[Pathogenesis and molecular pathology of vestibular schwannoma].

[Pathogenesis and molecular pathology of vestibular schwannoma].

HNO. 2016 Jul 15;

Authors: Brodhun M, Stahn V, Harder A

Abstract
Schwannomas are benign Schwann cell-derived tumors of the peripheral nerve sheath often involving the vestibular cranial nerve (vestibular schwannoma). Histologically, they consist of bipolar spindle cells and show a moderate cellularity. Typically, Antoni A regions with a storiform pattern and loose Antoni B regions are intermingled. Verocay bodies are the pathognomonic palisading structures. Malignant transformation is rare. Merlin (schwannomin), the protein product of NF2, is inactivated by mutations, loss of heterozygosity or methylation. Within neurofibromatosis type 2, a germline mutation is present in about half of cases, whereas tumors demonstrate an additional second hit of the NF2 gene. A loss of chromosome 22 or 22q is common. Merlin links the cell membrane with the cytoskeleton and regulates intracellular signaling pathways leading to dysorganization when merlin is inactivated. Loss of merlin activates Rac1 and Ras, and the PAK1, mTORC1, EGFR-Ras-ERK, PI3K-Akt, WNT and Hippo pathways as well as receptor tyrosine kinases. Furthermore, merlin locates to the nucleus and inhibits E3 ubiquitin ligase CRL4(DCAF1). Besides biallelic inactivation of NF2 in schwannomas, other genes are involved in the pathogenesis of schwannomatosis-associated schwannomas such as LZTR1, SMARCB1, COQ6 indicating an important role of SWI/SNF chromatin-remodeling complex for schwannoma development. Our own investigations point to deregulation of BAF170, another essential SWI/SNF complex component. Knowledge of mechanisms allows targeted molecular therapy, especially in vestibular schwannomas, using antagonists against mTOR (rapamycin/sirolmus/everolimus), EGFR (lapatinib) or VEGF (bevacizumab), although clinical studies have been in part disappointing so far.

PMID: 27421984 [PubMed - as supplied by publisher]

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Values of SP-A protein in the nasal mucosa.

Values of SP-A protein in the nasal mucosa.

HNO. 2016 Jul 15;

Authors: Passali D, Astore S, Boccuzzi S, Loglisci M, Cannatelli A, Passali GC, Bellussi L

Abstract
The paranasal sinus epithelium is exposed to the environment and therefore to a variety of biological, chemical and mechanical insults. Surfactant protein A (SP-A) is a 34-36 kD pulmonary surfactant-associated protein that appears to play an important role in mammalian first-line host defence. Recent studies have reported the possibility of local production of SP-A in the extrapulmonary organs and tissues of the human body. However, the presence of SP-A in the human paranasal sinus mucosa is not well known. The purpose of this study was to investigate the expression of SP-A protein in human turbinate mucosa and to compare the expression of SP-A mRNA in normal turbinate mucosa and turbinate mucosa of chronic rhinosinusitis patients. Reverse transcriptase polymerase chain reaction was used to detect SP-A mRNA. Student's t test was used for statistical comparison of the SP-A/GAPDH-mRNA ratio (GAPDH: glycerinaldehyde-3-phosphate dehydrogenase) of cases and controls. We found expression of SP-A mRNA in mucosa lining the inferior turbinates of healthy patients and its up-regulation in mucosa lining the inferior turbinates of patients with chronic rhinosinusitis. These results may provide targets for new therapies for chronic rhinosinusitis.

PMID: 27421983 [PubMed - as supplied by publisher]

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"Oral Surg Oral Med Oral Pathol Oral Radiol"[jour]; +18 new citations

18 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Oral Surg Oral Med Oral Pathol Oral Radiol"[jour]

These pubmed results were generated on 2016/07/17

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Delineation of the larynx as organ at risk in radiotherapy: a contouring course within "Rete Oncologica Piemonte-Valle d'Aosta" network to reduce inter- and intraobserver variability.

