from Hearing and Balance via ola Kala on Inoreader http://ift.tt/1oOcWJO
via IFTTT
A Case of Pranlukast-Induced Anaphylactic Shock.
Allergy Asthma Immunol Res. 2016 May;8(3):276-278
Authors: Kim S, Lee JM
Abstract
Leukotriene receptor antagonists, which are generally considered safe with a few adverse drug reactions, are increasingly used in the treatment of various allergic diseases, including asthma and allergic rhinitis. Although a few anaphylactic reactions to montelukast have been reported worldwide, there is still a lack of reports about severe adverse drug reactions associated with pranlukast. Here, we report a case of severe hypersensitivity reaction associated with pranlukast. A 65-year-old woman developed anaphylactic shock that presented as generalized urticaria, angioedema, collapse, and loss of consciousness after receiving pranlukast. A positive response to oral challenge and skin prick testing with pranlukast was observed in the patient. In this case, it was demonstrated that pranlukast can induce anaphylaxis, possibly mediated by the IgE-dependent pathway.
PMID: 26922938 [PubMed - as supplied by publisher]
CpG Oligodeoxynucleotide Inhibits Cockroach-Induced Asthma via Induction of IFN-γ⁺ Th1 Cells or Foxp3⁺ Regulatory T Cells in the Lung.
Allergy Asthma Immunol Res. 2016 May;8(3):264-275
Authors: Kim DH, Sohn JH, Park HJ, Lee JH, Park JW, Choi JM
Abstract
PURPOSE: CpG oligodeoxynucleotide (CpG-ODN), a TLR9 agonist, activates innate immunity and induces Th1 response. Although the immune modulatory effect of CpG-ODN has been extensively studied, its function in cockroach extract-induced allergic asthma has not been studied. Here, we investigated the inhibitory function of CpG-ODN in cockroach extract-induced asthma in mice with different treatment schemes.
METHODS: Scheme 1: BALB/C mice were intra-nasally co-administered by cockroach extract and CpG-ODN twice a week for 3 weeks; Scheme 2: The mice were intra-nasally pre-treated with CpG-ODN at day 0 and cockroach allergen challenge was performed from day 3 as in scheme 1. Scheme 3: Cockroach allergen challenge was performed as in scheme 1 and CpG-ODN was post-treated at day 21. Then, BAL cell count, flow cytometric analysis of alveolar macrophages, regulatory T cells, and lung tissue histology, Th1 and Th2 cytokines, serum IgE, cockroach specific IgE, IgG1/IgG2a ratio, and airway hyper-responsiveness were evaluated.
RESULTS: Mice with repeated intra-nasal exposure to CpG-ODN showed a dramatic decrease in eosinophilic inflammation, goblet cell hyperplasia, and airway hyper-responsiveness with reduction of IL-13, IL-5, and serum IgE, cockroach specific IgE and IgG1/IgG2a ratio. This inhibitory function might be related to the up-regulation of IL-10 and CD4⁺Foxp3⁺ regulatory T cells in the lung. Interestingly, one-time challenge of CpG-ODN either prior or posterior to cockroach extract exposure could modulate airway inflammation and hyper-responsiveness via increase of Th1 response.
CONCLUSIONS: Collectively, our data suggest that CpG-ODN treatment modulates Th2 inflammation in the lung by induction of regulatory T cells or Th1 response in a cockroach-induced asthma model.
PMID: 26922937 [PubMed - as supplied by publisher]
Induction of Bronchial Tolerance After 1 Cycle of Monophosphoryl-A-Adjuvanted Specific Immunotherapy in Children With Grass Pollen Allergies.
Allergy Asthma Immunol Res. 2016 May;8(3):257-263
Authors: Rosewich M, Girod K, Zielen S, Schubert R, Schulze J
Abstract
PURPOSE: Subcutaneous allergen-specific immunotherapy (SCIT) is a well-established and clinically effective method to treat allergic diseases, such as rhinitis and asthma. It remains unclear how soon after initiation of an ultra-short course of grass pollen immunotherapy adjuvanted with monophosphoryl lipid A (MPL)-specific bronchial tolerance can be induced.
METHODS: In a prospective study of 69 children double-sensitized to birch and grass pollens (51 males, average age 11.1 years), development of bronchial tolerance after 1 cycle of SCIT for grass was evaluated. In all the patients, the bronchial allergen provocation test (BAP) was performed before and after treatment. According to the results of the first BAP, the patients were divided into 2 groups: those showing a negative BAP with a decrease in FEV1 of <20% (seasonal allergic rhinitis [SAR] group, n=47); and those showing a positive BAP with a decrease in FEV1 of ≥20% (SAR with allergic asthma [SAR and Asthma] group, n=22). All the patients received MPL-adjuvanted, ultra-short course immunotherapy for birch, but only those with a positive BAP to grass received MPL-SCIT for grass.
RESULTS: After the pollen season, the BAP in the SAR group remained unchanged, while it was improved in the SAR and Asthma group (decrease in FEV1 of 28.8% vs 12.5%, P<0.01). The IgG4 levels increased after SCIT (median before SCIT 0.34 to 11.4 after SCIT), whereas the total and specific IgE levels remained unchanged.
CONCLUSIONS: After 1 cycle of MPL-SCIT, specific bronchial tolerance may be significantly induced, whereas in patients without SCIT, bronchial hyperactivity may remain unchanged.
PMID: 26922936 [PubMed - as supplied by publisher]
Long-Term Effects of Diesel Exhaust Particles on Airway Inflammation and Remodeling in a Mouse Model.
Allergy Asthma Immunol Res. 2016 May;8(3):246-256
Authors: Kim BG, Lee PH, Lee SH, Kim YE, Shin MY, Kang Y, Bae SH, Kim MJ, Rhim T, Park CS, Jang AS
Abstract
PURPOSE: Diesel exhaust particles (DEPs) can induce and trigger airway hyperresponsiveness (AHR) and inflammation. The aim of this study was to investigate the effect of long-term DEP exposure on AHR, inflammation, lung fibrosis, and goblet cell hyperplasia in a mouse model.
