OtoRhinoLaryngology News: 02/05/18

Δευτέρα 5 Φεβρουαρίου 2018

Baseline neutrophil to lymphocyte ratio combined with serum LDH level associated with outcome of nivolumab immunotherapy in a Japanese advanced melanoma population

Abstract

Although immune checkpoint inhibitors (ICI) significantly improve the survival of advanced melanoma, more than half of the patients received no benefit. To predict outcomes, efforts to associate baseline peripheral blood biomarkers were started in patients given treatment with ipilimumab. Among the most critical markers is an increased neutrophil-to-lymphocyte ratio (NLR), which negatively correlates with outcome. Although several baseline factors have been reported to correlate with outcome in patients treated with nivolumab/pembrolizumab (eosinophil count, lymphocyte count, lactate dehydrogenase [LDH], and c-reactive protein [CRP]), a positive link between NLR and outcome has yet to be shown.

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Wide skin markings pattern - melanoma descriptor or patient-related factor?

Abstract

We are intrigued by the findings reported in the letter titled "Uncovering the diagnostic dermoscopic features of flat melanomas located on the lower limbs"(1). Bassoli et al investigated the association of the "wider skin marking pattern" with cutaneous melanoma. They state that this feature corresponds to "…linear intercepting furrows, lighter than the lesion's overall pigmentation and wider compared to the surrounding skin. The authors conclude that "recognition of wider skin markings may…prompt the clinician to obtain a biopsy specimen." We respectfully ask the authors to clarify several aspects of their study methodology.

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Application of in vivo reflectance confocal microscopy (RCM) and ex vivo fluorescence confocal microscopy (FCM) in most common subtypes of Basal Cell Carcinoma and correlation with histopathology

Abstract

Basal cell carcinoma (BCC) accounts for 80% of non-melanoma skin cancer. The identification of the histological subtype is crucial for the correct management of the tumor. In vivo reflectance confocal microscopy (RCM) is a novel technique that has demonstrated high sensitivity and specificity in the in vivo diagnosis of BCC. In an effort to determine reliable criteria for preoperative diagnosis of BCC subtypes, Longo et al. and Peppelman et al., described RCM criteria present in different BCC subtypes.

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Hyaluronan metabolism enhanced during epidermal differentiation is suppressed by vitamin C

Abstract

Background

Hyaluronan is a large, linear glycosaminoglycan present throughout the narrow extracellular space of the vital epidermis. Increased hyaluronan metabolism takes place in epidermal hypertrophy, wound healing and cancer. Hyaluronan is produced by hyaluronan synthases (HAS1-3) and catabolized by hyaluronidases (HYAL1 and -2), reactive oxygen species (ROS), and the KIAA1199 protein.

Objectives

To investigate the changes in hyaluronan metabolism during epidermal stratification and maturation, and the impact of vitamin C.

Methods

Hyaluronan synthesis and expression of the hyaluronan-related genes were analyzed during epidermal maturation from a simple epithelium to a fully differentiated epidermis in organotypic cultures of rat epidermal keratinocytes (REK) using qRT-PCR, immunostainings, and western blotting, in the presence and absence of vitamin C.

Results

With epidermal stratification, both the production and the degradation of hyaluronan were enhanced, resulting in an increase of hyaluronan fragments of various sizes. While the mRNA levels of Has3 and KIAA1199 remained stable during the maturation, Has1, Has2, and Hyal2 showed a transient upregulation during stratification, Hyal1 remained permanently increased, and the hyaluronan receptor Cd44 decreased. At maturation, Vitamin C downregulated Has2, Hyal2 and Cd44, while it increased high molecular mass hyaluronan in the epidermis, and reduced small fragments in the medium, suggesting stabilization of epidermal hyaluronan.

Conclusions

Epidermal stratification and maturation is associated with enhanced hyaluronan turnover, and release of large amounts of hyaluronan fragments. The high turnover is suppressed by vitamin C, which is suggested to enhance normal epidermal differentiation in part through its effect on hyaluronan.

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Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial

Abstract

Objective

The aim of this study was to compare the clinical and radiographic efficacy of guided tissue regeneration with a modified perforated collagen membrane (MPM) or standard collagen membrane (CM) in the treatment of intrabony defects in patients with aggressive periodontitis (AgP).

Materials and methods

Fifteen AgP patients were included in the study. Two single intrabony defects of at least 3 mm depth with ≥ 6 mm probing pocket depth (PPD) from each patient were randomly assigned to either xenogenic graft plus MPM (test group) or xenogenic graft plus CM (control group). PPD, clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and at 12 months. The radiographic assessments included the measurements of defect depth (DD), change in alveolar crest position (ACP), linear defect fill (LDF), and percentage defect fill (%DF).

Results

After treatment, PPD, CAL, DD, and ACP values improved significantly in both groups, without statistical differences between them. However, with respect to LDF and %DF, the 12-month radiographic analysis at MPM-treated sites showed a significant improvement compared to the 6-month outcomes, that was not observed at control sites (additional LDF of 0.4 ± 0.5 mm, p = 0.010 and %DF of 6.4 ± 7.6%, p = 0.025).

Conclusions

Both strategies proved effective in the treatment of intrabony defects in patients with AgP. Nonetheless, enhanced LDF and %DF 12 months postoperatively at MPM-treated sites may stem from cellular and molecular migration from the periosteum and overlying gingival connective tissue through barrier's pores.

Clinical relevance

Modification of CM may have positive ramifications on periodontal regeneration.

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Assessing the Feasibility of an Electronic Patient-Reported Outcome (ePRO) Collection System in Caregivers of Cancer Patients

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Atrial Fibrillation for the Neurologist: Preventing both Ischemic and Hemorrhagic Strokes

Abstract

Purpose of Review

This review aims to help neurologists managing atrial fibrillation (AF) patients who had an ischemic stroke and/or with intracranial hemorrhage (ICH) markers, therefore at high embolic/hemorrhagic risks.

Recent Findings

Implantable loop recorders have substantially improved the accuracy of AF detection. Recent research yielded a set of powerful neuroimaging markers that can stratify ICH risk. Direct oral anticoagulants (DOAC) are easier to use with a lower ICH risk than warfarin in a general AF population. Finally, the FDA-approved left atrial appendage closure (LAAC) with the WATCHMAN device provides an option without the need for life-long anticoagulation.

Summary

In this review, we introduce the concept of preventing both ischemic and hemorrhagic strokes in AF patients through accurate AF diagnosis and stratification of both embolic and ICH risks. LAAC can be considered in patients at higher hemorrhagic risks while warfarin/DOAC use should be individualized in the majority of AF patients at a low risk of bleeding.

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Cancers, Vol. 10, Pages 44: Integrin Inhibitors in Prostate Cancer

Cancers, Vol. 10, Pages 44: Integrin Inhibitors in Prostate Cancer

Cancers doi: 10.3390/cancers10020044

Authors: Maylein Juan-Rivera Magaly Martínez-Ferrer

Prostate cancer (PCa) is the most frequently diagnosed cancer and the third highest cause of cancer-related deaths in men in the U.S. The development of chemotherapeutic agents that can bind PCa tumor cells with high specificity is critical in order to increase treatment effectiveness. Integrin receptors and their corresponding ligands have different expression patterns in PCa cells. They have been identified as promising targets to inhibit pathways involved in PCa progression. Currently, several compounds have proven to target specific integrins and their subunits in PCa cells. In this article, we review the role of integrins inhibitors in PCa and their potential as therapeutic targets for PCa treatments. We have discussed the following: natural compounds, monoclonal antibodies, statins, campothecins analog, aptamers, d-aminoacid, and snake venom. Recent studies have shown that their mechanisms of action result in decrease cell migration, cell invasion, cell proliferation, and metastasis of PCa cells.

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Herpes zoster at the vaccination site in immunized healthy children

Abstract

In this case series, we report seven immunized healthy children without underlying immunodeficiency who presented with herpes zoster that correlated with varicella-zoster vaccination site. The morphology of the lesions included erythematous papules, pseudovesicles, and plaques, with associated pain in two and pruritus in three patients; systemic symptoms ranged from none to low-grade fevers, upper respiratory symptoms, and joint pain. These cases highlight the clinical, diagnostic, and therapeutic implications of herpes zoster in vaccinated children.