Delineation of the larynx as organ at risk in radiotherapy: a contouring course within "Rete Oncologica Piemonte-Valle d'Aosta" network to reduce inter- and intraobserver variability.

Radiol Med. 2016 Jul 15;

Authors: Cante D, Petrucci E, Piva C, Borca VC, Sciacero P, Bertodatto M, Marta C, Franco P, Viale M, La Valle G, La Porta MR, Bertetto O, On behlaf of Rete Oncologica Piemonte-Valle d'Aosta

Abstract
AIMS: To evaluate the usefulness of a contouring course in reducing inter- and intraobserver variability in the definition of the larynx as organ at risk (OAR).
METHODS: Within the "Rete Oncologica Piemonte-Valle d'Aosta" network, a contouring course focusing on larynx delineation was proposed. Twenty-six radiotherapist technicians (RTTs) experienced in delineating OARs were asked to contour larynx before and after the training. An expert radiation oncologist defined the reference volume for educational purpose. The contoured volumes obtained before and after the course were compared using descriptive statistics (mean value, standard deviation-SD, and coefficient of variation-COV) of volumes and maximum diameters. Conformity index (CI), dice coefficient (DC), and percentage of overlap were used to evaluate the spatial accuracy of the different volumes compared to the reference. Further analysis regarding the variation in the centre of mass (COM) displacement was performed.
RESULTS: The mean volume was 40.4 cm(3) before and 65.9 cm(3) after the course, approaching the reference value. Mean anteroposterior, laterolateral, and craniocaudal diameters improved, getting each closer to the reference. Moreover, the COM moved approaching reference coordinates. Mean percentage of intersection and DC strongly increased after the course, rising from 57.76 to 93.83 % and from 0.68 to 0.89, respectively. CI enhanced from 0.06 to 0.31.
CONCLUSIONS: This study shows an improvement in larynx definition after the contouring course with lower interobserver variability and major consistency compared to the reference volume. Other specific educational activities may further increase the quality of radiation therapy contouring in this setting.

PMID: 27422528 [PubMed - as supplied by publisher]

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Real-time dual visualization of two different modalities for the evaluation of vocal fold vibration - Laryngeal videoendoscopy and 2D scanning videokymography: Preliminary report.

Real-time dual visualization of two different modalities for the evaluation of vocal fold vibration - Laryngeal videoendoscopy and 2D scanning videokymography: Preliminary report.

Auris Nasus Larynx. 2016 Jul 12;

Authors: Kim GH, Wang SG, Lee BJ, Park HJ, Kim YC, Kim HS, Sohn KT, Kwon SB

Abstract
OBJECTIVE: Currently, various tools have been introduced for the assessment of vocal fold vibration: laryngeal videolaryngoscopy (LV), videokymography (VKG), high speed videoendoscopy (HSV), digital videokymography (DKG), and 2D scanning videokymography (2D VKG). Among these, the authors have recently designed a dual modality examination system using LV and 2D VKG for more detailed information regarding the vibrations of the vocal folds. The clinical availability of this hybrid system offers medical imaging departments a range of potential advantages in the evaluation of vocal fold vibration. The obvious benefit of simultaneous acquisition is the improved integration of information that allows not only optimal anatomic localization, but also physical movement patterns. Other advantages include the lessened inconvenience to patients due to no longer requiring repeated examinations and shortening the examination time, and increased profitability. The purpose of study was to identify the efficacy of real-time dual examination of two different modalities for the evaluation of vocal fold vibration in human subjects and vocal fold vibration simulator.
METHODS: One vocally healthy subject and three patients with vocal fold nodules, a vocal cyst, and vocal fold paralysis took part in this study. The vibratory patterns of the vocal folds were visualized using simultaneous real-time examination of two different modalities. Additionally, qualitative and quantitative analyses of the dual LV and 2D VKG images were performed.
RESULTS: Real-time dual examination using a two modality system provided high definition images of the vibratory movements of the vocal folds. By assessing the obtained images, we confirmed that the dual modality examination method was useful in the evaluation of pathologic vibratory patterns, even in non-periodic phonation.
CONCLUSION: The present system might improve the understanding of the processes of vocal fold vibration and make a contribution to pathologic voice research, as well as clinical practice.

