearing outcomes reported using Gardner Robinson or the American Academy of Otolaryngology-Head and Neck Surgeons hearing grading scales, and average follow-up of 5 years. Preoperative, immediate postoperative, and last follow-up audiograms were required. Exclusion criteria included neurofibromatosis type 2 patients and surgery for salvage therapy or decompression. Data Extraction: Quality evaluated using Methodological Index for Non-Randomized Studies. Data Synthesis: Meta-analysis was performed using R v3.2.2, Metafor package v 1.9-7. Cohen's D was used to determine effect size. Ten reports had at least 5-year follow-up and used standardized hearing grading scales. The systematic review found that if hearing was preserved at Class A or B at early postop visit, the chance of preserving hearing at 5 years was excellent. Those who maintained speech discrimination score ≥ 89% at the early postoperative follow-up had better long-term hearing preservation. The meta-analysis reveals that only preoperative and postoperative pure-tone average was associated with long-term hearing preservation. Conclusion: Long-term (>5 yr) hearing durability rates are generally very good. Most studies do not report patient and tumor characteristics, therefore precluding combining studies for meta-analysis. Only preoperative and postoperative postoperative pure-tone average was associated with long-term hearing durability.

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Patterns Seen During Electrode Insertion Using Intracochlear Electrocochleography Obtained Directly Through a Cochlear Implant

Hypothesis: Intraoperative, intracochlear electrocochleography (ECochG) will provide a means to monitor cochlear hair cell and neural response during cochlear implant (CI) electrode insertion. Distinct patterns in the insertion track can be characterized. Background: Conventional CI surgery is performed without a means of actively monitoring cochlear hair cell and neural responses. Intracochlear ECochG obtained directly through the CI may be a source of such feedback. Understanding the patterns observed in the "insertion track" is an essential step toward refining intracochlear ECochG as a tool that can be used to assist in intraoperative decision making and prognostication of hearing preservation. Methods: Intracochlear ECochG was performed in 17 patients. During electrode insertion, a 50-ms tone burst acoustic stimulus was delivered with a frequency of 500 Hz at 110 dB SPL. The ECochG response was monitored from the apical-most electrode. The amplitude of the first harmonic was plotted and monitored in near real time by the audiologist-surgeon team during CI electrode insertion. Results: Three distinct patterns in first harmonic amplitude change were observed across subjects during insertion: Type A (52%), overall increase in amplitude from the beginning of insertion until completion; Type B (11%), a maximum amplitude at the beginning of insertion, with a decrease in amplitude as insertion progressed to completion; and Type C (35%), comparable amplitudes at the beginning and completion of the insertion with the maximum amplitude mid-insertion. Conclusion: Three ECochG patterns were observed during electrode advancement into the cochlea. Ongoing and future work will broaden our scope of knowledge regarding the relationship among these patterns, the presence of cochlear trauma, and functional outcomes related to hearing preservation.

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Cochlear Dysfunction is not Common in Human Meningioma of the Internal Auditory Canal

Hypothesis: Cochlear dysfunction is not common in human meningioma of the internal auditory canal. Background: Meningiomas arising from the cerebellopontine angle and internal auditory canal typically cause hearing loss. Cochlear dysfunction is known to contribute to sensorineural hearing loss induced by vestibular schwannoma, the most common tumor of the internal auditory canal. Detailed cochlear histopathology in meningioma has not been reported. Methods: Retrospective analysis of cochlear histopathology in five unoperated and five operated meningiomas of the internal auditory canal identified after screening human temporal bone collections from three academic medical centers. Results: While some dysfunction of all analyzed cochlear cell types was identified, a predominant or exclusive loss of hair cells was not observed in any meningioma. Only 14.3% of temporal bones showed significantly more hair cell damage on the side of the tumor when compared with the contralateral ear; cochlear neuronal damage was more prevalent in meningiomas. The incidence of hydrops, perilymphatic precipitate, or endolymphatic precipitate was low. Conclusions: Substantial cochlear damage in human meningioma of the internal auditory canal is not common. This may explain the anecdotal hearing improvement observed after surgical resection of meningioma. Our findings underline the importance of developing therapeutic strategies to prevent cochlear neuronal degeneration due to tumors of the internal auditory canal.

