OSBP-related protein 2 (ORP2): Unraveling its functions in cellular lipid/carbohydrate metabolism, signaling and F-actin regulation

Publication date: Available online 2 February 2019Source: The Journal of Steroid Biochemistry and Molecular BiologyAuthor(s): Vesa M. Olkkonen, Annika Koponen, Amita AroraAbstractOxysterol-binding protein (OSBP)-related proteins (ORPs) constitute a family of intracellular lipid-binding/transport proteins (LTPs) in eukaryotes. They typically have a modular structure comprising a lipid-binding domain and membrane targeting determinants, being thus suited for function at membrane contact sites. Among the mammalian ORPs, ORP2/OSBPL2 is the only member that only exists as a 'short' variant lacking a membrane-targeting pleckstrin homology domain.ORP2 is expressed ubiquitously and has been assigned a multitude of functions. Its OSBP-related domain binds cholesterol, oxysterols, and phosphoino...

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Restoring autophagic flux attenuates cochlear spiral ganglion neuron degeneration by promoting TFEB nuclear translocation via inhibiting MTOR.

Authors: Ye B, Wang Q, Hu H, Shen Y, Fan C, Chen P, Ma Y, Wu H, Xiang M Abstract Macroautophagy/autophagy dysfunction is associated with many neurodegenerative diseases. TFEB (transcription factor EB), an important molecule that regulates lysosomal and autophagy function, is regarded as a potential target for treating some neurodegenerative diseases. However, the relationship between autophagy dysfunction and spiral ganglion neuron (SGN) degeneration and the role of TFEB in SGN degeneration has not yet been established. Here, we showed that in degenerated SGNs, induced by sensory epithelial cell loss in the cochlea of mice following kanamycin and furosemide administration, the lipofuscin area and oxidative stress level were increased, the nuclear-to-cytoplasmic TFEB ratio was decre...

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OSBP-related protein 2 (ORP2): Unraveling its functions in cellular lipid/carbohydrate metabolism, signaling and F-actin regulation

Publication date: Available online 2 February 2019Source: The Journal of Steroid Biochemistry and Molecular BiologyAuthor(s): Vesa M. Olkkonen, Annika Koponen, Amita AroraAbstractOxysterol-binding protein (OSBP)-related proteins (ORPs) constitute a family of intracellular lipid-binding/transport proteins (LTPs) in eukaryotes. They typically have a modular structure comprising a lipid-binding domain and membrane targeting determinants, being thus suited for function at membrane contact sites. Among the mammalian ORPs, ORP2/OSBPL2 is the only member that only exists as a 'short' variant lacking a membrane-targeting pleckstrin homology domain.ORP2 is expressed ubiquitously and has been assigned a multitude of functions. Its OSBP-related domain binds cholesterol, oxysterols, and phosphoino...

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Restoring autophagic flux attenuates cochlear spiral ganglion neuron degeneration by promoting TFEB nuclear translocation via inhibiting MTOR.

Authors: Ye B, Wang Q, Hu H, Shen Y, Fan C, Chen P, Ma Y, Wu H, Xiang M Abstract Macroautophagy/autophagy dysfunction is associated with many neurodegenerative diseases. TFEB (transcription factor EB), an important molecule that regulates lysosomal and autophagy function, is regarded as a potential target for treating some neurodegenerative diseases. However, the relationship between autophagy dysfunction and spiral ganglion neuron (SGN) degeneration and the role of TFEB in SGN degeneration has not yet been established. Here, we showed that in degenerated SGNs, induced by sensory epithelial cell loss in the cochlea of mice following kanamycin and furosemide administration, the lipofuscin area and oxidative stress level were increased, the nuclear-to-cytoplasmic TFEB ratio was decre...

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Macroscopic and radiographic aspects of orthodontic movement associated with corticotomy: animal study

ConclusionTooth movement and the region of interest were influenced by corticotomy, regardless of the surgical technique in the 14  days. (Source: Oral and Maxillofacial Surgery)

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Macroscopic and radiographic aspects of orthodontic movement associated with corticotomy: animal study

ConclusionTooth movement and the region of interest were influenced by corticotomy, regardless of the surgical technique in the 14  days. (Source: Oral and Maxillofacial Surgery)

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Asthma and Allergy Mobile Apps in 2018

Abstract

Purpose of Review

This paper offers a comprehensive review of interactive mobile allergy and asthma smartphone applications available within the USA in 2018, with an emphasis on interactive asthma apps.

Recent Findings

Primary care and specialty clinicians interested in introducing digital health apps into their practices will soon have more choices, for Apple® and major electronic medical record software companies are investing heavily in the mobile medical marketplace, guaranteeing personal health information and access to care will always be immediately available in one's digital hand.

Summary

Interactive mobile asthma applications are valuable assets for patients and caregivers alike, for they offer immediate communications between patients and those responsible for providing for their needs.

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Primary Prevention of Food Allergy

Abstract

Purpose of Review

The goal of this review is to present an updated summary of the various approaches to prevent childhood food allergies and report recent advances in potential prevention trials for food allergy.

Recent Findings

Several approaches related to maternal dietary supplementation as well as infant GI-based supplementation have been tried and are the subject of ongoing clinical investigation.

Summary

The prevalence of food allergy appears to be increasing but several, varied approaches to prevention are being actively pursued such that an effective strategy may not be too far in the future.

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Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

Abstract

Purpose of Review

The advent of endoscopic sinus surgery (ESS) has enabled the development of minimally invasive surgical procedures in Rhinology. However, proficiency with ESS techniques can still be hampered by poorly controlled bleeding limiting visibility of the surgical field (VSF). This can lead to increased operating time and, more importantly, increased risk of major and minor complications. To optimize the VSF and mitigate the risk of complications, many strategies have been explored.

Recent Findings

This is a narrative review of the relative risks and benefits of pre- and intra-operative interventions aimed at optimizing intraoperative conditions during ESS. The value of these interventions is determined based on their impact on intraoperative blood loss, time of surgery, and the VSF, and weighed against their adverse event profile.

Summary

This review provides a comprehensive overview of the evidence relating to the safety and efficacy of interventions used to improve intraoperative conditions during ESS.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BipHFx

Asthma and Allergy Mobile Apps in 2018

Abstract

Purpose of Review

This paper offers a comprehensive review of interactive mobile allergy and asthma smartphone applications available within the USA in 2018, with an emphasis on interactive asthma apps.

Recent Findings

Primary care and specialty clinicians interested in introducing digital health apps into their practices will soon have more choices, for Apple® and major electronic medical record software companies are investing heavily in the mobile medical marketplace, guaranteeing personal health information and access to care will always be immediately available in one's digital hand.

Summary

Interactive mobile asthma applications are valuable assets for patients and caregivers alike, for they offer immediate communications between patients and those responsible for providing for their needs.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GmD8r8

Primary Prevention of Food Allergy

Abstract

Purpose of Review

The goal of this review is to present an updated summary of the various approaches to prevent childhood food allergies and report recent advances in potential prevention trials for food allergy.

Recent Findings

Several approaches related to maternal dietary supplementation as well as infant GI-based supplementation have been tried and are the subject of ongoing clinical investigation.

Summary

The prevalence of food allergy appears to be increasing but several, varied approaches to prevention are being actively pursued such that an effective strategy may not be too far in the future.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ts4Jv0

Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

Abstract

Purpose of Review

The advent of endoscopic sinus surgery (ESS) has enabled the development of minimally invasive surgical procedures in Rhinology. However, proficiency with ESS techniques can still be hampered by poorly controlled bleeding limiting visibility of the surgical field (VSF). This can lead to increased operating time and, more importantly, increased risk of major and minor complications. To optimize the VSF and mitigate the risk of complications, many strategies have been explored.

Recent Findings

This is a narrative review of the relative risks and benefits of pre- and intra-operative interventions aimed at optimizing intraoperative conditions during ESS. The value of these interventions is determined based on their impact on intraoperative blood loss, time of surgery, and the VSF, and weighed against their adverse event profile.

