Αρχειοθήκη ιστολογίου

Τρίτη 5 Απριλίου 2016

The CCN Executive Committee invites you to a lecture by Dr. George Koob!

The Center for Clinical and Cognitive Neuroscience Executive Committee is pleased to announce the CCN Distinguished Speaker Series. The goal of this speaker series is to invite high profile speakers to the SDSU campus to provide both public lectures and lectures that highlight new discoveries and cutting-edge research in cognitive neuroscience.


Up Next – Dr. George Koob!

The CCN Executive Committee invites you to a lecture by Dr. George Koob!

george koob

Dr. George Koob

“Neurobiology of addiction: A stress surfeit disorder”

Dr. George Koob
Director of the National Institute of Alcohol Abuse and Alcoholism

Friday, April 22, 2016
1-2:30pm, Conrad Prebys Aztec Center Theatre
2:30-3:30pm, Light reception to follow on the 4th Floor Outdoor Terrace

Paid parking available in PS6 (pdf)

Abstract:

Addiction to alcohol and drugs has been conceptualized as a chronically relapsing disorder of compulsive drug seeking and taking that progresses through three stages: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. Multiple sources of reinforcement contribute to the motivation to compulsively seek drugs including core elements of positive reinforcement (binge/intoxication stage) and negative reinforcement (withdrawal/negative affect stage) and conditioned reinforcement (preoccupation-anticipation stage). The construct of negative reinforcement can be defined here as drug taking that alleviates a negative emotional state created by drug abstinence. The negative emotional state that drives such negative reinforcement is hypothesized to derive from dysregulation of key neurochemical circuits that form the brain stress systems within the extended amygdala, basal ganglia and frontal cortex. Specific neuroplasticity in these circuits includes not only recruitment of the classic hormonal stress axis mediated by corticotropin-releasing factor (CRF) in the hypothalamus, but also extrahypothalamic CRF in the extended amygdala and frontal cortex. Recruitment of dynorphin-k opioid aversive systems in the ventral striatum and extended amygdala represents another dynamic neuroplasticity of the brain stress systems. In animal models, acute withdrawal from all major drugs of abuse increases reward thresholds, increases anxiety-like responses, increases extracellular levels of CRF in the central nucleus of the amygdala and increases basal ganglia dynorphin. CRF and kappa receptor antagonists block motivational responses associated with withdrawal, and compulsive-like drug taking during extended access. Excessive drug taking also engages activation of CRF in the medial prefrontal cortex and is accompanied by deficits in executive function that may facilitate the transition to compulsive-like responding and relapse. Thus, compelling evidence exists to argue that plasticity in the brain stress systems, a heretofore largely neglected component of dependence and addiction, is triggered by acute excessive drug intake, is sensitized during repeated withdrawal, persists into protracted abstinence, and contributes to the development and persistence of addiction. The neuroplasticity of the brain stress systems in addiction not only provides understanding of the neurobiology of negative reinforcement mechanisms in addiction, but also provides key insights into how the brain processes negative emotions.

 

 

 



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"Vestn Otorinolaringol"[jour]; +21 new citations

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

"Vestn Otorinolaringol"[jour]

These pubmed results were generated on 2016/04/05

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



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Insight into the epidemiology of cutaneous squamous cell carcinoma with perineural spread.

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Insight into the epidemiology of cutaneous squamous cell carcinoma with perineural spread.

Head Neck. 2016 Apr 4;

Authors: Warren TA, Whiteman DC, Porceddu SV, Panizza BJ

Abstract
BACKGROUND: Perineural spread (PNS) of cutaneous squamous cell carcinoma of the head and neck (SCCHN) can be associated with poor outcomes. Disease understanding and awareness is limited leading to delayed diagnosis and treatment. The purpose of this study was to identify epidemiological features of patients with PNS of cutaneous SCCHN.
METHODS: Tumor characteristics and demographics of patients with PNS of cutaneous SCCHN managed through a single institution were collected between 1998 and 2013.
RESULTS: One hundred twenty patients were included in this study. The majority had a history of skin cancer (85.8%). The median time from primary tumor treatment to PNS symptom onset was 16 months (range, 1-86 months). A total of 34.2% had no perineural invasion (PNI) detected in the primary, and 22.5% had no known primary tumor. Only 5.8% of the patients had nodal involvement at presentation.
CONCLUSION: Patients can present with PNS from cutaneous SCCHN with no known primary tumor or with primary tumors without PNI. The majority of patients presented without regional nodal involvement. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27043827 [PubMed - as supplied by publisher]



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Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia Using a Single-Plane, Flat Panel Detector Angiography System: Technical Note.

