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Melanoma in pregnancy: a case report and review of the literature.
Postepy Dermatol Alergol. 2015 Dec;32(6):483-7
Authors: Wielowieyska-Szybińska DK, Spałkowska M, Wojas-Pelc A
PMID: 26755917 [PubMed]
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Successful treatment of multiple cutaneous leiomyomas with carbon dioxide laser ablation.
Postepy Dermatol Alergol. 2015 Dec;32(6):480-2
Authors: Michajłowski I, Błażewicz I, Karpinsky G, Sobjanek M, Nowicki R
PMID: 26755916 [PubMed]
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Effectiveness of omalizumab in an asthmatic patient with severe airway and blood eosinophilia.
Postepy Dermatol Alergol. 2015 Dec;32(6):478-9
Authors: Kupryś-Lipińska I, Kołacińska-Flont M, Marczak J, Górski P, Kurmanowska Z, Kuna P
PMID: 26755915 [PubMed]
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Interstitial granulomatous dermatitis: a characteristic histological pattern with variable clinical manifestations.
Postepy Dermatol Alergol. 2015 Dec;32(6):475-7
Authors: Błażewicz I, Szczerkowska-Dobosz A, Pęksa R, Stawczyk-Macieja M, Barańska-Rybak W, Nowicki R
PMID: 26755914 [PubMed]
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Seckel syndrome with cutaneous pigmentary changes: two siblings and a review of the literature.
Postepy Dermatol Alergol. 2015 Dec;32(6):470-4
Authors: Kilic A, Çakmak SK, Tuncali T, Koz O, Ozhamamci E, Yasun O, Artuz F
PMID: 26755913 [PubMed]
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Quality of life in patients with leg ulcers or skin lesions - a pilot study.
Postepy Dermatol Alergol. 2015 Dec;32(6):465-9
Authors: Szewczyk MT, Mościcka P, Jawień A, Cwajda-Białasik J, Cierzniakowska K, Ślusarz R, Hancke E
Abstract
INTRODUCTION: Attempts to determine the quality of life are advisable in patients with ulcers as the group affected with this problem is relatively large. According to one Polish randomized trial, approximately 0.3-2% of the adult population suffers from active or healed venous ulcers.
AIM: To compare the quality of life of patients with leg ulcers of venous and arterial etiology and those with lower limb skin lesions due to chronic venous insufficiency.
MATERIAL AND METHODS: This study included 90 consecutive patients with ulcers of venous (n = 30) or arterial etiology (n = 30), or patients with trophic disorders of the skin associated with chronic venous insufficiency (n = 30) treated at the Venous Ulceration Outpatient Clinic and at the Department and Clinic of General Surgery, Dr. J. Biziel Memorial University Hospital No. 2, in Bydgoszcz. This study was designed as a questionnaire survey and included the Skindex-29 instrument for the assessment of quality of life in patients with dermatological conditions.
RESULTS: Overall, the global Skinndex-29 scores of all studied participants ranged between 37 and 136 points, 23.93 points on average. The analyzed groups of patients differed significantly with respect to the average level of the global quality of life determined using the Skindex-29 questionnaire.
CONCLUSIONS: Significant differences were observed in the global quality of life of patients who suffered from venous or arterial leg ulcers or skin lesions resulting from chronic venous insufficiency.
PMID: 26755912 [PubMed]
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Self-assessment of striae gravidarum prophylaxis.
Postepy Dermatol Alergol. 2015 Dec;32(6):459-64
Authors: Antoszewski B, Sobczak M, Kasielska-Trojan A
Abstract
INTRODUCTION: Striae are the most frequently occurring pathology of connective tissue during pregnancy. According to the statistical data, 70-90% of women suffer from striae gravidarum.
AIM: To assess effectiveness of topical products and massage used by pregnant women in striae gravidarum prophylaxis.
MATERIAL AND METHODS: The questionnaire study was conducted among 299 women who were maximum 6 months after delivery at term. The questionnaire included questions concerning age, occurrence of striae gravidarum during pregnancy, their location, week of gestation when the lesions appeared and used striae prophylaxis as well as its effectiveness in respondents' opinion.
RESULTS: Analysis of the correlation between striae gravidarum occurrence and use of different types of cosmetics showed that this kind of prophylaxis is effective when applied at least twice a day (63.7% vs. 77.6%). No correlation between the type of cosmetics and presence of striae was observed (p > 0.05).
CONCLUSIONS: Use of prophylactic measures like skin emollients and oils with the appropriate frequency significantly reduces the risk of striae gravidarum occurrence.
PMID: 26755911 [PubMed]
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Frequency of streptococcal upper respiratory tract infections and HLA-Cw*06 allele in 70 patients with guttate psoriasis from northern Poland.
Postepy Dermatol Alergol. 2015 Dec;32(6):455-8
Authors: Maciejewska-Radomska A, Szczerkowska-Dobosz A, Rębała K, Wysocka J, Roszkiewicz J, Szczerkowska Z, Placek W
Abstract
INTRODUCTION: The association of guttate psoriasis with a streptococcal throat infection and HLA-Cw*06 allele is well established in different populations. Nevertheless, only few studies on this form of disease have been performed in the Polish population.
AIM: To analyze the frequencies of streptococcal-induced guttate psoriasis and HLA-Cw*06 allele in 70 patients with guttate psoriasis originating from northern Poland.
MATERIAL AND METHODS: Seventy patients with guttate psoriasis and 24 healthy volunteers were enrolled into the study. Both groups were sex- and age-matched. The evidence of streptococcal infection was based on the positive throat swabs and/or elevated ASO titers. The modified method, including PCR-SSP and PCR-RFLP, was applied to HLA-Cw*06 genotyping.
RESULTS: HLA-Cw*06 allele was confirmed in 49 (70%) out of 70 patients, which is significantly higher than in the control population (30%) (p = 0.001). Evidence for streptococcal infection was found in 34 (48.5%) subjects with psoriasis. Twenty-seven of them (79%) carried HLA-Cw*06 allele. In 36 individuals in whom no evidence of streptococcal infection was found, 14 (39%) did not carry HLA-Cw*06 allele.
CONCLUSIONS: Our data confirm that HLA-Cw*06 is a major, but not imperative, genetic determinant for guttate psoriasis.
PMID: 26755910 [PubMed]
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Optical rhinometry in nasal provocation testing.
Postepy Dermatol Alergol. 2015 Dec;32(6):449-54
Authors: Krzych-Fałta E, Sybilski A, Wojas O, Samoliński B
Abstract
INTRODUCTION: Optical rhinometry (ORM) is a technique that allows for direct continuous measurement of changes in blood flow (optical density) in nasal vessels, at the same time analyzing changes per unit of time in the evaluated variable: intravascular blood flow and oxygen saturation.
AIM: To assess the extent to which ORM can be used as an objective measure of nasal mucosal edema following a nasal allergen provocation test in a group of patients with allergic rhinitis versus healthy controls.
MATERIAL AND METHODS: The study group included 60 subjects: 30 patients diagnosed with an allergy to common environmental allergens (dust mites/grasses) and 30 healthy controls. The method used in the study was a nasal provocation test with an allergen, with a standard dose of a control solution and an allergen (5,000 SBU/ml) administered using a calibrated atomizer into both nostrils in room temperature.
RESULTS: The mean delay to the onset of nasal mucosal response as measured by ORM was 3.15 min and the level of light extinction returned to baseline after 28.15 min (change in optical density 0.431). These objective changes in optical density strongly correlated with subjective perception measured via a visual analog scale.
CONCLUSIONS: Optical rhinometry is a valuable tool for nasal allergen provocation testing.
PMID: 26755909 [PubMed]
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Concentration of angiopoietins 1 and 2 and their receptor Tie-2 in peripheral blood in patients with chronic obstructive pulmonary disease.
Postepy Dermatol Alergol. 2015 Dec;32(6):443-8
Authors: Kierszniewska-Stępień D, Pietras T, Ciebiada M, Górski P, Stępień H
Abstract
INTRODUCTION: Both angiopoietins (angiopoietin 1 - Ang-1, angiopoietin 2 - Ang-2) and angiopoietin receptors (Tie) are involved in angiogenesis and vascular remodeling.
AIM: To assess concentrations of Ang-1, Ang-2 and Tie-2 in blood of patients with chronic obstructive pulmonary disease (COPD) and evaluate if their concentrations depend on the severity of the disease.
MATERIAL AND METHODS: Thirty patients with COPD (stage II-IV) and 8 healthy smokers as well as 8 healthy non-smokers were included in the study. Detailed history was taken, physical examination and spirometry tests were done and blood samples were taken for evaluation of serum concentrations of Ang-1, Ang-2 and Tie.