Summary

This review provides a comprehensive overview of the evidence relating to the safety and efficacy of interventions used to improve intraoperative conditions during ESS.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BipHFx

Double-strand break repair through homologous recombination in autosomal-recessive BCL10 deficiency

Three members of the caspase recruitment domain (CARD) family of adaptor proteins (CARD9, CARD10, and CARD11) are known to form heterotrimers with B-cell lymphoma 10 (BCL10) and mucosa-associated lymphoid tissue lymphoma translocation gene 1 (MALT1), resulting in the CARD-BCL10-MALT1 (CBM) complex. In humans and mice, the CBM complex mediates nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κB) and mitogen-activated protein kinase activation in a cell-type–specific and nonredundant manner, after the stimulation of various immune receptors. (Source: Journal of Allergy and Clinical Immunology)

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Genetic diagnosis of primary immunodeficiencies: A survey of the French national registry

Since the mid-1980s, continuous progress in genetics and genomics has accelerated the rapid identification of causative genetic variants leading to primary immunodeficiencies (PIDs;>300 genes),1 with the noticeable exception of B-cell disorders, such as common variable immunodeficiency (CVID). The identification of these mutations not only validates a clinical diagnosis but also is useful in several other respects (more accurate prognosis on phenotype/genotype correlation, targeted therapy, and genetic counseling). (Source: Journal of Allergy and Clinical Immunology)

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Dysfunctional ErbB2, an EGF receptor family member, hinders repair of airway epithelial cells from asthmatic patients

Genetic and genomic data increasingly point to the airway epithelium as critical to asthma pathogenesis. Epithelial growth factor (EGF) family members play a fundamental role in epithelial differentiation, proliferation, and repair. Although expression of erythroblastosis oncogene B2 (ErbB2) mRNA, an EGF family receptor, was reported to be lower in asthmatic patients, little is understood about its functional role. (Source: Journal of Allergy and Clinical Immunology)

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Double-strand break repair through homologous recombination in autosomal-recessive BCL10 deficiency

Three members of the caspase recruitment domain (CARD) family of adaptor proteins (CARD9, CARD10, and CARD11) are known to form heterotrimers with B-cell lymphoma 10 (BCL10) and mucosa-associated lymphoid tissue lymphoma translocation gene 1 (MALT1), resulting in the CARD-BCL10-MALT1 (CBM) complex. In humans and mice, the CBM complex mediates nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κB) and mitogen-activated protein kinase activation in a cell-type–specific and nonredundant manner, after the stimulation of various immune receptors. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D1wFie

Genetic diagnosis of primary immunodeficiencies: A survey of the French national registry

Since the mid-1980s, continuous progress in genetics and genomics has accelerated the rapid identification of causative genetic variants leading to primary immunodeficiencies (PIDs;>300 genes),1 with the noticeable exception of B-cell disorders, such as common variable immunodeficiency (CVID). The identification of these mutations not only validates a clinical diagnosis but also is useful in several other respects (more accurate prognosis on phenotype/genotype correlation, targeted therapy, and genetic counseling). (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G7MN5D

Dysfunctional ErbB2, an EGF receptor family member, hinders repair of airway epithelial cells from asthmatic patients

Genetic and genomic data increasingly point to the airway epithelium as critical to asthma pathogenesis. Epithelial growth factor (EGF) family members play a fundamental role in epithelial differentiation, proliferation, and repair. Although expression of erythroblastosis oncogene B2 (ErbB2) mRNA, an EGF family receptor, was reported to be lower in asthmatic patients, little is understood about its functional role. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D1wB1Y

Bone response after immediate placement of implants in the anterior maxilla: a systematic review

Abstract

Purpose

The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla.

Methods

After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure.

Results

From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT).

Conclusion

It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WLc6jg

Bone response after immediate placement of implants in the anterior maxilla: a systematic review

Abstract

Purpose

The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla.

Methods

After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure.

Results

From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT).

Conclusion

It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WLc6jg

Preventative and medical treatment of ear disease in remote or resource-constrained environments.

Preventative and medical treatment of ear disease in remote or resource-constrained environments.

J Laryngol Otol. 2019 Feb 01;:1-14

Authors: Brophy-Williams S, Jarosz K, Sommer J, Leach AJ, Morris PS

Abstract
BACKGROUND: Important ear problems can affect the outer ear, the middle ear and the inner ear. Globally, the greatest burden of disease is due to ear conditions that are associated with otorrhoea and hearing loss.
METHODS: This study reviewed the literature on the prevention and treatment of common ear conditions that are most relevant to settings with high rates of ear disease and limited resources. The grading of recommendations assessment, development and evaluation ('GRADE') approach was utilised to assess interventions.
RESULTS: Accurate diagnosis of ear disease is challenging. Much of the preventable burden of ear disease is associated with otitis media. Nine otitis media interventions for which there is moderate to high certainty of effect were identified. While most interventions only provide modest benefit, the impact of treatment is more substantial in children with acute otitis media with perforation and chronic suppurative otitis media.
CONCLUSION: Disease prevention through good hygiene practices, breastfeeding, reducing smoke exposure, immunisation and limiting noise exposure is recommended. Children with acute otitis media with perforation, chronic suppurative otitis media, complications of otitis media, and significant hearing loss should be prioritised for medical treatment.

PMID: 30706843 [PubMed - as supplied by publisher]

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Investigating the effect of a nasal decongestant on post-adenotonsillectomy respiratory complications in 25 paediatric patients with obstructive sleep apnoea: a pilot study.

Investigating the effect of a nasal decongestant on post-adenotonsillectomy respiratory complications in 25 paediatric patients with obstructive sleep apnoea: a pilot study.

J Laryngol Otol. 2019 Feb 01;:1-5

Authors: Shamil E, Rouhani MJ, Panayi AC, Lynch J, Tysome J, Jonas N

Abstract
OBJECTIVE: Adenotonsillectomy is frequently performed for obstructive sleep apnoea, but is associated with post-operative respiratory morbidity. This study assessed the effect of paediatric Otrivine (0.05 per cent xylometazoline hydrochloride) on post-operative respiratory compromise.
METHODS: Paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea were included. The control group (n = 24) received no intervention and the intervention group (n = 25) received intra-operative paediatric Otrivine during induction using a nasal patty. Post-operative outcomes included pain, respiratory distress signs and medical intervention level required (simple, intermediate and major).
RESULTS: Post-operative respiratory distress signs were exhibited by 4 per cent of the Otrivine group and 21 per cent of the control group. Sixty-eight per cent of the Otrivine group required simple medical interventions post-operatively, compared to 42 per cent of the control group. In the Otrivine group, 4 per cent required intermediate interventions; none required major interventions. In the control group, 12.5 per cent required both intermediate and major interventions. Fifty per cent of the control group reported pain post-operatively, compared with 40 per cent in the Otrivine group.
CONCLUSION: Intra-operative paediatric Otrivine may reduce post-operative respiratory compromise in paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea. A randomised controlled trial is required.

PMID: 30706841 [PubMed - as supplied by publisher]

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Evaluation of upper oesophageal sphincter in unilateral vocal fold paralysis.

Evaluation of upper oesophageal sphincter in unilateral vocal fold paralysis.

J Laryngol Otol. 2019 Feb 01;:1-6

Authors: Erdur O, Gul O, Ozturk K

Abstract
OBJECTIVE: To evaluate dysphagia and manometric changes in the upper oesophageal sphincter in patients with unilateral vocal fold paralysis.
METHODS: Thirty patients with unilateral vocal fold paralysis due to vagal nerve paralysis scheduled for evaluation were enrolled in the study group; 24 healthy subjects were included in the control group. Upper oesophageal sphincter basal and residual pressure, relaxation time, and pharyngeal pressure values were evaluated by manometry. All patients completed the Turkish Eating Assessment Tool 10 questionnaire, the MD Anderson dysphagia questionnaire and the reflux symptom index form.
RESULTS: Swallowing assessment questionnaires and reflux symptom index results were significantly higher in the study group. Upper oesophageal sphincter basal and relaxation pressures were lower in the study group. Upper oesophageal sphincter relaxation time was shorter in the study group, but pressure values recorded from the pharynx were higher.
CONCLUSION: Upper oesophageal sphincter manometric pressure was lower in patients with unilateral vocal fold paralysis. A hypotonic sphincter likely contributes to dysphagia and aspiration.

PMID: 30706840 [PubMed - as supplied by publisher]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DP1SqH

Preventative and medical treatment of ear disease in remote or resource-constrained environments.

Preventative and medical treatment of ear disease in remote or resource-constrained environments.

J Laryngol Otol. 2019 Feb 01;:1-14

Authors: Brophy-Williams S, Jarosz K, Sommer J, Leach AJ, Morris PS

Abstract
BACKGROUND: Important ear problems can affect the outer ear, the middle ear and the inner ear. Globally, the greatest burden of disease is due to ear conditions that are associated with otorrhoea and hearing loss.
METHODS: This study reviewed the literature on the prevention and treatment of common ear conditions that are most relevant to settings with high rates of ear disease and limited resources. The grading of recommendations assessment, development and evaluation ('GRADE') approach was utilised to assess interventions.
RESULTS: Accurate diagnosis of ear disease is challenging. Much of the preventable burden of ear disease is associated with otitis media. Nine otitis media interventions for which there is moderate to high certainty of effect were identified. While most interventions only provide modest benefit, the impact of treatment is more substantial in children with acute otitis media with perforation and chronic suppurative otitis media.
CONCLUSION: Disease prevention through good hygiene practices, breastfeeding, reducing smoke exposure, immunisation and limiting noise exposure is recommended. Children with acute otitis media with perforation, chronic suppurative otitis media, complications of otitis media, and significant hearing loss should be prioritised for medical treatment.

PMID: 30706843 [PubMed - as supplied by publisher]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DPjiTQ

Investigating the effect of a nasal decongestant on post-adenotonsillectomy respiratory complications in 25 paediatric patients with obstructive sleep apnoea: a pilot study.

Investigating the effect of a nasal decongestant on post-adenotonsillectomy respiratory complications in 25 paediatric patients with obstructive sleep apnoea: a pilot study.

