Objectives: The purpose of this study was to evaluate the specificity and sensitivity of two red flag protocols in detecting ear diseases associated with changes in hearing. Design: The presence of red-flag symptoms was determined in a chart review of 307 adult patients from the Mayo Clinic Florida Departments of Otorhinolaryngology and Audiology. Participants formed a convenience sample recruited for a separate study. Neurotologist diagnosis was the criterion for comparisons. Results: Of the 251 patient files retained for analysis, 191 had one or more targeted diseases and 60 had age- or noise-related hearing loss. Food and Drug Administration red flags sensitivity was 91% (confidence interval [CI], 86 to 95%) and specificity was 72% (CI, 59 to 83%). American Academy of Otolaryngology-Head and Neck Surgery red flags sensitivity was 98% (CI, 95 to 99%) and specificity was 20% (CI, 11 to 32%). Conclusions: Stakeholders must determine which diseases are meaningful contraindications for hearing aid use and whether these red-flag protocols have acceptable levels of sensitivity and specificity. As direct-to-consumer models of hearing devices increase, a disease detection method that does not require provider intercession would be useful. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal's Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: All authors contributed equally to this work. N.A.M.K. and D.A.Z. provided analyses. S.K.R. reviewed analyses and provided critical interpretation. D.A.Z., L.L., and S.K.R. contributed to data collection. S.K.R., R.A., and D.A.Z. pulled and deidentified data for analysis. N.A.M.K. wrote the initial draft of this work. All authors reviewed, edited, and approved the final paper. This research was supported by the National Institutes of Health/National Institute of Deafness and Other Communication Disorders (R21/33 DC013115; S.D. and D.A.Z.) and the Knowles Hearing Center at Northwestern University (S.D., D.A.Z., and D.W.N.). The authors declare no conflicts of interest. Address for correspondence: Niall A. M. Klyn, Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Dr, Evanston, IL 60208, USA. E-mail: niall.klyn@northwestern.edu Received July 6, 2017; accepted January 7, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Πέμπτη 1 Μαρτίου 2018
Sectioned images and 3D models of a cadaver head with reference to dermal filler injection
Publication date: Available online 2 March 2018
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Dong Sun Shin, YoungJoo Shim, Bong Chul Kim
The purpose of this study was to describe anatomical consideration with reference to dermal filler injection on sectioned images and three dimensional (3D) models using Visible Korean for medical education and clinical training purposes in the field of facial surgery. Serially sectioned images of the head were acquired from a cadaver. Anatomic structures related to dermal filler injection were 3D-reconstructed based on sectioned images, and additional structures were built on the basis of the established ones using a semi-automatic method. The anatomical 3D models were assembled and converted to a PDF file (66MB), which can be downloaded and used for free. In the PDF file, noticeable anatomical structures related with dermal filler injection can be identified on the 3D models as well as on the sectioned anatomical images. The 3D models in PDF were optimized and displayed in real time. These state-of-the-art sectioned images, outlined images, and 3D models will aid students and trainees to acquire a better understanding of the anatomy related to dermal filler injection, and will also improve medical understanding of patients and the general public. The 3D models in PDF files also can be used on dermal filler injection simulations.
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Editorial Board
Publication date: March 2018
Source:Annals of Anatomy - Anatomischer Anzeiger, Volume 216
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A periostin antisense oligonucleotide suppresses bleomycin-induced formation of a lung premetastatic niche for melanoma
Summary
Metastasis is the leading cause of cancer deaths. A tumor-supportive microenvironment, or premetastatic niche, at potential secondary tumor sites plays an important role in metastasis, especially in tumor cell colonization. Although a fibrotic milieu is known to promote tumorigenesis and metastasis, the underlying molecular contributors to this effect have remained unclear. Here we show that periostin, a component of the extracellular matrix that functions in tissue remodeling, has a key role in formation of a fibrotic environment that promotes tumor metastatic colonization. We found that periostin was widely expressed in fibrotic lesions of mice with bleomycin-induced lung fibrosis, and that up-regulation of periostin expression coincided with activation of myofibroblasts positive for α–smooth muscle actin. We established a lung metastasis model for B16 murine melanoma cells and showed that metastatic colonization of the lung by these cells was markedly promoted by bleomycin-induced lung fibrosis. Inhibition of periostin expression by intratracheal administration of an antisense oligonucleotide targeting periostin mRNA was found to suppress bleomycin-induced lung fibrosis and thereby to attenuate metastatic colonization of the lung by melanoma cells. Our results indicate that periostin is a key player in the development of bleomycin-induced fibrosis and consequent enhancement of tumor cell colonization in the lung, and they therefore implicate periostin as a potential target for prevention or treatment of lung metastasis.
This article is protected by copyright. All rights reserved.
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Feasibility of Carbon-Ion Radiotherapy for Re-Irradiation of Locoregionally Recurrent, Metastatic, or Secondary Lung Tumors
Summary
Intrathoracic recurrence after carbon-ion radiotherapy for primary or metastatic lung tumors remains a major cause of cancer-related deaths. However, treatment options are limited. Herein, we report on the toxicity and efficacy of re-irradiation with carbon-ion radiotherapy for locoregionally recurrent, metastatic, or secondary lung tumors. Data of 95 patients with prior intrathoracic carbon-ion radiotherapy who were treated with re-irradiation with carbon-ion radiotherapy at our institution between 2006 and 2016 were retrospectively analyzed. Seventy-three patients (76.8%) had primary lung tumors and 22 patients (23.2%) had metastatic lung tumors. The median dose of initial carbon-ion radiotherapy was 52.8 Gy (relative biological effectiveness) and the median dose of re-irradiation was 66.0 Gy (relative biological effectiveness). None of the patients received concurrent chemotherapy. The median follow-up period after re-irradiation was 18 months. Regarding Grade ≥3 toxicities, 1 patient experienced each of the following: Grade 5 bronchopleural fistula, Grade 4 radiation pneumonitis, Grade 3 chest pain, and Grade 3 radiation pneumonitis. The 2-year local control and overall survival rates were 54.0% and 61.9%, respectively. In conclusion, re-irradiation with carbon-ion radiotherapy was associated with relatively low toxicity and moderate efficacy. Re-irradiation with carbon-ion radiotherapy may be an effective treatment option for patients with locoregionally recurrent, metastatic, or secondary lung tumors.
This article is protected by copyright. All rights reserved.
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Influence of Backscatter Radiation on Cranial Bone Fixation Devices
Postoperative radiation can cause ulcer formation, leading to the denudation of skin over alloplastic materials. The influence of backscatter radiation from fixation devices has not been investigated. The aim of this study is to evaluate backscatter dose variations for different cranial bone fixation devices in an experimental model designed to simulate postoperative radiotherapy. The authors assessed the radiation backscatter doses associated with resorbable (PLLA-PGA) and titanium plates. The samples were irradiated with 6 and 10 MV photon beams from a linear accelerator. Measurements were obtained using an ionization chamber and radiochromic films cut from the same batch. As a result, the backscatter radiation of water and PLLA-PGA proportionally decreased as the depth increased. However, the backscatter radiation of the titanium plate increased just above the plate. This depth lies in the region of the scalp. Each material showed a dose of radioactivity that was higher at 10 MV than that at 6 MV. These devices showed a significant difference, which suggested that these materials amplified the dose compared with water at 6 MV. In conclusion, it is supposed that PLLA-PGA should be used to fix the cranium to decrease the potential for radiation ulcers. Address correspondence and reprint requests to Yoshiaki Sakamoto, MD, Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan; E-mail: ysakamoto@z8.keio.jp Received 26 March, 2017 Accepted 30 December, 2017 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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Surgical Management and Evaluation of the Craniofacial Growth and Morphology in Cleidocranial Dysplasia
Cleidocranial dysplasia (CCD, MIM 119600) is a rare autosomal dominant disorder affecting bone, cartilage, craniofacial growth, and tooth formation leading to supernumerary teeth. Few reports delineate the genotype–phenotype correlations related to the variations in craniofacial morphology and patterning of the dentition and the complexity of treating patient's malocclusion. Successful management of the craniofacial deformities in patients with CCD requires a multidisciplinary team of healthcare specialists. Approximately 70% of patients are due to point mutations in RUNX2 and
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Comparing the Efficacy of Peritonsillar Injection of Tramadol With Honey in Controlling Post-Tonsillectomy Pain in Adults
Introduction: The authors investigated the effect of honey on post-tonsillectomy pain and compare its efficacy with tramadol. Methods: This clinical trial was performed on 60 patients with American Society of Anesthesia I and II aged between 18 and 55 years and underwent tonsillectomy. Induction of anesthesia was carried out using 2 mg/kg propofol and 0.5 atracurium following 1.5 μg/kg fentanyl administration. Group B was given tramadol at dose of 2 mg/kg and with volume of 4 mL and Group A was given normal saline with the same volume 2 mL of medications were injected using needle (25) into tonsil bed and anterior old of each tonsil by an anesthesiologist. Three minutes after injection, the surgery was performed by the same ENT residents for all patients. In the recovery room Group B received antibiotics and oral acetaminophen. Group A was given antibiotics, oral acetaminophen, and honey dissolved in 40 mL warm water every 6 hours from when the patient was fully awake. Patients in Group A were told to eat honey 3 times a day 7 days postoperatively. Pain was scored using Numeric Rating Scale at the time points of 2, 6, 12, and 24 hours as well as 3 and 7 days postoperatively. Moreover, the healing status and epithelialization degree of tonsillar bed were considered on 1 and 7 days after the surgery by ENT specialist. Results: The mean of pain score was significantly higher in Group A within 24 hours postoperatively as compared with Group B (P 0.05). Considering restoration status and epithelialization degree of tonsillar bed on the 1st and 7th days, there was no statistically significant difference between 2 groups; however, tonsillar bed healing process was better in Group B on the 7th day. Conclusion: The current investigation confirmed the positive impact of tramadol on post-tonsillectomy pain relief in adults. The authors also found that honey can be used as a complementary treatment along with acetaminophen and other analgesics for reducing post-tonsillectomy pain. Considering honey impact on wound healing and its anti-inflammatory effect, it is suggested for relieving complications after surgery. Address correspondence and reprint requests to Vahid Zand, Assistant Professor, Department of Otolaryngology, Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; E-mail: drvzand@gmail.com Received 30 July, 2017 Accepted 30 December, 2017 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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The Specific Morphological Features of Alveolar Bone