RESULTS: Among COPD patients, 8 patients suffered from moderate disease, 8 patients had severe, while 14 patients had very severe disease. The concentrations of Ang-1 and Ang-2 were not significantly greater in patients with COPD than in healthy controls. The highest concentrations of Ang-1 and Ang-2 were observed in patients with moderate COPD, and levels of Ang-2 correlated with Tie-2 in this group of patients. The levels of Ang-1 were the lowest in healthy non-smokers and in patients with severe COPD, where they inversely correlated with Tie-2. The concentrations of Ang-2 were not significantly higher in patients with moderate COPD when compared with those with severe and very severe disease and healthy smokers, and were significantly higher than in healthy non-smokers.
CONCLUSIONS: It is possible that Ang-1, Ang-2 and Tie-2 play an important role especially in the early stage of COPD but not in the late phase when vascular complications of the disease occur.
PMID: 26755908 [PubMed]
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Expression of CXCR4 and CXCL12 and their correlations to the cell proliferation and angiogenesis in mycosis fungoides.
Postepy Dermatol Alergol. 2015 Dec;32(6):437-42
Authors: Maj J, Jankowska-Konsur AM, Hałoń A, Woźniak Z, Plomer-Niezgoda E, Reich A
Abstract
INTRODUCTION: Chemokines play an important role in tumor growth, invasion and metastasis. The CXCR4/CXCL12 axis has been implicated in development of both solid tumors and hematological malignancies and is also relevant in the pathogenesis of the most common primary cutaneous T-cell lymphoma, mycosis fungoides (MF).
AIM: To evaluate the expression of CXCR4 and CXCL12 in MF and to examine their associations with cell proliferation and angiogenesis.
MATERIAL AND METHODS: The material for the study consisted of skin samples obtained from 56 patients with MF and 20 healthy volunteers. The expression of CXCR4 and CXCL12 was assessed by immunohistochemistry on the paraffin blocks and compared to the expression of angiogenesis marker (CD34) and proliferation indicators (Ki-67, AgNORs).
RESULTS: The expression of chemokine CXCL12 and its receptor CXCR4 was significantly higher in MF than in the healthy skin (p < 0.001). There was no significant difference between early and advanced stages of MF. Similarly, there was no statistically important correlation between the expression of CXCR4/CXCL12 and angiogenesis and proliferation markers, however a significant correlation between CD34 and AgNORs expression was found (p < 0.001).
CONCLUSIONS: The CXCR4/CXCL12 axis seems to play an important role in MF development in the early as well as in the advanced stages of the disease. Therefore, the CXCR4/CXCL12 axis seems to be an interesting potential target for the future strategies of new drug development, giving hope for more efficacious therapies for mycosis fungoides.
PMID: 26755907 [PubMed]
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Extrabronchial symptoms and late phase reaction enhance the diagnostic value of aspirin bronchial challenge.
Postepy Dermatol Alergol. 2015 Dec;32(6):431-6
Authors: Tworek D, Zielińska-Wyderkiewicz E, Górski P, Kuna P
Abstract
INTRODUCTION: Lysine aspirin (l-ASA) bronchial challenge can be used in the diagnostics of aspirin exacerbated respiratory disease. It is safer than oral challenge, however it is characterized by a lower sensitivity.
AIM: We sought to investigate whether additional indicators of the positive result of l-ASA bronchial challenge, i.e. late phase reaction (LPR) and extrabronchial symptoms (EBS), may enhance its diagnostic value.
MATERIAL AND METHODS: Sixty-seven patients with a positive history of asthma exacerbated by aspirin and/or other non-steroidal inflammatory drugs underwent l-ASA bronchial challenge. The control groups comprised 15 aspirin tolerant asthmatics and 15 healthy subjects. Forced expiratory volume in 1 s (FEV1) and 24-hour peak expiratory flow (PEF) measurements were performed in all subjects in order to recognize early and late response to l-ASA. All subjects underwent oral ASA challenge 2 weeks after l-ASA bronchial challenge.
RESULTS: Basing on FEV1 and PEF results, early reaction was present in 50.7% of patients, early and LPR in 29.9% and LPR in only 10.4% of aspirin exacerbated respiratory disease patients. The EBS were noted in 31.3% of subjects. Inclusion of LPR and EBS as positive criteria of the challenge increased sensitivity to 94.0%.
CONCLUSIONS: These results indicate that both LPR and EBS should be considered as positive criteria of aspirin bronchial challenge as they enhance its diagnostic value.
PMID: 26755906 [PubMed]
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Itching sensation in psoriatic patients and its relation to body mass index and IL-17 and IL-31 concentrations.
Postepy Dermatol Alergol. 2015 Dec;32(6):426-30
Authors: Czarnecka-Operacz M, Polańska A, Klimańska M, Teresiak-Mikołajczak E, Molińska-Glura M, Adamski Z, Jenerowicz D
Abstract
INTRODUCTION: According to available data, pruritus is a common symptom of psoriasis, however its characteristics and pathogenesis are not clearly understood.
AIM: The main aim of this study was to assess itching sensation among patients suffering from psoriasis, including its incidence and severity. All factors triggering and worsening pruritic symptoms were also carefully analyzed. The authors assessed the relationship of itch with body mass index (BMI) and severity of disease. Moreover, serum levels of interleukin 17 (IL-17) and IL-31 were analyzed in relation to Psoriasis Activity and Severity Index, BMI and severity of pruritus.
MATERIAL AND METHODS: The study group consisted of 60 patients with plaque-type psoriasis. Analysis of impact of pruritus on the quality of life and worsening factors was based on the questionnaire. The severity of pruritus was assessed with the use of two independent scales. Serum IL-17 and IL-31 levels were measured in 30 patients suffering from psoriasis and in 10 healthy controls using immunoassay tests.
RESULTS: 88.3% of analyzed patients complained of itch and the most common factor which exacerbated pruritus was stress (39.6%). Pruritus in psoriasis was independent of gender, illness duration and extent of skin lesions. The average intensity of pruritus was assessed as moderate and did not correlate significantly with BMI level, IL-17 and IL-31.
CONCLUSIONS: Since the pathogenesis of pruritus in psoriasis is not fully understood, further investigation in this area needs to be conducted. Pruritus may be considered as a characteristic feature of psoriasis and, besides the skin lesions, should be a target in dermatological treatment to improve patient's quality of life.
PMID: 26755905 [PubMed]
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Allergen Challenge Chamber: an innovative solution in allergic rhinitis diagnosis.
Postepy Dermatol Alergol. 2015 Dec;32(6):421-5
Authors: Krzych-Fałta E, Sowa J, Wojas O, Piekarska B, Sybilski A, Samoliński B
Abstract
The Allergen Challenge Chamber (ACC) is definitely a serious challenge on the one hand and an innovative solution in allergic rhinitis diagnosis on the other. The gradual validation of the chamber (according to the test protocol) will allow for standardisation, which is a process undertaken by centres worldwide. The process of designing a consistent system that allows for creating conditions as those in the case of natural inhalation took into account all the aspects (technical specification) necessary to ensure appropriate inhalation.
PMID: 26755904 [PubMed]
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Role of primary and secondary prevention in atopic dermatitis.
Postepy Dermatol Alergol. 2015 Dec;32(6):409-20
Authors: Oszukowska M, Michalak I, Gutfreund K, Bienias W, Matych M, Szewczyk A, Kaszuba A
Abstract
Atopic dermatitis (AD) is a serious epidemiological problem in industrialized countries. The incidence of AD has increased considerably over the last 30 years. Atopic dermatitis is a chronic, recurrent, inflammatory skin disease accompanied by strong itching. It is characterized by typical features depending on age. The parents of children suffering from AD must be prepared to change their lifestyle. They should avoid factors which can promote skin lesions and apply appropriate, regular skin care. The article describes primary prevention of AD as well as prophylactic measures to avoid skin eczema. It presents the role of infections, vaccinations, breastfeeding and the influence of domestic animals, house renovation and moulds on development of AD. The article also describes the significance of the epidermal barrier, skin colonization by microbial agents, pruritus, stress, food and inhalant allergy among people who suffer from AD.
PMID: 26755903 [PubMed]
Regeneration of tracheal epithelium using mouse induced pluripotent stem cells.