J Laryngol Otol. 2019 Feb 01;:1-5

Authors: Shamil E, Rouhani MJ, Panayi AC, Lynch J, Tysome J, Jonas N

Abstract
OBJECTIVE: Adenotonsillectomy is frequently performed for obstructive sleep apnoea, but is associated with post-operative respiratory morbidity. This study assessed the effect of paediatric Otrivine (0.05 per cent xylometazoline hydrochloride) on post-operative respiratory compromise.
METHODS: Paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea were included. The control group (n = 24) received no intervention and the intervention group (n = 25) received intra-operative paediatric Otrivine during induction using a nasal patty. Post-operative outcomes included pain, respiratory distress signs and medical intervention level required (simple, intermediate and major).
RESULTS: Post-operative respiratory distress signs were exhibited by 4 per cent of the Otrivine group and 21 per cent of the control group. Sixty-eight per cent of the Otrivine group required simple medical interventions post-operatively, compared to 42 per cent of the control group. In the Otrivine group, 4 per cent required intermediate interventions; none required major interventions. In the control group, 12.5 per cent required both intermediate and major interventions. Fifty per cent of the control group reported pain post-operatively, compared with 40 per cent in the Otrivine group.
CONCLUSION: Intra-operative paediatric Otrivine may reduce post-operative respiratory compromise in paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea. A randomised controlled trial is required.

PMID: 30706841 [PubMed - as supplied by publisher]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MKgoTr

Evaluation of upper oesophageal sphincter in unilateral vocal fold paralysis.

Evaluation of upper oesophageal sphincter in unilateral vocal fold paralysis.

J Laryngol Otol. 2019 Feb 01;:1-6

Authors: Erdur O, Gul O, Ozturk K

Abstract
OBJECTIVE: To evaluate dysphagia and manometric changes in the upper oesophageal sphincter in patients with unilateral vocal fold paralysis.
METHODS: Thirty patients with unilateral vocal fold paralysis due to vagal nerve paralysis scheduled for evaluation were enrolled in the study group; 24 healthy subjects were included in the control group. Upper oesophageal sphincter basal and residual pressure, relaxation time, and pharyngeal pressure values were evaluated by manometry. All patients completed the Turkish Eating Assessment Tool 10 questionnaire, the MD Anderson dysphagia questionnaire and the reflux symptom index form.
RESULTS: Swallowing assessment questionnaires and reflux symptom index results were significantly higher in the study group. Upper oesophageal sphincter basal and relaxation pressures were lower in the study group. Upper oesophageal sphincter relaxation time was shorter in the study group, but pressure values recorded from the pharynx were higher.
CONCLUSION: Upper oesophageal sphincter manometric pressure was lower in patients with unilateral vocal fold paralysis. A hypotonic sphincter likely contributes to dysphagia and aspiration.

PMID: 30706840 [PubMed - as supplied by publisher]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DP1SqH

A high-fidelity, fully immersive simulation course to replicate ENT and head and neck emergencies.

Related Articles

A high-fidelity, fully immersive simulation course to replicate ENT and head and neck emergencies.

J Laryngol Otol. 2019 Feb 01;:1-4

Authors: Hogg ES, Kinshuck AJ, Littley N, Lau A, Tandon S, Lancaster J

Abstract
BACKGROUND: Simulation-based training has a fundamental role in medical education as it allows the learner to gain experience managing emergencies in a safe, controlled environment.
METHODS: This 1-day course consisted of eight high-fidelity simulation scenarios, followed by a video-assisted debrief focusing on the technical and non-technical (communication skills, teamwork, leadership and situational awareness) aspects of managing ENT and head and neck emergencies.
RESULTS: Eight courses have run since June 2014. Post-course questionnaires demonstrated that candidates' confidence scores in managing airway and head and neck emergencies increased following completion of the course (p < 0.0001).
CONCLUSION: This was the first fully immersive ENT simulation course developed in the region. The learning objectives for each scenario were mapped to the ENT Intercollegiate Surgical Curriculum Programme. Feedback from the course indicated a continued demand for this style of training, leading to its inclusion in the training calendar.

PMID: 30704547 [PubMed - as supplied by publisher]

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Mining Social Media Data to Assess the Risk of Skin and Soft Tissue Infections from Allergen Immunotherapy

Mining of social media data suggests that skin and soft tissue infection from allergen immunotherapy, prepared with aseptic technique, is as rare as skin and soft tissue infection from Influenza vaccination, a sterile pharmaceutical.

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Cockroach allergens – coping with challenging complexity

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Regulation of Ectodomain Shedding of ADAM33 In Vitro and In Vivo

TGF-β signaling regulates ectodomain shedding of ADAM33 mainly via an autocatalytic mechanism and is essential for shedding of catalytically-active ADAM33 in vivo. These mechanisms have implications for the genetic contribution of ADAM33 to asthma and BHR.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HIDjzs

Mining Social Media Data to Assess the Risk of Skin and Soft Tissue Infections from Allergen Immunotherapy

Mining of social media data suggests that skin and soft tissue infection from allergen immunotherapy, prepared with aseptic technique, is as rare as skin and soft tissue infection from Influenza vaccination, a sterile pharmaceutical.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HOMKgL

Cockroach allergens – coping with challenging complexity

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t3NOU0

Regulation of Ectodomain Shedding of ADAM33 In Vitro and In Vivo

TGF-β signaling regulates ectodomain shedding of ADAM33 mainly via an autocatalytic mechanism and is essential for shedding of catalytically-active ADAM33 in vivo. These mechanisms have implications for the genetic contribution of ADAM33 to asthma and BHR.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HIDjzs

Bone response after immediate placement of implants in the anterior maxilla: a systematic review

Abstract

Purpose

The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla.

Methods

After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure.

Results

From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT).

Conclusion

It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WLc6jg

Cartilage conduction as the third pathway for sound transmission

It has been long considered that air and bone are the two major mediators that conduct sounds to the inner ear. In 2004, Hosoi found that vibration of aural cartilage, generated by placing gently a transducer on it, could create audible sound with the same level of clarity as air- and bone-conduction sound. He thus proposed the term "cartilage conduction" for this concept. This research identified a third mediator for sound conduction to the inner ear. Hosoi also proposed the development of novel communication devices, such as hearing aids, telephones, etc.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rwm1Fu

Bone response after immediate placement of implants in the anterior maxilla: a systematic review

Abstract

Purpose

The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla.

Methods

After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure.

Results

From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT).

Conclusion

It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

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Cartilage conduction as the third pathway for sound transmission

It has been long considered that air and bone are the two major mediators that conduct sounds to the inner ear. In 2004, Hosoi found that vibration of aural cartilage, generated by placing gently a transducer on it, could create audible sound with the same level of clarity as air- and bone-conduction sound. He thus proposed the term "cartilage conduction" for this concept. This research identified a third mediator for sound conduction to the inner ear. Hosoi also proposed the development of novel communication devices, such as hearing aids, telephones, etc.

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Issue Information

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Issue Information

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Issue Information

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Cover Image

The cover image is based on the Original Article Aberrant histone modification and inflammatory cytokine production of peripheral CD4+ T cells in patients with oral lichen planus, by Jun Shen et al., DOI 10.1111/jop.12790.

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Issue Information

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Cover Image

The cover image is based on the Original Article Aberrant histone modification and inflammatory cytokine production of peripheral CD4+ T cells in patients with oral lichen planus, by Jun Shen et al., DOI 10.1111/jop.12790.

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Identification of residual–recurrent cholesteatoma in operated ears: diagnostic accuracy of dual-energy CT and MRI

Abstract

Purpose

The aim of this study was to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and dual-energy computed tomography (DECT) to identify residual–recurrent cholesteatoma using the second-look surgery as the reference standard.

Methods

This prospective, institutional review board-approved study included 19 consecutive patients (11 males and 8 females; mean age of 62.2, range 34–80 years). Since five patients were studied bilaterally, a total of 24 ears were evaluated with DECT and MRI between February 2017 and June 2018. Any abnormal middle ear attenuation on high-resolution CT images (HRCT) or DECT color-coded maps, and any abnormal signal on MRI images was evaluated by four experienced radiologists. Diagnostic accuracy values of HRCT, DECT maps and CT numbers (by using receiver operator curves) and MRI were compared. Interobserver and intraobserver agreement were calculated.

Results

Residual–recurrent cholesteatoma was diagnosed at surgery in 16/24 ears (66.6%). MRI and DECT revealed a total of 15/16 and 14/16 cholesteatomas, respectively. The sensitivity, specificity, PPV and NPV and accuracy of MRI and DECT were 93.7, 87.5, 93.7, 87.5, and 91.6% and 87.5, 87.5, 93.3, 87.5 and 87.5%, respectively. CT numbers were significantly different between positive (mean 57.6 HU, range − 65, 112 HU) and negative cases (mean 5.4 HU, range − 100, 66 HU) with p < 0.001. The interobserver and intraobserver agreement were k = 0.87 and k = 0.83, respectively.

Conclusion

DECT may provide an accurate demonstration of residual–recurrent middle ear cholesteatoma.

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Selective occlusion of splenic artery aneurysms with the coil packing technique: the impact of packing density on aneurysm reperfusion correlated between contrast-enhanced MR angiography and digital subtraction angiography

Abstract

Purpose

The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA.

