Can pulpal floor debonding be detected from occlusal surface displacement in composite restorations?

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): João Batista Novaes, Elissa Talma, Estevam Barbosa Las Casas, Wondwosen Aregawi, Lauren Wickham Kolstad, Sue Mantell, Yan Wang, Alex Fok
ObjectivesPolymerization shrinkage of resin composite restorations can cause debonding at the tooth–restoration interface. Theory based on the mechanics of materials predicts that debonding at the pulpal floor would half the shrinkage displacement at the occlusal surface. The aim of this study is to test this theory and to examine the possibility of detecting subsurface resin composite restoration debonding by measuring the superficial shrinkage displacements.MethodsA commercial dental resin composite with linear shrinkage strain of 0.8% was used to restore 2 groups of 5 model Class-II cavities (8-mm long, 4-mm wide and 4-mm deep) in aluminum blocks (8-mm thick, 10-mm wide and 14-mm tall). Group I had the restorations bonded to all cavity surfaces, while Group II had the restorations not bonded to the cavity floor to simulate debonding. One of the proximal surfaces of each specimen was sprayed with fine carbon powder to allow surface displacement measurement by Digital Image Correlation. Images of the speckled surface were taken before and after cure for displacement calculation. The experiment was simulated using finite element analysis (FEA) for comparison.ResultsGroup I showed a maximum occlusal displacement of 34.7±6.7μm and a center of contraction (COC) near the pulpal floor. Group II had a COC coinciding with the geometric center and showed a maximum occlusal displacement of 17.4±3.8μm. The difference between the two groups was statistically significant (p-value=0.0007). Similar results were obtained by FEA. The theoretical shrinkage displacement was 44.6 and 22.3μm for Group I and II, respectively. The lower experimental displacements were probably caused by slumping of the resin composite before cure and deformation of the adhesive layer.SignificanceThe results confirmed that the occlusal shrinkage displacement of a resin composite restoration was reduced significantly by pulpal floor debonding. Recent in vitro studies seem to indicate that this reduction in shrinkage displacement could be detected by using the most accurate intraoral scanners currently available. Thus, subject to clinical validation, the occlusal displacement of a resin composite restoration may be used to assess its interfacial integrity.



http://ift.tt/2jjWwJn

Characterization, mechanistic analysis and improving the properties of denture adhesives

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): Afsoon Fallahi, Nona Khadivi, Nima Roohpour, Andrew M. Middleton, Mehdi Kazemzadeh-Narbat, Nasim Annabi, Ali Khademhosseini, Ali Tamayol
ObjectiveDenture adhesives are widely used to avoid the detachment and sliding of dentures. However, the adhesion properties can be affected by variation in mouth conditions such as the level of salivation. The objective of this study was to understand the effect of environmental conditions on the adhesion properties of a commercially available denture adhesive named as Poligrip^® Free manufactured by GlaxoSmithKline Ltd., UK and to identify the reasons for the observed variation in its adhesion strength.MethodsThe failure mechanisms of denture adhesive have been assessed through using different physical, mechanical and thermal characterization experiments. All methods were used in different pH, temperatures, and salivation conditions and at the end, a strategy was proposed to overcome the failure of the paste in hyposalivation as well.ResultsIn vitro models mimicking the denture gingival interface were designed to evaluate the adhesion properties of the investigated adhesive. Changes in the adhesion strength in response to three major factors related to the oral conditions including level of salivation, pH, and temperature were measured. The results of lap shear, tensile test, and internal interactions suggested a cohesion failure, where the lowest adhesion strength was due to hyposalivation. Fourier transform infrared spectroscopy (FTIR) and rheological analysis confirmed the importance of hydrogen bonds and hydration in the adhesion strength of the paste.SignificanceThe investigated scenarios are widely observed in patient using denture adhesives and the clinical reports have indicated the inconsistency in adhesion strength of the commercial products. After identifying the potential reasons for such behavior, methods such as the addition of tripropylene glycol methyl ether (TPME) to enhance internal hydrogen bonds between the polymers are proposed to improve adhesion in the hyposalivation scenario.



http://ift.tt/2BC2onM

Practical and theoretical considerations on the fracture toughness testing of dental restorative materials

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): Renan Belli, Michael Wendler, José I. Zorzin, Ulrich Lohbauer
BackgroundAn important tool in materials research, development and characterization regarding mechanical performance is the testing of fracture toughness. A high level of accuracy in executing this sort of test is necessary, with strict requirements given in extensive testing standard documents. Proficiency in quality specimen fabrication and test requires practice and a solid theoretical background, oftentimes overlooked in the dental community. Aims: In this review we go through some fundamentals of the fracture mechanics concepts that are relevant to the understanding of fracture toughness testing, and draw attention to critical aspects of practical nature that must be fulfilled for validity and accuracy in results. We describe our experience with some testing methodologies for CAD/CAM materials and discuss advantages and shortcomings of different tests in terms of errors in testing the applicability of the concept of fracture toughness as a single-value material-specific property.



http://ift.tt/2jjOeBc

Bonding strategies for MIH-affected enamel and dentin

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): Norbert Krämer, Ngoc-Han Nana Bui Khac, Susanne Lücker, Vitus Stachniss, Roland Frankenberger
ObjectivesAim of the present study was to evaluate resin composite adhesion to dental hard tissues affected by molar incisor hypomineralisation (MIH).Methods94 freshly extracted human molars and incisors (53 suffering MIH) were used. 68 teeth (35 with MIH) were used for μ-TBS tests in enamel and dentin, 26 (18 with MIH) for qualitative evaluation. Specimens were bonded with Clearfil SE Bond, Scotchbond Universal, and OptiBond FL. For MIH affected enamel, additional OptiBond FL groups with NaOCl and NaOCl+Icon were investigated. Beside fractographic analysis, also qualitative evaluations were performed using SEM at different magnifications as well as histological sectioning.ResultsHighest μ-TBS values were recorded with dentin specimens (ANOVA, mod. LSD, p<0.05). Results were independent of adhesive and dentin substrate (p>0.05). Pre-test failures did not occur in dentin specimens. Sound enamel specimens exhibited significantly higher μ-TBS values than MIH enamel (p<0.05). The two-step self-etch adhesive (Clearfil SE Bond) and the two-step etch-and-rinse adhesive (Scotchbond Universal) showed the lowest values in affected enamel specimens (p<0.05) with most pre-test failures (p<0.05). OptiBond FL on affected enamel showed better results than Clearfil SE Bond (p<0.05). An additional pre-treatment of affected enamel with NaOCl or NaOCl and Icon did not enhance enamel bonding (p>0.05), however, it caused less pre-test failures (p<0.05). Micromorphological analyses revealed that conventional phosphoric acid etching produces a much less pronounced etching pattern in affected enamel and a porous structure as weak link for the resin-enamel bond was identified.SignificanceBonding to porous hypomineralized MIH enamel is the limiting factor in adhesion to MIH teeth. MIH-affected dentin may be bonded conventionally.



http://ift.tt/2BC2ifU

Photopolymerization of cell-laden gelatin methacryloyl hydrogels using a dental curing light for regenerative dentistry

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): Nelson Monteiro, Greeshma Thrivikraman, Avathamsa Athirasala, Anthony Tahayeri, Cristiane M. França, Jack L. Ferracane, Luiz E. Bertassoni
Photopolymerized hydrogels, such as gelatin methacryloyl (GelMA), have desirable biological and mechanical characteristics for a range of tissue engineering applications.ObjectiveThis study aimed to optimize a new method to photopolymerize GelMA using a dental curing light (DL).MethodsLithium acylphosphinate photo-initiator (LAP, 0.05, 0.067, 0.1% w/v) was evaluated for its ability to polymerize GelMA hydrogel precursors (10% w/v) encapsulated with odontoblast-like cells (OD21). Different irradiances (1650, 2300 and 3700mW/cm²) and photo-curing times (5–20s) were tested, and compared against the parameters typically used in UV light photopolymerization (45mW/cm², 0.1% w/v Irgacure 2959 as photoinitiator). Physical and mechanical properties of the photopolymerized GelMA hydrogels were determined. Cell viability was assessed using a live and dead assay kit.ResultsComparing DL and UV polymerization methods, the DL method photopolymerized GelMA precursor faster and presented larger pore size than the UV polymerization method. The live and dead assay showed more than 80% of cells were viable when hydrogels were photopolymerized with the different DL irradiances. However, the cell viability decreased when the exposure time was increased to 20s using the 1650mW/cm² intensity, and when the LAP concentration was increased from 0.05 to 0.1%. Both DL and UV photocrosslinked hydrogels supported a high percentage of cell viability and enabled fabrication of micropatterns using a photolithography microfabrication technique.SignificanceThe proposed method to photopolymerize GelMA cell-laden hydrogels using a dental curing light is effective and represents an important step towards the establishment of chair-side procedures in regenerative dentistry.



http://ift.tt/2jjF3AJ

STRO-1 confers myofibroblast transdifferentiation in fibroblasts derived from oral submucous fibrosis

Abstract

Background

STRO-1 is a mesenchymal cell marker present on all clonogenic stromal precursors. Current evidence has indicated that the pathogenesis of fibrotic changes may be mediated by stemness properties. The aim of this study was to investigate the role of STRO-1 in areca quid chewing-associated oral submucous fibrosis (OSF).

Methods

Thirty OSF specimens and ten normal buccal mucosa were examined by immunohistochemistry. The activity of STRO-1 from fibroblasts cultured from normal buccal mucosa (BMFs) and OSF (OSFFs) were measureed and the effects of arecoline, a major areca nut alkaloid, on STRO-1 in BMFs. Compared the activities between sorted STRO-1⁺ cells and STRO-1^- cells from OSFF were measured by collagen gel contraction, migration, invasion abilities, and the expression of α-smooth muscle actin (α-SMA) and pro-α1 (I) chain of type I collagen.

Results

Our results first showed that the expression of STRO-1 was more evident in areca quid chewing-associated OSF than normal buccal mucosa tissues (p<0.05). Arecoline dose-dependently activated the level of STRO-1 in BMFs (p<0.05). The relative expression of STRO-1 was significantly higher in OSFFs compared with BMFs (p<0.05). In addition, the sorted STRO-1⁺ cells from OSFFs exhibited higher collagen gel contraction, migration, and invasion abilities as well as elevated expression of α-SMA and pro-α1 (I) chain of type I collagen than the negative subset (p<0.05).

Conclusion

These findings suggested that the stemness marker STRO-1 may be a crucial factor in the pathogenesis of areca quid chewing-associated OSF.

This article is protected by copyright. All rights reserved.

http://ift.tt/2jWRIJo

Impact of statistical reconstruction and compressed sensing algorithms on projection data elimination during X-ray CT image reconstruction

Abstract

Objectives

To examine the effect of incomplete, or total elimination of, projection data on computed tomography (CT) images subjected to statistical reconstruction and/or compressed sensing algorithms.