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Decline of Low-Frequency Hearing in People With Ski-Slope Hearing Loss; Implications for Electrode Array Insertion

Hypothesis: The decline of low-frequency hearing in people with ski-slope hearing loss varies and might depend on etiology. Background: People with ski-sloping hearing loss might benefit from cochlear implantation with preservation of residual hearing. To reduce the risk of losing low-frequency hearing after implantation, the electrode-array can be inserted partially up to the desired frequency. That, however, obstructs electrical stimulation of lower frequencies. To decide between complete or partial insertion, knowledge regarding the natural decline of low-frequency hearing is helpful. Methods: Patients with at least two ski-slope audiograms over time were selected. We calculated progression at lower frequencies for 320 patients. Etiologies for hearing loss were retrieved from medical records. Progression of hearing loss was analyzed separately for patients with uni- and bilateral hearing losses. Relative progression of hearing loss was obtained by comparing progression to a reference group. Results: Average progression of PTA was 1.73 dB/yr and was not significantly different in the bilateral and unilateral group. Etiologies that did not show significantly more progression compared with the reference group could be identified as single or short-lasting pathologic events, whereas long-lasting conditions had significant more progression of PTA. Conclusion: Patients with a ski-slope hearing loss that was caused by a single or short-lasting event have low progression rate and are viable for partial insertion to minimize the risk of damaging residual low-frequency hearing. In the absence of such an event, complete insertion should be considered because faster than normal deterioration of low-frequency hearing over time will probably limit the advantage of preservation of residual hearing.

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Ontogenetic stage, plant vigor and sex mediate herbivory loads in a dioecious understory herb

Publication date: Available online 14 November 2017
Source:Acta Oecologica
Author(s): Sara Selaković, Vukica Vujić, Nemanja Stanisavljević, Živko Jovanović, Svetlana Radović, Dragana Cvetković
Plant-herbivore interactions can be mediated by plant apparency, defensive and nutritional quality traits that change through plant ontogeny, resulting in age-specific herbivory. In dioecious species, opposing allocation patterns in defense may lead to sex-biased herbivory. Here, we examine how onto stage and plant sex determine levels of herbivore damage in understory herb Mercurialis perennis under field conditions. We analyzed variation in plant size (height, total leaf area), physical (specific leaf area) and chemical (total phenolic and condensed tannins contents) defense, and nutritional quality (total water, soluble protein and nonstructural carbohydrate contents) during the shift from reproductive to post-reproductive stage. Furthermore, we explored correlations between the analyzed traits and levels of foliar damage. Post-reproductive plants had lower levels of chemical defense, and larger leaf area removed, in spite of having lower nutritive quality. Opposing patterns of intersexual differences were detected in protein and phenolic contents during reproductive stage, while in post-reproductive stage total leaf area was sexually dimorphic. Female-biased herbivory was apparent only after reproduction. Plant size parameters combined with condensed tannins content determined levels of foliar damage during post-reproductive stage, while the only trait covarying with herbivory in reproductive stage was total nonstructural carbohydrate content. Our results support claims of optimal defense theory – sensitive stage of reproduction was better defended. We conclude that different combinations of plant traits mediated interactions with herbivores in mature stages. Differences in reproductive allocation between the sexes may not immediately translate into different levels of damage, stressing the need for considering different ontogenetic stages when exploring sex bias in herbivory.



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Discovery of novel purine nucleoside derivatives as phosphodiesterase 2 (PDE2) inhibitors: structure-based virtual screening, optimization and biological evaluation

Publication date: Available online 14 November 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Xiaoxia Qiu, Yiyou Huang, Deyan Wu, Fei Mao, Jin Zhu, Wenzhong Yan, Hai-Bin Luo, Jian Li
Phosphodiesterase 2 (PDE2) has received much attention for the potential treatment of the central nervous system (CNS) disorders and pulmonary hypertension. Herein, we identified that clofarabine (4), an FDA-approved drug, displayed potential PDE2 inhibitory activity (IC50 = 3.12 ± 0.67 μM) by structure-based virtual screening and bioassay. Considering the potential therapeutic benefit of PDE2, a series of purine nucleoside derivatives based on the structure and binding mode of 4 were designed, synthesized and evaluated, which led to the discovery of the best compound 14e with a significant improvement of inhibitory potency (IC50 = 0.32 ± 0.04 μM). Further molecular docking and molecular dynamic (MD) simulations studies revealed that 5'-benzyl group of 14e could interact with the unique hydrophobic pocket of PDE2 by forming extra van der Waals interactions with hydrophobic residues such as Leu770, Thr768, Thr805 and Leu809, which might contribute to its enhancement of PDE2 inhibition. These potential compounds reported in this article and the valuable structure-activity relationships (SARs) might bring significant instruction for further development of potent PDE2 inhibitors.

Graphical abstract

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Bioluminescence Probe for γ-Glutamyl Transpeptidase Detection in vivo

Publication date: Available online 14 November 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Yuxing Lin, Yuqi Gao, Zhao Ma, Tianyu Jiang, Xin Zhou, Zhenzhen Li, Xiaojun Qin, Yun Huang, Lupei Du, Minyong Li
To detect γ-Glutamyl Transpeptidase (GGT) activity in vitro and in vivo, a bioluminescence probe with high sensitivity and specificity was well designed and synthesized. This probe can be recognized by GGT and release strong bioluminescence with its further reaction with luciferase. The performance of this probe was demonstrated in vitro and in cells. Finally, we applied the probe for detection of GGT activity in xenograft model.

