Αρχειοθήκη ιστολογίου

Παρασκευή 16 Μαρτίου 2018

Phonak Adds to Its Hearing Aid and Speech Understanding Technologies

Nadia B-R RIC.jpgPhonak has introduced two lithium-ion rechargeable hearing aids geared to the needs of specific patient populations—those with severe to profound hearing loss and children. Now in its fifth generation, Phonak's Naída B, for the first time, offers a rechargeable receiver-in-canal option. Naída B provides the industry's best speech intelligibility index results for those with severe to profound hearing loss, according to the company. Phonak has also added a rechargeable option to its Sky B products, which are designed specifically for children. Sky B-PR gives pediatric patients a full day of uninterrupted hearing on a single charge. Sky B features AutoSense Sky OS and SoundRecover2, which gives children access to a broader range of sounds essential for speech and language development.
 
The company has also launched its new MultiBeam Technology (MBT), the next generation of the Roger 2.4 GHz wireless technology first introduced in 2013. MBT uses three microphones to form six directional beams within 360 degrees. When a microphone with MBT is placed on a table, it automatically selects the speaker to improve speech understanding in group conversations and noisy situations. Powered by MBT are Phonak's Roger Select, which is equipped with three modes (automatic, manual, lapel) to enable wireless hearing in different environments, and Roger Table Mic II, which is ideal for working adults who need to actively participate in meetings. Phonak has also added the Roger Repeater, which extends the operating range of any Roger network in the Roger for Education portfolio and is ideal for school applications like auditoriums and gymnasiums.
 
The Phonak Naída B and Sky B are now available in the United States, with the rest of the world to follow this month. All new Roger products will be available later in spring 2018.
Published: 3/16/2018 12:24:00 PM


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Cellular differentiation, bioactive and mechanical properties of experimental light-curing pulp protection materials

Publication date: Available online 16 March 2018
Source:Dental Materials
Author(s): Salvatore Sauro, Ashvin Babbar, Borzo Gharibi, Victor Pinheiro Feitosa, Ricardo Marins Carvalho, Lidiany Karla Azevedo Rodrigues, Avijit Banerjee, Timothy Watson
ObjectiveMaterials for pulp protection should have therapeutic properties in order to stimulate remineralization and pulp reparative processes. The aim of this study was to evaluate the mechanical properties, biocompatibility, cell differentiation and bioactivity of experimental light-curable resin-based materials containing bioactive micro-fillers.MethodsFour calcium-phosphosilicate micro-fillers were prepared and incorporated into a resin blend: 1) Bioglass 45S5 (BAG); 2) zinc-doped bioglass (BAG-Zn); 3) βTCP-modified calcium silicate (β-CS); 4) zinc-doped β-CS (β-CS-Zn). These experimental resins were tested for flexural strength (FS) and fracture toughness (FT) after 24h and 30-day storage in simulated body fluid (SBF). Cytotoxicity was evaluated using MTT assay, while bioactivity was evaluated using mineralization and gene expression assays (Runx-2 & ALP).ResultsThe lowest FS and FT at 24h was attained with β-CS resin, while all the other tested materials exhibited a decrease in FS after prolonged storage in SBF. β-CS-Zn maintained a stable FT after 30-day SBF aging. Incorporation of bioactive micro-fillers had no negative effect on the biocompatibility of the experimental materials tested in this study. The inclusion of zinc-doped fillers significantly increased the cellular remineralization potential and expression of the osteogenic genes Runx2 and ALP (p<0.05).SignificanceThe innovative materials tested in this study, in particular those containing β-CS-Zn and BAG-Zn may promote cell differentiation and mineralization. Thus, these materials might represent suitable therapeutic pulp protection materials for minimally invasive and atraumatic restorative treatments.

Graphical abstract

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Acetylshikonin from Zicao ameliorates renal dysfunction and fibrosis in diabetic mice by inhibiting TGF-β1/Smad pathway

Abstract

Diabetic nephropathy (DN) is the major cause of end-stage renal disease in diabetic patients. Zicao, a well-known Chinese traditional medicine, has attracted much attention due to its beneficial effects in various medical fields. In this study, we attempted to investigate the effects and mechanisms of action of acetylshikonin, the main ingredient of Zicao, on renal dysfunction in DN. Our results showed that administration with acetylshikonin not only decreased blood urea nitrogen, urine creatinine and the mean kidney-to-body weight ratio in streptozotocin-induced diabetic mice, but also restored the loss of body weight, whereas the blood glucose was not changed. Masson's trichrome staining showed that acetylshikonin treatment resulted in a marked decrease in kidney fibrosis from diabetic mice. The increased expression of fibrosis proteins, such as plasminogen activator inhibitor type 1 (PAI-1), connective tissue growth factor, and collagen III and IV, were reduced after acetylshikonin administration. In addition, the expressions of interleukin-1β, interleukin-6, monocyte chemoattractant protein-1, intercellular adhesion molecule 1 and infiltration of macrophages in kidney tissues were decreased in acetylshikonin-treated diabetic mice. Acetylshikonin led to a reduction of transforming growth factor-β1 (TGF-β1) expression and Smad-2/3 phosphorylation, as accompanied by increased Smad7 expression. Furthermore, in vitro treatment with acetylshikonin markedly attenuated TGF-β1-induced the PAI-1, collagen III and IV, and Smad-2/3 phosphorylation in HK2 immortalized human proximal tubule epithelial cells. Acetylshikonin also prevented epithelial-to-mesenchymal transition induced by TGF-β1. Collectively, our study provides evidences that acetylshikonin attenuates renal fibrosis though inhibiting TGF-β1/Smad signaling pathway, suggesting that acetylshikonin may be a novel therapeutic agent for the treatment of DN.



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Is Acoustic Radiation Force Impulse (ARFI) Ultrasound Elastography Valuable in the Assessment of Cervical Lymphadenopathy?

Abstract

Cervical lymphadenopathy frequently poses a diagnostic challenge as neither clinical nor imaging assessment can reliably differentiate between benign and malignant lymphadenopathy. Non-invasive differentiation between the two may help to reduce the number of FNAC or biopsy. The purpose of this study was to evaluate whether the new ARFI technique (Virtual Touch Quantification), in conjunction with gray scale sonography and Doppler, can help in the characterization and differentiation of benign from malignant cervical lymphadenopathy. Fifty adult patients with cervical lymphadenopathy were included in the study and sonoelastography was done. Sonoelastographic findings were compared to the gold standard histopathology or cytopathology. ARFI measurements in benign and malignant enlarged lymph nodes were compared using the Student t test and ROC curve was used to arrive at the Youden index, sensitivity, specificity, PPV, NPV and diagnostic accuracy. Sonographic patterns indicative of malignancy includes heterogenous echopattern, short axis/long axis ratio > 0.5, absent echogenic fatty hilum and mixed vascular pattern. Sensitivity, specificity, PPV, NPV and accuracy in differentiation between the benign and malignant lymph nodes using ARFI elastography was 79.17, 100, 100, 83.9 and 89.9% respectively. ROC curve analysis of SWVs for differentiation between the malignant and benign lymph nodes gave a cut-off value of 2.8 m/s with an area under curve of 0.892. ARFI imaging technique quantifies the tissue stiffness of the cervical lymph nodes non-invasively and aids in characterisation and differentiation of benign from malignant cervical lymphadenopathy in conjunction with conventional sonography.



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Cochlear Implantation in Children with Otitis Media

Abstract

One of the concerns during the cochlear implant candidacy process is the presence of chronic otitis media which could delay the implantation process. The aim of this study was to evaluate the surgical difficulties and the long-term complications in children with otitis media and to examine whether it is necessary to delay the implantation until the infection is resolved. The study used a comparative retrospective design based on chart review of all patients who received their implant(s) from January to December of 2012. A total of 200 patients were identified and were followed for 4 years post surgery. Patients were divided into three groups based on their history of otitis media (non-otitis media, chronic otitis media with effusion, and acute otitis media). Data included long-term complications, operative time and duration from first clinical visit to the time until implantation was received. None of study participants had long-term complications during the study period. The operative time was longer in the acute otitis media group with a difference of 45 min. The average delay in cochlear implantation due to the presence of otitis media in chronic group was more than 5 months. Pediatric patients with otitis media could be implanted in one stage safely and effectively.



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Castleman’s Disease: a Suprarenal Surprise!

Abstract

Castleman's disease is a distinct form of lymph node hyperplasia. It commonly presents as a mediastinal mass and rarely as a solitary retroperitoneal mass. We narrate a case of Castleman's disease presenting as a right suprarenal mass emphasising the usefulness of robot-assisted retroperitoneoscopy in surgical management of retroperitoneal masses in close relation to vital structures.