Methods

Multidetector row CT images were used. The algebraic reconstruction technique (ART) and the maximum likelihood-expectation maximization (ML-EM) method were compared with filtered back-projection (FBP). Effects on reconstructed images were studied when the projection data of 360° (360 projections) were decreased to 180 or 90 projections by reducing the collection angle or thinning the image data. The total variation (TV) regularization method using compressed sensing was applied to images processed by the ART. Image noise was subjectively evaluated using the root-mean-square error and signal-to-noise ratio.

Results

When projection data were reduced by one-half or three-quarters, ART and ML-EM produced better image quality than FBP. Both ART and ML-EM resulted in high quality at a spread of 90 projections over 180° rotation. Computational loading was high for statistical reconstruction, but not for ML-EM, compared with the ART. TV regularization made it possible to use only 36 projections while still achieving acceptable image quality.

Conclusions

Incomplete projection data—accomplished by reducing the angle to collect image data or thinning the projection data without reducing the angle of rotation over which it is collected—made it possible to reduce the radiation dose while retaining image quality with statistical reconstruction algorithms and/or compressed sensing. Despite heavier computational calculation loading, these methods should be considered for reducing radiation doses.

http://ift.tt/2AAswAn

MassARRAY-based simultaneous detection of hotspot somatic mutations and recurrent fusion genes in papillary thyroid carcinoma: the PTC-MA assay

Abstract

Purpose

We exploited the MassARRAY (MA) genotyping platform to develop the "PTC-MA assay", which allows the simultaneous detection of 13 hotspot mutations, in the BRAF, KRAS, NRAS, HRAS, TERT, AKT1, PIK3CA, and EIF1AX genes, and six recurrent genetic rearrangements, involving the RET and TRK genes in papillary thyroid cancer (PTC).

Methods

The assay was developed using DNA and cDNA from 12 frozen and 11 formalin-fixed paraffin embedded samples from 23 PTC cases, together with positive and negative controls.

Results

The PTC-MA assay displays high sensitivity towards point mutations and gene rearrangements, detecting their presence at frequencies as low as 5%. Moreover, this technique allows quantification of the mutated alleles identified at each tested locus.

Conclusions

The PTC-MA assay is a novel MA test, which is able to detect fusion genes generated by genomic rearrangements concomitantly with the analysis of hotspot point mutations, thus allowing the evaluation of key diagnostic, prognostic, and therapeutic markers of PTC in a single experiment without any informatics analysis. As the assay is sensitive, robust, easily achievable, and affordable, it is suitable for the diagnostic practice. Finally, the PTC-MA assay can be easily implemented and updated by adding novel genetic markers, according to clinical requirements.

http://ift.tt/2AY6R7y

Hormones in milk

Publication date: August 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 31, Issue 4
Author(s): Andreas Hoeflich, Wieland Kiess




http://ift.tt/2jX84l6

3-D motion capture for long-term tracking of spontaneous locomotor behaviors and circadian sleep/wake rhythms in mouse

Publication date: 1 February 2018
Source:Journal of Neuroscience Methods, Volume 295
Author(s): Melissa Sourioux, Emma Bestaven, Etienne Guillaud, Sandrine Bertrand, Magali Cabanas, Lea Milan, Willy Mayo, Maurice Garret, Jean-René Cazalets
BackgroundLocomotor activity provides an index of an animal's behavioral state. Here, we report a reliable and cost-effective method that allows long-term (days to months) simultaneous tracking of locomotion in mouse cohorts (here consisting of 24 animals).New methodThe technique is based on a motion capture system used mainly for human movement study. A reflective marker was placed on the head of each mouse using a surgical procedure and labeled animals were returned to their individual home cages. Camera-recorded data of marker displacement resulting from locomotor movements were then analyzed with custom built software. To avoid any data loss, data files were saved every hour and automatically concatenated. Long-term recordings (up to 3 months) with high spatial (<1mm) and temporal (up to 100Hz) resolution of animal movements were obtained.ResultsThe system was validated by analyzing the spontaneous activity of mice from post-natal day 30–90. Daily motor activity increased up to 70days in correspondence with maturational changes in locomotor performance. The recorded actigrams also permitted analysis of circadian and ultradian rhythms in cohort sleep/wake behavior.Comparison with existing method(s)In contrast to traditional session-based experimental approaches, our technique allows locomotor activity to be recorded with minimal experimenter manipulation, thereby minimizing animal stress.ConclusionsOur method enables the continuous long-term (up to several months) monitoring of tens of animals, generating manageable amounts of data at minimal costs without requiring individual dedicated devices. The actigraphic data collected allows circadian and ultradian analysis of sleep/wake behaviors to be performed.

Graphical abstract

http://ift.tt/2jYsZ7l

Orbital cellulitis secondary to dacryocystitis: Is it common?

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Salman bin Amiruddin, Balwant Singh Gendeh




http://ift.tt/2jiusG2

An epidemiological study of 270 cases of carcinomas of the head and neck region in a Nigerian tertiary health care facility

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): B. Fomete, R. Agbara, E.T. Adebayo, O.D. Osunde, D.S. Adeola
IntroductionOral cancer is the sixth most frequently occurring malignant tumor and is the major cause of morbidity and mortality with high metastatic and invasive tendency. The incidence of oral cancer differs widely in various parts of the world with a range of 2–10 per 100,000 populations per year, approximately 300,000 new cases. Incidence and mortality as a result of oral cancer are higher in developing countries when compared to developed countries. This is the reason for the occurrence of the peak age in later decades of life.Patients and methodsAll consecutive cases of histologically diagnosed cases of orofacial carcinomas seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria over a 10 year period were retrospectively analyzed.ResultsOver the study period, a total of 1116 cases of maxillofacial conditions were seen in the unit out of which 270 represented orofacial cancers, giving a prevalence of 24.19%. Of the 270 cases, male accounted for 159(58.9%) while females were 111(41.1%) giving a male to female ratio of 1.43:1. The age ranged from 5 to 90 years, mean (SD), 48.4(16.12) years and patients in the 4th to 6th decades (47.7%) were mostly affected. There was no gender difference in terms of distribution of the tumors according to age.ConclusionSquamous cell carcinoma of the orofacial region has continued to pose great challenges to care givers and practitioners involved in their management.



http://ift.tt/2BD5VSL

Study of interactions between odorant molecules and the hOR1G1 olfactory receptor by molecular modeling

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Assia Belhassan, Hanane Zaki, Samir Chtita, Mohamed Benlyas, Tahar Lakhlifi, Mohammed Bouachrine
In order to initiate the process of determining how the molecular level receptor-odorant interactions are related to odor perception, we used the SWISS-MODEL modeling server to predict the three dimensional (3D) structure of the human olfactory receptor (hOR1G1). The model was refined using minimization and side-chain optimization using SCWRL. We then used the Autodockvina and Autodock tools to predict the binding site and binding energy for the library of 13 odorants characterized by different retention/release property values to hOR1G1 receptor, to investigate the relationship between this property and the ligand-hOR1G1 interactions. We find that when the retention property increases, hydrogen bond interactions between ligands and olfactory receptor (hOR1G1) become favorable.



http://ift.tt/2jjv2DD

Editorial Board

Publication date: July 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences, Volume 18, Issue 2





http://ift.tt/2BFLJjf

Orbital cellulitis secondary to dacryocystitis: Is it common?

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Salman bin Amiruddin, Balwant Singh Gendeh




http://ift.tt/2jiusG2

An epidemiological study of 270 cases of carcinomas of the head and neck region in a Nigerian tertiary health care facility

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): B. Fomete, R. Agbara, E.T. Adebayo, O.D. Osunde, D.S. Adeola
IntroductionOral cancer is the sixth most frequently occurring malignant tumor and is the major cause of morbidity and mortality with high metastatic and invasive tendency. The incidence of oral cancer differs widely in various parts of the world with a range of 2–10 per 100,000 populations per year, approximately 300,000 new cases. Incidence and mortality as a result of oral cancer are higher in developing countries when compared to developed countries. This is the reason for the occurrence of the peak age in later decades of life.Patients and methodsAll consecutive cases of histologically diagnosed cases of orofacial carcinomas seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria over a 10 year period were retrospectively analyzed.ResultsOver the study period, a total of 1116 cases of maxillofacial conditions were seen in the unit out of which 270 represented orofacial cancers, giving a prevalence of 24.19%. Of the 270 cases, male accounted for 159(58.9%) while females were 111(41.1%) giving a male to female ratio of 1.43:1. The age ranged from 5 to 90 years, mean (SD), 48.4(16.12) years and patients in the 4th to 6th decades (47.7%) were mostly affected. There was no gender difference in terms of distribution of the tumors according to age.ConclusionSquamous cell carcinoma of the orofacial region has continued to pose great challenges to care givers and practitioners involved in their management.



http://ift.tt/2BD5VSL

Study of interactions between odorant molecules and the hOR1G1 olfactory receptor by molecular modeling

Publication date: Available online 6 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Assia Belhassan, Hanane Zaki, Samir Chtita, Mohamed Benlyas, Tahar Lakhlifi, Mohammed Bouachrine
In order to initiate the process of determining how the molecular level receptor-odorant interactions are related to odor perception, we used the SWISS-MODEL modeling server to predict the three dimensional (3D) structure of the human olfactory receptor (hOR1G1). The model was refined using minimization and side-chain optimization using SCWRL. We then used the Autodockvina and Autodock tools to predict the binding site and binding energy for the library of 13 odorants characterized by different retention/release property values to hOR1G1 receptor, to investigate the relationship between this property and the ligand-hOR1G1 interactions. We find that when the retention property increases, hydrogen bond interactions between ligands and olfactory receptor (hOR1G1) become favorable.



http://ift.tt/2jjv2DD

Editorial Board

Publication date: July 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences, Volume 18, Issue 2





http://ift.tt/2BFLJjf

Acquired haemophilia A complicating alemtuzumab therapy for multiple sclerosis

Alemtuzumab is a highly efficacious therapy used in the treatment of multiple sclerosis (MS), but uncoupling of T and B cell repopulation during immune reconstitution associates with an increasing range of secondary B cell-mediated autoimmune complications. A 34-year-old woman developed Graves' disease 11 months following an initial course of alemtuzumab treatment for MS. Nine months following the second treatment with alemtuzumab, the patient presented with spontaneous intramuscular and subcutaneous haemorrhage due to development of an inhibitory autoantibody to coagulation factor VIII. Acquired haemophilia A (AHA) is an extremely rare complication in patients treated with alemtuzumab. Treatment with rituximab may induce a rapid remission of AHA; however, the patient's high John Cunningham virus (JCV) antibody index and alemtuzumab-induced T cell lymphopenia may lead to an increased risk of progressive multifocal leucoencephalopathy, a potential complication which was unacceptable to the patient.

http://ift.tt/2BOryRe

Parotid gland: an unusual site of breast cancer metastasis

Parotid gland metastases from breast cancer are an extremely rare and unusual event with a limited number of cases recorded in the literature. A 71-year-old woman with a history of ductal adenocarcinoma of the left breast presented to the maxillofacial clinic with an asymptomatic swelling of the left parotid gland. The presentation occurred 21 years after she underwent treatment for recurrent breast cancer. Investigations led to the diagnosis of a breast cancer metastasis which was oestrogen receptor and progesterone receptor positive and negative. Positron emission tomography scan confirmed this as a solitary metastasis. She was treated with aromatase inhibitors and a stable clinical response was observed on follow-up. Surgical intervention was avoided with its potential complications such as facial nerve injury. Metastasis from breast cancer to the parotid gland is a very rare phenomenon. However, in a patient with previous breast cancer, it should be considered as a possible differential diagnosis.

http://ift.tt/2ktK3WZ

Nerve abscess in pure neural leprosy mistaken for peripheral nerve sheath tumour with disastrous consequence: what can we learn?

