Αρχειοθήκη ιστολογίου

Κυριακή 31 Ιανουαρίου 2016

Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma.

Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma.

Neuro Oncol. 2016 Jan 28;

Authors: Abedalthagafi M, Bi WL, Aizer AA, Merrill PH, Brewster R, Agarwalla PK, Listewnik ML, Dias-Santagata D, Thorner AR, Van Hummelen P, Brastianos PK, Reardon DA, Wen PY, Al-Mefty O, Ramkissoon SH, Folkerth RD, Ligon KL, Ligon AH, Alexander BM, Dunn IF, Beroukhim R, Santagata S

Abstract
BACKGROUND: Meningiomas are the most common primary intracranial tumor in adults. Identification of SMO and AKT1 mutations in meningiomas has raised the possibility of targeted therapies for some patients. The frequency of such mutations in clinical cohorts and the presence of other actionable mutations in meningiomas are important to define.
METHODS: We used high-resolution array-comparative genomic hybridization to prospectively characterize copy-number changes in 150 meningiomas and then characterized these samples for mutations in AKT1, KLF4, NF2, PIK3CA, SMO, and TRAF7.
RESULTS: Similar to prior reports, we identified AKT1 and SMO mutations in a subset of non-NF2-mutant meningiomas (ie, ∼9% and ∼6%, respectively). Notably, we detected oncogenic mutations in PIK3CA in ∼7% of non-NF2-mutant meningiomas. AKT1, SMO, and PIK3CA mutations were mutually exclusive. AKT1, KLF4, and PIK3CA mutations often co-occurred with mutations in TRAF7. PIK3CA-mutant meningiomas showed limited chromosomal instability and were enriched in the skull base.
CONCLUSION: This work identifies PI3K signaling as an important target for precision medicine trials in meningioma patients.

PMID: 26826201 [PubMed - as supplied by publisher]



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Bulbar Paralysis and Facial Paralysis due to Metastatic Hepatocellular Carcinoma: A Case Report and Literature Review.

Bulbar Paralysis and Facial Paralysis due to Metastatic Hepatocellular Carcinoma: A Case Report and Literature Review.

Medicine (Baltimore). 2016 Jan;95(4):e2632

Authors: Liu M, Liu S, Liu B, Liu B, Guo L, Wang X, Wang Q, Yang S, Dong L

Abstract
Skull-base metastasis (SBM) from hepatocellular carcinoma (HCC) is extremely rare, and multiple cranial nerve paralysis due to SBM from HCC is also rare. We report a case of bulbar and facial paralysis due to SBM from HCC.A 46-year-old Chinese man presented with a hepatic right lobe lesion that was detected during a routine physical examination. After several failed attempts to treat the primary tumor and bone metastases, neurological examination revealed left VII, IX, X, and XI cranial nerve paralysis. Computed tomography of the skull base subsequently revealed a large mass that had destroyed the left occipital and temporal bones and invaded the adjacent structure. After radiotherapy (27 Gy, 9 fractions), the patient experienced relief from his pain, and the cranial nerve dysfunction regressed. However, the patient ultimately died, due to the tumor's progression.Radiotherapy is usually the best option to relieve pain and achieve regression of cranial nerve dysfunction in cases of SBM from HCC, although early treatment is needed to achieve optimal outcomes. The present case helps expand our understanding regarding this rare metastatic pathway and indicates that improved awareness of SBM in clinical practice can help facilitate timely and appropriate treatment.

PMID: 26825921 [PubMed - in process]



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The Extended Subfrontal and Fronto-Orbito-Zygomatic Approach in Skull Base Meningioma Surgery: Clinical, Radiologic, and Cosmetic Outcome.

The Extended Subfrontal and Fronto-Orbito-Zygomatic Approach in Skull Base Meningioma Surgery: Clinical, Radiologic, and Cosmetic Outcome.

J Craniofac Surg. 2016 Jan 28;

Authors: Soleman J, Leiggener C, Schlaeppi AJ, Kienzler J, Fathi AR, Fandino J

Abstract
OBJECTIVE: To review the outcome and cosmetic results of patients undergoing extended subfrontal and fronto-orbito-zygomatic craniotomy for resection of skull base meningiomas.
METHODS: All surgeries were performed in cooperation with an oral and maxillofacial surgeon between 2006 and 2012. Clinical presentation, surgical techniques and complications, cosmetic, clinical, and radiologic outcomes are presented.
RESULTS: This study included 25 consecutive patients with 26 operations. Total and subtotal tumor removal was obtained in 19 (73.1%) and 7 (26.9%) patients, respectively. Permanent postoperative complications were seen in 5 (19.2%) patients. Eight of 10 patients with preoperative visual impairment showed recovery at 6 months follow-up. Anosmia was improved in 50% and no worsening was seen in any case of hyposmia. All patients showed improved or complete correction of exophthalmos, cognitive deficits, and epilepsy. One patient (3.8%) developed a postoperative ptosis. No mortality was documented. All patients reported a favorable cosmetic satisfactory score over 6 (8.67 ± 1.6). Tumor recurrence rate was 7.7% (n = 2).
CONCLUSIONS: The extended subfrontal and fronto-orbito-zygomatic approach, used for resection of meningiomas located in the orbita and the skull base can provide better visibility of the tumor. In addition, these approaches lead to highly satisfying cosmetic and clinical results.

PMID: 26825741 [PubMed - as supplied by publisher]



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Facial Paralysis Secondary to Extensive Perineural Spread of Adenocarcinoma of the Parotid Gland Identified by PET/CT.

Facial Paralysis Secondary to Extensive Perineural Spread of Adenocarcinoma of the Parotid Gland Identified by PET/CT.

Clin Nucl Med. 2016 Jan 28;

Authors: Achong DM, Zloty M

Abstract
Brain MRI in an 82-year-old man with presumed Bell's palsy revealed a clinically unsuspected right parotid gland mass but no other acute findings. Biopsy revealed poorly differentiated adenocarcinoma. Staging F-FDG PET/CT revealed an FDG-avid parotid mass, abnormal FDG uptake along the course of the facial nerve from mass to skull base, and multiple FDG-avid right level II neck lymph nodes and hepatic metastases. The PET/CT findings and prolonged clinical course suggest that diffuse perineural spread of tumor from a smoldering parotid neoplasm, and not idiopathic Bell's palsy, was responsible for the patient's facial paralysis.

PMID: 26825200 [PubMed - as supplied by publisher]



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Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.

Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.

Eur Arch Otorhinolaryngol. 2016 Jan 29;

Authors: Yüksel A, Ugur KS, Kizilbulut G, Ark N, Kurtaran H, Kaya M, Gunduz M

Abstract
The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study.
SETTING: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver with ≥50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.

PMID: 26825802 [PubMed - as supplied by publisher]



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The nasal vestibular body: anatomy, clinical features, and treatment considerations.

The nasal vestibular body: anatomy, clinical features, and treatment considerations.

Eur Arch Otorhinolaryngol. 2016 Jan 29;

Authors: Locketz GD, Teo NW, Walgama E, Humphreys IM, Nayak JV

Abstract
Nasal obstruction is a common presenting complaint, with many possible etiologies. Herein, we provide an introductory anatomic description, clinical relevance, and proposed nomenclature for an underappreciated soft tissue focus in the nasal vestibule-the nasal vestibular body (NVB)-that can contribute to nasal obstruction in a subset of patients. This is a small mound of dynamic soft tissue in the lateral aspect of the internal nasal valve, situated inferior and anterior to the head of the inferior turbinate that can be missed on routine examination for many salient reasons. In well-selected patients, whose symptoms of nasal obstruction may in part be secondary to the presence of this soft tissue focus, directed testing and tissue reduction can be performed.

PMID: 26825801 [PubMed - as supplied by publisher]



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Retrospective analysis of the clinical efficacy of definitive chemoradiotherapy for patients with hypopharyngeal cancer.

Retrospective analysis of the clinical efficacy of definitive chemoradiotherapy for patients with hypopharyngeal cancer.

Jpn J Clin Oncol. 2016 Jan 29;

Authors: Takehana K, Kodaira T, Tachibana H, Kimura K, Shimizu A, Makita C, Tomita N, Nishikawa D, Suzuki H, Hirakawa H, Hanai N, Hasegawa Y

Abstract
OBJECTIVE: A retrospective analysis was performed to evaluate the clinical efficacy of definitive chemoradiotherapy including intensity-modulated radiotherapy for patients with hypopharyngeal cancer.
METHODS: Previously untreated 204 patients with hypopharyngeal cancer were treated with definitive chemoradiotherapy. Of note, 66-70 Gy was delivered to the primary and involved nodes and 36-54 Gy was delivered to the prophylactic lymph node using standard fractionated radiotherapy. One hundred and forty-six patients received induction chemotherapy as a larynx preservation strategy, followed by definitive radiotherapy with or without concurrent chemotherapy. Intensity-modulated radiotherapy was also performed after 2006.
RESULTS: The median follow-up time of this cohort was 43.4 months (range; 6.9-151.0). The 3-year overall survival, progression-free survival and larynx preservation survival rates were 78.8% (95% confidence interval; 73.0-85.0), 58.4% (95% confidence interval; 51.8-65.9) and 67.5% (95% confidence interval; 61.0-74.7), respectively. Multivariate analyses identified the following significant prognostic factors: an advanced age, the T category and N category for overall survival, the T category and N category for progression-free survival and the T category for larynx preservation survival. Acute toxicities of Grade 3 or higher were observed in 47 patients (23.0%). Two patients (1.0%) had Grade 4 pharyngeal edema. Suspicious treatment-related death due to lethal pharyngeal hemorrhage occurred in 1 (0.4%) patient. The rates of Grade 2 xerostomia in patients treated with intensity-modulated radiotherapy were 28.1, 17.4 and 9.5% at 6 months, 1 and 2 years after the completion of radiotherapy, respectively.
CONCLUSIONS: The efficacy and safety of definitive chemoradiotherapy are considered feasible with sufficient laryngeal preservation.

PMID: 26826721 [PubMed - as supplied by publisher]



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Resection of recurrent neck cancer with carotid artery replacement.

Resection of recurrent neck cancer with carotid artery replacement.