Objective: The aim of the study was to study the specific morphological features of alveolar bone and compare it to femoral bone in rats. Methods: Twelve 3-month-old nonpregnant female Sprague–Dawley rats were used in the present study. The left maxillae and femurs of 6 rats were used for micro-computed tomography (micro-CT) scanning. The trabecular bone of the distal femur and the interradicular alveolar bone of the maxillary first molar were reconstructed and analyzed. Another 6 rats were used for histological analysis of trabecular bone and alveolar bone. Results: Micro-CT analysis suggested that the femoral trabecular bone was porous with rod-like trabeculae with a scattered distribution in bone marrow, whereas alveolar bone showed a compact structure with plate-like trabeculae and limited bone marrow. Tissue mineral density, bone mineral density, bone volume fraction, and trabecular thickness were dramatically higher in the alveolar bone compared with that in the trabecular bone. Alveolar bone displayed lower trabecular number and trabecular separation. Histomorphometric analysis showed that alveolar bone was formed of compact bone with wide trabeculae, whereas femurs were composed of loose bone with finer trabeculae. Conclusions: In comparison to the spongiosa of the distal femur, alveolar bone displays specific morphological features with compact, wide, and highly mineralized trabeculae. Address correspondence and reprint requests to Lingyong Jiang, Center of Craniofacial Orthodontics, Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639 Zhi Zao Ju Road, Shanghai 200011, China; E-mail: jly117@sina.com Received 20 September, 2017 Accepted 20 December, 2017 SZ and YY equally contributed to this work. This work was supported in part by grants from the National Natural Science Foundation of China (NSFC) [81371121 and 81570950], Shanghai Summit&Plateau Disciplines, the "Chen Xing" project from Shanghai Jiaotong University. The authors report no conflict of interest. © 2018 by Mutaz B. Habal, MD.
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Successful Strategies for Dealing With Infected, Custom-Made Hydroxyapatite Cranioplasty
When a cranioplasty implant becomes infected, standard operating procedure dictates its removal and the initiation of a long course of antibiotic therapy. However, removing such a prosthesis can have a series of adverse consequences, including delayed cognitive and motor recovery, lack of brain tissue protection, unsightly deformity, and the need for two additional surgical procedures, not to mention the additional costs involved. To maintain the advantages of cranioplasty, we opted for a conservative approach (levofloxacin and rifampicin every 24 hours for 8 weeks) in a 68-year-old woman whose custom-made porous hydroxyapatite implant, fitted following aneurysm clipping, had become infected. The tissues overlying the implant were curettaged, and the patient's clinical condition, blood markers, and infection course were continuously monitored (local monitoring was performed by single-photon emission computed tomography [SPECT]/computed tomography [CT after intravenous administration of 99mTc-labeled antigranulocyte antibody). Blood tests and SPECT/CT evidenced a progressive reduction in phlogosis indices and infection locus, even 1 month after antibiotic therapy was commenced, and at 2 years from cranioplasty, the same tests and clinical examination were negative. At 6-year follow-up, clinical assessment revealed nothing out of the ordinary. Hence, specific cases (hydroxyapatite prosthesis, intact dura, cranial CT and magnetic resonance imaging negative for empyema, well-vascularized scalp, antibiotic-responsive bacteria) of infected cranial implant can be treated using a conservative approach consisting of appropriate antibiotic therapy, accompanied by local debridement where necessary, and assiduous monitoring of phlogosis indices and local verification via labeled-leukocyte scintigraphy. Our report, which was compiled after a long-term follow-up period, shows that this conservative procedure appears to be a viable option in cases of infected, custom-made hydroxyapatite cranioplasty, provided that some basic rules concerning clinical and instrumental standards are adhered to, as clearly stated in our report. Address correspondence and reprint requests to Nicola Zingaretti, MD, Department of Plastic Reconstructive Surgery, c/o Ospedale "S. Maria della Misericordia", Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy; E-mail: zingarettin@gmail.com. Received 24 July, 2017 Accepted 7 January, 2018 The authors declare no conflicts of interest to disclose. © 2018 by Mutaz B. Habal, MD.
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The State of Technology in Craniosynostosis
Introduction: Craniosynostosis, the premature fusion of ≥1 cranial sutures, is the leading cause of pediatric skull deformities, affecting 1 of every 2000 to 2500 live births worldwide. Technologies used for the management of craniofacial conditions, specifically in craniosynostosis, have been advancing dramatically. This article highlights the most recent technological advances in craniosynostosis surgery through a systematic review of the literature. Methods: : A systematic electronic search was performed using the PubMed database. Search terms used were "craniosynostosis" AND "technology" OR "innovation" OR "novel." Two independent reviewers subsequently reviewed the resultant articles based on strict inclusion and exclusion criteria. Selected manuscripts deemed novel by the senior authors were grouped by procedure categories. Results: Following review of the PubMed database, 28 of 536 articles were retained. Of the 28 articles, 20 articles consisting of 21 technologies were deemed as being novel by the senior authors. The technologies were categorized as diagnostic imaging (n = 6), surgical planning (n = 4), cranial vault evaluation (n = 4), machine learning (n = 3), ultrasound pinning (n = 3), and near-infrared spectroscopy (n = 1). Conclusion: Multiple technological advances have impacted the treatment of craniosynostosis. These innovations include improvement in diagnosis and objective measurement of craniosynostosis, preoperative planning, intraoperative procedures, communication between both surgeons and patients, and surgical education. Address correspondence and reprint requests to Mirko Gilardino, MD, MSc, FRCSC, FACS, Director, Plastic Surgery Residency Program, Associate Professor of Surgery, Division of Plastic & Reconstructive Surgery, McGill University Health Centre, Director, H.B. Williams Craniofacial & Cleft Surgery Unit, Montreal Children's Hospital, 1001 Decarie Boulevard, B05.3310, Montreal H4A 3J1, Canada; E-mail: mirkogilardino@hotmail.com Received 28 July, 2017 Accepted 5 January, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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Review of “The Prevalence of Burnout Among US Neurosurgery Residents” by Shakir HJ, McPheeters MJ, Shallwani H, Pittari JE, Reynolds RM in Neurosurgery [published ahead of print October 27, 2017] doi: 10.1093/neuros/nyx494
Reconstruction of Thin and Pliable Oral Mucosa After Wide Excision of Oral Cancer Using a Trimmed Anterolateral Thigh Free Flap as an Adipofascial Flap
A 21-year-old female patient underwent wide excision of the buccal mucosa and tongue as well as selective neck dissection due to squamous cell carcinoma on the left side of the tongue. She had a severe limitation in opening her mouth, owing to fibrosis of the mucosa and scar contracture after adjuvant radiation therapy. Reconstruction of the oral mucosa and tongue defect was performed after removal of the scar to improve mouth opening. An anterolateral thigh (ALT) flap was used, trimmed to an adipofascial flap for the reconstruction of the thin and pliable oral mucosa and tongue. The maximum mouth opening improved to 40 mm intraoperatively and was 30 mm after surgery. The adipofascial ALT flap had excellent viability and presented neomucosa after secondary healing. An adipofascial flap obtained by trimming an ALT flap could be a reliable option for the reconstruction of thin and pliable oral mucosa after wide excision of oral cancer. Address correspondence and reprint requests to Jee-Ho Lee, DDS, PhD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Asan Medical Center, 88, Olympic-ro, Songpa-gu, Seoul 138-736, Korea; E-mail: jeehoman@naver.com Received 28 August, 2017 Accepted 5 January, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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Removal of Maxillary Sinus Antrolith and Concomitant Intrasinus Augmentation
Maxillary sinus antrolithisis is a rare finding. Conservative surgical removal recommended. In the patients that need to maxillary intrasinus augmentation and antrolith is observed in preoperative radiography, 2 options remain. First, doing Caldwell-luc surgery to remove antrolith and delayed open sinus lift. Second way is removing antrolith and concomitant intrasinus augmentation. The first way has 2 disadvantages: prolonged waiting period and difficulty of open sinus lift in sinuses with scar and fibrosis. Coupling these 2 surgeries and using corticocancellous bone block as grafting material are recommended by us. Buccal fat pad is a good option to isolate this graft from maxillary sinus. Address correspondence and reprint requests to Saeedeh Khajehahmadi, DDS, Dental Research Center, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad 91735, Iran; E-mail: khajehahmadis@mums.ac.ir Received 2 December, 2017 Accepted 9 January, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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Eliminating bias and accelerating the clinical translation of oral microbiome research in oral oncology
Publication date: Available online 1 March 2018
Source:Oral Oncology
Author(s): Rohit Kunnath Menon, Divya Gopinath
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Does Pediatric Obstructive Sleep Apnea Syndrome Cause Systemic Microvascular Dysfunction?