A 34-year-old Indian man presented to an orthopaedician with gradually progressive hypoesthesia affecting his right lower limb and an ipsilateral common peroneal nerve swelling around the knee. The nerve swelling was diagnosed as a peripheral nerve sheath tumour based on MRI findings and was excised, only to be revealed as leprous nerve abscess on histopathology later. The patient developed right foot drop as a result of common peroneal nerve biopsy. This case presents several learning points in the diagnosis of pure neural leprosy.

http://ift.tt/2BLXG80

Gastric liposarcoma resected by laparoscopic total gastrectomy to achieve a wide surgical margin

Gastric liposarcoma is an extremely rare tumour that usually affects the extremities and retroperitoneum. Preoperative diagnosis is difficult, and operative procedures are not well standardised. A 61-year-old woman presented with melaena, epigastric discomfort and palpitations. Upper endoscopy revealed a submucosal tumour at the posterior gastric fundus with an actively bleeding ulcer on the top. Our preoperative diagnosis was lipoma, and we performed laparoscopic intragastric surgery. However, the histopathological diagnosis was liposarcoma. Laparoscopic total gastrectomy was performed to achieve a wide surgical margin. Several recent series have shown that a positive microscopic margin is associated with a higher rate of local recurrence than a negative margin. We have added a staged operation to obtain a wide margin in cases involving a positive surgical margin. Preoperative diagnosis of liposarcoma is still challenging. Gastric lipoma-like tumours should be resected with a wide margin because of their possibility of malignancy.

http://ift.tt/2kqtYkC

Pathological ECG that seemed normal following electrode misplacement

We report the case of a 57-year-old woman found at home who received an ECG after having recovered from a seizure, without any clinical cardiac anomaly. The ECG revealed an elevation of the ST segment from the V1 to V5 leads and negative T waves from V1 to V5 leads. At her hospital admission, the emergency care unit (ECU) nurse performed another ECG. It no longer showed any repolarisation anomaly. However, the ECU nurse had put the precordial electrodes 3 cm too low, probably due to the patient's voluminous breasts. In the end, the pathological trace reappeared after we returned the electrodes to their initial positions. Malpositioning of the electrodes caused a seemingly normal ECG result with life-threatening consequences.

http://ift.tt/2BLXxS0

Lentiform fork sign due to severe metabolic acidosis

Description

An 11-month-old, developmentally normal, female infant presented with acute-onset fever, vomiting, shallow breathing and gradually progressive lethargy for the past 2 days. There was no history of seizures, neck stiffness, focal motor deficits, cranial nerve palsies, tone changes, rash, diarrhoea, recurrent encephalopathies, abnormal body odour, recurrent infections or hospitalisations, drug or toxin ingestion. Her past and family history was not contributory. On examination, anthropometric parameters were normal for age. She had mild pallor, angular cheilitis, wrist widening, tachypnea (respiratory rate 58/min) with acidotic breathing. She was conscious with fluctuations in alertness (Glasgow Coma Scale (GCS) E4M5V2) and irritability with reduced spontaneous activity, mild hypotonia, preserved antigravity movements, brisk muscle stretch reflexes, bilateral extensor plantar response, absence of oculomotor abnormalities, cranial nerve palsies or bulbar signs and normal fundi. Rest of the systemic examination was unremarkable. A clinical diagnosis of acute febrile encephalopathy was considered.

Laboratory investigations showed...

http://ift.tt/2koteN5

Dysphagia lusoria presenting as epigastric pain

Description

A 36-year-old African–American woman with medical history of systemic lupus erythematosus, lupus nephritis, protein S deficiency and recurrent deep venous thrombosis presented to outpatient clinic complaining of epigastric pain associated with nausea, vomiting and unintentional weight loss. Esophagogastroduodenoscopy (EGD) was performed; however, mucosal tear was noted following severe retching. Subsequently, the procedure was terminated. EGD was significant for distal oesophageal obstruction. CT of the chest with contrast was significant for pneumomediastinum. Moreover it demonstrated an aberrant right subclavian artery compressing on the posterior part of the oesophagus (figure 1). The patient was diagnosed with dysphagia lusoria. This patient's symptoms were moderate and managed with dietary modifications. Thus, surgical intervention was not recommended. There was no further progression of symptoms at 1-year follow-up.

Figure 1

Aberrant right subclavian artery compressing on the posterior part of the oesophagus.

Dysphagia lusoria is a condition...

http://ift.tt/2BLSe57

Painful testicular metastasis from prostate adenocarcinoma

A 60-year-old man presented with unilateral testicular pain and urinary frequency. His presenting prostate-specific antigen (PSA) was 100 ng/mL, and a biopsy revealed Gleason 4+4 prostate adenocarcinoma. The significance of his initial PSA was somewhat complicated by possible prostatitis and early initiation of bicalutamide. PSA rose on two occasions prior to radiotherapy but coincided with a flare of testicular pain on one of these. Whole-body staging diffusion-weighted MRI scan was negative. He was treated with 3 years of androgen deprivation therapy (ADT) and radical radiotherapy. PSA fell to undetectable levels on ADT. Twelve months following completion of ADT, PSA rose to 3.6 ng/mL. No disease recurrence was noted on restaging MRI pelvis. The patient was well, except for persistent testicular symptoms, which failed to resolve following multiple antibiotics. Testicular tumour markers were negative. Ultrasound findings were consistent with chronic epididymitis. A right orchidectomy was performed for symptomatic relief, confirming metastatic prostate adenocarcinoma.

http://ift.tt/2ko1xE2

The association between cardiovascular disease and type 2 diabetes in adults with atopic dermatitis: a systematic review and meta-analysis

Abstract

Recent studies examining the association between atopic dermatitis (AD) and cardiovascular disease (CVD) and type 2 diabetes have shown inconsistent results. We compared the risk of CVD and diabetes between adult patients with and without AD by searching the Pubmed, Embase, and Web of Science databases. Data extraction was done by two independent reviewers. We found a total of 2,855 citations, of which 53 were considered relevant based on title and abstract. Sixteen publications were included in the qualitative analysis, of which 13 were also included in a quantitative meta-analysis of crude data. No association was observed between AD and unspecified, but suspected type 2, diabetes (pooled odds ratio [OR] 1.11; 95% confidence interval [CI] 0.87-1.42), hypertension (pooled OR 1.16; 95% CI 0.98-1.37), stroke (pooled OR 1.15; 95% CI 0.95-1.39) or myocardial infarction (pooled OR 1.14; 95% CI 0.83-1.56), but a positive association was observed with angina pectoris (OR 1.73; 95% CI 1.27-2.37). Meta-analysis on adjusted data gave similar results. While adults with AD in some populations have increased prevalence of cardiovascular risk factors, such as obesity and smoking, it is unlikely that AD represents an independent and clinically relevant risk factor for cardiometabolic disease.

This article is protected by copyright. All rights reserved.

http://ift.tt/2zRUfuY

The association between cardiovascular disease and type 2 diabetes in adults with atopic dermatitis: a systematic review and meta-analysis

Abstract

Recent studies examining the association between atopic dermatitis (AD) and cardiovascular disease (CVD) and type 2 diabetes have shown inconsistent results. We compared the risk of CVD and diabetes between adult patients with and without AD by searching the Pubmed, Embase, and Web of Science databases. Data extraction was done by two independent reviewers. We found a total of 2,855 citations, of which 53 were considered relevant based on title and abstract. Sixteen publications were included in the qualitative analysis, of which 13 were also included in a quantitative meta-analysis of crude data. No association was observed between AD and unspecified, but suspected type 2, diabetes (pooled odds ratio [OR] 1.11; 95% confidence interval [CI] 0.87-1.42), hypertension (pooled OR 1.16; 95% CI 0.98-1.37), stroke (pooled OR 1.15; 95% CI 0.95-1.39) or myocardial infarction (pooled OR 1.14; 95% CI 0.83-1.56), but a positive association was observed with angina pectoris (OR 1.73; 95% CI 1.27-2.37). Meta-analysis on adjusted data gave similar results. While adults with AD in some populations have increased prevalence of cardiovascular risk factors, such as obesity and smoking, it is unlikely that AD represents an independent and clinically relevant risk factor for cardiometabolic disease.

This article is protected by copyright. All rights reserved.

http://ift.tt/2zRUfuY

A question of class: treatment options for patients with relapsed and/or refractory multiple myeloma

Publication date: Available online 5 December 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Gordon Cook, Sonja Zweegman, María-Victoria Mateos, Florence Suzan, Philippe Moreau
Multiple classes of agent with distinct mechanisms of action are now available for the treatment of patients with relapsed and/or refractory multiple myeloma (RRMM), including immunomodulatory agents, proteasome inhibitors, histone deacetylase inhibitors and monoclonal antibodies. Additionally, several different drugs may be available within each agent class, each with their own specific efficacy and safety profile. This expansion of the treatment landscape has dramatically improved outcomes for patients. However, as the treatment options for RRMM become more complex, choosing the class of agent or combination of agents to use in the relapsed setting becomes increasingly challenging. Furthermore, treatment options for specific patient populations such as the elderly, those with high-risk cytogenetic abnormalities and those with refractory disease are yet to be defined in the current treatment landscape. When choosing an appropriate treatment approach, physicians must consider multiple criteria including both patient-related and disease-related factors. The aim should be to provide patient-specific treatment in order to gain a clinical benefit while minimizing toxicity. This review provides an overview of the mechanism of action and efficacy and safety profiles of each class of agent and of treatment regimens that combine different classes of agent, with a special focus on treating specific patient populations.



http://ift.tt/2Az4l55

A water-soluble near-infrared fluorescent probe for specific Pd2+ detection

Publication date: Available online 6 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Jia Wen, Yinghua Lv, Pengyi Xia, Fengyu Liu, Yongqian Xu, Hongjuan Li, Su-Shing Chen, Shiguo Sun
Palladium (Pd) is widely used in chemistry, biology, environmental science etc., and Pd²⁺ is the most plenitudinous oxidation state of the Pd that can exist under physiological conditions or in living cells, which could have adverse effects on both our health and environment. Thus, it is of great significance to monitor the changes of Pd²⁺. Hence, a novel near-infrared fluorescent probe M-PD has been developed for selective detection of Pd²⁺ based on naphthofluorescein in this work. The result demonstrated that M-PD exhibited favorable properties for sensing Pd²⁺ such as excellent water solubility, high selectivity and sensitivity. And the limit of detection was estimated as 10.8 nM, much lower than the threshold in drugs (5-10 ppm) specified by European Directorate for the Quality Control of Medicines. More importantly, detection and recovery experiments of Pd²⁺ in aspirin aqoeous solution and soil are satisfactory. In addition, M-PD has also been successfully used for near-infrared fluorescence imaging of Pd²⁺ in living cells, indicating that the probe has better feasibility and application potential in the determination of Pd²⁺.