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In Reply to Güngör et al

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Wilma D. Heemsbergen, Ruud C. Wortel, Luca Incrocci, Robert Jan Smeenk, Marnix G. Witte, Floris J. Pos, Stijn Krol




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2018 Red Journal Conflicts of Interest and Photographs

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5





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In Regard to Cahlon et al

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Jee Suk Chang, Yong Bae Kim, Jaeyong Shin




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Locally Advanced Lung Cancer: Is It Time to Take Cardiac Protection Seriously in Radiation Planning?

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): James J. Urbanic, Ronald C. McGarry, Megan E. Daly, David A. Palma




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In Reply to Ong et al

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): David D. Yang, Paul L. Nguyen




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Live to SABR Another Day?

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Phuoc T. Tran, Felix Feng, Piet Ost




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Androgen Deprivation Fortified

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Prateek Mendiratta, Jorge Garcia




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Issue Highlights

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5





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Apply an Oligometastatic Paradigm for Nodal Recurrence

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Daniel Song




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…of Radiation Oncology, Biology, and Physics

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Jay W. Burmeister, Monica W. Tracey, Sara E. Kacin, Michael M. Dominello, Michael C. Joiner




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In Reply to Hamstra

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Stephen A. Rosenberg, Kristin A. Bradley, Randall J. Kimple




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In Reply to Garden

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): David M. Routman, Robert L. Foote, Daniel J. Ma, Samir H. Patel, Michael L. Hinni




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Erratum to: Mahmood J, Connors CQ, Alexander AA, et al. Cavernous nerve injury by radiation therapy may potentiate erectile dysfunction in rats. Int J Radiat Oncol Biol Phys 2017;99:680-688.

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5





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Comparison of 36 Gy, 20 Gy, or No Radiation Therapy After 6 Cycles of EBVP Chemotherapy and Complete Remission in Early-Stage Hodgkin Lymphoma Without Risk Factors: Results of the EORT-GELA H9-F Intergroup Randomized Trial

Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): José Thomas, Christophe Fermé, Evert M. Noordijk, Franck Morschhauser, Théodore Girinsky, Isabelle Gaillard, Pieternella J. Lugtenburg, Marc André, Marnix L.M. Lybeert, Aspasia Stamatoullas, Max Beijert, Philippe Hélias, Houchingue Eghbali, Jean Gabarre, Richard W.M. van der Maazen, Jérôme Jaubert, Krimo Bouabdallah, Olivier Boulat, Judith M. Roesink, Bernard Christian, Francisca Ong, Dominique Bordessoule, Gérard Tertian, Hugo Gonzalez, Andrej Vranovsky, Philippe Quittet, Umberto Tirelli, Daphne de Jong, Josée Audouin, Berthe M.P. Aleman, Michel Henry-Amar
PurposeWhile patients with early-stage Hodgkin lymphoma (HL) have an excellent outcome with combined treatment, the radiation therapy (RT) dose and treatment with chemotherapy alone remain questionable. This noninferiority trial evaluates the feasibility of reducing the dose or omitting RT after chemotherapy.Methods and MaterialsPatients with untreated supradiaphragmatic HL without risk factors (age ≥ 50 years, 4 to 5 nodal areas involved, mediastinum-thoracic ratio ≥ 0.35, and erythrocyte sedimentation rate ≥ 50 mm in first hour without B symptoms or erythrocyte sedimentation rate ≥ 30 mm in first hour with B symptoms) were eligible for the trial. Patients in complete remission after chemotherapy were randomized to no RT, low-dose RT (20 Gy in 10 fractions), or standard-dose involved-field RT (36 Gy in 18 fractions). The limit of noninferiority was 10% for the difference between 5-year relapse-free survival (RFS) estimates. From September 1998 to May 2004, 783 patients received 6 cycles of epirubicin, bleomycin, vinblastine, and prednisone; 592 achieved complete remission or unconfirmed complete remission, of whom 578 were randomized to receive 36 Gy (n=239), 20 Gy of involved-field RT (n=209), or no RT (n=130).ResultsRandomization to the no-RT arm was prematurely stopped (≥20% rate of inacceptable events: toxicity, treatment modification, early relapse, or death). Results in the 20-Gy arm (5-year RFS, 84.2%) were not inferior to those in the 36-Gy arm (5-year RFS, 88.6%) (difference, 4.4%; 90% confidence interval [CI] −1.2% to 9.9%). A difference of 16.5% (90% CI 8.0%-25.0%) in 5-year RFS estimates was observed between the no-RT arm (69.8%) and the 36-Gy arm (86.3%); the hazard ratio was 2.55 (95% CI 1.44-4.53; P<.001). The 5-year overall survival estimates ranged from 97% to 99%.ConclusionsIn adult patients with early-stage HL without risk factors in complete remission after epirubicin, bleomycin, vinblastine, and prednisone chemotherapy, the RT dose may be limited to 20 Gy without compromising disease control. Omitting RT in these patients may jeopardize the treatment outcome.



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A Randomized, Open-Label, Multicenter, Global Phase 2 Study of Durvalumab (D), Tremelimumab (T), or D Plus T, in Patients With PD-L1 Low/Negative Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: CONDOR

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): L. Siu, C. Even, R. Mesía, A. Daste, J. Krauss, N.F. Saba, L. Nabell, N.E. Ready, I.Brana Garcia, N. Kotecki, D.P. Zandberg, J. Gilbert, H. Mehanna, A. Jarkowski, G. Melillo, J.M. Armstrong, J. Fayette




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OPTIMA—A Phase 2 Trial of Induction Chemotherapy Response-Stratified Radiation Therapy Dose and Volume De-escalation for HPV+ Oropharyngeal Cancer: Efficacy, Toxicity, and HPV Subtype Analysis

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Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): T. Seiwert, J.M. Melotek, C.C. Foster, E.A. Blair, T.G. Karrison, N. Agrawal, L. Portugal, Z. Gooi, K.M. Stenson, R.J. Brisson, S. Arshad, A. Dekker, S. Kochanny, V. Saloura, M.T. Spiotto, V.M. Villaflor, D.J. Haraf, E.E. Vokes




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Management of Borderline Resectable Pancreatic Cancer

Publication date: 1 April 2018
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 100, Issue 5
Author(s): Diego A.S. Toesca, Amanda J. Koong, George A. Poultsides, Brendan C. Visser, Sigurdis Haraldsdottir, Albert C. Koong, Daniel T. Chang
With the rapid development of imaging modalities and surgical techniques, the clinical entity representing tumors that are intermediate between resectable and unresectable pancreatic adenocarcinoma has been identified has been termed "borderline resectable" (BR). These tumors are generally amenable for resection but portend an increased risk for positive margins after surgery and commonly necessitate vascular resection and reconstruction. Although there is a lack of consensus regarding the appropriate definition of what constitutes a BR pancreatic tumor, it has been demonstrated that this intermediate category carries a particular prognosis that is in between resectable and unresectable disease. In order to downstage the tumor and increase the probability of clear surgical margins, neoadjuvant therapy is being increasingly utilized and studied. There is a lack of high-level evidence to establish the optimal treatment regimen for BR tumors. When resection with negative margins is achieved after neoadjuvant therapy, the prognosis for BR tumors approaches and even exceeds that for resectable disease. This review presents the current definitions, different treatment approaches, and the clinical outcomes of BR pancreatic cancer.



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Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members

Journal of Neurotrauma, Ahead of Print.


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BRAF and RAS Mutational Status in Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features and Invasive Subtype of Encapsulated Follicular Variant of Papillary Thyroid Carcinoma in Korea

Thyroid, Ahead of Print.


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A Nomogram Based on the Characteristics of Metastatic Lymph Nodes to Predict Papillary Thyroid Carcinoma Recurrence

Thyroid, Volume 28, Issue 3, Page 301-310, March 2018.


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Mild Maternal Hypothyroxinemia During Pregnancy Induces Persistent DNA Hypermethylation in the Hippocampal Brain-Derived Neurotrophic Factor Gene in Mouse Offspring

Thyroid, Volume 28, Issue 3, Page 395-406, March 2018.


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Acknowledgment of Reviewers

Thyroid, Volume 28, Issue 3, Page 422-426, March 2018.


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Effect of Thyroglobulin Autoantibodies on the Metabolic Clearance of Serum Thyroglobulin

Thyroid, Volume 28, Issue 3, Page 288-294, March 2018.


