Source apportionment of soil-contamination in Baotou City (North China) based on a combined magnetic and geochemical approach

Publication date: 15 November 2018
Source:Science of The Total Environment, Volume 642
Author(s): Bo Wang, Dunsheng Xia, Ye Yu, Hong Chen, Jia Jia
We studied the magnetic properties and trace element concentrations (Cr, Cu, Fe, Mn, Pb, Ti, V, Zn) of urban topsoils from 111 urban sites in a large REE-Nb-Fe mining and smelting city, Baotou, Inner Mongolia, China. The results show that pseudo-single domain and multi-domain magnetite dominates the magnetic properties of the soil samples, and the magnetic concentration parameters show a large positive anomaly near the Baotou iron and steel works. The average contents of all trace metals exceeded their background level in soils in Inner Mongolia, except for Pb. The spatial distribution and correlation analysis show that magnetic parameters related to the magnetite concentration and Cr, Fe, Mn, Ti, V and Zn show similar trends of variation. In addition, the results of PCA show that Fe, Ti, and V are highly correlated with the magnetic particles derived from the Baotou iron and steel works, tailing dam, chromium plant, and cement plant. In contrast, Cr, Mn, Pb and Zn are derived from both the steel plant and traffic pollution. Using a PMF model, three potential pollution sources are identified: industrial pollution, including the steel works, tailing dam, cement plant and chromium plant, are reflected by χlf, χARM, SIRM and SOFT, and they account for 71.2%; traffic pollution is reflected by Pb and Zn and accounts for 9.0%; and natural sources, reflected by χfd%, χARM/χ, χARM/SIRM, HARD%, S−300, S−100 and Ti, contribute 19.8%. The results are potentially useful for developing control measures for reducing trace metal contamination in soils in Baotou city, and in addition we conclude that a combined magnetic approach and geochemical approach is an effective means for qualitative and quantitative sources apportionment of urban surface soil pollution.

Graphical abstract

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Perineural Low-Dose Dexamethasone Prolongs Interscalene Block Analgesia With Bupivacaine Compared With Systemic Dexamethasone: A Randomized Trial

Background and Objectives Perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration. The effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater. This triple-blind, randomized trial examined the effect of 1 mg IV versus perineural dexamethasone on interscalene block (ISB) analgesia duration. Methods Patients undergoing ambulatory shoulder arthroscopy received an ultrasound-guided ISB with 15 mL bupivacaine 0.5% and 1 mg preservative-free dexamethasone that was administered perineurally (PeriD) or IV (IVDex). All patients received IV ketorolac and were discharged on naproxen 500 mg 2 times a day plus oxycodone/acetaminophen as needed. Peripheral nerve block duration, pain, opioid consumption, and block satisfaction were assessed via telephone follow-ups. Results There were 63 PeriD patients and 62 IVDex patients who completed the primary outcome follow-up. The median time until analgesia from the ISB completely wore off was 3.5 hours (95% confidence interval, 1.0–6.0 hours) longer in the PeriD versus IVDex groups; P = 0.007). Time until the pain relief from the ISB began to wear off was also longer in the PeriD versus IVDex group (5.5 hours [95% confidence interval, 2.1–9.0 hours]; P = 0.002). Other secondary outcomes, including opioid consumption, satisfaction, and pain scores, were not different between groups. Conclusions In patients undergoing shoulder arthroscopy, low-dose perineural dexamethasone (1 mg) in combination with 15 mL of 0.5% bupivacaine prolonged the median time until pain relief from the ISB completely wore off compared with 1 mg IV dexamethasone. However, the degree of prolongation was smaller than the a priori–defined minimal clinically meaningful difference of 5 hours. Clinical Trial Registration This study was registered at Clinicaltrials.gov, identifier NCT02506660. Accepted for publication February 12, 2018. Address correspondence to: Richard L. Kahn, MD, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 (e-mail: KahnR@HSS.edu). This study was funded by East River Medical Associates and the Research and Education Fund, Anesthesiology Department, Hospital for Special Surgery, New York, NY. REDCap use was supported by the National Center for Advancing Translational Science of the National Institutes of Health (UL1TR000457). This was presented in part at the Society for Ambulatory Anesthesia 32nd Annual Meeting (May 4–6, 2017) in Scottsdale, AZ. The authors declare no conflict of interest. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.

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The association between autologous breast reconstruction and body mass index in breast oncology

No abstract available

https://ift.tt/2sKmgmG

Reply to Letter to the Editor by Dr. Innocenti et al. on our paper the Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

https://ift.tt/2HzHjgw

Reply: The association between autologous breast reconstruction and body mass index in breast oncology

No abstract available

https://ift.tt/2sKYRl5

Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

https://ift.tt/2HzHg4k

Prepectoral Breast Reconstruction

No abstract available

https://ift.tt/2sLVcU0

The Differential Use of Bilobed and Trilobed Transposition Flaps in Cutaneous Nasal Reconstructive Surgery

Background: Bilobed and trilobed transposition flaps are versatile random pattern transposition flaps which reliably restore nasal symmetry, topography, light reflex, contour and are frequently used in cutaneous nasal reconstructive surgery. We wish to compare the characteristics of bilobed and trilobed flaps in cutaneous reconstructive surgery and to identify scenarios for their differential use. Methods: A retrospective chart review over 7 years of consecutive patients reconstructed with a bilobed or trilobed flap after Mohs micrographic surgery was performed. Statistical analysis of patient and surgery characteristics, anatomic distribution, postprocedural events and need for revisions after both flap types was conducted. Results: One hundred eleven patients with bilobed flaps and 74 patients with trilobed flaps were identified. Bilobed flaps are significantly more frequently used on the inferior nasal dorsum and on the sidewall whereas trilobed flaps are significantly more frequently used on the nasal tip and infratip. No significant difference in postprocedural events (complications, erythema, trapdoor, etc) was noted between the two flap types. Conclusion: Bilobed and trilobed transposition flaps are versatile repairs for nasal reconstruction. Trilobed flaps may be used to repair defects in a more distal nasal location than bilobed flaps. Regardless of flap type, complications are rare. Conflicts of interest: none declared Funding sources: none Presented at: American College of Mohs Surgeons Annual Meeting 2017 in San Francisco, CA Corresponding author/Reprint requests: Nathaniel J. Jellinek, MD, 1672 South County Trail, Suite 101, East Greenwich, RI, 02818, (401)-885-6647 (phone), (401)-885-6639 (fax), email: winenut15@yahoo.com ©2018American Society of Plastic Surgeons

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A simple dynamic strategy to deliver stem cells to decellularized nerve allografts

Background: The addition of adipose-derived Mesenchymal Stromal Cells (MSCs) to decellularized nerve allografts may improve outcomes of nerve reconstruction. Prior techniques used for cell seeding are traumatic to both the MSCs and nerve graft. An adequate, reliable and validated cell seeding technique is an essential step for evaluating the translational utility of MSC-enhanced decellularized nerve grafts. The purpose of this study was to develop a simple seeding strategy with an optimal seeding duration. Methods: A dynamic bioreactor was used to seed rat and human MSCs separately onto rat and human decellularized nerve allografts. Cell viability was evaluated by MTS assays and cellular topology after seeding was determined by SEM microscopy. Cell density and distribution were determined by LIVE/DEAD assays and Hoechst staining at 4 different time points (6, 12, 24 and 72 hours). The validity and reliability of the seeding method were calculated. Results: Cells remained viable at all time points, and MSCs exhibited exponential growth in the first 12 hours of seeding. Seeding efficiency increased significantly from 79.5% at 6 hours to 89.2% after 12 hours of seeding (p = 0.004). Both intra-rater (r = 0.97) and inter-rater reliability (r = 0.92) of the technique were high. Conclusions: This study describes and validates a new method to effectively seed decellularized nerve allografts with MSCs. This method is reproducible, distributes cells homogenously over the graft and does not traumatize the intra-neural architecture of the allograft. Utilization of this validated seeding technique will permit critical comparison of graft outcomes. Financial Disclosure Statement: Funding for this study was received from the Mayo Clinic Center for Regenerative Medicine Acknowledgements: We thank the American Donor Services for providing fresh human cadaveric motor nerves. We also thank Drs. Anthony Windebank, Allan Dietz, Amel Dudakovic and Roman Thaler for their expertise and guidance. Presentations: Part of this work was presented at the Annual Meeting of the American Society for Peripheral Nerve, Hawaii, United States, January 13th, 2017. Author Contributions: Nadia Rbia: contributed to the conception, analysis, interpretation of the data, as well as drafting of the manuscript for submission.Liselotte F. Bulstra: contributed to the conception, analysis, interpretation of the data, as well as the drafting of the manuscript for submission. Allen T. Bishop: contributed to the conception and interpretation of data, as well as edited the manuscript. Andre J. van Wijnen: contributed to the conception and interpretation of data, as well as edited the manuscript. Alexander Y. Shin: contributed to the conception and interpretation of data, as well as the acquisition of funding and editing of this manuscript. Corresponding Author: Alexander Y. Shin, M.D., Professor of Orthopedic Surgery, Professor of Neurosurgery, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, Phone: 507-284-0475, Email: shin.alexander@mayo.edu. ©2018American Society of Plastic Surgeons

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Comparison of the microstructures and properties of different microcannulas for HA injection

BACKGROUND: Microcannulas are used for hyaluronic acid and other fillers injection and reduce the side effects and complications. There are several microcannulas manufactured by different manufacturers but the differences between microcannulas haven't been carefully investigated. OBJECTIVE: To compare the microstructures and properties of different microcannulas by several trials and provide guidance for clinical application. METHODS: In this study, 9 kinds of microcannulas, from different manufacturers were chose. Scanning electron microscope(SEM) was used to obtain high-definition image of microstructures, chemical composition analyzers were used to test the chemical composition for the microcannulas' tips and universal testing machine was used to measure mechanical properties. Injection speed test recorded the time spent for the weight pushed hyaluronic acid out during different microcannulas. Vessel piercing force test was conducted to simulate the process of puncturing the vessels in vitro. RESULTS: The SEM images showed the differences in the tips and inner surfaces which may relate to the characteristics. Most microcannulas' chemical composition met the American Society for Testing Material(ASTM) standards basically. For mechanical properties, the elastic modulus and the yield strength were obviously different. The injection speed test showed the speed of difference microcannulas through same force was discrepant more than 7 times. The vessel piercing test showed which microcannula was most difficult to puncture the aorta and which was the easiest. CONCLUSION: The results indicated there are significant differences between different microcannulas. The differences are instructive to physician to select suitable microcannulas to improve the injection effect and reduce discomfort and complications. Financial disclosure: The authors have no financial interest to declare in relation to the content of this article. Acknowledgement: none Corresponding author: Wang Hang, Sichuan Univ, West China Sch Stomatol, Dept Oral & Maxillofacial Surg, 14,3rd Sect,RenMin Nan Rd, Chengdu 610041, Peoples R China. Tel: +86 13980888813, E-mail:dr.hangwang@hotmail.com ©2018American Society of Plastic Surgeons