Acta Otolaryngol. 2016 Jan 12;:1-6
Authors: Ikeda M, Imaizumi M, Yoshie S, Otsuki K, Miyake M, Hazama A, Wada I, Omori K
Abstract
Conclusion The findings demonstrated the potential use of induced pluripotent stem cells for regeneration of tracheal epithelium. Objective Autologous tissue implantation techniques using skin or cartilage are often applied in cases of tracheal defects with laryngeal inflammatory lesions and malignant tumor invasion. However, these techniques are invasive with an unstable clinical outcome. The purpose of this study was to investigate regeneration in a tracheal defect site of nude rats after implantation of ciliated epithelium that was differentiated from induced pluripotent stem cells. Method Embryoid bodies were formed from mouse induced pluripotent stem cells. They were cultured with growth factors for 5 days, and then cultured at the air-liquid interface. The degree of differentiation achieved prior to implantation was determined by histological findings and the results of real-time polymerase chain reaction. Embryoid bodies including ciliated epithelium were embedded into collagen gel that served as an artificial scaffold, and then implanted into nude rats, creating an 'air-liquid interface model'. Histological evaluation was performed 7 days after implantation. Results The ciliated epithelial structure survived on the lumen side of regenerated tissue. It was demonstrated histologically that the structure was composed of ciliated epithelial cells.
PMID: 26755348 [PubMed - as supplied by publisher]
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Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study.
J Vestib Res. 2015 Oct 15;25(3,4):185-194
Authors: Herdman SJ, Hall CD, Maloney B, Knight S, Ebert M, Lowe J
Abstract
BACKGROUND: Vestibular rehabilitation (VR) improves symptoms and function in some but not all patients with bilateral vestibular hypofunction (BVH).
OBJECTIVE: The purpose of this retrospective study was to examine change following vestibular rehabilitation and to identify factors associated with rehabilitation outcome in patients with BVH.
METHODS: Data from 69 patients with BVH were analyzed. Factors studied included patient characteristics, subjective complaints and physical function. Outcome measures included symptom intensity, balance confidence, quality of life, gait speed, fall risk, and dynamic visual acuity. Bivariate correlations were used to examine relationships of patient characteristics and baseline measures with outcome measures. One-way ANOVAs were used to compare outcomes in patients with BVH versus unilateral vestibular hypofunction (UVH).
RESULTS: As a group, patients with BVH improved in all outcome measures except disability following a course of vestibular rehabilitation (VR); however, only 38-86% demonstrated a meaningful improvement, depending on the specific outcome measure examined. Several factors measured at baseline - age, DGI score, gait speed and perceived dysequilibrium - were associated with outcomes. For example, greater age was related to higher DVA scores at discharge; lower initial DGI scores were related to higher Disability scores at discharge. Compared to patients with UVH, reported previously [9], a smaller percentage of patients with BVH improve and to a lesser extent.
CONCLUSION: Consideration of baseline factors may provide guidance for setting patient goals. Further research is needed determine what factors predict outcome and to develop more effective treatment strategies for those patients who do not improve.
PMID: 26756134 [PubMed - as supplied by publisher]
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Ototoxicity from organic solvents assessed by an inner ear test battery.
J Vestib Res. 2015 Oct 15;25(3,4):177-183
Authors: Hsu PC, Cheng PW, Young YH
Abstract
OBJECTIVE: This study adopted an inner ear test battery comprising audiometry, and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP) and caloric tests to assess inner ear function in patients with long term exposure to organic solvents.
METHODS: Eighteen patients exposed to organic solvents and another 18 non-exposed controls from the same environment were enrolled in this study. Each subject underwent an inner ear test battery.
RESULTS: The percentages of abnormalities identified by the oVEMP test, cVEMP test, audiometry and caloric test for the exposed group were 85%, 54%, 50% and 33%, respectively, which showed significant differences when compared with the respective 8%, 8%, 6% and 0 for the non-exposed group. Additionally, a significantly declining trend of inner ear deficits from the utricle to the saccule, cochlea, and semicircular canals was noted in the exposed group, but not in the non-exposed group.
CONCLUSION: Ototoxicity was identified in those exposed to organic solvents, with the sequence of abnormal inner ear function from the utricle to the saccule, cochlea, and semicircular canals.
PMID: 26756133 [PubMed - as supplied by publisher]
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Spontaneous inversion of nystagmus without a positional change in the horizontal canal variant of benign paroxysmal positional vertigo.
J Vestib Res. 2015 Oct 15;25(3,4):169-175
Authors: Ogawa Y, Ichimura A, Otsuka K, Hagiwara A, Inagaki T, Shimizu S, Nagai N, Itani S, Suzuki M
Abstract
OBJECTIVE: We investigated the neuro-otological findings, including nystagmus, and the clinical course of patients with the horizontal canal variant of benign paroxysmal positional vertigo (HC-BPPV), who showed spontaneous inversion of nystagmus without a positional change. Furthermore, we speculated on the possible mechanism of spontaneous inversion of nystagmus without a positional change.
PATIENTS AND METHODS: The characteristics of spontaneous inversion of positional nystagmus without a positional change were analyzed in 7 patients with HC-BPPV.
RESULTS: All patients were diagnosed as having HC-BPPV. During the positional test, the spontaneous inversion of nystagmus was observed in the same head position in all patients. Spontaneous inversion was observed on both sides in 5 patients, and only on 1 side in 2 patients. All patients presented with geotropic nystagmus in the first phase, and ageotropic nystagmus in the second phase.
CONCLUSIONS: The coexistence of cupulolithiasis and canalolithiasis appears to be a possible mechanism of the spontaneous inversion of positional nystagmus.
PMID: 26756132 [PubMed - as supplied by publisher]
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Test-retest reliability of binaural simultaneous cervical vestibular evoked myogenic potential recording.
J Vestib Res. 2015 Oct 15;25(3,4):151-160
Authors: Lee MY, Yi YJ, Park H, Kim MH, Lee JH, Oh SH, Suh MW
Abstract
AIMS: The purpose of this study is to compare the test-retest reliability of cervical vestibular evoked myogenic potential (cVEMP) parameters between monaural sequential (mSEQ) cVEMP and binaural simultaneous (bSIM) cVEMP recordings.
MATERIALS AND METHODS: Twenty two volunteers aged 22 from 38 years were enrolled. Two different methods of cVEMP measurement were performed in the subjects. The two methods were (1) monaural sequential (mSEQ) measurement and (2) binaural simultaneous (bSIM) measurement. After a mean test-retest interval of 7.1 ± 2.8 days, the second run of the cVEMP measurement was performed in a random order. To compare the test-retest reliability of mSEQ and bSIM cVEMP responses, Intraclass correlation coefficient (ICC) and Spearman correlation were applied.
RESULTS: Both p13 and n23 latencies did not show a statistically significant difference between the two cVEMP recording methods. Also, there were no significant differences in the inter-peak amplitude (IPA) and interaural amplitude difference (IAD) ratio between the two methods. The test-retest reliability of inter-peak amplitude (IPA) demonstrated a positive correlation for both mSEQ and bSIM cVEMP methods. The IAD ratio of bSIM cVEMP response demonstrated a statistically significant test-retest reliability (ICC = 0.691, p= 0.015). However, the IAD ratio of mSEQ cVEMP response did not demonstrate a statistically significant test-retest correlation.
CONCLUSION: Results implicate that bSIM cVEMP not only saves time, but it also has an advantage of a more reliable test-retest outcome.
PMID: 26756130 [PubMed - as supplied by publisher]
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The influence of yaw motion on the perception of active vs passive visual curvilinear displacement.
J Vestib Res. 2015 Oct 15;25(3,4):125-141
Authors: Savona F, Stratulat AM, Roussarie V, Bourdin C
Abstract
Self-motion perception, which partly determines the realism of dynamic driving simulators, is based on multisensory integration. However, it remains unclear how the brain integrates these cues to create adequate motion perception, especially for curvilinear displacements. In the present study, the effect of visual, inertial and visuo-inertial cues (concordant or discordant bimodal cues) on self-motion perception was analyzed. Subjects were asked to evaluate (externally produced) or produce (self-controlled) curvilinear displacements as accurately as possible. The results show systematic overestimation of displacement, with better performance for active subjects than for passive ones. Furthermore, it was demonstrated that participants used unimodal or bimodal cues differently in performing their activity. When passive, subjects systematically integrated visual and inertial cues even when discordant, but with weightings that depended on the dynamics. On the contrary, active subjects were able to reject the inertial cue when the discordance became too high, producing self-motion perception on the basis of more reliable information. Thereby, multisensory integration seems to follow a non-linear integration model of, i.e., the cues' weight changes with the cue reliability and/or the intensity of the stimuli, as reported by previous studies. These results represent a basis for the adaptation of motion cueing algorithms are developed for dynamic driving simulators, by taking into account the dynamics of simulated motion in line with the status of the participants (driver or passenger).
