Probing the toxicity mechanism of multiwalled carbon nanotubes on bacteria

Abstract

Carbon nanotubes (CNTs) have emerged recently as superior adsorbent materials for the removal of recalcitrant pollutants. The potential of combining the sorption capability of CNTs with bacterial degradation for pollutant removal, however, necessitates further investigation of the mechanisms of CNTs' toxicity towards bacterial cells. In this study, we used a panel of stress-responsive recombinant Escherichia coli bioluminescence bacterial strains to explore the possible mechanisms of toxicity of multiwalled carbon nanotubes (MWCNTs). The effects of MWCNTs on markers of oxidative stress, protein, DNA, and membrane damage enabled the exposition of some of the mechanisms of their antimicrobial properties. Using both a bioluminescence bioreporter panel and live/dead staining, we observed that membrane damage played a role in the toxicity of MWCNTs. A subsequent viability study using three strains of bacteria—two gram-negative (Escherichia coli, Pseudomonas aeruginosa) and one gram-positive (Bacillus subtilis)—showed significant MWCNT toxicity in hypotonic water and phosphate-buffered saline solution, compared with the MWCNT toxicity towards the same bacteria incubated in isotonic-rich media. Using a field-emission scanning electron microscope, we demonstrated that membrane damage is caused largely by MWCNTs trapping bacteria and piercing the cell walls. As a result of our observations, we propose integrating MWCNTs and bacteria degradation for pollutant removal in nutrient-rich media to minimize the toxicity effect of CNTs.

http://ift.tt/2AwXKIq

Does the air condition system in busses spread allergic fungi into driver space?

Abstract

The aim of this study was to establish whether the air-conditioning system in buses constitutes an additional source of indoor air contamination with fungi, and whether or not the fungi concentration depends on the period from the last disinfection of the system, combined with replacement of the cabin dust particle filter. The air samples to fungi analysis using impact method were taken in 30 buses (20 with an air-conditioning system, ACS; 10 with a ventilation system, VS) in two series: 1 and 22 weeks after cabin filter replacement and disinfection of the air-conditioning system. During one test in each bus were taken two samples: before the air-conditioning or ventilation system switched on and 6 min after operating of these systems. The atmospheric air was the external background (EB). After 1 week of use of the system, the fungi concentrations before starting of the ACS and VS system were 527.8 and 1053.0 cfu/m³, respectively, and after 22 weeks the concentrations were 351.9 and 1069.6 cfu/m³, respectively. While in the sample after 6 min of ACS and VS system operating, the fungi concentration after 1 week of use was 127.6 and 233.7 cfu/m³, respectively, and after 22 weeks it was 113.3 and 324.9 cfu/m³, respectively. Results do not provide strong evidence that air-conditioning system is an additional source of indoor air contamination with fungi. A longer operation of the system promoted increase of fungi concentration in air-conditioned buses only.

http://ift.tt/2AsAf5w

Generation of highly potent organic fertilizer from pernicious aquatic weed Salvinia molesta

Abstract

Utilization of Salvinia molesta, an aquatic weed which is notorious for its allelopathy and invasiveness, has been explored by its vermicomposting. Fourier transform infrared spectroscopy (FT-IR) and plant bioassay tests were conducted to analyze the composition and fertilizer value of S .molesta vermicompost. Germination and seedling growth tests were performed in soil supplemented with vermicompost at levels ranging from 0.75 to 40% by weight of the soil on three common food plants, ladies finger (Abelmoschus esculentus), cucumber (Cucumis sativus), and green gram (Vigna radiata). The influence of S. molesta's vermicompost on some of the physicochemical and biological attributes of the soil was also studied. FT-IR analysis revealed that S. molesta loses its allelopathy, as the chemical compounds that are responsible for it are largely destroyed, in the course of its vermicomposting. There is also an indication that a portion of lignin content of S. molesta is degraded. Vermicompost enhanced the germination success and promoted the morphological growth and biochemical content of the plant species studied. It also bestowed plant friendly physicochemical and biological attributes to the soil. The findings raise the prospect that billions of tons of S. molesta biomass―which not only goes to waste at present but is also a cause of serious harm to the environment―may become utilizable in organic agriculture.

http://ift.tt/2Ax0Mw8

Residue behavior and risk assessment of imidacloprid applied on greenhouse-cultivated strawberries under different application conditions

Abstract

A risk assessment for imidacloprid applied on strawberries under different conditions was performed after residue determination using the quick, cheap, effective, rugged, and safe (QuEChERS) method. The application conditions were varied according to the applied dosage, addition of a plant oil or organosilicon surfactant, water volume, and sprayer type. The degradation dynamics of imidacloprid on strawberries followed first-order kinetics. At applied doses of 30–60 g a.i. ha⁻¹, the half-lives of imidacloprid were 2.89–3.46, 1.98–3.65, and 2.57–2.77 days after application without a surfactant or with a plant oil or organosilicon surfactant, respectively. For water volumes of 112.5, 225, 450, 675, and 900 L ha⁻¹, the half-lives of imidacloprid applied in the presence of the plant oil surfactant were 3.30, 7.70, 5.33, 7.70, and 6.30 days, respectively. The half-lives after application with a knapsack mist duster, electric sprayer, and manual sprayer were 2.16, 5.77, and 7.70 days, respectively. The health risk assessment revealed risk quotients less than 1 in all cases, indicating that the application of imidacloprid poses a low health risk to humans after a pre-harvest interval of 10 days under our application conditions. The risk assessment results can provide reference data for setting a reasonable maximum residue limit for imidacloprid on strawberries in China.

http://ift.tt/2ArJimY

Cumulative impacts from multiple human activities on seagrass meadows in eastern Mediterranean waters: the case of Saronikos Gulf (Aegean Sea, Greece)

Abstract

Ecosystem-based management (EBM) addresses the fundamental need to account for cumulative impacts of human activities with the aim of sustainably delivering ecosystem services. The Saronikos Gulf, a large embayment of the Aegean Sea, provides a wide range of ecosystem services that are impacted by multiple human activities, deriving from the metropolitan area of Athens (situated at the northeast part of the Gulf). The anthropogenic impacts affect the status of several marine ecosystem components, e.g., seagrass meadows. Cymodocea nodosa meadows are only present at the most confined western part of the Gulf, whereas Posidonia oceanica meadows are mainly distributed in the inner and outer part of the Gulf. The aim of this study is to assess the cumulative impacts from multiple human activities on the seagrass meadows in the Gulf. The main results indicated that most impacted meadows are P. oceanica in the inner part of the Gulf, adjacent to the most urbanized coastal areas, and near port infrastructures. Land-based pollution, as well as physical damage and loss seem to be the main pressures exerted on the meadows. Understanding cumulative impacts is crucial for informing policy decisions under an EBM approach.

http://ift.tt/2AxjxzP

A giant popliteal lipoblastoma in a 23-month-old girl: a case report

Lipoblastomas are rare benign tumors that arise from embryonic white fat and almost always occur in babies and children. Here, we report a case of a giant popliteal lipoblastoma in a 23-month-old Japanese girl...

http://ift.tt/2ilquvE

Clinical predictors of chronic rhinosinusitis: do the Canadian clinical practice guidelines for acute and chronic rhinosinusitis predict CT-confirmation of disease?

The diagnosis of chronic rhinosinusitis (CRS) based on clinical presentation alone remains challenging. To improve the accuracy of clinical diagnosis, the Canadian Rhinosinusitis Guidelines recommend the use o...

http://ift.tt/2iORfwh

Clinical predictors of chronic rhinosinusitis: do the Canadian clinical practice guidelines for acute and chronic rhinosinusitis predict CT-confirmation of disease?

The diagnosis of chronic rhinosinusitis (CRS) based on clinical presentation alone remains challenging. To improve the accuracy of clinical diagnosis, the Canadian Rhinosinusitis Guidelines recommend the use o...

http://ift.tt/2iORfwh

Occurrence, distribution and composition of aliphatic and polycyclic aromatic hydrocarbons in sediment cores from the Lower Fox River, Wisconsin, US

Abstract

The Lower Fox River is a 39 mile section which supports approximately 270,000 rural inhabitants across 18 counties, 303,000 metropolitan residents in Green Bay and Appleton, Wisconsin, and several large industrial complexes such as paper mills and power plants. This paper presents the distribution and concentrations of aliphatic (n-alkanes) and aromatic hydrocarbons (polycyclic aromatic hydrocarbons [PAHs]) as well as total organic carbon (TOC) in the Lower Fox River to identify the sources of hydrocarbon contamination. Excluding one outlier, percent TOC values were between 0.73 and 19.9% with an average value of 6.74%. Total n-alkanes ranged from 3.51 μg/g to 117 μg/g and showed a strong presence of odd carbon-numbered n-alkane ratios (range of C25 to C35), suggesting source input from terrestrial biomass. The mean polycyclic aromatic hydrocarbon (PAH) concentration was 24,800 ng/g. High molecular weight PAH concentrations dominated the distribution of hydrocarbon contaminants. Cross-plots of PAHs were used to compare diagnostic source ratios of benz[a]anthracene (BaA), chrysene (Chr), fluoranthene (Flu), pyrene (Pyr), anthracene (Ant), phenanthrene (Phe), indeno[1,2,3-cd]pyrene (InP), and benzo[g,h,i]perylene (BghiP) by depth and area. PAH ratios varied slightly with the core depth. Deeper core sections indicated the presence of biomass combustion while the upper core sections indicated combustion of both petroleum and biomass. The PAH toxicity of one core was estimated using toxicity equivalency factors, and the benzo[a]pyrene toxic equivalence quotient totaled 2,293 ng/g-dry wt. Levels of PAHs in sediments are compared with established regulatory values and recommendations are made.

http://ift.tt/2AvPzfy

A two-center, assessor-blinded, prospective trial evaluating the efficacy of a novel hypertonic draining cream for cellulite reduction: A Clinical and instrumental (Antera 3D CS) assessment

Summary

Introduction

Gynoid lipodystrophy, also known as cellulite, is a very common skin alteration representing mainly a cosmetic problem rather than a real disease. An effective treatment of cellulite has not been well established. The initial phase of cellulite is characterized by subdermal tissue edema with interstitial fluids retention. A new hypertonic topical product with draining action (HTC) containing NaCl 13%, escine, caffeine, and beta-sitosterol has been recently developed. A 28-day double-blind placebo-controlled study has shown that this cream is able to reduce thigh circumference and the thickness of adipose tissue. No data so far are available regarding an objective evaluation of skin appearance for a longer application period.

Study aim

To evaluate the clinical efficacy of 2-month HCT treatment with clinical and instrumental assessments.

Subjects and methods

In a prospective, 2-center, assessor-blinded trial 20 women (mean age 34 years) with cellulite of Grade I-III in severity were enrolled after their informed consent. HTC was applied once daily for 60 days. Primary outcomes of the trial were the evolution of thigh circumference measurements (assessed at baseline, after 1 and 2 months) and the computer-analysis of skin profilometry (ie, skin volumes) of a prespecified target area evaluated by means of Antera 3D CS digitalized images (assessed at baseline and at the end of the trial). Secondary outcome was the orange peel severity score (from 0 to 5) before and after pitch test.

Results

All subjects concluded the study period. Thigh circumference was reduced by −0.88 (right)/−1.2 cm (left) and by −1.8(right)/−2.1 (left) cm, after 30 and 60 days of treatment, respectively (P = .001, Wilcoxon test vs baseline). Antera 3D profilometry of the target zone showed a significant reduction in skin depression expressed in mm³ of −56% (from 59.7 to 26.73 mm³) after HTC application. Orange peel (no pitch test) mean (SD) score was 2.3 (1) at baseline, 2.0 (1) and 1.8 (0.8) after 1 and 2 months (P = .0031), respectively. After-pitch orange peel score was significantly reduced after treatment (from 3.3 to 2.2).