PMID: 27421819 [PubMed - as supplied by publisher]

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Changes in neurotrophic factors of adult rat laryngeal muscles during nerve regeneration.

Changes in neurotrophic factors of adult rat laryngeal muscles during nerve regeneration.

Neuroscience. 2016 Jul 12;

Authors: Hernández-Morato I, Sharma S, Pitman MJ

Abstract
Injury to the recurrent laryngeal nerve (RLN) leads to the loss of ipsilateral laryngeal fold movement, with dysphonia, and occasionally dysphagia. Functional movement of the vocal folds is never restored due to misrouting of regenerating axons to agonist and antagonist laryngeal muscles. Changes of neurotrophic factor expression within denervated muscles occur after nerve injury and may influence nerve regeneration, axon guidance and muscle reinnervation. This study investigates the expression of certain neurotrophic factors in the laryngeal muscles during the course of axonal regeneration using RT-PCR. The timing of neurotrophic factor expression was correlated to the reinnervation of the laryngeal muscles by motor axons. NGF, BDNF and NTN-1 increased their expression levels in laryngeal muscles after nerve section and during regeneration of RLN. The upregulation of trophic factors returned to control levels following regeneration of RLN. The expression levels of the neurotrophic factors were correlated with the innervation of regenerating axons into the denervated muscles. The results suggest that certain neurotrophic factor expression is strongly correlated to the reinnervation pattern of the regenerating RLN. These factors may be involved in guidance and neuromuscular junction formation during nerve regeneration. In the future, their manipulation may enhance the selective reinnervation of the larynx.

PMID: 27421227 [PubMed - as supplied by publisher]

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Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease.

Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease.

Eur Arch Otorhinolaryngol. 2016 Jul 15;

Authors: Maxwell R, Jerin C, Gürkov R

Abstract
To determine whether vestibular evoked myogenic potential (VEMP) measurements that combine the VEMP 500/1000 Hz frequency tuning ratio and the inter-aural asymmetry ratio can reliably detect unilateral Meniere's disease ears as compared to healthy controls. Forty-two consecutive patients with certain unilateral Meniere's disease (as confirmed using a locally enhanced inner ear MRI (LEIM)) were assessed. Cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP) were recorded at 500 and 1000 Hz. The VEMP amplitudes, asymmetry ratios, and the 500/1000 Hz amplitude ratios were compared with those of 21 age-matched healthy controls. A multi-frequency VEMPs score that combined: (1) the cVEMP 500/1000 Hz amplitude ratio, (2) the oVEMP 500/1000 Hz amplitude ratio, (3) the 500 Hz cVEMP asymmetry ratio, (4) the 1000 Hz cVEMP asymmetry ratio, produced a ROC curve with an area under the curve (AUC) of 0.814. The inclusion of audiology data further improved the result to 0.906. This score can be used to discriminate with a good degree of clinical accuracy between Meniere's ears (unilateral) and those of healthy controls. Multi-frequency VEMP analysis offers a simple, cost-effective solution to the diagnostic difficulties presented by Meniere's disease.

PMID: 27422626 [PubMed - as supplied by publisher]

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Olfactory function in patients with hyposmia compared to healthy subjects - An fMRI study.

Olfactory function in patients with hyposmia compared to healthy subjects - An fMRI study.