PMID: 26756128 [PubMed - as supplied by publisher]
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Perceived radial translation during centrifugation.
J Vestib Res. 2015 Oct 15;25(3,4):119-124
Authors: Bos JE, Correia Grácio BJ
Abstract
BACKGROUND: Linear acceleration generally gives rise to translation perception. Centripetal acceleration during centrifugation, however, has never been reported giving rise to a radial, inward translation perception.
OBJECTIVE: To study whether centrifugation can induce a radial translation perception in the absence of visual cues.
METHODS: To that end, we exposed 12 subjects to a centripetal acceleration with eyes closed. To avoid confounding with angular motion perception, subjects were fist rotated on-axis, and were shifted out fast and slow only after rotation sensation had vanished. They were asked for translation direction and velocity right after the shift-out, as well as after about 60 seconds of constant centrifugation.
RESULTS: Independent of fast or slow shift-out, the vast statistically significant majority of trials yielded an inward radial translation perception, which velocity was constant after 60 seconds of constant centrifugation.
CONCLUSIONS: We therefore conclude that during centrifugation, an inward radial translation perception does exist in humans, which perception reaches a constant, non-zero value during constant rotation, lasting for at least one minute. These results can be understood by high-pass filtering of otolith afferents to make a distinction between inertial and gravitational acceleration, followed by a mere integration over time to reach a constant velocity perception.
PMID: 26756127 [PubMed - as supplied by publisher]
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Benign paroxysmal positional vertigo: Diagnostic criteria.
J Vestib Res. 2015 Oct 15;25(3,4):105-117
Authors: von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, Newman-Toker D
Abstract
This article presents operational diagnostic criteria for benign paroxysmal positional vertigo (BPPV), formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society. The classification reflects current knowledge of clinical aspects and pathomechanisms of BPPV and includes both established and emerging syndromes of BPPV. It is anticipated that growing understanding of the disease will lead to further development of this classification.
PMID: 26756126 [PubMed - as supplied by publisher]
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Regeneration of tracheal epithelium using mouse induced pluripotent stem cells.
Acta Otolaryngol. 2016 Jan 12;:1-6
Authors: Ikeda M, Imaizumi M, Yoshie S, Otsuki K, Miyake M, Hazama A, Wada I, Omori K
Abstract
Conclusion The findings demonstrated the potential use of induced pluripotent stem cells for regeneration of tracheal epithelium. Objective Autologous tissue implantation techniques using skin or cartilage are often applied in cases of tracheal defects with laryngeal inflammatory lesions and malignant tumor invasion. However, these techniques are invasive with an unstable clinical outcome. The purpose of this study was to investigate regeneration in a tracheal defect site of nude rats after implantation of ciliated epithelium that was differentiated from induced pluripotent stem cells. Method Embryoid bodies were formed from mouse induced pluripotent stem cells. They were cultured with growth factors for 5 days, and then cultured at the air-liquid interface. The degree of differentiation achieved prior to implantation was determined by histological findings and the results of real-time polymerase chain reaction. Embryoid bodies including ciliated epithelium were embedded into collagen gel that served as an artificial scaffold, and then implanted into nude rats, creating an 'air-liquid interface model'. Histological evaluation was performed 7 days after implantation. Results The ciliated epithelial structure survived on the lumen side of regenerated tissue. It was demonstrated histologically that the structure was composed of ciliated epithelial cells.
PMID: 26755348 [PubMed - as supplied by publisher]
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Editorial Change of publisher for Cochlear Implants International.
Cochlear Implants Int. 2016 Jan;17(1):1
Authors: Graham J, Cooper H
PMID: 26754487 [PubMed - in process]
Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.
Int J Audiol. 2016 Jan 12;:1-10
Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA
Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.
PMID: 26754550 [PubMed - as supplied by publisher]
A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.
Int J Audiol. 2016 Jan 12;:1-5
Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U
Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.
PMID: 26754548 [PubMed - as supplied by publisher]
| | Related Articles |
Acute necrotizing herpetic tonsillitis: a report of two cases.
Head Neck Pathol. 2015 Mar;9(1):119-22
Authors: Borhan WM, Dababo MA, Thompson LD, Saleem M, Pashley N
Abstract
The finding of herpetic tonsillitis is rare. Tonsillectomies are usually done for children with recurrent chronic tonsillitis, while viral throat infections are generally self-limiting. We present two cases: A 5 year-old girl, with atypical hemolytic anemia managed with Eculizumab, who presented with a pharyngeal infection and tonsillar enlargement that did not respond to intravenous antibiotics or antifungal therapies; and a 30 year-old man who presented with upper airway obstruction and fever; bilateral tonsillectomies were performed. Histopathological examination showed a necrotizing tonsillitis with numerous ground-glass intranuclear inclusions, characteristic of herpes viral infection, further confirmed by Herpes simplex virus in situ hybridization. Both patients were managed by intravenous Acyclovir, with dramatic improvement.
PMID: 24338612 [PubMed - indexed for MEDLINE]
Endoscopic submucosal tunnel dissection for large superficial esophageal squamous cell neoplasms.
World J Gastroenterol. 2016 Jan 7;22(1):435-45
Authors: Zhai YQ, Li HK, Linghu EQ
Abstract
Endoscopic submucosal dissection (ESD) is a well-established treatment for superficial esophageal squamous cell neoplasms (SESCNs) with no risk of lymphatic metastasis. However, for large SESCNs, especially when exceeding two-thirds of the esophageal circumference, conventional ESD is time-consuming and has an increased risk of adverse events. Based on the submucosal tunnel conception, endoscopic submucosal tunnel dissection (ESTD) was first introduced by us to remove large SESCNs, with excellent results. Studies from different centers also reported favorable results. Compared with conventional ESD, ESTD has a more rapid dissection speed and R0 resection rate. Currently in China, ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique, as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria. However, not all patients with SESCNs are candidates for ESTD, and postoperative esophageal strictures should also be taken into consideration, especially for lesions with a circumference greater than three-quarters. In this article, we describe our experience, review the literature of ESTD, and provide detailed information on indications, standard procedures, outcomes, and complications of ESTD.
PMID: 26755889 [PubMed - in process]
A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study.
PLoS One. 2016;11(1):e0146996
Authors: Li L, Yang J, Chu Y, Wu W, Xue J, Liang P, Chen L
Abstract
OBJECTIVE: To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery.
MATERIALS AND METHODS: In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems.
RESULTS: The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D) virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons.
CONCLUSION: The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon's skills and knowledge, not as a substitute.
PMID: 26757365 [PubMed - as supplied by publisher]
A Review of Clinical Signs Related to Ecchymosis.
WMJ. 2015 Apr;114(2):61-5
Authors: Epperla N, Mazza JJ, Yale SH
Abstract
Ecchymosis is a large area of discoloration caused by extravasation of blood into the subcutaneous tissue. It is an objective physical finding that may provide valuable clues as to its possible etiology. Ecchymosis is associated with eponyms based on the physician who first described the physical findings, which can be divided into 4 anatomical categories: base of the skull, abdominal wall and retroperitoneum, groin and scrotum, and lower extremity. Classic external signs and eponyms associated with ecchymosis are reviewed. Knowledge of these signs on physical examination may prove to be a useful clue directing the examiner to consider potentially serious causes of disease.
PMID: 26756058 [PubMed - in process]
Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele.
Childs Nerv Syst. 2016 Jan 11;
Authors: Oh BH, Lee OJ, Park YS
Abstract
INTRODUCTION: Although encephalocele is a rare congenital abnormality, secondary encephalocele is extremely rare and can cause fatal complications. Here, we report a case of secondary encephalocele caused by frontal sinus wall defect due to chronic sinusitis, which was completely removed by cranialization with autologous bone graft. A 50-year-old man with a 10-year history of chronic sinusitis visited our hospital due to suddenly altered mentality characterized by stupor. Computerized tomography scanning and magnetic resonance imaging revealed an enlarged left frontal sinus with sinusitis. The frontal sinus cavity was calcified, and the left frontal lobe had herniated into the cavity accompanied by yellow pus. A large dural defect was also found around the frontal sinus area. After removal of the abscess and some of the frontal lobe, frontal skull base repair by cranialization was performed using autologous bone graft. Streptococcus pneumoniae was cultured from the cerebrospinal fluid (CSF), necessitating treatment with antibiotics. After the operation, the mental status of the patient improved and no CSF leakage was observed.
DISCUSSION: In addition to correct diagnosis and early treatment including antibiotics, the surgical repair of defects is needed in patients with secondary encephalocele to prevent further episodes of meningitis. Surgical correction of frontal sinus encephalocele can be achieved through bifrontal craniotomy or endoscopic transnasal repair. If a patient has CSF leakage, open craniotomy may facilitate repair of the dural defect and allow for cranialization of the sinus.