Conclusion

Once daily application of HTC for 2 months has confirmed its efficacy in the improvement of objective and subjective assessments of cellulite parameters.(Trial Number registration: ISRCTN15111614).

http://ift.tt/2zNlN4O

Immediate effect and safety of HIFU single treatment for male subcutaneous fat reduction

Summary

Background

The increasing search for procedures for fat reduction is related to dissatisfaction with body shape. High-intensity focused ultrasound (HIFU) has been proven effective in body sculpting when used noninvasively to reduce subcutaneous fat and improve body contour.

Aims

This study aimed to evaluate the immediate effect and safety of HIFU single treatment for male localized fat and body remodeling.

Patients/Methods

Twenty-four male subjects (18 to 59 years old) with BMI ≤ 30 kg/cm² and at least 2 cm of abdominal fat received a single HIFU treatment session. Individuals were subjected to abdominal measurements before and after procedure. In addition, biochemical analyses of blood samples were performed to assess possible inflammatory effects or oxidative stress induction by the treatment.

Results

High-intensity focused ultrasound was found to be an effective treatment in reducing localized adiposities in the abdominal region. A significant decrease (0.6%) was observed in infraumbilical circumference of subjects submitted to HIFU single treatment when compared with control subjects. The laboratory parameters did not present any appreciable changes.

Conclusion

This study further strengthens the current view that HIFU is an effective and safe tool for localized fat reduction.

http://ift.tt/2nsZ8Jn

A two-center, assessor-blinded, prospective trial evaluating the efficacy of a novel hypertonic draining cream for cellulite reduction: A Clinical and instrumental (Antera 3D CS) assessment

Summary

Introduction

Gynoid lipodystrophy, also known as cellulite, is a very common skin alteration representing mainly a cosmetic problem rather than a real disease. An effective treatment of cellulite has not been well established. The initial phase of cellulite is characterized by subdermal tissue edema with interstitial fluids retention. A new hypertonic topical product with draining action (HTC) containing NaCl 13%, escine, caffeine, and beta-sitosterol has been recently developed. A 28-day double-blind placebo-controlled study has shown that this cream is able to reduce thigh circumference and the thickness of adipose tissue. No data so far are available regarding an objective evaluation of skin appearance for a longer application period.

Study aim

To evaluate the clinical efficacy of 2-month HCT treatment with clinical and instrumental assessments.

Subjects and methods

In a prospective, 2-center, assessor-blinded trial 20 women (mean age 34 years) with cellulite of Grade I-III in severity were enrolled after their informed consent. HTC was applied once daily for 60 days. Primary outcomes of the trial were the evolution of thigh circumference measurements (assessed at baseline, after 1 and 2 months) and the computer-analysis of skin profilometry (ie, skin volumes) of a prespecified target area evaluated by means of Antera 3D CS digitalized images (assessed at baseline and at the end of the trial). Secondary outcome was the orange peel severity score (from 0 to 5) before and after pitch test.

Results

All subjects concluded the study period. Thigh circumference was reduced by −0.88 (right)/−1.2 cm (left) and by −1.8(right)/−2.1 (left) cm, after 30 and 60 days of treatment, respectively (P = .001, Wilcoxon test vs baseline). Antera 3D profilometry of the target zone showed a significant reduction in skin depression expressed in mm³ of −56% (from 59.7 to 26.73 mm³) after HTC application. Orange peel (no pitch test) mean (SD) score was 2.3 (1) at baseline, 2.0 (1) and 1.8 (0.8) after 1 and 2 months (P = .0031), respectively. After-pitch orange peel score was significantly reduced after treatment (from 3.3 to 2.2).

Conclusion

Once daily application of HTC for 2 months has confirmed its efficacy in the improvement of objective and subjective assessments of cellulite parameters.(Trial Number registration: ISRCTN15111614).

http://ift.tt/2zNlN4O

Immediate effect and safety of HIFU single treatment for male subcutaneous fat reduction

Summary

Background

The increasing search for procedures for fat reduction is related to dissatisfaction with body shape. High-intensity focused ultrasound (HIFU) has been proven effective in body sculpting when used noninvasively to reduce subcutaneous fat and improve body contour.

Aims

This study aimed to evaluate the immediate effect and safety of HIFU single treatment for male localized fat and body remodeling.

Patients/Methods

Twenty-four male subjects (18 to 59 years old) with BMI ≤ 30 kg/cm² and at least 2 cm of abdominal fat received a single HIFU treatment session. Individuals were subjected to abdominal measurements before and after procedure. In addition, biochemical analyses of blood samples were performed to assess possible inflammatory effects or oxidative stress induction by the treatment.

Results

High-intensity focused ultrasound was found to be an effective treatment in reducing localized adiposities in the abdominal region. A significant decrease (0.6%) was observed in infraumbilical circumference of subjects submitted to HIFU single treatment when compared with control subjects. The laboratory parameters did not present any appreciable changes.

Conclusion

This study further strengthens the current view that HIFU is an effective and safe tool for localized fat reduction.

http://ift.tt/2nsZ8Jn

Learning From Major Clinical Trials: Bending Without Breaking.

Author: Pfeffer, Marc A. MD, PhD

Page: 2207-2209

http://ift.tt/2jQUjV5

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor Therapy: Payer Approvals and Rejections, and Patient Characteristics for Successful Prescribing.

Author: Hess, Gregory P. MD, MSc; Natarajan, Pradeep MD, MMSc; Faridi, Kamil F. MD; Fievitz, Anna BS; Valsdottir, Linda MS; Yeh, Robert W. MD, MSc

Page: 2210-2219

http://ift.tt/2ik5K7m

J Curve in Patients Randomly Assigned to Different Systolic Blood Pressure Targets: An Experimental Approach to an Observational Paradigm.

Author: Kalkman, Deborah N. MD; Brouwer, Tom F. MD; Vehmeijer, Jim T. MD; Berger, Wouter R. MD; Knops, Reinoud E. MD, PhD; de Winter, Robbert J. MD, PhD; Peters, Ron J. MD, PhD; van den Born, Bert-Jan H. MD, PhD

Page: 2220-2229

http://ift.tt/2jPEbmE

The Tale of an Innocent: Intensive Treatment and the J-Curve in the SPRINT Trial (Systolic Blood Pressure Intervention Trial).

Author: Verdecchia, Paolo MD; Angeli, Fabio MD; Reboldi, Gianpaolo MD, PhD, MSc

Page: 2230-2232

http://ift.tt/2im3Fb4

Latent Rheumatic Heart Disease: Identifying the Children at Highest Risk of Unfavorable Outcome.

Author: Beaton, Andrea MD; Aliku, Twalib MMed; Dewyer, Alyssa BS; Jacobs, Marni PhD, MPH; Jiang, Jiji MD, MS; Longenecker, Chris T. MD; Lubega, Sulaiman MMed; McCarter, Robert ScD; Mirabel, Mariana MD; Mirembe, Grace MMed; Namuyonga, Judith MMed; Okello, Emmy MMed, PhD; Scheel, Amy BS; Tenywa, Emmanuel MMed; Sable, Craig MD; Lwabi, Peter MMed

Page: 2233-2244

http://ift.tt/2jSGjdg

Echocardiographic Detection of Latent Rheumatic Heart Disease: A Pandora's Box?.

Author: Essop, Mohammed R. MBBCh; Mayosi, Bongani M. MBChB

Page: 2245-2247

http://ift.tt/2im3BrQ

Binding of FUN14 Domain Containing 1 With Inositol 1,4,5-Trisphosphate Receptor in Mitochondria-Associated Endoplasmic Reticulum Membranes Maintains Mitochondrial Dynamics and Function in Hearts in Vivo.

Author: Wu, Shengnan PhD *; Lu, Qiulun PhD *; Wang, Qilong PhD; Ding, Ye PhD; Ma, Zejun MD, PhD; Mao, Xiaoxiang MD; Huang, Kai MD, PhD; Xie, Zhonglin MD, PhD; Zou, Ming-Hui MD, PhD

Page: 2248-2266

http://ift.tt/2jSGfu2

FUNDC1: A Novel Protein in Cardiac Health.

Author: Munoz, Juan Pablo PhD; Zorzano, Antonio PhD

Page: 2267-2270

http://ift.tt/2impSWD

Tryptophan-Derived 3-Hydroxyanthranilic Acid Contributes to Angiotensin II-Induced Abdominal Aortic Aneurysm Formation in Mice In Vivo.

Author: Wang, Qiongxin PhD; Ding, Ye PhD; Song, Ping PhD; Zhu, Huaiping PhD; Okon, Imoh PhD; Ding, Yang-Nan BSc; Chen, Hou-Zao PhD; Liu, De-Pei PhD; Zou, Ming-Hui MD, PhD

Page: 2271-2283

http://ift.tt/2jOLds3

Increased Inflammation in Pericardial Fluid Persists 48 Hours After Cardiac Surgery.

Author: Butts, Brittany PhD, RN; Goeddel, Lee A. MD, MPH; George, David J. BS; Steele, Chad PhD; Davies, James E. MD; Wei, Chih-Chang PhD; Varagic, Jasmina MD, PhD; George, James F. PhD; Ferrario, Carlos M. MD; Melby, Spencer J. MD; Dell'Italia, Louis J. MD

Page: 2284-2286

http://ift.tt/2iiGhLv

Letter by Jin-shan and Xue-bin Regarding Article, "Genotype-Phenotype Correlation of SCN5A Mutation for the Clinical and Electrocardiographic Characteristics of Probands With Brugada Syndrome: A Japanese Multicenter Registry".

Author: Jin-shan, He MD; Xue-bin, Li MD

Page: 2287-2288

http://ift.tt/2jNQQGQ

Response by Yamagata et al to Letter Regarding Article, "Genotype-Phenotype Correlation of SCN5A Mutation for the Clinical and Electrocardiographic Characteristics of Probands With Brugada Syndrome: A Japanese Multicenter Registry".

Author: Yamagata, Kenichiro MD, PhD; Aiba, Takeshi MD, PhD; Shimizu, Wataru MD, PhD

Page: 2289-2290

http://ift.tt/2ik89yM

Letter by Kotsiou and Gourgoulianis Regarding Article, "Pathophysiology of Takotsubo Syndrome".

Author: Kotsiou, Ourania S. MD, PhD; Gourgoulianis, Konstantinos I. Prof. PhD

Page: 2291-2292

http://ift.tt/2jQ6KR5

Letter by Stiermaier and Eitel Regarding Article, "Pathophysiology of Takotsubo Syndrome".

Author: Stiermaier, Thomas MD; Eitel, Ingo MD

Page: 2293-2294

http://ift.tt/2inbRbf

2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary.