The aim of this study was to evaluate whether pediatric obstructive sleep apnea syndrome (OSAS) secondary to adenoid hypertrophy causes systemic microvascular dysfunction. This is a prospective single-blinded case–control study. As the patient group, 81 patients diagnosed to have OSAS secondary to adenoid hypertrophy at our hospital between January 2016 and May 2016; as the control group, 26 healthy pediatric volunteers who presented to the hospital for health screening were included in this study. Three groups of OSAS patients were defined as mild, moderate, and severe respectively, according to the lateral nasopharynx x-ray. Patients with comorbid diseases were excluded from the study. For microvascular dysfunction, videocapillaroscopic evaluation was performed at the nailfold and capillary density (CD) and postocclusive reactive hyperemia (PORH) values were measured and statistical analysis between the groups was performed. The duration of complaints in all patients with OSAS was at least 6 months and 0.05). PORH measurement in the control group and mild, moderate, and severe OSAS group was 95.6 ± 8.6, 97.9 ± 10.1, 96 ± 8.7, and 93.9 ± 9.3, respectively, with no significant difference between the groups (P > 0.05). OSAS secondary to adenoid hypertrophy in pediatric patients was demonstrated to cause no dysfunction in microvascular circulation and carried no cardiovascular risk in the early period. Address correspondence and reprint requests to Hasan Emre Koçak, MD, Bakirköy Dr. Sadi Konuk Eğitim ve Araştirma Hastanesi, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakirköy, Istanbul 34147, Türkiye; E-mail: drhekbb@gmail.com Received 29 June, 2017 Accepted 29 December, 2017 All the authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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Anatomic Considerations for Temporomandibular Joint Vascularized Composite Allotransplantation
Concomitant temporomandibular joint (TMJ) transplantation is an obvious advancement in the reconstructive armamentarium for face transplantation in scenarios involving TMJ ankylosis. This study investigates the fidelity of mandibular morphology and explores the feasibility of bilateral mandibular condyle transfer in facial vascularized composite allotransplantation. Geometric analysis was performed on 100 skeletally mature maxillofacial computed tomography scans. Exclusion criteria included mandibular trauma and dentoalveolar disease. Parameters measured were posterior height, ramus tilt, anterior height, intercondylar widths, condyle height, coronoid height, interglenoid distances, symphyseal and gonial angles, condyle and glenoid volumes, and condyle shapes. Parameters were compared by gender and ethnicity using χ2, independent sample t tests, and one-way ANOVA. Correlation with age was assessed using Pearson correlation coefficients. Bilateral measurements were compared using paired-sample t tests. Mean intercondylar width was 102.5 mm (SD 7.0 mm), anterior height 21.5 mm (5.5), and posterior height 65.3 mm (7.7), Males demonstrate larger geometric parameters, for example, intercondylar width (4 mm mean difference, P = 0.005), anterior height (2.3 mm, P = 0.032), posterior height (5 mm, P = 0.001). Asians demonstrated statistically larger intercondylar width (8 mm difference to Caucasians, P
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Impact of perioperative hyperglycemia in patients undergoing microvascular reconstruction
Abstract
Background
The effects of perioperative hyperglycemia on complications and outcomes in microvascular reconstruction have not been reported in the literature.
Methods
A retrospective cohort of 203 patients undergoing microvascular reconstruction was generated. Perioperative glucose levels and clinical factors were tested for associations with complications using simple and multivariate analyses.
Results
Hyperglycemia (blood glucose ≥ 180 mg/dL) occurred in 91 patients (44.8%) perioperatively, and was associated with increased rates of surgical complications, medical complications, surgical site infections, fistulas, and wound dehiscence. On univariate analysis, a more strict definition of hyperglycemia (blood glucose ≥ 165 mg/dL) was significantly associated with greater rates of venous thrombosis, although this lost statistical significance on multivariate analysis.
Conclusion
Perioperative hyperglycemia occurs commonly in patients undergoing microvascular reconstruction and is associated with higher rates of complications, independent of a preexisting diagnosis of diabetes mellitus. Further research is needed to define the ideal glycemic target in this population.
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PREVALENCE OF POTENTIAL HYBRID AND CONVENTIONAL COCHLEAR IMPLANT CANDIDATES BASED ON AUDIOMETRIC PROFILE
Structural Analysis of Tensor Tympani Muscle, Tympanic Diaphragm, Epitympanum, and Protympanum in Menière's Disease: a Human Temporal Bone Study
Hypothesis: We hypothesized that there would be significant anatomic differences of the tensor tympani muscle (TTM), tympanic diaphragm, epitympanum, and protympanum in patients with versus without Menière's disease. Background: The effects of tenotomy on Menière's disease suggested it relieves the pressure on the inner ear of the contraction of the TTM and of negative middle ear pressure. Methods: Using human temporal bones from patients with Menière's disease, two studies were conducted. We examined the presence of otitis media, cholesteatoma, and endolymphatic hydrops, the length, diameter, configuration, the volume of the TTM and tendon, and the area of the tympanic isthmus (Study 1). We examined the presence of otitis media, cholesteatoma and endolymphatic hydrops, and the area and volume of the protympanum (Study 2). Results: In study 1, we observed no significant differences between the two groups. In study 2, we did not observe a small and narrow protympanum in the Menière's disease group. None of the ears in the Menière's or control groups had otitis media or cholesteatoma in either study. We observed hydrops in all the temporal bones of the Menière's disease group and none in the control groups. Conclusion: The position, configuration, and size of the tensor tympani muscle and tendon do not seem to play a role in the pathogenesis of Menière's disease. Because the tympanic isthmus and protympanum in Menière's disease are not smaller than controls and that none of the temporal bones had otitis media or cholesteatoma, it is unlikely that there was dysventilation in the middle ear. Address correspondence and reprint requests to Sebahattin Cureoglu, M.D., Department of Otolaryngology, University of Minnesota, Lions Research Building, Room 210, 2001 6th St. SE, Minneapolis, MN 55455, USA; E-mail: cureo003@umn.edu This project was funded by the International Hearing Foundation; the Starkey Hearing Foundation; the 5 M Lions International. This article does not include any studies with human participants performed by any of authors. The Institutional Review Board of the University of Minnesota approved this study (0206M26181). The authors disclose no conflicts of interest. Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Electrocochleography Results in Patients With Bilateral Vestibular Paresis and Sound- or Pressure-Induced Horizontal Nystagmus
Objective: To describe the electrocochleography (ECochG) findings in patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus. Design: Retrospective case series. Setting: Tertiary care center. Patients: Three adult patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus were evaluated from 2012 to 2016. Main Outcome Measure: All patients underwent ECochG, vestibular evoked myogenic potential (VEMP) testing, bithermal caloric testing, rotary chair testing, audiometric testing, and temporal bone computed tomography (CT). For ECochG, the summating potential (SP) to action potential (AP) ratio was determined. Results: All patients had normal temporal bone CT, reduced caloric responses bilaterally, decreased gain on rotary chair, and abnormal ECochG. For two subjects, the SP/AP was elevated bilaterally. One subject had unilateral SP/AP elevation. Cervical VEMPs were present in all subjects, but at reduced thresholds in two subjects. Conclusion: SP/AP elevation was found in all three patients with the syndrome of bilateral vestibular paresis and/or sound- or pressure-induced horizontal nystagmus. As the etiology of this syndrome remains unclear, understanding the basis for abnormal ECochG may shed insight into the pathophysiology of this condition. Address correspondence and reprint requests to Katherine D. Heidenreich, M.D., 1904 Taubman Center, 1500 E. Medical Center Dr, SPC 5312, Ann Arbor, MI 48109-5312; E-mail: kheidenr@med.umich.edu Sources of funding: None. The authors disclose no conflicts of interest. Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Increased Single fiber jitter level is associated with reduction in motor function with aging
ABSTRACTObjectiveAge-associated skeletal muscle weakness is a major contributing factor to an increased late life mortality and morbidity, but its neurobiology is poorly understood. Previously, we provided histological evidence of dying-back axonal degeneration of motor neurons and denervation of neuromuscular junctions (NMJ) in age-associated muscle weakness. Given this, we aim to evaluate the relation between impaired neuromuscular transmission and various aspects of age-associated muscle weakness.DesignWe compared two electrophysiological measures, single fiber jitter and compound motor action potential (CMAP) in mice of different age groups, and correlated them with various physical performance measures, such as grip strength, standing and walking time and treadmill performance.ResultsConsistent with our previous histological data, single fiber jitter, a measure of NMJ transmission, was significantly increased in older animals, while CMAP shows no difference between young and old age groups. Neither jitter nor CMAP correlated with any of physical performance measures, except for jitter and standing activity.ConclusionImpaired neuromuscular transmission – represented as increase in SFEMG jitter level – reflects decline in motor function with aging. Objective Age-associated skeletal muscle weakness is a major contributing factor to an increased late life mortality and morbidity, but its neurobiology is poorly understood. Previously, we provided histological evidence of dying-back axonal degeneration of motor neurons and denervation of neuromuscular junctions (NMJ) in age-associated muscle weakness. Given this, we aim to evaluate the relation between impaired neuromuscular transmission and various aspects of age-associated muscle weakness. Design We compared two electrophysiological measures, single fiber jitter and compound motor action potential (CMAP) in mice of different age groups, and correlated them with various physical performance measures, such as grip strength, standing and walking time and treadmill performance. Results Consistent with our previous histological data, single fiber jitter, a measure of NMJ transmission, was significantly increased in older animals, while CMAP shows no difference between young and old age groups. Neither jitter nor CMAP correlated with any of physical performance measures, except for jitter and standing activity. Conclusion Impaired neuromuscular transmission – represented as increase in SFEMG jitter level – reflects decline in motor function with aging. Acknowledgement This work was supported by RMSTP K12 grant (5K12HD001097-19), the Dr. Miriam and Sheldon G Adelson Medical Research Foundation, the National Institutes on Aging (NIA) (R21-AG025143) and the Johns Hopkins Older Americans Independence Center (P30-AG021334). Correspondence: Tae Chung, MD, Johns Hopkins School of Medicine, Department of Physical Medicine and Rehabilitation, 4940 Eastern Avenue/Asthma Allergy bldg. 1A44, Baltimore MD 21224, Email: tchung7@jhmi.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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CD10+GPR77+ Cancer-Associated Fibroblasts Promote Chemoresistance [Stem Cells]
CD10 and GPR77 define a cancer-associated fibroblast (CAF) subset that sustains cancer stemness.