Graphical abstract

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P272 Disseminated cutaneous warts in X-linked hyper-IGM syndrome: a case report

X-linked hyper-IgM syndrome (XHIGM) is a primary immunodeficiency caused by mutations in the CD40Ligand (CD40L) gene, leading to defective immunoglobulin class-switch recombination and impaired T-cell activation. Well-known manifestations of the syndrome include recurrent sinopulmonary infections, gastrointestinal complications, and neuroendocrine tumors. Cutaneous warts have rarely been reported in XHIGM.

http://ift.tt/2igkSTC

P271 Experience with two patients with activated PI3K delta syndrome: case reports

Activated Phosphoinositide-3 Kinase (PI3k) delta syndrome (APDS) is a combined immunodeficiency caused by gain of function mutations in PIK3 protein or receptor. We present two patients with APDS, one protein (APDS1) and one receptor mutation (APDS2).

http://ift.tt/2AH6HxT

P428 The empty nose syndrome (ENS): a diagnostic and therapeutic challenge for the allergist-immunologist

ENS is a rare rhinological disorder occurring months to years after sinonasal surgery, with symptoms of paradoxical nasal obstruction, nasal dryness, crusting, and dyspnea. Little is known of its pathogenesis, although anatomical changes leading to disruption of mucosal cooling, and disordered neurosensory mechanisms are strongly implicated. Medical therapies include mucosal humidification, irrigations, emollients, and surgical therapy with turbinate reconstruction reserved for refractory cases.

http://ift.tt/2igaSK2

P427 Eosinophils in nasal discharge and nasal cavity culture in children

There are many infants having nose symptoms in general practice, but it is difficult to distinguish between recurrent upper respiratory inflammation and allergic rhinitis (AR). Skin tests, nasal mucous membrane provocation tests, and the presence of eosinophil in the nasal discharge (END) are necessary for the diagnosis of AR. We often check the END for infants who are uncooperative in medical examinations.

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„Enge zahnärztliche Kooperation aufbauen!“

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Druckdolenter Strang unterhalb der Brustwarze

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Januskinsase-Inhibitoren bei atopischer Dermatitis

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NMSC: immer mehr Neuerkrankungen

Weltweit steigt die Zahl der nicht melanozytären Hautkrebsdiagnosen von Jahr zu Jahr — auch in Deutschland. Und es ist keine Trendwende in Sicht.

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Muskel- und Gelenkbeschwerden bei Checkpointinhibitoren

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Spezialist und Dienstleister in Weiß

Die Versorgungslandschaft wird sich noch gewaltig verändern. Davon sind junge Ärzte überzeugt. Eine aktuelle Studie der apoBank zeigt recht detailliert, was Heilberufler umtreibt.

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Friseurgranulom

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Melanom: Was tun bei Virusinfektionen?

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Fassaden als organische Gebäudehülle

Die Haut dient dem menschlichen Körper als Schutz — sie ist aber auch Medium der sinnlichen Wahrnehmung und wichtige Mittlerin zwischen dem Innen und Außen. Sie regelt den Wärmehaushalt des Körpers, absorbiert Sauerstoff und reproduziert sich selbst. All das sollen zunehmend auch moderne Gebäudefassaden leisten.

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Inhaltsverzeichnis

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Schweißdrüsenkarzinome: schwer zu erkennen

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Isotretinointherapie: kein Störfaktor für viele weitere Maßnahmen

Bis heute wird empfohlen, Isotretinoin vor einem dermatologischen Eingriff abzusetzen oder die Wirkung des Medikaments über sechs bis zwölf Monate abklingen zu lassen. Hautärzte aus den USA haben jetzt die Berechtigung für diese Vorsichtsmaßnahme anhand der Studienlage neu überprüft.

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PDT: ALA-Inkubation mit Mikronadeln verkürzen

Mit einem mit Mikronadeln gespickten Roller soll die Einwirkzeit der Aminolävulinsäure für die photodynamische Therapie der aktinischen Keratose verkürzt und die Prozedur für die Patienten erträglicher werden.

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Lymphknotenbiopsie bei T1-Melanom?

Antidepressiva verfügen über eine immunmodulatorische und antiphlogistische Wirkung. Inwieweit sich dieser Effekt für die Behandlung entzündlicher Dermatosen nutzen lässt, war Gegenstand eines aktuellen Reviews.

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Melanom: schlechte Prognose bei NRAS-Mutation

Eine retrospektive Untersuchung mit außerhalb von Studien versorgten Melanompatienten gibt Aufschluss über den Zusammenhang von Mutationsstatus und Prognose.

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Mit Antidepressiva Hautkrankheiten behandeln?