Author: Olasveengen, Theresa M. MD, PhD, Chair; de Caen, Allan R. MD, FRCP(C); Mancini, Mary E. RN, PhD, NE-BC, FAHA, ANEF; Maconochie, Ian K. PhD; Aickin, Richard BMedSc, MbChB, DCH; Atkins, Dianne L. MD, FAHA; Berg, Robert A. MD, FAHA; Bingham, Robert M. MBBS, FRCA; Brooks, Steven C. MD, MHSc; Castren, Maaret MD, PhD; Chung, Sung Phil MD, PhD; Considine, Julie RN, PhD; Couto, Thomaz Bittencourt MD, MS; Escalante, Raffo MD; Gazmuri, Raul J. MD, PhD; Guerguerian, Anne-Marie MD, PhD; Hatanaka, Tetsuo MD, PhD; Koster, Rudolph W. MD, PhD; Kudenchuk, Peter J. MD, FAHA; Lang, Eddy MDCM, CCFP(EM), CSPQ; Lim, Swee Han MBBS; Lofgren, Bo MD, PhD, FAHA; Meaney, Peter A. MD, MPH; Montgomery, William H. MD, FAHA; Morley, Peter T. MBBS; Morrison, Laurie J. MD, MSc; Nation, Kevin J. NZRN; Ng, Kee-Chong MBBS, MMed (Paeds); Nadkarni, Vinay M. MD, MS, FAHA; Nishiyama, Chika RN, PhD; Nuthall, Gabrielle MBChB, FRACP, FCICM; Ong, Gene Yong-Kwang MBBS, MRCPCH; Perkins, Gavin D. MBChB, MMEd, MD; Reis, Amelia G. MD, PhD; Ristagno, Giuseppe MD, PhD; Sakamoto, Tetsuya MD, PhD; Sayre, Michael R. MD, FAHA; Schexnayder, Stephen M. MD; Sierra, Alfredo F. MD, MAdm; Singletary, Eunice M. MD; Shimizu, Naoki MD, PhD; Smyth, Michael A. MSc; Stanton, David CCA; Tijssen, Janice A. MD; Travers, Andrew MD, MSc, FRCP(C); Vaillancourt, Christian MD, MSc, CSPQ; Van de Voorde, Patrick MD, PhD; Hazinski, Mary Fran RN, MSN, FAHA; Nolan, Jerry P. FRCA, FRCP, FFICM, FRCEM; On behalf of the ILCOR Collaborators

Page: e424-e440

http://ift.tt/2jQAFZo

Muscle fiber conduction velocity and EMG amplitude of the upper trapezius muscle in healthy subjects after low-level laser irradiation: a randomized, double-blind, placebo-controlled, crossover study

Abstract

Although low-level laser therapy (LLLT) is an important resource for the treatment of non-specific neck pain patients, the dose which presents the greatest therapeutic potential for the treatment of this pathology is still unclear. The present study aimed to evaluate the immediate effect of LLLT on the muscle fiber conduction velocity (MFCV) and electromyographic activity (EMG) of the upper trapezius (UT) muscle in healthy individuals. A total of 20 healthy subjects were enrolled in a randomized, double-blind, crossover study. Active LLLT (820 nm wavelength, 30 mW, energy total 18 J) or placebo LLLT (pLLLT) was delivered on the UT muscle. Each subject was subjected to a single session of active LLLT and pLLLT. Surface electromyography (sEMG) signal of the UT muscle was recorded during five different step contractions of shoulder elevation force (10–30% maximal voluntary contraction) pre- and post-LLLT irradiation. The values of MFCV and sEMG global amplitude (RMS_G) were used to calculate the effects of LLLT. The results showed no difference in the MFCV comparing the LLLT and pLLLT groups (F = 0.72 p = 0.39, η _p² = 0.004). However, a significant difference was observed in the RMS_G between the LLLT and pLLLT (F _1,2 = 16.66; P < 0.0001, η _p² = 0.09). Individuals who received active LLLT presented a significant decrease in RMS_G after laser application (F = 61.28; p < 0.0001, η _p² = 0.43). In conclusion, the 820 nm LLLT, with energy total of 18 J, did not alter the MFCV but significantly reduced the sEMG signal amplitude of the upper trapezius muscle in healthy subjects to a level of up to 30% of maximal voluntary contraction.

http://ift.tt/2kmjqmK

Is photobiomodulation (PBM) effective for the treatment of dentin hypersensitivity? A systematic review

Abstract

The present study aims to evaluate the current scientific data regarding the effectiveness of photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH) as an alternative method for pain control. A systematic review was conducted to assess the effectiveness of PBM as treatment for DH. A complete literature search was performed up to October 2016. Searches were conducted using Boolean operators and MeSH terms. References of all selected full-text articles and related reviews were scanned. A total of 280 articles were identified (241 articles were excluded by the title and abstract). Of the 39 articles selected for analysis, 36 were excluded because they presented one or more exclusion criteria. Therefore, three articles were qualified for inclusion in this systematic review. PBM may not lead to adverse effects provided that adequately controlled parameters are followed when treating DH. More consistent studies should be conducted in order to adequately observe the advantageous therapeutic effect of PBM.

http://ift.tt/2AsLsme

Subcutaneous granuloma annulare involving the scalp

Abstract

Subcutaneous granuloma annulare (SGA) is an uncommon subtype of granuloma annulare. There are few reports of this entity solely affecting the scalp. We report a case of biopsy-proven SGA in a 21-month-old boy with six asymptomatic, rock-hard scalp nodules.

http://ift.tt/2nrbQIm

CME Accreditation Page

http://ift.tt/2AXbEqk

Psychosocial Impact of Vascular Anomalies on Children and Their Families

Vascular anomalies are divided into tumors and malformations based on their clinical and cytologic attributes. Vascular malformations are further subcategorized as low-flow lymphatic, venous, capillary, or mixed lesions and as high-flow arteriovenous malformations. Treatment is reserved for vascular anomalies that are symptomatic or cosmetically disfiguring, and surgical and nonsurgical treatment options are widely varied with variable outcomes.

http://ift.tt/2A4Gld8

Forthcoming Issues

Otosclerosis and Stapes Surgery

http://ift.tt/2AXbxuU

Congenital Vascular Lesions of the Head and Neck

The number of physicians interested in the treatment of vascular anomalies has grown exponentially over the last several decades from a mere handful in the mid 1980s to several thousand today. Every year, hundreds of peer-reviewed articles are published in this field. Some of the most interesting articles have shed light on the underlying genetic and molecular bases of some of these conditions. This has led to the development of at least one group of medical therapies for some vascular lesions.

http://ift.tt/2A50YpM

Contents

Sujana S. Chandrasekhar

http://ift.tt/2AXbr6w

Orthognathic Considerations of Vascular Malformations

Vascular malformations affect the craniofacial skeleton in many ways, depending on the type of the lesion and its location. The lesions may exert a mass effect and cause thinning or thickening of the bone or cause expansion from direct bony infiltration. Orthognathic surgery can be used to correct any malocclusion or open bite deformities after the soft tissues are addressed.

http://ift.tt/2A50W18

Contributors

SUJANA S. CHANDRASEKHAR, MD

http://ift.tt/2AVPNjg

Multidisciplinary Approach to Vascular Anomalies Maximizes Outcomes

The birth of a child is a glorious and simultaneously nerve-wracking event in every family. If this is the 1 in 22 children born with a vascular lesion of the head and neck (which is visible in every picture and to every visitor), the parents' concerns multiply. Will my baby bleed? Will my baby stay deformed by this lesion? Is this the tip of the iceberg of other problems? Will my baby be forced to enter chronic medical/surgical care? These are some of the questions that race through the parents' brains, even as they marvel at the wondrousness of new life.

http://ift.tt/2A50OPc

Copyright

Elsevier

http://ift.tt/2AXbcs8

Classification and Pathology of Congenital and Perinatal Vascular Anomalies of the Head and Neck

Accurate histopathologic description in correlation with clinical and radiological evaluation is required for treatment of vascular anomalies, both neoplastic and malformative. It is important to examine current clinical, histologic, and immunophenotypical features that distinguish the major types of congenital and perinatal vascular anomalies affecting the head and neck. General discussions of pathogenesis and molecular diagnosis must also be taken into account. This article provides an overview of the features that distinguish the major types of congenital and perinatal vascular anomalies affecting the head and neck, and summarizes the diagnostic histopathologic criteria and nomenclature currently applied to these lesions.

http://ift.tt/2A50hga

Congenital Vascular Lesions of the Head and Neck

OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA

http://ift.tt/2AVPDbE

Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) describes the presenting manifestations of a disorder that is characterized by pathologic blood vessels. HHT is inherited as an autosomal dominant trait with variable penetrance. The abnormal vascular structures (dysplasias) can affect all the organs in the human body. The link between a physical stimulus and new lesion development has been established for mucosal trauma owing to nasal airflow turbulence, for ultraviolet exposure to the fingers, and for mechanical trauma to the dominant hand. The pressing question then is whether HHT treatment constitutes a stimulus that is sufficient to trigger new lesion development.

http://ift.tt/2A50C2q

Outcome Measurement for Vascular Malformations of the Head and Neck

Vascular malformations are congenital anomalies of the vascular and/or lymphatic system that affect the head and neck region. The most common treatment options are sclerotherapy, laser therapy, surgery, and embolization. Because vascular malformations are variable in type, size, extent, and location, it is a challenge to select methods for evaluation of treatment outcome. Without standardized outcome reporting, it is difficult to compare and combine scientific evidence to support therapeutic decision making. Standardized collection and reporting of outcome data are the first steps toward a fair comparison between treatments. This article describes outcome measurements for vascular malformations and initiatives to improve outcome reporting.

http://ift.tt/2AUMoRu

The Surgical Management of Infantile Hemangiomas

The surgical management of facial infantile hemangiomas presents a unique challenge. The aim of the surgeon should be to remove the hemangioma and to restore normal facial features. Each of the facial zones has its own special features and challenges. The surgeon should remember that the child started out with normal anatomy and that as the hemangioma proliferated, it displaced and thinned these normal structures and in many cases, expanded adjacent tissue. Hemangiomas do not as a rule, invade adjacent tissues as they proliferate. These facts will help in planning the various surgical approaches.

http://ift.tt/2A50uzY

The Management of Vascular Malformations of the Airway

Vascular malformations may affect nearly all aspects of the upper airway. Each type of malformation has a characteristic pattern of disease. These lesions may be focal or diffuse, and require directed management strategies. Physicians treating these entities should have a high level of suspicion to consider airway evaluation even in the absence of overt symptoms. However, cutaneous head and neck venous malformations or other lesions affecting the lips, oral cavity, or tongue can herald the presence of coexisting airway lesions. A multidisciplinary approach is critical in achieving comprehensive treatment.

http://ift.tt/2AVHB2t

Infantile Hemangiomas in the Head and Neck Region

Infantile hemangiomas (IHs) are benign vascular tumors of infancy most common in the region of the head and neck. Infantile hemangiomas are common; but they are extremely heterogeneous and cause a range of complications depending on their morphology, size, or location. Medical interventions for high-risk patients include topical and systemic therapies, including oral propranolol, which has revolutionized the management of IHs over the past recent years. In the following article, the authors aim to provide a review of the natural history, pathology, complications, syndromes, and medical management of infantile hemangioma.

http://ift.tt/2A57BZ7

Multidisciplinary Approach to the Management of Lymphatic Malformations of the Head and Neck

Lymphatic malformations (LMs) occur in 2.8 to 5 per 100,000 live births. Most involve the head and neck and they are equally common in men and women. They are developmental anomalies of unknown cause, although recent evidence suggests that an upregulation of the mammalian target of rapamycin (mTOR) pathway may be a causal factor leading to the overproduction of abnormal lymph vessels. These vessels are likely dilated lymphatic sacs sequestered from the lymphatic and venous systems. This overproduction results in the accumulation of lymph in dilated cystic spaces, which in turn results in the clinical features of an LM.

http://ift.tt/2AWNlZM

The Role of Surgery in the Management of Infantile Hemangiomas

Surgery for the management of infantile hemangiomas has become commonplace. Surgical technique articles are plentiful; however, little has been written about the timing of surgery. Knowledge of the biology of the tumors, data from developmental psychology, and the utility of facial reconstruction provide guidelines for timing of surgical intervention.

http://ift.tt/2A3j9fb

Congenital Vascular Tumors

Vascular tumors are benign neoplasms, which result from proliferating endothelial cells. These lesions present during infancy or childhood, may affect any location, and exhibit postnatal growth. Local complications include bleeding, tissue destruction, and pain whereas systemic sequelae include thrombocytopenia, congestive heart failure, and death. Vascular tumors should be differentiated from vascular malformations, which present at birth, have a quiescent endothelium, and grow in proportion to the child. Together, vascular tumors and malformations comprise the field of vascular anomalies.