CONCLUSIONS: Removal of dysplastic herniated brain tissue and cranialization of the frontal sinus may be a good option for treating secondary encephalocele and its associated complications, including meningitis, abscess formation, and infarction of the herniated brain parenchyma.
PMID: 26753900 [PubMed - as supplied by publisher]
| Related Articles |
Inter-rater reliability and validity of two ataxia rating scales in children with brain tumours.
Childs Nerv Syst. 2015 May;31(5):693-7
Authors: Hartley H, Pizer B, Lane S, Sneade C, Pratt R, Bishop A, Kumar R
Abstract
OBJECTIVES: This study aimed to investigate the inter-rater reliability and construct validity of the Scale for the Assessment and Rating of Ataxia (SARA) and Brief Ataxia Rating Scale (BARS) in children with posterior fossa tumours. These scales have been developed for adults with genetic ataxias, and the performance of these scales in children with brain tumours has not previously been described.
METHODS: The participants, who had undergone surgical resection for a posterior fossa tumour (inclusion criteria age 4-18 years), were recruited from the neuro-oncology service at a tertiary children's hospital. Children were assessed using the SARA, BARS and Paediatric Evaluation of Disability Index (PEDI) mobility domain, a measure of function. Children were independently rated by two therapists to determine the inter-rater reliability of the SARA and BARS. The construct validity was determined by assessing the correlation between the two scales with the PEDI.
RESULTS: Forty-four children were recruited. Inter-rater reliability was good for both scales, demonstrating the strong correlations (SARA, r = 0.94; BARS, r = 0.91) and the good consistency (93 % of SARA and 90 % of BARS paired scores differing by less than 2 points) between two raters. Both ataxia scales demonstrated a strong negative correlation with the mobility domain of the PEDI (SARA, r = -0.77; BARS, r = -0.76), indicating that more severe ataxia was associated with worse mobility. The mean time for completion of the SARA was 4.5 and 2.7 min for the BARS.
CONCLUSIONS: The SARA and BARS are reliable and valid measures and appear to be of equal value in determining the severity of ataxia in children with posterior fossa tumours.
PMID: 25735848 [PubMed - indexed for MEDLINE]
| Related Articles |
The occipitum-dens line: the purpose of a new ultrasonographic landmark in the evaluation of the relationship between the foetal posterior fossa structures and foramen magnum.
Childs Nerv Syst. 2015 May;31(5):729-33
Authors: de Sá Barreto EQ, Moron AF, Milani HJ, Hisaba WJ, Nardozza LM, Araujo Júnior E, Cavalheiro S
Abstract
PURPOSE: The aims of this study were to describe a new ultrasonographic technique to assess the normal level of the cerebellum and the brainstem in the posterior fossa in normal foetuses and to compare in pathologic cases.
METHODS: We propose a new line cross between the dens cervical and the inferior portion of occipitum (occipitum-dens line-ODL). In a cross-sectional study, a single observer with experience in foetal neurosonography evaluated 54 foetuses (40 normal and 14 with open neural tube defect) between 20 and 28 weeks of gestation. The reference points for the ODL are principally the lower portion of the occipital bone (occipitum) and odontoid process of the second cervical vertebra (dens). The line was considered the level zero (near level of foramen magnum). Structures above it had a positive measurement and below it had a negative measurement.
RESULTS: Moreover, in most foetuses with open neural tube defect (93 %), the end portion of cerebellum was below the ODL associated with different degrees of ventriculomegaly.
CONCLUSION: The proposed innovation aims to bring to the ultrasound the most likely anatomical parameters of evaluation in normal foetuses and in foetuses with spinal dysraphism.
PMID: 25700613 [PubMed - indexed for MEDLINE]
| Related Articles |
Clinical characteristics and prognosis factors analysis for post-operative ptosis of sphenocavernous meningiomas: a single institution study.
Clin Neurol Neurosurg. 2015 Apr;131:35-41
Authors: Hao S, Tian R, Wu Z, Jia G, Wang L, Tang J, Xiao X, Liu B, Zhang L, Zhang J
Abstract
OBJECTIVE: Complete and safe resection of sphenocavernous (SC) meningiomas is difficult and also a great challenge for neurosurgeons. The goal of our study was to report the surgical results and complications for these patients treated at our institution as well as trying to find the factors resulted in ptosis after the operation.
MATERIALS AND METHODS: Forty-nine consecutive SC meningiomas cases that underwent surgery between April 1997 and December 2012 were reviewed. The clinical courses of all patients were recorded. Prognosis factors of post-operative ptosis were evaluated.
RESULTS: There were 38 female and 11 male patients. Mean duration of symptoms was 20.9 months. Visual deficit (34.7%) and headache (22.4%) were the most common presenting symptoms. Mean maximum diameter of the tumors on MRI was 5.1 cm. Subtotal resection was achieved in 51.0% of patients. Follow-up data were available for 39 patients, with a mean follow-up of 73.7 months, and four patients died during follow-up period. Of the 35 living patients, 22 (62.9%) lived a normal life. Univariate analyses showed that factors associated with post-operative ptosis included female patient, with primary operation and the cavernous extension in Category 3 of Hirsch' grading, while multivariate regression analyses showed that only the cavernous extension in Category 3 of Hirsch' grading was independently associated with post-operative ptosis.
CONCLUSIONS: Our experience suggests that the most common complication after the SC meningioma surgery is ocular cranial nerve dysfunction, and the only significance factor relative to post-operative ptosis is the level of extension to the cavernous.
PMID: 25688032 [PubMed - indexed for MEDLINE]
Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.
Int J Audiol. 2016 Jan 12;:1-10
Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA
Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.
PMID: 26754550 [PubMed - as supplied by publisher]
A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.
Int J Audiol. 2016 Jan 12;:1-5
Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U
Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.
PMID: 26754548 [PubMed - as supplied by publisher]
Construction and identification of small hairpin RNA plasmids targeting neuropilin-1 gene and their inhibitory effect on human nasopharyngeal carcinoma CNE-2Z cell proliferation in vitro and in vivo.
Eur Arch Otorhinolaryngol. 2016 Jan 11;
Authors: Sun J, Wang L, Lou WH, Cao H, Tian XF, Sang JZ
Abstract
We observed the effects of small hairpin RNA (shRNA) plasmids targeting neuropilin-1 (NRP-1) gene on human nasopharyngeal carcinoma (NPC) CNE-2Z cell growth in vitro and in vivo. Three fluorescein-labeled shRNA eukaryotic expression vectors targeting NRP-1 gene, including pSilencer-shRNA1, pSilencer-shRNA2 and pSilencer-shRNA3 were constructed. The three plasmids were, respectively, transfected into human NPC CNE-2Z cells. The most effective plasmid was injected into xenograft tumors in nude mice. The sequencing for these recombinant plasmids was consistent with that of designed shRNA templates. Green fluorescence was seen in the transfected CNE-2Z cells and xenograft tumors in nude mice. MTT assay indicated that CNE-2Z cell proliferation was significantly inhibited. PT-PCR and Western blot displayed that both mRNA and protein of NRP-1 gene were all decreased, particularly in the cells treated with shRNA3. At the end of the experiment, xenograft tumors in plasmid group (0.599 ± 0.002 cm(3)) were significantly inhibited with a tumor inhibition rate of 48.6 %, as compared to those in negative (1.141 ± 0.013 cm(3)) and blank control groups (1.165 ± 0.308 cm(3)) (all P < 0.05). shRNA targeting NRP-1 gene can effectively inhibit human NPC CNE-2Z cell proliferation in vitro and in vivo. This provides an experiment basis for NPC gene therapy.
PMID: 26755049 [PubMed - as supplied by publisher]
Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.
Eur Arch Otorhinolaryngol. 2016 Jan 11;
Authors: Windfuhr JP, Toepfner N, Steffen G, Waldfahrer F, Berner R
Abstract
More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more reliable eradication of β-hemolytic streptococci is desirable. In cases of allergy or incompatibility of penicillin, cephalosporins or macrolides (e.g. Erythromycin-estolate) are valuable alternatives.
PMID: 26755048 [PubMed - as supplied by publisher]
Perspectives in chemosensitivity and chemoresistance assays and their implementation in head and neck cancer.