Graphical abstract

http://ift.tt/2BMRJYa

1,5-Disubstituted 1,2,3-Triazole Linked Disaccharides: Metal-Free Syntheses and Screening of a New Class of Ribonuclease A Inhibitors

Publication date: Available online 5 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Anirban Kayet, Dhrubajyoti Datta, Ashrukana Das, Swagata Dasgupta, Tanmaya Pathak
1,5-Regioisomeric triazole linked disccharides have been synthesized and screened for their inhibitory properties against ribonuclease A (RNase A). The angular constraint-driven 'crescent shaped' inhibitors accommodated themselves into the enzyme active site. An improved enzyme inhibition was observed with increased H-bonding ability of polar functional groups in the modified disaccharides. In this series, introduction of two carboxyl groups in the furanose rings elicited the best result with an inhibition constant of 50±3 µM. This is the first ever report on the use of disaccharides as RNase A inhibitors.

Graphical abstract

http://ift.tt/2BMRFYq

Genotoxicity assessment of raw and treated water samples using Allium cepa assay: evidence from Perak River, Malaysia

Abstract

Allium cepa assay was carried out in this study to evaluate genotoxic effects of raw and treated water samples from Perak River in Perak state, Malaysia. Samples were collected from three surface water treatment plants along the river, namely WTPP, WTPS, and WTPK. Initially, triplicates of equal size Allium cepa (onions) bulbs, 25–30 mm in diameter and average weight of 20 g, were set up in distilled water for 24 h at 20 ± 2 °C and protected from direct sunlight, to let the roots to grow. After germination of roots (0.5–1.0 cm in length), bulbs were transferred to collected water samples each for a 96-h period of exposure. The root physical deformations were observed. Genotoxicity quantification was based on mitotic index and genotoxicity level. Statistical analysis using cross-correlation function for replicates from treated water showed that root length has inverse correlation with mitotic indices (r = − 0.969) and frequencies of cell aberrations (r = − 0.976) at lag 1. Mitotic indices and cell aberrations of replicates from raw water have shown positive correlation at lag 1 (r = 0.946). Genotoxicity levels obtained were 23.4 ± 1.98 (WTPP), 26.68 ± 0.34 (WTPS), and 30.4 ± 1.13 (WTPK) for treated water and 17.8 ± 0.18 (WTPP), 37.15 ± 0.17 (WTPS), and 47.2 ± 0.48 (WTPK) for raw water. The observed cell aberrations were adherence, chromosome delay, C-metaphase, chromosome loss, chromosome bridge, chromosome breaks, binucleated cell, mini cell, and lobulated nuclei. The morphogenetic deformations obtained were likely due to genotoxic substances presence in collected water samples. Thus, water treatment in Malaysia does not remove genotoxic compounds.

http://ift.tt/2krW5A5

Impact of oral cadmium intoxication on levels of different essential trace elements and oxidative stress measures in mice: a response to dose

Abstract

The study evaluated the effect of oral intoxication of cadmium and the possible causes of oxidative stress and its preferential accumulation in different organs as well as sub-sequential effects in mice. Twenty-four Swiss albino male mice were divided into three groups viz., normal control group without cadmium chloride (CdCl₂), whereas a daily dose of 0.5 and 1.2 mg of CdCl₂ was orally administered for a period of a week to dose group 1 (DG-1) and dose group 2 (DG-2), respectively. A significant increase in the severity of cadmium toxicity was observed in animals as evidenced by aggravation in liver enzymes viz., serum alanine aminotransferase and aspartate transaminase, whereas lower levels of antioxidative stress markers in liver and kidney tissues of treated mice were observed as compared to normal control group. A significant depletion of calcium levels in liver tissues of DG-1 (217.36 ± 1.73 μg/g of wet tissues) and DG-2 (186.41 ± 1.56 μg/g of wet tissues) groups, along with Cd accumulation, was observed. To summarize, the current study would increase our understanding with respect to dose-dependent absorption of Cd and its toxicity led to mortality as well as adverse health effects in the body of mice.

Graphical abstract

ᅟ

http://ift.tt/2iqyefA

Bioengineered silver nanoparticles as potent anti-corrosive inhibitor for mild steel in cooling towers

Abstract

Silver nanoparticle-aided enhancement in the anti-corrosion potential and stability of plant extract as ecologically benign alternative for microbially induced corrosion treatment is demonstrated. Bioengineered silver nanoparticles (AgNPs) surface functionalized with plant extract material (proteinacious) was generated in vitro in a test tube by treating ionic AgNO₃ with the leaf extract of Azadirachta indica that acted as dual reducing as well as stabilizing agent. Purity and crystallinity of the AgNPs, along with physical and surface characterizations, were evaluated by performing transmission electron microscopy, Fourier transform infrared spectroscopy, energy dispersive x-ray spectra, single-area electron diffractions, zeta potential, and dynamic light scattering measurements. Anti-corrosion studies against mild steel (MS1010) by corrosion-inducive bacterium, Bacillus thuringiensis EN2 isolated from cooling towers, were evaluated by performing electrochemical impedance spectroscopy (EIS), weight loss analysis, and surface analysis by infrared spectroscopy. Our studies revealed that AgNPs profoundly inhibited the biofilm on MS1010 surface and reduced the corrosion rates with the CR of 0.5 mm/y and an inhibition efficiency of 77% when compared to plant extract alone with a CR of 2.2 mm/y and an inhibition efficiency of 52%. Further surface analysis by infrared spectra revealed that AgNPs formed a protective layer of self-assembled film on the surface of MS1010. Additionally, EIS and surface analysis revealed that the AgNPs have inhibited the bacterial biofilm and reduced the pit on MS1010. This is the first report disclosing the application of bioengineered AgNP formulations as potent anti-corrosive inhibitor upon forming a protective layer over mild steel in cooling water towers.

Graphical Abstract

ᅟ

http://ift.tt/2iqHjoO

Sugar-based collagen membrane cross-linking increases barrier capacity of membranes

Abstract

Objectives

This study examines the permeability and barrier capacity of a sugar cross-linked resorbable collagen membrane ex vivo and in vivo.

Materials and methods

In an ex vivo study, injectable platelet-rich fibrin (i-PRF), a peripheral blood-derived human leukocyte-and-platelet-rich plasma was used to analyze membrane permeability. in vivo subcutaneous implantation in Wistar rats (n = 4 per time point and group) was used to investigate the barrier capacity of the membrane. The induced in vivo cellular reaction was evaluated at 3, 15, and 30 days and compared to sham OP (control) without biomaterial using histological, immunohistochemical, and histomorphometric methods.

Results

Ex vivo, the membrane was impenetrable to leukocytes, platelets, and fibrin from peripheral human blood concentrate (PRF). In vivo, the membrane maintained its structure and remained impervious to cells, connective tissue, and vessels over 30 days. CD-68-positive cell (macrophage) numbers significantly decreased from 3 to 15 days, while from day 15 onwards, the number of multinucleated giant cells (MNGCs) increased significantly. Correspondingly, a rise in implantation bed vascularization from 15 to 30 days was observed. However, no signs of degradation or material breakdown were observed at any time point.

Conclusion

Ex vivo and in vivo results showed material impermeability to cellular infiltration of human and murine cells, which highlights the membrane capacity to serve as a barrier over 30 days. However, whether the induced MNGCs will lead to material degradation or encapsulation over the long term requires further investigation.

Clinical relevance

The data presented are of great clinical interest, as they contribute to the ongoing discussion concerning to what extent an implanted material should be integrated versus serving only as a barrier membrane.

http://ift.tt/2BLxIBr

Uterine rupture in a primigravid patient, an uncommon but severe obstetrical event: a case report

A spontaneous rupture of the unscarred uterus in a primigravid patient is extremely rare and is associated with high perinatal and maternal morbidity and mortality.

http://ift.tt/2kq8Zym

Editorial Board

http://ift.tt/2B35e9m

News and announcement

http://ift.tt/2AbaCar

Focusing on claudin-5: a promising candidate in the regulation of BBB to treat ischemic stroke

Publication date: Available online 5 December 2017
Source:Progress in Neurobiology
Author(s): Jianjun Lv, Wei Hu, Zhi Yang, Tian Li, Shuai Jiang, Zhiqiang Ma, Fulin Chen, Yang Yang
Claudin-5 is a tight junction (TJ) protein in the blood-brain barrier (BBB) that has recently attracted increased attention. Numerous studies have demonstrated that claudin-5 regulates the integrity and permeability of the BBB. Increased claudin-5 expression plays a neuroprotective role in neurological diseases, particularly in cerebral ischemic stroke. Moreover, claudin-5 might be a potential marker for early hemorrhagic transformation detection in ischemic stroke. In light of the distinctive effects of claudin-5 on the nervous system, we present the elaborate network of roles that claudin-5 plays in ischemic stroke. In this review, we first introduce basic knowledge regarding the BBB and the claudin family, the characterization and regulation of claudin-5, and association between claudin-5 and other TJ proteins. Subsequently, we describe BBB dysfunction and neuron-specific drivers of pathogenesis of ischemic stroke, including inflammatory disequilibrium and oxidative stress. Furthermore, we summarize promising ischemic stroke treatments that target the BBB via claudin-5, including modified rt-PA therapy, pharmacotherapy, hormone treatment, receptor-targeted therapy, gene therapy, and physical therapy. This review highlights recent advances and provides a comprehensive summary of claudin-5 in the regulation of the BBB and may be helpful for drug design and clinical therapy for treatment of ischemic stroke.



http://ift.tt/2iX1VsK

DNA damage signaling and polyploid macrophages in chronic inflammation

Veronika Horn | Antigoni Triantafyllopoulou

http://ift.tt/2AvFSzJ

Immunoresolvents signaling molecules at intersection between the brain and immune system

Jesmond Dalli | Charles N Serhan

http://ift.tt/2AyyYHQ

New roles and controls of mast cells

Eric Espinosa | Salvatore Valitutti

http://ift.tt/2AvFPE3

Recent advances in inflammasome biology

David E Place | Thirumala-Devi Kanneganti

http://ift.tt/2AAKS4e

A ravenous defense: canonical and non-canonical autophagy in immunity

Payel Sil | Ginger Muse | Jennifer Martinez

http://ift.tt/2AtguL3

Control of innate-like B cell location for compartmentalised IgM production

Lucy H Jackson-Jones | Cécile Bénézech

http://ift.tt/2AyyUb4

Heme and hemolysis in innate immunity: adding insult to injury

Rui Martins | Sylvia Knapp

http://ift.tt/2Av6l0b

Innate sensing of cancer's non-immunologic hallmarks

Ruth Seelige | Stephen Searles | Jack D Bui

http://ift.tt/2AyyOjI

Type I interferon-mediated autoinflammation and autoimmunity

Stefanie Kretschmer | Min Ae Lee-Kirsch

http://ift.tt/2At211D

Negative selection, epitope mimicry and autoimmunity

Noel R Rose

http://ift.tt/2AAKDWS

Monogenic lupus: it's all new!