Materials and methods

Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated.

Results

Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method.

Conclusion

Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction.

Level of evidence

Level IV, therapeutic study.

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Diagnostic accuracy of dual-energy CT and virtual non-calcium techniques to evaluate bone marrow edema in vertebral compression fractures

Abstract

Purpose

The aim of this study was to evaluate DECT diagnostic accuracy in the identification of vertebral bone marrow edema, using MRI as standard of reference.

Methods

This prospective institutional review board-approved study included 76 consecutive patients (29 males and 47 females; mean age 62.3, range 51–82 years) studied with DECT (90 kV and tin filter 150 kV) and MRI within 7 days. Three radiologists evaluated DECT (reader 1 and 2) and MRI images (reader 3). Diagnostic accuracy of the DECT maps (qualitative assessment) and of the CT numbers (quantitative assessment), interobserver and intraobserver agreements were calculated.

Results

MRI revealed 61 edematous vertebrae and 52 collapsed non-edematous vertebrae. The sensitivity, specificity, PPV and NPV and accuracy of the qualitative assessment of the DECT maps were 88.6, 92.3, 93.1, 87.3 and 90.3%, for reader 1, 90.2, 90.3, 91.6, 88.7 and 90.3, for reader 2, and 91.8, 90.4, 91.6, 90.4 and 91.1% for quantitative analysis, respectively. DECT numbers were significantly different between positive (mean − 23 HU, range − 189, 29 HU) and negative cases (mean − 126 HU, range − 321, − 66 HU) with p < 0.001. The ROC curve analysis revealed an AUC of 0.886 (95% confidence interval 0.722–0.913). The interobserver and intraobserver agreements were near perfect (k = 0.87 and k = 0.83, respectively).

Conclusion

DECT represents an accurate imaging technique for demonstrating bone marrow edema in vertebral compression fracture, if compared to MRI.

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Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis

Abstract

Objective

The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery.

Methods

A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured.

Results

The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm.

Conclusions

It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery.

Clinical relevance

The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

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Identification of residual–recurrent cholesteatoma in operated ears: diagnostic accuracy of dual-energy CT and MRI

Abstract

Purpose

The aim of this study was to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and dual-energy computed tomography (DECT) to identify residual–recurrent cholesteatoma using the second-look surgery as the reference standard.

Methods

This prospective, institutional review board-approved study included 19 consecutive patients (11 males and 8 females; mean age of 62.2, range 34–80 years). Since five patients were studied bilaterally, a total of 24 ears were evaluated with DECT and MRI between February 2017 and June 2018. Any abnormal middle ear attenuation on high-resolution CT images (HRCT) or DECT color-coded maps, and any abnormal signal on MRI images was evaluated by four experienced radiologists. Diagnostic accuracy values of HRCT, DECT maps and CT numbers (by using receiver operator curves) and MRI were compared. Interobserver and intraobserver agreement were calculated.

Results

Residual–recurrent cholesteatoma was diagnosed at surgery in 16/24 ears (66.6%). MRI and DECT revealed a total of 15/16 and 14/16 cholesteatomas, respectively. The sensitivity, specificity, PPV and NPV and accuracy of MRI and DECT were 93.7, 87.5, 93.7, 87.5, and 91.6% and 87.5, 87.5, 93.3, 87.5 and 87.5%, respectively. CT numbers were significantly different between positive (mean 57.6 HU, range − 65, 112 HU) and negative cases (mean 5.4 HU, range − 100, 66 HU) with p < 0.001. The interobserver and intraobserver agreement were k = 0.87 and k = 0.83, respectively.

Conclusion

DECT may provide an accurate demonstration of residual–recurrent middle ear cholesteatoma.

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Selective occlusion of splenic artery aneurysms with the coil packing technique: the impact of packing density on aneurysm reperfusion correlated between contrast-enhanced MR angiography and digital subtraction angiography

Abstract

Purpose

The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA.

Materials and methods

Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated.

Results

Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method.

Conclusion

Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction.

Level of evidence

Level IV, therapeutic study.

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Diagnostic accuracy of dual-energy CT and virtual non-calcium techniques to evaluate bone marrow edema in vertebral compression fractures

Abstract

Purpose

The aim of this study was to evaluate DECT diagnostic accuracy in the identification of vertebral bone marrow edema, using MRI as standard of reference.

Methods

This prospective institutional review board-approved study included 76 consecutive patients (29 males and 47 females; mean age 62.3, range 51–82 years) studied with DECT (90 kV and tin filter 150 kV) and MRI within 7 days. Three radiologists evaluated DECT (reader 1 and 2) and MRI images (reader 3). Diagnostic accuracy of the DECT maps (qualitative assessment) and of the CT numbers (quantitative assessment), interobserver and intraobserver agreements were calculated.

Results

MRI revealed 61 edematous vertebrae and 52 collapsed non-edematous vertebrae. The sensitivity, specificity, PPV and NPV and accuracy of the qualitative assessment of the DECT maps were 88.6, 92.3, 93.1, 87.3 and 90.3%, for reader 1, 90.2, 90.3, 91.6, 88.7 and 90.3, for reader 2, and 91.8, 90.4, 91.6, 90.4 and 91.1% for quantitative analysis, respectively. DECT numbers were significantly different between positive (mean − 23 HU, range − 189, 29 HU) and negative cases (mean − 126 HU, range − 321, − 66 HU) with p < 0.001. The ROC curve analysis revealed an AUC of 0.886 (95% confidence interval 0.722–0.913). The interobserver and intraobserver agreements were near perfect (k = 0.87 and k = 0.83, respectively).

Conclusion

DECT represents an accurate imaging technique for demonstrating bone marrow edema in vertebral compression fracture, if compared to MRI.

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Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis

Abstract

Objective

The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery.

Methods

A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured.

Results

The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm.

Conclusions

It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery.

Clinical relevance

The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

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Severe deviated nose treatment: importance of preserving the dorsal septal remnant

Abstract

Purpose

To compare the surgical outcomes of modified extracorporeal septoplasty and anterior septal reconstruction for the management of the severe deviated nose.

Methods

In a prospective cohort study, we selected 86 patients referred for septorhinoplasty to a tertiary center in May 2015–April 2017 with a primary complaint of nasal obstruction and deformity. They had moderate-to-severe septal deviation and severely deviated noses, particularly in the dorsum. Forty-three patients underwent each procedure. The cohorts were age- and sex-matched, and were operated at a similar time point. Surgical outcome was assessed and compared using anthropometric measurement of photographs, acoustic rhinometry, and The Nasal Obstruction Septoplasty Effectiveness questionnaire (including a visual analog scale).

Results

In all patients, MCA1 (initial minimum cross-sectional area) and MCA2 (minimum cross-sectional area after topical decongestion of the nasal mucosa), anthropometric angles (nasolabial, nasofacial and tip projection), and The Nasal Obstruction Septoplasty Effectiveness questionnaire significantly improved after surgery in both groups (p = 0001), with no significant difference in improvement between two groups. However, anthropometric angles and minimal cross-sectional area were better in anterior septal reconstruction group.

Conclusion

Both methods are effective in patients with a severely deviated nose for correction of deviation and obstruction. Anterior septal reconstruction is the preferable method in patients with more deviation.

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Chemical chaperone 4-phenylbutyrate prevents hearing loss and cochlear hair cell death in Cdh23erl/erl mutant mice

We previously developed Cdh23erl/erl mutant mice (erl mice) as a model of hearing loss for otoprotective drug evaluation and showed that the erl mutation leads to hearing loss related to endoplasmic reticulum (ER) stress-induced cochlear hair cell apoptosis. Small molecular chemical chaperones, 4-phenylbutyrate (4PBA), targeting ER stress exert a neuroprotective effect. To evaluate whether 4PBA exerts an otoprotective effect, we intraperitoneally injected erl mice with 4PBA daily from postnatal age day 7 up to 12 weeks. Our results showed that treatment with 4PBA significantly alleviated hearing loss and suppressed hair cell death in erl mice. In addition, ER stress-related proteins were downregulated by 4PBA treatment. Our study showed that 4PBA exerts an otoprotective effect, which provi...

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Atoh1 regulation in the cochlea: more than just transcription

AbstractMore than 80% of all cases of deafness are related to the death or degeneration of cochlear hair cells and the associated spiral ganglion neurons, and a lack of regeneration of these cells leads to permanent hearing loss. Therefore, the regeneration of lost hair cells is an important goal for the treatment of deafness.Atoh1 is a basic helix-loop-helix (bHLH) transcription factor that is critical in both the development and regeneration of cochlear hair cells. Atoh1 is transcriptionally regulated by several signaling pathways, including Notch and Wnt signalings. At the post-translational level, it is regulated through the ubiquitin-proteasome pathway. In vitro and in vivo studies have revealed that manipulation of these signaling pathways not only controls development, but also lead...