METHODS: BALB/c mice were exposed to DEPs 1 hour a day for 5 days a week for 3 months in a closed-system chamber attached to a ultrasonic nebulizer (low dose: 100 μg/m³ DEPs, high dose: 3 mg/m³ DEPs). The control group was exposed to saline. Enhanced pause was measured as an indicator of AHR. Animals were subjected to whole-body plethysmography and then sacrificed to determine the performance of bronchoalveolar lavage and histology.
RESULTS: AHR was higher in the DEP group than in the control group, and higher in the high-dose DEP than in the low-dose DEP groups at 4, 8, and 12 weeks. The numbers of neutrophils and lymphocytes were higher in the high-dose DEP group than in the low-dose DEP group and control group at 4, 8, and 12 weeks. The levels of interleukin (IL)-5, IL-13, and interferon-γ were higher in the low-dose DEP group than in the control group at 12 weeks. The level of IL-10 was higher in the high-dose DEP group than in the control group at 12 weeks. The level of vascular endothelial growth factor was higher in the low-dose and high-dose DEP groups than in the control group at 12 weeks. The level of IL-6 was higher in the low-dose DEP group than in the control group at 12 weeks. The level of transforming growth factor-β was higher in the high-dose DEP group than in the control group at 4, 8, and 12 weeks. The collagen content and lung fibrosis in lung tissue was higher in the high-dose DEP group at 8 and 12 weeks.
CONCLUSIONS: These results suggest that long-term DEP exposure may increase AHR, inflammation, lung fibrosis, and goblet cell hyperplasia in a mouse model.
PMID: 26922935 [PubMed - as supplied by publisher]
Antibody Production, Anaphylactic Signs, and T-Cell Responses Induced by Oral Sensitization With Ovalbumin in BALB/c and C3H/HeOuJ Mice.
Allergy Asthma Immunol Res. 2016 May;8(3):239-245
Authors: Pablos-Tanarro A, López-Expósito I, Lozano-Ojalvo D, López-Fandiño R, Molina E
Abstract
PURPOSE: Two mouse strains, BALB/c and C3H/HeOuJ, broadly used in the field of food allergy, were compared for the evaluation of the allergenic potential of ovalbumin (OVA).
METHODS: Sensitization was made by administering 2 different OVA doses (1 and 5 mg), with cholera toxin as Th2-polarizing adjuvant. Antibody levels, severity of anaphylaxis, and Th1 and Th2 responses induced by the allergen were assessed. In addition, because the mice selected had functional toll-like receptor 4, the influence of contamination with lipopolysaccharide (LPS) on the immunostimulating capacity of OVA on spleen cells was also evaluated.
RESULTS: Both strains exhibited similar susceptibility to OVA sensitization. The 2 protein doses generated similar OVA-specific IgE and IgG1 levels in both strains, whereas C3H/HeOuJ mice produced significantly more IgG2a. Oral challenge provoked more severe manifestations in C3H/HeOuJ mice as indicated by the drop in body temperature and the severity of the anaphylactic scores. Stimulation of splenocytes with OVA led to significantly higher levels of Th2 and Th1 cytokines in BALB/c, and these were less affected by protein contamination with LPS.
CONCLUSIONS: The antibody and cytokine levels induced by OVA in BALB/c mice and the observation that BALB/c spleen cell cultures were more resistant than those of C3H/HeOuJ mice to the stimulus of LPS make this strain prone to exhibit Th2-mediated food allergic reactions and very adequate for the study of the features of OVA that make it allergenic.
PMID: 26922934 [PubMed - as supplied by publisher]
Introduction of the Reliable Estimation of Atopic Dermatitis in ChildHood: Novel, Diagnostic Criteria for Childhood Atopic Dermatitis.
Allergy Asthma Immunol Res. 2016 May;8(3):230-238
Authors: Lee SC, Bae JM, Lee HJ, Kim HJ, Kim BS, Li K, Cho JW, Park CO, Cho SH, Lee KH, Kim DW, Park CW, Kim KH, Korean Atopic Dermatitis Association's Atopic Dermatitis Criteria Group
Abstract
PURPOSE: Questionnaire-based diagnostic criteria for atopic dermatitis (AD) have been proposed to detect the major group of AD with flexural dermatitis. We aimed to develop novel, questionnaire-based diagnostic criteria for childhood AD, which can detect more comprehensive AD including non-flexural type.
METHODS: The draft version of questionnaire to detect childhood AD was prepared to be used for preliminary hospital- (n=1,756) and community-based (n=1,320) surveys. From analysis, the Reliable Estimation of Atopic dermatitis of ChildHood (REACH) was derived and verified in derivation (n=1,129) and validation (n=1,191) sets by community-based surveys.
RESULTS: The REACH consists of 11 questions including 2 major and 9 minor criteria. AD is diagnosed as the major group of 'eczema on the antecubital or popliteal fossa' to fulfill the 2 major criteria (2M), and the minor group of 'eczema on the non-antecubital or popliteal fossa' to fulfill the 1 major plus 4 or more minor criteria (1M+4m). In the validation set, the overall 1-year AD prevalence by the REACH was estimated as 12.3% (95% CI, 10.5%-14.2%), and the REACH showed a sensitivity of 75.2%, a specificity of 96.1%, and an error rate of 6.4%. The REACH demonstrated better diagnostic performance than the ISAAC in terms of the number of misclassification (10.0%).
CONCLUSIONS: We propose the REACH as new full, questionnaire-based diagnostic criteria for childhood AD in epidemiological surveys. Further studies are warranted to validate the REACH in different populations or countries in the context of large-scale, epidemiological surveys.
PMID: 26922933 [PubMed - as supplied by publisher]
Seasonal Patterns of Asthma in Children and Adolescents Presenting at Emergency Departments in Korea.
Allergy Asthma Immunol Res. 2016 May;8(3):223-229
Authors: Won YK, Hwang TH, Roh EJ, Chung EH
Abstract
PURPOSE: Seasonal variations in asthma-related hospitalizations and emergency department visits have long been recognized. This study aimed to investigate the seasonal patterns of asthma in children and adolescents who presented at emergency departments in Korea.
METHODS: We analyzed the National Emergency Department Information System records from 117 emergency departments in Korea that comprised all of the patients with asthma who were aged 3-18 years and who presented at the emergency departments from 2007 to 2012. The children and adolescents were divided into 3 groups based on their ages, namely, 3-6 years, 7-12 years, and 13-18 years. The data were tabulated, and graphs were created to show the seasonal trends in the monthly numbers of emergency department visits as a consequence of asthma.