Patricia Costa-Reis | Kathleen E Sullivan

http://ift.tt/2AwlFKi

What's up in the ALPS

Frédéric Rieux-Laucat

http://ift.tt/2AzaL4s

Molecular control of regulatory T cell development and function

Yohko Kitagawa | Shimon Sakaguchi

http://ift.tt/2AwlA9s

Insights into immune tolerance from AIRE deficiency

Irina Proekt | Corey N Miller | Michail S Lionakis | Mark S Anderson

http://ift.tt/2Ay8uGl

Biomarker-guided stratification of autoimmune patients for biologic therapy

Sabine Ivison | Christine Des Rosiers | Sylvie Lesage | John D Rioux | Megan K Levings

http://ift.tt/2At8MjQ

Have we pushed the needle for treatment of Type 1 diabetes?

Nida Naushad | Ana Luisa Perdigoto | Jinxiu Rui | Kevan C Herold

http://ift.tt/2AAKrH8

Hemophagocytic syndrome: primary forms and predisposing conditions

Fernando E Sepulveda | Geneviève de Saint Basile

http://ift.tt/2AwlpLk

Leveraging blood and tissue CD4+ T cell heterogeneity at the single cell level to identify mechanisms of disease in rheumatoid arthritis

Chamith Y Fonseka | Deepak A Rao | Soumya Raychaudhuri

http://ift.tt/2AAKouW

Lessons from CTLA-4 deficiency and checkpoint inhibition

Bernice Lo | Ussama M Abdel-Motal

http://ift.tt/2At8AkC

Psoriasis: a mixed autoimmune and autoinflammatory disease

Yun Liang | Mrinal K Sarkar | Lam C Tsoi | Johann E Gudjonsson

http://ift.tt/2Ay8u9j

Reliability of temporal bone high-resolution CT in patients with facial paralysis in temporal bone fracture

Publication date: Available online 5 December 2017
Source:American Journal of Otolaryngology
Author(s): Yaofeng Chen, Kai Zhang, Yanfeng Xu, Yanxu Che, Linna Guan, Yefeng Li
ObjectiveThis study aimed to investigate the reliability of temporal bone high-resolution CT (HRCT) in patients with traumatic facial paralysis.MethodsHRCT with cross-sectional scanning and multi-planar reformation (MPR) was performed on 26 cases with traumatic facial paralysis, and the preoperative imaging manifestations were compared with surgical findings.ResultsPreoperative HRCT revealed fallopian canal damage at the posterior genu in 1 case, geniculate ganglion in 22 cases, labyrinthine segment in 4 cases, tympanic segment in 13 cases and mastoid segment in 0 case, while surgical findings confirmed fallopian canal damage at the posterior genu in 7 cases, geniculate ganglion in 23 cases, labyrinthine segment in 4 cases, tympanic segment in 17 cases and mastoid segment in 7 cases. The accuracy of temporal bone HRCT in revealing damage at those segments of fallopian canal was 14.3%, 95.7%, 100%, 76.5, and 0%, respectively.ConclusionTemporal bone HRCT can generally estimate the extent of damage and provide important information for traumatic facial paralysis before surgery. However, it is unreliable in revealing the damage of fallopian canal at the posterior genu and mastoid segment.



http://ift.tt/2iqrAWH

Intestinal permeability and Ménière's disease

Publication date: Available online 5 December 2017
Source:American Journal of Otolaryngology
Author(s): F. Di Berardino, E. Ciusani, C. Caccia, V. Leoni, U. De Grazia, E. Filipponi, D. Zanetti, L. Elli
PurposeMénière disease (MD) is a multifactorial chronic disabling condition characterized by episodic vertigo, ear fullness, and hearing loss. MD patients often complain of aspecific gastrointestinal symptoms associated with autonomic dysregulation, frequently outweighed by the otological manifestations. Dietary modifications have been reported to improve the typical MD symptoms in some cases. Our purpose was to test the urinary levels of lactulose and mannitol (double sugar test) and the fecal calprotectin, both markers of altered intestinal permeability, in subjects with definite MD in an active and inactive stage.Materials and methodsTwenty-six with definite unilateral MD were studied: 14 patients were symptomatic for at least 3months with moderate to severe vertigo spells and a functional level ≥4; 12 patients had been asymptomatic (no vertigo spells) for at least 3months and had a functional level=1 at the time of testing. Twenty healthy volunteers were recruited as "control group".ResultsLactulose and mannitol absorption was significantly increased in the symptomatic M patients compared to the asymptomatic group (p<0.02 and p<0.004, respectively) and to the controls. FC were also higher than normal only in the symptomatic group. (p<0.01).ConclusionsAn altered intestinal permeability, according to the two assays, was found only in symptomatic MD patients. The rationale for a possible relationship between MD and intestinal permeability is forwarded. The double-sugar test and FC quantification might be implemented in the MD diagnostic workup.



http://ift.tt/2jWdug9

Symptomatic unilateral vocal fold paralysis following cardiothoracic surgery

Publication date: Available online 6 December 2017
Source:American Journal of Otolaryngology
Author(s): Cassandra Puccinelli, Mara C. Modzeski, Diana Orbelo, Dale C. Ekbom
PurposeUnilateral vocal fold paralysis (UVFP) is a complication associated with cardiothoracic procedures that presents clinically as dysphonia and/or dysphagia with or without aspiration. The literature lacks both data on recovery of mobility and consensus on best management. Herein, our goals are to 1) Identify cardiothoracic procedures associated with symptomatic UVFP at our institution; 2) Review timing and nature of laryngology diagnosis and management; 3) Report spontaneous recovery rate of vocal fold mobility.Materials and methodsRetrospective case series at single tertiary referral center between 2002 and 2015. 141 patients were included who underwent laryngology interventions (micronized acellular dermis injection laryngoplasty and/or type 1 thyroplasty) to treat symptomatic UVFP diagnosed subsequent to cardiothoracic surgery.ResultsPulmonary procedures were most often associated with UVFP (n=50/141; 35.5%). 87.2% had left-sided paralysis (n=123/141). Median time to diagnosis was 42days (x¯=114±348). Over time, UVFP was diagnosed progressively earlier after cardiothoracic surgery. 63.4% of patients (n=95/141) underwent injection laryngoplasty as their initial intervention with median time from diagnosis to injection of 11days (x¯=29.6±54). 41.1% (n=58/141) ultimately underwent type 1 thyroplasty at a median of 232.5days (x¯=367±510.2) after cardiothoracic surgery. 10.2% (n=9/88) of those with adequate follow-up recovered full vocal fold mobility.ConclusionsMany cardiothoracic procedures are associated with symptomatic UVFP, predominantly left-sided. Our data showed poor recovery of vocal fold mobility relative to other studies. Early diagnosis and potential surgical medialization is important in the care of these patients.



http://ift.tt/2ioJiKq

IL-24 is a common and specific autoantigen of IgE in chronic spontaneous urticaria

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Oliver Schmetzer, Elisa Lakin, Fatih A. Topal, Patricia Preusse, Denise Freier, Martin K. Church, Marcus Maurer
BackgroundThe efficacy of omalizumab (anti-IgE) and elevated IgE levels in chronic spontaneous urticaria (CSU) suggest autoallergic mechanisms.ObjectiveTo identify autoallergic targets of IgE in CSU patients.MethodsSera of CSU patients together with idiopathic anaphylaxis patients and healthy controls (seven of each) were screened for IgE-autoantibodies using an array of >9,000 proteins. Sera of 1062 CSU patients and 482 healthy controls were used in an IgE-anti-Interleukin-24 (IL-24) specific ELISA to investigate the association of IgE-anti-IL-24 and CSU.ResultsBy array analyses, over 200 IgE-autoantigens were found in CSU patients that were not in controls. Of the 31 IgE-autoantigens detected in >70% of patients, eight were soluble or membrane bound and expressed in skin. Of these, only IgE-autoantibodies to IL-24 were found in all CSU patients. In vitro studies showed IL-24 to release histamine from human mast cells sensitized with purified IgE of CSU patients but not controls. By ELISA analyses, the mean ± SD levels of IgE-anti-IL-24 were 0.52 ± 0.24 IU/ml in CSU and 0.27 ± 0.08 IU/ml in controls with 80% of CSU patients but only 20% of controls having levels >0.33 IU/ml (P< 0.0001). IgE-anti-IL-24 showed acceptable predictive properties for CSU, with a likelihood ratio of 3.9. Clinically, IgE-anti-IL-24 levels showed an association with disease activity as assessed by the urticaria activity score and with reduced basophil counts.ConclusionOur findings show that CSU patients frequently exhibit IgE-autoantibodies against many autoantigens and that IL-24 is a common, specific, and functional autoantigen of IgE-antibodies in CSU.



http://ift.tt/2zSI1Cl

PGE2 suppresses human group 2 innate lymphoid cell function

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jovana Maric, Avinash Ravindran, Luca Mazzurana, Åsa K. Björklund, Aline Van Acker, Anna Rao, Danielle Friberg, Sven-Erik Dahlén, Akos Heinemann, Viktoria Konya, Jenny Mjösberg
BackgroundGroup 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.ObjectiveWe set out to investigate how PGE2 regulates human ILC2 function.MethodsThe effects of PGE2 on human ILC2 proliferation, intracellular cytokine and transcription factor expression were assessed by flow cytometry. Cytokine production was measured by ELISA and real-time quantitative PCR was performed to detect PGE2 receptor expression.ResultsPGE2 inhibited the expression of GATA3, as well as the production of type 2 cytokines, IL-5 and IL-13, from human tonsil and blood ILC2 in response to stimulation with a combination of IL-25, IL-33, TSLP and IL-2. Furthermore, PGE2 downregulated the expression of IL-2Rα (CD25). In line with that observation, PGE2 decreased ILC2 proliferation. These effects were mediated by the combined action of the EP2 and EP4 receptors, which were specifically expressed on ILC2.ConclusionOur findings reveal that PGE2 limits ILC2 activation and propose that selective EP2 and EP4 receptor agonists might serve as promising therapeutic approach in treating allergic diseases by suppressing ILC2 function.