Antidepressiva verfügen über eine immunmodulatorische und antiphlogistische Wirkung. Inwieweit sich dieser Effekt für die Behandlung entzündlicher Dermatosen nutzen lässt, war Gegenstand eines aktuellen Reviews.

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Junge Ärzte kämpfen gegen Vorurteile älterer Kollegen

Dass Nachwuchsmediziner ihr Bedürfnis nach Freizeit über die Nöte ihrer Patienten stellen und zu hohe Anforderungen an Ausbilder und künftige Arbeitgeber haben, ist reines Schubladendenken, finden junge Ärzte — und fordern ein neues Arbeitsklima.

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Neurodermitis: ab wann systemisch behandeln?

Die Umstände, die für die Umstellung von Neurodermitspatienten auf eine systemische Therapie sprechen, gehen aus den Leitlinien nicht klar hervor. Daher hat ein internationales Expertengremium entsprechende Empfehlungen verfasst, die Ärzte und Patienten bei der Entscheidung unterstützen sollen.

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Wählen und gewinnen!

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Kinder mit Psoriasis früh auf Komorbidität screenen

Bei pädiatrischen Psoriasispatienten sollten schon früh Risikofaktoren beachtet werden, die künftige Komorbiditäten ankündigen können. US-Mediziner haben zusammengetragen, worauf es hierbei ankommt.

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P272 Disseminated cutaneous warts in X-linked hyper-IGM syndrome: a case report

X-linked hyper-IgM syndrome (XHIGM) is a primary immunodeficiency caused by mutations in the CD40Ligand (CD40L) gene, leading to defective immunoglobulin class-switch recombination and impaired T-cell activation. Well-known manifestations of the syndrome include recurrent sinopulmonary infections, gastrointestinal complications, and neuroendocrine tumors. Cutaneous warts have rarely been reported in XHIGM.

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P271 Experience with two patients with activated PI3K delta syndrome: case reports

Activated Phosphoinositide-3 Kinase (PI3k) delta syndrome (APDS) is a combined immunodeficiency caused by gain of function mutations in PIK3 protein or receptor. We present two patients with APDS, one protein (APDS1) and one receptor mutation (APDS2).

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P428 The empty nose syndrome (ENS): a diagnostic and therapeutic challenge for the allergist-immunologist

ENS is a rare rhinological disorder occurring months to years after sinonasal surgery, with symptoms of paradoxical nasal obstruction, nasal dryness, crusting, and dyspnea. Little is known of its pathogenesis, although anatomical changes leading to disruption of mucosal cooling, and disordered neurosensory mechanisms are strongly implicated. Medical therapies include mucosal humidification, irrigations, emollients, and surgical therapy with turbinate reconstruction reserved for refractory cases.

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P427 Eosinophils in nasal discharge and nasal cavity culture in children

There are many infants having nose symptoms in general practice, but it is difficult to distinguish between recurrent upper respiratory inflammation and allergic rhinitis (AR). Skin tests, nasal mucous membrane provocation tests, and the presence of eosinophil in the nasal discharge (END) are necessary for the diagnosis of AR. We often check the END for infants who are uncooperative in medical examinations.

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Bone marrow adipocytes in haematological malignancies

Publication date: Available online 14 November 2017
Source:Acta Histochemica
Author(s): Ewa Frączak, Mateusz Olbromski, Aleksandra Piotrowska, Natalia Glatzel-Plucińska, Piotr Dzięgiel, Jarosław Dybko, Kazimierz Kuliczkowski, Tomasz Wróbel
Bone marrow adipocytes (BMAs) derived from mesenchymal stem cells (MSC) are an active and significant element of the bone marrow microenvironment. They are involved in metabolic functions, complex interactions with other stromal cells, and in the development and progression of tumours. Currently, there is little data regarding the role of BMAs in haematological malignancies. Due to this, we have attempted to characterise the BMAs in these malignancies in terms of quantity and morphology. Our study included 30 patients aged 22–76 with myelo- (n=17) and lymphoproliferative malignancies (n=13), both with and without bone marrow infiltration. Trepanobioptate was the evaluated material. The number and diameter of BMAs were measured, and the percentage of adipocytes (adipocyte fraction – AF), hematopoietic cells (hematopoietic fraction – HF) and trabecular bone (trabecular bone fraction – BF) was calculated. The obtained results were considered against the clinical parameters of age, sex, body weight, body surface area (BSA) and body mass index (BMI). We observed that as age increases, the number of BMA/mm², the diameter of adipocytes and AF increase while BF and HF decrease. However, this relationship was not statistically significant. A significant correlation of BMA parameters was also not found in relation to weight, BMI and BSA, and the number and diameter of BMAs were comparable in both sexes. The trepanobioptate of infiltrated bone marrow showed a decreased number of BMA/mm² compared to the trepanobioptate from bone marrow without infiltration (97.44±69.16 vs. 164.14±54.16; p=0.010) with a marked difference in men (69.75±65.26 vs. 180.33±60.40; p=0.007). These trepanobioptate also showed an increase in the number of BMA/mm² with age (r=0.472; p=0.041), and with an increase of BMI, an increase in diameter of BMAs (r=0.625; p=0.007) and AF (r=0.546; p=0.023). The number and size of BMAs, as well as AF, BF and HF in patients with myeloproliferative malignancies did not differ significantly compared to patients with lymphoproliferative malignancies.