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“Oncological Resection and Reconstruction of the Chest Wall –19 year experience in a single center”

OBJECTIVE: The study aim was to analyse chest wall reconstruction following oncological resection by a single surgeon over an 19 year period. METHODS: A retrospective review was performed for 135 patients who underwent oncological chest wall resection during 1997-2015. RESULTS: Average patient age was 57.8 years. Indications for resection were: advanced breast cancer n=44, soft tissue sarcoma n=38, bone or chondrosarcoma n=28, desmoid tumour n=11, metastasis from other cancers n=7, and other primary tumours n=7. There were 72 full-thickness and 63 partial-thickness resections (34 soft tissue resections only and 29 skeletal bone resections only). Resection margins were wide n=29, marginal n=82 and intralesional n=24. Reconstruction was warranted in 118 cases: chest wall stabilization and flap coverage n=57, chest wall stabilization only n=36 and soft tissue flap coverage only n=25. In total, 82 flaps were performed (17 free flaps and 65 pedicled/local flaps). There were no perioperative mortalities nor flap losses. Complications occurred in 29 operations (Clavien-Dindo classifications grII 12, grIIIa 4, grIIIb 10, grIVa 3) and 19 re-operations were necessary. Median follow-up was 49 months. Survival was calculated by the Kaplan and Meier Method. One- year, 2-year and 5-year survival rates were 84%, 82% and 70%, respectively. CONCLUSION: With careful patient selection, appropriate peri- and postoperative care and accurate surgical technique, even extensive chest wall resections and reconstructions are safe. Financial Disclosure Statement: Dr. Salo and Dr. Tukiainen had nothing to disclose. No funding was received for this article. Presented at (if applicable): EURAPS 2017 meeting, in Pisa, Italy Corresponding author: Juho T.K. Salo M.D., Department of Plastic Surgery, Töölö Hospital, PO Box 266, FIN 0029 HUS, Finland, email: juho.salo@hus.fi tel: + 358 50 428 4681 fax: + 358 9 471 87 217 ©2018American Society of Plastic Surgeons

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Anatomical Understanding of Target Subcutaneous Tissue Layer for Thinning Procedures in TDAP, SCIP and ALT Perforator Flaps

Background: Thinned perforator flaps, reported techniques and degree of thinning differ by study. This study investigated the anatomy of subcutaneous tissue according to the varying fattiness and identified which component and how much of the subcutaneous tissue layer needed to be excluded to meet target flap thickness using computed tomography(CT). Methods: Three stratified fattiness groups consisting of 30 donors were made for TDAP, SCIP and ALT flaps. The thickness of the superficial fat layer (SFL) and the deep fat layer (DFL) were measured at 3 points in TDAP, 2 points in SCIP and 3 points in ALT flaps, and the proportion of SFL and DFL to exclude to reach target flap thickness (4, 6, and 8mm) was calculated. Result: The median proportion for SFL ranged from 54.8% to 75.2% for TDAP, 62.1% to 72.7% for SCIP and 48.7% to 69.1% for ALT depending on donor fattiness. The estimated % reduction of thickness after thin flap elevation along superficial fascia was approximately one third of the whole layer. A variable proportion of SFL and DFL needs to be excluded to obtain required thinness and in very thick groups, part of the SFL must be removed to reach any of the target thicknesses for three flaps. Conclusion: The present study demonstrated the frequent need for SFL manipulation when obtaining a thin perforator flap. To cope with various combinations of donor site fattiness and different required thicknesses effectively, an appropriate thinning method should have increased adaptability, including the ability to control SFL thickness. Financial Disclosure: None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author Contact Information: Dr. Goo-Hyun Mun, M.D., Ph.D. Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, S. Korea, 06351 Tel.: 82-2-3410-2233/Fax: 82-2-3410-0036/E-mail: supramicro@gmail.com ©2018American Society of Plastic Surgeons

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SIMULTANEOUS LOWER BODY LIFT AND GLUTEAL IMPLANTS: SEVERE COMPLICATIONS RELATED TO THE SAME INCISIONAL APPROACH

No abstract available

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Prepectoral Breast Reconstruction.

No abstract available

https://ift.tt/2LERKBL

Editorial Board

Publication date: July 2018
Source:Acta Histochemica, Volume 120, Issue 5





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Changes in mucins and matrix metalloproteases in the endometrium of early pregnant alpacas (Vicugna pacos)

Publication date: July 2018
Source:Acta Histochemica, Volume 120, Issue 5
Author(s): Daniela E. Barraza, Renato Zampini, Silvana A. Apichela, Joel I. Pacheco, Martin E. Argañaraz
South American Camelids (SAC) have unique reproductive features, one of which is that 98% of the pregnancies develop in the left uterine horn. Furthermore, early pregnancy is an uncharacterized process in these species, especially in regard to the ultrastructural, biochemical and genetic changes that the uterine epithelial surface undergoes to allow embryo implantation. The present study describes the uterine horn luminal surface and the characteristics of the mucinous glycocalyx in non-pregnant and early pregnant (15 days) female alpacas. In addition, the relative abundance of Mucin 1 and 16 genes (MUC1 and MUC16) was determined, as well as the relative mRNA abundance of matrix metalloproteinases (MMPs) that could be involved in MUC shedding during early pregnancy. Noticeable changes were detected in the uterine luminal epithelium and glycocalyx of pregnant alpacas in comparison to non-pregnant ones, as well as presence of MUCs and MMPs in the endometrial environment. The decrease in glycocalyx staining and in the relative abundance of MUC 1 and MUC 16 transcripts in pregnant females would allow embryo attachment to the luminal epithelium and its subsequent implantation, as has been described in other mammals. These results suggest a crucial role of MUC1 and MUC16 and a possible role of MMPs in successful embryo implantation and survival in alpacas.



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Anatomical, histological and immunohistochemical study of testicular development in Columba livia (Aves: Columbiformes)

Publication date: July 2018
Source:Acta Histochemica, Volume 120, Issue 5
Author(s): G.B. Olea, M.V. Aguirre, D.M. Lombardo
In this work, testicular ontogeny is analyzed at the anatomical, histological and immunohistochemical levels; the latter through the detection of GnRHR and PCNA in the testicles of embryos, neonates and juveniles of Columba livia. We analyzed 150 embryos, 25 neonates and 5 juveniles by means of observations under a stereoscopic magnifying glass and scanning electron microscope (SEM). The histological analysis was performed using hematoxylin-eosin staining techniques and the PAS reaction. For the immunohistochemical analysis, the expression of GnRHR and PCNA in embryos corresponding to stages 41, 43 and in neonates of 2, 5, 7 and 75 days post-hatch was revealed in testicular histological preparations. That gonadal outline is evident in stage 18. In stage 29, the testes are constituted of a medulla in which the PGCs are surrounded by the Sertoli cells, constituting the seminiferous tubules. From stage 37 a greater organization of the tubules is visualized and at the time of hatching the testicle is constituted of the closed seminiferous tubules, formed of the PGCs and Sertoli cells. The Leydig cells are evident outside the tubules. In the juvenile stages, the differentiation of germline cells and the organization of small vessels that irrigate the developing testicle begin to be visible. In the analyzed stages, the immunodetection of the GnRHR receptor and PCNA revealed specific marking in the plasma membrane and in the perinuclear zone for GnRHR and in the nucleus of the germline cells in juvenile testicles for PCNA. These results can be used as a basis for further study of endocrine regulation events during testicular ontogeny in avian species.



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Second primary malignancies after high-dose-rate 60Co photon or 252Cf neutron brachytherapy in conjunction with external-beam radiotherapy for endometrial cancer

Publication date: Available online 9 June 2018
Source:Brachytherapy
Author(s): Ernestas Janulionis, Vitalija Samerdokiene, Konstantinas Povilas Valuckas, Vydmantas Atkocius, Mark J. Rivard
PurposeSecond primary malignancies (SPMs) may occur in organs after radiotherapy (RT). This study aimed to determine the rate and distribution of SPMs for photon- or neutron-emitting radiotherapy sources for patients treated for primary endometrial cancer.Methods and MaterialsThe cohort comprised 426 patients with 5334 patient-years of observation. Patients were treated by different methods of RT from 1990 to 2000. Patients received postoperative ⁶⁰Co external-beam radiotherapy (43.4%), external-beam radiotherapy + high-dose-rate (HDR) intracavitary brachytherapy with ⁶⁰Co or ²⁵²Cf (42.3%), or HDR intracavitary brachytherapy alone with ⁶⁰Co or ²⁵²Cf (14.3%).ResultsOver a 25-year period, 47 SPMs were observed (21 for HDR ⁶⁰Co and 26 for HDR ²⁵²Cf). SPMs were observed for 13 patients in the high-intermediate risk group for each radiation source. Patients treated with ⁶⁰Co developed SPMs in the urinary tract (1.2%) and in lymphoid/hematopoietic tissues (1.2%). Only three SPM cases (0.7%) were observed in digestive tract. In comparison, the patient group treated with ²⁵²Cf developed SPMs in the digestive tract (1.4%) with the majority in the colon (1.2%), urinary tract (0.9%) primarily the kidneys, and vulva (0.7%). All other SPMs (4.9%) were in the low-risk group. Of these, SPMs in the skin were most prevalent (1.6%) for ⁶⁰Co, and breast (1.6%) for ²⁵²Cf, but believed to be caused by factors other than treatment. SPM incidence in the digestive and urinary tracts were similar (2.1%), regardless of radiation source.ConclusionsFor followup at 25 years, 47 SPMs were observed with no differences in the high-intermediate risk group depending on the RT source.



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The detection of brucellosis antibody in whole serum based on the low-fouling electrochemical immunosensor fabricated with magnetic Fe3O4@Au@PEG@HA nanoparticles

Publication date: 15 October 2018
Source:Biosensors and Bioelectronics, Volume 117
Author(s): Shuli Lv, Jinliang Sheng, Shiyi Zhao, Mingchao Liu, Lihua Chen
It is a novel competitive challenge for electrochemical biosensor to directly, rapidly and ultrasensitively detect the disease markers in the whole serum due to biofouling caused by the complexity of actual samples. In this paper, poly (ethylene glycol) (PEG) and hyaluronic acid (HA) were utilized to modify Fe3O4 @Au nanoparticles (NPs). Based on the successfully preparation and characterization of Fe3O4 @Au@PEG@HA NPs with TEM, SEM, XRD, FTIR and EDS, respectively, a novel immunosensor of brucellosis with high selectivity, sensitivity and almost perfect protein-resistant properties in various external environments, especially, in complex biological systems was fabricated. More importantly, this immunosensor is capable of assaying brucellosis antibody in 100% serum without suffering from any significant biological interference. In addition, a wide linear response range from 10^–15 g mL⁻¹ to 10^–11 g mL⁻¹ towards antibody in 100% serum and a low limit of detection (LOD) of 0.36 fg mL⁻¹ (3σ, n = 13) are demonstrated, which indicates that this immunosensor has a promising potential in clinical diagnosis.