J Vasc Surg. 2016 Jan 26;

Authors: Illuminati G, Schneider F, Minni A, Calio FG, Pizzardi G, Ricco JB

Abstract
OBJECTIVE: The management of patients with recurrent neck cancer invading the carotid artery is controversial. The purpose of this study was to evaluate overall survival rate, primary patency of vascular reconstructions, and quality-adjusted life-years (QALYs) after en bloc resection of the carotid artery and tumor with in-line polytetrafluoroethylene (PTFE) carotid grafting, followed by radiotherapy.
METHODS: From 2000 to 2014, 31 consecutive patients with recurrent neck cancer invading the carotid artery underwent en bloc resection and simultaneous carotid artery reconstruction with a PTFE graft, which was associated in 18 cases with a myocutaneous flap. The primary tumor was a squamous cell carcinoma of the larynx in 17 patients and of the hypopharynx in 7, an undifferentiated carcinoma of unknown origin in 4, and an anaplastic carcinoma of the thyroid in 3. All of the patients underwent postoperative radiotherapy (50-70 Gy), and 10 of them also underwent chemotherapy (doxorubicin and cisplatin).
RESULTS: None of the patients died or sustained a stroke during the first 30 days after the index procedure. Postoperative morbidity consisted of 6 transitory dysphagias, 3 vocal cord palsies, 2 wound dehiscences, 1 transitory mandibular claudication, and 1 partial myocutaneous flap necrosis. No graft infection occurred during follow-up. Fifteen patients (48%) died from metastatic cancer during a mean follow-up of 45.4 months (range, 8-175 months). None of the patients showed evidence of local recurrence, stroke, or thrombosis of the carotid reconstruction. The 5-year survival rate was 49 ± 10%. The overall number of QALYs was 3.12 (95% confidence interval, 1.87-4.37) with a significant difference between patients without metastasis at the time of redo surgery (n = 26; QALYs, 3.74) and those with metastasis (n = 5; QALYs, 0.56; P = .005). QALYs were also significantly improved in patients with cancer of the larynx (n = 17; QALYs, 4.69) compared to patients presenting with other types of tumors (n = 14; QALYs, 1.29; P = .032).
CONCLUSIONS: Aggressive en bloc resection of recurrent neck cancer with PTFE grafting can be curative in patients without metastases at the time of redo surgery. In this subset of patients, extensive neck surgery with carotid artery replacement can lead to excellent local control of the disease with improved quality of survival.

PMID: 26826056 [PubMed - as supplied by publisher]



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The Effects of Passive Smoking on Laryngeal and Tracheal Mucosa in Male Wistar Rats During Growth: An Experimental Study.

The Effects of Passive Smoking on Laryngeal and Tracheal Mucosa in Male Wistar Rats During Growth: An Experimental Study.

J Voice. 2016 Jan 26;

Authors: Zaquia Leão H, Galleano Zettler C, Cambruzzi E, Lammers M, Rigon da Luz Soster P, Bastos de Mello F, Reghelin Goulart G, de Campos D, Pereira Jotz G

Abstract
Cigarettes contain toxic and carcinogenic substances. In this context, cigarette smoking, and similar activities, are associated with numerous pathologies, being considered a risk factor in up to 10% of the total number of deaths in adults. Recent evidence suggests that the exposure of children to smoking in the early days of their development causes many diseases. Using light microscopy, this study aims to analyze the possible histopathological effects of an experimental model of chronic inhalation of cigarette smoke (passive smoking) on the laryngeal and tracheal mucosa of young Wistar rats. A total of 24 young Wistar rats were studied for a period of 120 days. The animals were divided into two groups: passive smoking (n = 16) and control (n = 8). The level of exposure to cigarette smoke was evaluated from the urinary cotinine level. Although no cancerous lesions were identified, histopathological analysis in the laryngeal and tracheal mucosa of all the animals in the experimental group showed that the proportion of moderate and focal inflammation was higher in animals exposed to chronic inhalation of cigarette smoke (P = 0.041). Histopathologic analysis revealed moderate and focal inflammatory lesions in the region of the infraglottic mucosa in exposed animals, although without dysplastic or neoplastic lesions in the laryngeal and tracheal mucosa.

PMID: 26825467 [PubMed - as supplied by publisher]



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Evaluation of a smartphone camera system to enable visualization and image transmission to aid tracheal intubation with the Airtraq(®) laryngoscope.

Evaluation of a smartphone camera system to enable visualization and image transmission to aid tracheal intubation with the Airtraq(®) laryngoscope.

J Anesth. 2016 Jan 29;

Authors: Lee DW, Thampi S, Yap EP, Liu EH

Abstract
Using three-dimensional printing, we produced adaptors to attach a smartphone with camera to the eyepiece of the Airtraq(®) laryngoscope. This low-cost system enabled a team to simultaneously view the laryngoscopy process on the smartphone screen, and also enabled image transmission. We compared the Airtraq(®) with the smartphone Airtraq(®) system in a crossover study of trainee anesthesiologists performing tracheal intubation in a manikin. We also evaluated the smartphone Airtraq(®) system for laryngoscopy and tracheal intubation in 30 patients, including image transmission to and communication with a remote instructor. In the manikin study, the smartphone Airtraq(®) system enabled instruction where both trainee and instructor could view the larynx simultaneously, and did not substantially increase the time required for intubation. In the patient study, we were able to view the larynx in all 30 patients, and the remote instructor was able to receive the images and to respond on correctness of laryngoscopy and tracheal tube placement. Tracheal intubation was successful within 90s in 19 (63 %) patients. In conclusion, use of a smartphone with the Airtraq(®) may facilitate instruction and communication of laryngoscopy with the Airtraq(®), overcoming some of its limitations.

PMID: 26825311 [PubMed - as supplied by publisher]



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Endoscopic ultrasound of the larynx.

Endoscopic ultrasound of the larynx.

Curr Opin Otolaryngol Head Neck Surg. 2016 Jan 27;

Authors: Arens C, Kraft M

Abstract
PURPOSE OF REVIEW: Endoscopic ultrasound (EUS) of the larynx is a vertical endoscopic imaging technique that gives further information about the extension of a lesion apart from normal white light endoscopy, chromoendoscopy, as well as palpation. It combines the advantages of ultrasound and endoscopy. Miniprobes or ultrasound endoscopes with 10-20 MHz are applied. The present review is focused on the use of EUS in the larynx especially in the management of laryngeal cancer.
RECENT FINDINGS: At present, the larynx is routinely assessed by computed tomography and MRI. Alternatively, endoscopic endoluminal application of miniprobes enables the laryngologist to predict the exact extension of a laryngeal tumor larger than 3 mm during microlaryngoscopy before surgery is performed. Generally, tumors are hypoechoic and can easily be differentiated from the surrounding tissue especially in the hyperechoic supraglottic structures. Thyroid cartilage infiltration can be detected by the interruption of the hyperechoic inner perichondrium.
SUMMARY: EUS proved to be a reliable imaging tool for the investigation of laryngeal lesions and can easily be used during microlaryngoscopy. It offers a higher image resolution compared with computed tomography and MRI and allows a complete sonographic evaluation of the larynx as well as its pathological changes, especially laryngeal cancer. VIDEO FILE LINK: http://ift.tt/1KMeF70.

PMID: 26825259 [PubMed - as supplied by publisher]



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Σάββατο 30 Ιανουαρίου 2016

"Acta Otorhinolaryngol Ital"[jour]; +23 new citations

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Rapid palatal expansion vs quad-helix in orthodontic treatment of cleft lip and palate patients.

Related Articles

Rapid palatal expansion vs quad-helix in orthodontic treatment of cleft lip and palate patients.

Minerva Stomatol. 2016 Jan 28;

Authors: Dalessandri D, Tonni I, Dianiskova S, Migliorati M, Bonetti S, Visconti L, Salgarello S, Paganelli C

Abstract
BACKGROUND: The purpose of this study was to compare the results obtained using the Rapid Palate Expander (RPE) and the Quad-Helix (QH) in the treatment of cleft lip and palate (CLP) patients in mixed dentition.
METHODS: In this retrospective clinical trial 28 CLP patients in mixed dentition were enrolled and divided into a group RPE, consisting of 11 patients, and a group QH, consisting of 17 patients. Plaster models before and after treatment were scanned and measurements were made using the software Ortho AnalyzerTM. Measurements, obtained with a digital gauge on plaster models, were regarded as the gold standard and compared with those on digital models. Measurement error was assessed by the method of Dahlberg and the reliability and accuracy of the measurements were evaluated by the Interclass coefficient (ICC). The unpaired t-test was used to compare the group RPE with the group QH.
RESULTS: Measurement error found with Dahlberg's method was 0.36. ICC values indicated a strong repeatability of the evaluator's measurements on digital models and an almost perfect repeatability on plaster models, with a value of 0.79 and 0.93 respectively. The ICC for the accuracy of the measurements on digital models was equal to 0.74, indicating a strong agreement with measurements realized on plaster models. Patients in the QH group presented a gain of the anterior palatal diameter significantly greater than those in the RPE group.
CONCLUSION: The use in mixed dentition of the quad-helix allows obtaining a greater gain of the anterior palatal diameter and a greater symmetry of the dental arch.

PMID: 26822995 [PubMed - as supplied by publisher]



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Irradiation with narrowband-ultraviolet B suppresses phorbol ester-induced up-regulation of H1 receptor mRNA in HeLa cells.

Irradiation with narrowband-ultraviolet B suppresses phorbol ester-induced up-regulation of H1 receptor mRNA in HeLa cells.

Acta Otolaryngol. 2016 Jan 29;:1-5

Authors: Kitamura Y, Mizuguchi H, Okamoto K, Kitayama M, Fujii T, Fujioka A, Matsushita T, Mukai T, Kubo Y, Kubo N, Fukui H, Takeda N

Abstract
Conclusion These findings suggest that low dose irradiation with 310 nm NB-UVB specifically suppressed the up-regulation of H1R gene expression without inducing apoptosis and that UVB of shorter or longer wavelength than 310 nm NB-UVB had no such effects. Objective To develop a narrowband-ultraviolet B(NB-UVB) phototherapy for allergic rhinitis, this study investigated the effects of irradiation with NB-UVB at wavelength of 310 nm on phorbol-12-myristate-13-acetate (PMA)-induced up-regulation of histamine H1 receptor (H1R) mRNA in HeLa cells. Methods The mRNA levels of H1R in HeLa cells were measured using real-time RT-PCR. Apoptosis were evaluated with DNA fragmentation assay. Results PMA induced a significant increase in H1R mRNA expression in HeLa cells. Irradiation with 305 nm UVB and 310 nm NB-UVB, but not with 315 nm UVB at doses of 200 and 300 mJ/cm(2) significantly suppressed PMA-induced up-regulation of H1R mRNA. At a dose of 200 mJ/cm(2), irradiation with 305 nm UVB, but not with 310 nm NB-UVB, induced apoptosis, although exposure of the cells to both 305 and 310 nm UVB induced apoptosis at a dose of 300 mJ/cm(2) after PMA treatment in HeLa cells. Conversely, irradiation with 315 nm UVB at doses of 200 and 300 mJ/cm(2) did not induce apoptosis.