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Ionizing Radiation Deregulates the MicroRNA Expression Profile in Differentiated Thyroid Cells

Thyroid, Volume 28, Issue 3, Page 407-421, March 2018.


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Future Meetings

Thyroid, Volume 28, Issue 3, Page 427-428, March 2018.


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Clinicopathologic and Prognostic Significance of Programmed Cell Death Ligand 1 Expression in Patients with Non-Medullary Thyroid Cancer: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 3, Page 349-361, March 2018.


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Temporal Trends in the Presentation, Treatment, and Outcome of Medullary Thyroid Carcinoma: An Israeli Multicenter Study

Thyroid, Volume 28, Issue 3, Page 369-376, March 2018.


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Samsum Ant Venom Exerts Anticancer Activity Through Immunomodulation In Vitro and In Vivo

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 65-73, March 2018.


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Current and Future Approaches for Effective Cancer Imaging and Treatment

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 39-51, March 2018.


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PTPN12 Affects Nasopharyngeal Carcinoma Cell Proliferation and Migration Through Regulating EGFR

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 60-64, March 2018.


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64Cu-Labeled Phosphonate Cross-Bridged Chelator Conjugates of c(RGDyK) for PET/CT Imaging of Osteolytic Bone Metastases

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 74-83, March 2018.


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Degree of Functional Impairment Associated With Vestibular Hypofunction Among Older Adults With Cognitive Decline

Objective: Considering the altered multisensory signal compensation during senescence, the aim of the present study was to evaluate the integration rearrangements in unilateral vestibular hypofunction (UVH) during age-related cognitive decline. Study Design: Cross-sectional study. Setting: Longitudinal cohort study unit and of University tertiary referral center. Patients: Older UVH individuals ≥ 55 years with Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) and matched UVH control group with age-appropriate cognitive function. Intervention: Vestibulo-ocular reflex, postural sway examination (respectively performed by means of video head impulse test and static posturography), and dizziness-related and quality of life scores were collected in all three groups of UVH patients cognitively evaluated by means of Mini Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS-cog). Main Outcome Measures: Vestibulo-ocular reflex gain, length, surface, and spectral values of body oscillation were measured. Dizziness Handicap Inventory, Activities-specific Balance Confidence scale, and Dynamic Gait Index scores were collected. Results: A significant (p 

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The molecular mechanism of anticancer action of novel octahydropyrazino[2,1-a:5,4-a′]diisoquinoline derivatives in human gastric cancer cells

Summary

Objective The aim of the current study was to examine the anticancer activity and the detailed mechanism of novel diisoquinoline derivatives in human gastric cancer cells (AGS). Methods The viability of AGS cells was measured by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Cell cycle analysis and apoptosis assay were performed by standard flow cytometric method. Confocal microscopy bioimaging was used to demonstrate the expression of pivotal proteins engaged in apoptosis (caspase-8, caspase-3, p53) and cell signaling (AKT, ERK1/2). Results All compounds decreased the number of viable cells in a dose-dependent manner after 24 and 48 h of incubation, although compound 2 was a more cytotoxic agent, with IC50 values of 21 ± 2 and 6 ± 2 μM, compared to 80 ± 2 and 45 ± 2 μM for etoposide. The cytotoxic and antiproliferative effects of novel compounds were associated with the induction of apoptosis. The highest percentage of early and late apoptotic cells was observed after 48 h of incubation with compound 2 (89.9%). The value was higher compared to compound 1 (20.4%) and etoposide (24.1%). The novel diisoquinoline derivatives decreased the expression of AKT and ERK1/2. Their mechanism was associated with p53-mediated apoptosis, accumulation of cells in the G2/M phase of cell cycle and inhibition of topoisomerase II. Conclusion These data strongly support compound 2 as a promising molecule for treatment of gastric cancer.



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Degree of Functional Impairment Associated With Vestibular Hypofunction Among Older Adults With Cognitive Decline

Objective: Considering the altered multisensory signal compensation during senescence, the aim of the present study was to evaluate the integration rearrangements in unilateral vestibular hypofunction (UVH) during age-related cognitive decline. Study Design: Cross-sectional study. Setting: Longitudinal cohort study unit and of University tertiary referral center. Patients: Older UVH individuals ≥ 55 years with Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) and matched UVH control group with age-appropriate cognitive function. Intervention: Vestibulo-ocular reflex, postural sway examination (respectively performed by means of video head impulse test and static posturography), and dizziness-related and quality of life scores were collected in all three groups of UVH patients cognitively evaluated by means of Mini Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS-cog). Main Outcome Measures: Vestibulo-ocular reflex gain, length, surface, and spectral values of body oscillation were measured. Dizziness Handicap Inventory, Activities-specific Balance Confidence scale, and Dynamic Gait Index scores were collected. Results: A significant (p 

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Non-motor outcomes of subthalamic stimulation in Parkinson's disease depend on location of active contacts

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Publication date: Available online 16 March 2018
Source:Brain Stimulation
Author(s): Haidar Salimi Dafsari, Jan Niklas Petry-Schmelzer, K. Ray-Chaudhuri, Keyoumars Ashkan, Luca Weis, Till A. Dembek, Michael Samuel, Alexandra Rizos, Monty Silverdale, Michael T. Barbe, Gereon R. Fink, Julian Evans, Pablo Martinez-Martin, Angelo Antonini, Veerle Visser-Vandewalle, Lars Timmermann
BackgroundSubthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in Parkinson's disease (PD). Few studies have investigated the influence of the location of neurostimulation on NMS.ObjectiveTo investigate the impact of active contact location on NMS in STN-DBS in PD.MethodsIn this prospective, open-label, multicenter study including 50 PD patients undergoing bilateral STN-DBS, we collected NMSScale (NMSS), NMSQuestionnaire (NMSQ), Hospital Anxiety and Depression Scale (anxiety/depression, HADS-A/-D), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, motor complications, activities of daily living (ADL), and levodopa equivalent daily dose (LEDD) preoperatively and at 6 months follow-up. Changes were analyzed with Wilcoxon signed-rank/t-test and Bonferroni-correction for multiple comparisons. Although the STN was targeted visually, we employed an atlas-based approach to explore the relationship between active contact locations and DBS outcomes. Based on fused MRI/CT-images, we identified Cartesian coordinates of active contacts with patient-specific Mai-atlas standardization. We computed linear mixed-effects models with x-/y-/z-coordinates as independent, hemispheres as within-subject, and test change scores as dependent variables.ResultsNMSS, NMSQ, PDQ-8, motor examination, complications, and LEDD significantly improved at follow-up. Linear mixed-effect models showed that NMS and QoL improvement significantly depended on more medial (HADS-D, NMSS), anterior (HADS-D, NMSQ, PDQ-8), and ventral (HADS-A/-D, NMSS, PDQ-8) neurostimulation. ADL improved more in posterior, LEDD in lateral neurostimulation locations. No relationship was observed for motor examination and complications scores.ConclusionsOur study provides evidence that more anterior, medial, and ventral STN-DBS is significantly related to more beneficial non-motor outcomes.



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The ASA Committee for Neuroanesthesia and Anesthesia Quality Institute: Report for Demographic Patterns for Neurosurgical Anesthesia Practice in the United States

imageNo abstract available

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Neuroanesthesiology Update

imageWe provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, and anesthetic neurotoxicity.

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Neuroanesthesia

No abstract available

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Dexmedetomidine Reduces Perioperative Opioid Consumption and Postoperative Pain Intensity in Neurosurgery: A Meta-analysis

imageBackground: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. Materials and Methods: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery. PubMed, the Web of science, the Cochrane Library, and Scopus were searched. The resulting data were combined to calculate the pooled mean differences (MDs), standard MDs or odds ratios (ORs), and 95% confidence intervals (CIs), as appropriate. Heterogeneity and potential publication bias were assessed. Furthermore, a trial sequential analysis was performed to improve the precision of our findings. Results: A total of 11 published RCTs involving 674 patients undergoing neurosurgery (335 patients, 339 controls) were included in this meta-analysis. There were significant differences in postanesthesia care unit (PACU) visual analog scale scores between the groups (MD=−1.54, 95% CI, −2.33 to 0.75, I2=87%, P=0.0001). In addition, there were significant differences in PACU opioid requirements between the treatment and control groups (standard MD=−0.88, 95% CI, −1.74 to 0.02, I2=91%, P=0.05). Furthermore, intraoperative opioid consumption was significantly reduced in the treatment group (MD=−127.75, 95% CI, −208.62 to 46.89, I2=98%, P=0.002). Conclusions: DEX could reduce perioperative and PACU opioid consumption as well as postoperative pain intensity.