Rhinology. 2016 Jul 16;

Authors: Pellegrino R, Hähner A, Bojanowski V, Hummel C, Gerber J, Hummel T

Abstract
BACKGROUND: Individuals with hyposmia, or the partial loss of smell, represent a large sector (15 %) of the population that is likely to grow with the current aging population; however, our understanding to how hyposmics centrally process odors is still not clear. One popular non-invasive tool for in vivo imaging of biological activity among human brains has been function magnetic resonance imaging (fMRI) which uses blood-oxygenation level dependent (BOLD) signal as an indirect measurement. Therefore, the aim of this study was to understand differences in olfaction processing between patients with hyposmia and healthy controls using functional magnetic resonance imaging (fMRI).
METHODOLOGY: Eleven hyposmic and 12 healthy, normosmic subjects were exposed to two different food-related odors (coffee and peach) during a block-designed fMRI session. Additionally, odor perception qualities were rated for each odor throughout the scanning session.
RESULTS: The activations of the normosmic group were localized in typical olfactory areas (insula, orbitofrontal cortex [OFC], limbic system and amygdala). The hyposmic group showed similar regions of activation (insula, OFC, limbic system), however, less activation was found in the amygdala, left anterior cingulate and right OFC, but higher activation was shown in the right parahippocampal and both the left and right posterior cingulate gyrus which are assumed to play an important role in the processing and remembrance of memories.
CONCLUSIONS: These results indicate similar central olfactory processing among groups, yet subjects with partial loss may attempt to compensate smell impairment with odor memory or higher motivation to smell.

PMID: 27421303 [PubMed - as supplied by publisher]

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[Giant inflammatory pseudotumor of the cranial base].

[Giant inflammatory pseudotumor of the cranial base].

Neurocirugia (Astur). 2016 Jul 12;

Authors: Carrasco-Moro R, Martínez-San Millán J, Pian H

Abstract
The inflammatory pseudotumour (IPT) is a non-neoplastic entity of unknown origin, and is characterised by a proliferation of connective tissue and a polyclonal inflammatory infiltrate. Central nervous system involvement is uncommon, and usually represents a diagnostic and therapeutic challenge even for the experienced clinician. This reports deals with the case of a 56year-old woman diagnosed with a giant, infiltrating mass centred in the left cavernous sinus, who had a rapid clinical and radiological response to steroid therapy. Biopsy specimens were diagnostic for IPT. The progression of a small orbital residual lesion was detected after steroid withdrawal. Treatment with cyclophosphamide induced a complete response that remains stable after six years of follow-up.

PMID: 27422698 [PubMed - as supplied by publisher]

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Differential protein expression in the secretory fluids of maxillary sinusitis and maxillary retention cyst.

Differential protein expression in the secretory fluids of maxillary sinusitis and maxillary retention cyst.

Eur Arch Otorhinolaryngol. 2016 Jul 15;

Authors: Kim SM, Eo MY, Cho YJ, Kim YS, Lee SK

Abstract
Both maxillary sinusitis (MS) and maxillary retention cyst (MRC) involve the maxillary sinus and show similar clinical features. Clinically, differentiating between MS and MRC is sometimes difficult in asymptomatic patients, despite their quite different pathogenic behaviors. To identify differential protein expressions in the secretory fluids of MS and MRC, 25 cases of asymptomatic MS and 15 cases of asymptomatic MRC were examined pathologically in this study. All patients underwent routine endoscopic sinus surgery or modified Caldwell-Luc procedure and the sinus mucosal specimens obtained during these procedures with the approval of the Institutional Review Board. Their secretory fluids were analyzed via immunoprecipitation-based high-performance liquid chromatography (IP-HPLC) using 25 types of antiserum, including inflammatory cytokines, antimicrobial proteins, and mucosal protective proteins. In the histological examinations, MS and MRC showed similar features in the secretory columnar epithelial lining and thick submucosal connective tissue, both of which contained few inflammatory cells infiltrates. The IP-HPLC analysis revealed that TNFα, IL-1, -8, MMP-3, -10, α1-antitrypsin, cathepsin C, lysozyme, lactoferrin, β-defensin-1, -3, LL-37, mucocidin, and mucin-1 were more intensely expressed in MS than in MRC; whereas IgA, cystatin A, and proline-rich proteins were more strongly expressed in MRC than in MS. These data indicate that the secretory fluid of MS is indicative of a more robust inflammatory reaction to certain bacteria compared to that of MRC, while the secretory fluid of MRC contains more abundant mucosal protective proteins compared to that of MS. Taken together, the IP-HPLC analysis of MS and MRC secretory fluid revealed that MRC showed a weaker inflammatory reaction but a stronger mucosal protective function than MS.