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Enhanced Recovery After Surgery (ERAS®) in thoracic surgical oncology

Future Oncology, Ahead of Print.

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Is it appropriate to perform video-assisted thoracoscopic surgery for advanced lung cancer?

Future Oncology, Ahead of Print.

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Publication date: February 2018
Source:Cancer Epidemiology, Volume 52

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Title page / Editorial Board

Publication date: February 2018
Source:Cancer Epidemiology, Volume 52

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Metastatic melanoma with dedifferentiation and extensive rhabdomyosarcomatous heterologous component

Melanoma may undergo dedifferentiation and sarcomatous transformation with loss of melanocytic markers. Dedifferentiated melanoma rarely forms true rhabdomyoblasts with skeletal muscle immunophenotype (rhabdomyosarcomatous heterologous component). A 52 year-old woman was diagnosed with invasive melanoma (Breslow depth 0.83 mm) of the upper back in 2012, treated by wide local excision only. In 2013, an axillary mass was excised to show metastatic melanoma with two morphologies: an epithelioid morphology expressing S100 and MART-1 and a spindled morphology with loss of melanocytic markers but strong expression of desmin. This metastasis was found to have BRAF V600E mutation. In 2015, a thoracic epidural mass biopsy showed atypical spindle cells with focal HMB-45 but essentially no S100 expression. Numerous rhabdomyoblasts, some with striations that were strongly positive for desmin and myogenin, were present. In 2016, a right nephrectomy was performed for metastasis to the kidney, and showed sheets of spindle cells and rhabdomyoblasts expressing desmin and myogenin but not S100. Only focal areas demonstrated expression of HMB-45 and SOX-10, supporting the melanocytic origin of the tumor. The numerous rhabdomyoblasts and the loss of S100 expression in the metastatic lesions in this case could have easily led to misdiagnosis if the clinical history was not known.

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Event-related desynchronization of mu and beta oscillations during the processing of novel tool names

Publication date: February–March 2018
Source:Brain and Language, Volumes 177–178
Author(s): Laura Bechtold, Marta Ghio, Joachim Lange, Christian Bellebaum
According to the embodied cognition framework, the formation of conceptual representations integrates the type of experience during learning. In this electroencephalographic study, we applied a linguistic variant of a training paradigm, in which participants learned to associate novel names to novel tools while either manipulating or visually exploring them. The analysis focused on event-related desynchronization (ERD) of oscillations in the mu and beta frequency range, which reflects activation of sensorimotor brain areas. After three training sessions, processing names of manipulated tools elicited a stronger ERD of the beta (18–25 Hz, 140–260 ms) and the lower mu rhythm (8–10 Hz, 320–440 ms) than processing names of visually explored tools, reflecting a possible reactivation of experiential sensorimotor information. Given the unexpected result that familiarized pseudo-words elicited an ERD comparable to names of manipulated tools, our findings could reflect a suppression of sensorimotor activity during the processing of objects with exclusively visual features.

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Long-term study of the efficacy and safety of OnabotulinumtoxinA for the prevention of chronic migraine: COMPEL study

OnabotulinumtoxinA is approved for the prevention of headache in those with chronic migraine (CM); however, more clinical data on the risk-benefit profile for treatment beyond one year is desirable.

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In Vitro and In Vivo Characterization of a Preclinical Radiation-Adapted Model for Ewing Sarcoma

Publication date: Available online 5 February 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Mary Carroll Shapiro, Tien Tang, Atreyi Dasgupta, Lyazat Kurenbekova, Ryan Shuck, M. Waleed Gaber, Jason T. Yustein
PurposeRadiation therapy (RT) is a viable therapeutic option for Ewing sarcoma (ES) patients. However, little progress has been made to elucidate mechanisms of radioresistance. This study establishes a novel ES radiation-adapted model designed to assess molecular and fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) alterations secondary RT.Methods and MaterialsRadiation-adapted cell lines (RACL) were created in vitro by exposing ES human cell lines to fractionated doses of radiation. Assays to assess migration/invasion potential and RNA expression were performed on the RACL. Orthotopic intra-tibial in vivo investigations were performed with radiation-sensitive and radiation-adapted ES cells to generate tumors. Transplanted mice were imaged using ¹⁸F-FDG-PET followed by fractionated RT directed at the primary tumor. Mice were monitored for tumor regression and change in metabolic activity using ¹⁸F-FDG PET imaging. Protein expression analyses were performed on the RACL and orthotopic tumors.ResultsExposure to fractionated doses of radiation caused a significant increase in migratory and invasive properties in the RACL when compared to non-irradiated wild type ES cells. RACL transcriptomic and proteomic analysis suggests enhanced activation of the mTOR-AKT pathway when compared to wild type ES cells. Radiation-adapted tumors demonstrated significantly less tumor regression (p = 0.03) compared to wild type tumors. Wild type tumors also had decreased expression of lactate dehydrogenase A (LDHA) protein and significantly lower metabolic activity after RT compared to radiation-adapted tumors (p = 0.03).ConclusionsWe developed novel in vitro and in vivo radiation-adapted ES models. In vitro investigations revealed increased migratory and invasive phenotypes in the RACL. In vivo investigations demonstrated increased metabolic activity and significantly decreased sensitivity to RT in the radiation-adapted tumors as demonstrated by growth response curves and ¹⁸F-FDG PET activity. Investigations of the RACL identified possible radiosensitizing-dependent targets in LDHA and mTOR-AKT pathway.

Teaser

Ewing sarcoma (ES) is the second most common pediatric bone cancer, and patients with relapsed/resistant disease have a five-year overall survival rate of only 15-20%. Front-line standard of care treatment for patients with ES includes chemotherapy and local control with surgery and/or radiation. We have developed novel in vitro and in vivo radiation-adapted ES models that demonstrate a relationship between metabolism and radioresistance as well as identify several candidate biomarkers for radioresistant disease in ES.

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Does Prophylactic Radiotherapy to avoid Gynecomastia in Patients with Prostate Cancer increase the risk of Breast Cancer?

Publication date: Available online 5 February 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Bjørg Y. Aksnessæther, Arne Solberg, Olbjørn H. Klepp, Tor Åge Myklebust, Eva Skovlund, Solveig Roth Hoff, Lars J. Vatten, Jo-Åsmund Lund
PurposeProstate cancer (PC) patients treated with antiandrogen monotherapy are offered prophylactic radiotherapy to the breast buds (PRT) to avoid gynecomastia. The aim of this study was to evaluate whether the risk of breast cancer (BC) in men with PC as their first cancer diagnosis, was influenced by PRT.Methods and MaterialsFrom the Norwegian Cancer Registry we collected data on all patients with PC as their first cancer diagnosis diagnosed between 1997- 2014. We registered all radiotherapy given to the patients in the same period, and the occurrence of BC diagnosed 3 months or more following the PC diagnosis. The histopathological diagnoses of all BC cases were collected. Subdistribution hazard ratios (SHR) for the risk of BC in PRT and non-PRT treated patients were estimated. A standardized incidence ratio (SIR) for BC was calculated by comparing our cohort to the standard male population.ResultsWe analyzed 59 169 patients with PC, whom 7864 (13.3%) had received PRT. Median follow-up time was 4 years. Three of 12 men diagnosed with BC had received PRT, and two of three were phyllodes tumors. The risk of BC was not statistically significantly different in patients given RT as compared to the non-RT patients, SHR 1.62 95% CI 0.41-5.62, adjusted for age and time of diagnosis. SIR was 0.996 95 % CI 0.57-1.75.ConclusionsIn this registry based study, we did not find an increased risk of BC in PC patients treated with PRT. The number of BC cases in our study was low, and the risk of secondary breast cancer following PRT seems to be negligible. The incidence of BC may, however rise with additional follow-up. It is noteworthy that two patients who had been treated with PRT were diagnosed with malignant phyllodes tumor, an extremely rare type of BC associated with gynecomastia.

Teaser

Nordic patients with prostate cancer receive prophylactic radiotherapy to the breast buds to avoid gynecomastia when treated with antiandrogen monotherapy. In this study with data from the Norwegian Cancer Registry, we did not find increased risk of breast cancer (BC) in irradiated patients compared to non-irradiated patients. It is noteworthy that in the RT group, there were two cases of malignant phyllodes breast tumor, an extremely rare type of BC associated with gynecomastia.