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Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia Using a Single-Plane, Flat Panel Detector Angiography System: Technical Note.

Neurol Med Chir (Tokyo). 2016 Apr 4;

Authors: Arishima H, Kawajiri S, Arai H, Higashino Y, Kodera T, Kikuta KI

Abstract
Percutaneous treatments for trigeminal neuralgia (TN) including glycerol rhizotomy (GR), radiofrequency thermocoagulation (RT), and balloon compression (BC) are effective for patients with medical comorbidities and risk factors of microvascular decompression (MVD). These procedures are usually performed under fluoroscopy. Surgeons advance the needle to the trigeminal plexus through the foramen ovale while observing landmarks of fluoroscopic images; however, it is sometimes difficult to appropriately place the needle tip in Meckel's cave. We present the technical details of percutaneous GR using a single-plane, flat panel detector angiography system to check the needle positioning. When the needle tip may be located near the trigeminal cistern, three-dimensional (3-D) bone images are taken with cone-beam computed tomography (CT). These images clearly show the position of the needle tip in Meckel's cave. If it is difficult to place it through the foramen ovale, surgeons perform cone beam CT to observe the actual position of the needle tip at the skull base. After confirming the positional relation between the needle tip and foramen ovale, surgeons can advance it in the precise direction. In 10 procedures, we could place the nerve-block needle in about 14.5 minutes on average without complications. We think that our method is simple and convenient for percutaneous treatments for TN, and it may be helpful for surgeons to perform such treatments.

PMID: 27041633 [PubMed - as supplied by publisher]



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Using fixed anatomical landmarks to avoid medial rectus injury: a radiographic analysis in patients with and without Graves' disease.

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Using fixed anatomical landmarks to avoid medial rectus injury: a radiographic analysis in patients with and without Graves' disease.

Am J Otolaryngol. 2016 Feb 9;

Authors: Suh JD, Kuan EC, Thompson CF, Scawn RL, Feinstein AJ, Barham HP, Kingdom TT, Ramakrishnan VR

Abstract
BACKGROUND: Injury to the medial rectus (MR) is a potentially devastating complication of orbital and sinus surgery. Precise knowledge of the MR relative to the lamina papyracea (LP) is important during endoscopic surgery for both Graves' ophthalmopathy and inflammatory disease. The objective of this study is to determine the location of the MR in relation to easily identified and frequently encountered intranasal landmarks in patients with and without Graves' disease.
METHODS: High-resolution computed tomography scans were analyzed in 100 controls and 63 patients with Graves' disease. The MR position was recorded relative to the maxillary sinus ostium (MSO), anterior ethmoid artery (AEA), and posterior ethmoid artery (PEA)/horizontal basal lamella (BL). Clinically relevant variables recorded at each level included the Keros stage, AEA position, MR height, and distance of the MR to orbital floor, skull base, and LP.
RESULTS: The mean distances between the MR and LP were statistically different for both groups. Controls at the MSO, AEA, and PEA/BL were 2.92, 1.69, and 1.06mm; for Graves' patients measurements at these sites were 2.12, 1.20, and 0.029mm. When comparing the two groups, each of these distances were statistically significant (p<0.02). There was no difference in ethmoid cavity width (p>0.05) between controls (9.66mm) and Graves' patients (9.70mm). Sex, age, and skull base depth were not statistically significant factors.
CONCLUSION: This study illustrates the position of the MR from the perspective of an endoscopic surgeon utilizing fixed intranasal landmarks. Knowledge of the position of MR is critical to safely perform decompression surgery and when operating adjacent to the LP during endoscopic surgery.

PMID: 27040416 [PubMed - as supplied by publisher]



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Asymmetric hearing loss is common and benign in patients aged 95 years and older.

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Asymmetric hearing loss is common and benign in patients aged 95 years and older.