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Patient, Surgeon, and Anesthesiologist Satisfaction: Who has the Priority?

imageNo abstract available

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Injury and Liability Associated With Spine Surgery

imageBackground: Although spine surgery is associated with significant morbidity, the anesthesia liability profile for spine surgery is not known. We examined claims for spine procedures in the Anesthesia Closed Claims Project database to evaluate patterns of injury and liability. Materials and Methods: A retrospective cohort study was performed. Inclusion criteria were anesthesia claims provided for surgical procedures in 2000 to 2014. We compared mechanisms of injury for cervical spine to thoracic or lumbar spine procedures using χ2 and the Fisher exact test. Univariate and multivariate logistic regression analyses were used to determine factors associated with permanent disabling injury in spine surgery claims. Results: The 207 spine procedure (73% thoracic/lumbar; 27% cervical) claims comprised >10% of claims. Permanent disabling injuries to nerves, the spinal cord, and the eyes or visual pathways were more common with spine procedures than in nonspine procedures. Hemorrhage and positioning injuries were more common in thoracic/lumbar spine claims, whereas difficult intubation was more common in cervical spine claims. Multiple logistic regression demonstrated prone positioning (odds ratio=3.50; 95% confidence interval, 1.30-9.43) and surgical duration of ≥4 hours increased the odds of severe permanent injury in spine claims (odds ratio=2.73; 95% confidence interval, 1.11-6.72). Conclusions: Anesthesia claims related to spine surgery were associated with severe permanent disability primarily from nerve and eye injuries. Prone positioning and surgical duration of ≥4 hours were associated with permanent disabling injuries. Attention to positioning, resuscitation during blood loss, and reducing length of surgery may reduce these complications.

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Editorial

No abstract available

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Effects of Hypertonic Saline and Sodium Lactate on Cortical Cerebral Microcirculation and Brain Tissue Oxygenation

imageBackground: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. Methods: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3.75 mL/kg intravenous infusion of either 3.2% HTS (group HTS, n=9), half-molar sodium lactate (group HTL, n=10), or normal saline (group C, n=9). Brain tissue partial pressure of oxygen (PbtO2) and microcirculation in the cerebral cortex using sidestream dark-field imaging were evaluated before, 20 and 40 minutes after 15 minutes of hyperosmolar solution infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of sidestream dark-field image recording. Results: No differences in the microcirculatory parameters were observed between the groups before and after the use of osmotherapy. Brain tissue oxygen deteriorated over time in groups C and HTL, this deterioration was not significant in the group HTS. Conclusions: Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.

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Prone Position, Cerebral Oximetry, and Delirium

No abstract available

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Comparison of 3% Hypertonic Saline and 20% Mannitol for Reducing Intracranial Pressure in Patients Undergoing Supratentorial Brain Tumor Surgery: A Randomized, Double-blind Clinical Trial

imageBackground: In the present study, we hypothesized that 3% hypertonic saline (HS) is more effective than 20% mannitol to reduce intracranial pressure (ICP) and to modify brain bulk in patients undergoing an elective supratentorial craniotomy. Materials and Methods: After institutional review board approval, patients scheduled to undergo supratentorial craniotomy were enrolled into this prospective, randomized, double-blind study. The patients were monitored for routine hemodynamic parameters, depth of anesthesia, and ICP. They received 5 mL/kg 20% mannitol (n=20) or 3% HS (n=19) as infusion for 15 minutes. The patients' ICP values were monitored during hypertonic fluid infusion and throughout 30 minutes after infusion as a primary outcome. Secondary outcomes were hemodynamic variables, serum sodium value, blood gases, and surgeon brain relaxation assessment score (1=relaxed, 2=satisfactory, 3=firm, 4=bulging). In addition, the length of intensive care unit and hospital stay were recorded. Results: Demographic and tumor characteristics were similar between groups. The basal (before hypertonic infusion, ICPT0) and last (30 min after hypertonic infusion finished, ICPT45) ICP values were 13.7±3.0 and 9.5±1.9 mm Hg, respectively, for the M group, which were comparable with the corresponding levels of 14.2±2.8 and 8.7±1.1 mm Hg in the HS group (P>0.05). The median amount of ICP reduction between T0 and T45 timepoints were 4 (1 to 7) and 5 (1 to 9) mm Hg for group M and group HS, respectively (P=0.035). Baseline central venous pressure, pulse pressure variation, and serum sodium and lactate values were similar between groups, but the last measured pulse pressure variation and lactate value were lower, and sodium value was higher in group HS than in group M (P

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A Comparison of Regional Versus General Anesthesia for Lumbar Spine Surgery: An Untouched Aspect of the Meta-Analysis

No abstract available

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Comparison of Anesthetic Management and Outcomes in Patients Having Either Transnasal or Transoral Endoscopic Odontoid Process Surgery

imageBackground: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. Methods: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively). Patient demographics, anesthetic technique, intraoperative course, and postoperative outcomes such as were recorded. Results: Patients who underwent transnasal odontoidectomy had a shorter length of stay and lower rates of tracheostomy compared with those having similar surgery via the transoral route. In those having transoral surgery, no patient presented to the operating room with a preexisting tracheostomy. In 16 of 17 patients within the transoral group, a tracheostomy was performed. In those having transnasal surgery, 2 of 5 patients had a preexisting tracheostomy. In the remaining 3 of 5 patients, orotracheal intubation was performed and patients were extubated after the procedure. Conclusions: The transnasal odontoid resection technique may become a more popular surgical approach without increasing rates of complications compared with those having transoral surgery. Ultimately, a larger, study is needed to further clarify these relationships.

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Spectrogram Analysis as a Monitor of Anesthetic Depth in a Pediatric Patient

imageNo abstract available

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Journal Club

No abstract available

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2017 SNACC Annual Meeting Report

No abstract available

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Dermalive Facial Filler Granulomas Masquerading as Neurofibromas

A 56-year-old woman presented with periocular nodules that were clinically suspected to be neurofibromas. Histopathologic examination of excised nodules revealed a pronounced granulomatous reaction to a foreign material that was composed of glossy polygonal palely eosinophilic fragments. These fragments were outlined in red with Masson trichrome, stained gray with the elastic stain, and were uniformly red with Gomori methenamine silver staining. The histopathologic appearance was consistent with a granulomatous reaction to Dermalive facial filler. Postoperatively the patient admitted that she had filler injections many years earlier in another country, and that nodules appeared 1 year after injection. Treatment with steroids, intralesional immunosuppressive agents and surgery had been previously attempted to eradicate the nodules. The literature pertaining to granulomatous reactions to Dermalive and related hybrid facial fillers is reviewed and treatment options are discussed. This report is the first to illustrate the unique histopathologic staining characteristics of Dermalive, which may be useful to ophthalmic pathologists in identifying this uncommon foreign material. Accepted for publication January 31, 2018. Heed Fellowship was awarded to N.W. The authors have no conflicts of interest to disclose. Address correspondence and reprint requests to Frederick A. Jakobiec, M.D., D.Sc., David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Suite 328, Boston, MA 02114. E-mail: Fred_Jakobiec@meei.harvard.edu. © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Frontalis Muscle Contraction and the Role of Visual Deprivation and Eyelid Proprioception

Purpose: To determine if frontalis muscle contraction can be induced by manipulating visual and eyelid proprioceptive inputs through simulating visual deprivation and ptosis. Methods: Volunteers without prior eyelid or forehead pathologic study were recruited for this nonrandomized, prospective study. Baseline and study phase brow positions were documented. The first phase was to simulate visual deprivation and the second to simulate ptosis. The dominant eye was used for each phase. As a proxy to simulate visual field deprivation, a black contact lens was placed on the eye, which reduced vision to light perception. As a proxy to simulate ptosis, an external eyelid weight was placed on the upper eyelid. Brow position ratios were calculated at various points along the brow and statistical analysis was performed. Results: Fifteen subjects participated. The average brow position ratio was 1.00 ± 0.08 for the visual deprivation group, which was not different from baseline (p = 0.86). The average brow position ratio for the external eyelid weight group was 1.13 ± 0.07, which was statistically significant compared with baseline and the visual deprivation group (p

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Primary Eyelid Amyloidosis Presenting as a Calcified Plaque: A Rare Presentation

No abstract available

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Quantitative Assessment of Dry Eye Parameters After Muller’s Muscle-Conjunctival Resection