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KRAS: Reasons for optimism in lung cancer

Publication date: August 2018
Source:European Journal of Cancer, Volume 99
Author(s): C.R. Lindsay, M. Jamal-Hanjani, M. Forster, F. Blackhall
Despite being the most frequent gain-of-function genetic alteration in human cancer, KRAS mutation has to date offered only limited potential as a prognostic and predictive biomarker. Results from the phase III SELECT-1 trial in non-small cell lung cancer (NSCLC) recently added to a number of historical and more contemporary disappointments in targeting KRAS mutant disease, including farnesyl transferase inhibition and synthetic lethality partners such as STK33. This narrative review uses the context of these previous failures to demonstrate how the knowledge gained from these experiences can be used as a platform for exciting advances in NSCLC on the horizon. It now seems clear that mutational subtype (most commonly G12C) of individual mutations is of greater relevance than the categorical evaluation of KRAS mutation presence or otherwise. A number of direct small molecules targeted to these subtypes are in development and have shown promising biological activity, with some in the late stages of preclinical validation.



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Harnessing immune history to combat influenza viruses

Jenna J Guthmiller | Patrick C Wilson

https://ift.tt/2JvMYpu

Independent effects of age and levodopa on reversal learning in healthy volunteers

Publication date: September 2018
Source:Neurobiology of Aging, Volume 69
Author(s): Andrew Vo, Ken N. Seergobin, Penny A. MacDonald
The dopamine overdose hypothesis has provided an important theoretical framework for understanding cognition in Parkinson's disease. It posits that effects of dopaminergic therapy on cognition in Parkinson's disease depend on baseline dopamine levels in brain regions that support different functions. Although functions performed by more severely dopamine-depleted brain regions improve with medication, those associated with less dopamine deficient areas are actually worsened. It is presumed that medication-related worsening of cognition owes to dopamine overdose. We investigated whether age-related changes in baseline dopamine levels would modulate effects of dopaminergic therapy on reward learning in healthy volunteers. In a double-blind, crossover design, healthy younger and older adults completed a probabilistic reversal learning task after treatment with 100/25 mg of levodopa/carbidopa versus placebo. Older adults learned more poorly than younger adults at baseline, being more likely to shift responses after misleading punishment. Levodopa worsened stimulus-reward learning relative to placebo to the same extent in both groups, irrespective of differences in baseline performance and expected dopamine levels. When order effects were eliminated, levodopa induced response shifts after reward more often than placebo. Our results reveal independent deleterious effects of age group and exogenous dopamine on reward learning, suggesting a more complex scenario than predicted by the dopamine overdose hypothesis.



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Functional networks underlying item and source memory: shared and distinct network components and age-related differences

Publication date: September 2018
Source:Neurobiology of Aging, Volume 69
Author(s): Zachary A. Monge, Matthew L. Stanley, Benjamin R. Geib, Simon W. Davis, Roberto Cabeza
Although the medial temporal lobes (MTLs) are critical for both item memory (IM) and source memory (SM), the lateral prefrontal cortex and posterior parietal cortex play a greater role during SM than IM. It is unclear, however, how these differences translate into shared and distinct IM versus SM network components and how these network components vary with age. Within a sample of younger adults (YAs; n = 15, Mage = 19.5 years) and older adults (OAs; n = 40, Mage = 68.6 years), we investigated the functional networks underlying IM and SM. Before functional MRI scanning, participants encoded nouns while making either pleasantness or size judgments. During functional MRI scanning, participants completed IM and SM retrieval tasks. We found that MTL nodes were similarly interconnected among each other during both IM and SM (shared network components) but maintained more intermodule connections during SM (distinct network components). Also, during SM, OAs (compared to YAs) had MTL nodes with more widespread connections. These findings provide a novel viewpoint on neural mechanism differences underlying IM versus SM in YAs and OAs.

Graphical abstract

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Editorial Board

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Data on modeling of nexus between entrepreneurs׳ commitment and business performance in a developing country

Publication date: August 2018
Source:Data in Brief, Volume 19
Author(s): Ayoade Omisade, Ogunnaike Olaleke, Adegbuyi Omotayo, Kehinde Oladele, Iyiola Oluwole, Lawal Fatai, Onakoya Femi
This article presents data that examined the modeling of nexus between entrepreneurs׳ commitment and business performance in a developing country. 315 copies of questionnaire were retrieved from 400 copies that were administered to Nigerian Association of Small Scale Industrialists (NASSI) Southwest chapters which comprised of six states. In addition to descriptive analysis of part of the data, correlation and regression analysis were used to present the data through structural equation model (SEM). The SEM path analysis shows the estimates of the interconnectedness of the major constructs in the data.



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Data regarding talent management practices and innovation performance of academic staff in a technology-driven private university

Publication date: August 2018
Source:Data in Brief, Volume 19
Author(s): Odunayo Salau, Adewale Osibanjo, Anthonia Adeniji, Olumuyiwa Oludayo, Hezekiah Falola, Ebeguki Igbinoba, Opeyemi Ogueyungbo
The article presented an integrated data on talent management practices and innovation performance of academic staff in a technology-driven private university in Nigeria. The study adopted a quantitative approach with a survey research design to establish the major determinants of talent management practices. The population of this study included academic staff and the use of questionnaire was adopted to elicit from the study population. Data was analysed with the use of structural equation modelling and the field data set is made widely accessible to enable critical or a more comprehensive investigation. The findings identified talent development and retention strategies as predictors for facilitating innovation performance in the sample University. It was recommended that management of the sampled university will consistently need to adopt reliable range of strategies to attract and retain people for excellence performance.



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Targeted inhibition of Axl receptor tyrosine kinase ameliorates anti-GBM-induced lupus-like nephritis

Publication date: Available online 9 June 2018
Source:Journal of Autoimmunity
Author(s): Yuxuan Zhen, Iris J. Lee, Fred D. Finkelman, Wen-Hai Shao
Glomerulonephritis (GN) is a typical lesion in autoantibody and immune complex disorders, including SLE. Because the Gas6/Axl pathway has been implicated in the pathogenesis of many types of GN, targeting this pathway might ameliorate GN. Consequently, we have studied the efficacy and mechanism of R428, a potent selective Axl inhibitor, in the prevention of experimental anti-GBM nephritis. Axl upregulation was investigated with Sp1/3 siRNA in the SV40-transformed mesangial cells. For Axl inhibition, a daily dose of R428 (125 mg/kg) or vehicle was administered orally. GN was induced with anti-GBM sera. Renal disease development was followed by serial blood urine nitrogen (BUN) determinations and by evaluation of kidney histology at the time of sacrifice. Axl-associated signaling proteins were analyzed by Western blotting and inflammatory cytokine secretion was analyzed by Proteome array. SiRNA data revealed the transcription factor Sp1 to be an important regulator of mesangial Axl expression. Anti-GBM serum induced severe nephritis with azotemia, protein casts and necrotic cell death. R428 treatment diminished renal Axl expression and improved kidney function, with significantly decreased BUN and glomerular proliferation. R428 treatment inhibited Axl and significantly decreased Akt phosphorylation and renal inflammatory cytokine and chemokine expression; similar effects were observed in anti-GBM antiserum-treated Axl-KO mice. These studies support a role for Axl inhibition in glomerulonephritis.



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Frequent HPV-independent p16/INK4A overexpression in head and neck cancer

Publication date: August 2018
Source:Oral Oncology, Volume 83
Author(s): Matt Lechner, Ankur R. Chakravarthy, Vonn Walter, Liam Masterson, Andrew Feber, Amrita Jay, Paul M. Weinberger, Richard A. McIndoe, Cillian T. Forde, Kerry Chester, Nicholas Kalavrezos, Paul O'Flynn, Martin Forster, Terry M. Jones, Francis M. Vaz, D. Neil Hayes, Tim R. Fenton
Objectivesp16^INK4A (p16) is the most widely used clinical biomarker for Human Papillomavirus (HPV) in head and neck squamous cell cancer (HNSCC). HPV is a favourable prognostic marker in HNSCC and is used for patient stratification. While p16 is a relatively accurate marker for HPV within the oropharynx, recent reports suggest it may be unsuitable for use in other HNSCC subsites, where a smaller proportion of tumors are HPV-driven.Materials and methodsWe integrated reverse phase protein array (RPPA) data for p16 with HPV status based on detection of viral transcripts by RNA-seq in a set of 210 HNSCCs profiled by The Cancer Genome Atlas project. Samples were queried for alterations in CDKN2A, and other pathway genes to investigate possible drivers of p16 expression.ResultsWhile p16 levels as measured by RPPA were significantly different by HPV status, there were multiple HPV (−) samples with similar expression levels of p16 to HPV (+) samples, particularly at non-oropharyngeal subsites. In many cases, p16 overexpression in HPV (−) tumors could not be explained by mutation or amplification of CDKN2A or by RB1 mutation. Instead, we observed enrichment for inactivating mutations in the histone H3 lysine 36 methyltransferase, NSD1 in HPV (−)/p16-high tumors.ConclusionsRPPA data suggest high p16 protein expression in many HPV (−) non-oropharyngeal HNSCCs, limiting its potential utility as an HPV biomarker outside of the oropharynx. HPV-independent overexpression of wild-type p16 in non-oropharyngeal HNSCC may be linked to global deregulation of chromatin state by inactivating mutations in NSD1.



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Transcriptional control of long-range cortical projections

Publication date: December 2018
Source:Current Opinion in Neurobiology, Volume 53
Author(s): Annalisa Paolino, Laura R Fenlon, Rodrigo Suárez, Linda J Richards
Long-range projection neurons of the neocortex form the major tracts of the mammalian brain and are crucial for sensory-motor, associative and executive functions. Development of such circuits involves neuronal proliferation, specification and migration, as well as axonal elongation, navigation and targeting, where growing axons encounter multiple guidance cues and integrate these signals to execute guidance decisions. The complexity of axon guidance mechanisms in the formation of long-range neuronal projections has suggested that they might be under control of transcription factors, which are DNA-binding proteins that regulate the expression of downstream genes. Here we discuss recent advances in our understanding of the control of axon guidance by transcriptional regulation, as well as future directions for the elucidation of the mechanisms and pathological relevance of this process.