Laryngoscope. 2016 Apr 4;

Authors: Leskowitz MJ, Caruana FF, Siedlecki B, Qian ZJ, Spitzer JB, Lalwani AK

Abstract
OBJECTIVES/HYPOTHESIS: The objective of our study was to investigate age-specific auditory function in the patient population aged 95 years and older.
STUDY DESIGN: Retrospective chart review at a tertiary medical center.
METHODS: Medical records of 51 patients older than 95 years (82% female, 18% male) who underwent audiologic testing were reviewed. The following information was collected: age at time of most recent audiogram and prior audiograms; results of pure tone, immittance, and speech audiometry; and findings on radiologic imaging.
RESULTS: None of the subjects had hearing in the normal range. For the poorer hearing ear, average low-frequency, high-frequency, and overall pure tone averages (PTA) for the population were 67.9, 82.1, and 74.9 dB hearing level, respectively. Mean word recognition score (WRS) was 57.6% and deteriorated with increasing PTA (P = .0002). Asymmetry, defined by a 10-dB difference at two frequencies, was present in 39.2% of the sample, and WRS asymmetry, defined as a difference of 12% in WRS between ears, was present in 33.0% of the sample. Retrocochlear evaluation did not identify pathology in any of the cases tested. In the poorer hearing ear, average decline in PTA per year was 2.9 dB.
CONCLUSIONS: In individuals >95 years of age, hearing loss was universal, moderately severe to profound in magnitude, and associated with substantial loss of speech recognition. Hearing loss progresses at a rate greater than for younger cohorts. In this "oldest old" population, asymmetry of loss and WRS was common and is not indicative of retrocochlear pathology.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27040356 [PubMed - as supplied by publisher]



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Statement of Retraction.

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Statement of Retraction.

Acta Otolaryngol. 2016 Mar;136(3):iii

Authors:

PMID: 27042961 [PubMed - as supplied by publisher]



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Clinical and morphological aspects of adenocarcinomas of the intestinal type in the inner nose: a retrospective multicenter analysis.

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Clinical and morphological aspects of adenocarcinomas of the intestinal type in the inner nose: a retrospective multicenter analysis.

Eur Arch Otorhinolaryngol. 2016 Apr 4;

Authors: Donhuijsen K, Kollecker I, Petersen P, Gaßler N, Wolf J, Schroeder HG

Abstract
Clinical and histological parameters from 117 patients with wood dust-related sinonasal adenocarcinomas of intestinal type (ITAC) were analyzed and correlated with a follow-up period of 5 years at least. The rate of survival for 5 years was 53.1 % and for 10 years 30.2 %. Only 33 patients were free of disease. 74.2 % of patients with recurrences died in relation to ITAC. As expected, tumors of T4-category had the worst prognosis. The mucus content of a tumor was the most important histological parameter. Endonasal methods of surgery had no more positive survival rates after 5 years. An effect of radiotherapy has to be in discussion. The high incidence of tumor recurrences requires control examinations consistently.

PMID: 27040559 [PubMed - as supplied by publisher]



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Initial severity of motor and non-motor disabilities in patients with facial palsy: an assessment using patient-reported outcome measures.

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Initial severity of motor and non-motor disabilities in patients with facial palsy: an assessment using patient-reported outcome measures.

Eur Arch Otorhinolaryngol. 2016 Apr 4;

Authors: Volk GF, Granitzka T, Kreysa H, Klingner CM, Guntinas-Lichius O

Abstract
Patients with facial palsy (FP) not only suffer from their facial movement disorder, but also from social and psychological disabilities. These can be assessed by patient-reported outcome measures (PROMs) like the quality-of-life Short-Form 36 Item Questionnaire (SF36) or FP-specific instruments like the Facial Clinimetric Evaluation Scale (FaCE) or the Facial Disability Index (FDI). Not much is known about factors influencing PROMs in patients with FP. We identified predictors for baseline SF36, FaCE, and FDI scoring in 256 patients with unilateral peripheral FP using univariate correlation and multivariate linear regression analyses. Mean age was 52 ± 18 years. 153 patients (60 %) were female. 90 patients (31 %) and 176 patients (69 %) were first seen <90 or >90 days after onset, respectively, i.e., with acute or chronic FP. House-Brackmann grading was 3.9 ± 1.4. FaCE subscores varied from 41 ± 28 to 71 ± 26, FDI scores from 65 ± 20 to 70 ± 22, and SF36 domains from 52 ± 20 to 80 ± 24. Older age, female gender, higher House-Brackmann grading, and initial assessment >90 days after onset were independent predictors for lower FaCE subscores and partly for lower FDI subscores (all p < 0.05). Older age and female gender were best predictors for lower results in SF36 domains. Comorbidity was associated with lower SF General health perception and lower SF36 Emotional role (all p < 0.05). Specific PROMs reveal that older and female patients and patients with chronic FP suffer particularly from motor and non-motor disabilities related to FP. Comorbidity unrelated to the FP could additionally impact the quality of life of patients with FP.