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Evaluation of the genotoxic effects of formocresol application in vital pulp therapy of primary teeth: a clinical study and meta-analysis

Abstract

Objectives

This in vivo research investigated whether pulp treatments using formocresol for 7 days would cause mutagenic changes in children's lymphocytes.

Materials and methods

The mutagenicity was tested in lymphocyte cultures established from the peripheral blood of children living in Brazil. The samples consisted of 2000 cells from teeth undergoing formocresol pulpotomies in which the formocresol pellet was sealed in the primary tooth for 7 days. It was removed on the seventh day, the base was placed, and the tooth was restored. Two venous blood samples (6–8 ml) were collected from each child; the first was prior to pulp therapy, and the second was 7 days later. Two thousand metaphases were analyzed. The level of significance adopted for the statistics was P < 0.05, and a random effects meta-analysis was performed combining this and two previous studies.

Results

There was no significant difference found in the metaphase analysis between the blood samples taken before and after the pulpotomy treatment (Wilcoxon signed rank test); however, the meta-analysis showed a significant difference between the combined studies.

Conclusions

This study did not reveal any mutagenic effects, but based on the combined meta-analysis, we recommend the careful use of formocresol.

Clinical relevance

This research helps to bring scientific evidence of the safe use of formocresol in deciduous pulpotomy treatments.

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Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP

Abstract

Objectives

The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP).

Material and methods

The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°–55°; 1.2 × 10⁶ cycles 0–50 N) and subsequent linear loading until failure.

Results

Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024).

Conclusions

Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure.

Clinical relevance

CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.

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Das Recht am eigenen Bild

Laryngo-Rhino-Otol 2018; 97: 121-122
DOI: 10.1055/s-0043-118941

Article in Thieme eJournals:
Table of contents | Full text

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Rhinoplastik

Laryngo-Rhino-Otol 2018; 97: 141-145
DOI: 10.1055/s-0043-124386

Article in Thieme eJournals:
Table of contents | Full text

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Endoskopisch ausgeführte Tympanoplastik mit Vorteilen

Laryngo-Rhino-Otol 2018; 97: 82-83
DOI: 10.1055/s-0043-121839

Kuo CH et al. Comparison of endoscopic and microscopic tympanoplasty. Eur Arch Otorhinolaryngol 2017;274:2727–2732 Welche Vor-und Nachteile hat die endoskopisch durchgeführte Tympanoplastik? Wie sieht die Erfolgs- und die Komplikationsrate bei alleiniger Rekonstruktion des Trommelfells und bei Wiederherstellung einer funktionalen Gehörknöchelchenkette aus?
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Article in Thieme eJournals:
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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 138-139
DOI: 10.1055/s-0044-101037

Article in Thieme eJournals:
Table of contents | Full text

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Erhöhtes Schlaganfallrisiko nach Neck Dissection?

Laryngo-Rhino-Otol 2018; 97: 83-84
DOI: 10.1055/s-0043-121847

Cramer JD et al. Is Neck Dissection Associated with an Increased Risk of Postoperative Stroke? Otolaryngol Head Neck Surg 2017; 157(2): 226–232 Der Schlaganfall gehört zu den schwersten Komplikationen der Kopf- und Hals- Chirurgie. Wie hoch das Risiko speziell nach einer Neck Dissection ist, haben Cramer und Kolleginnen/Kollegen jetzt in einer retrospektiven Kohortenstudie genauer untersucht.
[...]

Article in Thieme eJournals:
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Medikamentöse Therapie des Schilddrüsenknotens

Laryngo-Rhino-Otol 2018; 97: 89-91
DOI: 10.1055/s-0043-124607

Während in Regionen mit ausreichender Iodversorgung die Therapie des Schilddrüsenknotens mit Levothyroxin weitgehend verlassen wurde und auch nicht mehr in den Leitlinien empfohlen wird, gibt es für eine medikamentöse Therapie von Schilddrüsenknoten in Deutschland eine Indikation, wie die randomisierte, placebokontrollierte LISA-Studie nachgewiesen hat.Wesentlicher Grund ist ein leichter Iodmangel bei Patienten mit Schilddrüsenknoten. In der LISA-Studie führte eine Levothyroxin-Iodid-Kombinationstherapie zu einer mindestens 50 %igen Volumenreduktion der Knoten bei 21,6 % der Patienten gegenüber bei nur 5,2 % der Placebo-Behandelten.Unter der kombinierten L-T4-Iodidtherapie wird der TSH-Wert im unteren Referenzbereich eingestellt, eine TSH-Suppression (latente Hyperthyreose) muss vermieden werden, da sie zu Herzrhythmusstörungen führen kann.Im höheren Alter muss aufgrund der kardiovaskulären Risiken die Indikation zu einer Schilddrüsenhormontherapie überprüft, die Dosis häufig reduziert oder die Therapie abgesetzt werden.
[...]

Article in Thieme eJournals:
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Tympanoplastik Typ I im frühen Kindesalter erfolgsversprechend

Laryngo-Rhino-Otol 2018; 97: 84-85
DOI: 10.1055/s-0043-123911

Singh GB et al. Paediatric tympanoplasty: comparative study between patients aged 5–8 years and those aged over 14 years. J Laryngol Otol 2016; 130: 635–639
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Aktueller Status der Therapie und Prophylaxe des Oropharynxkarzinoms

Laryngo-Rhino-Otol 2018; 97: 123-137
DOI: 10.1055/s-0043-121329

Die Inzidenz von Oropharynxkarzinomen nimmt weltweit signifikant zu. Aufgrund ihres Zusammenhangs mit chronischem Tabak-/Alkoholkonsum, zunehmend aber auch mit dem humanen Papillomavirus HPV-16, sind die Oropharynxkarzinome eine genetisch heterogene Tumorgruppe mit hoher prognostischer Diversifikation. Dieser Beitrag versucht auf Basis der aktuellen Evidenzlage Empfehlungen zu Therapie, Prophylaxe und Früherkennung darzulegen.
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Durchführung und Interpretation der FEES (Fiberoptic Endoscopic Evaluation of Swallowing)

Laryngo-Rhino-Otol 2018; 97: 86-88
DOI: 10.1055/s-0043-125007

Article in Thieme eJournals:
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„Das Thema künstliche Intelligenz ist in der Radiologie angekommen“

Laryngo-Rhino-Otol 2018; 97: 140-140
DOI: 10.1055/s-0043-125319

Zum zweiten Mal nach 2017 findet im Februar 2018 der Kongress Emerging Technologies in Medicine – ETIM statt. Initiator des Zukunftskongresses ist Prof. Dr. Michael Forsting, Direktor der Universitätsradiologie Essen. Im Interview skizziert er die Themen der kommenden Tagung und welche Bedeutung sie für die Radiologie haben.
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Seltener Nasennebenhöhlen Tumor

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-123652

Article in Thieme eJournals:
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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 79-80
DOI: 10.1055/s-0044-100459

[...]

Article in Thieme eJournals:
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Current concepts in cleft care: A multicenter analysis

The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center.

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Response to: baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO

We read with interest comments from Oppenheimer and Greenberger1 highlighting the baseline findings of the PROSPERO trial that describe a real-world population with moderate to severe asthma accompanied by multiple comorbidities, a substantial disease burden, and a heterogeneous biomarker profile who were initiated on omalizumab.2 We agree with their conclusions that patients with severe asthma represent a challenging population and that multiple factors must be considered when evaluating patients as candidates for biologic therapies.

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Biologics in allergic and immunologic diseases: promises and challenges in the era of personalized medicine

Discovery of new biologics offer promise in the treatment of chronic, refractory allergic and immunologic conditions. Emerging biologic therapies have ushered in an era of personalized medicine, also referred to as precision medicine, whereby physicians can choose targeted therapies based on disease phenotype. Undoubtedly, this has been a significant advance for patients with conditions such as severe asthma, and also offers hope for successful management of other allergic and immunologic conditions, such as severe atopic dermatitis and refractory chronic urticaria.