http://ift.tt/2AYZhde

Etiology and Genetics of Congenital Vascular Lesions

The detection of somatic, activating genetic mutations to underlie development of vascular tumors and malformations led to a better understanding of their pathophysiology. Proteins encoded by the detected mutated genes activate the two major signaling pathways, also involved in cancer: the RAS/MAPK/ERK pathway and/or the PI3K/AKT/mTOR pathway. This gives a strong basis for studies to repurpose cancer therapeutics to patients with vascular tumors and malformations.

http://ift.tt/2A5bI7q

CME Accreditation Page

http://ift.tt/2AXbEqk

Psychosocial Impact of Vascular Anomalies on Children and Their Families

Vascular anomalies are divided into tumors and malformations based on their clinical and cytologic attributes. Vascular malformations are further subcategorized as low-flow lymphatic, venous, capillary, or mixed lesions and as high-flow arteriovenous malformations. Treatment is reserved for vascular anomalies that are symptomatic or cosmetically disfiguring, and surgical and nonsurgical treatment options are widely varied with variable outcomes.

http://ift.tt/2A4Gld8

Forthcoming Issues

Otosclerosis and Stapes Surgery

http://ift.tt/2AXbxuU

Congenital Vascular Lesions of the Head and Neck

The number of physicians interested in the treatment of vascular anomalies has grown exponentially over the last several decades from a mere handful in the mid 1980s to several thousand today. Every year, hundreds of peer-reviewed articles are published in this field. Some of the most interesting articles have shed light on the underlying genetic and molecular bases of some of these conditions. This has led to the development of at least one group of medical therapies for some vascular lesions.

http://ift.tt/2A50YpM

Contents

Sujana S. Chandrasekhar

http://ift.tt/2AXbr6w

Orthognathic Considerations of Vascular Malformations

Vascular malformations affect the craniofacial skeleton in many ways, depending on the type of the lesion and its location. The lesions may exert a mass effect and cause thinning or thickening of the bone or cause expansion from direct bony infiltration. Orthognathic surgery can be used to correct any malocclusion or open bite deformities after the soft tissues are addressed.

http://ift.tt/2A50W18

Contributors

SUJANA S. CHANDRASEKHAR, MD

http://ift.tt/2AVPNjg

Multidisciplinary Approach to Vascular Anomalies Maximizes Outcomes

The birth of a child is a glorious and simultaneously nerve-wracking event in every family. If this is the 1 in 22 children born with a vascular lesion of the head and neck (which is visible in every picture and to every visitor), the parents' concerns multiply. Will my baby bleed? Will my baby stay deformed by this lesion? Is this the tip of the iceberg of other problems? Will my baby be forced to enter chronic medical/surgical care? These are some of the questions that race through the parents' brains, even as they marvel at the wondrousness of new life.

http://ift.tt/2A50OPc

Copyright

Elsevier

http://ift.tt/2AXbcs8

Classification and Pathology of Congenital and Perinatal Vascular Anomalies of the Head and Neck

Accurate histopathologic description in correlation with clinical and radiological evaluation is required for treatment of vascular anomalies, both neoplastic and malformative. It is important to examine current clinical, histologic, and immunophenotypical features that distinguish the major types of congenital and perinatal vascular anomalies affecting the head and neck. General discussions of pathogenesis and molecular diagnosis must also be taken into account. This article provides an overview of the features that distinguish the major types of congenital and perinatal vascular anomalies affecting the head and neck, and summarizes the diagnostic histopathologic criteria and nomenclature currently applied to these lesions.

http://ift.tt/2A50hga

Congenital Vascular Lesions of the Head and Neck

OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA

http://ift.tt/2AVPDbE

Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) describes the presenting manifestations of a disorder that is characterized by pathologic blood vessels. HHT is inherited as an autosomal dominant trait with variable penetrance. The abnormal vascular structures (dysplasias) can affect all the organs in the human body. The link between a physical stimulus and new lesion development has been established for mucosal trauma owing to nasal airflow turbulence, for ultraviolet exposure to the fingers, and for mechanical trauma to the dominant hand. The pressing question then is whether HHT treatment constitutes a stimulus that is sufficient to trigger new lesion development.

http://ift.tt/2A50C2q

Outcome Measurement for Vascular Malformations of the Head and Neck

Vascular malformations are congenital anomalies of the vascular and/or lymphatic system that affect the head and neck region. The most common treatment options are sclerotherapy, laser therapy, surgery, and embolization. Because vascular malformations are variable in type, size, extent, and location, it is a challenge to select methods for evaluation of treatment outcome. Without standardized outcome reporting, it is difficult to compare and combine scientific evidence to support therapeutic decision making. Standardized collection and reporting of outcome data are the first steps toward a fair comparison between treatments. This article describes outcome measurements for vascular malformations and initiatives to improve outcome reporting.

http://ift.tt/2AUMoRu

The Surgical Management of Infantile Hemangiomas

The surgical management of facial infantile hemangiomas presents a unique challenge. The aim of the surgeon should be to remove the hemangioma and to restore normal facial features. Each of the facial zones has its own special features and challenges. The surgeon should remember that the child started out with normal anatomy and that as the hemangioma proliferated, it displaced and thinned these normal structures and in many cases, expanded adjacent tissue. Hemangiomas do not as a rule, invade adjacent tissues as they proliferate. These facts will help in planning the various surgical approaches.

http://ift.tt/2A50uzY

The Management of Vascular Malformations of the Airway

Vascular malformations may affect nearly all aspects of the upper airway. Each type of malformation has a characteristic pattern of disease. These lesions may be focal or diffuse, and require directed management strategies. Physicians treating these entities should have a high level of suspicion to consider airway evaluation even in the absence of overt symptoms. However, cutaneous head and neck venous malformations or other lesions affecting the lips, oral cavity, or tongue can herald the presence of coexisting airway lesions. A multidisciplinary approach is critical in achieving comprehensive treatment.

http://ift.tt/2AVHB2t

Infantile Hemangiomas in the Head and Neck Region

Infantile hemangiomas (IHs) are benign vascular tumors of infancy most common in the region of the head and neck. Infantile hemangiomas are common; but they are extremely heterogeneous and cause a range of complications depending on their morphology, size, or location. Medical interventions for high-risk patients include topical and systemic therapies, including oral propranolol, which has revolutionized the management of IHs over the past recent years. In the following article, the authors aim to provide a review of the natural history, pathology, complications, syndromes, and medical management of infantile hemangioma.

http://ift.tt/2A57BZ7

Multidisciplinary Approach to the Management of Lymphatic Malformations of the Head and Neck

Lymphatic malformations (LMs) occur in 2.8 to 5 per 100,000 live births. Most involve the head and neck and they are equally common in men and women. They are developmental anomalies of unknown cause, although recent evidence suggests that an upregulation of the mammalian target of rapamycin (mTOR) pathway may be a causal factor leading to the overproduction of abnormal lymph vessels. These vessels are likely dilated lymphatic sacs sequestered from the lymphatic and venous systems. This overproduction results in the accumulation of lymph in dilated cystic spaces, which in turn results in the clinical features of an LM.

http://ift.tt/2AWNlZM

The Role of Surgery in the Management of Infantile Hemangiomas

Surgery for the management of infantile hemangiomas has become commonplace. Surgical technique articles are plentiful; however, little has been written about the timing of surgery. Knowledge of the biology of the tumors, data from developmental psychology, and the utility of facial reconstruction provide guidelines for timing of surgical intervention.

http://ift.tt/2A3j9fb

Congenital Vascular Tumors

Vascular tumors are benign neoplasms, which result from proliferating endothelial cells. These lesions present during infancy or childhood, may affect any location, and exhibit postnatal growth. Local complications include bleeding, tissue destruction, and pain whereas systemic sequelae include thrombocytopenia, congestive heart failure, and death. Vascular tumors should be differentiated from vascular malformations, which present at birth, have a quiescent endothelium, and grow in proportion to the child. Together, vascular tumors and malformations comprise the field of vascular anomalies.

http://ift.tt/2AYZhde

Etiology and Genetics of Congenital Vascular Lesions

The detection of somatic, activating genetic mutations to underlie development of vascular tumors and malformations led to a better understanding of their pathophysiology. Proteins encoded by the detected mutated genes activate the two major signaling pathways, also involved in cancer: the RAS/MAPK/ERK pathway and/or the PI3K/AKT/mTOR pathway. This gives a strong basis for studies to repurpose cancer therapeutics to patients with vascular tumors and malformations.

http://ift.tt/2A5bI7q

Mechanisms of {beta}-cell dedifferentiation in diabetes: recent findings and future research directions

Like all the cells of an organism, pancreatic β-cells originate from embryonic stem cells through a complex cellular process termed differentiation. Differentiation involves the coordinated and tightly controlled activation/repression of specific effectors and gene clusters in a time-dependent fashion thereby giving rise to particular morphological and functional cellular features. Interestingly, cellular differentiation is not a unidirectional process. Indeed, growing evidence suggests that under certain conditions, mature β-cells can lose, to various degrees, their differentiated phenotype and cellular identity and regress to a less differentiated or a precursor-like state. This concept is termed dedifferentiation and has been proposed, besides cell death, as a contributing factor to the loss of functional β-cell mass in diabetes. β-cell dedifferentiation involves: 1) the downregulation of β-cell-enriched genes, including key transcription factors, insulin, glucose metabolism genes, protein processing and secretory pathway genes, 2) the concomitant upregulation of genes suppressed or expressed at very low levels in normal β-cells; the β-cell forbidden genes, and 3) the likely upregulation of progenitor cell genes. These alterations lead to phenotypic reconfiguration of β-cells and ultimately defective insulin secretion. While the major role of glucotoxicity in β-cell dedifferentiation is well established, the precise mechanisms involved are still under investigation. This review highlights the identified molecular mechanisms implicated in β-cell dedifferentiation including oxidative stress, endoplasmic reticulum (ER) stress, inflammation and hypoxia. It discusses the role of FoxO1, MYC and inhibitor of differentiation proteins and underscores the emerging role of non-coding RNAs. Finally, it proposes a novel hypothesis of β-cell dedifferentiation as a potential adaptive mechanism to escape cell death under stress conditions.

http://ift.tt/2AwHc3n

Usefulness of our proposed olfactory scoring system during endoscopic sinus surgery in patients with chronic rhinosinusitis

Abstract

Introduction

The primary aim of the current study was to examine the usefulness of our proposed olfactory scoring system in chronic rhinosinusitis (CRS) patients with olfactory disorders (n = 213) receiving endoscopic sinus surgery (ESS).

Materials and methods

Analyzed patients were divided into two groups: an eosinophilic CRS (ECRS) group (n = 153); and a non-ECRS group (n = 60). The T&T recognition threshold test was used to evaluate olfaction at baseline and at 3 and 12 months after ESS. Patients with mean recognition threshold < 2.0 at 3 or 12 months or with a decrease of ≥ 1.0 as compared with baseline were defined as showing clinical improvement. We scored mucosal conditions as normal (0 points), edema (1 point), and polyp (2 points) at the canopy of olfactory cleft (OC), middle and superior turbinates, superior nasal meatus, and sphenoethmoidal recess during ESS. The total score of OCs (SOCs) was calculated (range 0–20 points). We compared SOCs between ECRS and non-ECRS groups. Factors related to olfactory improvement were also investigated using uni- and multivariate analyses.

Results

SOCs in the ECRS and non-ECRS groups showed significant correlations with mean recognition thresholds at baseline and at 3 and 12 months. In the multivariate analysis for predicting improvement of mean recognition threshold, lower SOCs were significantly associated with olfactory improvement factors at 3 and 12 months postoperatively in the ECRS group.