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Does Virtual Reality Increase Emotional Engagement During Exposure for PTSD? Subjective Distress During Prolonged and Virtual Reality Exposure Therapy

Publication date: Available online 8 June 2018
Source:Journal of Anxiety Disorders
Author(s): Greg M. Reger, Derek Smolenski, Aaron Norr, Andrea Katz, Benjamin Buck, Barbara O. Rothbaum
Prolonged exposure (PE) is a treatment for posttraumatic stress disorder (PTSD) based on emotional processing theory. According to this theory, emotional engagement during imaginal exposure is critical to clinical outcome. One rationale for virtual reality exposure therapy (VRE) is the ability of trauma-relevant, multi-sensory stimuli to increase emotional engagement. This study compared the subjective distress of active duty soldiers (N = 108) during exposure via PE or VRE. Soldiers with higher mean or peak distress during the first imaginal exposure had higher baseline PTSD symptom severity. There was no difference between groups on average or peak distress during imaginal exposure at the first or final exposure session. There were no significant differences in between-session habituation observed between VRE and PE groups. However, each ten-point decrease in SUDS scores, either mean or peak, from the initiation of imaginal exposure to the end of treatment, was associated with a greater decrease in CAPS-W scores for both groups. There were no group differences in these trajectories or the magnitude of the association between distress/habituation, and PTSD symptoms. Future research on VRE should measure patient ratings of engagement during exposure to better understand which patients are aided by this innovative approach to treatment.



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Editorial Board

Publication date: July–August 2018
Source:Journal of Communication Disorders, Volume 74





https://ift.tt/2Jw4EkT

Feasibility of using computer simulation to predict the postoperative outcome of the minimally invasive Nuss procedure: Simulation prediction vs. postoperative clinical observation

The Nuss procedure is the most minimally invasive and commonly used surgical correction for pectus excavatum (PE) by using a pre-bent pectus bar to elevate the deformed chest wall. However, there exist some complications such as postoperative pain as well as surgical uncertainties due to human judgement. It is therefore important to understand the biomechanical effect of the pectus bar on PE thoraces undergoing an operation to alleviate the postoperative pain as well as to improve surgical outcome.

https://ift.tt/2JoZs6y

Should Planned/Desired Pregnancy be Considered an Absolute Contraindication to Breast Reconstruction with Free Abdominal Flaps? A Retrospective Case Series and Systematic Review

Autologous breast reconstruction is considered by many to be the gold standard reconstructive modality following mastectomy. Despite the advantages of autologous reconstruction, however, surgeons have been cautious in recommending this approach to patients who desire to becoming pregnant postoperatively due to concerns related to abdominal wall morbidity. While intuitive, this approach does not appear to be based on robust data. Hence, the authors examined the clinical outcome in patients who became pregnant following autologous breast reconstruction.

https://ift.tt/2HAZYbx

Long-Distance Care of Face Transplant Recipients in the United States

Promising aesthetic and functional outcomes in facial transplantation have fueled the interest of patients and providers alike. However, there are currently only 11 active face transplant centers in the United States, and only five have accumulated operative experience to date, resulting in an extremely unbalanced geographical distribution of providers. Since face transplant recipients must receive life-long follow-up, this presents unique challenges for face transplant candidates and provider teams, as long-distance travel may add considerable difficulty to pre- and post-transplant care.

https://ift.tt/2JoZnzM

“Immediate breast reconstruction with a Wise pattern mastectomy and NAC-sparing McKissock vertical bipedicle dermal flap”

Preservation of the nipple-areola complex (NAC) in immediate reconstruction of ptotic and large breasts is surgically challenging. This article presents a modification of the inferior dermal flap ("dermal sling") to a vertical bipedicle flap with NAC preservation. The flap is well described in breast reductions, but has never been described in a mastectomy setting. The study reviews data for a case series of 17 breasts in 11 women who were reconstructed with the new technique. The complication rate was 12 percent and the vertical bipedicle NAC-sparing flap has to be considered a feasible option in women with ptotic and/or large breasts.

https://ift.tt/2LE5Y5I

Risk factors for developing capsular contracture in women after breast implant surgery A systematic review of the literature

Capsular contracture is the most frequent complication in breast augmentation or reconstruction with breast implants. The exact mechanism for this complication is not completely understood. Yet, it is most likely to be a multifactorial condition. Several patient-, as well as surgery-, and implant-specific risk factors have been related to cause capsular contracture. This review aims to provide a clear overview of all risk factors for capsular contracture.

https://ift.tt/2JoZhbo

DONOR SKIN ALLOGRAFT SURVIVAL AFTER BONE MARROW TRANSPLANTATION: CASE REPORT AND SYSTEMATIC REVIEW OF THE LITERATURE

we present a case of skin allograft survival in a patient who previously received a bone marrow transplant from the same HLA-matched donor. DNA fingerprinting of skin biopsies showed mixed cellularity originating from the donor and recipient (68% and 32% donor DNA in the allograft skin and the native recipient's skin, respectively). Histologic sections demonstrated both grade 3/4 rejection and graft-versus-host- disease. We have conducted a systematic review in search for other cases of donor skin allograft survival after a bone marrow or hematopoietic stem cell transplantation.

https://ift.tt/2Hxx24p

Are facial injuries really different?

The article by Rahtz and colleagues concludes that appearance concern after facial injury may not lead either to stigma or to psychosocial burden.1 This is the conclusion that I reached this conclusion in an uncontrolled follow-up study of facial casualties of the First World War treated at the Cambridge Military Hospital, Aldershot and the Queen's Hospital, Sidcup (now Queen Mary's Hospital).

https://ift.tt/2JoZco6

A novel punch biopsy technique without scissors or forceps

https://ift.tt/2sVrB9U

Rituximab Treatment Of Pemphigus Foliaceus- A Retrospective Study Of 12 Patients

https://ift.tt/2Mc1uEF

Ocular abnormalities in congenital Zika syndrome: a case report, and review of the literature

As the number of children with Zika virus-related complications grows, the long-term developmental trajectory and its effects on families are unknown. We present the first known case of congenital Zika syndrom...

https://ift.tt/2kY94q7

Toward a new threshold for the P value?

Publication date: Available online 8 June 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): O. Laccourreye, H. Maisonneuve




https://ift.tt/2sJry1U

Surgical treatment of enterovirus D68 brainstem encephalitis-induced dysphagia

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Takafumi Togashi, Hironori Baba, Meiko Kitazawa, Nao Takahashi, Yasuhiro Samejima, Eiji Yumoto, Arata Horii
Cluster of acute flaccid paralysis and cranial nerve dysfunction was associated with a 2014 outbreak of enterovirus D68 (EV-D68) respiratory illness in US. We describe a 33 year-old male patient of refractory dysphagia due to EV-D68-induced brainstem encephalitis successfully treated by surgery. Following acute upper respiratory tract infection, he developed dysphagia and bilateral facial paralysis. A coughing reflex was readily produced when the laryngopharyngeal fiberscope touched the epiglottis, however, water infusion induced only very weak and slow swallowing reflex, suggesting that only motor component was impaired but sensory function was preserved during swallowing. Despite eight months-conservative rehabilitations, Food Intake Level Scale (FILS) remained level 4. Therefore, corrective surgeries including cricopharyngeal myotomy, laryngeal suspension, and pharyngeal flap were performed. Thirty-six days after surgery, FILS rapidly and dramatically improved to level 8. This is the first report describing a successful surgical intervention for EV-D68-induced refractory dysphagia. Surgical treatment was suitable for EV-D68-induced dysphagia, perhaps because sensory function was preserved and only motor disturbance was present during the pharyngeal stage of swallowing.



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Music enjoyment with cochlear implantation

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Charlotte Prevoteau, Stephanie Y. Chen, Anil K. Lalwani
Since the advent of cochlear implant (CI) surgery in the 1960s, there have been remarkable technological and surgical advances enabling excellent speech perception in quiet with many CI users able to use the telephone. However, many CI users struggle with music perception, particularly with the pitch-based and melodic elements of music. Yet remarkably, despite poor music perception, many CI users enjoy listening to music based on self-report questionnaires, and prospective studies have suggested a disassociation between music perception and enjoyment. Music enjoyment is arguably a more functional measure of one's listening experience, and thus enhancing one's listening experience is a worthy goal. Recent studies have shown that re-engineering music to reduce its complexity may enhance enjoyment in CI users and also delineate differences in musical preferences from normal hearing listeners.



https://ift.tt/2JpO3n1

Pyoderma gangrenosum on the nose

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Takuya Tomioka, Keiko Soma, Yoichiro Sato, Koshiro Miura, Ayako Endo
Pyoderma gangrenosum is a rare ulcerative condition associated with various systemic diseases. Lesions on the lower extremities and the trunk are common, but lesions on the nose are rare. Here we report a case of pyoderma gangrenosum on the nose. A 33-year-old woman presented with fever, nasal obstruction, and painful swelling on the nasal bridge. Physical examination revealed swellings on the nasal septal mucosa bilaterally. Computed tomography showed a septal abscess and a subcutaneous abscess on the nasal bridge. The lesions worsened despite treatment with intravenous antibiotics and abscess drainage. Meanwhile, the patient also complained of bloody stools and was diagnosed with ulcerative colitis. Therefore, pyoderma gangrenosum on the nose was suspected, and was diagnosed by exclusion of other diseases. Treatment with systemic corticosteroids was started and the nasal lesions improved rapidly. However, saddle nose deformity occurred. A review of the literature reveals that pyoderma gangrenosum on the nose can cause ulcerations, septal abscess, and sinusitis. Further, there is a high likelihood of nasal complications, including saddle nose deformity, septal perforation, and skin defects. Pyoderma gangrenosum should be included in the differential diagnosis when nasal ulceration, abscesses, and sinusitis do not improve with antibiotics and drainage.