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E-cigarette Report Reveals Research Gaps [News in Brief]
In a comprehensive analysis of existing studies, the U.S. National Academies of Sciences, Engineering, and Medicine concluded that electronic cigarettes are addictive, though less toxic than conventional cigarettes. The report also identified key areas for future research, including smoking cessation, adolescent use, and long-term health effects.
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Dimerization Is Critical for the Functions of Wild-type and Mutant KRAS [Lung Cancer]
Wild-type KRAS increases survival and resistance to MEK inhibitors in KRAS-mutant lung cancer cells.
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CNS Metastases Needn't Rule Out Trial Inclusion [News in Brief]
New guidelines from an expert working group describe when to include or exclude patients with brain metastases from clinical trials. In the past, these patients have often been inappropriately excluded from trials, resulting in a dearth of information on the efficacy of cancer drugs in the central nervous system.
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First Comprehensive Companion Diagnostic OK'd [News in Brief]
The FDA has approved F1CDx, a comprehensive companion diagnostic test that can detect genetic alterations and two genomic signatures in any type of solid tumor. Patients with five common types of advanced cancer can be matched to one of 17 targeted therapies with this single test.
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Chromatin-Remodeling Genes Promote Immunotherapy Resistance [News in Brief]
Two studies show that genes that encode a chromatin-remodeling complex foster resistance to checkpoint inhibitors. One study identified the proteins by using CRISPR/Cas9 to knock out genes in mouse melanoma cells. The other study converged on the same result by identifying mutations in patients with clear cell renal cell carcinoma who responded to PD-1 inhibitors.
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Nivolumab plus Ipilimumab Achieves Responses in dMMR/MSI-H Tumors [Clinical Trials]
Nivolumab plus ipilimumab achieves higher response rates than previously reported for nivolumab alone.
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Patients with Desmoplastic Melanoma May Respond to PD-1 Blockade [Immunotherapy]
PD-1 blockade achieved responses in 70% of patients with desmoplastic melanoma in a retrospective analysis.
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KRASG12D Gene Dosage Drives Pancreatic Tumor Evolution and Progression [Pancreatic Cancer]
Allelic imbalance with increased KrasG12D gene dosage drives key PDAC characteristics.
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Chromosomal Instability Drives Metastasis Independent of Aneuploidy [Metastasis]
Chromosomal instability (CIN) promotes metastasis with little effect on primary tumor growth.
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Autophagy Sustains Pancreatic Cancer Growth through Both Cell-Autonomous and Nonautonomous Mechanisms [Research Brief]
Autophagy has been shown to be elevated in pancreatic ductal adenocarcinoma (PDAC), and its role in promoting established tumor growth has made it a promising therapeutic target. However, due to limitations of prior mouse models as well as the lack of potent and selective autophagy inhibitors, the ability to fully assess the mechanistic basis of how autophagy supports pancreatic cancer has been limited. To test the feasibility of treating PDAC using autophagy inhibition and further our understanding of the mechanisms of protumor effects of autophagy, we developed a mouse model that allowed the acute and reversible inhibition of autophagy. We observed that autophagy inhibition causes significant tumor regression in an autochthonous mouse model of PDAC. A detailed analysis of these effects indicated that the tumor regression was likely multifactorial, involving both tumor cell–intrinsic and host effects. Thus, our study supports that autophagy inhibition in PDAC may have future utility in the treatment of pancreatic cancer and illustrates the importance of assessing complex biological processes in relevant autochthonous models.
Significance: This work demonstrates that autophagy is critical pancreatic tumor maintenance through tumor cell–intrinsic and –extrinsic mechanisms. These results have direct clinical relevance to ongoing clinical trials as well as drug-development initiatives. Cancer Discov; 8(3); 276–87. ©2018 AACR.
See related commentary by Noguera-Ortega and Amaravadi, p. 266.
This article is highlighted in the In This Issue feature, p. 253
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In This Issue [In This Issue]
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Expressed Gene Fusions as Frequent Drivers of Poor Outcomes in Hormone Receptor-Positive Breast Cancer [Research Articles]
We sought to uncover genetic drivers of hormone receptor–positive (HR+) breast cancer, using a targeted next-generation sequencing approach for detecting expressed gene rearrangements without prior knowledge of the fusion partners. We identified intergenic fusions involving driver genes, including PIK3CA, AKT3, RAF1, and ESR1, in 14% (24/173) of unselected patients with advanced HR+ breast cancer. FISH confirmed the corresponding chromosomal rearrangements in both primary and metastatic tumors. Expression of novel kinase fusions in nontransformed cells deregulates phosphoprotein signaling, cell proliferation, and survival in three-dimensional culture, whereas expression in HR+ breast cancer models modulates estrogen-dependent growth and confers hormonal therapy resistance in vitro and in vivo. Strikingly, shorter overall survival was observed in patients with rearrangement-positive versus rearrangement-negative tumors. Correspondingly, fusions were uncommon (<5%) among 300 patients presenting with primary HR+ breast cancer. Collectively, our findings identify expressed gene fusions as frequent and potentially actionable drivers in HR+ breast cancer.
Significance: By using a powerful clinical molecular diagnostic assay, we identified expressed intergenic fusions as frequent contributors to treatment resistance and poor survival in advanced HR+ breast cancer. The prevalence and biological and prognostic significance of these alterations suggests that their detection may alter clinical management and bring to light new therapeutic opportunities. Cancer Discov; 8(3); 336–53. ©2017 AACR.
See related commentary by Natrajan et al., p. 272.
See related article by Liu et al., p. 354.
This article is highlighted in the In This Issue feature, p. 253
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People [News in Brief]
Chi Van Dang, MD, PhD, and Elizabeth Barrett, MBA, are featured.
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Enhancer-Driven Gene Expression Changes Facilitate Metastasis [Osteosarcoma]
Altered enhancer activity allows for dynamic gene expression to promote osteosarcoma metastasis.
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Advancing Cancer Screening with Liquid Biopsies [News in Brief]
A new liquid biopsy technique, CancerSEEK, that evaluates tumor mutations and cancer-linked proteins can detect 70% of cancers in patients who have one of eight tumor types. The technique can pinpoint the location of a tumor in 68% of cases. However, its sensitivity drops off at earlier disease stages.
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LXR Agonism Depletes MDSCs to Promote Antitumor Immunity [Immunology]
LXR activation reduces immunosuppressive MDSCs to activate antitumor cytotoxic T cells.
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Novel anatomic variation: heptafurcation of the celiac trunk
Abstract
We report here anatomic variants which were found during a retrospective study of a male patient, 54 years old, evaluated in computed tomography: heptafurcation of the celiac trunk (CT) and bilateral double renal arteries. The seven branches of the heptafurcated CT were the (1) left and (2) right inferior phrenic arteries, the (3) splenic and (4) left gastric artery, the (5) common hepatic artery, further sending off the (a) proper, continued as left, hepatic artery and (b) the gastroduodenal artery, (6) a replaced right hepatic artery and (7) the dorsal pancreatic artery. To our knowledge, heptafurcation of the CT was not reported previously. The arterial variants have great importance during various surgical and interventional procedures and should be documented prior to respective procedures.