Conclusion

SOCs appears promising for estimating olfactory prognosis after ESS in CRS patients.

http://ift.tt/2A1k3cd

Sialendoscopy in treating pediatric salivary gland disorders: a systematic review

Abstract

Objective

The primary aim of this study is to conduct a systematic review in order to evaluate the use of sialendoscopy in treating pediatric salivary gland disorders.

Methods

Eligible articles were identified through a comprehensive search of electronic databases. Using predefined inclusion criteria, published articles on sialendoscopy in children were selected and reviewed.

Results

17 articles including 323 pediatric patients and 424 salivary glands managed by sialendoscopy were identified. The most common salivary gland disorder affected was the parotid (83% of cases), followed by the submandibular gland (16.5% of cases). Juvenile recurrent parotitis (68.9%) was the most frequent diagnosis followed by sialolithiasis (14.7%). The most common complication was ductal perforation. During a pooled mean follow-up time of 18.3 months, recurrences were reported in 14.5% of patients mostly in patients diagnosed with juvenile recurrent parotitis.

Conclusion

Sialendoscopy is a minimally invasive diagnostic and therapeutic tool for inflammatory salivary gland disorders in pediatric patients. Based on the current review, sialendoscopy can be successfully implemented in cases of pediatric salivary gland disorders.

http://ift.tt/2AWvFgQ

Reply to the letter “Laryngopharyngeal reflux disease in the elderly”

http://ift.tt/2A3Cs8r

The outcome of cochlear implantation among children with genetic syndromes

Abstract

Objective

To assess the outcome and efficacy of cochlear implantation in children with genetic syndromes.

Method

Study design: case–control study.

Setting

A cochlear implantation tertiary referral center.

Patients

All pediatric cochlear implantation recipients with Waardenburg syndrome, Usher syndrome, Dandy–Walker syndrome, or albinism. A control group was appropriately matched to the syndromic group with regard to age at implantation and duration of device use.

Intervention

Cochlear implantation.

Main outcome measures

Subjects' auditory abilities, speech intelligibility, and pure tone thresholds were compared between the syndromic and non-syndromic group.

Results

A total of 25 subjects (13 syndromic and 12 non-syndromic) participated in the study. Neither auditory ability nor speech intelligibility scores differed significantly by group. The final PTA of both the groups showed normal-to-mild hearing loss: 26 dB HL in the syndromic group and 23 dB HL for the control group.

Conclusions

Cochlear implant recipients with genetic syndromes achieved similar levels auditory perception and speech intelligibility as their peers with a genetic syndrome. The presence of any of the genetic syndromes described herein should not be a contraindication to cochlear implant provision, as it would have a positive impact on the patients' sensory perception and lifestyle.

http://ift.tt/2AWnwJp

Prognostic value of the lymph node ratio in oropharyngeal carcinoma stratified for HPV-status

Abstract

Objective

Lymph node ratio (LNR) was shown to be a prognostic factor in laryngeal and oral cavity primaries. The purpose of this study was to investigate the impact of the lymph node ratio in oropharyngeal squamous cell carcinoma (OPSCC) with a high incidence of HPV-related disease. Therefore, the role of LNR was evaluated as an additional predictive parameter to the 8th edition of AJCC TNM staging system.

Methods

From December 2009 to August 2015, patients diagnosed with primary oropharyngeal squamous cell carcinoma were prospectively enrolled. After tumor resection with uni- or bilateral neck dissection, patients with ≥ 1 nodal metastasis (pN+) were eligible for a retrospective LNR analysis.

Results

137 patients underwent tumor resection with uni- or bilateral neck dissection. The proportion of HPV-associated disease was 42%. Most patients (n = 96; 70%) presented with involved neck nodes. In p16-positive OPSCC, the rate of pN + cases was significantly increased compared to p16-negative OPSCC (86% vs. 58%, p = 0.007). Patients with LNR ≤ 10% had a significant better overall survival (OS) and disease-specific survival (DSS). However, when stratified for p16-status, LNR ≤ 10% had a significant impact on OS only for HPV-associated tumors (p = 0.027), whereas LNR of ≤ 10% was not a significant predictor for better OS in p16-negative OPSCC (p = 0.143).

Conclusion

The LNR with a cut-off value of 10% serves as an additional prognostic parameter in HPV-related OPSCC and may help to improve risk stratification in combination with the revised AJCC 8th edition TNM classification.

http://ift.tt/2A3DLUQ

Reply to the Letter to the Editor concerning “Combined microscopic/endoscopic management of petrous apex lesions”

http://ift.tt/2AWnmSj

Usefulness of our proposed olfactory scoring system during endoscopic sinus surgery in patients with chronic rhinosinusitis

Abstract

Introduction

The primary aim of the current study was to examine the usefulness of our proposed olfactory scoring system in chronic rhinosinusitis (CRS) patients with olfactory disorders (n = 213) receiving endoscopic sinus surgery (ESS).

Materials and methods

Analyzed patients were divided into two groups: an eosinophilic CRS (ECRS) group (n = 153); and a non-ECRS group (n = 60). The T&T recognition threshold test was used to evaluate olfaction at baseline and at 3 and 12 months after ESS. Patients with mean recognition threshold < 2.0 at 3 or 12 months or with a decrease of ≥ 1.0 as compared with baseline were defined as showing clinical improvement. We scored mucosal conditions as normal (0 points), edema (1 point), and polyp (2 points) at the canopy of olfactory cleft (OC), middle and superior turbinates, superior nasal meatus, and sphenoethmoidal recess during ESS. The total score of OCs (SOCs) was calculated (range 0–20 points). We compared SOCs between ECRS and non-ECRS groups. Factors related to olfactory improvement were also investigated using uni- and multivariate analyses.

Results

SOCs in the ECRS and non-ECRS groups showed significant correlations with mean recognition thresholds at baseline and at 3 and 12 months. In the multivariate analysis for predicting improvement of mean recognition threshold, lower SOCs were significantly associated with olfactory improvement factors at 3 and 12 months postoperatively in the ECRS group.

Conclusion

SOCs appears promising for estimating olfactory prognosis after ESS in CRS patients.

http://ift.tt/2A1k3cd

Sialendoscopy in treating pediatric salivary gland disorders: a systematic review

Abstract

Objective

The primary aim of this study is to conduct a systematic review in order to evaluate the use of sialendoscopy in treating pediatric salivary gland disorders.

Methods

Eligible articles were identified through a comprehensive search of electronic databases. Using predefined inclusion criteria, published articles on sialendoscopy in children were selected and reviewed.

Results

17 articles including 323 pediatric patients and 424 salivary glands managed by sialendoscopy were identified. The most common salivary gland disorder affected was the parotid (83% of cases), followed by the submandibular gland (16.5% of cases). Juvenile recurrent parotitis (68.9%) was the most frequent diagnosis followed by sialolithiasis (14.7%). The most common complication was ductal perforation. During a pooled mean follow-up time of 18.3 months, recurrences were reported in 14.5% of patients mostly in patients diagnosed with juvenile recurrent parotitis.

Conclusion

Sialendoscopy is a minimally invasive diagnostic and therapeutic tool for inflammatory salivary gland disorders in pediatric patients. Based on the current review, sialendoscopy can be successfully implemented in cases of pediatric salivary gland disorders.

http://ift.tt/2AWvFgQ

Reply to the letter “Laryngopharyngeal reflux disease in the elderly”

http://ift.tt/2A3Cs8r

The outcome of cochlear implantation among children with genetic syndromes

Abstract

Objective

To assess the outcome and efficacy of cochlear implantation in children with genetic syndromes.

Method

Study design: case–control study.

Setting

A cochlear implantation tertiary referral center.

Patients

All pediatric cochlear implantation recipients with Waardenburg syndrome, Usher syndrome, Dandy–Walker syndrome, or albinism. A control group was appropriately matched to the syndromic group with regard to age at implantation and duration of device use.

Intervention

Cochlear implantation.

Main outcome measures

Subjects' auditory abilities, speech intelligibility, and pure tone thresholds were compared between the syndromic and non-syndromic group.

Results

A total of 25 subjects (13 syndromic and 12 non-syndromic) participated in the study. Neither auditory ability nor speech intelligibility scores differed significantly by group. The final PTA of both the groups showed normal-to-mild hearing loss: 26 dB HL in the syndromic group and 23 dB HL for the control group.

Conclusions

Cochlear implant recipients with genetic syndromes achieved similar levels auditory perception and speech intelligibility as their peers with a genetic syndrome. The presence of any of the genetic syndromes described herein should not be a contraindication to cochlear implant provision, as it would have a positive impact on the patients' sensory perception and lifestyle.

http://ift.tt/2AWnwJp

Prognostic value of the lymph node ratio in oropharyngeal carcinoma stratified for HPV-status

Abstract

Objective

Lymph node ratio (LNR) was shown to be a prognostic factor in laryngeal and oral cavity primaries. The purpose of this study was to investigate the impact of the lymph node ratio in oropharyngeal squamous cell carcinoma (OPSCC) with a high incidence of HPV-related disease. Therefore, the role of LNR was evaluated as an additional predictive parameter to the 8th edition of AJCC TNM staging system.

Methods

From December 2009 to August 2015, patients diagnosed with primary oropharyngeal squamous cell carcinoma were prospectively enrolled. After tumor resection with uni- or bilateral neck dissection, patients with ≥ 1 nodal metastasis (pN+) were eligible for a retrospective LNR analysis.

Results

137 patients underwent tumor resection with uni- or bilateral neck dissection. The proportion of HPV-associated disease was 42%. Most patients (n = 96; 70%) presented with involved neck nodes. In p16-positive OPSCC, the rate of pN + cases was significantly increased compared to p16-negative OPSCC (86% vs. 58%, p = 0.007). Patients with LNR ≤ 10% had a significant better overall survival (OS) and disease-specific survival (DSS). However, when stratified for p16-status, LNR ≤ 10% had a significant impact on OS only for HPV-associated tumors (p = 0.027), whereas LNR of ≤ 10% was not a significant predictor for better OS in p16-negative OPSCC (p = 0.143).