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Surgical outcomes in the treatment of temporal bone cerebrospinal fluid leak: A systematic review

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Federico Maria Gioacchini, Ettore Cassandro, Matteo Alicandri-Ciufelli, Shaniko Kaleci, Claudia Cassandro, Alfonso Scarpa, Massimo Re




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Facial nerve palsy and laryngospasm as a complication of local anaesthesia during adenotonsillectomy

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Michał Lubszczyk, Anna Łuczyńska-Sopel, Dariusz Polaczkiewicz
Tonsil surgeries are the most frequently performed surgical procedures in ENT departments. We would like to present the case of a 5-year-old patient who suffered from unilateral peripheral facial nerve palsy and laryngeal spasm following adenotonsillectomy. Paresis was observed immediately after the transfer of the patient to the postoperative room. The activity of facial muscles was restored within 2 hours from the beginning of the surgery. We assume that this was the direct effect of an anaesthetic on the extracranial processes of the facial nerve.



https://ift.tt/2HAMEUE

Cochlear implantation in patients with bilateral deafness caused by otitis media with ANCA-associated vasculitis (OMAAV): A report of four cases

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Takeshi Watanabe, Haruo Yoshida, Kan Kishibe, Yuka Morita, Naohiro Yoshida, Haruo Takahashi, Yasuaki Harabuchi
ObjectiveAntineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) without systemic symptoms but with initial symptoms related to the ear, such as hearing loss, otalgia, and dizziness, has recently been reported. We have categorized this condition as otitis media with AAV (OMAAV), and have recently proposed its diagnostic criteria.MethodsTo determine the effectiveness of cochlear implantation (CI) in patients with profound hearing loss due to OMAAV. We examined the language understanding ability of four patients with bilateral profound or total deafness due to OMAAV, who underwent CI.ResultsIn three of the four patients, the language understanding ability with CI was poor. These three patients with poor performance had characteristic features, including a short interval from the onset of ear symptoms to total deafness and clear enhancement of the cochlea on magnetic resonance imaging (MRI).ConclusionThe poor results observed in patients with a rapidly progressive history of hearing loss were attributed to possible severe and profuse intracochlear bleeding and/or destruction of structures, including the spiral ganglion. All the three patients showed contrast enhancement in the inner ear on MRI. We believe that preoperative evaluation of the history of hearing loss as well as the findings of contrast-enhanced MRI is important for predicting the prognosis after CI.



https://ift.tt/2Joh6ah

Editorial Board

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5





https://ift.tt/2HzqEJZ

The protective effect of adrenocorticotropic hormone treatment against noise-induced hearing loss

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Ahmet Mutlu, Fatma Ceyda Akin Ocal, Seyra Erbek, Levent Ozluoglu
ObjectiveNIHL is a common problem, and steroids are the most effective treatment option. In this study, we aimed to evaluate the protective effects of the synthetic adrenocorticotropic hormone (ACTH) analogues, which induce endogenous steroid secretion, against noise-induced hearing loss (NIHL) and to compare their effectiveness with that of steroid treatment.MethodsTwenty-four male Sprague–Dawley albino rats were divided into four subgroups as follows: group 1 (n=6) control, group 2 (n=6) saline, group 3 (n=6) dexamethasone (2mg/kg/day intramuscularly [IM]), group 4 (n=6) ACTH analogue (0,4mg/kg/day IM), respectively. Three groups (groups 2–4) were exposed to white noise (105dB SPL, 12h). All the rats were evaluated for hearing thresholds of 10kHz, 20kHz, and 32kHz via acoustic brainstem responses (ABR) measurement. After the basal threshold measurements, measurements were repeated immediately after the noise and on day 7 and day 21.ResultsBoth steroid and ACTH analogue groups showed significantly better hearing outcomes than the saline group on day 7 (p<0.001) and day 21 (p<0.001) after the noise exposure. No superior treatment effect was demonstrated in either the steroid or ACTH analogue group. None of the related intervention groups reached the basal hearing thresholds.ConclusionSteroids were effective drugs for the treatment of NIHL. ACTH analogues also demonstrated promising therapeutic effects for NIHL. Further studies to establish ACTH analogues as an alternative NIHL treatment option to steroids are needed.



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Endoscopic cartilage versus temporalis fascia grafting for anterior quadrant tympanic perforations — A prospective study in a tertiary care hospital

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Sanjeev Mohanty, Vinoth Manimaran, Preethi Umamaheswaran, Shivapriya Jeyabalakrishnan, Sreenivas Chelladurai
ObjectiveManagement of anterior perforations of tympanic membrane is a surgical challenge. The objective of this study is to analyse and compare the results of composite cartilage perichondrium island (CCPI) graft and temporalis fascia graft by endoscopic technique in anterior quadrant perforations.MethodsA prospective study was conducted in a tertiary care centre from 2012–16. A total of 187 ear drums(n) in 168 patients with perforations involving anterior quadrant were included in the study. All the patients were operated completely by endoscopic technique. Tragal Composite cartilage perichondrium island (CCPI) graft was used in 87 ears and temporalis fascia in 100. Each group was categorised into A and B depending on perforation size. The outcome parameters assessed include graft success with regard to perforation size, pre- and postoperative ABG, mean improvement in ABG, ABG closure ratio and graft medialisation/lateralisation status.ResultsCartilage group had 91.95% (80/87) success rate overall, while fascia had 79% (79/100). In category 1, the success rate for cartilage and temporalis fascia were 89.6% (26/29) and 68.9% (20/29) respectively (p=0.51788). In category 2, the success rates were 93.1% (54/58) and 83.1% (59/71) respectively (p=0.86356). The mean improvement in ABG for both groups were 17.52±3.84dB and 15.26±5.56dB respectively (p=0.04). ABG closure ratio for both the groups were 62.84±11.87 % and 53.6±19.6 % respectively (p=0.0008).ConclusionEndoscopic composite cartilage perichondrium island graft is an effective technique in managing perforations of anterior quadrant barring the expertise required for endoscopic ear surgeries.



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Instrumental head impulse test changes after intratympanic gentamicin for unilateral definite Ménière’s disease: A systematic review and meta-analysis

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Pedro Santos Marques, Claudia Camila Dias, Nicolas Perez-Fernandez, Jorge Spratley
ObjectiveTo estimate how much could intratympanic gentamicin (ITG) interfere with the vestibular-ocular reflex (VOR) parameters on instrumental head impulse test (HIT), either with scleral search coil or video head impulse test and, eventually, foresee the control of vertigo crisis in unilateral intractable Ménière's disease (MD).MethodsA literature search was conducted in PubMed, Scopus, Web of Science and Cochrane search engines. The search terms used were "vestibular ocular reflex", "head impulse test", "gentamicin," and "Meniere's disease". Limitations included text availability to be full text, species to be humans and language to be English. All study types were included. 89 articles were screened identifying four eligible studies were identified. Studies were included after consensus of the authors. Meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was analysed using Review Manager software.ResultsInstrumental HIT, after ITG for MD, demonstrated, in the treated ear, a decreased gain in the horizontal, posterior and superior semicircular canals (SCC), of 0.36 (0.26; 0.47; 95% CI), 0.35 (0.22; 0.48; 95% CI) and 0.28 (0.21; 0.35; 95% CI), respectively. Gain asymmetry increases between the treated and non-treated ear of 23.78 (7.22; 40.35; 95% CI), 32.01 (12.27; 51.76; 95% CI) and 17.49 (9.99; 24.99; 95% CI), were similarly detected in the horizontal, posterior and superior SCC, respectively. Significantly smaller gain values after the first treatment were observed for a single injection group versus multiple injection group in the horizontal (p=0.002) and superior SCCs (p=0.016).ConclusionsInstrumental HIT is effective in evaluating the SCC function after ITG for intractable unilateral MD. VOR gain changes in the direction of the treated ear in the three SCC have been clearly registered. An increased reduction of the VOR gain in the horizontal and anterior SCC also seemed to foresee the control of vertigo crisis. Still, after meta-analysis, the small number of patients' data available did not allow to define a treatment end-point value. This review also indicated that further and better-designed studies are warranted.



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Management of laryngeal cleft in mechanically ventilated children with severe comorbidities

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Rumi Ueha, Takao Goto, Asako Kaneoka, Tomonori Takano, Taku Sato, Yoichiro Hirata, Takaharu Nito, Tatsuya Yamasoba
Laryngeal clefts are rare congenital malformations of the posterior part of the larynx. The severities are correlated with the downward extension of the cleft and can involve numerous clinical symptoms including dysphagia and respiratory distress. As significant comorbidities may be present, individual treatments depend on the child's general condition and type of cleft involved. Herein, we describe two cases of children with laryngeal clefts and severe comorbidities requiring mechanical ventilation. One child with type III laryngeal cleft was successfully managed with the lateral pharyngotomy approach. The other child with type II laryngeal cleft has not been able to undergo cleft-closure surgery because of severe general conditions, therefore has continued training for feeding and swallowing.



https://ift.tt/2HzRv8O

Analysis of chemosensory function in patients with chronic Eustachian tube dysfunction prior to and after balloon dilatation

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Walliczek-Dworschak Ute, Schmierer Lisa, Greene Brandon, Pellegrino Robert, Dworschak Philipp, Boris Alexander Stuck, Güldner Christian
ObjectiveEustachian tube dysfunction (ETD) affects approximately 1% of adults in the general population. Non treated Eustachian tube dysfunction can result in chronic middle ear diseases, which have been shown to significantly affect taste sensitivity. A promising treatment is balloon dilatation of the Eustachian tube. The primary aim of the present study was to investigate whether individuals with ETD had impairment in chemosensory functions, and the changes of the chemosensory function after balloon dilatation of the Eustachian tube.Methods26 patients (17 female, 9 male) (=56 ears) suffering from ETD with a mean age of 39±15years were included in the present study. 20 patients (76%) returned to be evaluated at the follow up (=40 ears) 51±22days after balloon dilatation. For pre- and post operation, gustatory function was measured with a lateralized gustatory test with the taste strips and olfactory function was tested by means of the Sniffin' Sticks test battery (threshold, discrimination and identification (ID)).ResultsPatients' baseline taste function (summed taste score 9.8±3.5 (mean±SD)) was significantly impaired compared to normative data (summed taste score 12.4±2.3; p=0.002). After balloon dilatation of the Eustachian tube, the taste function remained stable (summed taste score 9.4±4.3; p=0.814). Olfactory function (odor ID, summed score (TDI)) improved postoperatively (TDI 32.4±3.6) compared to pre-operative scores (TDI 33.6±4.0; p=0.012), but not to a clinically relevant extent.ConclusionThis study suggests, that patients suffering from ETD exhibit reduced taste scores. Balloon dilatation of the Eustachian tube does not seem to influence gustatory function, but olfactory function showed improvement.



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Conservative treatment for cutaneous fistula resulted from abscess formation in patients with tuberculous cervical lymphadenitis

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Bo Hae Kim, Yung Jin Jeon, Young Ju Jin, Woo-jin Jeong, Sung Joon Park, Soon-Hyun Ahn
ObjectiveThis study describes the clinical characteristics and course of conservative treatment using anti-Tb medication and dressing in patients with tuberculous cervical fistula resulting from abscess formation, and to investigate factors prognostic of dressing and treatment duration.MethodsThe medical records of patients with tuberculous cervical lymphadenitis were reviewed, and 38 of these patients who presented with cutaneous fistula that resulted from abscess formation were included in the study.ResultsThe mean duration of dressing until fistula closure was 3.7±2.0months (range 0.2–8.5), and the mean duration of treatment with anti-Tb medication was 10.6±2.6months (range 6.0–16.0). Patients with concomitant Tb, beyond the cervical lymph nodes showed significantly prolonged duration of dressing (4.6 months vs. 3.2 months, p=0.025) and anti-Tb medication (11.8 months vs. 9.8 months, p=0.015).ConclusionOur results indicate that about 3.7 months of dressing was required for fistula closure. Tuberculous cervical lymphadenitis patients with fistula who had Tb beyond the cervical lymph nodes could be expected to require dressing for 4.6 months and prolonged and anti-Tb medication treatment.