PMID: 27040558 [PubMed - as supplied by publisher]



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Effects of Full-Neck Volumetric Modulated Arc Therapy versus Split-Field Intensity Modulated Head and Neck Radiation Therapy on Low Neck Targets and Structures.

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Effects of Full-Neck Volumetric Modulated Arc Therapy versus Split-Field Intensity Modulated Head and Neck Radiation Therapy on Low Neck Targets and Structures.

Br J Radiol. 2016 Apr 4;:20160009

Authors: Anamalayil SJ, Teo BK, Lin A, Robert LA, Ahn PH

Abstract
OBJECTIVES: While split-field Intensity Modulated Radiation Therapy (SF-IMRT) decreases dose to low neck (LAN) structures such as glottic larynx compared to full-neck IMRT, it is unknown whether SF-IMRT affords superior dose avoidance to organs compared to whole neck-field Volumetric Modulated Arc Therapy (WF-VMAT).
METHODS: Ten patients treated definitively with radiation for oropharyngeal, oral cavity, or nasopharyngeal carcinoma were compared. Only patients ideally suited for SF-IMRT plans were included. Glottic larynx, supraglottic larynx, arytenoids, pharyngeal constrictors, esophagus, brachial plexus and target volume coverage in the low neck were compared between WF-VMAT and SF-IMRT.
RESULTS: VMAT yielded statistically significant decreases in maximum dose to the arytenoids and mean dose to the esophagus. There was no difference in dose to the glottic larynx, supraglottic larynx, pharyngeal constrictors, and the brachial plexus.WF-VMAT led to improved coverage to 50Gy/2Gy fraction equivalent in low neck compared to SF-IMRT using an AP LAN field, but no difference to the 60Gy/2Gy fraction equivalent between SF-IMRT and WF-VMAT using AP/PA LAN boost.
CONCLUSIONS: WF-VMAT affords equivalent glottic and supraglottic larynx dose, and lower dose to the arytenoids and esophagus. WF-VMAT better covers most low neck target structures. Given these findings as well as concerns with matchline cold or hotspots with SF-IMRT, patients requiring comprehensive elective nodal irradiation should typically be treated with WF-VMAT. Advances in Knowledge: Split-field IMRT for larynx-sparing has better dosimetric results to normal structures than whole-neck IMRT, but with increased matchline recurrence risk. We show dosimetric equivalence or superiority of whole-neck VMAT compared to split-field IMRT.

PMID: 27043353 [PubMed - as supplied by publisher]



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Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: A multicenter retrospective review.

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Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: A multicenter retrospective review.

Head Neck. 2016 Apr 4;

Authors: Choi YS, Park SG, Song EK, Cho SH, Park MR, Park KU, Lee KH, Song IC, Lee HJ, Jo DY, Kim S, Yun HJ, Korean South West Oncology Group (KSWOG) Investigators

Abstract
BACKGROUND: In T4a laryngeal cancer with thyroid cartilage invasion, no optimal frontline treatment has yet been defined in controlled trials.
METHODS: We reviewed data from 89 patients with T4a laryngeal cancer featuring thyroid cartilage invasion who were treated initially with either total laryngectomy (n = 53) or a larynx-preservation strategy (n = 36).
RESULTS: The median progression-free survival (PFS) of the total laryngectomy group had not been attained at the time of analysis and was thus significantly longer than that of the larynx-preservation group (8.7 months). The median overall survival (OS) of patients who underwent total laryngectomy was 87.2 months, significantly longer than that of the larynx-preservation group (31.3 months). The survival benefit of primary surgery compared to a larynx-preservation strategy was more striking in patients of lower N classifications.
CONCLUSION: Total laryngectomy may be a better therapeutic option to treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially in patients exhibiting limited nodal involvement (N0/N1). © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27043228 [PubMed - as supplied by publisher]



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Thyroid Gland Involvement in Carcinoma Larynx and Hypopharynx-Predictive Factors and Prognostic Significance.

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Thyroid Gland Involvement in Carcinoma Larynx and Hypopharynx-Predictive Factors and Prognostic Significance.