Conclusion

The LNR with a cut-off value of 10% serves as an additional prognostic parameter in HPV-related OPSCC and may help to improve risk stratification in combination with the revised AJCC 8th edition TNM classification.

http://ift.tt/2A3DLUQ

Reply to the Letter to the Editor concerning “Combined microscopic/endoscopic management of petrous apex lesions”

http://ift.tt/2AWnmSj

Spectrum of health condition in methyl isocyanate (MIC)-exposed survivors measured after 30 years of disaster

Abstract

Health effects of methyl isocyanate (MIC) exposure were mostly reported on the one-time acute exposure in Bhopal population. Epidemiological survey conducted by the Indian apex body of health research has been reported as Technical Reports, which were lacking in peer review by the expert epidemiologic scientists. The present pilot survey was aimed to measure the health effects 30 years post disaster in MIC-exposed survivors. Questionnaire-based survey has captured every health complaint in 168 individuals and grouped as systemic functions for interpreting the long-term effects of MIC. Key health parameters, including reproductive outcome and respiratory/orthopedic/general morbidity, were prevalent among the severely exposed population compared to control and moderately exposed groups. The collective incidence of diabetes, hypertension, and cancer also was prevalent in the severely exposed group. Ophthalmic morbidity was almost similar in the three groups, rather with higher incidence in the control group, though not statistically significant. Among all health parameters, reproductive, ophthalmic, and respiratory effects were prevalent over others. Although the incidence of health problems has been declined among the survivors, long-term effect is apparent as scars of one-time acute exposure might trigger sequel of long-term effects. Additionally, acquisition of genetic rearrangements, survival of T cell sub-populations, variable latency of chemical effect on DNA nucleosides, nutritional status, occupational exposure, living environment, lifestyle, and overall gene–environment interaction might perturb individual immunity and favor onset of long-term illness in a scenario of background exposure to MIC. However, the exercise should be continued on a larger sample size for drawing a conclusive result on long-term MIC effect on survivors' health.

http://ift.tt/2jeTu8X

Repair of Occipital Bone Defects in Neurofibromatosis Type 1 by Means of CAD/CAM Prefabricated Titanium Plates

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1608699

Certain skeletal defects may develop in neurofibromatosis type 1 (NF1), a common tumor-suppressor syndrome, such as cranial lesions confined to the lambdoid suture region. Here, we report on the repair of osseous defects of occipital bone in a NF1 patient with history of skull trauma and tumorous hemorrhage. Computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted devices were applied to safely close the bone defects. The variable phenotype of NF1 in the occipital skull region is discussed and a brief review is presented on NF1-related therapies for tumors and malformations of the occipitoparietal skull region.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

http://ift.tt/2ikI3fj

Metastasierung kutaner Plattenepithelkarzinome im HNO-Bereich

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-122745

Hintergrund Kutane Plattenepithelkarzinome können lymphogen sowohl nach intraparotideal, als auch nach zervikal metastasieren. Prognostisch scheinen sich gemäß mehreren Studien die beiden Metastasierungswege zu unterscheiden. Wir möchten mit klinikeigenen Daten das Metastasierungsverhalten hinsichtlich der Prognose untersuchen. Material und Methoden In die retrospektive Studie aufgenommen wurden 29 Kaukasier mit einem Plattenepithelkarzinom der Haut im Kopf-Halsbereich, welche sich zwischen 2004 und 2016 an unserer Hals-Nasen-Ohren-Klinik vorgestellt haben. Bei allen Patienten wurde eine Tumorresektion mit Neck dissection durchgeführt. Sowohl das präoperative Staging, wie auch die Nachsorge erfolgten mittels Ultraschall oder Computertomographie (konventionell oder PET Scan). Die Patienten wurden nach Metastasierungsverhalten eingeteilt und die entsprechenden Überlebensraten wurden ermittelt. Ergebnisse 11 Patienten hatten zervikale Metastasen, 4 Patienten parotideale Metastasen, 5 Patienten hatten beides. Bei 9 Patienten wurde eine prophylaktische Neck dissection bei cN0 durchgeführt. Ein lokoregionäres Tumorrezidiv trat in insgesamt 24 % der Fälle auf, davon waren alle mit einer zervikalen Metastasierung assoziiert. Die 5-Jahres Überlebensrate betrug in diesen Fällen 71 %. Im Gegensatz dazu betrug diese bei alleiniger parotidealer Metastasierung 100 %. Im Rahmen der prophylaktischen Neck dissection wurden in einem Fall okkulte Metastasen diagnostiziert. Schlussfolgerungen Eine zervikale Metastasierung geht im Gegensatz zu einer alleinigen parotidealen Metastasierung mit einer schlechteren Prognose einher. Die Überlebensrate nach chirurgischer Therapie, sowie gegebenenfalls zusätzlichen adjuvanten Radiotherapie ist insgesamt gut (79 %). Die Rolle einer prophylaktischen Neck dissection bei cN0 und entsprechenden Risikofaktoren ist nicht abschließend geklärt.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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

http://ift.tt/2kkkqHL

Metastasierung kutaner Plattenepithelkarzinome im HNO-Bereich

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-122745

Hintergrund Kutane Plattenepithelkarzinome können lymphogen sowohl nach intraparotideal, als auch nach zervikal metastasieren. Prognostisch scheinen sich gemäß mehreren Studien die beiden Metastasierungswege zu unterscheiden. Wir möchten mit klinikeigenen Daten das Metastasierungsverhalten hinsichtlich der Prognose untersuchen. Material und Methoden In die retrospektive Studie aufgenommen wurden 29 Kaukasier mit einem Plattenepithelkarzinom der Haut im Kopf-Halsbereich, welche sich zwischen 2004 und 2016 an unserer Hals-Nasen-Ohren-Klinik vorgestellt haben. Bei allen Patienten wurde eine Tumorresektion mit Neck dissection durchgeführt. Sowohl das präoperative Staging, wie auch die Nachsorge erfolgten mittels Ultraschall oder Computertomographie (konventionell oder PET Scan). Die Patienten wurden nach Metastasierungsverhalten eingeteilt und die entsprechenden Überlebensraten wurden ermittelt. Ergebnisse 11 Patienten hatten zervikale Metastasen, 4 Patienten parotideale Metastasen, 5 Patienten hatten beides. Bei 9 Patienten wurde eine prophylaktische Neck dissection bei cN0 durchgeführt. Ein lokoregionäres Tumorrezidiv trat in insgesamt 24 % der Fälle auf, davon waren alle mit einer zervikalen Metastasierung assoziiert. Die 5-Jahres Überlebensrate betrug in diesen Fällen 71 %. Im Gegensatz dazu betrug diese bei alleiniger parotidealer Metastasierung 100 %. Im Rahmen der prophylaktischen Neck dissection wurden in einem Fall okkulte Metastasen diagnostiziert. Schlussfolgerungen Eine zervikale Metastasierung geht im Gegensatz zu einer alleinigen parotidealen Metastasierung mit einer schlechteren Prognose einher. Die Überlebensrate nach chirurgischer Therapie, sowie gegebenenfalls zusätzlichen adjuvanten Radiotherapie ist insgesamt gut (79 %). Die Rolle einer prophylaktischen Neck dissection bei cN0 und entsprechenden Risikofaktoren ist nicht abschließend geklärt.
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Georg Thieme Verlag KG Stuttgart · New York

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

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IgG4-related disease presenting as hoarseness and postcricoid ulcer

Immunoglobulin G4–related disease (IgG4-RD) is an uncommon immune-mediated disorder with heterogeneous clinicopathologic features and variable disease manifestations.1 IgG4-RD is characterized by single-organ or multiorgan involvement, and tissue infiltration with IgG4 plasma cells and associated fibrosclerosis.2–5 Autoimmune pancreatitis represents the prototype of IgG4-RD, yet involvement of almost all organs has been reported.1–7 Elevated IgG4 serum concentration is noted in the majority of patients with IgG4-RD and is generally related to the more severe disease phenotype.

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IgG4-related disease presenting as hoarseness and postcricoid ulcer

Immunoglobulin G4–related disease (IgG4-RD) is an uncommon immune-mediated disorder with heterogeneous clinicopathologic features and variable disease manifestations.1 IgG4-RD is characterized by single-organ or multiorgan involvement, and tissue infiltration with IgG4 plasma cells and associated fibrosclerosis.2–5 Autoimmune pancreatitis represents the prototype of IgG4-RD, yet involvement of almost all organs has been reported.1–7 Elevated IgG4 serum concentration is noted in the majority of patients with IgG4-RD and is generally related to the more severe disease phenotype.

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Central xanthoma of the mandible associated with hyperlipidemia: A rare presentation

Xanthoma is a common, self-limiting cutaneous lesion of non-Langerhans cell, lipid-laden foamy histiocytes that is often concomitant with hyperlipidemia. The intraosseous counterpart is rarely encountered and typically presents as a painless, expansile osteolytic process in the context of hyperlipidemia or normolipidemia. Only a scant number of gnathic xanthomas have been reported in the otolaryngologic literature. We report the clinical, laboratory, radiographic, histopathologic, immunohistochemical, and ultrastructural studies of a mandibular lesion discovered in an asymptomatic 16-year-old male, and associated with 2 previously unreported comorbidities, namely hyperlipidemia and vitamin D deficiency.

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Temporal dynamics of total and free-living nitrogen-fixing bacterial community abundance and structure in soil with and without history of arsenic contamination during a rice growing season

Abstract

Despite the fact that the nitrogen (N) fixers act as the key regulator of ecosystem process, a detailed study of their abundance, diversity, and dynamics in arsenic (As)-contaminated rice fields is missing so far. DNA extracted from soil followed by 16S rRNA and nifH gene-based real-time qPCR, clone library analysis, and DNA sequencing were used to examine the status of the total and diazotrophic communities in two agricultural fields with and without arsenic contamination history during one rice cultivation season. In general, higher nifH and 16S rRNA gene copy numbers were observed in rice growing soils with lesser As than that with higher As. Elevated levels of 16S rRNA and nifH genes in soil is directly associated with total and nitrogen fixers abundance in the agricultural land without As contamination history through the cultivation period, but the copy number of 16S rRNA gene was decreased, and the nifH gene remained unchanged in the As-contaminated land. Additionally, Canonical Correspondence Analysis (CCA) indicated the possible suppression of nifH gene abundance by soil pH, phosphate, and As content. Increased abundance of total and Acidobacterial lineages in low As-containing soil and the detection of several uncultured groups among nifH gene sequence in higher frequency indicated the presence of novel nifH bearing bacterial groups. Conversely, the abundance of copiotrophic Proteobacterial lineages gradually increased in soil with higher As. Herein, our study demonstrated that the dynamics of free-living nitrogen-fixing bacterial communities were perturbed due to As contamination in agricultural land.

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Hyalinizing clear cell carcinoma of salivary gland origin in the head and neck: clinical and histopathological analysis

Hyalinizing clear cell carcinoma (HCCC) is an extremely rare neoplasm of salivary gland origin with a low-grade indolent nature. It is difficult to distinguish from other malignant salivary gland tumours. Clinical outcomes following surgery are generally reported as good. The aim of this study was to further determine the features of HCCC. This study was approved by Medical ethics review of affiliated hospital of jiangsu university. Fourteen new cases of HCCC are reported. The clinical and histopathological data of these 14 cases were analysed alongside those of 141 cases identified in a systematic review of the literature (up to 2016).

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Magnitude of Neck-Surface Vibration as an Estimate of Subglottal Pressure During Modulations of Vocal Effort and Intensity in Healthy Speakers

Purpose

This study examined the relationship between the magnitude of neck-surface vibration (NSV_Mag; transduced with an accelerometer) and intraoral estimates of subglottal pressure (P′_sg) during variations in vocal effort at 3 intensity levels.

Method

Twelve vocally healthy adults produced strings of /pɑ/ syllables in 3 vocal intensity conditions, while increasing vocal effort during each condition. Measures were made of P′_sg (estimated during stop-consonant closure), NSV_Mag (measured during the following vowel), sound pressure level, and respiratory kinematics. Mixed linear regression was used to analyze the relationship between NSV_Mag and P′_sg with respect to total lung volume excursion, levels of lung volume initiation and termination, airflow, laryngeal resistance, and vocal efficiency across intensity conditions.

Results

NSV_Mag was significantly related to P′_sg (p < .001), and there was a significant, although small, interaction between NSV_Mag and intensity condition. Total lung excursion was the only additional variable contributing to predicting the NSV_Mag–P′_sg relationship.

Conclusions

NSV_Mag closely reflects P′_sg during variations of vocal effort; however, the relationship changes across different intensities in some individuals. Future research should explore additional NSV-based measures (e.g., glottal airflow features) to improve estimation accuracy during voice production.

http://article/doi/10.1044/2017_JSLHR-S-17-0180/2665792/Magnitude-of-NeckSurface-Vibration-as-an-Estimate

Longitudinal Associations Across Prematurity, Attention, and Language in School-Age Children

Purpose

This research note explores the potential role of attention in mediating previously reported associations between language outcomes and prematurity.

Method

As a follow-up investigation to Mahurin Smith, DeThorne, Logan, Channell, and Petrill (2014), we employed multilevel modeling to analyze longitudinal data on language and attention collected when children were, on average, ages of 7, 8, and 10 years. The sample of 114 children taken from the Western Reserve Reading and Math Project was selected to oversample children with a history of prematurity while also controlling for differences in confounding influences such as age, gender, parental education, and race.