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Age-related vulnerability of pattern separation in C57BL/6J mice

Publication date: February 2018
Source:Neurobiology of Aging, Volume 62
Author(s): Aurélia Cès, Thibaut Burg, Karine Herbeaux, Céline Héraud, Jean-Bastien Bott, Ayikoe Guy Mensah-Nyagan, Chantal Mathis
Aging is associated with impaired performance in behavioral pattern separation (PS) tasks based on similarities in object features and in object location. These deficits have been attributed to functional alterations in the dentate gyrus (DG)-CA3 region. Animal studies suggested a role of adult-born DG neurons in PS performance. The present study investigated the effect of aging in C57BL/6J mice performing PS tasks based on either object features or object location. At the age of 18 months or more, performance was severely impaired in both tasks. Spatial PS performance declined gradually over adult lifespan from 3 to 21 months. Subchronic treatment with the cognitive enhancer D-serine fully rescued spatial PS performance in 18-month-old mice and induced a modest increase in the number of 4-week-old adult-born cells in the DG. Performance of mice in these PS tasks shows an age dependence, which appears to translate well to that found in humans. This model should help in deciphering physiological changes underlying PS deficits and in identifying future therapeutic targets.



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Prostaglandin J2 promotes O-GlcNAcylation raising APP processing by α- and β-secretases: relevance to Alzheimer's disease

Publication date: February 2018
Source:Neurobiology of Aging, Volume 62
Author(s): Teneka Jean-Louis, Patricia Rockwell, Maria E. Figueiredo-Pereira
Regulation of the amyloid precursor protein (APP) processing by α- and β-secretases is of special interest to Alzheimer's disease (AD), as these proteases prevent or mediate amyloid beta formation, respectively. Neuroinflammation is also implicated in AD. Our data demonstrate that the endogenous mediator of inflammation prostaglandin J2 (PGJ2) promotes full-length APP (FL-APP) processing by α- and β-secretases. The decrease in FL-APP was independent of proteasomal, lysosomal, calpain, caspase, and γ-secretase activities. Moreover, PGJ2-treatment promoted cleavage of secreted APP, specifically sAPPα and sAPPβ, generated by α and β-secretase, respectively. Notably, PGJ2-treatment induced caspase-dependent cleavage of sAPPβ. Mechanistically, PGJ2-treatment selectively diminished mature (O- and N-glycosylated) but not immature (N-glycosylated only) FL-APP. PGJ2-treatment also increased the overall levels of protein O-GlcNAcylation, which occurs within the nucleocytoplasmic compartment. It is known that APP undergoes O-GlcNAcylation and that the latter protects proteins from proteasomal degradation. Our results suggest that by increasing protein O-GlcNAcylation levels, PGJ2 renders mature APP less prone to proteasomal degradation, thus shunting APP toward processing by α- and β-secretases.



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Brain structural differences between 73- and 92-year olds matched for childhood intelligence, social background, and intracranial volume

Publication date: February 2018
Source:Neurobiology of Aging, Volume 62
Author(s): Stuart J. Ritchie, David Alexander Dickie, Simon R. Cox, Maria del C. Valdés Hernández, Ruth Sibbett, Alison Pattie, Devasuda Anblagan, Paul Redmond, Natalie A. Royle, Janie Corley, Susana Muñoz Maniega, Adele M. Taylor, Sherif Karama, Tom Booth, Alan J. Gow, John M. Starr, Mark E. Bastin, Joanna M. Wardlaw, Ian J. Deary
Fully characterizing age differences in the brain is a key task for combating aging-related cognitive decline. Using propensity score matching on 2 independent, narrow-age cohorts, we used data on childhood cognitive ability, socioeconomic background, and intracranial volume to match participants at mean age of 92 years (n = 42) to very similar participants at mean age of 73 years (n = 126). Examining a variety of global and regional structural neuroimaging variables, there were large differences in gray and white matter volumes, cortical surface area, cortical thickness, and white matter hyperintensity volume and spatial extent. In a mediation analysis, the total volume of white matter hyperintensities and total cortical surface area jointly mediated 24.9% of the relation between age and general cognitive ability (tissue volumes and cortical thickness were not significant mediators in this analysis). These findings provide an unusual and valuable perspective on neurostructural aging, in which brains from the 8th and 10th decades of life differ widely despite the same cognitive, socioeconomic, and brain-volumetric starting points.