RESULTS: A total of 41,128 subjects were identified, and the male-to-female ratio was 1:0.5. General ward admissions comprised 42.6% (n=17,524 patients) of the emergency department visits, and intensive care unit admissions comprised 0.8% (n=335 patients) of the emergency department visits. The monthly numbers of emergency department visits for asthma varied according to the season, with high peaks during fall, which was from September to November, and low levels in summer, which was from June to August.
CONCLUSIONS: Important differences in the seasonal patterns of emergency department visits for asthma were evident in children and adolescents. Identifying seasonal trends in asthma-related emergency department visits may help determine the causes and reduce the likelihood of asthma exacerbation.
PMID: 26922932 [PubMed - as supplied by publisher]
Allergen-Dependent Differences in ILC2s Frequencies in Patients With Allergic Rhinitis.
Allergy Asthma Immunol Res. 2016 May;8(3):216-222
Authors: Fan D, Wang X, Wang M, Wang Y, Zhang L, Li Y, Fan E, Cao F, Van Crombruggen K, Zhang L
Abstract
PURPOSE: Group 2 innate lymphoid cells (ILC2s) are a novel population of lineage-negative cells that induce innate type 2 responses by producing the critical Th2-type cytokines IL-5 and IL-13 in response to IL-25 and IL-33 stimulation. ILC2s accumulation in the peripheral blood of patients with allergic rhinitis (AR) is controversial; the precise role of ILC2s in the immunopathogenesis of AR is still not clear. We investigated the role of ILC2s in phenotypic AR sensitized to distinct allergens.
METHODS: Flow cytometric analysis of the peripheral blood of 7 healthy controls (HCs), 9 patients monosensitized to house dust mite (HDM), and 8 patients monosensitized to mugwort was performed to quantify ILC2s frequency. Peripheral blood mononuclear cells (PBMCs) were isolated from HDM-AR and mugwort-AR patients, and Lineage⁻ and Lineage⁺ cells were separated using a fluorescence-activated cell sorter (FACS). IL-5 and IL-13 levels in the supernatants of PBMCs, and Lineage⁻ and Lineage⁺ cells stimulated with IL-25 and/or IL-33 combined with IL-2 in vitro were assessed using the Milliplex magnetic bead kit.
RESULTS: The percentage of ILC2s was significantly elevated in HDM-AR patients compared to mugwort-AR patients and HCs, while no significant difference was found between mugwort-AR patients and HCs. IL-33±IL-25 plus IL-2 induced a significantly greater release of IL-5 and IL-13 in the PBMCs of HDM-AR patients compared to PBMCs of mugwort-AR patients. IL-25 plus IL-2 also induced a significantly greater release of IL-13 in the PBMCs of HDM-AR patients compared to PBMCs of mugwort-AR patients. Stimulation with IL-33 and/or IL-25 combined with IL-2 also induced a significantly greater IL-5 and IL-13 release from Lineage⁻ cells compared to Lineage⁺ cells.
CONCLUSIONS: AR patients sensitized to HDM or mugwort allergen have distinct phenotypic and functional profiles in ILC2s frequencies. ILC2s mediate major type 2 immunity in the development of HDM-AR and may be a potential therapeutic target.
PMID: 26922931 [PubMed - as supplied by publisher]
Flagellin Modulates the Function of Invariant NKT Cells From Patients With Asthma via Dendritic Cells.
Allergy Asthma Immunol Res. 2016 May;8(3):206-215
Authors: Shim JU, Rhee JH, Jeong JU, Koh YI
Abstract
PURPOSE: Invariant natural killer T (iNKT) cells play a critical role in the pathogenesis of asthma. We previously reported the association between circulating Th2-like iNKT cells and lung function in asthma patients and the suppressive effect of Toll-like receptor 5 ligand flagellin B (FlaB) on asthmatic in a mouse model. Thus, we investigated whether FlaB modulates the function of circulating iNKT cells in asthmatic patients.
METHODS: Peripheral blood mononuclear cells (PBMCs) were treated with FlaB, and the secreted and intracellular cytokines of iNKT cells were evaluated by using ELISA and flow cytometry, respectively, following stimulation with α-galactosylceramide. Foxp3⁺ iNKT cells were also measured. To determine the effect of FlaB-treated dendritic cells (DCs) on iNKT cells, we co-cultured CD14⁺ monocyte-derived DCs and T cells from patients with house dust mite-sensitive asthma and analyzed intracellular cytokines in iNKT cells.
RESULTS: A reduction of IL-4 and IL-17 production by iNKT cells in PBMCs after FlaB treatment was alleviated following blocking of IL-10 signaling. A decrease in the frequencies of IL-4⁺ and IL-17⁺ iNKT cells by FlaB-treated DCs was reversed after blocking of IL-10 signaling. Simultaneously, an increase in Foxp3⁺ iNKT cells induced by FlaB treatment disappeared after blocking of IL-10.
CONCLUSIONS: FlaB may inhibit Th2- and Th17-like iNKT cells and induce Foxp3⁺ iNKT cells by DCs via an IL-10-dependent mechanism in asthmatic patients. In patients with a specific asthma phenotype associated with iNKT cells, FlaB may be an effective immunomodulator for iNKT cell-targeted immunotherapy.
PMID: 26922930 [PubMed - as supplied by publisher]
IgG Sensitization to Extracellular Vesicles in Indoor Dust Is Closely Associated With the Prevalence of Non-Eosinophilic Asthma, COPD, and Lung Cancer.
Allergy Asthma Immunol Res. 2016 May;8(3):198-205
Authors: Kim YS, Choi JP, Kim MH, Park HK, Yang S, Kim YS, Kim TB, Cho YS, Oh YM, Jee YK, Lee SD, Kim YK
Abstract
PURPOSE: Recent experimental evidence shows that extracellular vesicles (EVs) in indoor dust induce neurtrophilic pulmonary inflammation, which is a characteristic pathology in patients with severe asthma and chronic obstructive pulmonary disease (COPD). In addition, COPD is known to be an important risk factor for lung cancer, irrespective of cigarette smoking. Here, we evaluated whether sensitization to indoor dust EVs is a risk for the development of asthma, COPD, or lung cancer.