PMID: 27422628 [PubMed - as supplied by publisher]

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Intraoperative monitoring of the recurrent laryngeal nerve by vagal nerve stimulation in thyroid surgery.

Intraoperative monitoring of the recurrent laryngeal nerve by vagal nerve stimulation in thyroid surgery.

Eur Arch Otorhinolaryngol. 2016 Jul 15;

Authors: Farizon B, Gavid M, Karkas A, Dumollard JM, Peoc'h M, Prades JM

Abstract
The aim of the present study was to evaluate the thyroarytenoid muscle response during bilateral thyroid surgery using vagal nerve stimulation. 195 patients (390 nerves at risk) underwent a total thyroidectomy. The recurrent laryngeal nerve's function was checked by analyzing the amplitude and the latency of the thyroarytenoid muscle's responses after a vagal nerve's stimulation (0.5 and 1 mA) using the NIM3 Medtronic system. All patients were submitted to preoperative and postoperative laryngoscopy. 20 patients get no thyroarytenoid muscle response to the vagal nerve stimulation, and 14 postoperative recurrent laryngeal nerve palsies were confirmed (3.8 %). Two palsies were present after 6 months (0.51 %). All the patients with muscle's response have normal mobility vocal fold. The test sensitivity was 100 % and the test specificity was 98 %. Physiologically, the mean latencies of the muscular potentials for the right RLN were, respectively, 3.89 and 3.83 ms (p > 0.05) for the stimulation at 0.5 and 1 mA. The mean latencies for the left RLN were, respectively, 6.25 and 6.22 ms for the stimulation at 0.5 and 1 mA (p > 0.05). The difference of the latencies between the right and the left nerve was 2.30 ms (1.75-3.25 ms) with a stimulation of 0.5 or 1 mA (p < 0.05). Thyroarytenoid muscle's response via a vagal nerve stimulation showed a functional asymmetry of the laryngeal adduction with a faster right response. Surgically, this method can predict accurately an immediate postoperative vocal folds function in patients undergoing a bilateral thyroid surgery.

PMID: 27422627 [PubMed - as supplied by publisher]

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Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease.

Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease.

Eur Arch Otorhinolaryngol. 2016 Jul 15;

Authors: Maxwell R, Jerin C, Gürkov R

Abstract
To determine whether vestibular evoked myogenic potential (VEMP) measurements that combine the VEMP 500/1000 Hz frequency tuning ratio and the inter-aural asymmetry ratio can reliably detect unilateral Meniere's disease ears as compared to healthy controls. Forty-two consecutive patients with certain unilateral Meniere's disease (as confirmed using a locally enhanced inner ear MRI (LEIM)) were assessed. Cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP) were recorded at 500 and 1000 Hz. The VEMP amplitudes, asymmetry ratios, and the 500/1000 Hz amplitude ratios were compared with those of 21 age-matched healthy controls. A multi-frequency VEMPs score that combined: (1) the cVEMP 500/1000 Hz amplitude ratio, (2) the oVEMP 500/1000 Hz amplitude ratio, (3) the 500 Hz cVEMP asymmetry ratio, (4) the 1000 Hz cVEMP asymmetry ratio, produced a ROC curve with an area under the curve (AUC) of 0.814. The inclusion of audiology data further improved the result to 0.906. This score can be used to discriminate with a good degree of clinical accuracy between Meniere's ears (unilateral) and those of healthy controls. Multi-frequency VEMP analysis offers a simple, cost-effective solution to the diagnostic difficulties presented by Meniere's disease.

PMID: 27422626 [PubMed - as supplied by publisher]

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