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Chemical chaperone 4-phenylbutyrate prevents hearing loss and cochlear hair cell death in Cdh23erl/erl mutant mice

We previously developed Cdh23erl/erl mutant mice (erl mice) as a model of hearing loss for otoprotective drug evaluation and showed that the erl mutation leads to hearing loss related to endoplasmic reticulum (ER) stress-induced cochlear hair cell apoptosis. Small molecular chemical chaperones, 4-phenylbutyrate (4PBA), targeting ER stress exert a neuroprotective effect. To evaluate whether 4PBA exerts an otoprotective effect, we intraperitoneally injected erl mice with 4PBA daily from postnatal age day 7 up to 12 weeks. Our results showed that treatment with 4PBA significantly alleviated hearing loss and suppressed hair cell death in erl mice. In addition, ER stress-related proteins were downregulated by 4PBA treatment. Our study showed that 4PBA exerts an otoprotective effect, which provi...

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Atoh1 regulation in the cochlea: more than just transcription

AbstractMore than 80% of all cases of deafness are related to the death or degeneration of cochlear hair cells and the associated spiral ganglion neurons, and a lack of regeneration of these cells leads to permanent hearing loss. Therefore, the regeneration of lost hair cells is an important goal for the treatment of deafness.Atoh1 is a basic helix-loop-helix (bHLH) transcription factor that is critical in both the development and regeneration of cochlear hair cells. Atoh1 is transcriptionally regulated by several signaling pathways, including Notch and Wnt signalings. At the post-translational level, it is regulated through the ubiquitin-proteasome pathway. In vitro and in vivo studies have revealed that manipulation of these signaling pathways not only controls development, but also lead...

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Embolization of brain arteriovenous malformations with the diluted Onyx technique: initial experience

Abstract

Purpose

Insufficient nidus occlusion is a matter of great concern to routine Onyx embolization of brain arteriovenous malformations (AVMs). This paper described an efficient method which using the diluted Onyx embolization technique to treat brain AVM.

Methods

The diluted Onyx technique was performed in a series of 15 patients with brain AVMs (10 males, 5 females; age range, 11–44 years). It consists of initial embolization with routine Onyx-18, followed by the diluted Onyx (1.5 mL of Onyx-18 diluted with 0.5 mL of DMSO) through the same microcatheter. The technical skills and angiographic and clinical outcomes were analyzed.

Results

A total of 15 embolization sessions were performed with diluted Onyx via 16 arterial feeders in these 15 patients. Each patient underwent one attempt of diluted Onyx through a single feeder except one patient. In this patient, the AVM was simultaneously embolized with diluted Onyx through double microcatheters which were placed in two feeders. When the length of reflux reached to 2 cm (or close to the determined length) and the embolic material could not move distally any more despite some rounds of "injection-reflux-waiting," regular Onyx 18 was changed to diluted Onyx. Antegrade flow of embolic material into the nidus was observed in 12 cases but failed in 3. An average of 90% (range 55–100%) estimated size reduction was achieved, and 6 AVMs were completely obliterated. No functionally relevant complications occurred.

Conclusion

The diluted Onyx technique could be a useful adjunct to routine Onyx embolization which may offer more embolic material penetrating into the nidus of AVM, but additional work is needed to validate this technique.

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Embolization of brain arteriovenous malformations with the diluted Onyx technique: initial experience

Abstract

Purpose

Insufficient nidus occlusion is a matter of great concern to routine Onyx embolization of brain arteriovenous malformations (AVMs). This paper described an efficient method which using the diluted Onyx embolization technique to treat brain AVM.

Methods

The diluted Onyx technique was performed in a series of 15 patients with brain AVMs (10 males, 5 females; age range, 11–44 years). It consists of initial embolization with routine Onyx-18, followed by the diluted Onyx (1.5 mL of Onyx-18 diluted with 0.5 mL of DMSO) through the same microcatheter. The technical skills and angiographic and clinical outcomes were analyzed.

Results

A total of 15 embolization sessions were performed with diluted Onyx via 16 arterial feeders in these 15 patients. Each patient underwent one attempt of diluted Onyx through a single feeder except one patient. In this patient, the AVM was simultaneously embolized with diluted Onyx through double microcatheters which were placed in two feeders. When the length of reflux reached to 2 cm (or close to the determined length) and the embolic material could not move distally any more despite some rounds of "injection-reflux-waiting," regular Onyx 18 was changed to diluted Onyx. Antegrade flow of embolic material into the nidus was observed in 12 cases but failed in 3. An average of 90% (range 55–100%) estimated size reduction was achieved, and 6 AVMs were completely obliterated. No functionally relevant complications occurred.

Conclusion

The diluted Onyx technique could be a useful adjunct to routine Onyx embolization which may offer more embolic material penetrating into the nidus of AVM, but additional work is needed to validate this technique.

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Is Day Care Tonsillectomy a Safe Procedure?

Abstract

Tonsillectomy with or without adenoidectomy is the commonest procedure performed by an otolaryngologist. It has been performed as an in-patient procedure. To present our experience of 15 years of day care tonsillectomy with or without adenoidectomy and to assess the safety of tonsillectomy as a day care procedure. Design: retrospective study. A retrospective study of all day care tonsillectomies with or without adenoidectomies operated at a Secondary care ENT Hospital from 2002 to 2016 has been carried out. In last 15 years, we have operated 1207 tonsillectomies with or without adenoidectomies as a day care procedure. Postoperatively, the patients were discharged after observing for 6 to 8 h. Out of 1207 patients, 3 patients required readmission due to bleeding and 5 due to pain. Hence the overall readmission rate following tonsillectomy was 8/1027, which equals to 0.778 percent. Two patients with postoperative bleeding within 6 h were taken up for exploration and control of hemostasis. One patient of secondary haemorrhage was managed conservatively. None of the patients required blood transfusion. Day care tonsillectomy with or without adenoidectomy is a safe procedure as long as the patients are carefully selected. It is also cost effective. Level of evidence: Level 4.

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Is Day Care Tonsillectomy a Safe Procedure?

Abstract

Tonsillectomy with or without adenoidectomy is the commonest procedure performed by an otolaryngologist. It has been performed as an in-patient procedure. To present our experience of 15 years of day care tonsillectomy with or without adenoidectomy and to assess the safety of tonsillectomy as a day care procedure. Design: retrospective study. A retrospective study of all day care tonsillectomies with or without adenoidectomies operated at a Secondary care ENT Hospital from 2002 to 2016 has been carried out. In last 15 years, we have operated 1207 tonsillectomies with or without adenoidectomies as a day care procedure. Postoperatively, the patients were discharged after observing for 6 to 8 h. Out of 1207 patients, 3 patients required readmission due to bleeding and 5 due to pain. Hence the overall readmission rate following tonsillectomy was 8/1027, which equals to 0.778 percent. Two patients with postoperative bleeding within 6 h were taken up for exploration and control of hemostasis. One patient of secondary haemorrhage was managed conservatively. None of the patients required blood transfusion. Day care tonsillectomy with or without adenoidectomy is a safe procedure as long as the patients are carefully selected. It is also cost effective. Level of evidence: Level 4.

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Inhibition of Histone Methyltransferase G9a Attenuates Noise-Induced Cochlear Synaptopathy and Hearing Loss

In this study, we investigated the effect of G9a (KMT1C, EHMT2), a major histone lysine methyltransferase encoded by the humanEHMT2 gene and responsible for histone H3 lysine 9 dimethylation (H3K9me2) on noise-induced permanent hearing loss (NIHL) in adult CBA/J mice. The conditions of noise exposure used in this study led to losses of cochlear synapses and outer hair cells (OHCs) and permanent auditory threshold shifts. Inhibition of G9a with its specific inhibitor BIX 01294 or with siRNA significantly attenuated these pathological features. Treatment with BIX 01294 also prevented the noise-induced decrease of KCNQ4 immunolabeling in OHCs. Additionally, G9a was increased in cochlear cells, including both outer and inner sensory hair cells, some spiral ganglion neurons (SGNs), and marginal...

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Inhibition of Histone Methyltransferase G9a Attenuates Noise-Induced Cochlear Synaptopathy and Hearing Loss

In this study, we investigated the effect of G9a (KMT1C, EHMT2), a major histone lysine methyltransferase encoded by the humanEHMT2 gene and responsible for histone H3 lysine 9 dimethylation (H3K9me2) on noise-induced permanent hearing loss (NIHL) in adult CBA/J mice. The conditions of noise exposure used in this study led to losses of cochlear synapses and outer hair cells (OHCs) and permanent auditory threshold shifts. Inhibition of G9a with its specific inhibitor BIX 01294 or with siRNA significantly attenuated these pathological features. Treatment with BIX 01294 also prevented the noise-induced decrease of KCNQ4 immunolabeling in OHCs. Additionally, G9a was increased in cochlear cells, including both outer and inner sensory hair cells, some spiral ganglion neurons (SGNs), and marginal...

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Authors' response to a critique by Jauhar and Hayes of ‘a systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guideline evidence-based?’

Publication date: Available online 1 February 2019

Source: Addictive Behaviors

Author(s): James Davies, John Read

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Authors' response to a critique by Jauhar and Hayes of ‘a systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guideline evidence-based?’

Publication date: Available online 1 February 2019

Source: Addictive Behaviors

Author(s): James Davies, John Read

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Thank you!