METHODS: Serum IgG antibodies against dust EVs were measured in 90 healthy control subjects, 294 asthmatics, 242 COPD patients, and 325 lung cancer patients. Serum anti-dust EV IgG titers were considered high if they exceeded a 95 percentile value of the control subjects. Age-, gender-, and cigarette smoke-adjusted multiple logistic regression analyses were performed to determine odds ratios (ORs) for asthma, COPD, and lung cancer patients vs the control subjects.
RESULTS: In total, 4.4%, 13.6%, 29.3%, and 54.9% of the control, asthma, COPD, and lung cancer groups, respectively, had high serum anti-dust EV IgG titers. Adjusted multiple logistic regression revealed that sensitization to dust EVs (high serum anti-dust EV IgG titer) was an independent risk factor for asthma (adjusted OR, 3.3; 95% confidence interval [CI], 1.1-10.0), COPD (adjusted OR, 8.0; 95% CI, 2.0-32.5) and lung cancer (adjusted OR, 38.7; 95% CI, 10.4-144.3).
CONCLUSIONS: IgG sensitization to indoor dust EVs appears to be a major risk for the development of asthma, COPD, and lung cancer.
PMID: 26922929 [PubMed - as supplied by publisher]
Allergen Immunotherapy: Past, Present, and Future.
Allergy Asthma Immunol Res. 2016 May;8(3):191-197
Authors: Jutel M, Kosowska A, Smolinska S
Abstract
Allergen-specific immunotherapy (AIT), although in clinical use for more than a century, is still the only causal treatment of allergic diseases. The safety and efficacy of AIT has been demonstrated in a large number of clinical trials. In addition to allergy symptom reduction AIT plays an essential role in preventing new allergies and asthma and shows long-term effects after discontinuation of treatment. Ideally, it is capable of curing allergy. However, AIT is not effective in all allergic individuals and is not equally effective in the treatment of various hypersensitivities to different allergens. For many years, the route of administration and the vaccine compositions have been evolving. Still there is a strong need for research in the field of new AIT modalities to increase its effectiveness and safety. Growing evidence on immunological effects of AIT, especially new T cell subsets involved in antigen/allergen tolerance, provides novel concepts for safer and more effective vaccination. Pharmacoeconomic studies have demonstrated a clear advantage of AIT over pharmacologic therapies.
PMID: 26922928 [PubMed - as supplied by publisher]
A Comprehensive Review of the Treatment of Atopic Eczema.
Allergy Asthma Immunol Res. 2016 May;8(3):181-190
Authors: Lee JH, Son SW, Cho SH
Abstract
Atopic eczema (AE) is a chronic, inflammatory skin disorder which usually develops in early childhood. In spite of intensive investigations, the causes of AE remain unclear, but are likely to be multifactorial in nature. Environmental factors or genetic-environmental interactions seem to play a key role in disease progression. Among various measures of AE managment, cutaneous hydration, which improves barrier function and relieve itchiness, may be helpful to reduce the need for topical steroid use and therefore should be used as a basic treatment. Avoiding aggravating factors is also a basic treatment of AE. Standard medical treatment with a pharmacologic approach may be necessary if basic treatment fails to control symptoms satisfactorily. Recently, more attention is given to a proactive therapeutic by regular intermittent application of low potency steroids or topical calcineurin inhibitors to prevent new flares. Furthermore, various targeted biologics are being introduced for AE control and are proposed as promising therapies. This paper provides a summary of the recent literature on the manangement of AE and a treatment guideline.
PMID: 26922927 [PubMed - as supplied by publisher]
Extracellular Vesicle: An Unknown Environmental Factor for Causing Airway Disease.
Allergy Asthma Immunol Res. 2016 May;8(3):179-180
Authors: Pyun BY
PMID: 26922926 [PubMed - as supplied by publisher]
Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia.
Eur Arch Otorhinolaryngol. 2016 Feb 29;
Authors: van der Heijden M, Dikkers FG, Halmos GB
Abstract
In most cases, laryngomalacia presents as a mild disease, and the symptoms resolve after wait-and-see policy. Up to 20 % of patients present with severe laryngomalacia and may require surgery (i.e. supraglottoplasty); however, the indication for surgery is not firmly established yet. The goal of this study is to determine whether supraglottoplasty results in a better outcome than wait-and-see and to investigate how different comorbidities influence outcome. A retrospective study of pediatric cases of in a tertiary referral center was performed. Photo and video documentation was available and revised in all cases. Electronic and paper charts were reviewed for the following variables: gender, sex, gestational age, birth weight, symptoms, comorbidity, date of endoscopy, severity and type of laryngomalacia, treatment modality and technique and follow-up data and a total 89 patients were included. Supraglottoplasty was found to lead to significantly faster complete improvement of laryngomalacia than wait-and-see policy (5 weeks vs. 29, p = 0.026). Synchronous airway lesions (SALs) were present in 40.4 % of patients and were associated with prolonged symptoms of laryngomalacia (38.5 weeks vs. 14.5, p = 0.043). Supraglottoplasty is safe and effective in treatment of severe laryngomalacia. SALs and comorbidities are frequently found in patients with laryngomalacia and are responsible for longer onset of complaints.
PMID: 26924742 [PubMed - as supplied by publisher]
Endoscopic repair technique for traumatic penetrating injuries of the clivus.
J Clin Neurosci. 2016 Feb 25;
Authors: Liebelt BD, Boghani Z, Haider AS, Takashima M
Abstract
Unlike basilar skull fractures, penetrating traumatic injuries to the clivus are uncommon. We present two novel and interesting cases of traumatic crossbow arrow injury and penetrating screwdriver injury to the clivus. A review of the literature describing methods to repair these injuries was performed. A careful, systematic approach is required when working up and treating these injuries, as airway preservation is critical. An adaptation to the previously described "gasket-seal" method for skull base repair was utilized to repair the traumatic cerebrospinal fluid (CSF) fistulas. This repair technique is unique in that it is tailored to a much smaller defect than typical post-surgical defects. Two patients are presented, one with a post-traumatic CSF fistula after penetrating crossbow injury to the clivus and one with a penetrating screwdriver injury to the clivus. The patients were treated successfully with transnasal endoscopic repair with fascia lata graft and a nasoseptal flap, a novel adaptation to the previously described "gasket-seal" technique of skull base repair.