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Comparison of xerostomia incidence after three-dimensional conformal radiation therapy and contralateral superficial lobe parotid-sparing intensity-modulated radiotherapy for oropharyngeal and hypopharyngeal cancer

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Terufumi Kawamoto, Keiji Nihei, Yujiro Nakajima, Satoshi Kito, Keisuke Sasai, Katsuyuki Karasawa
ObjectiveIn the treatment of head–neck cancer, parotid-sparing intensity-modulated radiotherapy (IMRT) could reduce the incidence of xerostomia. When the parotid glands cannot be sufficiently spared because of the widespread tumor, contralateral superficial lobe parotid-sparing (CSLPS)-IMRT could be used to reduce marginal recurrence, however the success of this approach remains to be determined. The primary purpose of this study was to compare the incidence of xerostomia between three-dimensional conformal radiotherapy (3D-CRT) and CSLPS-IMRT for oropharyngeal and hypopharyngeal cancer. In a second aim, we also compared the clinical efficacy of 3D-CRT and CSLPS-IMRT.MethodsWe retrospectively reviewed the medical records of locally advanced oropharyngeal and hypopharyngeal cancer patients who were treated with definitive concurrent chemoradiotherapy between June 2007 and April 2014. We estimated the average mean dose delivered to the parotid glands, the incidence of xerostomia≥Grade 2, patterns of failure, and survival outcomes.ResultsSeventeen patients received 3D-CRT and 21 received CSLPS-IMRT. The average mean dose delivered to the superficial lobe of the contralateral parotid gland was 45.3Gy and 26.6Gy (p<0.001), and the incidence of xerostomia≥Grade 2 following treatment was 75% and 26% at 12 months (p=0.012) and 67% and 18% at 24 months (p=0.018) in the 3D-CRT and CSLPS-IMRT groups, respectively. Patterns of failure did not differ between the two groups. The 2-year progression-free survival was 59% and 62% (p=0.73), and the 2-year overall survival rate was 71% and 71% in the 3D-CRT and CSLPS-IMRT groups, respectively (p=0.76).ConclusionIncidence of xerostomia was significantly lower in patients receiving CSLPS-IMRT compared with 3D-CRT, while clinical efficacy did not differ between two treatment strategies.



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Multicenter phase I/II study of chemoradiotherapy with high-dose CDDP for head and neck squamous cell carcinoma in Japan

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Hiroshi Matsuyama, Keisuke Yamazaki, Ryuichi Okabe, Yushi Ueki, Ryusuke Shodo, Jo Omata, Yuichiro Sato, Hisayuki Ota, Takeshi Takahashi, Masahiko Tomita, Yusuke Yokoyama, Takafumi Togashi, Hidefumi Aoyama, Eisuke Abe, Yasuo Saijo, Kouji Katsura, Marie Soga, Tadashi Sugita, Yasuo Matsumoto, Emiko Tsuchida, Arata Horii
ObjectiveRecent data indicated that concurrent chemoradiotherapy (CCRT) using high dose cisplatin (CDDP) is the most useful treatment for advanced head and neck squamous cell carcinoma (SCC). Regarding the dose of CDDP, 100mg/m² is most recommended in Western countries. However, in terms of a balance of efficacy and adverse events, appropriate dose of cytotoxic drugs such as CDDP may be different among the different ethnic groups. In this multicenter phase I/II study, we aimed to identify the optimal dose of CDDP in CCRT for patients with advanced head and neck SCC in the Japanese.MethodsPatients were eligible for inclusion if they had head and neck SCC that was treated with radical CCRT comprising whole-neck irradiation of the primary lesion and level II–IV lymph nodes on both sides. For the phase I study, a CDDP dose was 70mg/m² for level 0, 80mg/m² for level 1, and 100mg/m² for level 2. Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) were examined by phase I trial, by which CDDP dose for phase II was determined. The primary endpoint for the phase II was CCRT completion rate, and the secondary endpoint was full-dose-CCRT completion rate, the percentage of patients receiving a total CDDP dose of ≥200mg/m², response rate, and incidences of adverse events.ResultsA CDDP dose of 100mg/m² was the MTD for phase I, and the recommended dose for phase II was 80 mg/m². Forty-seven patients were evaluated in the phase II trial. CCRT completion rate, full-dose-CCRT rate, and the percentage of patients receiving a total CDDP dose of ≥200mg/m², were 93.6%, 78.7%, and 93.6%, respectively. One patient (2.1%) developed grade 2 renal dysfunction, and no patient developed febrile neutropenia or a grade 4 adverse event.ConclusionThe present phase I study indicated that a CDDP dose of 80mg/m² is the optimal dose in terms of safety. The phase II study revealed that CCRT completion rate, response rate, and rates of adverse events were not inferior for a CDDP dose of 80mg/m² as compared with a dose of 100mg/m², and a dose of 80mg/m² is therefore recommended in CCRT for the Japanese.This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; identification No. UMIN000010369).



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Pneumolabyrinth, intracochlear and vestibular fluid loss after cochlear implantation

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Hideaki Moteki, Yasunari Fujinaga, Tetsuya Goto, Shin-ichi Usami
The present case was a 38-year-old male who presented with progressive hearing loss, resulting in profound bilateral hearing loss. He had a past history of childhood medulloblastoma, which was treated with posterior fossa craniotomy and radiotherapy. A ventriculoperitoneal (VP) shunt was put in place to manage the hydrocephalus. Cochlear implantation (CI) was carried out on his right ear by a standard procedure. At CI activation, the electric impedance of the electrode was very high, and computed tomography revealed that there was no area of liquid density, suggesting depletion of the perilymph in the cochlea and vestibule. Eight months later, the impedance improved gradually, and the cochlea was filled with perilymph. Consequently, one of the causes of the pneumolabyrinth in the present case was that a scarred stenotic cochlear canaliculus secondary to surgery or radiation therapy might have prevented the CSF from filling the scala. In addition, it is also possible that the VP shunt might have altered the CSF pressure, leading to depletion of the perilymph.



https://ift.tt/2JoNEkC

Transoral videolaryngoscopic surgery for papillary carcinoma arising in lingual thyroid

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Chisato Mogi, Hirotaka Shinomiya, Natsumi Fujii, Tomoyuki Tsuruta, Naruhiko Morita, Tatsuya Furukawa, Masanori Teshima, Maki Kanzawa, Mitsuyoshi Hirokawa, Naoki Otsuki, Ken-ichi Nibu
Carcinoma arising in lingual thyroid is an extremely rare entity accounting for only 1% of all reported ectopic thyroids. Here, we report a case of carcinoma arising in lingual thyroid, which has been successfully managed by transoral resection and bilateral neck dissections.A lingual mass 4-cm in diameter with calcification was incidentally detected by computed tomography at medical check-up. No thyroid tissue was observed in normal position. Ultrasound examination showed bilateral multiple lymphadenopathies. Fine needle aspiration biopsy from lymph node in his right neck was diagnosed as Class III and thyroglobulin level of the specimen was 459ng/ml. Due to the difficulty in performing FNA of the lingual masses, right neck dissection was performed in advance for diagnostic purpose. Pathological examination showed existence of large and small follicular thyroid tissues in several lymph nodes, suggesting lymph node metastasis from thyroid carcinoma. Two months after the initial surgery, video-assisted transoral resection of lingual thyroid with simultaneous left neck dissection was performed. Postoperative course was uneventful. Papillary carcinoma was found in the lingual thyroid and thyroid tissues were also found in left cervical lymph nodes.Video-assisted transoral resection was useful for the treatment of thyroid cancer arising in lingual thyroid.



https://ift.tt/2HAMcFW

Does drug-induced sleep endoscopy predict surgical success of limited palatal muscle resection in patients with obstructive sleep apnea?

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Jae-Wook Kim, Deok Soo Kim, Sung-Dong Kim, Sue Jean Mun, Soo-Kweon Koo, Kyu-Sup Cho
ObjectiveThe aims of this study were to determine the associated factors affecting the success rate of limited palatal muscle resection (LPMR), and to investigate whether drug-induced sleep endoscopy (DISE) could predict the therapeutic response to LPMR in patients with obstructive sleep apnea obstructive sleep apnea (OSA).MethodsTwenty-one consecutive OSA patients underwent LPMR were enrolled. All patients received routine ENT examination, preoperative DISE, and polysomnography (PSG). Clinical, polysomnographic, cephalometric variables, and DISE findings were evaluated. The measurements were related to the success or failure of LPMR based on the results of preoperative and postoperative PSG.ResultsThe overall success rate of LPMR was 66.6%. Postoperative AHI and minimal oxygen saturation were significantly decreased after LPMR (p<0.001). Comparison between success and failure groups revealed no significant differences in BMI, Friedman stage, preoperative AHI, minimal oxygen saturation, and all cephalometric parameters. However, the success of LPMR was significantly correlated with site, degree, and configuration of obstruction in DISE. In the velopharynx, complete obstruction (p=0.006) with anterolateral or concentric pattern (p=0.044) had significantly better success rate than partial obstruction with lateral pattern.ConclusionDISE was only predictive method for identifying the success in OSA patients undergoing LPMR. Patients with anteroposterior or concentric total obstruction in the velopharynx might be suitable candidate for LPMR.