Publication date: March 2019

Source: International Journal of Pediatric Otorhinolaryngology, Volume 118

Author(s):

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Erratum to “Population-based cross-sectional study to assess newborn hearing screening program in Central Germany” [Int. J. Pediatr. Otorhinolaryngol., 107 (2018) 110–120]

Publication date: Available online 2 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Anke Rissmann, Andrea Koehn, Marja Loderstedt, Cornelia Schwemmle, Gerrit Goetze, Sylva Bartel, Stefan K. Plontke, Joerg Langer, Klaus Begall, Peter Matulat, Friedrich-Wilhelm Roehl, Ulrich Vorwerk

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Risk of occurrence and recurrence of otitis media with effusion in children suffering from cleft palate

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caroline Rieu-Chevreau, Nolwenn Lavagen, Cica Gbaguidi, Stéphanie Dakpé, Nathalie Klopp-Dutote, Cyril Page

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Evaluation of hearing in pediatric familial Mediterranean fever patients during attack period and attack-free period

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Asif Salimov, Umut Akyol, Bunyamin Cildir, Ezgi Deniz Batu, Seza Ozen

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Thank you!

Publication date: March 2019

Source: International Journal of Pediatric Otorhinolaryngology, Volume 118

Author(s):

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Erratum to “Population-based cross-sectional study to assess newborn hearing screening program in Central Germany” [Int. J. Pediatr. Otorhinolaryngol., 107 (2018) 110–120]

Publication date: Available online 2 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Anke Rissmann, Andrea Koehn, Marja Loderstedt, Cornelia Schwemmle, Gerrit Goetze, Sylva Bartel, Stefan K. Plontke, Joerg Langer, Klaus Begall, Peter Matulat, Friedrich-Wilhelm Roehl, Ulrich Vorwerk

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Risk of occurrence and recurrence of otitis media with effusion in children suffering from cleft palate

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caroline Rieu-Chevreau, Nolwenn Lavagen, Cica Gbaguidi, Stéphanie Dakpé, Nathalie Klopp-Dutote, Cyril Page

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Evaluation of hearing in pediatric familial Mediterranean fever patients during attack period and attack-free period

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Asif Salimov, Umut Akyol, Bunyamin Cildir, Ezgi Deniz Batu, Seza Ozen

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Ethnomedicinal uses of the local flora in Chenab riverine area, Punjab province Pakistan

Because of diverse topographical habitats, the Chenab River wetland harbors a wealth of medicinal and food plant species. This paper presents first quantitative assessment on the ethnobotanical use of plants b...

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Ethnomedicinal uses of the local flora in Chenab riverine area, Punjab province Pakistan

Because of diverse topographical habitats, the Chenab River wetland harbors a wealth of medicinal and food plant species. This paper presents first quantitative assessment on the ethnobotanical use of plants b...

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Loneliness among adults with visual impairment: prevalence, associated factors, and relationship to life satisfaction

Little is known about whether and to what extent loneliness impacts the lives of people with visual impairment (VI). Thus, the aim of this study was to examine the prevalence of and factors associated with lon...

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Loneliness among adults with visual impairment: prevalence, associated factors, and relationship to life satisfaction

Little is known about whether and to what extent loneliness impacts the lives of people with visual impairment (VI). Thus, the aim of this study was to examine the prevalence of and factors associated with lon...

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Reduced axial diffusivity and increased mode and T2 signals in cerebral white matter of chronic obstructive pulmonary disease using tract-based spatial statistics

Abstract

Purpose

Chronic obstructive pulmonary disease (COPD) is considered to be a multi-systemic disease involving pathological changes in the brain. This study investigated how diffusion tensor imaging (DTI) parameters in patients with non-hypoxemic COPD differ from those in controls. Moreover, we tried to examine whether the mode of anisotropy (MO) reflects early changes in white matter (WM) integrity in COPD.

Methods

DT images were obtained from 13 male COPD patients and 13 age- and sex-matched healthy controls. Raw DT images were processed using an automated tract-based spatial statistics (TBSS) pipeline. DTI scalars of fractional anisotropy (FA); axial, radial, and mean diffusivities (AD, RD, and MD, respectively); MO; and raw T2 signal (S0) were statistically compared between COPD patients and controls. TBSS methods were used for analysis.

Results

In patients with COPD, decreased AD was observed in the temporal stem (TS), corticospinal tract (CST), thalamus, subiculum, crus cerebri, and midbrain. Increased MO values were found in the corpus callosum, CST, internal capsule, cerebellar peduncle (CP), and medial lemniscus (ML). Additionally, increased S0 was found in the TS, CP, pons, and cerebellar tonsil (threshold-free cluster enhancement to a family-wise error rate of p < 0.05).

Conclusion

The results revealed decreased AD and increased MO scalars in COPD patients compared with the controls, although there were no differences in FA, RD, and MD scalars. Decreased AD and increased MO scalars may reflect early changes in WM integrity in COPD patients.

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Psychosocial factors and self‐reported transitions in oral and general health

Psychosocial factors may explain variance in health beyond conventional indicators, such as behaviours. This study aimed to examine changes in health associated with perceived stress, social support, and self‐efficacy, controlling for sociodemographic characteristics and health behaviour. A random sample of 45‐ to 54‐yr‐old subjects was surveyed in 2004–2005, with a follow‐up 2 yr later. The outcomes were self‐reported changes in oral and general health. Explanatory variables included stress, social support, and perceived health competence with covariates of income, gender, dentition status, toothbrushing, and smoking. Responses were collected from 986 persons (response = 44.4%). At the 2‐yr follow‐up, 25.6% reported worsening in oral health and 15.3% reported worsening in general health. Prevalence ratios (PR) from adjusted log‐binomial regression showed an association between worsening oral health and higher perceived health competence (PR = 0.75, 95% CI: 0.57–0.99), and worsening general health was associated with perceived health competence (PR = 0.82, 95% CI: 0.72–0.94) and stress (PR = 1.17, 95% CI: 1.03–1.32). Worsening oral and general health were seen for male subjects (PR = 1.33, 95% CI: 1.06–1.68 and PR = 1.14, 95% CI: 1.01–1.29) and low income (PR = 1.40, 95% CI: 1.04–1.89 and PR = 1.20, 95% CI: 1.03–1.40). Health‐related self‐efficacy representing psychosocial resilience was associated with oral and general health, while stress was associated with general health. Psychosocial factors were independent predictors of change in health after controlling for sociodemographic characteristics and health behaviours.

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Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach

Abstract

Purpose

According to the revised World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) of 2016, oligodendrogliomas are now defined primarily by a specific molecular signature (presence of IDH mutation and 1p19q codeletion). The purpose of our study was to assess the value of dynamic susceptibility contrast MR imaging (DSC-MRI) and diffusion-weighted imaging (DWI) to characterize oligodendrogliomas and to distinguish them from astrocytomas.

Methods

Seventy-one adult patients with untreated WHO grade II and grade III diffuse infiltrating gliomas and known 1p/19q codeletion status were retrospectively identified and analyzed using relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) maps based on whole-tumor volume histograms. The Mann-Whitney U test and logistic regression were used to assess the ability of rCBV and ADC to differentiate between oligodendrogliomas and astrocytomas both independently, but also related to the WHO grade. Prediction performance was evaluated in leave-one-out cross-validation (LOOCV).

Results

Oligodendrogliomas showed significantly higher microvascularity (higher rCBV_Mean ≥ 0.80, p = 0.013) and higher vascular heterogeneity (lower rCBV_Peak ≤ 0.044, p = 0.015) than astrocytomas. Diffuse gliomas with higher cellular density (lower ADC_Mean ≤ 1094 × 10⁻⁶ mm²/s, p = 0.009) were more likely to be oligodendrogliomas than astrocytomas. Histogram analysis of rCBV and ADC was able to differentiate between diffuse astrocytomas (WHO grade II) and anaplastic astrocytomas (WHO grade III).

Conclusion

Histogram-derived rCBV and ADC parameter may be used as biomarkers for identification of oligodendrogliomas and may help characterize diffuse gliomas based upon their genetic characteristics.

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Psychosocial factors and self‐reported transitions in oral and general health

Psychosocial factors may explain variance in health beyond conventional indicators, such as behaviours. This study aimed to examine changes in health associated with perceived stress, social support, and self‐efficacy, controlling for sociodemographic characteristics and health behaviour. A random sample of 45‐ to 54‐yr‐old subjects was surveyed in 2004–2005, with a follow‐up 2 yr later. The outcomes were self‐reported changes in oral and general health. Explanatory variables included stress, social support, and perceived health competence with covariates of income, gender, dentition status, toothbrushing, and smoking. Responses were collected from 986 persons (response = 44.4%). At the 2‐yr follow‐up, 25.6% reported worsening in oral health and 15.3% reported worsening in general health. Prevalence ratios (PR) from adjusted log‐binomial regression showed an association between worsening oral health and higher perceived health competence (PR = 0.75, 95% CI: 0.57–0.99), and worsening general health was associated with perceived health competence (PR = 0.82, 95% CI: 0.72–0.94) and stress (PR = 1.17, 95% CI: 1.03–1.32). Worsening oral and general health were seen for male subjects (PR = 1.33, 95% CI: 1.06–1.68 and PR = 1.14, 95% CI: 1.01–1.29) and low income (PR = 1.40, 95% CI: 1.04–1.89 and PR = 1.20, 95% CI: 1.03–1.40). Health‐related self‐efficacy representing psychosocial resilience was associated with oral and general health, while stress was associated with general health. Psychosocial factors were independent predictors of change in health after controlling for sociodemographic characteristics and health behaviours.