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An interleaved sequence for simultaneous magnetic resonance angiography (MRA), susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM)

Publication date: Available online 14 November 2017
Source:Magnetic Resonance Imaging
Author(s): Yongsheng Chen, Saifeng Liu, Sagar Buch, Jiani Hu, Yan Kang, E. Mark Haacke
PurposeTo image the entire vasculature of the brain with complete suppression of signal from background tissue using a single 3D excitation interleaved rephased/dephased multi-echo gradient echo sequence. This ensures no loss of signal from fast flow and provides co-registered susceptibility weighted images (SWI) and quantitative susceptibility maps (QSM) from the same scan.Materials and methodsThe suppression of background tissue was accomplished by subtracting the flow-dephased images from the flow-rephased images with the same echo time of 12.5ms to generate a magnetic resonance angiogram and venogram (MRAV). Further, a 2.5ms flow-compensated echo was added in the rephased portion to provide sufficient signal for major arteries with fast flow. The QSM data from the rephased 12.5ms echo was used to suppress veins on the MRAV to generate an artery only MRA. The proposed approach was tested on five healthy volunteers at 3T.ResultsThis three-echo interleaved GRE sequence provided complete background suppression of stationary tissues, while the short echo data gave high signal in the internal carotid and middle cerebral arteries (MCA). The contrast-to-noise ratio (CNR) of the arteries was significantly improved in the M3 territory of the MCA compared to the non-linear subtraction MRA and TOF-MRA. Veins were suppressed successfully utilizing the QSM data.ConclusionThe background tissue can be properly suppressed using the proposed interleaved MRAV sequence. One can obtain whole brain MRAV, MRA, SWI, true-SWI (or tSWI) and QSM data simultaneously from a single scan.



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High frequency neurons determine effective connectivity in neuronal networks

Publication date: 1 February 2018
Source:NeuroImage, Volume 166
Author(s): Aref Pariz, Zahra G. Esfahani, Shervin S. Parsi, Alireza Valizadeh, Santiago Canals, Claudio R. Mirasso
The emergence of flexible information channels in brain networks is a fundamental question in neuroscience. Understanding the mechanisms of dynamic routing of information would have far-reaching implications in a number of disciplines ranging from biology and medicine to information technologies and engineering. In this work, we show that the presence of a node firing at a higher frequency in a network with local connections, leads to reliable transmission of signals and establishes a preferential direction of information flow. Thus, by raising the firing rate a low degree node can behave as a functional hub, spreading its activity patterns polysynaptically in the network. Therefore, in an otherwise homogeneous and undirected network, firing rate is a tunable parameter that introduces directionality and enhances the reliability of signal transmission. The intrinsic firing rate across neuronal populations may thus determine preferred routes for signal transmission that can be easily controlled by changing the firing rate in specific nodes. We show that the results are generic and the same mechanism works in the networks with more complex topology.



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Overlapping frontoparietal networks for tactile and visual parametric working memory representations

Publication date: 1 February 2018
Source:NeuroImage, Volume 166
Author(s): Yuan-hao Wu, Işıl Uluç, Timo Torsten Schmidt, Kathrin Tertel, Evgeniya Kirilina, Felix Blankenburg
Previous working memory (WM) research based on non-human primate electrophysiology and human EEG has shown that frontal brain regions maintain frequencies of flutter stimulation across different sensory modalities by means of a supramodal parametric WM code. These findings imply that frontal regions encode the memorized frequencies in a sensory-unspecific, quantitative format. Here, we explored which brain regions maintain information about frequencies provided by different sensory modalities at the level of activity pattern across fMRI voxel populations. Moreover, we sought evidence for a supramodal multivariate WM representation. Participants maintained the same set of frequencies of tactile vibration and visual flicker for a 6 s WM delay in a frequency discrimination task. A support vector regression model for multivariate pattern analysis was applied. We observed that sensory cortices were only selective for memoranda of their corresponding modalities, while frontoparietal regions exhibited distinguishable activity patterns to memorized frequencies regardless of sensory modality. A common multivariate code was not evident in our data. Collectively, we show that mnemonic representations for stimulus frequencies are maintained throughout the cortical hierarchy, in line with the suggested transformation of information across different representational formats. Although evidence for a supramodal multivariate code is absent, our findings underpin the generalized role of the frontoparietal cortex for maintaining quantitative information across sensory modalities.