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High frequency jet ventilation during endolaryngeal surgery: Risk factors for complications

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Demet Altun, Emre Çamcı, Mukadder Orhan-Sungur, Nükhet Sivrikoz, Bora Başaran, Tülay Özkan-Seyhan




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A retrospective study of treatment for curative synchronous double primary cancers of the head and neck and the esophagus

Publication date: October 2018
Source:Auris Nasus Larynx, Volume 45, Issue 5
Author(s): Tabito Okamoto, Chikatoshi Katada, Shouko Komori, Keishi Yamashita, Shunsuke Miyamoto, Koichi Kano, Yutomo Seino, Hiroshi Hosono, Hiroki Matsuba, Hiromitsu Moriya, Mitsuhiro Sugawara, Mizutomo Azuma, Hiromichi Ishiyama, Satoshi Tanabe, Kazushige Hayakawa, Wasaburo Koizumi, Makito Okamoto, Taku Yamashita
ObjectiveCurative synchronous double primary cancers of the head and neck and the esophagus (CSC-HE) are frequently detected, but a standard treatment remains to be established. We studied the clinical course to explore appropriate treatment strategies.MethodsWe retrospectively studied consecutive 33 patients who had CSC-HE. The disease stage was classified into 4 groups: group A, early head and neck cancer (HNC) and early esophageal cancer (EC); group B, early HNC and advanced EC; group C, advanced HNC and early EC; and group D, advanced HNC and advanced EC. As induction chemotherapy, the patients received 3 courses of TPF therapy (docetaxel 75mg/m² on day 1, cisplatin 75mg/m² on day 1, and 5-fluorouracil 750mg/m² on days 1–5) at 3-week intervals. The clinical courses and treatment outcomes were studied according to the disease stage of CSC-HE.ResultsThe disease stage of CSC-HE was group A in 1 patient (3%), group B in 9 patients (27.3%), group C in 3 patients (9.1%), and group D in 20 patients (60.6%). The median follow-up was 26months, and the 2-year overall survival rate was 67.4%. In groups A, B, and C, the 2-year overall survival rate was 83.3%. In group D, the 2-year overall survival rate was 62.6%. Ten of 20 patients in group D received induction chemotherapy with TPF, and 6 patients were alive and disease free at the time of this writing.ConclusionThe treatment outcomes of patients with CSC-HE were relatively good. TPF induction chemotherapy might be an effective treatment for patients with advanced HNC and advanced EC.



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Validation of the revised Food Neophobia Scale (FNS-R) in the Italian context

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Margherita Guidetti, Luciana Carraro, Nicoletta Cavazza, Michele Roccato
Measuring individuals' level of food neophobia, i.e., the reluctance to eat novel food, is a critical task since it negatively affects diet variety and quality. Using structural equations models, the revised Food Neophobia Scale (FNS-R) was validated with a sample of 711 Italian adults. After deleting 4 items characterized by both low face validity and a suboptimal association with the other items, and after correcting statistically for the acquiescent response-set, the resulting 6-item, fully balanced FNS-R showed a good construct validity. Moreover, it showed the expected positive correlations with General Neophobia and with Disgust Sensitivity. Finally, it resulted invariant across participants' genders, age classes, and levels of education, and across methods of administration (paper-and-pencil and on-line). Strong points and possible developments of the study are discussed.



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Pain and modifiable risk factors among weight loss seeking Veterans with overweight

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Kathryn M. Godfrey, Anastasia J. Bullock, Lindsey M. Dorflinger, Kathryn M. Min, Christopher B. Ruser, Robin M. Masheb
ObjectiveOverweight/obesity and chronic pain frequently co-occur and demonstrate a bidirectional relationship. Modifiable risk factors, such as eating behaviors and mental health symptoms, may be important to understand this relationship and improve interventions in Veterans.DesignCross-sectional.SettingVeterans Health Administration Medical Center outpatient clinic.SubjectsThe sample of Veterans (N = 126) was mostly male (89.7%), White (76%), and non-Hispanic (94%) with average age of 61.9 years (SD = 8.5) and average body mass index (BMI) of 38.5 (SD = 7.5).MethodsVeterans referred for weight loss treatment (MOVE!) at VA Connecticut completed self-report questionnaires, and electronic medical records were reviewed.ResultsMean self-reported pain rating was 4.5 out of 10 (SD = 2.3). Moderate to severe pain was endorsed by 60% of the sample. Veterans with higher pain intensity and interference reported higher global eating disorder symptoms, emotional overeating, night eating, insomnia severity, and mental health symptoms (all p's < 0.01). However, pain intensity and interference were not associated with BMI.ConclusionsFor Veterans seeking behavioral weight loss treatment, higher pain intensity and interference were associated with more severe eating disorder, sleep, and mental health symptoms. A better description of the clinical characteristics of Veterans with pain who participate in MOVE! highlights their unique needs and may improve treatments to address pain in the context of weight loss treatment.



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Experimental scarcity increases the relative reinforcing value of food in food insecure adults

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Amanda K. Crandall, Jennifer L. Temple
People with fewer financial resources are at greater risk for obesity, but the mechanisms of this relationship are not fully understood. One factor that is related, both cross-sectionally and prospectively, to obesity is the relative reinforcing value of food. It is possible that the experience of scarcity increases this reinforcing value. To date, no studies have examined this potential relationship experimentally in humans. The purpose of the studies presented here was to test the hypothesis that experimental manipulations of perceived scarcity would impact the relative reinforcing value of food. A secondary hypothesis was that individuals who report experiencing food insecurity would be more sensitive to these experimental manipulations. In order to test these hypotheses, we investigated the effects of experimentally manipulated scarcity on the relative reinforcing value of food in a laboratory setting. Study 1 had a within-subjects design and included 25 adults. Scarcity was manipulated by placing time and resource limits on the relative reinforcing value task and examining responding for a high calorie snack food versus that of an alternative reinforcer. Study 1 showed a tendency for food insecure participants to respond more for all reinforcers across conditions and have a higher proportional response for food when resources were limited. Study 2 also made use of a within-subjects design with 30 adults and primed scarcity by creating financial gains and losses on the Iowa Gambling Task. We observed higher relative reinforcing values of food among food insecure participants in the control condition, which decreased in the financial gain condition. When taken together, these two studies suggest that individuals who report experiencing food insecurity respond to acute manipulations of scarcity by increasing their reinforcing value of snack food.



https://ift.tt/2kX7kNE

Usefulness of EEG-EMG coherence analysis to confirm epileptic nature of spells mimicking hemifacial spasms

Publication date: Available online 8 June 2018
Source:Clinical Neurophysiology
Author(s): Edoardo Ferlazzo, Sara Gasparini, Chiara Sueri, Vittoria Cianci, Damiano Branca, Silvana Franceschetti, Ferruccio Panzica, Laura Canafoglia, Umberto Aguglia




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Atypical Auditory Language Processing in Adolescents with Autism Spectrum Disorders

Publication date: Available online 8 June 2018
Source:Clinical Neurophysiology
Author(s): Junpei Tanigawa, Kuriko Kagitani-Shimono, Junko Matsuzaki, Rei Ogawa, Ryuzo Hanaie, Tomoka Yamamoto, Koji Tominaga, Shin Nabatame, Ikuko Mohri, Masako Taniike, Keiichi Ozono
ObjectiveIndividuals with autism spectrum disorder (ASD) often show characteristic differences in auditory processing. To clarify the mechanisms underlying communication impairment in ASD, we examined auditory language processing with both anatomical and functional methods.MethodsWe assessed the language abilities of adolescents with ASD and typically developing (TD) adolescents, and analyzed the surface-based morphometric structure between the groups using magnetic resonance imaging. Furthermore, we measured cortical responses to an auditory word comprehension task with magnetoencephalography and performed network-based statistics using the phase locking values.ResultsWe observed no structural differences between the groups. However, the volume of the left ventral central sulcus (vCS) showed a significant correlation with linguistic scores in ASD. Moreover, adolescents with ASD showed weaker cortical activation in the left vCS and superior temporal sulcus. Furthermore, these regions showed differential correlations with linguistic scores between the groups. Moreover, the ASD group had an atypical gamma band (25–40 Hz) network centered on the left vCS.ConclusionsAdolescents with ASD showed atypical responses on the auditory word comprehension task and functional brain differences.SignificanceOur results suggest that phonological processing and gamma band cortical activity play a critical role in auditory language processing-related pathophysiology in adolescents with ASD.



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Small fibre neuropathy in mitochondrial diseases explored with sudoscan

Publication date: August 2018
Source:Clinical Neurophysiology, Volume 129, Issue 8
Author(s): Marco Luigetti, Guido Primiano, Cristina Cuccagna, Daniela Bernardo, Donato Sauchelli, Catello Vollono, Serenella Servidei
ObjectivePolyneuropathy in mitochondrial diseases (MDs) is relatively common and widely investigated, but few data are instead reported about small fibres involvement.MethodsIn order to investigate the involvement of small fibres in MDs we performed extensive neurophysiological test (nerve conduction studies; sympathetic skin response; sudoscan) in 27 patients with genetic diagnosis of MD (7 m.3243A > G; 4 m.8344A > G; 9 single mtDNA deletion; 7 multiple mtDNA deletions).ResultsNCS showed a polyneuropathy in 11/27 cases (41%). The incidence was very high in POLG1 (100%), m.8344A > G (75%) and m.3243A > G (43%), while only 11% of patients with single deletion had evidence of large fibres involvement. Sympathetic skin response was abnormal only in three patients (one progressive external ophthalmoplegia with single mtDNA deletion; one patient with m.3243A > G mutation; one patient with POLG1 mutation). Sudoscan revealed the presence of an autonomic small fibres dysfunction in 9/27 cases (33%), most of them (7/9) carrying a single mtDNA deletion. Sudoscan data were also confirmed in a sub-group of patients by laser evoked potentials study. Considering only patients with single mtDNA deletion 7/9 (78%) showed abnormal results at sudoscan.ConclusionsSmall fibre neuropathy is another feature to investigate in mitochondrial diseases and seems specifically associated with the presence of single mtDNA deletion.SignificanceThe correct identification through specific neurophysiological tests of small fibres involvement in MDs represents another tile in this challenging diagnosis.



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Incidence of epileptiform discharges in children during induction of anaesthesia using Propofol versus Sevoflurane

Publication date: Available online 8 June 2018
Source:Clinical Neurophysiology
Author(s): Susanne Koch, Leopold Rupp, Christine Prager, Rudolf Mörgeli, Sylvia Kramer, Klaus Dieter Wernecke, Astrid Fahlenkamp, Claudia Spies
ObjectiveIn pediatric patients, anaesthesia induction is often performed with intravenous Propofol or Sevoflurane inhalation. Although epileptiform discharges have been observed during inductions with Sevoflurane, their occurrence has not been investigated for i.v. Propofol inductions. The aim of this study is to compare the incidence of epileptiform discharges in children during anaesthesia induction using Propofol versus Sevoflurane.MethodsProspective, observational cohort study in children aged 0.5 to 8 years undergoing elective surgery. Children were anaesthetized with either Propofol or Sevoflurane. Bi-frontal electroencephalograms electrodes were placed before start of anaesthesia. Visual electroencephalogram analysis was performed from start of anesthetic agent administration until Intubation with regard to identify epileptiform patterns, i.e. delta with spikes; rhythmic polyspikes; periodic, epileptiform discharges; or suppression with spikes.Results39 children were anaesthetized with Propofol, and 18 children with Sevoflurane. Epileptiform discharges were seen in 36% of the children in the Propofol group, versus 67% in the Sevoflurane group (p=0.03). Incidence of the distinct types of epileptiform discharge differed for periodic, epileptiform discharges (Sevoflurane group 39% vs. Propofol group 3%; p<0.001). Higher concentration of Remifentanil (≥ 0.15µg/kg/min) was associated with less frequent epileptiform discharges (Exp 5.8; CI 95% 1.6 / 21.2; p=0.008).ConclusionsPropofol i.v. induction of anaesthesia in children triggers epileptiform discharges, whereas to a lesser extent than Sevoflurane does.SignificancePresuming that epileptiform discharges have an impact on postoperative brain function, it is advisable to use Propofol rather than Sevoflurane and higher level of Remifentanil for anaesthesia induction in children.