Results

As predicted, attention differentially predicted language outcomes based on form of measurement. Specifically, parent and examiner ratings of attention were significantly associated with standardized test performance at all 3 time points (R ² = 15.2%–20%). Associations between attention and language sample measures were less consistent across home visits and tended to be smaller in effect size.

Conclusion

Attention abilities are associated with children's language performance even in the absence of an attention-deficit/hyperactivity disorder diagnosis. Clinical implications, particularly as related to assessment, are discussed.

http://article/doi/10.1044/2017_JSLHR-L-17-0015/2665790/Longitudinal-Associations-Across-Prematurity

Receptive Vocabulary, Cognitive Flexibility, and Inhibitory Control Differentially Predict Older and Younger Adults' Success Perceiving Speech by Talkers With Dysarthria

Purpose

Previous research has demonstrated equivocal findings related to the effect of listener age on intelligibility ratings of dysarthric speech. The aim of the present study was to investigate the mechanisms that support younger and older adults' perception of speech by talkers with dysarthria.

Method

Younger and older adults identified words in phrases produced by talkers with dysarthria. Listeners also completed assessments on peripheral hearing, receptive vocabulary, and executive control functions.

Results

Older and younger adults did not differ in their ability to perceive speech by talkers with dysarthria. Younger adults' success in identifying words produced by talkers with dysarthria was associated only with their hearing acuity. In contrast, older adults showed effects of working memory and cognitive flexibility and interactions between hearing acuity and receptive vocabulary and between hearing acuity and inhibitory control.

Conclusions

Although older and younger adults had equivalent performance identifying words produced by talkers with dysarthria, older adults appear to utilize more cognitive support to identify those words.

http://article/doi/10.1044/2017_JSLHR-H-17-0119/2665789/Receptive-Vocabulary-Cognitive-Flexibility-and

Modeling Speech Level as a Function of Background Noise Level and Talker-to-Listener Distance for Talkers Wearing Hearing Protection Devices

Purpose

Studying the variations in speech levels with changing background noise level and talker-to-listener distance for talkers wearing hearing protection devices (HPDs) can aid in understanding communication in background noise.

Method

Speech was recorded using an intra-aural HPD from 12 different talkers at 5 different distances in 3 different noise conditions and 2 quiet conditions.

Results

This article proposes models that can predict the difference in speech level as a function of background noise level and talker-to-listener distance for occluded talkers. The proposed model complements the existing model presented by Pelegrín-García, Smits, Brunskog, and Jeong (2011) and expands on it by taking into account the effects of occlusion and background noise level on changes in speech sound level.

Conclusions

Three models of the relationship between vocal effort, background noise level, and talker-to-listener distance for talkers wearing HPDs are presented. The model with the best prediction intervals is a talker-dependent model that requires the users' unoccluded speech level at 10 m as a reference. A model describing the relationship between speech level, talker-to-listener distance, and background noise level for occluded talkers could eventually be incorporated with radio protocols to transmit verbal communication only to an intended set of listeners within a given spatial range—this range being dependent on the changes in speech level and background noise level.

http://article/doi/10.1044/2017_JSLHR-S-17-0052/2665791/Modeling-Speech-Level-as-a-Function-of-Background

The Influence of Target and Masker Characteristics on Infants' and Adults' Detection of Speech

Purpose

Several investigators have compared infants' detection of speech in speech and nonspeech maskers to evaluate developmental differences in masking. Such comparisons have produced contradictory results, possibly because each investigation used different stimuli. The current study examined target and masker effects on infants' and adults' detection of speech.

Method

An observer-based procedure was used to compare infants' and adults' detection of the vowel /ʌ/ and the word "baby" in a 2-talker speech masker and matched speech-spectrum noise. The measure of performance was d′. A total of 43 7-month-old infants and 41 young adults were randomly assigned to 1 target–masker combination condition, and mean performance was compared across conditions at each age.

Results

Adults' detection was influenced by an interaction between the target and the masker: Adults detected the vowel better in the 2-talker masker than in speech-spectrum noise but detected the word equally well in the 2 maskers. In contrast, infants detected both targets better in speech-spectrum noise than in the 2-talker masker.

Conclusions

The relative effects of the masker on target detection by infants and adults depend on the target to be detected. Thus, conclusions drawn about differences between infants and adults in the mechanisms responsible for masking will depend on the stimuli. Standardization of speech stimuli in developmental research would help clarify the nature of infants' segregation difficulties.

Supplemental Material

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http://article/doi/10.1044/2017_JSLHR-H-16-0464/2665222/The-Influence-of-Target-and-Masker-Characteristics

PGE2 suppresses human group 2 innate lymphoid cell function

Group 2 innate lymphoid cells (ILC2) are involved in the initial phase of type 2 inflammation and can amplify allergic immune responses by orchestrating other type 2 immune cells. PGE2 is a bioactive lipid that plays protective roles in the lung, particularly during allergic inflammation.

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Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography

Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct.

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Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography

Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct.

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In This Issue [IN THIS ISSUE]

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Development of a Novel CD4+ TCR Transgenic Line That Reveals a Dominant Role for CD8+ Dendritic Cells and CD40 Signaling in the Generation of Helper and CTL Responses to Blood-Stage Malaria [NOVEL IMMUNOLOGICAL METHODS]

We describe an MHC class II (I-A^b)–restricted TCR transgenic mouse line that produces CD4⁺ T cells specific for Plasmodium species. This line, termed PbT-II, was derived from a CD4⁺ T cell hybridoma generated to blood-stage Plasmodium berghei ANKA (PbA). PbT-II cells responded to all Plasmodium species and stages tested so far, including rodent (PbA, P. berghei NK65, Plasmodium chabaudi AS, and Plasmodium yoelii 17XNL) and human (Plasmodium falciparum) blood-stage parasites as well as irradiated PbA sporozoites. PbT-II cells can provide help for generation of Ab to P. chabaudi infection and can control this otherwise lethal infection in CD40L-deficient mice. PbT-II cells can also provide help for development of CD8⁺ T cell–mediated experimental cerebral malaria (ECM) during PbA infection. Using PbT-II CD4⁺ T cells and the previously described PbT-I CD8⁺ T cells, we determined the dendritic cell (DC) subsets responsible for immunity to PbA blood-stage infection. CD8⁺ DC (a subset of XCR1⁺ DC) were the major APC responsible for activation of both T cell subsets, although other DC also contributed to CD4⁺ T cell responses. Depletion of CD8⁺ DC at the beginning of infection prevented ECM development and impaired both Th1 and follicular Th cell responses; in contrast, late depletion did not affect ECM. This study describes a novel and versatile tool for examining CD4⁺ T cell immunity during malaria and provides evidence that CD4⁺ T cell help, acting via CD40L signaling, can promote immunity or pathology to blood-stage malaria largely through Ag presentation by CD8⁺ DC.

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Robert acland (1941-2016) innovator, microsurgeon, anatomist and teacher

The breadth and depth of Robert (Bob) Acland's contribution to Plastic and Reconstructive Surgery merits communication to younger generations. From early days at boarding school Bob took a great interest in acquiring precision skills in metalwork and carpentry which were to prepare him for later innovations in the design and manufacture of prototype microsurgical instruments. He then worked with suppliers and manufacturers to market the microsurgical instrumentation which is in international use today.

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Glycogen Synthase Kinase-3 Modulates Cbl-b and Constrains T Cell Activation [IMMUNE REGULATION]

The decision between T cell activation and tolerance is governed by the spatial and temporal integration of diverse molecular signals and events occurring downstream of TCR and costimulatory or coinhibitory receptor engagement. The PI3K–protein kinase B (PKB; also known as Akt) signaling pathway is a central axis in mediating proximal signaling events of TCR and CD28 engagement in T cells. Perturbation of the PI3K–PKB pathway, or the loss of negative regulators of T cell activation, such as the E3 ubiquitin ligase Cbl-b, have been reported to lead to increased susceptibility to autoimmunity. In this study, we further examined the molecular pathway linking PKB and Cbl-b in murine models. Our data show that the protein kinase GSK-3, one of the first targets identified for PKB, catalyzes two previously unreported phosphorylation events at Ser⁴⁷⁶ and Ser⁴⁸⁰ of Cbl-b. GSK-3 inactivation by PKB abrogates phosphorylation of Cbl-b at these two sites and results in reduced Cbl-b protein levels. We further show that constitutive activation of PKB in vivo results in a loss of tolerance that is mediated through the downregulation of Cbl-b. Altogether, these data indicate that the PI3K–PKB–GSK-3 pathway is a novel regulatory axis that is important for controlling the decision between T cell activation and tolerance via Cbl-b.

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Ubc9 Binds to ADAP and Is Required for Rap1 Membrane Recruitment, Rac1 Activation, and Integrin-Mediated T Cell Adhesion [MOLECULAR AND STRUCTURAL IMMUNOLOGY]

Although the immune adaptor adhesion and degranulation-promoting adaptor protein (ADAP) acts as a key mediator of integrin inside-out signaling leading to T cell adhesion, the regulation of this adaptor during integrin activation and clustering remains unclear. We now identify Ubc9, the sole small ubiquitin-related modifier E2 conjugase, as an essential regulator of ADAP where it is required for TCR-induced membrane recruitment of the small GTPase Rap1 and its effector protein RapL and for activation of the small GTPase Rac1 in T cell adhesion. We show that Ubc9 interacted directly with ADAP in vitro and in vivo, and the association was increased in response to anti-CD3 stimulation. The Ubc9-binding domain on ADAP was mapped to a nuclear localization sequence (aa 674–700) within ADAP. Knockdown of Ubc9 by short hairpin RNA or expression of the Ubc9-binding–deficient ADAP mutant significantly decreased TCR-induced integrin adhesion to ICAM-1 and fibronectin, as well as LFA-1 clustering, although it had little effect on the TCR proximal signaling responses and TCR-induced IL-2 transcription. Furthermore, downregulation of Ubc9 impaired TCR-mediated Rac1 activation and attenuated the membrane targeting of Rap1 and RapL, but not Rap1-interacting adaptor molecule. Taken together, our data demonstrate for the first time, to our knowledge, that Ubc9 acts as a functional binding partner of ADAP and plays a selective role in integrin-mediated T cell adhesion via modulation of Rap1-RapL membrane recruitment and Rac1 activation.

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Cutting Edge: c-Maf Is Required for Regulatory T Cells To Adopt ROR{gamma}t+ and Follicular Phenotypes [CUTTING EDGE]

Regulatory T cells (Tregs) adopt specialized phenotypes defined by coexpression of lineage-defining transcription factors, such as RORt, Bcl-6, or PPAR, alongside Foxp3. These Treg subsets have unique tissue distributions and diverse roles in maintaining organismal homeostasis. However, despite extensive functional characterization, the factors driving Treg specialization are largely unknown. In this article, we show that c-Maf is a critical transcription factor regulating this process in mice, essential for generation of both RORt⁺ Tregs and T follicular regulatory cells, but not for adipose-resident Tregs. c-Maf appears to function primarily in Treg specialization, because IL-10 production, expression of other effector molecules, and general immune homeostasis are not c-Maf dependent. As in other T cells, c-Maf is induced in Tregs by IL-6 and TGF-β, suggesting that a combination of inflammatory and tolerogenic signals promote c-Maf expression. Therefore, c-Maf is a novel regulator of Treg specialization, which may integrate disparate signals to facilitate environmental adaptation.