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Preimplantation Genetic Diagnosis of Multiple Endocrine Neoplasia Type 2A Using Informative Markers Identified by Targeted Sequencing
Thyroid , Vol. 0, No. 0.
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The SS18-SSX Oncoprotein Hijacks KDM2B-PRC1.1 to Drive Synovial Sarcoma
Publication date: Available online 1 March 2018
Source:Cancer Cell
Author(s): Ana Banito, Xiang Li, Aimée N. Laporte, Jae-Seok Roe, Francisco Sanchez-Vega, Chun-Hao Huang, Amanda R. Dancsok, Katerina Hatzi, Chi-Chao Chen, Darjus F. Tschaharganeh, Rohit Chandwani, Nilgun Tasdemir, Kevin B. Jones, Mario R. Capecchi, Christopher R. Vakoc, Nikolaus Schultz, Marc Ladanyi, Torsten O. Nielsen, Scott W. Lowe
Synovial sarcoma is an aggressive cancer invariably associated with a chromosomal translocation involving genes encoding the SWI-SNF complex component SS18 and an SSX (SSX1 or SSX2) transcriptional repressor. Using functional genomics, we identify KDM2B, a histone demethylase and component of a non-canonical polycomb repressive complex 1 (PRC1.1), as selectively required for sustaining synovial sarcoma cell transformation. SS18-SSX1 physically interacts with PRC1.1 and co-associates with SWI/SNF and KDM2B complexes on unmethylated CpG islands. Via KDM2B, SS18-SSX1 binds and aberrantly activates expression of developmentally regulated genes otherwise targets of polycomb-mediated repression, which is restored upon KDM2B depletion, leading to irreversible mesenchymal differentiation. Thus, SS18-SSX1 deregulates developmental programs to drive transformation by hijacking a transcriptional repressive complex to aberrantly activate gene expression.
Graphical abstract
Teaser
Banito et al. show that SS18-SSX fusions characteristic of synovial sarcoma associate with KDM2B-PRC1.1, a non-canonical polycomb repressive complex 1, to aberrantly activate the expression of developmentally regulated transcription factors that are normally targets of polycomb-mediated gene repression.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2t8sEH1
ORY-1001, a Potent and Selective Covalent KDM1A Inhibitor, for the Treatment of Acute Leukemia
Publication date: Available online 1 March 2018
Source:Cancer Cell
Author(s): Tamara Maes, Cristina Mascaró, Iñigo Tirapu, Angels Estiarte, Filippo Ciceri, Serena Lunardi, Nathalie Guibourt, Alvaro Perdones, Michele M.P. Lufino, Tim C.P. Somervaille, Dan H. Wiseman, Cihangir Duy, Ari Melnick, Christophe Willekens, Alberto Ortega, Marc Martinell, Nuria Valls, Guido Kurz, Matthew Fyfe, Julio Cesar Castro-Palomino, Carlos Buesa
The lysine-specific demethylase KDM1A is a key regulator of stem cell potential in acute myeloid leukemia (AML). ORY-1001 is a highly potent and selective KDM1A inhibitor that induces H3K4me2 accumulation on KDM1A target genes, blast differentiation, and reduction of leukemic stem cell capacity in AML. ORY-1001 exhibits potent synergy with standard-of-care drugs and selective epigenetic inhibitors, reduces growth of an AML xenograft model, and extends survival in a mouse PDX (patient-derived xenograft) model of T cell acute leukemia. Surrogate pharmacodynamic biomarkers developed based on expression changes in leukemia cell lines were translated to samples from patients treated with ORY-1001. ORY-1001 is a selective KDM1A inhibitor in clinical trials and is currently being evaluated in patients with leukemia and solid tumors.
Teaser
Maes et al. develop ORY-1001, a highly potent and selective inhibitor of KDM1A/LSD1. ORY-1001 induces differentiation of leukemic cells in cell lines, primary AML samples, and AML patients. ORY-1001 is able to decrease leukemic growth and prolong survival of mouse models of acute leukemia.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2FKyMIm
Validation of a Novel Clinical Score: The Rostock Functional and Cosmetic Cranioplasty Score
Journal of Neurotrauma , Vol. 0, No. 0.
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Rho Inhibitor VX-210 in Acute Traumatic Subaxial Cervical Spinal Cord Injury: Design of the SPinal Cord Injury Rho INhibition InvestiGation (SPRING) Clinical Trial
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Perceived Injustice and Its Correlates after Mild Traumatic Brain Injury
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Commentary on Jenny et al., “Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation”
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Motor Function in Former Professional Football Players with History of Multiple Concussions
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Temporal Trends in Functional Outcomes after Severe Traumatic Brain Injury: 2006–2015
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Rodent Neural Progenitor Cells Support Functional Recovery after Cervical Spinal Cord Contusion
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A Retrospective Study of Predictors of Return to Duty versus Medical Retirement in an Active Duty Military Population with Blast-Related Mild Traumatic Brain Injury
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The PanCareSurFup cohort of 83,333 five-year survivors of childhood cancer: a cohort from 12 European countries
Abstract
Childhood cancer survivors face risks from a variety of late effects, including cardiac events, second cancers, and late mortality. The aim of the pan-European PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies (PanCareSurFup) Consortium was to collect data on incidence and risk factors for these late effects among childhood cancer survivors in Europe. This paper describes the methodology of the data collection for the overall PanCareSurFup cohort and the outcome-related cohorts. In PanCareSurFup 13 data providers from 12 countries delivered data to the data centre in Mainz. Data providers used a single variable list that covered all three outcomes. After validity and plausibility checks data was provided to the outcome-specific working groups. In total, we collected data on 115,596 patients diagnosed with cancer from 1940 to 2011, of whom 83,333 had survived 5 years or more. Due to the eligibility criteria and other requirements different numbers of survivors were eligible for the analysis of each of the outcomes. Thus, 1014 patients with at least one cardiac event were identified from a cohort of 39,152 5-year survivors; for second cancers 3995 survivors developed at least one second cancer from a cohort of 71,494 individuals, and from the late mortality cohort of 79,441 who had survived at least 5 years, 9247 died subsequently. Through the close cooperation of many European countries and the establishment of one central data collection and harmonising centre, the project succeeded in generating the largest cohort of children with cancer to date.
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A Novel Transcranial Magnetic Stimulator for Focal Stimulation of Rodent Brain
Source:Brain Stimulation
Author(s): Qinglei Meng, Li Jing, Jean Paul Badjo, Xiaoming Du, Elliot Hong, Yihong Yang, Hanbing Lu, Fow-Sen Choa
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Novel anatomic variation: heptafurcation of the celiac trunk
Abstract
We report here anatomic variants which were found during a retrospective study of a male patient, 54 years old, evaluated in computed tomography: heptafurcation of the celiac trunk (CT) and bilateral double renal arteries. The seven branches of the heptafurcated CT were the (1) left and (2) right inferior phrenic arteries, the (3) splenic and (4) left gastric artery, the (5) common hepatic artery, further sending off the (a) proper, continued as left, hepatic artery and (b) the gastroduodenal artery, (6) a replaced right hepatic artery and (7) the dorsal pancreatic artery. To our knowledge, heptafurcation of the CT was not reported previously. The arterial variants have great importance during various surgical and interventional procedures and should be documented prior to respective procedures.
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CME Accreditation Page
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Forthcoming Issues
Global Health in Otolaryngology
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The Stapes Prosthesis
Since the original carved Teflon stapes over vein graft, stapedectomy prostheses have undergone evolution. Prostheses shapes, materials, and surgical techniques for placement have reflected advances in biomaterials and surgical tools. The variability in prostheses has reflected alternative techniques of stapedectomy and stapedotomy and differing strategies for attachment to the incus. Although many iterations of stapes prostheses have been proposed, excellent results can be achieved with various prostheses designed to rest on tissue grafts in stapedectomy techniques or pass through the footplate in stapedotomy techniques when used by surgeons experienced with technique details specific to the selected prosthesis.
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Otosclerosis
Over the past several years, with the evolution of genetic and molecular research, several etiologic factors have been implicated in the pathogenesis of otosclerosis. Overall, current evidence suggests that otosclerosis is a complex disease with a variety of potential pathways contributing to the development of abnormal bone remodeling in the otic capsule. These pathways involved in the pathogenesis of otosclerosis are influenced by both genetic and environmental factors.
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Copyright-Page
Elsevier
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History of Otosclerosis and Stapes Surgery
The current advancements in otosclerosis therapy cannot be fully appreciated without studying the history, rediscovery, and modification of a once-forgotten procedure. The evolution of stapes surgery can be best summarized into 4 noteworthy eras: the preantibiotic era (which was forgotten and then rediscovered), the fenestration era (mainstreamed by Julius Lempert), the mobilization era (led by Samuel Rosen), and the modern stapedectomy era (revived and revolutionized by John Shea). Each era is unique with its own challenges and ingenious techniques to overcome what used to be among the leading causes of deafness.