PMID: 26824787 [PubMed - as supplied by publisher]



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Degeneration of stria vascularis in age-related hearing loss; a corrosion cast study in a mouse model.

Degeneration of stria vascularis in age-related hearing loss; a corrosion cast study in a mouse model.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Carraro M, Harrison RV

Abstract
Conclusion With age, in a mouse model, degenerative changes to the capillaries of the stria vascularis are observed. These range from a narrowing of vessel lumen to complete degeneration of strial vessels. Other vascular beds in the cochlea are relatively unchanged with age. Strial capillaries at the cochlear base are significantly more affected than those in mid-apical turns. Objectives Previous work suggests that age-related hearing loss is associated with degenerative changes to cochlear vasculature; the term strial presbyacusis is often cited. This study reports on vascular changes observed in a murine model of presbyacusis, analyzed using corrosion cast techniques. Methods A novel corrosion cast technique was developed to compare cochlear vasculature in control mice (non-presbycusic, CD1) and old (> 6 months) C57BL/6 animals. ABR measures indicated a significant age-related threshold elevation in the C57BL/6 mice. Cochlear vascular casts were imaged using scanning electron microscopy, and vessel degeneration was quantified by measuring capillary diameters. Results Corrosion casts of cochlear vasculature in 6-12 month old C57BL/6 mice reveal significant degeneration of stria vascularis. Other capillary beds (spiral ligament and the spiral limbus) appear unchanged. Comparison of strial capillary diameters reveals significantly more damage in basal/lower-turn regions compared with the cochlear mid-turn.

PMID: 26824717 [PubMed - as supplied by publisher]



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Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss.

Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss.

Acta Otolaryngol. 2016 Jan 29;:1-7

Authors: Suarez H, Ferreira E, Alonso R, Arocena S, San Roman C, Herrera T, Lapilover V

Abstract
Conclusions The assessment of postural responses (PR) based in a feedback control system model shows selective gains in different bands of frequencies adaptable with child development. Objective PR characterization of pre-lingual cochlear implant users (CIU) in different sensory conditions. Methods Total energy consumption of the body's center of pressure signal (ECCOP) and its distribution in three bands of frequencies: band 1 (0-0.1 Hz), band 2 (0.1-0.7 Hz), and band 3 (0.7-20 Hz) was measured in a sample of 18 CIU (8-16 years old) and in a control group (CG) (8-15 years old). They were assessed in a standing position on a force platform in two sensory conditions: 1 = Eyes open. 2 = Eyes closed and standing on foam. Results In condition 1, total ECCOP of PR and its proportion of energy consumption in the three bands of frequencies were similar between CIU and CG (p > 0.05). In condition 2, CIU have significantly higher ECCOP, mainly in high frequencies (bands 2 and 3) (p < 0.05). ECCOP values decreased with age also, mainly in bands 2 and 3. This behavior is interpreted in the control system model proposed as an adaptation process related with child development.

PMID: 26824633 [PubMed - as supplied by publisher]



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Estimating the benefit of a second bone anchored hearing implant in unilaterally implanted users with a testband.

Estimating the benefit of a second bone anchored hearing implant in unilaterally implanted users with a testband.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Kompis M, Kurz A, Flynn M, Caversaccio M

Abstract
Conclusion Using a second bone anchored hearing implant (BAHI) mounted on a testband in unilaterally implanted BAHI users to test its potential advantage pre-operatively under-estimates the advantage of two BAHIs placed on two implants. Objectives To investigate how well speech understanding with a second BAHI mounted on a testband approaches the benefit of bilaterally implanted BAHIs. Method Prospective study with 16 BAHI users. Eight were implanted unilaterally (group A) and eight were implanted bilaterally (group B). Aided speech understanding was measured. Speech was presented from the front and noise came either from the left, right, or from the front in two conditions for group A (with one BAHI, and with two BAHIs, where the second device was mounted on a testband) and in three conditions for group B (same two conditions as group A, and in addition with both BAHIs mounted on implants). Results Speech understanding in noise improved with the additional device for noise from the side of the first BAHI (+0.7 to +2.1 dB) and decreased for noise from the other side (-1.8 dB to -3.9 dB). Improvements were highest (+2.1 dB, p = 0.016) and disadvantages were smallest (-1.8 dB, p = 0.047) with both BAHIs mounted on implants. Testbands yielded smaller advantages and higher disadvantages of the additional BAHI (average difference = -0.9 dB).

PMID: 26824519 [PubMed - as supplied by publisher]



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A novel mutation in PAX3 associated with Waardenburg syndrome type I in a Chinese family.

A novel mutation in PAX3 associated with Waardenburg syndrome type I in a Chinese family.

Acta Otolaryngol. 2016 Jan 29;:1-7

Authors: Xiao Y, Luo J, Zhang F, Li J, Han Y, Zhang D, Wang M, Ma Y, Xu L, Bai X, Wang H

Abstract
Conclusion The novel compound heterozygous mutation in PAX3 was the key genetic reason for WS1 in this family, which was useful to the molecular diagnosis of WS1. Purpose Screening the pathogenic mutations in a four generation Chinese family with Waardenburg syndrome type I (WS1). Methods WS1 was diagnosed in a 4-year-old boy according to the Waardenburg syndrome Consortium criteria. The detailed family history revealed four affected members in the family. Routine clinical, audiological examination, and ophthalmologic evaluation were performed on four affected and 10 healthy members in this family. The genetic analysis was conducted, including the targeted next-generation sequencing of 127 known deafness genes combined with Sanger sequencing, TA clone and bioinformatic analysis. Results A novel compound heterozygous mutation c.[169_170insC;172_174delAAG] (p.His57ProfsX55) was identified in PAX3, which was co-segregated with WS1 in the Chinese family. This mutation was absent in the unaffected family members and 200 ethnicity-matched controls. The phylogenetic analysis and three-dimensional (3D) modeling of Pax3 protein further confirmed that the novel compound heterozygous mutation was pathogenic.

PMID: 26824486 [PubMed - as supplied by publisher]



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The auditory phenotype of children harboring mutations in the prestin gene.

The auditory phenotype of children harboring mutations in the prestin gene.

Acta Otolaryngol. 2016 Jan 29;:1-5

Authors: Matsunaga T, Morimoto N

Abstract
Conclusion Auditory phenotypes of two children harboring prestin gene mutations were congenital or pre-lingual onset, moderate to profound, slowly progressive or non-progressive, and audiograms with either flat configuration or prominently elevated thresholds at middle and high frequencies. Objectives Despite the essential role of the prestin gene in hearing, only one mutation in two families and a missense variant in a family had been reported previously before our study reporting another family. The purpose of this study was to characterize auditory phenotypes in children recently found to harbor novel mutations in the prestin gene. Methods The subjects were two sisters with bilateral sensorineural hearing loss who were compound heterozygotes for c.209G > A (p.W70X) and c.390A > C (p.R130S) mutations in the prestin gene. Clinical history and auditory test results were collected and analyzed. Results Hearing loss was present from birth in the younger sister and occurred before 6 years of age in the elder sister. The degree of hearing loss was profound in the elder sister with little progression, and moderate in the younger sister with no progression. The audiogram of the elder sister showed prominently elevated thresholds at middle and high frequencies, while that of the younger sister demonstrated a flat configuration.

PMID: 26824437 [PubMed - as supplied by publisher]



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En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

Acta Otolaryngol. 2016 Jan 29;:1-8

Authors: Mazzoni A, Zanoletti E, Marioni G, Martini A

Abstract
Conclusions En bloc resection should always be primarily considered in ear carcinoma, also in advanced tumors growing beyond the walls of the external auditory canal, because it achieves a full specimen for histopathological evaluation and allows a correlation between clinical, pathological features, and outcomes. Objective and methods Dismal outcome of surgical and radiotherapic therapies for advanced ear carcinoma required a critical discussion of the oncological principles of treatment. Our analysis involved preliminarily a detailed description of surgical technique including the contribution of modern skull base microsurgery. Results Evident limits in diagnostic protocols, surgical treatment and outcome evaluation modalities pointed to the need of a new approach towards an accurate definition of pre-operative tumor location, size, and behavior. En bloc resection achieved a specimen for a final pathological evaluation and an adjunctive piecemeal excision was necessary only whenever resection was not felt falling in safe, tumor-free tissue. Chemotherapy and radiotherapy should be considered in selected cases for adjuvant treatment.

PMID: 26824405 [PubMed - as supplied by publisher]



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Potential of laryngeal muscle regeneration using induced pluripotent stem cell-derived skeletal muscle cells.

Potential of laryngeal muscle regeneration using induced pluripotent stem cell-derived skeletal muscle cells.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Dirja BT, Yoshie S, Ikeda M, Imaizumi M, Nakamura R, Otsuki K, Nomoto Y, Wada I, Hazama A, Omori K

Abstract
Conclusion Induced pluripotent stem (iPS) cells may be a new potential cell source for laryngeal muscle regeneration in the treatment of vocal fold atrophy after recurrent laryngeal nerve paralysis. Objectives Unilateral vocal fold paralysis can lead to degeneration, atrophy, and loss of force of the thyroarytenoid muscle. At present, there are some treatments such as thyroplasty, arytenoid adduction, and vocal fold injection. However, such treatments cannot restore reduced mass of the thyroarytenoid muscle. iPS cells have been recognized as supplying a potential resource for cell transplantation. The aim of this study was to assess the effectiveness of the use of iPS cells for the regeneration of laryngeal muscle through the evaluation of both in vitro and in vivo experiments. Methods Skeletal muscle cells were generated from tdTomato-labeled iPS cells using embryoid body formation. Differentiation into skeletal muscle cells was analyzed by gene expression and immunocytochemistry. The tdTomato-labeled iPS cell-derived skeletal muscle cells were transplanted into the left atrophied thyroarytenoid muscle. To evaluate the engraftment of these cells after transplantation, immunohistochemistry was performed. Results The tdTomato-labeled iPS cells were successfully differentiated into skeletal muscle cells through an in vitro experiment. These cells survived in the atrophied thyroarytenoid muscle after transplantation.