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A direct comparison between ERP and fMRI measurements of food-related inhibitory control: Implications for BMI status and dietary intake

Publication date: 1 February 2018
Source:NeuroImage, Volume 166
Author(s): Kaylie A. Carbine, Kara M. Duraccio, C. Brock Kirwan, Nathan M. Muncy, James D. LeCheminant, Michael J. Larson
Obesity and maintaining a healthy diet have important implications for physical and mental health. One factor that may influence diet and obesity is inhibitory control. We tested how N2 and P3 amplitude, event-related potential (ERP) components that reflect inhibitory control, and functional magnetic resonance imaging (fMRI) activity in brain regions associated with inhibitory control differed toward high- and low-calorie food stimuli across BMI status. We also assessed the relationship between neural indices of food-related inhibitory control and laboratory and daily food intake. Fifty-four individuals (17 normal-weight; 18 overweight; 19 individuals with obesity) completed two food-based go/no-go tasks (one with high- and one with low-calorie foods as no-go stimuli), once during ERP data acquisition and once during fMRI data acquisition. After testing, participants were presented with an ad libitum weighed food buffet. Participants also recorded their food intake using the Automated Self-Administered 24-hour Dietary Recall (ASA24) system across four days. Individuals recruited more inhibitory control when withholding responses towards high-compared to low-calorie foods, although this effect was more consistent for N2 than P3 or fMRI assessments. BMI status did not influence food-related inhibitory control. A larger inhibitory response as measured by N2 amplitude was related to increased ASA24 food intake; P3 amplitude and fMRI region of interest activity did not predict ASA24 intake; neither method predicted food intake from the buffet. ERP and fMRI measurements show similar neural responses to food, although N2 amplitude may be somewhat more sensitive in detecting differences between food types and predicting self-reports of food intake.



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Putting Bandits Into Context: How Function Learning Supports Decision Making.

Author: Schulz, Eric; Konstantinidis, Emmanouil; Speekenbrink, Maarten

DOI: 10.1037/xlm0000463

Publication Date: POST AUTHOR CORRECTIONS, 13 November 2017

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Charge transport in graphene oxide

Publication date: Available online 14 November 2017
Source:Nano Today
Author(s): Dong Wook Chang, Jong-Beom Baek
The transport of ionic species in nano-fluidic channels has recently attracted tremendous interest in various research areas. This is because extraordinary nanoscale transport phenomena have been achieved in these materials, including ultrafast and highly selective ion movement. A variety of organic and inorganic materials have been employed to construct nano-channels or nano-pores with controlled sizes and dimensions. In particular, because of its unique two-dimensional planar architecture, as well as the possession of numerous oxygenated functionalities, GO has emerged as a promising building block for high-performance nano-fluidic ion channels. The simple exfoliation-reconstruction approach can readily assemble individual GO sheets into a free-standing, layered, film-like structure. In addition to its utilization as a versatile solid support for nano-fluidic ion transport, GO can play different but positive roles as a filler in composite electrolytes, as a mixed proton/electron conductor, and as a selective ion permeation membrane. Herein, we summarize the recent advances in the transport of ionic species within GO-based electrolytes. Moreover, the perspectives and current challenges of this promising field are discussed.

Graphical abstract

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Editorial Board

Publication date: 15 January 2018
Source:Materials & Design, Volume 138





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Total caloric eye speed in patients with vestibular migraine

Vestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine.

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Development and face validation of a Virtual Reality Epley Maneuver System (VREMS) for home Epley treatment of benign paroxysmal positional vertigo: A randomized, controlled trial

To develop and validate a smartphone based Virtual Reality Epley Maneuver System (VREMS) for home use.

http://ift.tt/2zXYOrs

Total caloric eye speed in patients with vestibular migraine

Vestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine.

http://ift.tt/2zBk1qy

Inhibition of leukotriene B4 synthesis protects against early brain injury possibly via reducing the neutrophil-generated inflammatory response and oxidative stress after subarachnoid hemorrhage in rats

Publication date: 26 February 2018
Source:Behavioural Brain Research, Volume 339
Author(s): Zhen-Nan Ye, Ling-Yun Wu, Jing-Peng Liu, Qiang Chen, Xiang-Sheng Zhang, Yue Lu, Meng-Liang Zhou, Wei Li, Zi-Huan Zhang, Da-Yong Xia, Zong Zhuang, Chun-Hua Hang
Leukotriene B4 (LTB4) is a highly potent neutrophil chemoattractant and neutrophils induces inflammatory response and oxidative stress when they recruit to and infiltrate in the injuried/inflamed site, such as the brain parenchyma after aneurysmal subarachnoid hemorrhage (SAH). This study is to investigate the potential effects of inhibition of LTB4 synthesis on neutrophil recruitment, inflammatory response and oxidative stress, as well as early brain injury (EBI) in rats after SAH. A pre-chiasmatic cistern SAH model of rats was used in this experiment. SC 57461A was used to inhibit LTB4 synthesis via intracerebroventricular injection. The brain tissues of temporal lobe after SAH were analyzed. Neuronal injury, brain edema and neurological function were evaluated to investigate the development of EBI. We found that inhibition of LTB4 synthesis after SAH could reduce the level of myeloperoxidase, alleviate the inflammatory response and oxidative stress, and reduce neuronal death in the brain parenchyma, and ameliorate brain edema and neurological behavior impairment at 24h after SAH. These results suggest that inhibition of LTB4 synthesis might alleviate EBI after SAH possibly via reducing the neutrophil-generated inflammatory response and oxidative stress.