Purpose: Muller's muscle-conjunctival resection (MMCR) is a highly effective technique to correct upper eyelid ptosis. However, several authorities have raised concerns about the possibility of postoperative ocular surface dryness. This study was performed to assess the impact of MMCR on clinically meaningful parameters of the ocular surface. Methods: In adult patients, tear break-up time, lipid layer thickness, and osmolarity were measured via direct observation, interferometry, and impedance measurements before surgery and 3 months after surgery in patients who underwent MMCR. Statistical analysis was performed via a dedicated software package. Results: Fifteen eyes of 14 patients were included in the study. Mean pre- and postoperative tear break-up times were 12.71 ± 2.20 and 12.43 ± 2.41 seconds, respectively (p = 0.1648). Preoperatively, the mean lipid layer thickness measurement was 91.00 ± 7.02 nm, whereas the mean postoperative value was 88.86 ± 21.36 nm (p = 0.6613). The mean preoperative tear osmolarity measured 291.4 ± 8.86 mOsm/l, and the mean postoperative measurement was 289.86 ± 9.74 mOsm/l (p = 0.2652). Conclusions: MMCR does not appear to change clinically meaningful ocular surface disease parameters, and postoperative dryness did not result from this procedure. In appropriately selected patients, MMCR can be safely performed without increased concerns regarding postoperative dry eye disease. Accepted for publication February 4, 2018. The research adhered to the tenets of the Declaration of Helsinki as amended in 2008. The abstract of this manuscript has been presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Annual Meeting, American Academy of Ophthalmology, New Orleans, Louisiana, November 10, 2017 Fall Scientific Symposium. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to: Sana Ali Bautista, M.D., Department of Ophthalmology, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208. E-mail: alis4@amc.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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A Simple Quantitative Measure of Orbital Compliance

Purpose: This study evaluates the reliability of a frequently used subjective measurement of orbital compliance (0–3 scale) and describes a simple, quantitative measure with excellent intra- and interrater reliability. Methods: Two examiners performed both measurements on 100 orbits (50 consecutive patients) from the office of 1 oculoplastics surgeon. Each measurement was obtained at 2 different time points, 10 minutes apart. For the subjective measurement, the patient was asked to close their eyes, and the globe was displaced posteriorly with digital pressure until moderate resistance was felt. This was graded on a 0 to 3 scale. For the quantitative measurement (millimeter scale), the difference in axial displacement was measured using a Hertel exophthalmometer. Results: The subjective measurement (scale, 0–3) showed excellent test–retest reliability (average, 0.901) for both examiners at both time points and good interobserver reliability (average, 0.677). The quantitative measurement (millimeter scale) showed excellent test–retest reliability (average, 0.848) and very good interobserver reliability (average, 0.756). Conclusion: This study shows that while both methods have both excellent test–retest reliability, the interobserver reliability is slightly higher with the quantitative measurement. This suggests that the described measurement of orbital compliance is both a reasonable alternative and possibly more accurate measurement without the steep learning curve. Accepted for publication January 31, 2018. A consent was obtained and is on file for the figure used in the paper. Supported by an unrestricted grant from Research to Prevent Blindness to Columbia University School of Medicine. The authors have no financial or conflicts of interest to disclose. This work has not been published or presented at any meeting previously. Address correspondence and reprint requests to: Michael Kazim, M.D., Harkness Eye Institute, Columbia University Medical Center, 635 West 165th Street, New York, NY 10032. E-mail: mk48@cumc.columbia.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Orbital and Ocular Ischemic Syndrome With Blindness After Facial Filler Injection

The authors herein describe a case of orbital and ocular ischemic syndrome with blindness after cosmetic hyaluronic acid filler injection. Orbital function, but not visual function, returned after treatment with orbital hyaluronidase and corticosteroids. Accepted for publication February 4, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Sathyadeepak Ramesh, M.D., UCLA Stein Eye Institute, 300 Stein Plaza, Los Angeles, CA 90095. E-mail: Sathyadeepak.Ramesh@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Orbital Plates and Screws Causing Globe Fixation: A Rare and Delayed Complication of Craniomaxillofacial Surgery

A 24-year-old woman presented with a 1-year history of gradually increasing pain on eye movements, worse on the right. She had a significant background of undergoing intracranial correction of orbital hypertelorism with internal fixation of the lateral orbital rims at the age of 6 years. Imaging was consistent with bilateral metallic foreign bodies from both lateral orbital rims protruding into the globes. The patient underwent removal of bilateral plates and screws, with a significant improvement of symptoms and ocular motility postoperatively. This case demonstrates the need to consider orbital screw/plate migration in the setting of reduced ocular motility and painful eye movements. Accepted for publication January 25, 2018. Written consent was gained from the patient for publication and use of photographs The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to: Varun Chandra, M.B.B.S., Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC, Australia. E-mail: varun.chandra@hotmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Tetrandrine (TET) Induces Death Receptors: Apo Trail R1 (DR4) and Apo Trail R2 (DR5) and sensitizes Prostate Cancer Cells to TRAIL induced apoptosis

TNF-related apoptosis-inducing ligand (TRAIL) selectively induces apoptosis in cancer cells, but not in normal cells, as such is a promising therapeutic agent. However, therapeutic resistance limits its clinical use in many malignancies including prostate cancer (PCa). Strategies to sensitize cancer cells to TRAIL are urgently needed. We demonstrate here that small-molecule Tetrandrine (TET) potentially sensitizes previously resistant (LNCaP and C4-2B cells) and mildly sensitive (PC3 cells) PCa cells to TRAIL- induced apoptosis, and they do so by up-regulating mRNA expression and protein levels of death receptors Apo Trail R1 (DR4) and Apo Trail R2 (DR5). Using shRNA knockdown, we show critical requirement of DR4 and DR5 in sensitization of PCa cells to TRAIL. We show that double knock down of DR4 and DR5 abrogated the apoptotic effects of TET and TRAIL. We also demonstrate that TET induced DR4 and DR5 expression is independent of p53 status. Given that loss of p53 is associated with progression of PCa to CRPC and NEPC, our results show that TET by acting as a TRAIL sensitizing agent in PCa could serve as a potential therapeutic agent in CRPC and NEPC for which there is no cure to date.



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The DNA-PK inhibitor VX-984 enhances the radiosensitivity of glioblastoma cells grown in vitro and as orthotopic xenografts

Radiotherapy is a primary treatment modality for glioblastomas (GBMs). Because DNA-PKcs is a critical factor in the repair of radiation-induced double strand breaks (DSBs), this study evaluated the potential of VX-984, a new DNA-PKcs inhibitor, to enhance the radiosensitivity of GBM cells. Treatment of the established GBM cell line U251 and the GBM stem-like cell (GSC) line NSC11 with VX-984 under in vitro conditions resulted in a concentration-dependent inhibition of radiation-induced DNA-PKcs phosphorylation. In a similar concentration dependent manner, VX-984 treatment enhanced the radiosensitivity of each GBM cell line as defined by clonogenic analysis. As determined by H2AX expression and neutral comet analyses, VX-984 inhibited the repair of radiation-induced DNA double strand break in U251 and NSC11 GBM cells, suggesting that the VX-984-induced radiosensitization is mediated by an inhibition of DNA repair. Extending these results to an in vivo model, treatment of mice with VX-984 inhibited radiation-induced DNA-PKcs phosphorylation in orthotopic brain tumor xenografts, indicating that this compound crosses the blood-brain tumor barrier at sufficient concentrations. For mice bearing U251 or NSC11 brain tumors VX-984 treatment alone had no significant effect on overall survival; radiation alone increased survival. The survival of mice receiving the combination protocol was significantly increased as compared with control and as compared with radiation alone. These results indicate that VX-984 enhances the radiosensitivity of brain tumor xenografts and suggest that it may be of benefit in the therapeutic management of GBM.



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Kir2.1 interaction with Stk38 promotes invasion and metastasis of human gastric cancer by enhancing MEKK2-MEK1/2-ERK1/2 signaling

Potassium ion channels are emerging as pro-malignant factors involved in cancer progression. In this study, we found that invading human gastric cancer (GC) cells express high level of inwardly rectifying potassium channel 2.1 (Kir2.1). Silencing Kir2.1 markedly reduced the invasive and metastatic capabilities as well as the epithelial-mesenchymal transition (EMT) of GC cells. The pro-malignant nature of Kir2.1 in GC cells was independent of potassium permeation but relied on its interaction with serine/threonine-protein kinase 38 (Stk38) to inhibit ubiquitination and degradation of mitogen-activated protein kinase kinase kinase 2 (MEKK2). Degradation of MEKK2 was mediated by small mothers against decapentaplegic-specific E3 ubiquitin protein ligase 1 (Smurf1), which resulted in activation of the MEK1/2-ERK1/2-Snail pathway in GC cells. In human GC tissues, expression was high and positively correlated with invasion depth and metastatic status of the tumors as well as poor overall patient survival. Cox regression analysis identified Kir2.1 as an independent prognostic indicator for GC patients. Our results suggest that Kir2.1 is an important regulator of GC malignancy and acts as a novel prognostic marker and a therapeutic target for GC.