PMID: 26824385 [PubMed - as supplied by publisher]



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Reduction of internal carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Reduction of internal carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Acta Otolaryngol. 2016 Jan 29;:1-8

Authors: Peng Y, Zhang L, Hu D, Dai Y, Wang S, Liao H, Xiong Y

Abstract
Conclusion Multi-level surgeries for the nasal cavity and palate can reduce the severity of obstructive sleep apnea with major narrowing above the retropalatal airway and reduce the carotid intima-media thickness, which can provide cardiovascular benefits to patients. Objective To evaluate the outcomes of moderate-to-severe obstructive sleep apnea syndrome by surgeries and the change of internal carotid artery intima-media thickness after surgeries. Subjects and methods Sixty-four patients with obstructive sleep apnea, narrowing at the nasal cavity, and retropalatal airways were enrolled in this study. Fifty-two patients underwent nasal surgery and modified uvulopalatopharyngoplasty. Twelve patients who refused surgeries and continuous positive airway pressure treatment received only conservative treatment. All patients were evaluated within 1 month before and 6 months after treatment using polysomnography, upper airway endoscopy, and B mode ultrasound. Results The success rate was 61.5% (32/52 patients) in the surgery group. There were significant differences between the surgery group and non-surgery group 6 months after treatment in the apnea hypopnea index, minimum and mean oxygen saturation, blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and internal Carotid intima-media thickness. The changes in the oxygen saturation and the apnea hypopnea index showed significant correlations with the changes in the intima-media thickness.

PMID: 26824298 [PubMed - as supplied by publisher]



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Fluid stimulation elicits hearing in the absence of air and bone conduction-An animal study.

Fluid stimulation elicits hearing in the absence of air and bone conduction-An animal study.

Acta Otolaryngol. 2016 Jan 29;:1-3

Authors: Perez R, Adelman C, Sohmer H

Abstract
Conclusion Cochlea can be directly excited by fluid (soft-tissue) stimulation. Objective To determine whether there is no difference in auditory-nerve-brainstem evoked response (ABR) thresholds to fluid stimulation between normal and animal models of post radical-mastoidectomy, as seen in a previous human study. Background It has been shown in humans that hearing can be elicited with stimulation to fluid in the external auditory meatus (EAM), and radical-mastoidectomy cavity. These groups differed in age, initial hearing, and drilling exposure. To overcome this difference, experiments were conducted in sand-rats, first intact, and after inducing a radical-mastoidectomy. Methods The EAM of five sand-rats was filled with 0.3 ml saline. ABR thresholds were determined in response to vibratory stimulation by a clinical bone-vibrator with a plastic rod, applied to the saline in the EAM. Then the tympanic membrane was removed, and malleus dislocated (radical-mastoidectomy model). The cavity was filled with 0.45 ml saline and the ABR threshold was determined in response to vibratory stimulation to the cavity fluid. Results There was no difference in ABR fluid thresholds to EAM and mastoidectomy cavity stimulation. Air-conduction stimulation from the bone-vibrator was not involved (conductive loss due to fluid). Bone-conduction stimulation was not involved (large difference in acoustic impedance between fluid and bone).

PMID: 26824146 [PubMed - as supplied by publisher]



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Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military.

Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military.

Int J Audiol. 2016 Jan 28;:1-13

Authors: Lobarinas E, Scott R, Spankovich C, Le Prell CG

Abstract
OBJECTIVE: Firearm discharges produce hazardous levels of impulse noise that can lead to permanent hearing loss. In the present study, we evaluated the effects of suppression, ammunition, and barrel length on AR-15 rifles.
DESIGN: Sound levels were measured left/right of a user's head, and 1-m left of the muzzle, per MIL-STD-1474-D, under both unsuppressed and suppressed conditions.
STUDY SAMPLE: Nine commercially available AR-15 rifles and 14 suppressors were used.
RESULTS: Suppressors significantly decreased peak dB SPL at the 1-m location and the left ear location. However, under most rifle/ammunition conditions, levels remained above 140 dB peak SPL near a user's right ear. In a subset of conditions, subsonic ammunition produced values near or below 140 dB peak SPL. Overall suppression ranged from 7-32 dB across conditions.
CONCLUSIONS: These data indicate that (1) suppressors reduce discharge levels to 140 dB peak SPL or below in only a subset of AR-15 conditions, (2) shorter barrel length and use of muzzle brake devices can substantially increase exposure level for the user, and (3) there are significant left/right ear sound pressure differences under suppressed conditions as a function of the AR-15 direct impingement design that must be considered during sound measurements to fully evaluate overall efficacy.

PMID: 26821935 [PubMed - as supplied by publisher]



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Effects of low speed wind on the recognition/identification and pass-through communication tasks of auditory situation awareness afforded by military hearing protection/enhancement devices and tactical communication and protective systems.

Effects of low speed wind on the recognition/identification and pass-through communication tasks of auditory situation awareness afforded by military hearing protection/enhancement devices and tactical communication and protective systems.

Int J Audiol. 2016 Jan 28;:1-9

Authors: Lee K, Casali JG

Abstract
OBJECTIVE: To investigate the effect of controlled low-speed wind-noise on the auditory situation awareness performance afforded by military hearing protection/enhancement devices (HPED) and tactical communication and protective systems (TCAPS).
DESIGN: Recognition/identification and pass-through communications tasks were separately conducted under three wind conditions (0, 5, and 10 mph). Subjects wore two in-ear-type TCAPS, one earmuff-type TCAPS, a Combat Arms Earplug in its 'open' or pass-through setting, and an EB-15LE™ electronic earplug. Devices with electronic gain systems were tested under two gain settings: 'unity' and 'max'. Testing without any device (open ear) was conducted as a control.
STUDY SAMPLE: Ten subjects were recruited from the student population at Virginia Tech. Audiometric requirements were 25 dBHL or better at 500, 1000, 2000, 4000, and 8000 Hz in both ears.
RESULTS: Performance on the interaction of communication task-by-device was significantly different only in 0 mph wind speed. The between-device performance differences varied with azimuthal speaker locations.
CONCLUSIONS: It is evident from this study that stable (non-gusting) wind speeds up to 10 mph did not significantly degrade recognition/identification task performance and pass-through communication performance of the group of HPEDs and TCAPS tested. However, the various devices performed differently as the test sound signal speaker location was varied and it appears that physical as well as electronic features may have contributed to this directional result.

PMID: 26821823 [PubMed - as supplied by publisher]



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HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients.

HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients.

J Natl Cancer Inst. 2016 Jun;108(6)

Authors: Castellsagué X, Alemany L, Quer M, Halec G, Quirós B, Tous S, Clavero O, Alòs L, Biegner T, Szafarowski T, Alejo M, Holzinger D, Cadena E, Claros E, Hall G, Laco J, Poljak M, Benevolo M, Kasamatsu E, Mehanna H, Ndiaye C, Guimerà N, Lloveras B, León X, Ruiz-Cabezas JC, Alvarado-Cabrero I, Kang CS, Oh JK, Garcia-Rojo M, Iljazovic E, Ajayi OF, Duarte F, Nessa A, Tinoco L, Duran-Padilla MA, Pirog EC, Viarheichyk H, Morales H, Costes V, Félix A, Germar MJ, Mena M, Ruacan A, Jain A, Mehrotra R, Goodman MT, Lombardi LE, Ferrera A, Malami S, Albanesi EI, Dabed P, Molina C, López-Revilla R, Mandys V, González ME, Velasco J, Bravo IG, Quint W, Pawlita M, Muñoz N, Sanjosé Sd, Xavier Bosch F, ICO International HPV in Head and Neck Cancer Study Group

Abstract
BACKGROUND: We conducted a large international study to estimate fractions of head and neck cancers (HNCs) attributable to human papillomavirus (HPV-AFs) using six HPV-related biomarkers of viral detection, transcription, and cellular transformation.
METHODS: Formalin-fixed, paraffin-embedded cancer tissues of the oral cavity (OC), pharynx, and larynx were collected from pathology archives in 29 countries. All samples were subject to histopathological evaluation, DNA quality control, and HPV-DNA detection. Samples containing HPV-DNA were further subject to HPV E6*I mRNA detection and to p16(INK4a), pRb, p53, and Cyclin D1 immunohistochemistry. Final estimates of HPV-AFs were based on HPV-DNA, HPV E6*I mRNA, and/or p16(INK4a) results.
RESULTS: A total of 3680 samples yielded valid results: 1374 pharyngeal, 1264 OC, and 1042 laryngeal cancers. HPV-AF estimates based on positivity for HPV-DNA, and for either HPV E6*I mRNA or p16(INK4a), were 22.4%, 4.4%, and 3.5% for cancers of the oropharynx, OC, and larynx, respectively, and 18.5%, 3.0%, and 1.5% when requiring simultaneous positivity for all three markers. HPV16 was largely the most common type. Estimates of HPV-AF in the oropharynx were highest in South America, Central and Eastern Europe, and Northern Europe, and lowest in Southern Europe. Women showed higher HPV-AFs than men for cancers of the oropharynx in Europe and for the larynx in Central-South America.
CONCLUSIONS: HPV contribution to HNCs is substantial but highly heterogeneous by cancer site, region, and sex. This study, the largest exploring HPV attribution in HNCs, confirms the important role of HPVs in oropharyngeal cancer and drastically downplays the previously reported involvement of HPVs in the other HNCs.

PMID: 26823521 [PubMed - in process]



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[Asbestos and respiratory diseases].

[Asbestos and respiratory diseases].