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Otosclerosis and Stapes Surgery
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA
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Advanced Otosclerosis
Diagnosis and treatment of advanced otosclerosis can be controversial. In 1961, House and Sheehy defined advanced otosclerosis as hearing loss in air conduction threshold by 85 dB with nonmeasurable bone conduction. Recently, the definition of advanced otosclerosis is mostly based on the decrease of speech recognition. There are some treatment modalities: stapes surgery and hearing aids, cochlear implantation, or direct acoustic cochlear implant. The authors propose a new algorithm for treatment. If the patient is treated with cochlear implantation, the surgeon should be cautious for facial nerve stimulation after surgery because it is the most prevalent complication.
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Medical Management of Otosclerosis
Otosclerosis/otospongiosis is a primary osteodystrophy of the otic capsule that affects genetically predisposed individuals and leads to progressive hearing loss. Diagnosis is usually clinical, based on the findings of anamnesis, physical examination, and audiometric evaluation. However, high-resolution computed tomography scan and MRI have played an important role in the diagnosis and therapeutic approach of otosclerosis and in assisting in the differential diagnosis. The therapeutic approach is aimed at preventing, or at least minimizing, disease progression while attempting to restore hearing. The use of sodium fluoride and bisphosphonates can be an important adjunct, perhaps even primary treatment, in managing active lesions.
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Use of Lasers in Otosclerosis Surgery
Lasers were introduced as an atraumatic modality for accomplishing several of the crucial steps in otosclerosis surgery. Advances in laser technology have spurred coevolution of refinements in the technique of the operation. Several varieties of laser systems are available to suit individual preference and to augment a surgeon's armamentarium; however, a clear advantage in terms of surgical outcome or patient safety remains to be demonstrated.
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Revision Surgery for Otosclerosis
This article is an overview of the care of patients requiring revision surgery for otosclerosis. Preoperative evaluation of the patient including surgical history, audiologic results, and physical findings is discussed, and the causes of failure of primary surgery are reviewed. A discussion of evidence-based surgical technique and postoperative care then follows.
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Contributors
SUJANA S. CHANDRASEKHAR, MD
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Impulse control disorders in Parkinson’s disease patients with RLS: a cross sectional-study
Source:Sleep Medicine
Author(s): Ana Marques, Michela Figorilli, Bruno Pereira, Philippe Derost, Berengere Debilly, Patricia Beudin, Tiphaine Vidal, Franck Durif, Maria Livia Fantini
BackgroundAlthough dopamine replacement therapy is the main risk factor for the occurrence of Impulse Control Disorders (ICDs) in Parkinson's disease (PD), non-pharmacological risk factors for have also been identified in that population and sleep disorders could be part of them. Our objective is to determine whether Restless Legs Syndrome (RLS), that has been associated with more impulsive choices in general population regardless of dopaminergic therapy, could be associated with a specific psycho-behavioral profile and ICDs in PD.Methodseighty consecutive PD patients were screened for the presence of RLS in a cross-sectional study. Sleep features were evaluated during one video-polysomnography. The frequency of ICDs, according to standard criteria, together with a broad range of psycho-behavioral features using the Ardouin Scale of Behavior in PD, were compared in patients with RLS (PD-RLS, n=30) versus without RLS (PD-nRLS, n=50).ResultsPD patients with RLS reported significantly more ICDs than those without RLS (50% versus 26%, p=0.03), especially compulsive eating disorders, and a different psycho-behavioral profile with more hyperdopaminergic behaviors. There was no between group difference for total and dopamine agonists levodopa equivalent doses. However, age and durations of both disease and dopaminergic treatment were greater in the RLS group. Multivariate and propensity score analyses controlling for age, gender, total sleep time, disease severity, dose and duration of treatment, anxiety and depression showed that RLS was an independent predictor of ICDs in PD (OR=5.91 [1.63;22.1] and OR=2.89 [1.63;6.67] respectively).ConclusionRLS per se could be a risk factor for impulsive behaviors in PD.
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Open access: Is there a predator at the door?
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Naive and effector B-cell subtypes are increased in chronic rhinosinusitis with polyps
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Headaches and facial pain in rhinology
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Assessing the onset of allergic rhinitis by nasal cytology and immunoglobulin E antibody levels in children
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Optimal cutoff values of allergen-specific immunoglobulin E to house dust mites and animal dander based on skin-prick test results: Analysis in 16,209 patients with allergic rhinitis
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Oral allergy syndrome
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How often is sinus surgery performed for chronic rhinosinusitis with versus without nasal polyps?
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Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series
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Comparison between endoscopic and external dacryocystorhinostomy by using the Lacrimal Symptom Questionnaire: A pilot study
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Extent of surgery in endoscopic transsphenoidal skull base approaches and the effects on sinonasal morbidity
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Use of intraoperative negative margins reduces inverted papilloma recurrence
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Using the nasoseptal flap for reconstruction after endoscopic debridement of radionecrosis in nasopharyngeal carcinoma
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Esthetic nasolabial angle according to the degree of upper lip protrusion in an Asian population
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Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients.
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Expanding the phenotypic spectrum of type III GM1 gangliosidosis: Progressive dystonia with auditory startle
Neurology India 2018 66(7):149-150
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Interleaving pallidal deep brain stimulation improves the degree of benefit obtained in a patient with dystonia
Neurology India 2018 66(7):138-141
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Belly dancer's dyskinesia: A rare movement disorder
Neurology India 2018 66(7):156-157
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The rise of movement disorders
Neurology India 2018 66(7):10-11
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Classification of movement disorders: The problem of terminology
Neurology India 2018 66(7):12-14
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Hemimyoclonus: A rare presentation of hemimegalencephaly
Neurology India 2018 66(7):142-145
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Parkinsonian syndromes: A review
Neurology India 2018 66(7):15-25
Since James Parkinson published his remarkable clinical observations in the "An Essay On The Shaking Palsy" in 1817, the number of diseases included in the spectrum of parkinsonian syndromes (a group of diseases that have some part of their clinical features resembling those seen in Parkinson's disease), are growing. Careful history taking, comprehensive neurological examination, and utilization of proper investigations will lead the physicians to make an accurate diagnosis of the specific disease entity present. In this recent review, we cover the issue of classification of parkinsonian syndromes, and comprehensively review the characteristic features of the commonly encountered diseases that present with this syndrome. The salient aspects of the epidemiology, key clinical features, proper investigations, and possible treatment options of these diseases have also been addressed.
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Does cerebral infarction ameliorate essential tremor? A mini-review
Neurology India 2018 66(7):152-154
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Parkinson's disease: A review
Neurology India 2018 66(7):26-35
Parkinson's disease is a common movement disorder seen in neurological practice, but the diagnosis and management is challenging. The diagnosis is clinical and sometimes difficult, considering a large number of motor and non-motor symptoms in PD patients. The medical management of PD patients is difficult, as choices of drugs are limited and levodopa is the mainstay of treatment. However, levodopa-induced dyskinesia (LID) is commonly seen in Parkinson's disease patients treated with levodopa. This side effect is usually encountered after a long duration of treatment, but occasionally, this may be seen even after a few days or months of treatment. Different types of surgical approaches, including unilateral pallidotomy and deep brain stimulation, have given very good results in PD patients, who cannot be managed by medications alone.
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The cover page
Neurology India 2018 66(7):1-2
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Tremor syndromes: A review
Neurology India 2018 66(7):36-47
Among the involuntary movement disorders, tremor is a common phenomenology seen in clinical practice. The important factors that need to be determined while assessing a patient with tremor include the phenomenology of tremor, presence or absence of other neurologic signs, and the effect of medications or alcohol. Tremor can broadly be classified based on the circumstances under which it occurs, i.e., rest or action. The basal ganglia-cerebello-thalamic and dentate-olivary circuits are involved in the generation of tremor. Experimental data have suggested the olivocerebellar system as the site of the central oscillator in essential tremor. Generation of tremor in Parkinson's disease results from loss of dopaminergic neurons of the retrorubral area causing dysfunction of the globus pallidus, which finally leads to abnormal firing pattern of the ventrolateral posterior neurons of the thalamus. Involvement of the cerebello-thalamic pathways leads to orthostatic tremor. Palatal tremor is thought to be generated by the cells of the inferior olive. Holmes tremor usually results from the disruption of the dentate-rubro-thalamic circuit and also the nigro-striatal circuit. Multiple drugs can cause tremors. Demyelinating neuropathies are associated with tremors. Involvement of the deep cerebellar nuclei, cerebellar outflow tracts and the cerebrocerebellar loops has been postulated in the cerebellar tremor production. Electrophysiological methods are valuable in characterizing tremors. In addition to the pharmacological therapy including botulinum toxin therapy, surgical therapies in form of DBS or lesional surgeries are beneficial in reducing the symptoms.
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Dystonia: A review
Neurology India 2018 66(7):48-58
Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions that cause abnormal repetitive movements, abnormal postures, or both. The new consensus classifies dystonia into two axes to characterize clinical characteristics, and etiology. This system allows correct identification of isolated and combined forms of dystonia and retains the description of generalized and focal dystonia which is very useful in planning investigations and management. The characterization of dystonia for its better identification and a brief overview of its management are discussed in this article. The treatment options for dystonia include drugs, botulinum toxin and deep brain stimulation surgery.