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Reduced axial diffusivity and increased mode and T2 signals in cerebral white matter of chronic obstructive pulmonary disease using tract-based spatial statistics

Abstract

Purpose

Chronic obstructive pulmonary disease (COPD) is considered to be a multi-systemic disease involving pathological changes in the brain. This study investigated how diffusion tensor imaging (DTI) parameters in patients with non-hypoxemic COPD differ from those in controls. Moreover, we tried to examine whether the mode of anisotropy (MO) reflects early changes in white matter (WM) integrity in COPD.

Methods

DT images were obtained from 13 male COPD patients and 13 age- and sex-matched healthy controls. Raw DT images were processed using an automated tract-based spatial statistics (TBSS) pipeline. DTI scalars of fractional anisotropy (FA); axial, radial, and mean diffusivities (AD, RD, and MD, respectively); MO; and raw T2 signal (S0) were statistically compared between COPD patients and controls. TBSS methods were used for analysis.

Results

In patients with COPD, decreased AD was observed in the temporal stem (TS), corticospinal tract (CST), thalamus, subiculum, crus cerebri, and midbrain. Increased MO values were found in the corpus callosum, CST, internal capsule, cerebellar peduncle (CP), and medial lemniscus (ML). Additionally, increased S0 was found in the TS, CP, pons, and cerebellar tonsil (threshold-free cluster enhancement to a family-wise error rate of p < 0.05).

Conclusion

The results revealed decreased AD and increased MO scalars in COPD patients compared with the controls, although there were no differences in FA, RD, and MD scalars. Decreased AD and increased MO scalars may reflect early changes in WM integrity in COPD patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S5qzI9

Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach

Abstract

Purpose

According to the revised World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) of 2016, oligodendrogliomas are now defined primarily by a specific molecular signature (presence of IDH mutation and 1p19q codeletion). The purpose of our study was to assess the value of dynamic susceptibility contrast MR imaging (DSC-MRI) and diffusion-weighted imaging (DWI) to characterize oligodendrogliomas and to distinguish them from astrocytomas.

Methods

Seventy-one adult patients with untreated WHO grade II and grade III diffuse infiltrating gliomas and known 1p/19q codeletion status were retrospectively identified and analyzed using relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) maps based on whole-tumor volume histograms. The Mann-Whitney U test and logistic regression were used to assess the ability of rCBV and ADC to differentiate between oligodendrogliomas and astrocytomas both independently, but also related to the WHO grade. Prediction performance was evaluated in leave-one-out cross-validation (LOOCV).

Results

Oligodendrogliomas showed significantly higher microvascularity (higher rCBV_Mean ≥ 0.80, p = 0.013) and higher vascular heterogeneity (lower rCBV_Peak ≤ 0.044, p = 0.015) than astrocytomas. Diffuse gliomas with higher cellular density (lower ADC_Mean ≤ 1094 × 10⁻⁶ mm²/s, p = 0.009) were more likely to be oligodendrogliomas than astrocytomas. Histogram analysis of rCBV and ADC was able to differentiate between diffuse astrocytomas (WHO grade II) and anaplastic astrocytomas (WHO grade III).

Conclusion

Histogram-derived rCBV and ADC parameter may be used as biomarkers for identification of oligodendrogliomas and may help characterize diffuse gliomas based upon their genetic characteristics.

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Residual inhibition: from the putative mechanisms to potential tinnitus treatment

Publication date: Available online 1 February 2019

Source: Hearing Research

Author(s): A.V. Galazyuk, R.J. Longenecker, S.V. Voytenko, I. Kristaponyte, G.L. Nelson

Abstract

Neurons in various sensory systems show some level of spontaneous firing in the absence of sensory stimuli. In the auditory system spontaneous firing has been shown at all levels of the auditory pathway from spiral ganglion neurons in the cochlea to neurons of the auditory cortex. This internal "noise" is normal for the system and it does not interfere with our ability to perceive silence or analyze sound. However, this internal noise can be elevated under pathological conditions, leading to the perception of a phantom sound known as tinnitus. The efforts of many research groups, including our own, led to the development of a mechanistic understanding of this process: After cochlear insult the input to the central auditory system becomes markedly reduced. As a result, the neural activity in the central auditory system is enhanced to compensate for this reduced input. Such hyperactivity is hypothesized to be interpreted by the brain as a presence of sound. This implies that suppression of hyperactivity should reduce/eliminate tinnitus. This review explores research from our laboratory devoted to identifying the mechanism underlying residual inhibition of tinnitus, a brief suppression of tinnitus following a sound stimulus. The key mechanisms that govern neural suppression of spontaneous activity in animals closely resemble clinical psychoacoustic findings of residual inhibition (RI) observed in tinnitus patients. This suppression is mediated by metabotropic glutamate receptors (mGluRs). Lastly, drugs targeting mGluRs suppress spontaneous activity in auditory neurons and reduce/eliminate behavioral signs of tinnitus in mice. Thus, these drugs are therapeutically relevant for tinnitus suppression in humans.

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Neuroprotective effects of MK-801 on auditory cortex in salicylate-induced tinnitus: involvement of neural activity, glutamate and ascorbate

Publication date: Available online 1 February 2019

Source: Hearing Research

Author(s): Shan Xiong, Yu Song, Junxiu Liu, Yali Du, Yujing Ding, Huan Wei, Kevin Bryan, Furong Ma, Lanqun Mao

Abstract

Tinnitus may cause anxiety, depression, insomnia, which impair the quality of life of millions worldwide. However, the mechanism of tinnitus remains to be understood, it has been previously hypothesized that the activation of N-methyl-D-aspartate (NMDA) receptor is involved in the tinnitus processes and blockade of the NMDA receptor is regarded as a therapeutic strategy for tinnitus treatment even if the rescue treatment is still proved invalid in some cases. To demonstrate the therapeutic effect of the NMDA receptor blocker on tinnitus, we examined here the spontaneous firing rate (SFR) and the neurochemical dynamics in the auditory cortex (AC) of rats after sodium salicylate (SS) injection, which is a widely used model for tinnitus research. We also recorded their responses to MK-801 treatment. Electrophysiological studies showed that MK-801 significantly suppresses SFR in AC of rats with SS-induced tinnitus. In addition, by using a technique that combining in vivo microdialysis with an online electrochemical system (OECS) and a high-performance liquid chromatography (HPLC), we found that the levels of both glutamate and ascorbate in AC dramatically increased after SS injection and that MK-801 administration attenuated those response. Further studies found that MK-801 given at a time point of 30 min pre- or post- injection of SS were more effective than that given at a time point of 60 min post-SS injection, indicating that the time point of MK-801 intervention has a critical impact on the therapeutic effect. These findings suggest that MK-801 plays a neuroprotective role against hyperactivity during tinnitus induced by SS and that the therapeutic effect depends on the time point of MK-801 intervention, which would advance the studies on understanding of the therapeutic potential of NMDA receptor antagonist in tinnitus therapy.

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Residual inhibition: from the putative mechanisms to potential tinnitus treatment

Publication date: Available online 1 February 2019

Source: Hearing Research

Author(s): A.V. Galazyuk, R.J. Longenecker, S.V. Voytenko, I. Kristaponyte, G.L. Nelson

Abstract

Neurons in various sensory systems show some level of spontaneous firing in the absence of sensory stimuli. In the auditory system spontaneous firing has been shown at all levels of the auditory pathway from spiral ganglion neurons in the cochlea to neurons of the auditory cortex. This internal "noise" is normal for the system and it does not interfere with our ability to perceive silence or analyze sound. However, this internal noise can be elevated under pathological conditions, leading to the perception of a phantom sound known as tinnitus. The efforts of many research groups, including our own, led to the development of a mechanistic understanding of this process: After cochlear insult the input to the central auditory system becomes markedly reduced. As a result, the neural activity in the central auditory system is enhanced to compensate for this reduced input. Such hyperactivity is hypothesized to be interpreted by the brain as a presence of sound. This implies that suppression of hyperactivity should reduce/eliminate tinnitus. This review explores research from our laboratory devoted to identifying the mechanism underlying residual inhibition of tinnitus, a brief suppression of tinnitus following a sound stimulus. The key mechanisms that govern neural suppression of spontaneous activity in animals closely resemble clinical psychoacoustic findings of residual inhibition (RI) observed in tinnitus patients. This suppression is mediated by metabotropic glutamate receptors (mGluRs). Lastly, drugs targeting mGluRs suppress spontaneous activity in auditory neurons and reduce/eliminate behavioral signs of tinnitus in mice. Thus, these drugs are therapeutically relevant for tinnitus suppression in humans.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MJNsLj

Neuroprotective effects of MK-801 on auditory cortex in salicylate-induced tinnitus: involvement of neural activity, glutamate and ascorbate