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Prognostic factors in head and neck mucoepidermoid carcinoma: experience at a single institution based on 64 consecutive patients over a 28-year period

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): M. Granic, P. Suton, D. Mueller, I. Cvrljevic, I. Luksic
Mucoepidermoid carcinoma (MEC) is the most common malignancy of the salivary glands. The clinical behaviour of MEC is largely unpredictable, ranging from indolent tumour growth to highly aggressive metastatic spread. The objective of this study was to determine the clinicopathological predictors of recurrence and survival in patients with head and neck MEC. The medical records of 64 patients who underwent surgical treatment for head and neck MEC between 1982 and 2010 were reviewed. The main outcome measures were disease-free survival (DFS) and overall survival (OS). Clinicopathological parameters evaluated were age, sex, anatomical subsite, histological grade, tumour stage, tumour size, adjuvant therapy, and nodal and margin status. For the entire cohort, the 5-year DFS was 82.8% and the 5-year OS was 67.2%. Histological grade and tumour subsite were statistically significant predictors of OS. Furthermore, tumour stage and nodal status were statistically significant predictors with respect to OS. Advanced tumour stage, high histological grade, submandibular/sublingual localization, and positive nodal status were independent predictors of the prognosis in patients with head and neck MEC. Further studies into the molecular biology of MEC are needed in order to provide new therapeutic strategies for patients with locally aggressive and highly metastatic carcinomas.

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Donor site morbidity after vascularized fibula free flap: gait analysis during prolonged walk conditions

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): N. Hadouiri, D. Feuvrier, J. Pauchot, P. Decavel, Y. Sagawa
The aim of this study was to determine the effect of vascularized fibula free flap (VFFF) harvest on gait variables during the six-minute walk test (6MWT). Eleven patients who had undergone VFFF harvest and 11 healthy peers participated in this case–control study. The main evaluation consisted of the collection of gait variables using the GAITRite system during three periods of the 6MWT: beginning (0–1min), middle (2:30–3:30min), and end (5–6min). The 6MWT was significantly shorter in the VFFF group than in the reference group (−31%, P<0.001). Most gait variables differed significantly between the groups for each period (P-value range 0.04–0.0004), including toe in/out on the operated side (P-value range 0.005–0.01). The increase in toe in/out on the operated side suggests a functional modification caused by an imbalance of the agonist–antagonist muscles. On comparison of the different periods, gait velocity decreased between the beginning and middle periods and increased between the middle and end periods in both groups. However, a significantly lower velocity between the beginning and end periods was found only for the VFFF group (P=0.026), suggesting an alteration in physical management. In conclusion, these results suggest that VFFF harvesting could alter gait and joint integrity.

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Editorial Board/Reviewing Committee

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3

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Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction–mandibular setback surgery in patients with cleft lip and palate

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): T. Susami, Y. Mori, K. Ohkubo, M. Takahashi, Y. Hirano, H. Saijo, T. Takato
Maxillary distraction is increasingly used for the correction of severe maxillary retrusion in patients with cleft lip and palate. However, control of the maxillary movement is difficult, and the need to wear visible distractors for a long period of time causes psychosocial problems. A two-stage surgical approach consisting of maxillary distraction and mandibular setback was developed to overcome these problems. In this study, changes in maxillofacial morphology and velopharyngeal function were examined in 22 patients with cleft lip and palate who underwent this two-stage approach. Lateral cephalograms taken just before the first surgery, immediately after the second surgery, and at completion of the active post-surgical orthodontic treatment were used to examine maxillofacial morphology. Velopharyngeal function was evaluated by speech therapists using a 4-point scale for hypernasality. The average forward movement of the maxilla with surgery at point A was 7.5mm, and the average mandibular setback at pogonion was 8.6mm. The average relapse rate during post-surgical orthodontic treatment was 25.2% for the maxilla and 11.2% for the mandible. After treatment, all patients had positive overjet, and skeletal relapse was covered by tooth movement during postoperative orthodontics. Velopharyngeal function was not changed by surgery. This method can shorten the period during which the distractors have to be worn and reduce the patient burden.

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Quantitative assessment of the learning curve for cleft lip repair using LC-CUSUM

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): E. Segna, J.-B. Caruhel, P. Corre, A. Picard, D. Biau, R.H. Khonsari
The first step in cleft lip repair is the precise positioning of anatomical landmarks and tracing of the incisions on the patient's lip at the beginning of the procedure. The aim of this study was to evaluate progress made in learning cleft lip repair tracing using a quantitative assessment of learning curves: LC-CUSUM (learning curve – cumulative sum). Eight surgical residents were enrolled and asked to trace lip repair incisions on five cases of unilateral left cleft lip over 5 consecutive weeks. Results were compared to a reference tracing based on the positioning of nine anatomical landmarks and assessed using LC-CUSUM. Competence was defined as the accurate positioning of the nine landmarks (less than 1.4mm deviation from the reference positions, with an accepted 15% failure rate). After five tracing sessions, competence was not achieved evenly for all trainees, or for all landmarks, underlining differences in inter-individual learning ability even with similar training. However, despite an initial marked lack of theoretical and practical training in lip repair techniques, repeated drawings of cleft lip incisions allowed a satisfactory level of competence to be reached for most landmarks and most trainees. Nevertheless it was found that not all landmarks are understood by students with similar ease, and that landmark positioning reveals significant inter-individual differences. This approach allowed a global assessment of the teaching of cleft repair and will help to focus training on specific problematic points for which competence was not obtained according to the LC-CUSUM test.

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The role of psychological factors in the development of burning mouth syndrome

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): H.S. Yoo, S.H. Jin, Y.J. Lee, C.M. Song, Y.B. Ji, K. Tae
The psychiatric profiles of 50 patients diagnosed with burning mouth syndrome (BMS) were compared to those of 50 age- and sex-matched individuals as the control group. The Symptom Checklist-90-Revised (SCL-90-R) questionnaire was used to evaluate the role of psychological factors in the development of BMS. Somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, psychoticism, global severity index (GSI), positive symptom total (PST), and positive symptom distress index (PSDI) scores were significantly higher in the patients with BMS than in the control group. In a subgroup analysis according to sex, women with BMS had higher T-scores for somatization, obsessive-compulsive, paranoid ideation, GSI, PST, and PSDI than women in the control group. In contrast, only the PSDI score was significantly higher in men with BMS compared to men in the control group. There was a significant difference in the T-scores for somatization, psychoticism, and GSI between the three age subgroups (≤50, 51–65, and ≥66 years). The obsessive-compulsive and PSDI scores were significantly higher in patients with BMS who also had at least one chronic disease than in patients with BMS who had no chronic disease. In conclusion, psychological factors are correlated with BMS.

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Clinical implications of taste thresholds in patients with odontogenic maxillary sinusitis

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): T. Tsuji, S. Tanaka, Y. Nishide, M. Kogo, T. Yamamoto
Patients with odontogenic maxillary sinusitis (OMS) often complain of reduced taste sensitivity as well as nasal obstruction. The filter paper disc method (the conventional gustatory test) was applied to nine patients who underwent sinus surgery to open the inferior nasal meatus and sinus drainage, on three different days: 1day prior to surgery, 7days postoperative, and 28days postoperative. The same test was applied to nine non-clinical participants with or without clipping the nose to interfere with smooth nasal airflow on two different days. Acquired recognition thresholds for the four basic tastes of sweet, salty, sour, and bitter were assessed. In OMS patients, the recognition thresholds for all four tastes were markedly decreased at 7 and 28days postoperative, and subjective taste sensitivity and the elimination of nasal obstruction was improved. The mean recognition threshold for the four tastes correlated negatively with taste satisfaction scores. Clipping the nose in non-clinical participants induced increases in gustatory detection and recognition thresholds. Despite the small sample size and different ages and sexes of the study subjects, it was demonstrated that nasal obstruction in OMS patients and nose clipping in non-clinical subjects reduce taste reactivity, and surgical intervention to promote nasal airflow recovers impaired taste reactivity.