PMID: 26924184 [PubMed - as supplied by publisher]
Objective detection of auditory steady-state evoked potentials based on mutual information.
Int J Audiol. 2016 Feb 29;:1-7
Authors: Bidelman GM, Bhagat SP
Abstract
OBJECTIVE: Recently, we developed a metric to objectively detect human auditory evoked potentials based on the mutual information (MI) between neural responses and stimulus spectrograms. Here, the MI algorithm is evaluated further for validity in testing the auditory steady-state response (ASSR), a sustained potential used in objective audiometry.
DESIGN: MI was computed between spectrograms of ASSRs and their evoking stimuli to quantify the shared time-frequency information between neuroelectric activity and stimulus acoustics. MI was compared against two traditional ASSR detection metrics: F-test and magnitude-squared coherence (MSC).
STUDY SAMPLE: Using an empirically derived threshold (⊖MI=1.45), MI was applied as a binary classifier to distinguish actual biological responses recorded in human participants (n=11) from sham recordings, containing only EEG noise (i.e., non-stimulus-control condition).
RESULTS: MI achieved high overall accuracy (>90%) in identifying true ASSRs from sham recordings, with true positive/true negative rates of 82/100%. During online averaging, comparison with two other indices (F-test, MSC) indicated that MI could detect ASSRs in roughly half the number of trials (i.e., ∼400 sweeps) as the MSC and performed comparably to the F-test, but showed slightly better signal detection performance.
CONCLUSIONS: MI provides an alternative, more flexible metric for efficient and automated ASSR detection.
PMID: 26924597 [PubMed - as supplied by publisher]
Book Review.
Int J Audiol. 2016 Feb 29;:1
Authors: Bramlette SB
PMID: 26924490 [PubMed - as supplied by publisher]
Flufenamic acid prevents behavioral manifestations of salicylate-induced tinnitus in the rat.
Arch Med Sci. 2016 Feb 1;12(1):208-215
Authors: Bal R, Ustundag Y, Bulut F, Demir CF, Bal A
Abstract
INTRODUCTION: Tinnitus is defined as a phantom auditory sensation, the perception of sound in the absence of external acoustic stimulation. Given that flufenamic acid (FFA) blocks TRPM2 cation channels, resulting in reduced neuronal excitability, we aimed to investigate whether FFA suppresses the behavioral manifestation of sodium salicylate (SSA)-induced tinnitus in rats.
MATERIAL AND METHODS: Tinnitus was evaluated using a conditioned lick suppression model of behavioral testing. Thirty-one Wistar rats, randomly divided into four treatment groups, were trained and tested in the behavioral experiment: (1) control group: DMSO + saline (n = 6), (2) SSA group: DMSO + SSA (n = 6), (3) FFA group: FFA (66 mg/kg bw) + saline (n = 9), (4) FFA + SSA group: FFA (66 mg/kg bw) + SSA (400 mg/kg bw) (n = 10). Localization of TRPM2 to the plasma membrane of cochlear nucleus neurons was demonstrated by confocal microscopy.
RESULTS: Pavlovian training resulted in strong suppression of licking, having a mean value of 0.05 ±0.03 on extinction day 1, which is below the suppression training criterion level of 0.20 in control tinnitus animals. The suppression rate for rats having both FFA (66 mg/kg bw) and SSA (400 mg/kg bw) injections was significantly lower than that for the rats having SSA injections (p < 0.01).
CONCLUSIONS: We suggest that SSA-induced tinnitus could possibly be prevented by administration of a TRPM2 ion channel antagonist, FFA at 66 mg/kg bw.
PMID: 26925138 [PubMed - as supplied by publisher]
Day-case stapes surgery: Day-case versus inpatient stapes surgery for otosclerosis: a randomized controlled trial.
BMC Ear Nose Throat Disord. 2016;16:3
Authors: Derks LS, Wegner I, Tange RA, Kamalski DM, Grolman W
Abstract
BACKGROUND: Otosclerosis is characterized by bony deposits in the otic capsule, resulting in stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the stapes and replacing it with a prosthesis. Increasingly, stapes surgery is performed as a day-case procedure. The major drive towards day-case surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for surgery, a reduced risk of infection and most likely positively influences the patient's quality of life as a result of rapid discharge and rehabilitation. Even though stapes surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality.
METHODS AND DESIGN: A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case stapes surgery compared to inpatient stapes surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for stapes surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up).
DISCUSSION/CONCLUSION: This trial allows for a comparison between day-case and inpatient stapes surgery to investigate the hypothesis that day-case stapes surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient stapes surgery.
TRIAL REGISTRATION: Netherlands Trial Register (www.trialregister.nl): NTR4133, registration date 21(st) August 2013.
PMID: 26924941 [PubMed - as supplied by publisher]
Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population.
Braz J Otorhinolaryngol. 2016 Feb 13;
Authors: Manche SK, Madhavi J, Meganadh KR, Jyothy A
Abstract
INTRODUCTION: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity.
OBJECTIVE: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population.
METHODS: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT) specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ(2) test and binary logistic regression.
RESULTS: Tinnitus was observed in 29.3% (956) of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR=1.79, 95% CI=1.02-3.16) and inner (OR=3.00, 95% CI=1.65-5.45) inner ear diseases. It was noted that 96.9% (n=927) of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%), presbycusis (16.6%) and otosclerosis (14.3%) are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM) subjects.
CONCLUSION: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.
PMID: 26923827 [PubMed - as supplied by publisher]
School performance in cholesteatoma-operated children in Denmark: a nationwide population-based register-study.