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Bivalent chromatin domains in glioblastoma reveal a subtype-specific signature of glioma stem cells

Glioblastoma multiforme (GBM) can be clustered by gene expression into four main subtypes associated with prognosis and survival, but enhancers and other gene regulatory elements have not yet been identified in primary tumors. Here, we profiled six histone modifications and CTCF binding as well as gene expression in primary gliomas, and identified chromatin states that define distinct regulatory elements across the tumor genome. Enhancers in mesenchymal and classical tumor subtypes drove gene expression associated with cell migration and invasion, while enhancers in proneural tumors controlled genes associated with a less aggressive phenotype in GBM. We identified bivalent domains marked by activating and repressive chromatin modifications. Interestingly, the gene interaction network from common (subtype-independent) bivalent domains was highly enriched for homeobox genes and transcription factors, and dominated by SHH and Wnt signaling pathways. This subtype-independent signature of early neural development may be indicative of poised de-differentiation capacity in glioblastoma, and could provide potential targets for therapy.

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Antidromic neurogenic activity and cutaneous bacterial flora

Abstract

By its size and diversity, the cutaneous microbial flora is the second of the human body and there is a growing body of research showing its key role in cutaneous homeostasis. However, skin is also the first neuroendocrine organ and it is now demonstrated that bacteria can sense a multitude of human hormones and neurotransmitters. Then, besides of the intrinsic effect of their virulence factors on cutaneous neurogenic activity, recent data demonstrate that the virulence, invasion potential, and biofilm formation activity of some of the principal species of the cutaneous bacteria flora are directly controlled by neuropeptides released by sensory nerve endings including substance P and calcitonin gene-related peptide. Other factors involved in skin inflammation, such as atrial natriuretic peptides, vasoactive intestinal peptide, neuropeptide Y, and histamine should also directly and indirectly participate to the control of the cutaneous microbial flora. Herein, we highlight some of the more recent studies showing that the skin bacteria are interfering at multiple levels with cutaneous neurogenic inflammation. Understanding this mechanism was leading to the development of new cosmetic products, but this is also a promising route for novel therapeutic strategies for the care of cutaneous inflammatory diseases.



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Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients

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Publication date: April 2018
Source:Clinical Neurology and Neurosurgery, Volume 167
Author(s): Fuyou Guo, Guoqing Wang, Vigneyshwar Suresh, Dingkang Xu, Xiaoyang Zhang, Mengzhao Feng, Fang Wang, Xianzhi Liu, Laijun Song
ObjectivesThe optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases.Patients and MethodsClinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed.ResultsGross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p < 0.05). Multivariate analysis indicated that the tumor recurrence and surgical times played a negative role in the resection extent, the odds ratio and 95% confidence interval of the tumor recurrence and surgical times is [0.306 (0.155–0.603), (p < 0.01)] and [2.135 (1.101–4.142), (p < 0.05)] respectively. There was significant difference on panhypopituitarism between GTR and STR group (p < 0.05). However, No significant difference regarding the postoperative visual dysfunction and indepent quality of life respectively between GTR and STR group was found (p > 0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05).ConclusionsPresent findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors.



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Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study

Abstract

Objectives

This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images.

Materials and methods

CBCT images of 294 patients (143 female, 151 males; age range 18–78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2–10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth.

Results

More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05).

Conclusions

Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions.

Clinical relevance

Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.



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Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study

Abstract

Objectives

This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images.

Materials and methods

CBCT images of 294 patients (143 female, 151 males; age range 18–78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2–10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth.

Results

More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05).

Conclusions

Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions.

Clinical relevance

Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.



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Infrahyoid involvement may be a high-risk factor in the management of non-odontogenic deep neck infection: Retrospective study

This study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI.

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Editorial Board

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Publication date: April 2018
Source:Brain and Language, Volume 179





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Environmental exposure to peanut and the risk of an allergic reaction

• Data have shown that peanut butter vapors and smeared peanut butter on skin do not cause systemic reactions; that peanut can be abated from hands and surfaces using appropriate cleaning agents; and that shelled peanut dust does not become airborne• Recent data have suggested that a dose of 1.5mg peanut protein would be generally tolerated by about 95% of the peanut allergic population based on objective symptoms in challenge-based studies• Restrictive policies that focus on bans (or restricted presence in certain areas) of peanuts or peanut-containing products in environments such as schools or on commercial aircraft are not backed by evidence that such measures work

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The multidimensional burden of atopic dermatitis: an update

Atopic dermatitis (AD) is a chronic, inflammatory skin disease affecting 11% of children1 and 5-7% of adults 2,3 in the United States. Consequences of AD include itching, sleep disturbances, and impairment in physical activity and social functioning, affecting both patients and their families 4. AD may also impact academics and choice of occupation. The total annual burden of AD in 2004 USD was estimated to be $4.228 billion, combining direct and indirect costs of care, but this is likely an underestimate of present day costs 5.

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Mycoplasma pneumoniae induces allergy by producing p1-specific IgE

Our previous study found that most of MPP patients had elevated serum total IgE levels.

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Influence of venous stasis on survival of epigastric flaps in rats

Venous congestion results in tissue damage and remains the most common reason for failure of transfer of microvascular free flaps if it is not recognised early. The purpose of this study was to measure the critical duration of venous congestion and the resultant survival of flaps according to the duration of venous stasis. A standard epigastric flap was raised and repositioned in 35 rats, seven of which acted as controls. The superficial inferior epigastric vein was fully occluded for four, five, six, or seven hours in the rest (n=7 each group).

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Idiopathic condylar resorption

Idiopathic condylar resorption is a well-documented but poorly-understood pathological entity that predominantly affects young women, particularly during the pubertal growth spurt. Several theories have been proposed to explain its aetiopathogenesis, the most favoured of which are the hormonally mediated theory, the theory of avascular necrosis, and the dysfunctional remodelling theory. The condition is diagnosed by a combination of clinical and radiological data as well as elements from the patient's history.

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Early experience of a nurse-led clinic in a tertiary centre

A busy head and neck or oral and maxillofacial (OMFS) National Health Service (NHS) clinic treats patients with many different conditions. A large proportion will have cancer of the head and neck, and they will be at different stages of their treatment. Their clinical needs may be different from a larger group of patients who have been referred through the "two-week wait" referral pathway, and who are present in the same clinic for their biopsy results. We present our early experience of "fast-track" referrals and their potential effect on the overall volume of work.

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The relationship between mismatch response and the acoustic change complex in normal hearing infants

The importance of exposure to quality spoken language during the first year of life has been highlighted in studies of normal hearing (NH) infants and toddlers (Kuhl, 1991; Strange and Jenkins, 1978; Werker and Tees, 1984) and in studies of the later implications of this exposure on word learning and syntactic abilities (Graf Estes et al., 2007; van Leeuwen et al., 2008; Mueller et al., 2012). Research in infants with hearing loss (HL) has shown improved language outcomes when infants are fit with amplification and enrolled in early intervention by six months of age (Yoshinaga-Itano et al., 1998).

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Proving cortical death after vascular coma: Evoked potentials, EEG and neuroimaging

Prognostication of coma outcome is a key factor for the management of critically ill patients. The self-fulfilling prophecy related to treatment limitation is likely to appear after neurological insults with tragic consequences in case of erroneous prognostication, especially if a bad outcome is expected (Murray et al., 1993). With this caveat in mind, it is important to consider that clinical judgment appears frequently more severe than the objective assessment 6 months after traumatic brain injury (Bonds et al., 2015) and could conduce to inappropriate early care withdrawal in anoxic coma (Elmer et al., 2016; Gobert et al., 2016).

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Survival of dental implants placed in HIV-positive patients: a systematic review

No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017.