Publication date: Available online 1 February 2019

Source: Hearing Research

Author(s): Shan Xiong, Yu Song, Junxiu Liu, Yali Du, Yujing Ding, Huan Wei, Kevin Bryan, Furong Ma, Lanqun Mao

Abstract

Tinnitus may cause anxiety, depression, insomnia, which impair the quality of life of millions worldwide. However, the mechanism of tinnitus remains to be understood, it has been previously hypothesized that the activation of N-methyl-D-aspartate (NMDA) receptor is involved in the tinnitus processes and blockade of the NMDA receptor is regarded as a therapeutic strategy for tinnitus treatment even if the rescue treatment is still proved invalid in some cases. To demonstrate the therapeutic effect of the NMDA receptor blocker on tinnitus, we examined here the spontaneous firing rate (SFR) and the neurochemical dynamics in the auditory cortex (AC) of rats after sodium salicylate (SS) injection, which is a widely used model for tinnitus research. We also recorded their responses to MK-801 treatment. Electrophysiological studies showed that MK-801 significantly suppresses SFR in AC of rats with SS-induced tinnitus. In addition, by using a technique that combining in vivo microdialysis with an online electrochemical system (OECS) and a high-performance liquid chromatography (HPLC), we found that the levels of both glutamate and ascorbate in AC dramatically increased after SS injection and that MK-801 administration attenuated those response. Further studies found that MK-801 given at a time point of 30 min pre- or post- injection of SS were more effective than that given at a time point of 60 min post-SS injection, indicating that the time point of MK-801 intervention has a critical impact on the therapeutic effect. These findings suggest that MK-801 plays a neuroprotective role against hyperactivity during tinnitus induced by SS and that the therapeutic effect depends on the time point of MK-801 intervention, which would advance the studies on understanding of the therapeutic potential of NMDA receptor antagonist in tinnitus therapy.

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The prevalence and impact of cervical spine pathologies in patients with nasopharyngeal carcinoma

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Colin Shing-Yat Yung, Dennis Kwok Chuen Leung, Jason Pui Yin Cheung

Abstract

Objectives

Nasopharyngeal carcinoma (NPC) and its treatment can lead to cervical spine pathologies such as metastases, osteoradionecrosis (ORN) and infection. However, the occurrence rate and relationship between timing of diagnosis and outcomes of the ever-advancing technology of radiation therapy is largely unknown. Hence, the aim of this study is to determine the prevalence and impact of cervical spine pathologies in patients with NPC.

Materials and methods

This was a cross-sectional study of all newly diagnosed cases of NPC from 2007 to 2016 at a tertiary referral oncology and spine centre with minimum 1-year post-treatment follow-up. All cervical spine pathologies, their treatment and outcomes were determined. Presentation, onset time and correlations of the cervical spine pathologies with mortality and risk factors were also analysed.

Results

Out of 605 cases of verified cases of NPC, cervical spine pathologies were seen in 8.9% of patients. New onset neck pain was seen in 5.3%, symptomatic cervical spondylosis in 4.8%, cervical spine metastases in 2.5%, local tumour invasion in 0.8%, cervical ORN in 0.7%, osteomyelitis in 0.7%, radiculopathy in 0.3%, and myelopathy in 0.3%. Cervical spine pathologies were associated with an increased risk (odds ratio: 2.73) in overall mortality. Cervical spine metastases, invasion, ORN and infection were associated with significantly higher risk of mortality (p = 0.01–0.02).

Conclusion

Cervical spine pathologies in patients with NPC are heterogenous but not uncommon. Neck pain is prevalent but is often benign. ORN and osteomyelitis of the cervical spine is uncommon but have large clinical implications including higher mortality with subtle presentations.

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Direct and antibody-dependent cell-mediated cytotoxicity of head and neck squamous cell carcinoma cells by high-affinity natural killer cells

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Jay Friedman, Michelle Padget, John Lee, Jeffrey Schlom, James Hodge, Clint Allen

Abstract

High affinity natural killer cells (haNKs) are a cell therapy product capable of mediating both direct and antibody-dependent cell-mediated cytotoxicity (ADCC). These cells may be particularly useful in tumors that escape T-cell anti-tumor immunity by harboring antigen processing and presentation defects. Here, we demonstrated that haNKs directly kill both HPV-positive and negative head and neck squamous cell carcinoma cells. Variable tumor cell sensitivity to haNK direct cytotoxicity did not correlated with MHC class I chain-related protein A or B (MICA or MICB) expression. Importantly, haNK killing was significantly enhanced via ADCC mediated by cetuximab or avelumab in cells with higher baseline EGFR or PD-L1 expression, respectively. The ability of IFNγ to induce tumor cell PD-L1 expression correlated with enhanced PD-L1-specific ADCC. IFNγ induced neither tumor cell EGFR expression nor EGFR-specific ADCC. Although a single dose of 8 Gy IR did not appear to directly enhance susceptibility to haNK killing alone, enhanced PD-L1- and EGFR-mediated ADCC after IR correlated with increased PD-L1 and EGFR expression in one of four models. This pre-clinical evidence supports the investigation of haNK cellular therapy in combination with ADCC-mediating mAbs, with or without IR, in the clinical trial setting for patients with advanced HNSCCs. Given the MHC-unrestricted nature of this treatment, it may represent an opportunity to treat patients with non-T-cell inflamed tumors.

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Prognostic value of programed death ligand-1 and ligand-2 co-expression in salivary gland carcinomas

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Takafumi Nakano, Katsumi Takizawa, Azusa Uezato, Kenichi Taguchi, Satoshi Toh, Muneyuki Masuda

Abstract

Objectives

The aim of the present study was to investigate the molecular basis for the use of immune checkpoint inhibitors to treat salivary gland carcinomas (SGC).

Materials and methods

We examined the clinical and prognostic significance of programed death ligands 1 and 2 (PD-L1 and -L2) expression using immunohistochemistry and in situ hybridization, as well as microsatellite instability (MSI) status using polymerase chain reaction, along with tumor-infiltrating lymphocytes (TILs) in 30 cases of SGC.

Results

The SGC cases studied included adenoid cystic carcinoma (AdCC, 36.7%), salivary duct carcinoma (SDC, 26.7%), mucoepidermoid carcinoma (MEC, 23.3%), and carcinoma ex pleomorphic adenoma (CxPA, 13.3%). Either PD-L1 or PD-L2 overexpression was observed in 36.7% patients. PD-L2 expression was associated with reduced disease-specific survival (DSS) and disease-free survival (DFS) (P = 0.0266 and P = 0.0209, respectively). Simultaneous PD-L1 and PD-L2 overexpression was detected in 13.3% of cases, and was correlated with reduced DSS (P = 0.0113). Among non-AdCCs, all cases that developed distant metastasis were positive for PD-L2 (P = 0.001). Cases showing low-TILs that were positive for either PD-L1 or L2 were associated with poor DFS. No MSI was detected in the SGC cases studied.

Conclusion

To our knowledge, this is the first comprehensive study examining PD-L1 and PD-L2 status, MSI status, and TILs in SGC. Our results indicate that the PD-1/PD-L1 or PD-L2 pathway, which is associated with poor clinical outcomes, may provide promising therapeutic targets against SGC in selected patients. Further experimental and clinical studies are encouraged.

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Effect of prior cancer on trial eligibility and treatment outcomes in nasopharyngeal carcinoma: Implications for clinical trial accrual

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Ya-Qin Wang, Jia-Wei Lv, Ling-Long Tang, Xiao-Jing Du, Lei Chen, Wen-Fei Li, Xu Liu, Ying Guo, Ai-Hua Lin, Yan-Ping Mao, Ying Sun, Yu-Pei Chen, Jun Ma

Abstract

Objective

In cancer trials, prior cancer is a common exclusion criterion. We evaluated the characteristics of prior cancer exclusion criteria in nasopharyngeal carcinoma (NPC) trials and determined its prognostic effect on patients with NPC.

Methods

We reviewed NPC trials for prior cancer exclusion criteria. Then we estimated the effect of prior cancer among NPC patients using the Surveillance, Epidemiology, and End Results database. Propensity score-matching was used to compensate for differences in baseline characteristics between patients with and without prior cancer.

Results

There were 109 clinical trials involving 10,437 patients; 49 trials (45%) excluded patients with prior cancer. Prior cancer exclusion was more common in recent or phase III trials. We identified 10,195 NPC patients; 6.2% had prior cancer. More than 70% of these cancers were in situ/localized/regional and diagnosed relatively close to the NPC diagnosis (median 3.3 years). Patients with certain prior cancer type (prostate, breast, gynecological, hematological), time of diagnosis (>5 years ago), or stage (in situ/localized) did not have inferior survival compared with patients with no prior cancer. We tested one form of prior cancer exclusion criteria in an NPC cohort resembling a modern trial population: it did not adversely affect overall and NPC-specific survival.

Conclusions

Many NPC trials excluded patients with prior cancer, which impacts trial accrual and generalizability. Our findings suggest that broader inclusion in trials of patients with NPC with prior cancer might not affect trial outcomes. More research is needed to understand the appropriateness of this exclusion policy across cancer types and trials.

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