Eur Arch Otorhinolaryngol. 2016 Jan 11;
Authors: Bussmann L, Busch CJ, Lörincz BB, Rieckmann T, Block A, Knecht R
Abstract
Therapeutic options for patients with head and neck squamous cell carcinoma include surgery, radiation and chemotherapy. The latter plays a major role in the treatment selection of recurrent, metastatic or therapy resistant tumours, these being some of the major challenges in head and neck oncology. For these patients, chemosensitivity and chemoresistance assays would be paramount to identify their individual therapy options. In this review, seven common assays will be described and discussed in the context of several studies. Further, a new assay will also be presented, currently being validated in a European Union funded project. Comparisons will be drawn to evaluate the sensitivity and specificity of these assays in identifying individual treatment options, and their potential implementation in head and neck malignancies will be discussed. There is an unmet demand for the development of ex vivo diagnostic tools that may predict response in head and neck cancer on the way towards an individualized treatment for these patients.
PMID: 26755047 [PubMed - as supplied by publisher]
Ocular and Cervical Vestibular Evoked Myogenic Potentials (VEMPs) in healthy volunteers: the intra-, interobserver, and the test re-test reliability.
J Vestib Res. 2015 Oct 15;25(3,4):161-167
Authors: Venhovens J, Meulstee J, Verhagen WI
Abstract
OBJECTIVE: The aims of the study are to determine the intra-, interobserver, and the test re-test reliability of the cervical and ocular vestibular evoked myogenic potentials (VEMPs).
METHODS: Twenty healthy subjects underwent acoustically and forehead tap elicited cervical and ocular VEMPs. The measurements were repeated one week later.
RESULTS: The intra- and interobserver reliability of both ocular and cervical VEMPs is excellent. The test re-test reliability of the raw p13n23 peak-to-peak amplitudes of the cervical VEMPs is excellent (ICC: 0.76, 0.87) and the p13 latencies show a good reliability (ICC: 0.56, 0.73). The raw n1p1 peak-to-peak amplitudes of the ocular VEMPs show a fair-to-good test re-test reliability (ICC: 0.51, 0.64) and the n1 and p1 latencies show a poor reliability (ICC: -0.17 ≤ x ≤ 0.44).
CONCLUSIONS: The intra- and interobserver reliability of the cervical and ocular VEMPs is excellent. The raw ocular and cervical VEMP peak-to-peak amplitudes are the most reliable parameters, followed by the cervical VEMP latencies. The ocular VEMP latencies shows a poor test re-test reliability. The individual VEMP results, however, remained within normal limits despite the test re-test variability.
PMID: 26756131 [PubMed - as supplied by publisher]
Ocular vestibular evoked myogenic potentials in response to air-conducted 500 Hz short tones: Effect of stimulation procedure (monaural or binaural), age and gender.
J Vestib Res. 2015 Oct 15;25(3,4):143-149
Authors: Versino M, Colnaghi S, Ranzani M, Alloni R, Bolis C, Sacco S, Moglia A, Callieco R
Abstract
BACKGROUND: The ocular vestibular myogenic potentials (oVEMP) can be elicited by monaural air-conducted sound stimulation, and are usually recorded from the contralateral eye. In clinical setting a binaural stimulation would save time and require less effort from the subjects.
OBJECTIVE: We evaluated the differences between monaural and binaural stimulation, and the possible effect of age and gender on oVEMP parameters.
METHODS: Air-conducted oVEMP were recorded by binaural and by monaural stimulation in a group of 54 normal subjects, aged from 12 to 83 years, and in 50 vestibular patients. From each side, we measured the latency of the N1 component, and the peak-to-peak N1-P1 amplitude. For both parameters we also computed the asymmetry ratio.
RESULTS: In normal subjects binaural stimulation produced slightly larger responses than monaural stimulation; detectability, latency and amplitude ratio were the same for the two techniques. We found no differences related to gender, and the age-induced amplitude decline was likely to be negligible.oVEMP recorded not in an acute phase of their disorder, proved to be abnormal in about 20% of the patients, and the normal or abnormal findings obtained either with monaural or with binaural stimulation were always concordant.
CONCLUSIONS: The oVEMP obtained after binaural and monaural stimulation are very similar, and they are largely independent from age and gender.
PMID: 26756129 [PubMed - as supplied by publisher]
Verschluss der A. ethmoidalis anterior.
Laryngorhinootologie. 2016 Jan;95(1):69-71
Authors:
PMID: 26756660 [PubMed - as supplied by publisher]
Fragen für die Facharztprüfung.
Laryngorhinootologie. 2016 Jan;95(1):68
Authors:
PMID: 26756659 [PubMed - as supplied by publisher]
Chirurgie der Nase und Nasennebenhöhlen.
Laryngorhinootologie. 2016 Jan;95(1):51-67
Authors: Hofer M, Dacho A, Dietz A
Abstract
A compromised overview of surgical techniques regarding the nose (functional) and para nasal sinus inflammation surgical treatment is exposed in this article. The nasal septum is within the focus for function, form and stability for the nasal structure (especially for tip and back of the nose) and for success of a rhinoplasty. An important role play the lower nasal turbinates regulating nasal air flow and thus having a great effect after turbinate surgery (submucosal resection and lateral fracturing).The endonasal endoscopy is of utmost importance for diagnosis, therapy and detection of recurrence. In severe cases of nasal polyps, functional endoscopic sinus surgery (FESS) remains the ultimate therapy. However, the indication to operate will be carried out after exhaustion of medical treatment. The most important recurrent prophylaxis for rhino sinusitis and nasal polyps is an appropriate post operative nasal care.
PMID: 26756658 [PubMed - as supplied by publisher]
[From the Expert's Office: The Scale of Graz - Examination of Bell's Palsy in Consideration of the Principles of the Austrian Social Accident Insurance].
Laryngorhinootologie. 2016 Jan;95(1):48-50
Authors: Kuchler WW
PMID: 26756657 [PubMed - as supplied by publisher]
Nachruf auf Prof. Dr med. Klaus Jahnke.
Laryngorhinootologie. 2016 Jan;95(1):47
Authors: Jahnke K
PMID: 26756656 [PubMed - as supplied by publisher]
Eine bläuliche Erhabenheit der Rachenhinterwand.
Laryngorhinootologie. 2016 Jan;95(1):45-46
Authors: Glaas MF, Schipper J, Suttorp AC, Knapp F
PMID: 26756655 [PubMed - as supplied by publisher]
[A Rare Cause of Nasal Congestion].
Laryngorhinootologie. 2016 Jan;95(1):43-44
Authors: Furbish N, Neppl C, Hilber H, Haubner F
PMID: 26756654 [PubMed - as supplied by publisher]
[Optimal Postoperative Pain Management After Tonsillectomy: An Unsolved Problem].
Laryngorhinootologie. 2016 Jan;95(1):15-23
Authors: Guntinas-Lichius O, Geißler K, Preußler NP, Meißner W
Abstract
Tonsillectomy is one of the most painful surgical procedures. Unfortunately, it is not unusual that the patient hear statement like: "There is no way around" or "You receive already enough pain killers". Asking the anesthetist or the otorhinolaryngologist, one may get to hear: "Pain after tonsillectomy is not a real problem. We have a reliable pain management protocol". In contradiction, many clinical studies are showing that many patients have persistent and even severe pain after tonsillectomy despite postoperative pain therapy. Considering the results of many controlled clinical trials analyzing manifold varieties of pain management regimes it becomes obvious that there is no standard pain therapy after tonsillectomy with reliable proof of sufficient pain suppression. This review wants to give an overview on the current status of clinical research on pain measurement methods and pain management after tonsillectomy.
PMID: 26756653 [PubMed - as supplied by publisher]
Tipps & Tricks - Epistaxis Management unter Berücksichtigung der Kontamination.
Laryngorhinootologie. 2016 Jan;95(1):11-14
Authors: Riemann R
PMID: 26756652 [PubMed - as supplied by publisher]
[Clinical status in Otolaryngology - ear and nose].
Laryngorhinootologie. 2016 Jan;95(1):8-9
Authors: Roesch S, Janda P, Rasp G
PMID: 26756651 [PubMed - as supplied by publisher]
Cancer incidence among alcoholic liver disease patients in Finland. A retrospective registry study during years 1996-2013.