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Screening Tests Reveal High Risk Among Adjudicated Adolescents of Auditory Processing and Language Disorders

Purpose
The study investigated the prevalence of risk factors for auditory processing and language disorders among adolescents residing at a local juvenile detention center.
Method
A total of 782 adjudicated adolescents with normal hearing were screened with the Randomized Dichotic Digits Test (Strouse & Wilson, 1999) and the Dichotic Words Test (Moncrieff, 2015). A subset of 420 of those adolescents was also screened with the Clinical Evaluation of Language Fundamentals (CELF; Semel, Wiig, & Secord, 2003).
Results
More than 70% of the adolescents produced weakness on at least 1 dichotic listening test. One third of those produced weakness across both dichotic listening tests, consistent with a binaural integration deficit pattern. Nearly 48% of the subgroup of adolescents produced CELF scores that fell below the criterion for age. Dichotic listening and language scores were more associated in participants with poor performance in both ears during dichotic tests, who also produced the lowest scores on the CELF. There was no main effect of race, but 17- and 18-year-old Black adolescents produced lower CELF scores than White adolescents of the same age.
Conclusions
School-age children referred for disciplinary action may have undiagnosed deficits in auditory processing and/or language. Efforts to screen, diagnose, and remediate these deficits could lead to improvements in communication, learning, and language skills in this population.

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Assessing the potential role of scaffold-mediated local chemotherapy in oral cancer

Chemotherapy entails a fine balance between inducing cytotoxicity in cancer cells while preserving the integrity of the normal cells. Chemotherapy, unlike surgery or radiotherapy, is not precisely targeted and leads to non-selective accumulation of drugs in healthy tissues. The past decade has seen the invent of several targeted therapy systems to minimize cytotoxic effects on healthy tissues [1–3]. The nanoparticle-mediated delivery system has gained popularity in the past two decades. Although nanoparticles aid in the targeted delivery of the chemotherapeutic agents, the nanoparticles (Doxil, gold, silver, etc.) themselves have shown to have cytotoxic effects [4–7], thus restricting their use in cancer therapy.

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Assessing the potential role of scaffold-mediated local chemotherapy in oral cancer

Chemotherapy entails a fine balance between inducing cytotoxicity in cancer cells while preserving the integrity of the normal cells. Chemotherapy, unlike surgery or radiotherapy, is not precisely targeted and leads to non-selective accumulation of drugs in healthy tissues. The past decade has seen the invent of several targeted therapy systems to minimize cytotoxic effects on healthy tissues [1–3]. The nanoparticle-mediated delivery system has gained popularity in the past two decades. Although nanoparticles aid in the targeted delivery of the chemotherapeutic agents, the nanoparticles (Doxil, gold, silver, etc.) themselves have shown to have cytotoxic effects [4–7], thus restricting their use in cancer therapy.

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[Facial nerve injury in neurosurgery: a rehabilitation potential of botulinum therapy].

[Facial nerve injury in neurosurgery: a rehabilitation potential of botulinum therapy].

Zh Vopr Neirokhir Im N N Burdenko. 2018;82(1):111-118

Authors: Akulov MA, Orlova OR, Tabashnikova TV, Karnaukhov VV, Orlova AS

Abstract
Surgical treatment of posterior cranial fossa and cerebellopontine angle tumors is associated with a risk of facial nerve dysfunction. The causes for facial muscle paresis include nerve compression by the tumor, destruction of the nerve structure by the tumor growing from nerve fibers, nerve injury during surgical removal of the tumor, etc. The first 3 months after facial nerve injury are a potential therapeutic window for the use of botulinum toxin type A (BTA). During this period, the drug is introduced both in the healthy side to improve the facial symmetry at rest and during mimetic movements and in the affected side to induce drug-induced ptosis. Post-paralytic syndrome develops 4-6 months after facial nerve injury. At this stage, administration of BTA is also an effective procedure; in this case, drug injections are performed on the affected side at small doses and symmetrically on the healthy side at doses doubling those for the affected side. BTA injections are mandatory in complex treatment of facial muscle paralysis.

PMID: 29543223 [PubMed - in process]



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[Variability and age-related features of the anatomy of the midline structures of the anterior skull base].

[Variability and age-related features of the anatomy of the midline structures of the anterior skull base].

Zh Vopr Neirokhir Im N N Burdenko. 2018;82(1):102-110

Authors: Gol'bin DA, Cherekaev VA

Abstract
The article presents the literature data on the structural variability and age-related features of the midline anatomical structures of the anterior skull base (frontal sinus, ethmoid bone, anterior parasellar region, and medial orbital wall). This is the area of surgical interests of neurosurgeons and rhinosurgeons. The study objective is to analyze the literature data on the individual variability and age-related anatomy of these structures. The work is illustrated with original images from the authors' personal archive. The individual anatomical features of eloquent structures in the surgical area (structures within the surgical corridor, key anatomical landmarks, optic tract, internal carotid and ethmoidal arteries, etc.) should be considered in planning surgery in patients of all age groups because they can limit the view and the amount of safe manipulations or increase the risk of complications. The presented data may be useful for neurosurgeons and otolaryngologists whose surgical interests are focused on the midline structures of the anterior skull base.

PMID: 29543222 [PubMed - in process]



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[The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review)].

[The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review)].

Zh Vopr Neirokhir Im N N Burdenko. 2018;82(1):86-92

Authors: Sharipov OI, Kutin MA, Bayuklin AV, Imaev AA, Abdilatipov AA, Kurnosov AB, Fomichev DV, Mikhaylov NI, Kalinin PL

Abstract
Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.

PMID: 29543220 [PubMed - in process]



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How I do it: surgical clipping of vertebrobasilar junction aneurysms through a far-lateral transcondylar approach.

How I do it: surgical clipping of vertebrobasilar junction aneurysms through a far-lateral transcondylar approach.

Acta Neurochir (Wien). 2018 Mar 14;:

Authors: Nakov V, Spiriev T, Stavrev E

Abstract
BACKGROUND: Vertebrobasilar junction aneurysms occur rarely, but have a higher rupture rate than supratentoral aneurysms, and higher morbidity and mortality. Their location ventral to the neuroaxis makes them a challenging surgical lesion.
METHODS: In this paper, we share our experience with the surgical technique for the management of these complex aneurysms.
CONCLUSION: An in-depth understanding of the anatomy of these aneurysms, careful preoperative planning, and a meticulous surgical technique, including knowledge of every detail of the procedure-positioning, an advanced skull base technique, and careful aneurysm dissection and clipping-is essential for a successful outcome of the surgery.

PMID: 29541887 [PubMed - as supplied by publisher]



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Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

Surg Radiol Anat. 2018 Mar 15;:

Authors: Coquet T, Lefranc M, Chenin L, Foulon P, Havet É, Peltier J

Abstract
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.

PMID: 29541802 [PubMed - as supplied by publisher]



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Surgical Interventions for Advanced Parameningeal Rhabdomyosarcoma of Children and Adolescents.

Surgical Interventions for Advanced Parameningeal Rhabdomyosarcoma of Children and Adolescents.

Cureus. 2018 Jan 09;10(1):e2045

Authors: Choi PJ, Iwanaga J, Tubbs RS, Yilmaz E

Abstract
Owing to its rarity, rhabdomyosarcoma of the head and neck (HNRMS) has seldom been discussed in the literature. As most of the data is based only on the retrospective experiences of tertiary healthcare centers, there are difficulties in formulating a standard treatment protocol. Moreover, the disease is poorly understood at its pathological, genetic, and molecular levels. For instance, 20% of all histological assessment is inaccurate; even an experienced pathologist can confuse rhabdomyosarcoma (RMS) with neuroblastoma, Ewing's sarcoma, and lymphoma. RMS can occur sporadically or in association with genetic syndromes associated with predisposition to other cancers such as Li-Fraumeni syndrome and neurofibromatosis type 1 (von Recklinghausen disease). Such associations have a potential role in future gene therapies but are yet to be fully confirmed. Currently, chemotherapies are ineffective in advanced or metastatic disease and there is lack of targeted chemotherapy or biological therapy against RMS. Also, reported uses of chemotherapy for RMS have not produced reasonable responses in all cases. Despite numerous molecular and biological studies during the past three decades, the chemotherapeutic regimen remains unchanged. This vincristine, actinomycin, cyclophosphamide (VAC) regime, described in Kilman, et al. (1973) and Koop, et al. (1963), has achieved limited success in controlling the progression of RMS. Thus, the pathogenesis of RMS remains poorly understood despite extensive modern trials and more than 30 years of studies exploring the chemotherapeutic options. This suggests a need to explore surgical options for managing the disease. Surgery is the single most critical therapy for pediatric HNRMS. However, very few studies have explored the surgical management of pediatric HNRMS and there is no standard surgical protocol. The aim of this review is to explore and address such issues in the hope of maximizing the number of options available for young patients with HNRMS.