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Survival benefit of adjuvant brachytherapy after hysterectomy with positive surgical margins in cervical cancer

Publication date: Available online 8 June 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Richard Li, Ashwin Shinde, Yi-Jen Chen, Arya Amini, Stephen Lee, Thanh Dellinger, Ernest Han, Mark Wakabayashi, Rebecca Nelson, Sushil Beriwal, Scott Glaser
PurposeWe evaluated the utilization of brachytherapy (BT) in addition to external beam radiation therapy (EBRT) and the resulting impact on survival in patients with cervical cancer after hysterectomy with positive surgical margins.Methods and MaterialsPatients with cervical cancer diagnosed from 2004 to 2015 who underwent hysterectomy followed by adjuvant EBRT were identified using the National Cancer Data Base. Only patients with positive surgical margins were included for analysis. Logistic regression was used to evaluate predictors of BT utilization and for propensity score matching. Survival was compared between patients receiving EBRT alone and EBRT combined with BT for adjuvant treatment. Survival analysis using log-rank test and Cox proportional hazards modeling was performed in the overall and propensity score-matched cohorts.ResultsWe identified 1,719 patients who received hysterectomy with positive surgical margins followed by adjuvant radiation therapy, of which 778 patients (45.3%) received additional BT. Predictors of increased receipt of BT included age > 55 years, private rather than government insurance, radiation treatment duration ≥7 weeks, external beam radiation dose ≥4500 cGy, and time between radiation and surgery ≤9 weeks. With a median follow-up of 3.8 years, 3-year overall survival was 79.4% in patients receiving BT compared to 71.9% in patients receiving EBRT alone (log-rank p<0.001). On multivariate analysis, EBRT and BT was associated with significantly improved survival (hazard ratio 0.77; 95% confidence interval 0.64-0.92; p=0.003) compared to EBRT alone. The survival benefit of combining EBRT and BT persisted on propensity score-matched analysis (log-rank p=0.005).ConclusionsIn women with positive margins after hysterectomy for cervical cancer, the combination of EBRT and BT showed significantly improved overall survival compared to EBRT alone. However, only 45.3% of patients in our cohort received BT.

Teaser

We analyzed a cohort of patients from the National Cancer Database who underwent hysterectomy for cervical cancer with positive surgical margins followed by adjuvant radiation therapy. We found that the addition of brachytherapy to external beam radiation therapy was associated with improved overall survival compared to external beam radiation therapy alone. However, only 45% of patients in this cohort received brachytherapy.


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Analyzing Circulating Tumor Cells One at a Time

Publication date: Available online 8 June 2018
Source:Trends in Cell Biology
Author(s): Veronica Ortiz, Min Yu
Whole-genome sequencing has made a significant impact on cancer research, but traditional bulk methods fail to detect information from rare cells. Recently developed single-cell sequencing methods have provided new insights and unprecedented details about cancer progression and diversity. These advancements also enable the investigation of rare cells, such as circulating tumor cells (CTCs) derived from cancer patients. In this review, we outline various single-cell sequencing techniques that can elucidate the molecular properties of CTCs. In addition, we explain the drawbacks that need to be overcome for each method.



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Dexmedetomidine facilitates extubation in children who require intubation and respiratory support after airway foreign body retrieval: a case–cohort analysis of 57 cases

Abstract

Purpose

This study aimed to investigate whether dexmedetomidine had sedative weaning advantage for extubation after airway foreign body (FB) removal in children.

Methods

A retrospective case–cohort comparison study with total of 57 critical children who required mechanical ventilation after rigid bronchoscopy was performed. After tracheal intubation, group D (received dexmedetomidine 1 µg/kg over 10 min, followed by an infusion of 0.8 µg/kg/h), and group RP (received remifentanil–propofol 6–10 µg/kg/h and 1–3 mg/kg/h, respectively). The primary outcome was successful extubation rate on first weaning trial. The minor outcomes included weaning time, emergency agitation, coughing score and the incidence of respiratory adverse complications on emergency.

Main results

All 57 patients were included in the analysis, with 30 patients in group D and 27 controlled cases in group RP. The success rate of first weaning trial in the D group was 96.7 vs 77.8% in the RP group, risk ratio (RR) 1.56, 95% CI [0.78–1.98]. Time for resuming spontaneous breathing after termination infusion was shorter in the D group (median 8 min, IQR 15 min) vs RP group (median 12 min, IQR 19 min, P = 0.02, RR 0.56, 95% CI 0.14–6.57).

Conclusions

In mechanical ventilation of pediatric patients following rigid bronchoscopy, in comparison to remifentanil–propofol, dexmedetomidine is proved to have high success rate for weaning strategy.

What is already known?

Remifentanil is proved to be effective for weaning in ICU patients. Dexmedetomedine can provide similar rates of smooth extubation for pediatric patients who underwent airway surgery.

What this article adds?

Invasive ventilation is used for patients with severe comorbidity after airway surgery, but the correct strategy for pediatric extubation after removal of airway foreign body remains unclear. For these patients with short-term mechanical ventilation, dexmedetomedine may improve the extubation rate, when compared with remifentanil–propofol.

https://ift.tt/2xVSKzr

A novel punch biopsy technique without scissors or forceps

Publication date: Available online 9 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Ali Moiin, Brett C. Neill




https://ift.tt/2LBCgP7

Airway evaluation in children with single ventricle cardiac physiology

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Jose Ting, Soham Roy, Sriram Navuluri, Robert Hanfland, Lauren Mulcahy, Sancak Yuksel, Zhen Huang, Zi Yang Jiang
ObjectiveChildren with single ventricle cardiac physiology (SVC) often require airway procedures as an adjunct to their care. Descriptive analysis with a focus on outcomes of airway procedures in SVC patients have not been fully described in the literature.MethodsRetrospective, single-center cohort review of 270 patients born between Aug-2007 and Jan-2017. Patients were identified by cardiac database for single ventricle pathophysiology. A subset of these patients were identified to have been evaluated by otolaryngology with airway evaluations and/or interventions.Results88/270 patients (32.6%) required investigation or intervention for airway pathology. The most frequent procedure was flexible fiberoptic laryngoscopy (58/88 patients); it was the only procedure performed in 40 patients. Seventeen patients required tracheostomies with an associated increased length of stay (p < 0.001). Patients with cardiac procedures involving dissection around the aortic arch were considered higher airway risk due to the threat of recurrent laryngeal nerve injury, and were more likely to have vocal cord paralysis (58%) compared to patients with lower risk procedures (21%; p < 0.001). However, on multivariate logistic regression, vocal cord paralysis did not statistically impact the odds for tracheostomy placement, although the presence of subglottic stenosis increased the odds ratio of tracheostomy by 14.7 (p = 0.02).ConclusionsChildren with SVC often require airway evaluation and intervention. Patients with high risk cardiac procedures had a higher risk of recurrent laryngeal nerve injury but the presence of subglottic stenosis was the best predictor for a tracheostomy. This study represents one of the largest series of SVC children evaluated for airway pathology.



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A novel use of coblation in the treatment of subglottic stenosis

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Craig A. Bollig, Eliav Gov-Ari
Bipolar radiofrequency plasma ablation (Coblation) technology has recently been described in the treatment of airway stenosis. In these small case series and case reports, the mucosal and submucosal tissues have been removed. We describe a novel use of coblation technology, in which a coblation needle was used to submucosally ablate subglottic stenosis in a 9 month-old girl with grade II subglottic stenosis who had previously undergone multiple balloon dilations. This technique spared the overlying mucosa, similar to that utilized in coblation turbinoplasty. She experienced objective clinical improvement after the intervention and has not required additional airway interventions to date.



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Auditory brainstem response in very preterm, moderately preterm and late preterm infants

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Jayashree Seethapathy, Prakash Boominathan, Ajith Kumar Uppunda, Binu Ninan
BackgroundAuditory brainstem response across preterm infants help in understanding difference if any in auditory maturation. Objective: To analyze and compare absolute and interpeak latencies of ABR in very preterm, moderate preterm and late preterm infants at term age.MethodABR traces were obtained from 148 ears of preterm infants (52 of very preterm, 44 of moderately preterm & 52 of late preterm) at term age. ABR was recorded with 11.1/s clicks at different intensity levels.ResultsAbsolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between three preterm groups. One way ANOVA was used to compare ABR parameters between three groups of preterm infants and also to compare ABR parameters across various gestation ages. There were no overall differences in absolute latencies, interpeak latencies and amplitude of ABR between preterm groups and across various gestation ages (P>0.05). Pearson correlation was used to find the correlation between gestation age and ABR parameters. However, no correlation was found. ABRs were similar among preterm groups at term age which reflects that the brainstem maturation is similar among preterm groups.ConclusionGestational age at birth does not seem to influence absolute and interpeak latencies of ABR at term age. In preterm neonates, the findings lead to suggest that maturation of auditory pathway occurs in a similar manner in preterm infants regardless of gestational age at birth.We conclude that preterm birth alone as a risk factor does not appear to have any marked effect on the development of ABR at term age.



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Feasibility of a play-based intervention set for toddlers with autism

Publication date: September 2018
Source:Research in Developmental Disabilities, Volume 80
Author(s): Cooper R. Woodard, Jin Chung
The Meta-play Method is a play-based, naturalistic set of interventions designed to decrease the symptoms associated with autism in toddlers. The purpose of the present study was to explore the feasibility of using this intervention set with a small group of toddlers and their parents. We selected seven toddlers diagnosed with autism and tested these children for autism severity and severity of repetitive behaviors. Parents were trained on the basic concepts of DBTA and the Meta-play activities. Researchers reviewed the integrity of interventions at once- or twice-monthly home visits for a six-month period, and recorded progress as rated by the parent. Activities were adapted at each visit to the interests and progress of the participating toddler. At the end of six months, autism symptoms and repetitive behavior decreased and parents reported high levels of social validity. Additional aspects of data collection and outcome measures, and suitability of interventions and procedures are discussed. While some outcomes were encouraging, a number of changes are recommended for future research.



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