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Computed Tomography of Internal Hernias Following Laparoscopic Roux-en-Y Gastric Bypass Surgery

Publication date: Available online 14 November 2017
Source:Seminars in Ultrasound, CT and MRI
Author(s): Yoan Kagoma, Gabriela Gayer
Internal hernia in the postoperative laparoscopic Roux-en-Y patient is a diagnosis associated with significant morbidity and risk of death. The radiologist plays an instrumental role in workup of this patient group; however, the imaging assessment of these patients is not straightforward given their complex postsurgical anatomy. Multiple radiologic signs of internal hernia have been studied in the literature. This review article presents these signs with representative cases as well as a summary of their diagnostic accuracy.



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Surgical Management of Tumors Involving Meckel's Cave and Cavernous Sinus: Role of an Extended Middle Fossa and Lateral Sphenoidectomy Approach.

Objective: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). Study Design: Retrospective patient series. Setting: Tertiary referral center. Patients: Twenty-two consecutive patients (mean age: 45 yr, range: 16-76) who underwent transzygomatic, extended middle fossa approaches for tumors involving MC and CS. Interventions: Surgical access to MC and CS was achieved via extended middle fossa, trans-clinoid approach. Lateral sphenoidectomy was defined as drill-out of the greater sphenoid wing lateral to foramen rotundum and ovale, decompression of superior orbital fissure, and removal of anterior clinoid process. Reconstruction was achieved using combination of autologous and synthetic materials. Eleven patients (50%) received adjuvant radiation. Main Outcome Measures and Results: Tumor pathologies included meningioma (16 patients), epidermoid cyst (2), trigeminal schwannoma (2), invasive pituitary adenoma (1), and chondrosarcoma (1). Mean (range) preoperative tumor size was 4.0 cm (1.3-9). Mean (range) length of follow-up was 4 years (range 0.1-10). Overall tumor control and gross total resection were achieved in 95 and 23% of patients, respectively. Lateral sphenoidectomy was performed in 16 patients (73%) for enhanced surgical access and/or tumor extension to the infratemporal fossa (6 patients). Postoperatively, cranial nerve deficits occurred in 12 (55%) patients (V-9 patients; III, IV, or VI-4; VII-2; VIII-2). Cerebrospinal fluid leak and hydrocephalus occurred in two and four patients, respectively. Conclusion: In combination with middle fossa-based approaches to tumors involving MC and CS, lateral sphenoidectomy may play a viable role in tumor access and control. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction–mandibular setback surgery in patients with cleft lip and palate

Maxillary distraction is increasingly used for the correction of severe maxillary retrusion in patients with cleft lip and palate. However, control of the maxillary movement is difficult, and the need to wear visible distractors for a long period of time causes psychosocial problems. A two-stage surgical approach consisting of maxillary distraction and mandibular setback was developed to overcome these problems. In this study, changes in maxillofacial morphology and velopharyngeal function were examined in 22 patients with cleft lip and palate who underwent this two-stage approach.

http://ift.tt/2iVK0P6

Comparison of two physiotherapy programmes for rehabilitation after temporomandibular joint arthroscopy

The purpose of this study was to compare two physiotherapy programmes for rehabilitation after temporomandibular joint (TMJ) arthroscopy. The medical files of 137 consecutive patients diagnosed with closed lock and treated by arthroscopic lysis and lavage were analyzed retrospectively. Sixty-eight patients were rehabilitated with gradually increasing range of motion self-exercises (gradual programme) and 69 patients were rehabilitated with immediate full range of motion self-exercises (immediate programme).

http://ift.tt/2zJNgF8

The Reconstruction of the Donor Site of DP Flap Using Thoracodorsal Artery Perforator Flap

Summary: We performed a new procedure for reconstruction of donor site of a deltopectoral (DP) flap. A 58-year-old man presented with a wide subcutaneous abscess, which was caused by acute mandibular osteomyelitis due to dental caries. On admission, the patient received a neck incision for drainage. However, necrosis of the neck skin was observed after drainage. The patient had an 8 × 10 cm skin and soft-tissue defect, which we covered with a DP flap (15 × 7 cm). The DP flap donor site was reconstructed using a 16 × 8 cm pedicled thoracodorsal artery perforator (TDAP) flap. There was no flap necrosis, abscess formation, or scar contracture of the DP region. Debulking of the TDAP flap was not required. The pedicled TDAP flap is useful for the reconstruction of the donor site of DP flap. In this report, we describe our operative procedure.

http://ift.tt/2hzyzjF