PMID: 29541566 [PubMed]



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Myringoplasty in Children for Tympanic Membrane Perforation: Indications, Techniques, Results, Pre- and Post-Operative Care, and Prognostic Factors

Abstract

Purpose of the Review

The aim of this report is to identify the current relevant literature data on myringoplasty for chronic tympanic membrane perforation in children; to expose the different surgical techniques, traditional and recent techniques and to report their indications and results; and to address controversies of age in terms of timing of surgery and as a prognostic factor among many other factors.

Recent Findings

Myringoplasty is an easy and reliable surgery when performed in children in order to repair tympanic membrane perforation. Reported success rate is classically between 32 and 95% while some series have 100% rates. Timing of surgery in terms of age is still controversial and varies among teams related to their own experience.

Summary

Myringoplasty in children has high rates of anatomical and functional success when well indicated. Age has not been found to affect surgery results.



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NIR laser pointer for in vivo photothermal therapy of murine LM3 tumor using intratumoral China ink as a photothermal agent

Abstract

The photothermal effect is one of the most promising photonic procedures currently under development to successfully treat several clinical disorders, none the least some kinds of cancer. At present, this field is undergoing a renewed interest due to advances in both photothermal materials and better-suited light sources. However, scientific studies in this area are sometimes hampered by the relative unavailability of state-of-art materials or the complexity of setting up a dedicated optical facility. Here, we present a simple and affordable approach to do research in the photothermal field that relies on a commercial NIR laser pointer and a readily available everyday pigment: China ink. A proof-of-concept study is presented in which mice bearing intradermal LM3 mammary adenocarcinoma tumors were successfully treated in vivo employing China ink and the laser pointer. TUNEL and Ki-67 post-treatment tissue assessment clearly indicates the deleterious action of the photothermal treatment on the tumor. Therefore, the feasibility of this simple approach has been demonstrated, which may inspire other groups to implement simple procedures to further explore the photothermal effect.



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Phonak Adds to Its Hearing Aid and Speech Understanding Technologies

Nadia B-R RIC.jpgPhonak has introduced two lithium-ion rechargeable hearing aids geared to the needs of specific patient populations—those with severe to profound hearing loss and children. Now in its fifth generation, Phonak's Naída B, for the first time, offers a rechargeable receiver-in-canal option. Naída B provides the industry's best speech intelligibility index results for those with severe to profound hearing loss, according to the company. Phonak has also added a rechargeable option to its Sky B products, which are designed specifically for children. Sky B-PR gives pediatric patients a full day of uninterrupted hearing on a single charge. Sky B features AutoSense Sky OS and SoundRecover2, which gives children access to a broader range of sounds essential for speech and language development.
 
The company has also launched its new MultiBeam Technology (MBT), the next generation of the Roger 2.4 GHz wireless technology first introduced in 2013. MBT uses three microphones to form six directional beams within 360 degrees. When a microphone with MBT is placed on a table, it automatically selects the speaker to improve speech understanding in group conversations and noisy situations. Powered by MBT are Phonak's Roger Select, which is equipped with three modes (automatic, manual, lapel) to enable wireless hearing in different environments, and Roger Table Mic II, which is ideal for working adults who need to actively participate in meetings. Phonak has also added the Roger Repeater, which extends the operating range of any Roger network in the Roger for Education portfolio and is ideal for school applications like auditoriums and gymnasiums.
 
The Phonak Naída B and Sky B are now available in the United States, with the rest of the world to follow this month. All new Roger products will be available later in spring 2018.
Published: 3/16/2018 12:24:00 PM


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Table of Contents (Pantone 286 C)

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Publication date: April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 4





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Society Page (Headings are Pantone 286 C; logos are 4/color)

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Publication date: April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 4





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Information for Readers (Pantone 286 C)

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Publication date: April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 4





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Editorial Board (Pantone 286 C)

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Publication date: April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 125, Issue 4





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Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty

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Publication date: Available online 16 March 2018
Source:Auris Nasus Larynx
Author(s): Nesibe Gül Yüksel Aslıer, Selhan Gürkan, Mustafa Aslıer, Günay Kirkim, Enis Alpin Güneri, Ahmet Ömer Ikiz
ObjectiveThe purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty.MethodsThirty-four operated ears of 32 patients and 70 ears of 35 control subjects were included. Differences of pure-tone audiometry thresholds and wideband ambient-pressure absorbance ratios with respect to the graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery were analyzed. Receiver operating characteristics curve was generated to detect the absorbance level at which the reconstructed tympanic membrane behaves as 'near-normal tympanic membrane'.ResultsIn the surgical group, wideband energy absorbance ratios at all 1/2-octave band frequencies were significantly worse than normal ears. Energy absorbance ratios at 2000 and 2828Hz frequencies were higher in patients with tragal cartilage grafts. Higher absorbance ratios at 250–750Hz range were obtained in patients with 400μm cartilage graft thickness, <50% cartilage surface area ratio and ≥5 years since surgery. A multivariate generalized linear model revealed common effects of the independent variables at 8000Hz. The receiver operating characteristics analysis generated a cut-off level of 63.20% of sound energy absorbance at 1400Hz with 83% sensitivity and 88% specificity.ConclusionEven though no differences in hearing thresholds were observed; graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery affected the course of sound energy absorbance after type 1 cartilage tympanoplasty as evidenced by wideband tympanometry.



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The role of contour polarity, objectness, and regularities in haptic and visual perception

Abstract

Regularities like symmetry (mirror reflection) and repetition (translation) play an important role in both visual and haptic (active touch) shape perception. Altering figure-ground factors to change what is perceived as an object influences regularity detection. For vision, symmetry is usually easier to detect within one object, whereas repetition is easier to detect across two objects. For haptics, we have not found this interaction between regularity type and objectness (Cecchetto & Lawson, Journal of Experimental Psychology: Human Perception and Performance, 43, 103–125, 2017; Lawson, Ajvani, & Cecchetto, Experimental Psychology, 63, 197–214, 2016). However, our studies used repetition stimuli with mismatched concavities, convexities, and luminance, and so had mismatched contour polarities. Such stimuli may be processed differently to stimuli with matching contour polarities. We investigated this possibility. For haptics, speeded symmetry and repetition detection for novel, planar shapes was similar. Performance deteriorated strikingly if contour polarity mismatched (keeping objectness constant), whilst there was a modest disadvantage for between-2objects:facing-sides compared to within-1object:outer-sides comparisons (keeping contour polarity constant). For the same task for vision, symmetry detection was similar to haptics (strong costs for mismatched contour polarity, weaker costs for between-2objects:facing-sides comparisons), but repetition detection was very different (weak costs for mismatched contour polarity, strong benefits for between-2objects:facing-sides comparisons). Thus, objectness was less influential than contour polarity for both haptic and visual symmetry detection, and for haptic repetition detection. However, for visual repetition detection, objectness effects reversed direction (within-1object:outer-sides comparisons were harder) and were stronger than contour polarity effects. This pattern of results suggests that regularity detection reflects information extraction as well as regularity distributions in the physical world.



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Cross-modal attention modulates tactile subitizing but not tactile numerosity estimation

Abstract

Debate remains about whether the same attentional mechanism subserves subitizing (with number of items less than or equal to 4) and numerosity estimation (with number of items equal to or larger than 5), and evidence is scarce from the tactile modality. Here, we examined tactile numerosity perception. Using tactile Braille displays, participants completed the following three main tasks: (1) Unisensory task with focused attention: Participants reported the number (1~12) of the tactile pins. (2) Unisensory task with divided attention: Participants compared the numbers of pins across the upper and lower area of their left index fingers, in addition to reporting the number of tactile pins on their right index fingers. (3) Cross-modal task with divided attention: Participants reported the number of tactile pins and compared the numbers of visual dots across the upper and lower part of a (illusory) rectangle that overlaid the tactile stimuli. We found that performance of subitizing rather than estimation was interfered with in dual tasks, regardless of whether distractor events were from the same modality (tactile modality) or from a different modality (visual modality). Moreover, a further test of visual/tactile working memory capacity revealed that the precision of tactile subitizing, in the presence of a visual distractor, was correlated with the capacity of visual working memory, not of tactile working memory. Overall, our study revealed that tactile numerosity perception is accounted for by amodal attentional modulation yet by differential attentional mechanisms in terms of subitizing and estimation.



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Steps per Day and Its Relationship to Energy Expenditures

No abstract available

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