J Clin Diagn Res. 2016 Feb;10(2):XC05-XC07

Authors: Iype EM, Jagad V, Nochikattil SK, Varghese BT, Sebastian P

Abstract
INTRODUCTION: Intraoperative management of thyroid gland in laryngeal and hypopharyngeal cancer is controversial.
AIM: The objectives of this study were to determine the incidence of thyroid gland invasion in patients undergoing surgery for laryngeal or hypopharyngeal carcinoma, to assess predictive factors and to assess the prognosis in patients with and without thyroid gland invasion.
MATERIALS AND METHODS: One hundred and thirty-three patients who underwent surgery for carcinoma larynx and hypopharynx from 2006 to 2010 were reviewed retrospectively. Surgical specimens were examined to determine the incidence of thyroid gland invasion and predictive factors were analysed. The recurrence rate and the survival in patients with and without thyroid gland invasion were also analysed.
RESULTS: Out of the 133 patients with carcinoma larynx and hypopharynx who underwent surgery, histological thyroid gland invasion was observed in 28/133 (21%) patients. Significant relationship was found between histological thyroid gland invasion and preoperative evidence of thyroid cartilage erosion by CT scan and also when gross thyroid gland involvement observed during surgery. There is significant association between thyroid gland invasion when there is upper oesophageal or subglottic involvement.
CONCLUSION: After analysing the retrospective data from our study, we would like to suggest that thyroid gland need not be removed routinely in all laryngectomies, unless there is advanced disease with thyroid cartilage erosion and gross thyroid gland involvement or disease with significant subglottic or oesophageal involvement.

PMID: 27042568 [PubMed]



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Effect of Dissection of the Recurrent Laryngeal Nerves on Parathyroid Insufficiency during Total Thyroidectomy for Multinodular Goitre.

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Effect of Dissection of the Recurrent Laryngeal Nerves on Parathyroid Insufficiency during Total Thyroidectomy for Multinodular Goitre.

J Clin Diagn Res. 2016 Feb;10(2):PC01-3

Authors: Sukumaran V, Teli B, Avula S, Pavuluru J

Abstract
INTRODUCTION: Total thyroidectomy is the accepted standard treatment for benign goitrous enlargements. The surgical skill and technique is one of the most important factor which affect the outcome in thyroid surgery. Hypocalcaemia due to parathyroid insufficiency remains a significant postoperative morbidity after total thyroidectomy. The primary cause is unintentional damage to, or devascularization of, one or more parathyroid glands during surgery.
AIM: To study the risk of hypocalcaemia due to recurrent laryngeal nerves (RLNs) dissection during total thyroidectomy for benign multinodular goitre (MNG).
MATERIALS AND METHODS: The study is a non-randomized control trial, where 100 patients with benign MNG were divided into two groups (group A and group B) each consisting of 50 patients. All 100 patients underwent total thyroidectomy by a subcapsular dissection. In patients of group A, both RLNs were clearly dissected for a minimum length of 2cm down from its entry into the larynx before total thyroidectomy was performed. In group B, each patient had total thyroidectomy without making any deliberate attempt to dissect and demonstrate the RLNs. The patients in the two groups were followed up for the incidence of clinically significant hypocalcaemia in the postoperative period.
RESULTS: A total of 30% of patients in group A developed clinical and biochemical manifestations of hypocalcaemia but the incidence of hypocalcaemia was only 6% in the group B. Three (6%) patients out of those who developed hypocalcaemia in group A had a prolonged hypocalcaemia for upto six months. p-value is 0.003 and odds ratio is 6.59.
CONCLUSION: Routine dissection to identify the RLNs could predispose to a higher incidence of postop hypocalcaemia. Subcapsular dissection of the thyroid safely preserves the parathyroid glands.

PMID: 27042514 [PubMed]



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TotalTrack video intubating laryngeal mask in super-obese patients - series of cases.

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TotalTrack video intubating laryngeal mask in super-obese patients - series of cases.