Presse Med. 2016 Jan 25;

Authors: Scherpereel A

Abstract
Previous occupational asbestos exposure (more rarely environmental or domestic exposure) may induce various pleural and/or pulmonary, benign or malignant diseases, sometimes with a very long latency for malignant mesothelioma (MM). Asbestos has been widely extracted and used in Western countries and in emerging or developing countries, resulting in a peak of MM incidence in France around 2020 and likely in a world pandemic of asbestos-induced diseases. These patients have mostly benign respiratory diseases (pleural plugs) but may also be diagnosed with lung cancer or malignant pleural mesothelioma, and have a global poor outcome. New therapeutic tools (targeted therapies, immunotherapy…) with first promising results are developed. However, it is crucial to obtain a full ban of asbestos use worldwide, and to do a regular follow-up of asbestos-exposed subjects, mostly if they are already diagnosed with benign respiratory diseases. Finally, new cancers (larynx and ovary) were recently added to the list of asbestos-induced tumors.

PMID: 26822071 [PubMed - as supplied by publisher]



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Fluctuating flow. Vibrato, tremolo, or upper airway oscillation.

Related Articles

Fluctuating flow. Vibrato, tremolo, or upper airway oscillation.

Ann Am Thorac Soc. 2015 Apr;12(4):613-5

Authors: Sowho MO, Wolfe E, Murano EZ, Kirkness JP

PMID: 25897745 [PubMed - indexed for MEDLINE]



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Curcumin ameliorates asthmatic airway inflammation by activating nuclear factor-E2-related factor 2/haem oxygenase (HO)-1 signalling pathway.

http:--media.wiley.com-assets-7315-19-Wi Related Articles

Curcumin ameliorates asthmatic airway inflammation by activating nuclear factor-E2-related factor 2/haem oxygenase (HO)-1 signalling pathway.

Clin Exp Pharmacol Physiol. 2015 May;42(5):520-9

Authors: Liu L, Shang Y, Li M, Han X, Wang J, Wang J

Abstract
Previous studies have shown that curcumin alleviates asthma in vivo. However, the relationship between curcumin and the nuclear factor-E2-related factor 2 (Nrf2)/haem oxygenase (HO)-1 pathway in asthma treatment remains unknown. The aim of the present study was to investigate the mechanisms of curcumin involved in the amelioration of airway inflammation in a mouse asthma model. Curcumin was administrated to asthmatic mice, and bronchoalveolar lavage fluid was collected. Inflammatory cell infiltration was measured by Giemsa staining. Immunoglobulin E production in bronchoalveolar lavage fluid was measured by enzyme-linked immunosorbent assay. Histological analyses were evaluated with haematoxylin-eosin and periodic acid-Schiff staining. Airway hyperresponsiveness was examined by whole-body plethysmography. Nuclear factor-E2-related factor 2, HO-1, nuclear factor-κB and inhibitory κB/p-inhibitory κB levels in lung tissues were detected by western blot, and Nrf2 activity was measured by electrophoretic mobility shift assay. Tumour necrosis factor-α, interleukin (IL)-1β, and IL-6 levels in the small interfering RNA-transfected cells were detected by enzyme-linked immunosorbent assay. Curcumin treatment significantly reduced immunoglobulin E production, attenuated inflammatory cell accumulation and goblet cell hyperplasia, and ameliorated mucus secretion and airway hyperresponsiveness. Nuclear factor-E2-related factor 2 and HO-1 levels in lung tissues were significantly increased. Meanwhile, Nrf2 activity was enhanced. Nuclear factor-κB and p-inhibitory κB levels were elevated in the lung tissue of ovalbumin-challenged mice. Both were restored to normal levels after curcumin treatment. Haem oxygenase-1 and nuclear Nrf2 levels were enhanced in dose- and time-dependent manners in curcumin-treated RAW264.7 cells. Curcumin blocked lipopolysaccharide-upregulated expression of tumour necrosis factor-α, IL-1β, and IL-6. After the cells were transfected with HO-1 or Nrf2 small interfering RNA, lipopolysaccharide-induced pro-inflammation cytokine expression was significantly restored. In summary, curcumin might alleviate airway inflammation in asthma through the Nrf2/HO-1 pathway, potentially making it an effective drug in asthma treatment.

PMID: 25739561 [PubMed - indexed for MEDLINE]



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Ossifying fibromas of the paranasal sinuses: diagnosis and management.

Ossifying fibromas of the paranasal sinuses: diagnosis and management.

Acta Otorhinolaryngol Ital. 2015 Oct;35(5):355-361

Authors: Ciniglio Appiani M, Verillaud B, Bresson D, Sauvaget E, Blancal JP, Guichard JP, Saint Maurice JP, Wassef M, Karligkiotis A, Kania R, Herman P

Abstract
Fibro-osseous benign lesions rarely affect the sinonasal tract and are divided into 3 different entities, namely osteoma, fibrous dysplasia and ossifying fibroma. They share several clinical, radiological and histological similarities, but have different behaviours. Ossifying fibroma, and in particular the "juvenile" histological subtype, may have a locally aggressive evolution and a high risk for recurrence if removal is incomplete. The purpose of the present study is to compare the clinical behaviour of ossifying fibroma with the other benign fibro-osseous lesions; highlight different behaviour between the histological subtypes; compare the advantages, limitations and outcomes of an endoscopic endonasal approach with reports in the literature. We retrospectively reviewed 11 patients treated for sinonasal ossifying fibroma at a tertiary care centre. All patients underwent CT scan, and MRI was performed in cases of cranial base involvement or recurrence. Pre-operative biopsy was performed in cases where it was possible to use an endoscopic approach. One patient underwent pre-operative embolisation with ipsilateral visual loss after the procedure. Depending on its location, removal of the tumour was performed using an endoscopic (n = 7), or an external (n = 3) or combined (n = 1) approach. Histopathologically, 5 patients presented the conventional type, 5 the juvenile psammomatoid variant, which was associated in 1 case with an aneurismal bone cyst, and 1 case presented the trabecular juvenile variant. Three patients affected by the juvenile psammomatoid histological variant presented invasion of the skull base and underwent a subtotal removal that subsequently required, due to the regrowth of the remnant, a transbasal approach. Clinical, radiological and histological findings should all be considered to establish differential diagnosis among fibrous osseous lesions. More studies are necessary to conclude if the localisation and extension of the disease at the time of diagnosis is more important than the histological variant. An endoscopic approach is the first choice in most of cases even if an external open approach may be necessary in selected patients.

PMID: 26824919 [PubMed - as supplied by publisher]



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En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

Acta Otolaryngol. 2016 Jan 29;:1-8

Authors: Mazzoni A, Zanoletti E, Marioni G, Martini A

Abstract
Conclusions En bloc resection should always be primarily considered in ear carcinoma, also in advanced tumors growing beyond the walls of the external auditory canal, because it achieves a full specimen for histopathological evaluation and allows a correlation between clinical, pathological features, and outcomes. Objective and methods Dismal outcome of surgical and radiotherapic therapies for advanced ear carcinoma required a critical discussion of the oncological principles of treatment. Our analysis involved preliminarily a detailed description of surgical technique including the contribution of modern skull base microsurgery. Results Evident limits in diagnostic protocols, surgical treatment and outcome evaluation modalities pointed to the need of a new approach towards an accurate definition of pre-operative tumor location, size, and behavior. En bloc resection achieved a specimen for a final pathological evaluation and an adjunctive piecemeal excision was necessary only whenever resection was not felt falling in safe, tumor-free tissue. Chemotherapy and radiotherapy should be considered in selected cases for adjuvant treatment.

PMID: 26824405 [PubMed - as supplied by publisher]



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The cochlea in skull base surgery: an anatomy study.

The cochlea in skull base surgery: an anatomy study.

J Neurosurg. 2016 Jan 29;:1-11

Authors: Wang J, Yoshioka F, Joo W, Komune N, Quilis-Quesada V, Rhoton AL

Abstract
OBJECTIVE The object of this study was to examine the relationships of the cochlea as a guide for avoiding both cochlear damage with loss of hearing in middle fossa approaches and injury to adjacent structures in approaches directed through the cochlea. METHODS Twenty adult cadaveric middle fossae were examined using magnifications of ×3 to ×40. RESULTS The cochlea sits below the floor of the middle fossa in the area between and below the labyrinthine segment of the facial nerve and greater petrosal nerve (GPN) and adjacent to the lateral genu of the petrous carotid. Approximately one-third of the cochlea extends below the medial edge of the labyrinthine segment of the facial nerve, geniculate ganglion, and proximal part of the GPN. The medial part of the basal and middle turns are the parts at greatest risk in drilling the floor of the middle fossa to expose the nerves in middle fossa approaches to the internal acoustic meatus and in anterior petrosectomy approaches. Resection of the cochlea is used selectively in extending approaches through the mastoid toward the lateral edge of the clivus and front of the brainstem. CONCLUSIONS An understanding of the location and relationships of the cochlea will reduce the likelihood of cochlear damage with hearing loss in approaches directed through the middle fossa and reduce the incidence of injury to adjacent structures in approaches directed through the cochlea.

PMID: 26824375 [PubMed - as supplied by publisher]



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The Simpson grading revisited: aggressive surgery and its place in modern meningioma management.

The Simpson grading revisited: aggressive surgery and its place in modern meningioma management.

J Neurosurg. 2016 Jan 29;:1-10

Authors: Gousias K, Schramm J, Simon M

Abstract
OBJECTIVE Recent advances in radiotherapy and neuroimaging have called into question the traditional role of aggressive resections in patients with meningiomas. In the present study the authors reviewed their institutional experience with a policy based on maximal safe resections for meningiomas, and they analyzed the impact of the degree of resection on functional outcome and progression-free survival (PFS). METHODS The authors retrospectively analyzed 901 consecutive patients with primary meningiomas (716 WHO Grade I, 174 Grade II, and 11 Grade III) who underwent resections at the University Hospital of Bonn between 1996 and 2008. Clinical and treatment parameters as well as tumor characteristics were analyzed using standard statistical methods. RESULTS The median follow-up was 62 months. PFS rates at 5 and 10 years were 92.6% and 86.0%, respectively. Younger age, higher preoperative Karnofsky Performance Scale (KPS) score, and convexity tumor location, but not the degree of resection, were identified as independent predictors of a good functional outcome (defined as KPS Score 90-100). Independent predictors of PFS were degree of resection (Simpson Grade I vs II vs III vs IV), MIB-1 index (< 5% vs 5%-10% vs >10%), histological grade (WHO I vs II vs III), tumor size (≤ 6 vs > 6 cm), tumor multiplicity, and location. A Simpson Grade II rather than Grade I resection more than doubled the risk of recurrence at 10 years in the overall series (18.8% vs 8.5%). The impact of aggressive resections was much stronger in higher grade meningiomas. CONCLUSIONS A policy of maximal safe resections for meningiomas prolongs PFS and is not associated with increased morbidity.