Acta Otolaryngol. 2016 Feb 29;:1-6
Authors: Djurhuus BD, Hansen TG, Pedersen JK, Faber CE, Christensen K
Abstract
Conclusion Cholesteatoma in childhood had no long-term effect on school performance for the majority who completed lower secondary school. Aim To investigate whether individuals operated on for cholesteatoma in childhood have impaired school performance in adolescence. Methods All children born in Denmark between 1986-1991 with cholesteatoma surgery performed before the age of 15 years were included (cholestetaoma group). A control group consisting of a 5% random sample of all children born in Denmark during the same period was used for comparison. Final marks (average, mathematics, Danish, and English) achieved upon completion of lower secondary school (9th grade; age 15 or 16 years) were compared between groups. Results A total of 549 individuals met the inclusion criteria for the cholesteatoma group and 15 106 for the control group. High parental education and female sex were strongly associated with high 9th grade marks. The cholesteatoma group did equally as well as the control group in all outcome-measures except from in English (1st foreign language), where children with ≥2 cholesteatoma surgeries scored 0.26 marks lower (95% confidence interval = 0.03-0.48). In the cholesteatoma group, though, the odds ratio for not attaining a 9th grade exam was 1.33 (95% confidence interval = 1.03-1.72%) when compared with the control group.
PMID: 26924562 [PubMed - as supplied by publisher]
Adjuvant role of radiation therapy for locally advanced laryngeal cancer without pathological lymph node metastasis.
Acta Otolaryngol. 2016 Feb 29;:1-8
Authors: Kim SH, Lee YS, Kwon M, Kim JW, Roh JL, Choi SH, Kim SY, Lee SW, Nam SY
Abstract
Conclusion The application of adjuvant RT to reduce recurrence should be tailored in cases of pathologically negative node metastasis. Objectives The treatment modality following surgical resection of advanced laryngeal cancer is determined by adverse factors. Aside from lymph node metastasis (LNM) or positive margins, definite risk factors supporting adjuvant radiation therapy (RT) have not been clearly suggested. The aim of this study was to analyze the risk factors for advanced laryngeal cancer without LNM and the role of RT. Materials and methods Pathologically T3 and T4-staged laryngeal squamous cell carcinoma without LNM were reviewed. The patients were classified into RT (+) (n = 22) and RT (-) (n = 38) groups. Results Five-year overall survival (OS) of the RT (+) and RT (-) groups was 84.4% and 83.8%, respectively. Five-year disease-specific survival of the RT (+) and RT (-) groups was 88.4% and 93.9%. Five-year local control rate of the RT (+) and RT (-) groups was 94.7% and 91.3%. The factors affecting OS were smoking history and recurrence history (p = 0.02). By multivariate analysis, smoking history and recurrence history were determining factors for 5-year OS (p = 0.024 and p = 0.047, respectively).
PMID: 26924463 [PubMed - as supplied by publisher]
Validation of the Swedish translation of eating assessment tool (S-EAT-10).
Acta Otolaryngol. 2016 Feb 29;:1-5
Authors: Möller R, Safa S, Östberg P
Abstract
Conclusion The Swedish Eating Assessment Tool (S-EAT-10) is a reliable and valid self-administered tool in assessment of dysphagia in adult Swedish patients with high internal consistency, reliability, and discriminative validity. The normative data show that a score of 3 or more is abnormal. S-EAT-10 is recommended to be used in preliminary diagnostics of dysphagia. Objective To translate and adapt the EAT-10 for use in the Swedish patient population, and to present norms and measures of discriminative validity and reliability of a Swedish version of the Eating Assessment Tool-10 (S-EAT-10). Methods Prospective consecutive clinical study. In total, 134 community-dwelling adult respondents/controls without dysphagia completed the S-EAT-10, as did 119 patients referred for fiberendoscopic evaluation of swallowing at Karolinska University Hospital, Stockholm, Sweden. Patient vs control status was used as the criterion for discriminative validity assessment by logistic regression analysis. Results The mean S-EAT-10 score was 0.2 (range = 0-3) for controls and 18 (range = 0-38) for patients. Based on a cut-off score of ≥ 3 which was considered to be reflective of abnormalities, sensitivity was 98.5% and specificity 94.1%. Internal consistency reliability was high (Cronbach's alpha = 0.88), as was test-re-test reliability (ICC = 0.90).
PMID: 26924383 [PubMed - as supplied by publisher]
Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.
Acta Otolaryngol. 2016 Feb 29;:1-7
Authors: Hägg M, Tibbling L
Abstract
Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro® screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.
PMID: 26924256 [PubMed - as supplied by publisher]
Evaluation of aspirin hypersensitivity in patients with chronic rhinosinusitis.
Acta Otolaryngol. 2016 Feb 29;:1-3
Authors: Kwun C, Kim SI, Lee KH, Kim SW
Abstract
Conclusion The recurrence rates of chronic rhinosinusitis (CRS) were higher in the aspirin nasal provocation test (ANPT)-positive group, regardless of the presence of nasal polyps. Thus, a careful endoscopic examination is required during follow-up in ANPT-positive patients with CRS. Objectives The aim of this study was to evaluate the clinical features and prognosis after surgical treatment in patients with CRS and aspirin hypersensitivity. Methods In a prospective study, 100 patients were analyzed with CRS who underwent endoscopic sinus surgery at the hospital from October 2012 to March 2013. This study measured changes in nasal volume and symptoms before and after the ANPT and examined patient's asthma history, allergy, Lund-Mackay score (LMS), total immunoglobulin E, percentage of peripheral eosinophils, and objectively measured relapse at 6 months. Results Patients wwith CRS and nasal polyps (CRSwNP) were more likely to have a positive ANPT test result compared to those without nasal polyps (CRSsNP) (21.4% vs 5.5%). The ANPT-positive group had a higher LMS and required more revision endoscopic sinus surgery than those in the ANPT-negative group. The results were that similar results were observed in CRSwNP and CRSsNP.
PMID: 26924187 [PubMed - as supplied by publisher]
School performance in cholesteatoma-operated children in Denmark: a nationwide population-based register-study.
Acta Otolaryngol. 2016 Feb 29;:1-6
Authors: Djurhuus BD, Hansen TG, Pedersen JK, Faber CE, Christensen K
Abstract
Conclusion Cholesteatoma in childhood had no long-term effect on school performance for the majority who completed lower secondary school. Aim To investigate whether individuals operated on for cholesteatoma in childhood have impaired school performance in adolescence. Methods All children born in Denmark between 1986-1991 with cholesteatoma surgery performed before the age of 15 years were included (cholestetaoma group). A control group consisting of a 5% random sample of all children born in Denmark during the same period was used for comparison. Final marks (average, mathematics, Danish, and English) achieved upon completion of lower secondary school (9th grade; age 15 or 16 years) were compared between groups. Results A total of 549 individuals met the inclusion criteria for the cholesteatoma group and 15 106 for the control group. High parental education and female sex were strongly associated with high 9th grade marks. The cholesteatoma group did equally as well as the control group in all outcome-measures except from in English (1st foreign language), where children with ≥2 cholesteatoma surgeries scored 0.26 marks lower (95% confidence interval = 0.03-0.48). In the cholesteatoma group, though, the odds ratio for not attaining a 9th grade exam was 1.33 (95% confidence interval = 1.03-1.72%) when compared with the control group.