Graphical abstract

http://ift.tt/2nxPTaD

Generation of adult human T cell progenitors for immunotherapeutic applications

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Laura Simons, Kuiying Ma, Corinne de Chappedelaine, Ranjita Devi Moiranghtem, Elodie Elkaim, Juliette Olivré, Sandrine Susini, Kevin Appourchaux, Christian Reimann, Hanem Sadek, Olivier Pellé, Nicolas Cagnard, Elisa Magrin, Chantal Lagresle-Peyrou, Tom Taghon, Antonio Rausell, Marina Cavazzana, Isabelle André-Schmutz




http://ift.tt/2nynVf6

Thymic stromal lymphopoietin does not activate human basophils

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Nina Salabert-Le Guen, Caroline Hémont, Agathe Delbove, Caroline Poli, Cécile Braudeau, Aurélie Fantou, Karine Amouriaux, Gaelle Bériou, Jérôme C. Martin, Luc Colas, Vassili Soumelis, Régis Josien




http://ift.tt/2zQvNds

Modulating allergic response by engineering the major Parietaria allergens

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Angela Bonura, Daniela Di Blasi, Bianca Barletta, Cinzia Butteroni, Silvia Corinti, Francesco Gervasi, Raphael MelisMario, Carina Uasuf, Cibella Fabio, Gabriella Di Felice, Paolo Colombo
An engineered recombinant hybrid composed of the two major Parietaria allergens (PjEDcys) with reduced allergenicity, retained immunogenicity but immunomodulatory activity for Allergen Immunotherapy of Parietaria allergic patients.



http://ift.tt/2nynTE0

Changes in regulatory B cell levels in bone marrow, blood and sputum of asthmatics following inhaled allergen challenge

Publication date: Available online 6 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): John-Paul Oliveria, Amani I. El-Gammal, Michelle Yee, Caitlin D. Obminski, Tara X. Scime, Rick M. Watson, Karen Howie, Paul M. O'Byrne, Roma Sehmi, Gail M. Gauvreau

Teaser

Capsule Summary: Following allergen exposure in the airways of subjects with allergic asthma, Bregs appear to efflux from the bone marrow and accumulate in the lungs with a possible role in dampening local inflammatory responses.


http://ift.tt/2zQjKwN

Polyunsaturated fatty acids in plasma at 8 years and subsequent allergic disease

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jessica Magnusson, Sandra Ekström, Inger Kull, Niclas Håkansson, Sara Nilsson, Magnus Wickman, Erik Melén, Ulf Risérus, Anna Bergström
BackgroundPolyunsaturated fatty acids (PUFAs) are hypothesized to modulate the risk of allergic disease. However, evidence from previous studies is inconclusive, and limited longitudinal data exist using circulating biomarkers of PUFA intake and metabolism.ObjectiveWe aimed to investigate associations between n-3 and n-6 PUFAs at age 8 years and asthma, rhinitis, and aeroallergen sensitization at age 16 years.MethodsProportions of n-3 PUFAs (very long-chain n-3 [VLC n-3; sum of eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid] and α-linolenic acid) and n-6 PUFAs (linoleic acid and arachidonic acid [AA]) in blood samples at age 8 years were measured for 940 children from the prospective Swedish birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology). Allergic disease phenotypes were defined by using questionnaires and IgE measures at the ages of 8 and 16 years. Logistic regression was used to examine potential associations.ResultsA higher proportion of total VLC n-3 PUFAs in plasma at age 8 years was associated with a reduced risk of prevalent asthma, rhinitis, and aeroallergen sensitization at age 16 years and with incidence of asthma between 8 and 16 years (adjusted odds ratio, 0.67; 95% CI, 0.47-0.94). AA was associated with a reduced risk of asthma, aeroallergen sensitization, and allergic rhinitis. The findings were most evident for allergic phenotypes of asthma and rhinitis. Additionally, AA was associated with an increased probability of asthma and rhinitis remission between 8 and 16 years of age.ConclusionHigher proportions of certain VLC n-3 and very long-chain n-6 PUFAs in plasma phospholipids at age 8 years were associated with a reduced risk of allergic disease at age 16 years.



http://ift.tt/2AuYDTU

Effect of Grass Sublingual Tablet Immunotherapy is Similar in Children and Adults: A Bayesian Approach To Design Pediatric Sublingual Immunotherapy Trials

Publication date: Available online 5 December 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Amarjot Kaur, David Skoner, Joseph Ibrahim, Qing Li, Richard F. Lockey, Michael Blaiss, Albrecht Bufe, Jens Strodl Andersen, Giorgio Walter Canonica, Hendrik Nolte
BackgroundLarge sample sizes are needed for sublingual immunotherapy (SLIT) trials due to inherent data variability secondary to inconsistent allergen exposure. Obtaining large sample sizes for pediatric SLIT trials is challenging, but a Bayesian approach using prior adult data can reduce the necessary sample size.ObjectiveTo describe how a Bayesian framework utilizing prior information from adult trials can be used to improve pediatric SLIT clinical development.MethodsData were compiled using a frequentist approach (conventional clinical trial approach independent of prior data) from trials conducted during the clinical development of timothy grass SLIT-tablet.ResultsThe treatment effect of timothy grass SLIT-tablet was considered similar between pediatric (N=795) and adult (N=2299) data pools, with relative total combined symptom plus medication score improvement (95% CI) vs placebo of 21% (11.0, 30.4) and 20% (14.6, 24.4), respectively. Phleum pratense-specific IgG4 and IgE blocking factor increased from baseline in both children and adults treated with timothy grass SLIT-tablet. Given the reasonable assumption in similarity of treatment response between adults and children, a Bayesian approach is described to demonstrate rigorous efficacy criterion for pediatric trials incorporating information from prior adult trials, and thereby reduce the sample size.ConclusionsData support the similarity of efficacy and immunologic changes between children and adults treated with SLIT for allergic rhinoconjunctivitis. Therefore, it is appropriate to utilize data from adult trials to design feasible trials in children, which may reduce unsafe off-label use by promoting more quickly proper labeling of approved products.

Teaser

Capsule Summary SLIT effects are similar between children and adults. Analytical approaches that allow borrowing information from adult data are appropriate and will make future pediatric SLIT trials more feasible and therefore, quicker to complete, possibly reducing unsafe off-label use of non-approved SLIT formulations.


http://ift.tt/2AywUzA

Cover 1

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2zTnZaL

Brief Overview of This Month's JACI

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2nx1w1E

Advances in environmental and occupational disorders in 2016

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6
Author(s): William J. Sheehan, Jonathan M. Gaffin, David B. Peden, Robert K. Bush, Wanda Phipatanakul
In this review we highlight recent studies that advance the knowledge and understanding of the effects of various environmental factors and associated immune responses in patients with allergic diseases. This review will focus on new literature regarding allergic and immune responses to a variety of environmental factors, including aeroallergens, stinging insects, fungi, pollutants, viral respiratory tract infections, climate change, and microbial exposures.



http://ift.tt/2zQvQ98

Table of Contents

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2nxPyVp

Editorial Board

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2AywKIu

Information for Readers

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2AuYqQC

News & Notes

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2AAbEK0

Continuing Medical Education Calendar

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2Aus4W6

Biomarkers in connective tissue diseases

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6
Author(s): Neelakshi R. Jog, Judith A. James
Autoimmune connective tissue diseases are clinically variable, making biomarkers desirable for assessing future disease risk, supporting early and accurate diagnosis, monitoring disease activity and progression, selecting therapeutics, and assessing treatment response. Because of their correlations with specific clinical characteristics and often with disease progression, autoantibodies and other soluble mediators are considered potential biomarkers. Additional biomarkers might reflect downstream pathologic processes or appear because of ongoing inflammation and damage. Because of overlap between diseases, some biomarkers have limited specificity for a single autoimmune connective tissue disease. This review describes select current biomarkers that aid in the diagnosis and treatment of several major systemic autoimmune connective tissue disorders: systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and anti-neutrophil cytoplasmic antibody–associated vasculitides. Newly proposed biomarkers that target various stages in disease onset or progression are also discussed. Newer approaches to overcome the diversity observed in patients with these diseases and to facilitate personalized disease monitoring and treatment are also addressed.



http://ift.tt/2AzWJiG

Biomarkers in connective tissue diseases

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6





http://ift.tt/2AuYa46

Mechanisms of allergen immunotherapy for inhaled allergens and predictive biomarkers

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6
Author(s): Mohamed H. Shamji, Stephen R. Durham
Allergen immunotherapy is effective in patients with IgE-dependent allergic rhinitis and asthma. When immunotherapy is given continuously for 3 years, there is persistent clinical benefit for several years after its discontinuation. This disease-modifying effect is both antigen-specific and antigen-driven. Clinical improvement is accompanied by decreases in numbers of effector cells in target organs, including mast cells, basophils, eosinophils, and type 2 innate lymphoid cells. Immunotherapy results in the production of blocking IgG/IgG4 antibodies that can inhibit IgE-dependent activation mediated through both high-affinity IgE receptors (FcεRI) on mast cells and basophils and low-affinity IgE receptors (FcεRII) on B cells. Suppression of TH2 immunity can occur as a consequence of either deletion or anergy of antigen-specific T cells; induction of antigen-specific regulatory T cells; or immune deviation in favor of TH1 responses. It is not clear whether the altered long-term memory resides within the T-cell or the B-cell compartment. Recent data highlight the role of IL-10–producing regulatory B cells and "protective" antibodies that likely contribute to long-term tolerance. Understanding mechanisms underlying induction and persistence of tolerance should identify predictive biomarkers of clinical response and discover novel and more effective strategies for immunotherapy.