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Implications of secondary unresponsiveness to dopaminergic drugs with preserved response to subthalamic nucleus stimulation in Parkinson's disease
Neurology India 2018 66(7):135-137
Improvement in motor symptoms with levodopa is one of the hallmark features of Parkinson's disease (PD). The response to levodopa may reduce during the course of the illness. Few studies have also reported reduced response to levodopa in patients with PD several years after deep brain stimulation (DBS) of the subthalamic nucleus (STN) on both the sides. In this study, we report an extreme unresponsiveness to levodopa in the presence of a good response to STN stimulation in a patient 5 years after the DBS proceudre had been carried out. The implications of this phenomenon are also discussed.
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Pediatric movement disorders
Neurology India 2018 66(7):59-67
Pediatric movement disorders are commonly encountered clinical entities in the pediatric outpatient department. These disorders are a heterogenous group of disorders and may represent an underlying genetic disorder, a metabolic disorder or a hypoxic–ischemic insult during the perinatal period. Hyperkinetic movement disorders are more common as compared to hypokinetic disorders. This is unlike the situation in adult movement disorders where hypokinetic disorders are more often seen. A child's nervous system is more prone to hypoxic-ischemic insults due to its higher metabolic demands and the presence of an immature blood-brain barrier. The commonest movement disorders seen are tics, dystonia and chorea. Myoclonus is commonly associated with epilepsy syndromes. The aetiology of paediatric movement disorders depends on their course, their static or progressive nature, and whether an isolated symptom or an association with other neurological symptoms is present. The clue to the diagnosis is the proper recognition of the movement prevalent in the disorder.
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Comparative Study of Management of BPPV (Benign Paroxysmal Positional Vertigo) with only Drugs Versus Drugs Plus Epley Manoeuvre
Abstract
Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, accounting for 20% of all vertigo cases. Idiopathic BPPV is most common between the ages of 50 and 70, although the condition is found in all age groups. The importance of early diagnosis and treatment can lead to a much improved quality of life for patients afflicted by this ailment. It is presently common for physicians to treat these patients mainly with benzodiazepines, antihistamines, and anticholinergic medications, especially if the history and physical is consistent with BPPV. This method of treatment has had questionable success. Several reviews of the management of vertigo have shown that no medication in current use has well established curative or prophylactic value or is suitable for long-term treatment. Epleys manoeuvre is also used in the treatment of BPPV. This manoeuvre relocates free floating particles from the affected semi-circular canals back into utricle, thus relieving the symptoms of vertigo. The purpose of this study is to compare the efficacy of Epleys manoeuvre with conventional drug therapy versus conventional therapy alone in patients who present with vertigo. The purpose of this study to evaluate and examine two methods of treatment.
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Antibody-Mediated Encephalitis
Antibody-mediated encephalitides constitute a group of inflammatory brain diseases that are characterized by prominent neuropsychiatric symptoms and are associated with antibodies against neuronal cell-surface proteins, ion channels, or receptors (Table 1). Common clinical features include a change…
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HER2 deregulation in lung cancer: right time to adopt an orphan?
HER2-deregulated non-small cell lung cancer is an orphan of any specific therapy probably because of lack of both accurate patient selection and effective drugs. Recent evidence suggested that osimertinib could be effective in HER2 amplified or mutated lung cancer as a single agent or in combination.
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The RNA-binding protein MEX3B mediates resistance to cancer immunotherapy by downregulating HLA-A expression
Purpose: Cancer immunotherapy has shown promising clinical outcomes in many patients. However, some patients still fail to respond, and new strategies are needed to overcome resistance. The purpose of this study was to identify novel genes and understand the mechanisms that confer resistance to cancer immunotherapy. Experimental Design: To identify genes mediating resistance to T cell killing, we performed an open reading frame (ORF) screen of a kinome library to study whether overexpression of a gene in patient-derived melanoma cells could inhibit their susceptibility to killing by autologous Tumor-Infiltrating Lymphocytes (TILs). Results: The RNA-binding protein MEX3B was identified as a top candidate that decreased the susceptibility of melanoma cells to killing by TILs. Further analyses of anti-PD-1-treated melanoma patient tumor samples suggested that higher MEX3B expression is associated with resistance to PD-1 blockade. In addition, significantly decreased levels of IFN were secreted from TILs incubated with MEX3B-overexpressing tumor cells. Interestingly, this phenotype was rescued upon overexpression of exogenous HLA-A2. Consistent with this, we observed decreased HLA-A expression in MEX3B-overexpressing tumor cells. Finally, luciferase reporter assays and RNA-binding protein immunoprecipitation assays suggest that this is due to MEX3B binding to the 3' UTR of HLA-A to destabilize the mRNA. Conclusions: MEX3B mediates resistance to cancer immunotherapy by binding to the 3' UTR of HLA-A to destabilize the HLA-A mRNA and thus downregulate HLA-A expression on the surface of tumor cells, thereby making the tumor cells unable to be recognized and killed by T cells.
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Copyright
Source:Anesthesiology Clinics, Volume 36, Issue 1
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Contributors
Source:Anesthesiology Clinics, Volume 36, Issue 1
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Contents
Source:Anesthesiology Clinics, Volume 36, Issue 1
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Forthcoming Issues
Source:Anesthesiology Clinics, Volume 36, Issue 1
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Improving Perioperative Care: What Are the Tools That Lead to Sustainable Change?
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Lee A. Fleisher
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Quality Improvement and Implementation Science
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Meghan B. Lane-Fall, Lee A. Fleisher
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Quality Improvement and Implementation Science: Different Fields with Aligned Goals
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Meghan B. Lane-Fall, Lee A. Fleisher
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Implementation Science in Perioperative Care
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Meghan B. Lane-Fall, Benjamin T. Cobb, Crystal Wiley Cené, Rinad S. Beidas
Teaser
There is a 17-year gap between the initial publication of scientific evidence and its uptake into widespread practice in health care. The field of implementation science (IS) emerged in the 1990s as an answer to this "evidence-to-practice gap." In this article, we present an overview of implementation science, focusing on the application of IS principles to perioperative care. We describe opportunities for additional training and discuss strategies for funding and publishing IS work. The objective is to demonstrate how IS can improve perioperative patient care, while highlighting perioperative IS studies and identifying areas in need of additional investigation.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2HWFCLB
Human Factors Applied to Perioperative Process Improvement
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Joseph R. Keebler, Elizabeth H. Lazzara, Elizabeth Blickensderfer, Thomas D. Looke
Teaser
This article discusses some of the major theories of the science of human factors/ergonomics (HF/E) in relation to perioperative medicine, with a focus on safety and errors within these systems. The discussion begins with human limitations based in cognition, decision making, stress, and fatigue. Given these limitations, the importance of measuring human performance is discussed. Finally, using the HF/E perspective on safety, high-level recommendations are provided for increasing safety within the perioperative environment.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2oJeRkV
Quality Improvement in Anesthesiology — Leveraging Data and Analytics to Optimize Outcomes
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Elizabeth A. Valentine, Scott A. Falk
Teaser
Quality improvement is at the heart of practice of anesthesiology. Objective data are critical for any quality improvement initiative; when possible, a combination of process, outcome, and balancing metrics should be evaluated to gauge the value of an intervention. Quality improvement is an ongoing process; iterative reevaluation of data is required to maintain interventions, ensure continued effectiveness, and continually improve. Dashboards can facilitate rapid analysis of data and drive decision making. Large data sets can be useful to establish benchmarks and compare performance against other providers, practices, or institutions. Audit and feedback strategies are effective in facilitating positive change.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2HZ0u4D
Emergency Manuals
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Sara N. Goldhaber-Fiebert, Carl Macrae
Teaser
How can teams manage critical events more effectively? There are commonly gaps in performance during perioperative crises, and emergency manuals are recently available tools that can improve team performance under stress, via multiple mechanisms. This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2oI6DcP
Use of Simulation in Performance Improvement
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Amanda Burden, Erin White Pukenas
Teaser
Human error and system failures continue to play a substantial role in preventable errors that lead to adverse patient outcomes or death. Many of these deaths are not the result of inadequate medical knowledge and skill, but occur because of problems involving communication and team management. Anesthesiologists pioneered the use of simulation for medical education in an effort to improve physician performance and patient safety. This article explores the use of simulation for performance improvement. Educational theories that underlie effective simulation programs are described as driving forces behind the advancement of simulation in performance improvement.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2HTh7ih
Handovers in Perioperative Care
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Atilio Barbeito, Aalok V. Agarwala, Amanda Lorinc
Teaser
Handovers around the time of surgery are common, yet complex and error prone. Interventions aimed at improving handovers have shown increased provider satisfaction and teamwork, improved efficiency, and improved communication and have been shown to reduce errors and improve clinical outcomes in some studies. Common recommendations in the literature include a standardized institutional process that allows flexibility among different units and settings, the completion of urgent tasks before information transfer, the presence of all members of the team for the duration of the handover, a structured conversation that uses a cognitive aid, and education in team skills and communication.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2HUXKoS
Rethinking Clinical Workflow
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Joseph J. Schlesinger, Kendall Burdick, Sarah Baum, Melissa Bellomy, Dorothee Mueller, Alistair MacDonald, Alex Chern, Kristin Chrouser, Christie Burger
Teaser
The concept of clinical workflow borrows from management and leadership principles outside of medicine. The only way to rethink clinical workflow is to understand the neuroscience principles that underlie attention and vigilance. With any implementation to improve practice, there are human factors that can promote or impede progress. Modulating the environment and working as a team to take care of patients is paramount. Clinicians must continually rethink clinical workflow, evaluate progress, and understand that other industries have something to offer. Then, novel approaches can be implemented to take the best care of patients.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2oHvz3S
Developing Capacity to Do Improvement Science Work
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Irene McGhee, Yehoshua Gleicher
Teaser
Developing capacity to do improvement science starts with prioritizing quality improvement training in all health professions curricula so that a common knowledge base and understanding are created. Educational programs should include opportunities for colearning with patients, health professionals, and leaders. In this way, knowledge translation (also called implementation) is more effective and better coordinated when applied across organizations. Key factors that enable and drive behavior change are reviewed, as is the importance of influence and leadership. A comprehensive approach that accounts for these factors hardwires quality improvement into the health care systems and creates a culture that enables its ongoing development.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2HVsfLq
Diffusing Innovation and Best Practice in Health Care
Publication date: March 2018
Source:Anesthesiology Clinics, Volume 36, Issue 1
Author(s): Philip E. Greilich, Mary Eleanor Phelps, William Daniel
Teaser
Diffusing innovation and best practices in healthcare are among the most challenging aspects of advancing patient safety and quality improvement. Recommendations from the Baldrige Foundation, Institute for Healthcare Improvement, and The Joint Commission provide guidance on the principles for successful diffusion. Perioperative leaders are encouraged to applying these principles to high priority areas such as handovers, enhanced recovery and patient blood management. Completing a successful pilot project can be exciting, however, effective diffusion is essential to achieving meaningful and lasting impact on the service line and health system.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2oJeDKB
Impact of 68 Ga-PSMA-PET imaging on target volume definition and guidelines in radiation oncology - a patterns of failure analysis in patients with primary diagnosis of prostate cancer
Abstract
Background
68Ga-PSMA-PET-imaging has proven to be a highly sensitive and specific diagnostic element for patients with prostate cancer (PC). Does the standard clinical target volume (CTV) cover the majority of 68Ga-PSMA-PET detected lymph nodes (LNs) in a primary setting?