PMID: 26824369 [PubMed - as supplied by publisher]



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Fluctuating flow. Vibrato, tremolo, or upper airway oscillation.

Related Articles

Fluctuating flow. Vibrato, tremolo, or upper airway oscillation.

Ann Am Thorac Soc. 2015 Apr;12(4):613-5

Authors: Sowho MO, Wolfe E, Murano EZ, Kirkness JP

PMID: 25897745 [PubMed - indexed for MEDLINE]



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The speech-language pathologist's role in multidisciplinary burn care: An international perspective.

The speech-language pathologist's role in multidisciplinary burn care: An international perspective.

Burns. 2016 Jan 25;

Authors: Rumbach AF, Clayton NA, Muller MJ, Maitz PK

Abstract
PURPOSE: To explore international practices of speech-language pathology (SLP) within burn care in order to provide direction for education, training and clinical practice of the burns multidisciplinary team (MDT).
METHOD(S): A 17-item online survey was designed by two SLPs experienced in burn care with a range of dichotomous, multiple choice and open-ended response questions investigating the availability and scope of practice for SLPs associated with burn units. The survey was distributed via professional burn association gatekeepers. All quantitative data gathered were analysed using descriptive statistics and qualitative data were analysed using content analysis.
RESULT(S): A total of 240 health professionals, from 6 different continents (37 countries) participated within the study. All continents reported access to SLP services. Referral criteria for SLP were largely uniform across continents. The most dominant area of SLP practice was assessment and management of dysphagia, which was conducted in concert with other members of the MDT.
CONCLUSION: SLP has an international presence within burn care that is currently still emerging.

PMID: 26822697 [PubMed - as supplied by publisher]



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Irradiation with narrowband-ultraviolet B suppresses phorbol ester-induced up-regulation of H1 receptor mRNA in HeLa cells.

Irradiation with narrowband-ultraviolet B suppresses phorbol ester-induced up-regulation of H1 receptor mRNA in HeLa cells.

Acta Otolaryngol. 2016 Jan 29;:1-5

Authors: Kitamura Y, Mizuguchi H, Okamoto K, Kitayama M, Fujii T, Fujioka A, Matsushita T, Mukai T, Kubo Y, Kubo N, Fukui H, Takeda N

Abstract
Conclusion These findings suggest that low dose irradiation with 310 nm NB-UVB specifically suppressed the up-regulation of H1R gene expression without inducing apoptosis and that UVB of shorter or longer wavelength than 310 nm NB-UVB had no such effects. Objective To develop a narrowband-ultraviolet B(NB-UVB) phototherapy for allergic rhinitis, this study investigated the effects of irradiation with NB-UVB at wavelength of 310 nm on phorbol-12-myristate-13-acetate (PMA)-induced up-regulation of histamine H1 receptor (H1R) mRNA in HeLa cells. Methods The mRNA levels of H1R in HeLa cells were measured using real-time RT-PCR. Apoptosis were evaluated with DNA fragmentation assay. Results PMA induced a significant increase in H1R mRNA expression in HeLa cells. Irradiation with 305 nm UVB and 310 nm NB-UVB, but not with 315 nm UVB at doses of 200 and 300 mJ/cm(2) significantly suppressed PMA-induced up-regulation of H1R mRNA. At a dose of 200 mJ/cm(2), irradiation with 305 nm UVB, but not with 310 nm NB-UVB, induced apoptosis, although exposure of the cells to both 305 and 310 nm UVB induced apoptosis at a dose of 300 mJ/cm(2) after PMA treatment in HeLa cells. Conversely, irradiation with 315 nm UVB at doses of 200 and 300 mJ/cm(2) did not induce apoptosis.

PMID: 26824787 [PubMed - as supplied by publisher]



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Degeneration of stria vascularis in age-related hearing loss; a corrosion cast study in a mouse model.

Degeneration of stria vascularis in age-related hearing loss; a corrosion cast study in a mouse model.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Carraro M, Harrison RV

Abstract
Conclusion With age, in a mouse model, degenerative changes to the capillaries of the stria vascularis are observed. These range from a narrowing of vessel lumen to complete degeneration of strial vessels. Other vascular beds in the cochlea are relatively unchanged with age. Strial capillaries at the cochlear base are significantly more affected than those in mid-apical turns. Objectives Previous work suggests that age-related hearing loss is associated with degenerative changes to cochlear vasculature; the term strial presbyacusis is often cited. This study reports on vascular changes observed in a murine model of presbyacusis, analyzed using corrosion cast techniques. Methods A novel corrosion cast technique was developed to compare cochlear vasculature in control mice (non-presbycusic, CD1) and old (> 6 months) C57BL/6 animals. ABR measures indicated a significant age-related threshold elevation in the C57BL/6 mice. Cochlear vascular casts were imaged using scanning electron microscopy, and vessel degeneration was quantified by measuring capillary diameters. Results Corrosion casts of cochlear vasculature in 6-12 month old C57BL/6 mice reveal significant degeneration of stria vascularis. Other capillary beds (spiral ligament and the spiral limbus) appear unchanged. Comparison of strial capillary diameters reveals significantly more damage in basal/lower-turn regions compared with the cochlear mid-turn.

PMID: 26824717 [PubMed - as supplied by publisher]



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Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss.

Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss.

Acta Otolaryngol. 2016 Jan 29;:1-7

Authors: Suarez H, Ferreira E, Alonso R, Arocena S, San Roman C, Herrera T, Lapilover V

Abstract
Conclusions The assessment of postural responses (PR) based in a feedback control system model shows selective gains in different bands of frequencies adaptable with child development. Objective PR characterization of pre-lingual cochlear implant users (CIU) in different sensory conditions. Methods Total energy consumption of the body's center of pressure signal (ECCOP) and its distribution in three bands of frequencies: band 1 (0-0.1 Hz), band 2 (0.1-0.7 Hz), and band 3 (0.7-20 Hz) was measured in a sample of 18 CIU (8-16 years old) and in a control group (CG) (8-15 years old). They were assessed in a standing position on a force platform in two sensory conditions: 1 = Eyes open. 2 = Eyes closed and standing on foam. Results In condition 1, total ECCOP of PR and its proportion of energy consumption in the three bands of frequencies were similar between CIU and CG (p > 0.05). In condition 2, CIU have significantly higher ECCOP, mainly in high frequencies (bands 2 and 3) (p < 0.05). ECCOP values decreased with age also, mainly in bands 2 and 3. This behavior is interpreted in the control system model proposed as an adaptation process related with child development.

PMID: 26824633 [PubMed - as supplied by publisher]



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Estimating the benefit of a second bone anchored hearing implant in unilaterally implanted users with a testband.

Estimating the benefit of a second bone anchored hearing implant in unilaterally implanted users with a testband.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Kompis M, Kurz A, Flynn M, Caversaccio M

Abstract
Conclusion Using a second bone anchored hearing implant (BAHI) mounted on a testband in unilaterally implanted BAHI users to test its potential advantage pre-operatively under-estimates the advantage of two BAHIs placed on two implants. Objectives To investigate how well speech understanding with a second BAHI mounted on a testband approaches the benefit of bilaterally implanted BAHIs. Method Prospective study with 16 BAHI users. Eight were implanted unilaterally (group A) and eight were implanted bilaterally (group B). Aided speech understanding was measured. Speech was presented from the front and noise came either from the left, right, or from the front in two conditions for group A (with one BAHI, and with two BAHIs, where the second device was mounted on a testband) and in three conditions for group B (same two conditions as group A, and in addition with both BAHIs mounted on implants). Results Speech understanding in noise improved with the additional device for noise from the side of the first BAHI (+0.7 to +2.1 dB) and decreased for noise from the other side (-1.8 dB to -3.9 dB). Improvements were highest (+2.1 dB, p = 0.016) and disadvantages were smallest (-1.8 dB, p = 0.047) with both BAHIs mounted on implants. Testbands yielded smaller advantages and higher disadvantages of the additional BAHI (average difference = -0.9 dB).

PMID: 26824519 [PubMed - as supplied by publisher]



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A novel mutation in PAX3 associated with Waardenburg syndrome type I in a Chinese family.

A novel mutation in PAX3 associated with Waardenburg syndrome type I in a Chinese family.

Acta Otolaryngol. 2016 Jan 29;:1-7

Authors: Xiao Y, Luo J, Zhang F, Li J, Han Y, Zhang D, Wang M, Ma Y, Xu L, Bai X, Wang H

Abstract
Conclusion The novel compound heterozygous mutation in PAX3 was the key genetic reason for WS1 in this family, which was useful to the molecular diagnosis of WS1. Purpose Screening the pathogenic mutations in a four generation Chinese family with Waardenburg syndrome type I (WS1). Methods WS1 was diagnosed in a 4-year-old boy according to the Waardenburg syndrome Consortium criteria. The detailed family history revealed four affected members in the family. Routine clinical, audiological examination, and ophthalmologic evaluation were performed on four affected and 10 healthy members in this family. The genetic analysis was conducted, including the targeted next-generation sequencing of 127 known deafness genes combined with Sanger sequencing, TA clone and bioinformatic analysis. Results A novel compound heterozygous mutation c.[169_170insC;172_174delAAG] (p.His57ProfsX55) was identified in PAX3, which was co-segregated with WS1 in the Chinese family. This mutation was absent in the unaffected family members and 200 ethnicity-matched controls. The phylogenetic analysis and three-dimensional (3D) modeling of Pax3 protein further confirmed that the novel compound heterozygous mutation was pathogenic.

PMID: 26824486 [PubMed - as supplied by publisher]



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The auditory phenotype of children harboring mutations in the prestin gene.

The auditory phenotype of children harboring mutations in the prestin gene.