http://ift.tt/2AAbjHe

Biomarkers for severe eosinophilic asthma

Publication date: December 2017
Source:Journal of Allergy and Clinical Immunology, Volume 140, Issue 6
Author(s): Steven W. Yancey, Oliver N. Keene, Frank C. Albers, Hector Ortega, Stewart Bates, Eugene R. Bleecker, Ian Pavord
The last decade has seen the approval of several new biologics for the treatment of severe asthma-targeting specific endotypes and phenotypes. This review will examine how evidence generated from the mepolizumab clinical development program showed that blood eosinophil counts, rather than sputum or tissue eosinophil counts, evolved as a pharmacodynamic and predictive biomarker for the efficacy of treatment with mepolizumab in patients with severe eosinophilic asthma. Based on the available evidence and combined with clinical judgement, a baseline blood eosinophil threshold of 150 cells/μL or greater or a historical blood eosinophil threshold of 300 cells/μL or greater will allow selection of patients with severe eosinophilic asthma who are most likely to achieve clinically significant reductions in the rate of exacerbations with mepolizumab treatment.



http://ift.tt/2AurJ5M

Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders

Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether in...

http://ift.tt/2iXc6xA

Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders

Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether in...

http://ift.tt/2iXc6xA

On Exploring Vocal Ornamentation in Byzantine Chant

A special vocal ornament in Byzantine chant (BC), the single cycle ornamentation structure (SCOS), is defined and compared with the vibrato with respect to its time (rate, extent) and spectral (slope [SS], relative speaker's formant [SPF] level, formant frequencies [Fi] and bandwidths [Bi], and noise-to-harmonics ratio [NHR]) characteristics.

http://ift.tt/2AyQoEt

Effect of inhaled allergens and air pollutants on childhood rhinitis development

Rhinitis is a common pediatric disease that involves upper airway infection, in which allergic rhinitis affects 9.7% children in the United States.1 Some rhinitis symptoms are related to allergen exposures. Epidemiologic and experimental studies have documented that exposure to traffic-related air pollutants (TRAPs) increases the risk of allergen sensitization and allergic diseases,2–4 which suggests that allergens and TRAPs may have synergistic effects on the development of rhinitis. TRAPs include primary emissions from motor vehicles, such as carbon monoxide, nitrogen oxides, and particulate matter.

http://ift.tt/2ny5EhI

Effect of inhaled allergens and air pollutants on childhood rhinitis development

Rhinitis is a common pediatric disease that involves upper airway infection, in which allergic rhinitis affects 9.7% children in the United States.1 Some rhinitis symptoms are related to allergen exposures. Epidemiologic and experimental studies have documented that exposure to traffic-related air pollutants (TRAPs) increases the risk of allergen sensitization and allergic diseases,2–4 which suggests that allergens and TRAPs may have synergistic effects on the development of rhinitis. TRAPs include primary emissions from motor vehicles, such as carbon monoxide, nitrogen oxides, and particulate matter.

http://ift.tt/2ny5EhI

Do cemeteries emit drugs? A case study from southern Germany

Abstract

The risk of earth burials for the environment and public health is a matter of controversial debate. The aim of the present study is to characterise the drainage of cemeteries with regard to the concentration of a number of pharmaceuticals and to the soil's hydrochemical properties, and to discuss these data in comparison with data obtained for surface waters located upstream of the cemeteries. Of the 12 drainage samples analysed using LC-ESI-MS/MS, seven contained carbamazepine (< 225 ng l⁻¹), five contained hydrochlorothiazide, one contained metoprolol (23 ng l⁻¹) and one contained traces of ibuprofen. The surface water samples contained a larger number of different drugs (8 of the 12 drugs under investigation) and higher concentrations (e.g. metropolol 2230 ng l⁻¹). The NO₃, NH₄, PO₄ and DOC concentrations and the electrical conductivity of the cemetery drainages were in several samples higher than those of the surface water samples. The NO₃ and NH₄ concentrations exceeded the legal contaminant limits of drinking water in only one case. The present study found that the release of drugs and nutrients from cemeteries, measured in surface water drug loads, presents a low environmental risk. However, the study is only a snapshot and long-term monitoring of cemetery drainages, including a broad range of pharmaceuticals and detailed hydrological investigations, will have to be carried out before more substantiated statements can be made.

http://ift.tt/2jUerFZ

Re: Pentoxifylline: a review of its use in osteoradionecrosis

We read with great interest the recent paper by Lyons and Brennan that reviewed the use of pentoxifylline in the management of osteoradionecrosis.1 This promising regimen has had success within our local practice and across several reported case series.

http://ift.tt/2AUZg9X

Minimally invasive dorsal sympathicotomies for the treatment of hyperhidrosis: palmar microcirculatory assessment as an intraoperative-aid

Abstract

Background

Endoscopic transthoracic sympathicotomy has proven to be an effective and durable surgical treatment for severe primary hyperhidrosis. Anyhow, in some cases, especially in overweight patients, a thick overlying subpleural fat may obscure the sympathetic chain, precluding access to the ganglia and partial or total completion of the procedure. The aim of this study was to assess the value of palmar laser Doppler flowmetry (LDF) as an intraoperative-aid during minimally invasive dorsal sympathicotomies (T3) for the treatment of primary palmar hyperhidrosis.

Methods

The method was tested during 40 upper dorsal video-assisted minimally invasive sympathicotomies in 20 patients with bilateral palmar primary hyperhidrosis.

Results

The mean baseline LDF values were 36.05 pU (SD = 21.85 pU). The mean immediate postoperative LDF values were 75.94 pU (SD = 37.89 pU). A statistically significant difference was observed between preoperative and immediate (about 5 s after the sympathicotomies) postoperative values (p = 0.00000009).

Conclusions

According to our data, LDF allowed to obtain reliable and fast intraoperative evidence of a correct section of T3 ganglia. As such, we recommend LDF as a useful intraoperative tool when dealing with dorsal sympathicotomies for the treatment of palmar hyperhidrosis, both for the unexperienced surgeon and when the sympathetic chain is not clearly visualized.

Level of Evidence: Level IV, therapeutic study.

http://ift.tt/2jhElUk

Laser surface modification of decellularized extracellular cartilage matrix for cartilage tissue engineering

Abstract

The implantation of autologous cartilage as the gold standard operative procedure for the reconstruction of cartilage defects in the head and neck region unfortunately implicates a variety of negative effects at the donor site. Tissue-engineered cartilage appears to be a promising alternative. However, due to the complex requirements, the optimal material is yet to be determined. As demonstrated previously, decellularized porcine cartilage (DECM) might be a good option to engineer vital cartilage. As the dense structure of DECM limits cellular infiltration, we investigated surface modifications of the scaffolds by carbon dioxide (CO₂) and Er:YAG laser application to facilitate the migration of chondrocytes inside the scaffold. After laser treatment, the scaffolds were seeded with human nasal septal chondrocytes and analyzed with respect to cell migration and formation of new extracellular matrix proteins. Histology, immunohistochemistry, SEM, and TEM examination revealed an increase of the scaffolds' surface area with proliferation of cell numbers on the scaffolds for both laser types. The lack of cytotoxic effects was demonstrated by standard cytotoxicity testing. However, a thermal denaturation area seemed to hinder the migration of the chondrocytes inside the scaffolds, even more so after CO₂ laser treatment. Therefore, the Er:YAG laser seemed to be better suitable. Further modifications of the laser adjustments or the use of alternative laser systems might be advantageous for surface enlargement and to facilitate migration of chondrocytes into the scaffold in one step.

http://ift.tt/2AZM7gh

Dynamics of HPV viral loads reflect the treatment effect of photodynamic therapy in genital warts

Publication date: March 2018
Source:Photodiagnosis and Photodynamic Therapy, Volume 21
Author(s): Zhili Hu, Lishi Liu, Wenjing Zhang, Hui Liu, Junpeng Li, Lifen Jiang, Kang Zeng
BackgroundPhotodynamic therapy (PDT) has demonstrated good clinical cure rates and low recurrence rates in the treatment of genital warts. Human papillomavirus (HPV) genotypes and viral load assays can reflect the status of persistent or latent infection and serve as a predictor of infection clearance.MethodsSpecimens from 41 patients with HPV infection were obtained, and the HPV genotypes and viral load were analyzed using real-time polymerase chain reaction (PCR) assays. Traditional treatment, such as radiofrequency, microwave, or surgical therapy, was used to remove the visible lesions, and then PDT treatment was performed every week. HPV DNA testing was performed at every patient visit and the frequency of PDT treatment was determined by changes in HPV viral loads.ResultsHPV viral loads decreased significantly after PDT treatment. There were significant differences in HPV viral loads between pretherapy and three or six rounds of PDT treatment. Significant differences were also observed between single and multiple type HPV infection after six rounds of PDT treatment. Patients with single type HPV infection had significantly higher rates of negative HPV DNA test results, as compared with patients with multiple infections after six rounds of PDT treatment; however, there was no difference in recurrence rates between the two groups.ConclusionsDynamic monitoring of HPV genotypes and viral loads can be used to guide PDT treatment and indicate PDT treatment efficacy in eliminating HPV.



http://ift.tt/2A8pean

Editorial Board

Publication date: December 2017
Source:Photodiagnosis and Photodynamic Therapy, Volume 20





http://ift.tt/2AZp05m

Photochemical internalization (PCI) of bleomycin is equally effective in two dissimilar leiomyosarcoma xenografts in athymic mice

Publication date: December 2017
Source:Photodiagnosis and Photodynamic Therapy, Volume 20
Author(s): Simen Sellevold, Qian Peng, Ane Sofie Viset Fremstedal, Kristian Berg
BackgroundPhotochemical internalization (PCI) is a novel technique for delivery of active macromolecules into cancerous cells, via light activation of a specific photosensitizer and a low dose systemic drug. Numerous pre-clinical studies and one clinical trial have confirmed the treatment potential in carcinomas. Soft tissue sarcomas are rare and generally resistant to radio- and chemotherapy. Due to treatment resistance and surgical morbidity in sarcoma care, we seek to increase knowledge on PCI effects in sarcomas by studying two different, but closely related leiomyosarcomas.MethodsMES-SA and SK-LMS-1 tumours were established in the leg muscles of athymic mice. Treatment effects after AlPcS2a-PCI of bleomycin, PCI with no drug (photodynamic therapy, PDT) and control groups were evaluated by: 1) assessment of tumour growth, 2) uptake of contrast agent during MRI and 3) histopathology.ResultsPCI of bleomycin induced a similar and significant increase in time to reach the end point in both tumour models, while neither responded to AlPcS2a-PDT. In the MES-SA tumours PCI reduced the growth rate, while in the SK-LMS-1 tumours the growth was blocked for 12days followed by exponential growth close to that of untreated tumours. SK-LMS-1 tumours were more homogenously and better vascularized than MES-SA. After PCI the vascular shutdown was more complete in the SK-LMS-1 tumours than in the MES-SA tumours.ConclusionsAlPcS2a-based PCI, but not PDT, induced significant tumour growth delay in the evaluated sarcomas. Cellular responsiveness to bleomycin and tumour vascularity are identified as predictive markers for PCI treatment effects.



http://ift.tt/2A90MWg

Gene expression profiling of fimA gene encoding fimbriae among clinical isolates of Porphyromonas gingivalis in response to photo-activated disinfection therapy