PMID: 26924562 [PubMed - as supplied by publisher]
Adjuvant role of radiation therapy for locally advanced laryngeal cancer without pathological lymph node metastasis.
Acta Otolaryngol. 2016 Feb 29;:1-8
Authors: Kim SH, Lee YS, Kwon M, Kim JW, Roh JL, Choi SH, Kim SY, Lee SW, Nam SY
Abstract
Conclusion The application of adjuvant RT to reduce recurrence should be tailored in cases of pathologically negative node metastasis. Objectives The treatment modality following surgical resection of advanced laryngeal cancer is determined by adverse factors. Aside from lymph node metastasis (LNM) or positive margins, definite risk factors supporting adjuvant radiation therapy (RT) have not been clearly suggested. The aim of this study was to analyze the risk factors for advanced laryngeal cancer without LNM and the role of RT. Materials and methods Pathologically T3 and T4-staged laryngeal squamous cell carcinoma without LNM were reviewed. The patients were classified into RT (+) (n = 22) and RT (-) (n = 38) groups. Results Five-year overall survival (OS) of the RT (+) and RT (-) groups was 84.4% and 83.8%, respectively. Five-year disease-specific survival of the RT (+) and RT (-) groups was 88.4% and 93.9%. Five-year local control rate of the RT (+) and RT (-) groups was 94.7% and 91.3%. The factors affecting OS were smoking history and recurrence history (p = 0.02). By multivariate analysis, smoking history and recurrence history were determining factors for 5-year OS (p = 0.024 and p = 0.047, respectively).
PMID: 26924463 [PubMed - as supplied by publisher]
Validation of the Swedish translation of eating assessment tool (S-EAT-10).
Acta Otolaryngol. 2016 Feb 29;:1-5
Authors: Möller R, Safa S, Östberg P
Abstract
Conclusion The Swedish Eating Assessment Tool (S-EAT-10) is a reliable and valid self-administered tool in assessment of dysphagia in adult Swedish patients with high internal consistency, reliability, and discriminative validity. The normative data show that a score of 3 or more is abnormal. S-EAT-10 is recommended to be used in preliminary diagnostics of dysphagia. Objective To translate and adapt the EAT-10 for use in the Swedish patient population, and to present norms and measures of discriminative validity and reliability of a Swedish version of the Eating Assessment Tool-10 (S-EAT-10). Methods Prospective consecutive clinical study. In total, 134 community-dwelling adult respondents/controls without dysphagia completed the S-EAT-10, as did 119 patients referred for fiberendoscopic evaluation of swallowing at Karolinska University Hospital, Stockholm, Sweden. Patient vs control status was used as the criterion for discriminative validity assessment by logistic regression analysis. Results The mean S-EAT-10 score was 0.2 (range = 0-3) for controls and 18 (range = 0-38) for patients. Based on a cut-off score of ≥ 3 which was considered to be reflective of abnormalities, sensitivity was 98.5% and specificity 94.1%. Internal consistency reliability was high (Cronbach's alpha = 0.88), as was test-re-test reliability (ICC = 0.90).
PMID: 26924383 [PubMed - as supplied by publisher]
Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.
Acta Otolaryngol. 2016 Feb 29;:1-7
Authors: Hägg M, Tibbling L
Abstract
Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro® screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.
PMID: 26924256 [PubMed - as supplied by publisher]
Evaluation of aspirin hypersensitivity in patients with chronic rhinosinusitis.
Acta Otolaryngol. 2016 Feb 29;:1-3
Authors: Kwun C, Kim SI, Lee KH, Kim SW
Abstract
Conclusion The recurrence rates of chronic rhinosinusitis (CRS) were higher in the aspirin nasal provocation test (ANPT)-positive group, regardless of the presence of nasal polyps. Thus, a careful endoscopic examination is required during follow-up in ANPT-positive patients with CRS. Objectives The aim of this study was to evaluate the clinical features and prognosis after surgical treatment in patients with CRS and aspirin hypersensitivity. Methods In a prospective study, 100 patients were analyzed with CRS who underwent endoscopic sinus surgery at the hospital from October 2012 to March 2013. This study measured changes in nasal volume and symptoms before and after the ANPT and examined patient's asthma history, allergy, Lund-Mackay score (LMS), total immunoglobulin E, percentage of peripheral eosinophils, and objectively measured relapse at 6 months. Results Patients wwith CRS and nasal polyps (CRSwNP) were more likely to have a positive ANPT test result compared to those without nasal polyps (CRSsNP) (21.4% vs 5.5%). The ANPT-positive group had a higher LMS and required more revision endoscopic sinus surgery than those in the ANPT-negative group. The results were that similar results were observed in CRSwNP and CRSsNP.
PMID: 26924187 [PubMed - as supplied by publisher]
How do voice restoration methods affect the psychological status of patients after total laryngectomy?
HNO. 2016 Feb 29;
Authors: Saltürk Z, Arslanoğlu A, Özdemir E, Yıldırım G, Aydoğdu I, Kumral TL, Berkiten G, Atar Y, Uyar Y
Abstract
OBJECTIVE: This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients.
METHODS: The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients). The participants were asked to complete the Turkish version of the Voice Handicap Index-10 (VHI-10) to assess voice problems. They were also asked to complete the Turkish version of the Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). The test scores of the three groups were compared statistically.
RESULTS: Patients who used esophageal speech had a mean VHI-10 score of 10.25 ± 3.22 versus 19.42 ± 5.56 and 17.60 ± 1.92 for the tracheoesophageal fistula and Provox 2 and electrolarynx groups respectively, reflecting better perception of their voice. They also had a PSS score of 11.38 ± 3.92, indicating that they felt less stressed in comparison with the tracheoesophageal fistula and Provox 2 and electrolarynx groups, which scored 18.84 ± 5.50 and 16.20 ± 3.49 respectively. The HADS scores of the groups were not different, indicating that the patients' anxiety and depression status did not vary.