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Three-dimensionally printed personalized guide plate for percutaneous radiofrequency thermal coagulation in idiopathic trigeminal neuralgia

Publication date: March 2018
Source:International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 3
Author(s): M. Deng, H. Cai, W. Fang, X. Long
Radiofrequency thermocoagulation (RFT) is used widely for the treatment of idiopathic trigeminal neuralgia (TN). Precise puncture and placement of the electrode needle tip are crucial for successful RFT. This technical note introduces a novel method for performing RFT using a customized, three-dimensionally (3D)-printed guide plate. Eleven patients with idiopathic TN were treated using this method between February and July 2016. Three had V2 branch TN and eight had V3 branch TN. Punctures in eight patients were successful at the first attempt; slight adjustments were required subsequently in the other three patients. The puncture time in all cases was less than 1min. The patients reported pain relief immediately after RFT, and no complications were observed in any patient. Thus, the customized 3D-printed guide plate offers the advantages of precise placement of the puncture needle and minimal complications.

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Early removal of sequestrum in patients affected by medication-related osteonecrosis of the jaw

We wish to draw attention to a recent letter by Davies et al,1 in which they point out the importance of removing sequestra in patients with medication-related osteonecrosis of the jaw (MRONJ). They state correctly that there is no gold standard for the surgical or conservative management of MRONJ. Although we agree, we think that early removal of sequestra could be a possible solution. In the case of MRONJ, we learned the value of early removal the hard way, with several failures after conservative approaches.

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Comparing the Exposure-Response Relationships of Physiological and Traditional Vocal Warm-ups on Aerodynamic and Acoustic Parameters in Untrained Singers

The aim of this study was to quantify the effects of traditional and physiological warm-up exercises and to determine the optimal duration of these methods using acoustic and aerodynamic metrics.

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Editorial Board

Publication date: February 2018
Source:Hearing Research, Volume 358

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Zinc and silica are active components to efficiently treat in vitro simulated eroded dentin

Abstract

Objectives

Biomaterials for treating dentin hypersensitivity and dentin wear were evaluated to efficiently occlude the dentinal tubules and to increase dentin resistance to abrasion.

Materials and methods

Twenty-four dentin surfaces were treated with EDTA to expose dentinal tubules and were (1) non-brushed, (2) brushed with distilled water, or with pastes containing (3) monetite, (4) brushite, (5) Zn-monetite, (6) Zn-brushite, (7) Silica-brushite, and (8) NovaMin®. Topographical, nanomechanical, and chemical analysis were assessed on dentin surfaces (n = 3) after artificial saliva immersion for 24 h, and after citric acid challenge. Twenty-one further dentin specimens were created to evaluate dentin permeability after brushing, saliva storage, and acid application (n = 3). ANOVA, Student-Newman-Keuls (p < 0.05), and Student t test (p < 0.001) were used.

Results

Particles containing major proportion of silica attained intratubular occlusion by carbonate crystals (Raman carbonate peak heights 15.17 and 19.24 au; complex modulus 110 and 140 GPa, at intratubular dentin). When brushing with pastes containing higher proportion of silica or zinc, phosphate calcium compounds were encountered into tubules and over dentin surfaces (Raman intratubular phosphate peak heights 49 to 70 au, and at the intertubular dentin 78 to 92). The formed carbonated apatite and calcium phosphate layer were resistant to citric acid application. Zinc compounds drastically increased tubule occlusion, decreased dentin permeability (up to 30%), and augmented mechanical properties at the intertubular dentin (90–130 GPa); it was maintained after acid challenging.

Conclusions

Zinc-containing pastes occluded dentinal tubules and improved dentin mechanical properties.

Clinical relevance

Using zinc as an active component to treat eroded dentin is encouraged.

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Maresin 1 regulates autophagy and inflammation in human periodontal ligament cells through glycogen synthase kinase–3β/β-catenin pathway under inflammatory conditions

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Li Du, Yucheng Li, Weifeng Liu
ObjectiveAccumulating lines of evidence suggest that maresin 1 (MaR-1) exerts anti-inflammatory effects in many cell types and plays beneficial roles in inflammatory disease, such as peritonitis and colitis. Moreover, it has been demonstrated that MaR-1 play protective roles against localized aggressive periodontitis. However, the function and mechanism of MaR-1 in human periodontal ligament cells (PDL) cells from periodontitis are poorly understood. The present study aimed to clarify the effects and molecular mechanism of MaR-1 in PDL cell survival and inflammation.MethodsPDL cells were isolated from the middle third of the root surface of premolars from four healthy humans; MTT assay and cell death detection ELISA assay were used to detect cell survival and apoptosis; Inflammatory cytokines level was measured by ELISA assay; RT-PCR and western blot was used to measure the mRNA and protein expression in this study.ResultsHere we found that MaR-1 treatment markedly promotes survival and inhibits apoptosis in PDL cell treated by LPS. MaR-1 treatment strikingly suppressed the production of LPS-induced pro-inflammatory cytokines IL-6, IL-8, TNF-α and IL-1β. MaR-1 also promotes autophagy by increasing the ratio of LC3II/LC3I, the level of beclin-1 and reduced the expression of p62 in LPS treated PDL cells, which is beneficial to cell survival. Moreover, the results showed that MaR-1-mediated autophagy is dependent on the glycogen synthase kinase–3β(GSK-3β)/β-catenin signal pathway. The inhibitor of autophagy 3-MA and the inhibitor of the GSK-3β/β-catenin signal pathway LiCL both reverse the effects of MaR-1 on LPS-treated PDL cell survival and inflammation.ConclusionMaR-1 promotes cell survival and alleviates cell inflammation by activating GSK-3β/β-catenin-dependent autophagy. These results provide new insights into the mechanism of chronic periodontitis.

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Comparative proteomic profiling of human dental pulp stem cells and periodontal ligament stem cells under in vitro osteogenic induction

Publication date: May 2018
Source:Archives of Oral Biology, Volume 89
Author(s): He Wang, Dandan Ma, Xiaoyi Zhang, Shuaimei Xu, Tingting Ning, Buling Wu
ObjectiveThis study aimed to compare the proteomic profiling of human dental pulp stem cells (DPSCs) and periodontal ligament stem cells (PDLSCs) under in vitro osteogenic induction, which imitates the microenvironment during osteo-/odontogenesis of DPSCs and PDLSCs.DesignThe proteomic profiles of osteoinduced DPSCs and PDLSCs from a single donor were compared using the isobaric tag for relative and absolute quantitation (iTRAQ) technique and subsequent bioinformatics analysis.ResultsA total of 159 differentially expressed proteins in PDLSCs and DPSCs were identified, 82 of which had a higher expression level in PDLSCs, while 77 were more highly expressed in DPSCs. Among these enriched proteins, certain members from the collagen, heat shock protein and protein S100 families may distinguish osteoinduced PDLSCs and DPSCs. Gene ontology (GO) classification revealed that a large number of the enriched terms distinguishing PDLSCs and DPSCs are involved in catalytic activity, protein binding, regulation of protein metabolic processes and response to stimulus. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated several involved pathways, including the fatty acid biosynthesis pathway, pantothenate and CoA biosynthesis pathway, arachidonic acid metabolism pathway and PPAR signaling pathway. Further verification showed that the mineralization and migration capacities of PDLSCs were greater than those of DPSCs, in which heat shock protein beta-1, Protein S100-A10 and S100-A11 may play a part.ConclusionsLess than 5% of the differentially expressed proteins make up the comparative proteomic profile between osteoinduced PDLSCs and DPSCs. This study helps to characterize the differences between osteoinduced PDLSCs and DPSCs in vitro.

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MicroRNA-186 serves as a tumor suppressor in oral squamous cell carcinoma by negatively regulating the protein tyrosine phosphatase SHP2 expression

Publication date: May 2018
Source:Archives of Oral Biology, Volume 89
Author(s): Zhen Cai, Xiu-Yan Hao, Feng-Xin Liu
ObjectiveMicroRNAs (miRs) have been shown to play critical roles in the pathogenesis of oral squamous cell carcinoma (OSCC), the current study is designed to identify the potential role of miR-186 in OSCC.Materials and methodsRealtime polymerase chain reaction was used to determine miR-186 expression in paired tissue samples (OSCC and adjacent normal tissues) and multiple oral cell lines (normal oral keratinocyte HOK cell and OSCC cell lines). Cell viability, colony formation and flow cytometry assays were used to assess the biological function of miR-186. Furthermore, luciferase and western blot assays were used to verify the predicted target of miR-186.ResultsWe found that miR-186 expression was significantly downregulated in OSCC tissues and cell lines. Overexpression of miR-186 produced an anti-growth effect and induced apoptosis in Tca8113 and SCC-25 cells. Luciferase assay revealed that miR-186 directly targeted PTPN11 (a gene encodes the protein tyrosine phosphatase SHP2) mRNA 3′ untranslated region and suppressed its expression. Consistently, MiR-186 and SHP2 were negatively correlated in OSCC tissues. Consequently, miR-186 inhibited signaling activities of Extracellular Regulated protein Kinases (ERK) and Protein kinase B (AKT), which act downstream of SHP2 and are critical for growth of cancer cells.ConclusionWe identify that miR-186 serves as a tumor suppressor in OSCC. Downregulation of this microRNA may lead to a higher expression of oncogenic factor SHP2, which leads to activation of growth promoting signaling. Thus, miR-186 may be a novel and effective therapeutic agent for the treatment of OSCC.