Publication date: December 2017
Source:Photodiagnosis and Photodynamic Therapy, Volume 20
Author(s): Maryam Pourhajibagher, Abbas Bahador
BackgroundThe endodontic disinfection therapy majorly aims to eradicate microbial pathogens. Photo-activated disinfection (PAD), also known as antimicrobial photodynamic therapy, is an alternative antimicrobial modality used to control the microorganisms causing endodontic infections. Notably, microorganisms may be exposed to sub-lethal doses of PAD (sPAD), influencing microbial virulence. The present study assessed the effects of sPAD on expression profiling of the gene associated with the biofilm formation being the most essential virulence factor in Porphyromonas gingivalis strain cells that survive the photodynamic reatment in vivo.Materialas and methodsSixteen clinical strains of PAD resistant P. gingivalis that were isolated in vivo, were further photosensitized in vitro with toluidine blue O (TBO), methylene blue (MB), and indocyanine green (ICG) as the photosensitizing agents, which were excited with specific wavelength of light based on the photosensitizer. After evaluating sPAD, its effects on the fimA gene expression were assessed using real-time quantitative reverse transcription PCR (qRT-PCR).ResultsIn this study, maximum values of sPAD against P. gingivalis were 6.25μg/mL TBO at a fluency of 171.87J/cm², 15.6μg/mL ICG at fluency of 15.6J/cm², and 25μg/mL MB at fluency of 93.75J/cm². MB-, TBO-, and ICG-sPAD could cause about 4.6-, 14.4-, and 17.3-fold suppression of fimA expression, respectively. P. gingivalis strains expressed less virulence in cells surviving PAD.ConclusionsIn conclusion, the gene expression profiling was reduced in the bacterial cells, wherein greater reduction was observed for ICG-sPAD than TBO- and MB-sPAD.



http://ift.tt/2A9pMgj

Clinical predictors for satisfaction with incus vibroplasty: a preliminary study

Abstract

Objective

We aimed to evaluate the subjective satisfaction after incus vibroplasty and to determine predictive factors affecting patient satisfaction in sensorineural hearing loss.

Design

A retrospective review of audiological data and an additional survey about subjective satisfaction after surgery were performed in 14 patients who underwent incus vibroplasty surgery. A numeric rating scale reflecting the degree of satisfaction after incus vibroplasty, compared with experiences using a conventional hearing aid, was used. Patients who showed median or better satisfaction were deemed the highly satisfied (HS) group, and the others were deemed the less satisfied (LS) group. To find the predictive factors correlated with satisfaction for incus vibroplasty, comparative analysis between two groups was performed.

Results

We found that the numeric rating scale for satisfaction was variable, ranged from 0 to 10, and was negatively correlated with age at operation (p < 0.01). The HS group had a younger age (27.6 ± 22.2 years) and better preoperative air conduction threshold at 250 Hz (20.7 ± 7.9 dB) than the LS group (68.0 ± 9.7 years, 32.1 ± 10.7 dB). The LS group (13.6 ± 9.9 dB) showed a larger change of air–bone gap after surgery than the HS group (5.7 ± 6.7 dB) at 250 Hz (p = 0.12).

Conclusions

Age at operation and the preoperative air conduction threshold level at 250 Hz appear to be potential predictive factors for subjective satisfaction with incus vibroplasty. Furthermore, more conservative selection of candidates and caution during surgery, considering inevitable air–bone gap development postoperatively, may be necessary to achieve higher satisfaction for incus vibroplasty.

http://ift.tt/2jfmEVz

Elevated parathyroid hormone levels after successful parathyroidectomy for primary hyperparathyroidism: a clinical review

Abstract

Introduction

Surgery for primary hyperparathyroidism (PHPT) is traditionally deemed to be successful if serum calcium levels return to normal 6 months after parathyroidectomy. Regular monitoring of serum calcium and parathyroid hormone (PTH) in the follow-up of patients after parathyroidectomy for PHPT has drawn attention to the presence of a normocalcemic group of patients with elevated PTH (NCePTH) during the post-operative period. The etiological factors and mechanisms underlying this condition, its consequences, and the possibility of treatment are the object of this study.

Materials and methods

We conducted an unlimited PubMed search updated on March 31, 2017, which yielded 1628 results. We selected 37 articles, 33 of which included cases of NCePTH in their series and 23 performed statistical studies to assess factors associated with NCePTH.

Results

The maximum mean prevalence of NCePTH in the various series was 23.5%, ranging from 3 to 46%. Many factors were associated with NCePTH. The most important were higher pre-operative PTH, low pre-operative 25 (OH) D3, lower pre-operative creatinine clearance and greater adenoma weight. The origin of NCePTH may be multifactorial, since several factors were implicated in the etiology. NCePTH does not seem to be related to an increase in PHPT recurrence, although this possibility should not be dismissed. Vitamin D deficiency should be corrected. Treatment with calcium supplements seems to be clearly beneficial.

Conclusion

The prevalence of NCePTH is high. The causes of secondary hyperparathyroidism should be investigated carefully. Patients require treatment and long-term follow-up.

http://ift.tt/2BBGHEp

Clinical predictors for satisfaction with incus vibroplasty: a preliminary study

Abstract

Objective

We aimed to evaluate the subjective satisfaction after incus vibroplasty and to determine predictive factors affecting patient satisfaction in sensorineural hearing loss.

Design

A retrospective review of audiological data and an additional survey about subjective satisfaction after surgery were performed in 14 patients who underwent incus vibroplasty surgery. A numeric rating scale reflecting the degree of satisfaction after incus vibroplasty, compared with experiences using a conventional hearing aid, was used. Patients who showed median or better satisfaction were deemed the highly satisfied (HS) group, and the others were deemed the less satisfied (LS) group. To find the predictive factors correlated with satisfaction for incus vibroplasty, comparative analysis between two groups was performed.

Results

We found that the numeric rating scale for satisfaction was variable, ranged from 0 to 10, and was negatively correlated with age at operation (p < 0.01). The HS group had a younger age (27.6 ± 22.2 years) and better preoperative air conduction threshold at 250 Hz (20.7 ± 7.9 dB) than the LS group (68.0 ± 9.7 years, 32.1 ± 10.7 dB). The LS group (13.6 ± 9.9 dB) showed a larger change of air–bone gap after surgery than the HS group (5.7 ± 6.7 dB) at 250 Hz (p = 0.12).

Conclusions

Age at operation and the preoperative air conduction threshold level at 250 Hz appear to be potential predictive factors for subjective satisfaction with incus vibroplasty. Furthermore, more conservative selection of candidates and caution during surgery, considering inevitable air–bone gap development postoperatively, may be necessary to achieve higher satisfaction for incus vibroplasty.

http://ift.tt/2jfmEVz

Elevated parathyroid hormone levels after successful parathyroidectomy for primary hyperparathyroidism: a clinical review

Abstract

Introduction

Surgery for primary hyperparathyroidism (PHPT) is traditionally deemed to be successful if serum calcium levels return to normal 6 months after parathyroidectomy. Regular monitoring of serum calcium and parathyroid hormone (PTH) in the follow-up of patients after parathyroidectomy for PHPT has drawn attention to the presence of a normocalcemic group of patients with elevated PTH (NCePTH) during the post-operative period. The etiological factors and mechanisms underlying this condition, its consequences, and the possibility of treatment are the object of this study.

Materials and methods

We conducted an unlimited PubMed search updated on March 31, 2017, which yielded 1628 results. We selected 37 articles, 33 of which included cases of NCePTH in their series and 23 performed statistical studies to assess factors associated with NCePTH.

Results

The maximum mean prevalence of NCePTH in the various series was 23.5%, ranging from 3 to 46%. Many factors were associated with NCePTH. The most important were higher pre-operative PTH, low pre-operative 25 (OH) D3, lower pre-operative creatinine clearance and greater adenoma weight. The origin of NCePTH may be multifactorial, since several factors were implicated in the etiology. NCePTH does not seem to be related to an increase in PHPT recurrence, although this possibility should not be dismissed. Vitamin D deficiency should be corrected. Treatment with calcium supplements seems to be clearly beneficial.

Conclusion

The prevalence of NCePTH is high. The causes of secondary hyperparathyroidism should be investigated carefully. Patients require treatment and long-term follow-up.

http://ift.tt/2BBGHEp

3D endoscopic ear surgery: a clinical pilot study

Abstract

Objective

To evaluate the feasibility and efficacy of a new high-resolution 3D endoscope in endoscopic ear and lateral skull base surgery.

Methods

Eight patients, five women and three men, were included in this clinical pilot prospective study. Their age was 38 ± 17.3 years (mean ± SD, range 17–54 years). The right side was involved in five cases, and the left side in three cases. There were three cases of chronic otitis, one case of cholesteatoma of the external auditory canal, one case of otosclerosis, one case of cochlear implant surgery, and two cases of stage 2 vestibular schwannoma operated on with a retrosigmoid approach to preserve hearing.

Results

There were no intraoperative or postoperative complications. The new system was used during all procedures without the necessity to switch to a 2D mode. The surgeons felt comfortable using the system and its major advantages were considered to be in measuring the distances for ossicular chain reconstruction and in the sense of depth provided in the middle ear and cerebellopontine angle.

Conclusion

The sense of depth provided by the 3D system is effective in both middle ear and lateral skull base surgery. Further improvements (smaller and/or more angled endoscopes) should be considered for future developments in endoscopic ear surgery.

http://ift.tt/2BA4nsP

Reply

Cowan et al1 bring up a number of important points regarding our findings2 and the potential use of immunoglobulin replacement therapy (IGRT) for patients with chronic obstructive pulmonary disease (COPD).

http://ift.tt/2iq2Fmq

Chronic obstructive pulmonary disease exacerbation frequency and serum IgG levels

We compliment Leitao Filho et al1 for their recent publication titled "Serum immunoglobulin G and risk of exacerbations and hospitalizations in chronic obstructive pulmonary disease." Leitao Filho et al1 make a novel contribution to the understanding of the relationship between baseline serum IgG levels and the frequent chronic obstructive pulmonary disease (COPD) exacerbator phenotype.

http://ift.tt/2jUlfTP

Schluckbeschwerden bei einer Patientin mit postcricoidaler Raumforderung

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-121342

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

http://ift.tt/2ji7aQM

The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions

Purpose

This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.

Method

Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.

Results

By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.

Conclusions

Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and "switch-on." There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.

http://article/doi/10.1044/2017_AJA-17-0027/2665918/The-First-Step-to-Early-Intervention-Following

Factors Associated With Depression in Patients With Tinnitus and Hyperacusis

Purpose

The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.

Method

Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.

Results

One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.

Conclusion

Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.

http://article/doi/10.1044/2017_AJA-17-0008/2665914/Factors-Associated-With-Depression-in-Patients