Ther Clin Risk Manag. 2016;12:335-8

Authors: Gaszynski T

Abstract
BACKGROUND: Super-obese patients are at increased risk of difficult mask ventilation and difficult intubation. Therefore, devices that allow for simultaneous ventilation/oxygenation during attempts to visualize the entrance to the larynx, increase patient safety. TotalTrack video intubating laryngeal mask is a new device that allows for ventilation during intubation efforts.
PATIENTS AND METHODS: Twenty-four super-obese patients (body mass index >50 kg/m(2)) were divided into two subgroups: intubation efforts using 1) TotalTrack and 2) Macintosh blade standard laryngoscope in induction of general anesthesia. Visualization and successful intubation was evaluated for both groups with ventilation and post-mask complications additionally evaluated for TotalTrack.
RESULTS: In all cases in the TotalTrack group, the Cormack-Lehane score was 1, ventilation and intubation was successful in 11/12 patients. No hypoxia during intubation efforts was recorded. No serious complications of use of TotalTrack were observed. In the Macintosh blade laryngoscope group, all patients were intubated, but the Cormack-Lehane score was 2 in four cases, and 3 in three cases.
CONCLUSION: TotalTrack video intubating laryngeal mask is a device that allows for better visualization of the larynx compared to the standard Macintosh blade laryngoscope, it provides effective ventilation/oxygenation and intubation in super-obese patients.

PMID: 27042078 [PubMed]



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Hammer sound elicited tinnitus in car body repair worker cured by stapedial tenotomy - A case report.

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Hammer sound elicited tinnitus in car body repair worker cured by stapedial tenotomy - A case report.

Auris Nasus Larynx. 2016 Mar 31;

Authors: Ikeda R, Hidaka H, Miyazaki H, Kawase T, Katori Y, Kobayashi T

Abstract
Abnormal auditory sensations or tinnitus caused by abnormal middle ear muscle contraction are extremely rare and uncomfortable for patients. A 67-year-old man who performed paint and body work for cars presented at our hospital with complaint of an audible and annoying abnormal sound that was synchronous with the striking of his hammer against the metal of the car body during his work. The patient reported that the sound was audible of left ear with a split-second delay after his hammer struck the metal. Preoperative subjective and objective testing failed to reveal any abnormal findings in our case. The patient's symptom was successfully cured by selective transection of the stapedius tendon. The characteristic nature of tinnitus with a split-second delay after striking the metal helped our diagnosis and method of intervention in this case.

PMID: 27040425 [PubMed - as supplied by publisher]



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Introducing a 3-dimensionally Printed, Tissue-Engineered Graft for Airway Reconstruction: A Pilot Study.

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Introducing a 3-dimensionally Printed, Tissue-Engineered Graft for Airway Reconstruction: A Pilot Study.

Otolaryngol Head Neck Surg. 2015 Dec;153(6):1001-6

Authors: Goldstein TA, Smith BD, Zeltsman D, Grande D, Smith LP

Abstract
OBJECTIVE: To use 3-dimensional (3D) printing and tissue engineering to create a graft for laryngotracheal reconstruction (LTR).
STUDY DESIGN: In vitro and in vivo pilot animal study.
SETTING: Large tertiary care academic medical center.
SUBJECTS AND METHODS: A 3D computer model of an anterior LTR graft was designed. That design was printed with polylactic acid on a commercially available 3D printer. The scaffolds were seeded with mature chondrocytes and collagen gel and cultured in vitro for up to 3 weeks. Scaffolds were evaluated in vitro for cell viability and proliferation. Anterior graft LTR was performed on 9 New Zealand white rabbits with the newly created scaffolds. Three animals were sacrificed at each time point (4, 8, and 12 weeks). The in vivo graft sites were assessed via bronchoscopy and histology.
RESULTS: The in vitro cell proliferation assay demonstrated initial viability of 87.5%. The cells proliferated during the study period, doubling over the first 7 days. Histology revealed that the cells retained their cartilaginous properties during the 21-day study period. In vivo testing showed that all animals survived for the duration of the study. Bronchoscopy revealed a well-mucosalized tracheal lumen with no evidence of scarring or granulation tissue. Histology indicated the presence of newly formed cartilage in the region where the graft was present.
CONCLUSIONS: Our results indicate that it is possible to produce a custom-designed, 3D-printed, tissue-engineered graft for airway reconstruction.

PMID: 26392025 [PubMed - indexed for MEDLINE]



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[Occupational Hearing Loss (BK-No. 2301) - A Retrospective Analysis of 100 Consecutive Cases].

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[Occupational Hearing Loss (BK-No. 2301) - A Retrospective Analysis of 100 Consecutive Cases].