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The PBII gene of the human salivary proline-rich protein P-B produces another protein, Q504X8, with an opiorphin homolog, QRGPR

Publication date: April 2018
Source:Archives of Oral Biology, Volume 88
Author(s): Eiichi Saitoh, Takuya Sega, Akane Imai, Satoko Isemura, Tetsuo Kato, Akihito Ochiai, Masayuki Taniguchi
ObjectivesThe NCBI gene database and human-transcriptome database for alternative splicing were used to determine the expression of mRNAs for P-B (SMR3B) and variant form of P-B. The translational product from the former mRNA was identified as the protein named P-B, whereas that from the latter has not yet been elucidated. In the present study, we investigated the expression of P-B and its variant form at the protein level.DesignTo identify the variant protein of P-B, (1) cationic proteins with a higher isoelectric point in human pooled whole saliva were purified by a two dimensional liquid chromatography; (2) the peptide fragments generated from the in-solution of all proteins digested with trypsin separated and analyzed by MALDI-TOF-MS; and (3) the presence or absence of P-B in individual saliva was examined by 15% SDS-PAGE.ResultsThe peptide sequences (I³⁷PPPYSCTPNMNNCSR⁵², C⁵³HHHHKRHHYPCNYCFCYPK⁷², R⁵⁹HHYPCNYCFCYPK⁷² and H⁶⁰HYPCNYCFCYPK⁷²) present in the variant protein of P-B were identified. The peptide sequence (G⁶PYPPGPLAPPQPFGPGFVPPPPPPPYGPGR³⁶) in P-B (or the variant) and sequence (I³⁷PPPPPAPYGPGIFPPPPPQP⁵⁷) in P-B were identified. The sum of the sequences identified indicated a 91.23% sequence identity for P-B and 79.76% for the variant. There were cases in which P-B existed in individual saliva, but there were cases in which it did not exist in individual saliva.ConclusionsThe variant protein is produced by excising a non-canonical intron (CC-AC pair) from the 3′-noncoding sequence of the PBII gene. Both P-B and the variant are subject to proteolysis in the oral cavity.

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Third molar agenesis as a potential marker for craniofacial deformities

Publication date: April 2018
Source:Archives of Oral Biology, Volume 88
Author(s): Clarissa Christina Avelar Fernandez, Christiane Vasconcellos Cruz Alves Pereira, Ronir Raggio Luiz, Italo M. Faraco, Mary L. Marazita, Maria Arnaudo, Flavia M. de Carvalho, Fernando E. Poletta, Juan C. Mereb, Eduardo E. Castilla, Iêda M. Orioli, Marcelo de Castro Costa, Alexandre Rezende Vieira
The identification of clinical patterns of tooth agenesis in individuals born with craniofacial deformities may be a useful tool for risk determination of these defects. We hypothesize that specific craniofacial deformities are associated with third molar agenesis.ObjectiveThe aim of this study was to identify if third molar agenesis could have a relation with other craniofacial structure alterations, such as cleft lip and palate, skeletal malocclusion, or specific growth patterns in humans.DesignData were obtained from 550 individuals ascertained as part of studies aiming to identify genetic contributions to oral clefts. 831 dental records of patients aged over eight years seeking orthodontic treatment were also included. SN-GoGn angle were used to classify the growth pattern (hypo-divergent, normal and hyper-divergent), and the ANB angle was used to verify the skeletal malocclusion pattern (Class I, II and III). Panoramic radiographs were used to determine third molar agenesis.ResultsA high frequency of third molar agenesis among individuals born with cleft lip with or without cleft palate (55%), as well as among their relatives (93.5%) was found. Third molar agenesis was not associated to skeletal malocclusion or growth pattern.ConclusionIt appears that third molar agenesis is associated with the disturbances that lead to cleft lip and palate.

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Structure, property, and function of sheepshead (Archosargus probatocephalus) teeth

Publication date: May 2018
Source:Archives of Oral Biology, Volume 89
Author(s): J.F. Deang, A.K. Persons, A.L. Oppedal, H. Rhee, R.D. Moser, M.F. Horstemeyer
ObjectivesThis paper studies A. probatocephalus teeth and investigates the mechanical properties and chemical composition of the enameloid and dentin.DesignNanoindentation tests with a max load of 1000 μN and X-ray Energy Dispersive Spectroscopy (EDS) were performed along the diameter of the polished sample. Microstructural analysis of the dentin tubules was performed from SEM images.ResultsFrom nanoindentation testing, the dentin of the sheepshead teeth has a nanoindentation hardness of 0.89 ± 0.21 (mean ± S.D.) GPa and a reduced Young's modulus of 23.29 ± 5.30 GPa. The enameloid of A. probatocephalus has a hardness of 4.36 ± 0.44 GPa and a mean reduced Young's modulus of 98.14 ± 6.91 GPa. Additionally, nanoindentation tests showed that the enameloid's hardness and modulus increased closer to the surface of the tooth. X-ray Energy Dispersive Spectroscopy (EDS) data further suggests that the gradient may be a result of the wt% fluoride within the enameloid, where an increase in fluoride results in an increase in reduced Young's modulus and hardness.ConclusionThe microstructural characterization of the number density and area of the dentin tubules were used to address the porosity effect in the dentin to achieve the experimentally validated microhardness. The mechanical properties of the sheepshead teeth were also compared with previous nanoindentation tests from other aquatic species. The sheepshead teeth exhibit a greater reduced Young's modulus and hardness compared to shark and piranha teeth.

Graphical abstract

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Differentiation of stem cells from human deciduous and permanent teeth into spiral ganglion neuron-like cells

Publication date: April 2018
Source:Archives of Oral Biology, Volume 88
Author(s): Thanasup Gonmanee, Charoensri Thonabulsombat, Kutkao Vongsavan, Hathaitip Sritanaudomchai
ObjectiveStem cells from pulp tissue are a promising cell-based therapy for neurodegenerative patients based on their origin in the neural crest. The aim of this study was to differentiate and evaluate the ability of human dental pulp stem cells from permanent teeth (DPSC) and stem cells from human exfoliated deciduous teeth (SHED) to differentiate into spiral ganglion neurons.DesignAfter isolation and characterization of mesenchymal stem cell properties, DPSC and SHED were treated with the neurotrophins brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and glial cell-derived neurotrophic factor (GDNF). The differentiation was identified by immunostaining and qRT-PCR analysis of neuronal markers and measuring intracellular calcium activity.ResultsAfter 2 weeks of induction, morphological changes were observed in both DPSC and SHED. The differentiated cells expressed neuron-specific class III beta-tubulin, GATA binding protein 3 (GATA3) and tropomyosin receptor kinase B, protein markers of spiral ganglion neurons. These cells also showed upregulation of the genes encoding these proteins, namely GATA3 and neurotrophic receptor tyrosine kinase 2. Intracellular calcium dynamics that reflect neurotransmitter release were observed in differentiated DPSC and SHED.ConclusionThese results demonstrate that dental pulp stem cells from permanent and deciduous teeth can differentiate into spiral ganglion neuron-like cells.