Methods
25 out of 159 patients with primary PC who underwent 68Ga-PSMA-PET-imaging were analyzed in the process of this study. These 25 high-risk patients had a total of 126 LNs with positive 68Ga-PSMA-ligand uptake. A standard CTV according to the 'Radiation Therapy Oncology Group' consensus was delineated and LNs were judged whether they were in- or outside of this target volume. With a Pearson correlation we additionally evaluated whether the Gleason score, the prostate-specific antigen (PSA) value or the risk according to the Roach formula correlate with a higher chance of LNs being outside of the CTV in uncommon LN locations.
Results
81 (64.3%) of 126 LNs were covered by the CTV with a complete coverage of all positive LNs inside the respective radiation volume in 11 of 25 patients (44%). LNs that were not covered by the CTV included (para-aortic,) common-iliac, pre-sacral, obturatoric, para-rectal, para-vesical and pre-acetabular locations. In a statistical analysis neither the Gleason score, nor the PSA value, nor the calculated risk with the Roach formula correlated with LNs being inside or outside of the CTV in this patient group.
Conclusion
68Ga-PSMA-PET-imaging proves to be a valuable asset for patients and physicians for primary diagnosis and treatment planning. In our study, trusting the RTOG consensus for CTV delineation would have led to up to 35.7% of all LNs not to be included in the clinical radiation volume, which might have resulted in insufficient radiation dose coverage.
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ASBA Diplomate Dr. Shad Morris Selected to be Top Sleep Dentist in Former Player Health Screening/Testing at NFLPA’s Annual Meeting
The National Football League Players Association (NFLPA) chose Las Vegas, NV to host its annual meeting for player representatives March 2018. Along with usual discussions of player wages, benefits, and positional elections, the Living Heart Foundation offers a free health screening for former players who attend. Pro Player Health Alliance (PPHA) has covered the sleep/dental component of the screening for many years and has chosen to partner with the Project Rose Sleep Program as of late to provide the sleep testing. Founded by Earl Campbell and Gary Baxter, Project Rose Sleep Program is a premier sleep program that test, treat and do research in the field of sleep for better health and wellness outcomes.
In 2017, more than 100 retired players took advantage of the screening at the NFLPA Annual Meeting where they were assessed for body composition, blood pressure, pulmonary function, hearing, sleep apnea, and more. American Sleep and Breathing Academy (ASBA) Diplomate Dr. Shad Morris, a practicing dentist in Nevada and Utah, has been selected as the head dentist for the screening. Dr. Morris has done an excellent job of treating former players in the past, but this will be his first main event with Living Heart Foundation, NFLPA and Pro Player Health Alliance. He has lectured for the ASBA over the years and built a fine reputation of being one of the most successful sleep dentists in the country with thousands of positive outcomes.
Dr. Ronnie Rosenbaum will be the second ASBA Diplomate helping screen the former players at PPHA's sleep/dental station. Recently, Dr. Rosenbaum was the point dentist at the Pro Bowl Screening in Orlando, FL. He saw over 60 former players and began treatment for over 25 for their sleep apnea.
David Gergen, CEO of PPHA, has said he only selects ASBA Diplomates to participate in the NFLPA/Living Heart Foundation related screenings to ensure the highest quality of treatment. "I have spoken with several physicians over the years and some say, 'I sent the patient to a dentist and it did not work,' and that is because the dentist was not properly trained," says Gergen. "That is why the ASBA is so important. Dentists trained by our doctors know what they are doing—clinically and financially. If you get a dentist who makes an appliance that does not work, it hurts the dental sleep medicine industry as a whole."
The ASBA Annual Meeting, scheduled for April 13-14, 2018, in Las Vegas, NV, is the place to find this knowledge. With a laser-like focus on the business and clinical side of sleep medicine, it is the conference for dentists who are seriously interested in sleep medicine. Ultimately, dentists who are helping many patients, and succeeding financially, are not merely "dabbling" in sleep medicine. Instead, more than 50% of their practices are sleep.
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The breakdown of the Simon effect in cross-modal contexts: EEG evidence
Abstract
In everyday life we often must coordinate information across spatial locations and different senses for action. It is well known, for example, that reactions are faster when an imperative stimulus and its required response are congruent than when they are not, even if stimulus location itself is completely irrelevant for the task (the so-called Simon effect). However, because these effects have been frequently investigated in single modality scenarios, the consequences of spatial congruence when more than one sensory modality is at play are less well known. Interestingly, at a behavioural level, the visual Simon effect vanishes in mixed (visual and tactile) modality scenarios, suggesting that irrelevant spatial information ceases to exert influence on vision. In order to shed some light on this surprising result, here we address the expression of irrelevant spatial information in EEG markers typical of the visual Simon effect (P300, theta power modulation, LRP) in mixed modality contexts. Our results show no evidence for the visual spatial information to affect performance at behavioural and neurophysiological levels. The absence of evidence of the neural markers of visual S-R conflict in the mixed modality scenario implies that some aspects of spatial representations that are strongly expressed in single modality scenarios might be bypassed.
This article is protected by copyright. All rights reserved.
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"Vestn Otorinolaringol"[jour]; +19 new citations
19 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
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Durch das Cochlea-Implantat zum CODA?
Laryngo-Rhino-Otol 2018; 97: 176-180
DOI: 10.1055/s-0044-100741
Die Cochlea-Implantat-Versorgung gehörloser Kinder mit gehörlosen bzw. hochgradig hörgeschädigten Eltern ist möglich. Bereits vor der Operation muss ein tragfähiges (Re-)Habilitationskonzept zur Entwicklung und Förderung des Hör-Sprachprozesses erarbeitet werden. Der Erfolg der Kinder hängt von Vermittlern ab, die die Eltern unterstützen. Die Kinder wachsen zweisprachig auf: Gebärdensprache und Lautsprache. Sie können Schulen für Hörgeschädigte oder allgemeine Schulen für Hörende besuchen.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Dank an die Gutachter
Laryngo-Rhino-Otol 2018; 97: 154-154
DOI: 10.1055/s-0044-101394
Die Laryngo-Rhino-Otologie legt die online eingereichten wissenschaftlichen Manuskripte Experten zur Begutachtung vor. Überwiegend kommen diese Gutachter aus dem Gebiet der Hals-Nasen-Ohrenheilkunde, aber auch aus dem naturwissenschaftlichen Bereich und den klinischen Nachbarfächern. Die Schriftleitung und der Verlag möchten daher den neuen Jahrgang der Zeitschrift nicht beginnen, ohne zuvor allen Gutachtern des letzten Jahres und den Experten, die mit ihren sachkundigen Kommentaren die Rubrik „Referiert und diskutiert" aufwerten, den herzlichsten Dank für ihre Tätigkeit auszusprechen. Zunächst genannt seien die Gutachter, die für ihr besonderes Engagement ausgezeichnet wurden:
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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