Laryngorhinootologie. 2016 Apr 4;

Authors: Reiter R, Brosch S

Abstract
Introduction: In order for a diagnosis of Occupational Hearing Loss (BK-no. 2301) to be made certain criteria must be fulfilled to establish that the hearing loss is occupational in origin. This work compares 2 groups, those who fulfil the criteria (BKE) and those who do not (BKNE). Methods: A 100 consecutive reports ("Lärmgutachten BK-no. 2301") written by the authors were examined retrospectively. These recorded audiometric examination, an analysis of any tinnitus and noise exposure plus use of hearing protection. Pre- and post-noise exposure status together with an expert assessment of work limitations was made to produce a 7 point score. Results: 67% of the group fulfilled the conditions for occupational hearing loss (9% were entitled to compensation). In the BKE group 82% showed typical audiometric signs of noise damage with 75% of them fulfilling at least 6 criteria of occupational disease no. 2301. Tinnitus typical for noise exposure was found in 26%. Discussion: A 7 point score could be useful in the future as a method of helping distinguish hearing loss and tinnitus from occupational as opposed to other causes.

PMID: 27043186 [PubMed - as supplied by publisher]



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Changes in classification of follicular thyroid cancers.

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Changes in classification of follicular thyroid cancers.

Thyroid. 2016 Apr 4;

Authors: Hakala TT, Kholová I

Abstract
During the last decades the histopathological classification of thyroid gland tumors has changed with stricter criteria for follicular thyroid carcinoma (FTC), an establishment of poorly differentiated carcinoma and superposition of nuclear atypia of papillary thyroid carcinoma (PTC) above architecture. Furthermore, an increase in imaging of neck area revealed the frequency of thyroid nodules, which nevertheless harbor cancer only in 5% of the cases. In recent issues of Thyroid, both thyroid cancer epidemiology and FTC reclassification were interestingly covered (1,2). Vaccarella et al. estimated that diagnostic changes may account for ≥60% of thyroid cancer cases diagnosed during recent years in certain developed countries. In a study by Cipriani et al., FTC cases diagnosed during 1965-2007 were re-evaluated by three pathologists. A remarkable 71% of FTC cases were re-classified as follicular adenomas or PTCs. Elimination of follicular adenomas and PTCs led to decreased survival of re-classified FTC patients. Inter- and intraobserver variability in histologic interpretation leads to diagnostic challenges in follicular lesions. We analyzed thyroid cancer in Pirkanmaa region of Finland. During 1981-2002, a total of 495 patients with differentiated thyroid cancer were treated in Tampere University Hospital, Finland (3). We performed registry-based follow-up until December 2011. In our material, 71 (13%) tumors were initially classified as FTCs. In the patient with FTC, disease-specific mortality was 19 (27%) and overall mortality 38 (54%) cases. We performed re-classification of FTCs according to latest WHO guidelines with following results: five (7%) of 71 tumors were re-classified to follicular adenomas and 3 (4%) tumors were reclassified as PTCs. None of the re-classified cases with follicular adenoma or PTC died of thyroid malignancy. In re-classified FTC patients, 19 (30%) patients had FTC-related death, and overall mortality was 36 (57%) cases during the observation period. Our results corroborate that the diagnosis of FTC in may be inaccurate in previous pathology reports. However, in our series, the number of re-classified cases was only 8 out of 71 (11%). These figures are much lower than in the study of Cipriani et al., in which considerable 71% of FTC cases were re-classified to follicular adenomas or PTCs.

PMID: 27043936 [PubMed - as supplied by publisher]



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Misdiagnosis of Graves' disease with apparent severe hyperthyroidism in a patient taking biotin megadoses.

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Misdiagnosis of Graves' disease with apparent severe hyperthyroidism in a patient taking biotin megadoses.