Acta Otolaryngol. 2016 Jan 29;:1-5

Authors: Matsunaga T, Morimoto N

Abstract
Conclusion Auditory phenotypes of two children harboring prestin gene mutations were congenital or pre-lingual onset, moderate to profound, slowly progressive or non-progressive, and audiograms with either flat configuration or prominently elevated thresholds at middle and high frequencies. Objectives Despite the essential role of the prestin gene in hearing, only one mutation in two families and a missense variant in a family had been reported previously before our study reporting another family. The purpose of this study was to characterize auditory phenotypes in children recently found to harbor novel mutations in the prestin gene. Methods The subjects were two sisters with bilateral sensorineural hearing loss who were compound heterozygotes for c.209G > A (p.W70X) and c.390A > C (p.R130S) mutations in the prestin gene. Clinical history and auditory test results were collected and analyzed. Results Hearing loss was present from birth in the younger sister and occurred before 6 years of age in the elder sister. The degree of hearing loss was profound in the elder sister with little progression, and moderate in the younger sister with no progression. The audiogram of the elder sister showed prominently elevated thresholds at middle and high frequencies, while that of the younger sister demonstrated a flat configuration.

PMID: 26824437 [PubMed - as supplied by publisher]



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En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits.

Acta Otolaryngol. 2016 Jan 29;:1-8

Authors: Mazzoni A, Zanoletti E, Marioni G, Martini A

Abstract
Conclusions En bloc resection should always be primarily considered in ear carcinoma, also in advanced tumors growing beyond the walls of the external auditory canal, because it achieves a full specimen for histopathological evaluation and allows a correlation between clinical, pathological features, and outcomes. Objective and methods Dismal outcome of surgical and radiotherapic therapies for advanced ear carcinoma required a critical discussion of the oncological principles of treatment. Our analysis involved preliminarily a detailed description of surgical technique including the contribution of modern skull base microsurgery. Results Evident limits in diagnostic protocols, surgical treatment and outcome evaluation modalities pointed to the need of a new approach towards an accurate definition of pre-operative tumor location, size, and behavior. En bloc resection achieved a specimen for a final pathological evaluation and an adjunctive piecemeal excision was necessary only whenever resection was not felt falling in safe, tumor-free tissue. Chemotherapy and radiotherapy should be considered in selected cases for adjuvant treatment.

PMID: 26824405 [PubMed - as supplied by publisher]



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Potential of laryngeal muscle regeneration using induced pluripotent stem cell-derived skeletal muscle cells.

Potential of laryngeal muscle regeneration using induced pluripotent stem cell-derived skeletal muscle cells.

Acta Otolaryngol. 2016 Jan 29;:1-6

Authors: Dirja BT, Yoshie S, Ikeda M, Imaizumi M, Nakamura R, Otsuki K, Nomoto Y, Wada I, Hazama A, Omori K

Abstract
Conclusion Induced pluripotent stem (iPS) cells may be a new potential cell source for laryngeal muscle regeneration in the treatment of vocal fold atrophy after recurrent laryngeal nerve paralysis. Objectives Unilateral vocal fold paralysis can lead to degeneration, atrophy, and loss of force of the thyroarytenoid muscle. At present, there are some treatments such as thyroplasty, arytenoid adduction, and vocal fold injection. However, such treatments cannot restore reduced mass of the thyroarytenoid muscle. iPS cells have been recognized as supplying a potential resource for cell transplantation. The aim of this study was to assess the effectiveness of the use of iPS cells for the regeneration of laryngeal muscle through the evaluation of both in vitro and in vivo experiments. Methods Skeletal muscle cells were generated from tdTomato-labeled iPS cells using embryoid body formation. Differentiation into skeletal muscle cells was analyzed by gene expression and immunocytochemistry. The tdTomato-labeled iPS cell-derived skeletal muscle cells were transplanted into the left atrophied thyroarytenoid muscle. To evaluate the engraftment of these cells after transplantation, immunohistochemistry was performed. Results The tdTomato-labeled iPS cells were successfully differentiated into skeletal muscle cells through an in vitro experiment. These cells survived in the atrophied thyroarytenoid muscle after transplantation.

PMID: 26824385 [PubMed - as supplied by publisher]



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Reduction of internal carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Reduction of internal carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Acta Otolaryngol. 2016 Jan 29;:1-8

Authors: Peng Y, Zhang L, Hu D, Dai Y, Wang S, Liao H, Xiong Y

Abstract
Conclusion Multi-level surgeries for the nasal cavity and palate can reduce the severity of obstructive sleep apnea with major narrowing above the retropalatal airway and reduce the carotid intima-media thickness, which can provide cardiovascular benefits to patients. Objective To evaluate the outcomes of moderate-to-severe obstructive sleep apnea syndrome by surgeries and the change of internal carotid artery intima-media thickness after surgeries. Subjects and methods Sixty-four patients with obstructive sleep apnea, narrowing at the nasal cavity, and retropalatal airways were enrolled in this study. Fifty-two patients underwent nasal surgery and modified uvulopalatopharyngoplasty. Twelve patients who refused surgeries and continuous positive airway pressure treatment received only conservative treatment. All patients were evaluated within 1 month before and 6 months after treatment using polysomnography, upper airway endoscopy, and B mode ultrasound. Results The success rate was 61.5% (32/52 patients) in the surgery group. There were significant differences between the surgery group and non-surgery group 6 months after treatment in the apnea hypopnea index, minimum and mean oxygen saturation, blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and internal Carotid intima-media thickness. The changes in the oxygen saturation and the apnea hypopnea index showed significant correlations with the changes in the intima-media thickness.

PMID: 26824298 [PubMed - as supplied by publisher]



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Fluid stimulation elicits hearing in the absence of air and bone conduction-An animal study.

Fluid stimulation elicits hearing in the absence of air and bone conduction-An animal study.

Acta Otolaryngol. 2016 Jan 29;:1-3

Authors: Perez R, Adelman C, Sohmer H

Abstract
Conclusion Cochlea can be directly excited by fluid (soft-tissue) stimulation. Objective To determine whether there is no difference in auditory-nerve-brainstem evoked response (ABR) thresholds to fluid stimulation between normal and animal models of post radical-mastoidectomy, as seen in a previous human study. Background It has been shown in humans that hearing can be elicited with stimulation to fluid in the external auditory meatus (EAM), and radical-mastoidectomy cavity. These groups differed in age, initial hearing, and drilling exposure. To overcome this difference, experiments were conducted in sand-rats, first intact, and after inducing a radical-mastoidectomy. Methods The EAM of five sand-rats was filled with 0.3 ml saline. ABR thresholds were determined in response to vibratory stimulation by a clinical bone-vibrator with a plastic rod, applied to the saline in the EAM. Then the tympanic membrane was removed, and malleus dislocated (radical-mastoidectomy model). The cavity was filled with 0.45 ml saline and the ABR threshold was determined in response to vibratory stimulation to the cavity fluid. Results There was no difference in ABR fluid thresholds to EAM and mastoidectomy cavity stimulation. Air-conduction stimulation from the bone-vibrator was not involved (conductive loss due to fluid). Bone-conduction stimulation was not involved (large difference in acoustic impedance between fluid and bone).

PMID: 26824146 [PubMed - as supplied by publisher]



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Παρασκευή 29 Ιανουαρίου 2016

The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

Acta Otolaryngol. 2016 Jan 27;:1-6

Authors: Shoffel-Havakuk H, Lahav Y, Davidi ES, Haimovich Y, Hain M, Halperin D

Abstract
Conclusions Sampling surgical margins in trans-oral laser microsurgery for early glottic squamous cell carcinoma (SCC) may allow for increased local control rate, although with no difference in local control by endoscopic treatment alone. Objective To further delineate the role of routinely sampling separate surgical margins, in patients with early glottic SCC undergoing endoscopic laser resection. Methods A retrospective case control study. One hundres and two early glottic cancer patients staged Tis-T2 underwent endoscopic laser surgery with curative intent as the primary treatment. Separate margins from the surgical bed were sampled following complete tumor resection in 64 patients; in 38 patients no margins were sampled. Results Margin sampling showed a tendency towards reduced risk for local recurrence, adjusted HR = 0.439 (p-value = 0.096). However, there was no difference in local control by endoscopic treatment alone. The patients with sampled margins were further divided based on margins' status: 39 (61%) had negative margins, and 25 (39%) had positive margins. Compared with negative margins, patients with positive margins showed increased risk for recurrence, adjusted HR = 8.492 (p = 0.008). When margins were not sampled the risk for local recurrence was increased compared to negative margins (adjusted HR = 7.875, p-value = 0.008), and relatively comparable to what was observed when sampled margins were positive (adjusted HR = 0.927, p-value = 0.88).

PMID: 26817681 [PubMed - as supplied by publisher]



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Analysis on correlation between SP and NK-1R and intranasal mucosal contact point headache.

Analysis on correlation between SP and NK-1R and intranasal mucosal contact point headache.

Acta Otolaryngol. 2016 Jan 27;:1-6

Authors: Zhao G, Yin J, Peng H, Wang J

Abstract
Conclusion Distribution of SP and NK-1R, especially NK-1R, in nasal mucosal tissue at contact point was higher compared with non-contact point. It was suggested that SP and NK-1R were associated with mucosal contact point headache. Objectives To observe difference of substance P (SP) and NK-1 receptor (NK-1R) expression in tissues at contact point and non-contact point among the patients with intranasal mucosal contact point headache and speculate the role of SP and NK-1R in mucosal contact point headache. Methods SP and NK-1R in tissues of contact point and non-contact point among 40 patients with intranasal mucosal contact point headache were stained histologically by immunohistochemistry, and the mRNA level was detected by RT-PCR. Results SP was located in cytoplasm of acini epithelial cells, distributed in nasal mucosa tissues at both contact point and non-contact point. However, stain intensity was significantly increased at contact point (Z = -2.554, p < 0.05). NK-1R was located in the cytoplasm of acinar epithelial cells, inflammatory cells, and nerve fibers of contact point; only in cytoplasm of acinar epithelial cells and nerve fibers of non-contact point. Tinctorial rate of NK-1R increased significantly at contact point (χ(2) = 40.438, p < 0.01). mRNA level of SP and NK-1R was up-regulated in nasal mucosa at contact point compared with non-contact point.

PMID: 26817501 [PubMed - as supplied by publisher]



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[Lymphatic malformations in the head and neck area].

[Lymphatic malformations in the head and neck area].