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IgG1 Is Required for Optimal Protection after Immunization with the Purified Porin OmpD from Salmonella Typhimurium [IMMUNOTHERAPY AND VACCINES]

In mice, the IgG subclass induced after Ag encounter can reflect the nature of the Ag. Th2 Ags such as alum-precipitated proteins and helminths induce IgG1, whereas Th1 Ags, such as Salmonella Typhimurium, predominantly induce IgG2a. The contribution of different IgG isotypes to protection against bacteria such as S. Typhimurium is unclear, although as IgG2a is induced by natural infection, it is assumed this isotype is important. Previously, we have shown that purified S. Typhimurium porins including outer membrane protein OmpD, which induce both IgG1 and IgG2a in mice, provide protection to S. Typhimurium infection via Ab. In this study we report the unexpected finding that mice lacking IgG1, but not IgG2a, are substantially less protected after porin immunization than wild-type controls. IgG1-deficient mice produce more porin-specific IgG2a, resulting in total IgG levels that are similar to wild-type mice. The decreased protection in IgG1-deficient mice correlates with less efficient bacterial opsonization and uptake by macrophages, and this reflects the low binding of outer membrane protein OmpD–specific IgG2a to the bacterial surface. Thus, the Th2-associated isotype IgG1 can play a role in protection against Th1-associated organisms such as S. Typhimurium. Therefore, individual IgG subclasses to a single Ag can provide different levels of protection and the IgG isotype induced may need to be a consideration when designing vaccines and immunization strategies.

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Cutting Edge: Processing of Oxidized Peptides in Macrophages Regulates T Cell Activation and Development of Autoimmune Arthritis [CUTTING EDGE]

APCs are known to produce NADPH oxidase (NOX) 2–derived reactive oxygen species; however, whether and how NOX2-mediated oxidation affects redox-sensitive immunogenic peptides remains elusive. In this study, we investigated a major immunogenic peptide in glucose-6-phosphate isomerase (G6PI), a potential autoantigen in rheumatoid arthritis, which can form internal disulfide bonds. Ag presentation assays showed that presentation of this G6PI peptide was more efficient in NOX2-deficient (Ncf1^m1J/m1J mutant) mice, compared with wild-type controls. IFN-–inducible lysosomal thiol reductase (GILT), which facilitates disulfide bond–containing Ag processing, was found to be upregulated in macrophages from Ncf1 mutant mice. Ncf1 mutant mice exhibited more severe G6PI peptide-induced arthritis, which was accompanied by the increased GILT expression in macrophages and enhanced Ag-specific T cell responses. Our results show that NOX2-dependent processing of the redox-sensitive autoantigens by APCs modify T cell activity and development of autoimmune arthritis.

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Disruption of Thrombocyte and T Lymphocyte Development by a Mutation in ARPC1B [CLINICAL AND HUMAN IMMUNOLOGY]

Regulation of the actin cytoskeleton is crucial for normal development and function of the immune system, as evidenced by the severe immune abnormalities exhibited by patients bearing inactivating mutations in the Wiskott–Aldrich syndrome protein (WASP), a key regulator of actin dynamics. WASP exerts its effects on actin dynamics through a multisubunit complex termed Arp2/3. Despite the critical role played by Arp2/3 as an effector of WASP-mediated control over actin polymerization, mutations in protein components of the Arp2/3 complex had not previously been identified as a cause of immunodeficiency. Here, we describe two brothers with hematopoietic and immunologic symptoms reminiscent of Wiskott–Aldrich syndrome (WAS). However, these patients lacked mutations in any of the genes previously associated with WAS. Whole-exome sequencing revealed a homozygous 2 bp deletion, n.c.G623DEL-TC (p.V208VfsX20), in Arp2/3 complex component ARPC1B that causes a frame shift resulting in premature termination. Modeling of the disease in zebrafish revealed that ARPC1B plays a critical role in supporting T cell and thrombocyte development. Moreover, the defects in development caused by ARPC1B loss could be rescued by the intact human ARPC1B ortholog, but not by the p.V208VfsX20 variant identified in the patients. Moreover, we found that the expression of ARPC1B is restricted to hematopoietic cells, potentially explaining why a mutation in ARPC1B has now been observed as a cause of WAS, whereas mutations in other, more widely expressed, components of the Arp2/3 complex have not been observed.

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Lung-Infiltrating Foxp3+ Regulatory T Cells Are Quantitatively and Qualitatively Different during Eosinophilic and Neutrophilic Allergic Airway Inflammation but Essential To Control the Inflammation [ALLERGY AND OTHER HYPERSENSITIVITIES]

Understanding functions of Foxp3⁺ regulatory T cells (Tregs) during allergic airway inflammation remains incomplete. In this study, we report that, during cockroach Ag–induced allergic airway inflammation, Foxp3⁺ Tregs are rapidly mobilized into the inflamed lung tissues. However, the level of Treg accumulation in the lung was different depending on the type of inflammation. During eosinophilic airway inflammation, ~30% of lung-infiltrating CD4 T cells express Foxp3, indicative of Tregs. On the contrary, only ~10% of infiltrating CD4 T cells express Foxp3 during neutrophilic airway inflammation. Despite the different accumulation, the lung inflammation and inflammatory T cell responses were aggravated following Treg depletion, regardless of the type of inflammation, suggesting regulatory roles for Tregs. Interestingly, however, the extent to which inflammatory responses are aggravated by Treg depletion was significantly greater during eosinophilic airway inflammation. Indeed, lung-infiltrating Tregs exhibit phenotypic and functional features associated with potent suppression. Our results demonstrate that Tregs are essential regulators of inflammation, regardless of the type of inflammation, although the mechanisms used by Tregs to control inflammation may be shaped by environmental cues available to them.

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A Protective Function of IL-22BP in Ischemia Reperfusion and Acetaminophen-Induced Liver Injury [IMMUNE REGULATION]

Acute liver injury can be secondary to a variety of causes, including infections, intoxication, and ischemia. All of these insults induce hepatocyte death and subsequent inflammation, which can make acute liver injury a life-threatening event. IL-22 is a dual natured cytokine which has context-dependent protective and pathogenic properties during tissue damage. Accordingly, IL-22 was shown to promote liver regeneration upon acute liver damage. However, other studies suggest pathogenic properties of IL-22 during chronic liver injury. IL-22 binding protein (IL-22BP, IL-22Ra2) is a soluble inhibitor of IL-22 that regulates IL-22 activity. However, the significance of endogenous IL-22BP in acute liver injury is unknown. We hypothesized that IL-22BP may play a role in acute liver injury. To test this hypothesis, we used Il22bp-deficient mice and murine models of acute liver damage induced by ischemia reperfusion and N-acetyl-p-aminophenol (acetaminophen) administration. We found that Il22bp-deficient mice were more susceptible to acute liver damage in both models. We used Il22 x Il22bp double-deficient mice to show that this effect is indeed due to uncontrolled IL-22 activity. We could demonstrate mechanistically increased expression of Cxcl10 by hepatocytes, and consequently increased infiltration of inflammatory CD11b⁺Ly6C⁺ monocytes into the liver in Il22bp-deficient mice upon liver damage. Accordingly, neutralization of CXCL10 reversed the increased disease susceptibility of Il22bp-deficient mice. In conclusion, our data indicate that IL-22BP plays a protective role in acute liver damage, via controlling IL-22–induced Cxcl10 expression.

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Endogenous Calcitriol Synthesis Controls the Humoral IgE Response in Mice [ALLERGY AND OTHER HYPERSENSITIVITIES]

The vitamin D receptor participates in the control of IgE class-switch recombination in B cells. The physiologic vitamin D receptor agonist, 1,25(OH)₂D₃ (calcitriol), is synthesized by the essential enzyme 25-hydroxyvitamin D₃-1α-hydroxylase (CYP27B1), which can be expressed by activated immune cells. The role of endogenous calcitriol synthesis for the regulation of IgE has not been proven. In this study, we investigated IgE-responses in Cyp27b1-knockout (KO) mice following sensitization to OVA or intestinal infection with Heligmosomoides polygyrus. Specific Igs and plasmablasts were determined by ELISA and ELISpot, Cyp27b1 expression was measured by quantitative PCR. The data show elevated specific IgE and IgG1 concentrations in the blood of OVA-sensitized Cyp27b1-KO mice compared with wild-type littermates (+898 and +219%). Accordingly, more OVA-specific IgG1-secreting cells are present in spleen and fewer in the bone marrow of Cyp27b1-KO mice. Ag-specific mechanisms are suggested as the leucopoiesis is in general unchanged and activated murine B and T lymphocytes express Cyp27b1. Accordingly, elevated specific IgE concentrations in the blood of sensitized T cell–specific Cyp27b1-KO mice support a lymphocyte-driven mechanism. In an independent IgE-inducing model, i.e., intestinal infection with H. polygyrus, we validated the increase of total and specific IgE concentrations of Cyp27b1-KO compared with wild-type mice, but not those of IgG1 or IgA. We conclude that endogenous calcitriol has an impact on the regulation of IgE in vivo. Our data provide genetic evidence supporting previous preclinical and clinical findings and suggest that vitamin D deficiency not only promotes bone diseases but also type I sensitization.

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Serum IgA Immune Complexes Promote Proinflammatory Cytokine Production by Human Macrophages, Monocytes, and Kupffer Cells through Fc{alpha}RI-TLR Cross-Talk [INNATE IMMUNITY AND INFLAMMATION]

IgA is predominantly recognized to play an important role in host defense at mucosal sites, where it prevents invasion of pathogens by neutralization. Although it has recently become clear that IgA also mediates other immunological processes, little remains known about the potential of IgA to actively contribute to induction of inflammation, particularly in nonmucosal organs and tissues. In this article, we provide evidence that immune complex formation of serum IgA plays an important role in orchestration of inflammation in response to pathogens at various nonmucosal sites by eliciting proinflammatory cytokines by human macrophages, monocytes, and Kupffer cells. We show that opsonization of bacteria with serum IgA induced cross-talk between FcαRI and different TLRs, leading to cell type–specific amplification of proinflammatory cytokines, such as TNF-α, IL-1β, IL-6, and IL-23. Furthermore, we demonstrate that the increased protein production of cytokines was regulated at the level of gene transcription, which was dependent on activation of kinases Syk and PI3K. Taken together, these data demonstrate that the immunological function of IgA is substantially more extensive than previously considered and suggest that serum IgA–induced inflammation plays an important role in orchestrating host defense by different cell types in nonmucosal tissues, including the liver, skin, and peripheral blood.

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Mode of Tolerance Induction and Requirement for Aire Are Governed by the Cell Types That Express Self-Antigen and Those That Present Antigen [ANTIGEN RECOGNITION AND RESPONSES]

Aire controls the fate of autoreactive thymocytes (i.e., clonal deletion or development into regulatory T cells [Tregs]) through transcriptional control of the expression of tissue-restricted self-antigens (TRAs) from medullary thymic epithelial cells (mTECs) and bone marrow (BM)-derived cells. Although TRAs expressed by mTECs and BM-derived cells are suggested to complement each other to generate a full spectrum of TRAs, little is known about the relative contribution of TRAs from each component for establishment of self-tolerance. Furthermore, the precise role of Aire in specific types of Aire-expressing APCs remains elusive. We have approached these issues by generating two different types of transgenic mouse (Tg) model, which express a prefixed model self-antigen driven by the insulin promoter or the Aire promoter. In the insulin-promoter Tg model, mTECs alone were insufficient for clonal deletion, and BM-derived APCs were required for this action by utilizing Ag transferred from mTECs. In contrast, mTECs alone were able to induce Tregs, although at a much lower efficiency in the absence of BM-derived APCs. Importantly, lack of Aire in mTECs, but not in BM-derived APCs, impaired both clonal deletion and production of Tregs. In the Aire-promoter Tg model, both mTECs and BM-derived APCs could independently induce clonal deletion without Aire, and production of Tregs was impaired by the lack of Aire in mTECs, but not in BM-derived APCs. These results suggest that the fate of autoreactive thymocytes together with the requirement for Aire depend on the cell types that express self-antigens and the types of APCs involved in tolerance induction.

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