Int J Cancer. 2016 Jan 12;
Authors: Sahlman P, Nissinen M, Pukkala E, Färkkilä M
Abstract
Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. We aimed to assess the long-term risk of malignancies among patients with severe alcoholic liver disease, i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8796 male and 3077 female alcoholic liver disease patients from 1996-2013 was identified from the Finnish national Hospital Discharge Register. This nationwide cohort was combined with the data from the Finnish Cancer Registry for incidence of malignancies during the years 1996- 2013. The cancer cases diagnosed were compared to the number of cancers in the general population. The number of malignancies in our cohort was 1052 versus 368 expected. There was statistically significant excess of cancers of the liver, (standardized incidence ratio (SIR) 59.20; 95% CI 53.11-65.61), pancreas (SIR 37.1; 95% CI 2.72.-4.94), pharynx (SIR 9.25; 95% CI 6.05-13.56), mouth (SIR 8.31; 95% CI 4.84-13,29), esophagus (SIR 7.92; 95% CI 5.49-11.07), tongue (SIR 7,21; 95% CI 3.60-12.89), larynx (SIR 5.20; 95% CI 2.77-8.89), lung (SIR 2.77; 95% CI 2.27-3.32), stomach (SIR 2.76; 95% CI 1.79-4.07), kidney (SIR 2.69; 95% CI 1.84-3.79) and colon (SIR 2.33; 95% CI 1.70 - 3.11). There was no decreased risk of any cancer among alcoholic liver disease patients. Severe alcoholic liver disease is associated with markedly increased risk of malignancies. The risk is especially high for hepatocellular carcinoma, but also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys, and warrants cancer surveillance in selected cases. This article is protected by copyright. All rights reserved.
PMID: 26756434 [PubMed - as supplied by publisher]
Evaluation of Autologous Fascia Implantation With Controlled Release of Fibroblast Growth Factor for Recurrent Laryngeal Nerve Paralysis Due to Long-term Denervation.
Ann Otol Rhinol Laryngol. 2016 Jan 10;
Authors: Nagai H, Nishiyama K, Seino Y, Tabata Y, Okamoto M
Abstract
OBJECTIVES: Paralyzed tissue due to long-term denervation is resistant to many treatments because it induces irreversible histological changes and disorders of deglutition or phonation. We sought to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on long-term unilateral vocal fold paralysis (UVFP).
METHODS: Unilateral recurrent laryngeal nerve (RLN) section was performed on 20 rats. Five rats were implanted with autologous fascia only (fascia group), and 10 rats were implanted with autologous fascia and a gelatin hydrogel sheet with 1 μg (1 μg bFGF + fascia group) or 0.1 μg (0.1 μg bFGF + fascia group) of bFGF 4 months after RLN section. We evaluated the normalized glottal gap and laryngeal volume and histological changes 3 months after implantation.
RESULTS: The normalized glottal gap was significantly reduced in the 3 fascia implantation groups. Normalized laryngeal volume, fat volume, and lateral thyroarytenoid muscle volume were significantly increased in the 2 fascia implantation with bFGF groups.
CONCLUSIONS: The ATFV with controlled release of bFGF repaired the glottal gap and laryngeal volume after RLN section and may reduce the occurrence of aspiration and hoarseness. We speculate that this treatment improves laryngeal function in long-term RLN denervation.
PMID: 26755795 [PubMed - as supplied by publisher]
Clinical Conundrum: Killian-Jamieson Diverticulum with Paraesophageal Hernia.
Dysphagia. 2016 Jan 11;
Authors: Bock JM, Knabel MJ, Lew DA, Knechtges PM, Gould JC, Massey BT
Abstract
Killian-Jamieson diverticulum is a outpouching of the lateral cervical esophageal wall adjacent to the insertion of the recurrent laryngeal to the larynx and is much less common in clinical practice than Zenkers Diverticulum. Surgical management of Killian-Jamieson diverticulum requires open transcervical diverticulectomy due to the proximity of the recurrent laryngeal nerve to the base of the pouch. We present a case of a Killian-Jamieson diverticulum associated with a concurrent large type III paraesophageal hernia causing significant solid-food dysphagia, post-prandial regurgitation of solid foods, and chronic cough managed with open transcervical diverticulectomy and laparoscopic paraesophageal hernia repair with Nissen fundoplication.
PMID: 26753928 [PubMed - as supplied by publisher]
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Accuracy of conventional digital palpation and ultrasound of the cricothyroid membrane in obese women in labour.
Anaesthesia. 2015 Nov;70(11):1230-4
Authors: You-Ten KE, Desai D, Postonogova T, Siddiqui N
Abstract
Success of cricothyroidotomy depends on accurate identification of anatomical neck landmarks. Anaesthetists palpated the cricothyroid membrane of 28 obese and 28 non-obese women in labour (cut-off BMI 30 kg.m(-2) ) and marked the entry point for device insertion with an ultraviolet invisible pen. Ultrasonography was used to mark the midpoint of the cricothyroid membrane and the distance between the two marks was measured. The median (IQR [range]) distance between the two marks was significantly greater in the obese than the non-obese patients (5 (2-9.5 [0-34]) mm vs 1.8 (0.1-6 [0-15]) mm, respectively; p = 0.02). The cricothyroid membrane was accurately identified with digital palpation in only 39% (11/28) of obese compared with 71% (20/28) of non-obese patients (p = 0.03). Increased neck circumference in obese patients was significantly associated with inaccuracy in locating the cricothyroid membrane. Percutaneous identification of the cricothyroid membrane in obese women in labour was poor. Pre-procedural ultrasound may help improved the identification of neck landmarks for cricothyroidotomy.
PMID: 26186092 [PubMed - indexed for MEDLINE]
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Study on the correlation between extracellular matrix protein-1 and the growth, metastasis and angiogenesis of laryngeal carcinoma.
Asian Pac J Cancer Prev. 2015;16(6):2313-6
Authors: Meng XY, Liu J, Lv F, Liu MQ, Wan JM
Abstract
OBJECTIVE: To investigate the correlation between extracellular matrix protein-1 (ECM1) and the growth, metastasis and angiogenesis of laryngeal carcinoma.
MATERIALS AND METHODS: Forty-five samples with laryngeal benign and malignant tumors confirmed by pathology in Laiwu City People's Hospital from March 2006 to March 2011 were collected, in which there were 29 cases with laryngeal carcinoma and 16 with benign tumors. The expression of ECM1 and factor VIII-related antigens in patients with laryngeal carcinoma and those with benign tumors was respectively detected using immunohistochemical method, and the correlation between ECM1 staining grade and microvessel density (MVD) was analyzed.
RESULTS: In laryngeal carcinoma tissue, ECM1 was mainly expressed in cytoplasm, less in cytomembrane or intercellular substance. With abundant expression in the tissue of laryngeal benign tumors (benign mesenchymoma and hemangioma), ECM1 was primarily expressed in the connective tissue, which was different from the expression in laryngeal carcinoma tissue. The proportion of positive ECM1 staining (++) in patients with laryngeal carcinoma was dramatically higher than those with benign tumors (p<0.05), and that of strongly-positive ECM1 staining (+++) slightly higher. The results of Spearman nonparametric correlation analysis revealed that ECM1 staining grade in laryngeal carcinoma tissue had a significantly-positive correlation with MVD (r=0.866, p=0.000).
CONCLUSIONS: ECM1 expression in laryngeal carcinoma is closely associated with tumor cell growth, metastasis and angiogenesis, which can be considered as an effective predictor in the occurrence and postoperative recurrence of laryngeal carcinoma.
PMID: 25824756 [PubMed - indexed for MEDLINE]
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Confirmation of local anesthetic distribution by radio-opaque contrast spread after ultrasound guided infraclavicular catheters placed along the posterior cord in children: a prospective analysis.
Paediatr Anaesth. 2015 Mar;25(3):253-7
Authors: Ponde V, Shah D, Johari A
Abstract
BACKGROUND: The needle tip placed at the level of posterior cord under ultrasound guidance is described as the most effective way to obtain single shot successful block in adults, for forearm and hand surgeries.
OBJECTIVE: The aim of this research was to study the spread of dye (depicting the local anesthetic) through catheters placed along the posterior cord. This was performed with continuous infraclavicular blocks placed under ultrasound guidance in children.
METHODS: Twenty-four ASA 1 and 2 children, aged 7 months to 8 years old, scheduled for upper limb orthopedic surgeries were included in this prospective descriptive study. They received continuous infraclavicular block under ultrasound guidance. Skin markings were obtained from catheters that were placed below the posterior cord inserted 2-3 cm beyond the tip of the Tuohy needle. A radio-opaque dye was injected into the catheters and 5 min later, the dye spread was evaluated fluoroscopically. Postoperatively, all patients received a continuous infusion of 0.125% bupivacaine for pain relief.
RESULTS: All 24 cases showed the presence of the dye along the neurovascular bundle in the infraclavicular region suggesting successful blocks. The mean ± standard deviation of the skin marking for the catheter was 5.61 ± 1.77 cm. Postoperatively, all patients had adequate pain relief with the catheters. One patient had break through pain on day 1 and four catheters were accidentally dislodged on day 2.
CONCLUSION: We conclude that continuous infraclavicular catheters can be accurately and effectively placed along the posterior cord exclusively under ultrasound guidance in infants and small children.