CONCLUSION: Patients who used esophageal speech perceived less stress and were less handicapped by their voice.
PMID: 26923487 [PubMed - as supplied by publisher]
[Imaging of the head and neck region].
HNO. 2016 Feb 29;
Authors: Lell M, Mantsopoulos K, Uder M, Wuest W
Abstract
Tumors of the head and neck are predominantly squamous cell carcinomas and those of the salivary glands are predominantly adenocarcinomas, adenoid cystic carcinomas and mucoepidermoid carcinomas. In 2011 the incidence of tumors of the oral cavity and pharynx in Germany was 6839 (5026 male and 1813 female) and of the larynx 1878 (1642 male and 236 female). The incidence of tumors of the nose and paranasal sinuses (467) and salivary glands (470) were much lower ( http://ift.tt/1PIyTjh ). The primary aim of imaging in head and neck cancer is staging of the disease and a precise assessment of tumor invasion. This information is essential for therapy decision-making (i. e. surgery or radiochemotherapy), planning of the extent of resection and subsequent reconstructive measures and also estimation of functional deficits after therapy. Computed tomography (CT) and magnetic resonance imaging (MRI) are the imaging modalities of choice but both have specific advantages and disadvantages. In certain cases both CT and MRI need to be performed for accurate treatment planning.
PMID: 26923486 [PubMed - as supplied by publisher]
Incidence of metastases from 524 patients with papillary thyroid carcinoma in cervical lymph nodes posterior to the sternoclavicular joint (level VIa): Relevance for endoscopic thyroidectomy.
Surgery. 2016 Feb 25;
Authors: Wang J, Gao L, Song C, Xie L
Abstract
BACKGROUND: Dissection of central cervical lymph nodes posterior to the sternoclavicular joint is unsatisfactory in endoscopic thyroid surgery via remote access because of the barrier posed by the sternoclavicular joint. The purpose of this study was to determine the incidence and risk factors of papillary thyroid carcinoma (PTC) metastasis to the area posterior to the sternoclavicular joint.
METHODS: A total of 524 patients with PTC who underwent traditional thyroid surgery form January 2012 to December 2013 were analyzed retrospectively. Their cervical lymph nodes were harvested and divided into central cervical lymph nodes cranial to the sternoclavicular joint (VIb) and those nodes posterior to the sternoclavicular joint (VIa). The VIa status was correlated with clinicopathologic factors, including sex, age, clinical N classification, comorbid thyroid disease, tumor size, extrathyroidal extension, multifocality, tumor location, and central cervical lymph node metastasis.
RESULTS: The VIa metastases were detected in 138 patients (26.3%; 138 of the 524). There were a mean 3.8 lymph nodes in VIa region, and the average number of metastatic lymph nodes was 0.5. Multivariate logistic regression revealed that cN1, extrathyroidal extension, VIb positivity, tumor size greater than 0.9 cm, and tumor location in the lower third of the thyroid lobe were factors associated with VIa metastasis.
CONCLUSION: Patients undergoing PTC with tumor location in the lower third of the thyroid lobe, a tumor size greater than 0.9 cm, extrathyroidal extension, or cN1 may be contraindicated for an endoscopic thyroidectomy.
PMID: 26923988 [PubMed - as supplied by publisher]
Immunohistochemical study on ADAM33 in sinonasal inverted papillomas and squamous cell carcinomas of the larynx.
Arch Med Sci. 2016 Feb 1;12(1):89-94
Authors: Stasikowska-Kanicka O, Wągrowska-Danilewicz M, Danilewicz M
Abstract
INTRODUCTION: ADAM33 protein is a member of the family of transmembrane glycoproteins composed of multidomains. Members of the ADAM family have different activities, such as proteolysis and adhesion, making them good candidates to mediate the extracellular matrix remodeling and changes in cellular adhesion that characterize certain pathologies and cancer development.
MATERIAL AND METHODS: The immunohistochemical method was used to examine the immunoexpression of ADAM33 in 39 formalin-fixed, paraffin-embedded tissue specimens of sinonasal inverted papillomas (IP), 44 laryngeal squamous cell carcinomas (GI grade = 11, GII grade = 33) and 14 disease-free tissue specimens as a control.
RESULTS: The immunoexpression of ADAM33 was localized in the epithelial cells, mesenchymal cells of the vessels and infrequently in the stromal cells. The majority of the ADAM33 was localized intracellularly, although membrane immunoexpression was also noted. All epithelial and vascular staining scores were found to be significantly increased in GI and GII grades of laryngeal cancer compared with controls (p < 0.001) and IP (p < 0.001). No statistically significant differences were found in immunoexpression of ADAM33 between GI and GII tumors. The immunoexpression of ADAM33 was significantly higher in IP patients than in controls (p < 0.02).
CONCLUSIONS: Our findings suggest that ADAM33 could potentially contribute to tumorigenesis of the laryngeal and sinonasal region.
PMID: 26925122 [PubMed - as supplied by publisher]
Day-case stapes surgery: Day-case versus inpatient stapes surgery for otosclerosis: a randomized controlled trial.
BMC Ear Nose Throat Disord. 2016;16:3
Authors: Derks LS, Wegner I, Tange RA, Kamalski DM, Grolman W
Abstract
BACKGROUND: Otosclerosis is characterized by bony deposits in the otic capsule, resulting in stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the stapes and replacing it with a prosthesis. Increasingly, stapes surgery is performed as a day-case procedure. The major drive towards day-case surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for surgery, a reduced risk of infection and most likely positively influences the patient's quality of life as a result of rapid discharge and rehabilitation. Even though stapes surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality.
METHODS AND DESIGN: A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case stapes surgery compared to inpatient stapes surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for stapes surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up).
DISCUSSION/CONCLUSION: This trial allows for a comparison between day-case and inpatient stapes surgery to investigate the hypothesis that day-case stapes surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient stapes surgery.
TRIAL REGISTRATION: Netherlands Trial Register (www.trialregister.nl): NTR4133, registration date 21(st) August 2013.
PMID: 26924941 [PubMed - as supplied by publisher]