HNO. 2016 Jan 28;

Authors: Wiegand S, Werner JA

Abstract
Lymphatic malformations are congenital malformations of the lymphatic system. They are mainly located in the head and neck area, and grow proportional to the patients' body growth. Depending on the morphology, it can be distinguished between macrocystic, microcystic and mixed lymphatic malformations. Due to their infiltrative growth, microcystic lymphatic malformations are particularly difficult to treat. Therapeutic approaches include conventional surgical resection, laser therapy, sclerotherapy and systemic drug therapies.

PMID: 26820157 [PubMed - as supplied by publisher]



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The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

Acta Otolaryngol. 2016 Jan 27;:1-6

Authors: Shoffel-Havakuk H, Lahav Y, Davidi ES, Haimovich Y, Hain M, Halperin D

Abstract
Conclusions Sampling surgical margins in trans-oral laser microsurgery for early glottic squamous cell carcinoma (SCC) may allow for increased local control rate, although with no difference in local control by endoscopic treatment alone. Objective To further delineate the role of routinely sampling separate surgical margins, in patients with early glottic SCC undergoing endoscopic laser resection. Methods A retrospective case control study. One hundres and two early glottic cancer patients staged Tis-T2 underwent endoscopic laser surgery with curative intent as the primary treatment. Separate margins from the surgical bed were sampled following complete tumor resection in 64 patients; in 38 patients no margins were sampled. Results Margin sampling showed a tendency towards reduced risk for local recurrence, adjusted HR = 0.439 (p-value = 0.096). However, there was no difference in local control by endoscopic treatment alone. The patients with sampled margins were further divided based on margins' status: 39 (61%) had negative margins, and 25 (39%) had positive margins. Compared with negative margins, patients with positive margins showed increased risk for recurrence, adjusted HR = 8.492 (p = 0.008). When margins were not sampled the risk for local recurrence was increased compared to negative margins (adjusted HR = 7.875, p-value = 0.008), and relatively comparable to what was observed when sampled margins were positive (adjusted HR = 0.927, p-value = 0.88).

PMID: 26817681 [PubMed - as supplied by publisher]



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Analysis on correlation between SP and NK-1R and intranasal mucosal contact point headache.

Analysis on correlation between SP and NK-1R and intranasal mucosal contact point headache.

Acta Otolaryngol. 2016 Jan 27;:1-6

Authors: Zhao G, Yin J, Peng H, Wang J

Abstract
Conclusion Distribution of SP and NK-1R, especially NK-1R, in nasal mucosal tissue at contact point was higher compared with non-contact point. It was suggested that SP and NK-1R were associated with mucosal contact point headache. Objectives To observe difference of substance P (SP) and NK-1 receptor (NK-1R) expression in tissues at contact point and non-contact point among the patients with intranasal mucosal contact point headache and speculate the role of SP and NK-1R in mucosal contact point headache. Methods SP and NK-1R in tissues of contact point and non-contact point among 40 patients with intranasal mucosal contact point headache were stained histologically by immunohistochemistry, and the mRNA level was detected by RT-PCR. Results SP was located in cytoplasm of acini epithelial cells, distributed in nasal mucosa tissues at both contact point and non-contact point. However, stain intensity was significantly increased at contact point (Z = -2.554, p < 0.05). NK-1R was located in the cytoplasm of acinar epithelial cells, inflammatory cells, and nerve fibers of contact point; only in cytoplasm of acinar epithelial cells and nerve fibers of non-contact point. Tinctorial rate of NK-1R increased significantly at contact point (χ(2) = 40.438, p < 0.01). mRNA level of SP and NK-1R was up-regulated in nasal mucosa at contact point compared with non-contact point.

PMID: 26817501 [PubMed - as supplied by publisher]



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Ocular vestibular evoked myogenic potentials to vertex low frequency vibration as a diagnostic test for superior canal dehiscence.

Ocular vestibular evoked myogenic potentials to vertex low frequency vibration as a diagnostic test for superior canal dehiscence.

Clin Neurophysiol. 2016 Jan 12;

Authors: Verrecchia L, Westin M, Duan M, Brantberg K

Abstract
OBJECTIVE: To explore ocular vestibular evoked myogenic potentials (oVEMP) to low-frequency vertex vibration (125Hz) as a diagnostic test for superior canal dehiscence (SCD) syndrome.
METHODS: The oVEMP using 125Hz single cycle bone-conducted vertex vibration were tested in 15 patients with unilateral superior canal dehiscence (SCD) syndrome, 15 healthy controls and in 20 patients with unilateral vestibular loss due to vestibular neuritis. Amplitude, amplitude asymmetry ratio, latency and interaural latency difference were parameters of interest.
RESULTS: The oVEMP amplitude was significantly larger in SCD patients when affected sides (53μVolts) were compared to non-affected (17.2μVolts) or compared to healthy controls (13.6μVolts). Amplitude larger than 33.8μVolts separates effectively the SCD ears from the healthy ones with sensitivity of 87% and specificity of 93%. The other three parameters showed an overlap between affected SCD ears and non-affected as well as between SCD ears and those in the two control groups.
CONCLUSIONS: oVEMP amplitude distinguishes SCD ears from healthy ones using low-frequency vibration stimuli at vertex.
SIGNIFICANCE: Amplitude analysis of oVEMP evoked by low-frequency vertex bone vibration stimulation is an additional indicator of SCD syndrome and might serve for diagnosing SCD patients with coexistent conductive middle ear problems.

PMID: 26818880 [PubMed - as supplied by publisher]



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Vestibular Disorders in Children With Congenital Cytomegalovirus Infection.

http:--highwire.stanford.edu-icons-exter Related Articles

Vestibular Disorders in Children With Congenital Cytomegalovirus Infection.

Pediatrics. 2015 Oct;136(4):e887-95

Authors: Bernard S, Wiener-Vacher S, Van Den Abbeele T, Teissier N

Abstract
BACKGROUND: Congenital cytomegalovirus (CMV) infection is the leading infectious cause of neurologic disabilities and sensorineural hearing loss in children. Sensorineural hearing loss prevalence in CMV suggests a viral tropism for the inner ear. Vestibular disorders induced by CMV infection are underestimated. This is the largest and most thorough study to assess the incidence of vestibular disorders and their correlation with hearing thresholds in children with CMV.
METHODS: This retrospective study assessed a cohort of 52 children with congenital CMV infection and sensorineural impairment who received a complete hearing and vestibular assessment. Vestibular evaluation included clinical examination, caloric bithermal test, earth vertical axis rotation, off-vertical axis rotation, and vestibular evoked myogenic potential. The prevalence, progression, and clinical impact of vestibular disorders were studied and correlated with hearing thresholds and the severity of congenital CMV infection.
RESULTS: Forty-eight children (92.3%) had hearing loss and vestibular disorders. Of those, vestibular disorders were complete and bilateral in 33.3%, partial and bilateral in 43.7%, and partial and unilateral in 22.9%. Serial testing in 14 children showed stable vestibular function in 50% and deterioration in 50%. Congenital CMV infection has a negative impact on postural development that is correlated with neurologic and vestibular impairment. Vestibular disorders were significantly associated with hearing disorders, but their respective severities showed no concordance.
CONCLUSIONS: Vestibular disorders are frequent and severe in CMV-infected children. Routine screening and appropriate management of vestibular lesions is essential to initiate adapted care.

PMID: 26347442 [PubMed - indexed for MEDLINE]



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Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery.

Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery.

Case Rep Emerg Med. 2015;2015:789076

Authors: Calogero CG, Miller AC, Greenberg MR

Abstract
Inferior thyroid artery (ITA) rupture is rare and may progress to life-threatening conditions. We present a patient who visited the emergency department after an episode of syncope and dizziness in which he had a mechanical fall that resulted in abrasions and a hematoma to his left forehead. The patient presented with dysphagia and anterior neck swelling that progressed rapidly into airway compromise requiring endotracheal intubation. Emergent computed tomography revealed a large retropharyngeal hematoma, with active arterial extravasation that was thought to be arising from the thyrocervical trunk on the left. The hematoma measured approximately 6.7 cm transversely and 3.2 cm anteroposteriorly and extended from the level of the lower nasopharynx, down the neck into the retropharyngeal and danger space and into the mediastinum posterior to the esophagus, overall approximately 25 cm. The larynx was deviated anteriorly and there was esophageal compression. An emergent arteriogram and catheterization confirmed bleeding from branches of the ITA, and successful embolization was performed. It is important to recognize the ITA rupture as a potential etiology of an acute airway compromise. In emergent situations, while securing an airway is a priority, rapidly initiating diagnostic testing to confirm the diagnosis and arranging for arterial embolization can be life-saving.

PMID: 26819785 [PubMed]



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Cancer Incidence in Appalachia, 2004-2011.

Cancer Incidence in Appalachia, 2004-2011.

Cancer Epidemiol Biomarkers Prev. 2016 Jan 27;

Authors: Wilson RJ, Ryerson AB, Singh SD, King JB

Abstract
BACKGROUND: Limited literature is available about cancer in the Appalachian Region. This is the only known analysis of all cancers for Appalachia and non-Appalachia covering 100% of the US population. Appalachian cancer incidence and trends were evaluated by state, sex, and race and compared with those found in non-Appalachian regions.
METHODS: US counties were identified as Appalachian or non-Appalachian. Age-adjusted cancer incidence rates, standard errors, and confidence intervals were calculated using the most recent data from the United States Cancer Statistics for 2004 to 2011.
RESULTS: Generally, Appalachia carries a higher cancer burden compared with non-Appalachia, particularly for tobacco-related cancers. For all cancer sites combined, Appalachia has higher rates regardless of sex, race, or region. The Appalachia and non-Appalachia cancer incidence gap has narrowed, with the exception of oral cavity and pharynx, larynx, lung and bronchus, and thyroid cancers.
CONCLUSIONS: Higher cancer incidence continues in Appalachia and appears at least in part to reflect high tobacco use and potential differences in socioeconomic status, other risk factors, patient health care utilization, or provider practices. It is important to continue to evaluate this population to monitor results from screening and early detection programs, understand behavioral risk factors related to cancer incidence, increase efforts to reduce tobacco use and increase cancer screening, and identify other areas where effective interventions may mediate disparities.
IMPACT: Surveillance and evaluation of special populations provide means to monitor screening and early detection programs, understand behavioral risk factors, and increase efforts to reduce tobacco use to mediate disparities. Cancer Epidemiol Biomarkers Prev; 25(2); 1-9. ©2016 AACR.

PMID: 26819264 [PubMed - as supplied by publisher]



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