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An in vitro study on the influence of viscosity and frequency of application of fluoride/tin solutions on the progression of erosion of bovine enamel

Publication date: Available online 3 February 2018
Source:Archives of Oral Biology
Author(s): Letícia Oba Sakae, Sávio José Cardoso Bezerra, Samira Helena João-Souza, Alessandra Buhler Borges, Idalina V. Aoki, Ana Cecília Côrrea Aranha, Taís Scaramucci
ObjectiveTo evaluate the influence of the viscosity and frequency of application of solutions containing sodium fluoride (NaF) and stannous chloride (SnCl2) on enamel erosion prevention.DesignBovine enamel specimens were randomly distributed into 12 groups (n = 10), according to the following study factors: solution (C: deionized water; F: 500 ppm F⁻; F + Sn: 500 ppm F⁻ + 800 ppm Sn²⁺); viscosity (low and high); and frequency of application (once and twice a day). Specimens were submitted to an erosive cycling model, consisting of 5 min immersion in 0.3% citric acid, followed by 60 min exposure to a mineral solution. This procedure was repeated 4x/day, for 5 days. Treatment with the experimental solutions was performed for 2 min, 1x/day or 2x/day. Enamel surface loss (SL) was determined by optical profilometry. Data were analyzed by 3-way ANOVA and Tukey tests (α = 0.05).ResultsThere were significant differences between the levels of the factor solution (p < 0.001), viscosity (p < .001) and in the interaction between solution and viscosity (p = 0.01). Regarding solution, the mean SL ± standard deviation for the groups was F + Sn (4.90 ± 1.12) < F (7.89 ± 1.19) < C (14.20 ± 1.69). High viscosity solutions demonstrated less SL than low viscosity; however, only when applied once a day (p < .001). Applying the solutions twice a day yielded lower SL than once a day, but only for the low viscosity solutions (p = 0.003).ConclusionsUnder the conditions of this short-term in vitro experiment, it could be concluded that increasing the viscosity of the oral rinse solutions reduced enamel loss by erosion; however, this effect was small and only observed when the solutions were applied once a day.

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Effects of sub-minimum inhibitory concentrations of lemon essential oil on the acid tolerance and biofilm formation of Streptococcus mutans

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Yanwei Sun, Sijia Chen, Chen Zhang, Yali Liu, Li Ma, Xiangyu Zhang
ObjectivesLemon essential oil (LEO) is a kind of secondary metabolite from lemon peels and has been found to inhibit cariogenic bacteria for decades. However, its effects on main cariogenic virulence factors are rarely reported. The present study aimed to investigate the effects of sub-minimum inhibitory concentrations (sub-MICs) of LEO on the acid tolerance and biofilm formation of Streptococcus mutans (S. mutans) and preliminarily reveal the possible underlying mechanisms.DesignsEffects of LEO on the acid tolerance and biofilm formation of S. mutans were investigated by the broth dilution method and crystal violet staining method respectively. The expression of luxS, srtA and spaP gene was also determined to explore the underlying mechanism. In addition, Tea polyphenols (TP), a major natural inhibitor of cariogenic virulence factors, and limonene (LIM), the major component of LEO, were selected as comparisons to evaluate the effects of LEO.ResultsSub-MICs of LEO, LIM and TP exhibited a dose-dependent inhibition of growth of S. mutans at pH ranging from 4.0 to 7.0. The formation of S. mutans biofilm was remarkably inhibited and the inhibitory rates of LEO, LIM and TP were 97.87%, 94.88% and 96.01% respectively at 1/2 MIC. Similarly, a down-regulation was observed in the expression of luxS, srtA and spaP gene at sub-MIC levels.ConclusionsEffects of LEO were similar or slightly stronger than LIM and TP, suggesting that LEO might represent a novel, natural anticarious agent that inhibited the specific genes associated with bacterial acid tolerance and biofilm formation without necessarily affecting the growth of oral bacteria.

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Proteomics and immunohistochemistry identify the expression of α-cardiac myosin heavy chain in the jaw-closing muscles of sooty mangabeys (order primates)

Publication date: Available online 3 February 2018
Source:Archives of Oral Biology
Author(s): Christine E. Wall, Megan Holmes, Erik Soderblom, Andrea B. Taylor
ObjectiveThe jaw-closing muscles of humans and nonprimate mammals express alpha-cardiac fibers but MyHC α-cardiac has not been identified in the jaw adductors of nonhuman primates. We determined whether MyHC α-cardiac is expressed in the superficial masseter and temporalis muscles of the sooty mangabey (Cercocebus atys), an African Old World monkey that specializes on hard seeds.DesignLC-MS/MS based proteomics was used to identify the presence of MyHC Iα.Immunohistochemistry was used to analyze the composition and distribution of fiber types in the superficial masseter and temporalis muscles of eight C. atys. Serial sections were stained against MyHC α-cardiac (MYH6), as well as MyHC-1 (NOQ7.5.4D), MyHC-2 (MY-32), and MyHC-M (2F4).ResultsProteomics analysis identified the presence of Myosin-6 (MyHC α-cardiac) in both heart atrium and superficial masseter. MyHC α-cardiac was expressed in abundance in the superficial masseter and temporalis muscles of all eight individuals and hybrid fibers were common.ConclusionsThe identification of MyHC α-cardiac in the jaw adductors of sooty mangabeys is a novel finding for nonhuman primates. The abundance of MyHC α-cardiac indicates a fatigue-resistant fiber population characterized by intermediate speed of contraction between pure MyHC-1 and MyHC-2 isoforms. We suggest that α-cardiac fibers may be advantageous to sooty mangabeys, whose feeding behavior includes frequent crushing of relatively large, hard seeds during the power stroke of ingestion. Additional studies comparing jaw-adductor fiber phenotype of hard-object feeding primates and other mammals are needed to explore this relationship further.

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EMCrit RACC Podcast 217 – The Ultimate “Ultimate” BVM

So in prior posts, I have discussed the jerry-rigged "ultimate" BVM. But there is a better way–the creation of a manufactured BVM that helps us not kill patients. It would have the following characteristics: Facets of the Ultimate BVM Now on to the Vodcast…

EMCrit Project by Scott Weingart.

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Pancreatic cyst biopsy: Improvement in diagnosis with micro forceps biopsy

Clinician's Corner represents the opinions and views of the author and does not reflect any policy or opinion of the American Cancer Society, Cancer Cytopathology, or Wiley unless this is clearly specified. Cancer Cytopathol 2018. © 2018 American Cancer Society.

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Cytologic-histologic correlation of programmed death-ligand 1 immunohistochemistry in lung carcinomas

BACKGROUND

Programmed cell death protein 1 inhibitors increasingly are being used to treat patients with advanced lung carcinomas. Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) in tumor cells (TCs) and tumor-infiltrating immune cells (ICs) is used to select patients for programmed cell death protein 1 inhibition, but few studies have evaluated PD-L1 IHC in cytology specimens. The objective of the current study was to compare PD-L1 IHC in cytology cell blocks and matched surgical specimens.

METHODS

A total of 56 cytology specimens obtained between 2013 and 2016 with matching surgical specimens were stained with anti-PD-L1. Membranous positivity was scored as a percentage of the TCs and ICs by 2 pathologists. Results were compared between cytology and surgical specimens, and interobserver concordance was assessed.

RESULTS

The average PD-L1 positivity rate was 28% in TCs and 5% in ICs in surgical specimens (standard deviations of 37% and 7%, respectively), and 21% in TCs and 8% in ICs in cytology specimens (standard deviations of 33% and 15%, respectively). Interobserver concordance was high for TCs in surgical and cytology specimens (intraclass correlation coefficients of 0.96 and 0.96, respectively), and was moderate for ICs in surgical and cytology specimens (intraclass correlation coefficients of 0.47 and 0.67, respectively). There was moderate to high correlation between PD-L1 positivity in TCs between surgical and cytology specimens (Spearman correlation coefficient [Spearman r], 0.69), particularly among fine-needle aspiration specimens (Spearman r, 0.78), but not between PD-L1 positivity in ICs in surgical and cytology specimens (Spearman r, 0.14), including among fine-needle aspiration specimens (Spearman r, 0.23).

CONCLUSIONS

Tumor PD-L1 IHC positivity in cytology specimens appears to correlate strongly with results obtained from matching surgical specimens. PD-L1 IHC in ICs within cytology specimens does not reflect results in matched surgical specimens and should not be used in clinical decision making. Cancer Cytopathol 2018. © 2018 American Cancer Society.