Thyroid. 2016 Apr 4;

Authors: Barbesino G

Abstract
BACKGROUND: Accurate immunoassays measuring minute quantities of hormones are the cornerstone of the practice of endocrinology. Despite tremendous advances in this field, novel pitfalls in these tests emerge from time to time. Oral biotin can interfere with immunoassays of several hormones. The purpose of this report is to relate an extreme case of such interference.
PATIENT FINDINGS: A patient with progressive multiple sclerosis was found to have extremely elevated free thyroxine (FT4), triiodothyronine (T3) and suppressed thyrotropin (TSH) levels. His TSH receptor binding inhibiting antibody (TBII) level was also elevated. This constellation of laboratory findings suggested a diagnosis of severe Graves' disease. All of the assays yielding abnormal results employed the biotin-streptavidin affinity in their design. The patient had no symptoms of hyperthyroidism and detailed review of his medications revealed intake of megadoses of biotin. Temporary discontinuation of biotin treatment resulted in complete resolution of the biochemical abnormalities.
CONCLUSIONS: Non-physiologic biotin supplementation may interfere with several immunoassays, including thyroid hormones, TSH, thyroglobulin (Tg) and TBII leading to erroneous diagnoses. Questioning for biotin intake should be part of the evaluation for patients undergoing endocrine tests. Interruption of biotin supplementation for at least 2 days prior to biotin-sensitive tests should be sufficient to avoid major misdiagnoses.

PMID: 27043844 [PubMed - as supplied by publisher]



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Prediction of occult lymph node metastasis in squamous cell carcinoma of the oral cavity and the oropharynx using peritumoral Prospero homeobox protein 1 lymphatic nuclear quantification.

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Prediction of occult lymph node metastasis in squamous cell carcinoma of the oral cavity and the oropharynx using peritumoral Prospero homeobox protein 1 lymphatic nuclear quantification.

Head Neck. 2016 Apr 4;

Authors: Mermod M, Bongiovanni M, Petrova TV, Dubikovskaya EA, Simon C, Tolstonog G, Monnier Y

Abstract
BACKGROUND: The use of lymphatic vessel density as a predictor of occult lymph node metastasis (OLNM) in head and neck squamous cell carcinoma (HNSCC) has never been reported.
METHODS: Staining of the specific lymphatic endothelial cells nuclear marker, PROX1, as an indicator of lymphatic vessel density was determined by counting the number of positive cells in squamous cell carcinomas (SCCs) of the oral cavity and the oropharynx with clinically negative necks. Correlation with histopathological data was established.
RESULTS: Peritumoral PROX1 lymphatic nuclear count significantly correlated with the detection of OLNM in multivariate analysis (p < .005). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this parameter was 60%, 95%, 85%, and 90%, respectively.
CONCLUSION: Peritumoral PROX1 lymphatic nuclear count in primary SCCs of the oral cavity and the oropharynx allows accurate prediction of occult lymph node metastasis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27043718 [PubMed - as supplied by publisher]



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Relapse status as a prognostic factor in patients receiving salvage surgery for recurrent or residual nasopharyngeal cancer after definitive treatment.

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Relapse status as a prognostic factor in patients receiving salvage surgery for recurrent or residual nasopharyngeal cancer after definitive treatment.

Head Neck. 2016 Apr 4;

Authors: Chee J, Ting Y, Ong YK, Chao SS, Loh KS, Lim CM

Abstract
BACKGROUND: The purpose of this study was to determine the prognostic value of relapse status (recurrent vs residual disease) in patients receiving surgical salvage for nasopharyngeal carcinoma (NPC).
METHODS: Retrospective review was conducted on 52 patients who underwent salvage surgery for locoregional relapse of NPC. Univariate and multivariate analyses were used to investigate the prognostic value of relapse status.
RESULTS: Median follow-up duration was 44.4 months. Mean overall survival (OS) and disease-free survival (DFS) for patients with NPC with residual and recurrent disease after surgical salvage were 107.4 and 54.4 months, and 83.6 and 34.6 months, respectively (p < .001). This improved survival was demonstrated regardless whether the relapse was at the primary or nodal site. Multivariate analysis revealed that recurrent disease status and nodal disease relapse were independent poor prognostic factors for survival in patients receiving salvage surgery for NPC.
CONCLUSION: In patients undergoing surgical salvage for NPC relapse, residual disease carries a better prognosis than recurrent disease. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27043448 [PubMed - as supplied by publisher]



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Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study.

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Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study.

PLoS One. 2016;11(4):e0153092

Authors: Chang TP, Lin YW, Sung PY, Chuang HY, Chung HY, Liao WL

Abstract
BACKGROUND: Benign paroxysmal positional vertigo (BPPV), the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation.
METHODS: Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls.
RESULTS: In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001). After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27-2.47). This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39-2.26).
CONCLUSIONS: Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should consider dental procedures to be a risk factor, and dentists should recognize BPPV as a possible complication of dental treatment.

PMID: 27044009 [PubMed - as supplied by publisher]



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