PMID: 25331111 [PubMed - indexed for MEDLINE]
Evaluation of Autologous Fascia Implantation With Controlled Release of Fibroblast Growth Factor for Recurrent Laryngeal Nerve Paralysis Due to Long-term Denervation.
Ann Otol Rhinol Laryngol. 2016 Jan 10;
Authors: Nagai H, Nishiyama K, Seino Y, Tabata Y, Okamoto M
Abstract
OBJECTIVES: Paralyzed tissue due to long-term denervation is resistant to many treatments because it induces irreversible histological changes and disorders of deglutition or phonation. We sought to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on long-term unilateral vocal fold paralysis (UVFP).
METHODS: Unilateral recurrent laryngeal nerve (RLN) section was performed on 20 rats. Five rats were implanted with autologous fascia only (fascia group), and 10 rats were implanted with autologous fascia and a gelatin hydrogel sheet with 1 μg (1 μg bFGF + fascia group) or 0.1 μg (0.1 μg bFGF + fascia group) of bFGF 4 months after RLN section. We evaluated the normalized glottal gap and laryngeal volume and histological changes 3 months after implantation.
RESULTS: The normalized glottal gap was significantly reduced in the 3 fascia implantation groups. Normalized laryngeal volume, fat volume, and lateral thyroarytenoid muscle volume were significantly increased in the 2 fascia implantation with bFGF groups.
CONCLUSIONS: The ATFV with controlled release of bFGF repaired the glottal gap and laryngeal volume after RLN section and may reduce the occurrence of aspiration and hoarseness. We speculate that this treatment improves laryngeal function in long-term RLN denervation.
PMID: 26755795 [PubMed - as supplied by publisher]
Correction to: Thyroid 2015;25(11):1191-1198.
Thyroid. 2016 Jan;26(1):187
Authors:
PMID: 26756693 [PubMed - as supplied by publisher]
Future Meetings.
Thyroid. 2016 Jan;26(1):185-186
Authors:
PMID: 26756692 [PubMed - as supplied by publisher]
Thyroid Imaging Reporting and Data System for Risk Stratification of Thyroid Nodules: Categorization Based on Solidity and Echogenicity.
Thyroid. 2016 Jan 12;
Authors: Na DG, Baek JH, Sung JY, Kim JH, Kim JK, Choi YJ, Seo H
Abstract
BACKGROUND: Although ultrasonography (US) has an essential role in assessing the malignancy risk of thyroid nodules, a malignancy risk stratification system has not been established. The purpose of this study was to develop a clinically feasible US risk stratification system, thyroid imaging reporting and data system (TIRADS), primarily based on the solidity and echogenicity of thyroid nodules.
METHODS: From January 2010 to May 2011, a total of consecutive 2000 thyroid nodules (≥ 1 cm) with final diagnoses were enrolled from the database of low and high cancer volume institutions (1000 nodules from each institution). For the development of TIRADS, we analyzed the type and predictive value of US predictors in the groups categorized by solidity and echogenicity, and the US predictors were integrated and categorized according to the malignancy risk.
RESULTS: The suspicious US features of microcalcification, taller than wide shape, and spiculated/microlobulated margin were independently predictive of malignancy in the solid or hypoechoic nodule group (p < 0.001, respectively). Meanwhile, only microcalcification was independently predictive of malignancy in the partially cystic nodule group (p = 0.006), and microcalcification and spiculated/microlobulated margin were independently predictive of malignancy in the iso- and hyperechoic nodule group (p = 0.002 and p = 0.015, respectively). Although the presence of any suspicious US features had a high malignancy risk in the group of solid hypoechoic nodules, it had an intermediate malignancy risk in the group of partially cystic or iso- and hyperechoic nodules. The malignancy risk of thyroid nodules was stratified into five TIRADS categories by integrating the type and predictive values of US predictors based on solidity and echogenicity.
CONCLUSION: The malignancy risk of thyroid nodules can be stratified by the TIRADS according to US patterns by combining solidity, echogenicity, and suspicious US features. The proposed risk stratification system based on solidity and echogenicity will be useful for risk stratification and management decision of thyroid nodules.
PMID: 26756476 [PubMed - as supplied by publisher]
Anthropometric factors and thyroid cancer risk by histological subtype: pooled analysis of 22 prospective studies.
Thyroid. 2016 Jan 12;
Authors: Kitahara CM, McCullough M, Franceschi S, Rinaldi S, Wolk A, Neta G, Olov Adami H, Anderson K, Andreotti G, Beane Freeman L, Bernstein L, Buring J, Clavel-Chapelon F, De Roo L, Gao YT, Gaziano JM, Giles G, Hakansson N, Horn-Ross PL, Kirsh V, Linet M, MacInnis R, Orsini N, Park Y, Patel AV, Purdue M, Riboli E, Robien K, Rohan T, Sandler D, Schairer C, Schneider AB, Sesso H, Shu XO, Singh P, Van Den Brandt P, Ward E, Weiderpass E, White E, Xiang YB, Zeleniuch-Jacquotte A, Zheng W, Hartge P, Berrington de Gonzalez A
Abstract
BACKGROUND: Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality.
METHODS: In this large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women), we investigated thyroid cancer incidence associated with greater height, body mass index (BMI) at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information.
RESULTS: During follow-up, 2,996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: HRs (95% CIs) for height (per 5 cm)=1.07 (1.04-1.10), BMI (per 5 kg/m2)=1.06 (1.02-1.10), waist circumference (per 5 cm)=1.03 (1.01-1.05), young-adult BMI (per 5 kg/m2)=1.13 (1.02-1.25), and adulthood BMI gain (per 5 kg/m2)=1.07 (1.00-1.15). Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (P-interaction=0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality.
CONCLUSION: Our results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but most aggressive form, anaplastic carcinoma, and higher thyroid cancer mortality. Potential underlying biological mechanisms should be explored in future studies.
PMID: 26756356 [PubMed - as supplied by publisher]
Circulating Myeloid Derived Suppressor Cells Predict Differentiated Thyroid Cancer Diagnosis and Extent.
Thyroid. 2016 Jan 12;
Authors: Angell TE, Lechner MG, Smith AM, Martin SE, Groshen SG, Maceri D, Singer P, Epstein AL
Abstract
<b>Background:</b> Establishing the pre-operative diagnosis and long-term prognosis of differentiated thyroid cancer (DTC) remain challenging in some patients. Myeloid-derived suppressor cells (MDSC) are tumor-induced cells mediating immune tolerance that are detectable in the peripheral blood of cancer patients. We previously developed a novel clinical assay to detect the phenotypes of two human MDSC subsets in peripheral blood, and hypothesize that higher MDSC levels measured by this assay correlate positively with both malignancy and worse patient outcomes. <b>Methods:</b> We performed a prospective observational pilot study of patients undergoing thyroidectomy for a solitary thyroid nodule. The presence of a thyroid nodule greater >1cm was confirmed sonographically and fine needle aspiration biopsy performed in all cases. Peripheral blood collected pre-operatively was analyzed using a novel flow cytometry-based immunoassay to detect and quantify two subsets of human MDSC. Circulating MDSC levels were compared by histopathologic diagnosis, stage, and presence of persistent disease after treatment. <b>Results:</b> Of 50 patients included in this study, MDSC measurement was successful in 47 (94%). One patient was found to have a concurrent renal cell carcinoma after data acquisition leaving 46 patients for primary analysis. Final histopathology was benign in 11 (24%) and DTC in 35 (76%), encompassing 34 PTC cases and one follicular thyroid carcinoma. Mean percentages of granulocytic CD11b<sup>+</sup>HLA-DR<sup>low</sup>HIF1a<sup>+</sup> MDSC (CD11b<sup>+</sup>MDSC) were 14.0%±6.2% and 7.9%±3.6%, in DTC versus benign nodules, respectively (P<0.005). A cut-off of 12% yielded a specificity of 0.91, a sensitivity of 0.72, and a likelihood ratio of 7.9. Mean CD11b<sup>+</sup>MDSC levels increased linearly with higher TNM stage (P<0.01) and were 19.4±5.4 in patients with persistent cancer after surgery compared to 13.2±6.8 in those without evidence of disease (P<0.05). <b>Conclusion:</b> MDSC measurement using this flow-cytometry based assay represents a novel approach for pre-operatively assessing malignancy risk and cancer extent in patients with thyroid nodules. While further validation is needed, MDSC assessment may serve as a useful adjunct when cytology is indeterminate, and predict tumor stage and recurrence risk in cases of thyroid cancer.
PMID: 26756227 [PubMed - as supplied by publisher]