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Welcome New Associate Editor Anthony Kim to the World Journal of Surgery

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Defining Early Recurrence of Hilar Cholangiocarcinoma After Curative-intent Surgery: A Multi-institutional Study from the US Extrahepatic Biliary Malignancy Consortium

Abstract

Background

Time to tumor recurrence may be associated with outcomes following resection of hepatobiliary cancers. The objective of the current study was to investigate risk factors and prognosis among patients with early versus late recurrence of hilar cholangiocarcinoma (HCCA) after curative-intent resection.

Methods

A total of 225 patients who underwent curative-intent resection for HCCA were identified from 10 academic centers in the USA. Data on clinicopathologic characteristics, pre-, intra-, and postoperative details and overall survival (OS) were analyzed. The slope of the curves identified by linear regression was used to categorize recurrences as early versus late.

Results

With a median follow-up of 18.0 months, 99 (44.0%) patients experienced a tumor recurrence. According to the slope of the curves identified by linear regression, the functions of the two straight lines were y = −0.465x + 16.99 and y = −0.12x + 7.16. The intercept value of the two lines was 28.5 months, and therefore, 30 months (2.5 years) was defined as the cutoff to differentiate early from late recurrence. Among 99 patients who experienced recurrence, the majority (n = 80, 80.8%) occurred within the first 2.5 years (early recurrence), while 19.2% of recurrences occurred beyond 2.5 years (late recurrence). Early recurrence was more likely present as distant disease (75.1% vs. 31.6%, p = 0.001) and was associated with a worse OS (Median OS, early 21.5 vs. late 50.4 months, p < 0.001). On multivariable analysis, poor tumor differentiation (HR 10.3, p = 0.021), microvascular invasion (HR 3.3, p = 0.037), perineural invasion (HR 3.9, p = 0.029), lymph node metastases (HR 5.0, p = 0.004), and microscopic positive margin (HR 3.5, p = 0.046) were independent risk factors associated with early recurrence.

Conclusions

Early recurrence of HCCA after curative resection was common (~35.6%). Early recurrence was strongly associated with aggressive tumor characteristics, increased risk of distant metastatic recurrence and a worse long-term survival.

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Data Improvement Through Simplification: Implications for Low-Resource Settings

Abstract

Background

The focus of many data collection efforts centers on creation of more granular data. The assumption is that more complex data are better able to predict outcomes. We hypothesized that data are often needlessly complex. We sought to demonstrate this concept by examination of the American Society of Anesthesiologists (ASA) scoring system.

Methods

First, we created every possible consecutive two, three and four category combinations of the current five category ASA score. This resulted in 14 combinations of simplified ASA. We compared the predictive ability of these simplified scores for postoperative outcomes for 2.3 million patients in the NSQIP database. Individual model performance was assessed by comparing receiver operator characteristic (ROC) curves for each model with the standard ASA.

Results

Two of our 4-category models and one of our 3-category models had ability to predict all outcomes equivalent to standard ASA. These results held for all outcomes and on all subgroups tested. The performance of the three best performing simplified ASA scores were also equivalent to the standard ASA score in the univariate analysis and when included in a multivariate model.

Conclusions

It is assumed that the most granular data and use of the largest number of variables for risk-adjusted predictions will increase accuracy. This complexity is often at the expense of utility. Using the single best predictor in surgical outcomes research, we have shown this is not the case. In this example, we demonstrate that one can simplify ASA into a 3-category variable without losing any ability to predict outcomes.

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A Novel Indocyanine Green Fluorescence-Guided Video-Assisted Technique for Sentinel Node Biopsy in Breast Cancer

Abstract

Background

The equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique.

Methods

The technique for detecting SLN was radioisotope (RI) in 194 cases, video-assisted ICG-guided in 70 cases and a combined method in 71 cases. In the video-assisted ICG group, a full HD laparoscopic system equipped with xenon lamps was used for a laser-free detection of ICG within a colored and magnified high-resolution image.

Results

Detection of ICG fluorescence using a laparoscope with a near-infrared filter provided a highly defined and colored image during SLN biopsy. SLN was identified in 100% of patients in all groups. Multiple SLNs were identified in 0.5% of RI patients, in 12.9% of ICG patients and in 14.1% of ICG + RI patients (p < 0.0001). In ICG + RI group, 95.1% of lymph nodes were radioactive and 92.7% were fluorescent. Operative times and healthcare costs were equivalent between groups.

Conclusions

Video-assisted ICG-guided technique is a feasible and surgeon-friendly method for SLN biopsy, with equivalent efficacy compared to RI, providing an accurate staging of the axilla.

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Elderly with Heart Failure Have Higher Risk of Hearing Loss, Says Research

A new study shows evidence of the correlation between heart failure and hearing loss among older adults in the United States. Researchers from Weill Cornell Medical College in New York City used data from the 2005-2006 and 2009-2010 National Health and Nutrition Examination Survey examined the prevalence and correlation of hearing loss among the elderly with or without heart conditions.

Study authors Madeline R. Sterling, MD, MPH, Frank R. Lin, MD, PhD, Deanna P. Jannat-Khah, DrPH, MSPH, Adele M. Goman, PhD, Sandra E. Echeverria, PhD, and Monika M. Safford, in a research letter, wrote that "Hearing loss is common among older adults in the United States and is associated with coronary heart disease and its risk factors. Yet, the prevalence of hearing loss among adults with heart failure (HF) has not been well described."

The study, titled Hearing Loss Among Older Adults with Heart Failure in the United States, revealed that the participants with heart failure were older, with more existing cardiovascular medical conditions, and had a higher disposition to hearing loss compared with those participants without heart failure. The researchers looked into the survey data of adults aged 70 and older and found out that hearing loss among those with heart failure was more common at 74.4 percent compared with the 63.3 percent among those without coronary comorbidity. Results of the examination also showed that participants with heart failure are more likely susceptible to varying degrees of hearing loss.

"Although hearing loss was more common among adults with HF compared with those without it, HF was not independently associated with hearing loss after accounting for demographic and clinical characteristics," the research authors explained.

The researchers said that further studies on heart failure-hearing loss link among the elder population in the United States may provide more information. "Future studies might examine potential correlates of hearing loss that we were unable to study, including ejection fraction and HF-specific medications like furosemide, which has ototoxic properties."

Published: 2/5/2018 8:27:00 AM

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Integrated optoelectronic microprobes

Publication date: June 2018
Source:Current Opinion in Neurobiology, Volume 50
Author(s): L Rudmann, MT Alt, D Ashouri Vajari, T Stieglitz
Optogenetics opened not only new exciting opportunities to interrogate the nervous system but also requires adequate probes to facilitate these wishes. Therefore, a multidisciplinary effort is essential to match these technical opportunities with biological needs in order to establish a stable and functional material-tissue interface. This in turn can address an optical intervention of the genetically modified, light sensitive cells in the nervous system and recording of electrical signals from single cells and neuronal networks that result in behavioral changes. In this review, we present the state of the art of optoelectronic probes and assess advantages and challenges of the different design approaches. At first, we discuss mechanisms and processes at the material-tissue interface that influence the performance of optoelectronic probes in acute and chronic implantations. We classify optoelectronic probes by their property of delivering light to the tissue: by waveguides or by integrated light sources at the sites of intervention. Both approaches are discussed with respect to size, spatial resolution, opportunity to integrate electrodes for electrical recording and potential interactions with the target tissue. At last, we assess translational aspects of the state of the art. Long-term stability of probes and the opportunity to integrate them into fully implantable, wireless systems are a prerequisite for chronic applications and a transfer from fundamental neuroscientific studies into treatment options for diseases and clinical trials.

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Germline promoter hypermethylation in BRCA1 and BRCA2 genes is not present in hereditary breast cancer patients

Abstract

Purpose

Germline promoter hypermethylation of BRCA1 and BRCA2 genes is an alternative event of gene silencing that has not been widely investigated in hereditary breast and ovarian cancer (HBOC) syndrome.

Methods

We analyzed germline BRCA promoter hypermethylation in HBOC patients with and without BRCA mutations and control subjects, using a recently developed BRCA methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay.

Results

Neither the patients tested nor the control subjects showed germline hypermethylation of the BRCA1 and BRCA2 promoter regions analyzed.

Conclusions

Despite the results achieved at somatic levels by other researchers, these were not confirmed in our study at the germline level. Our results show the need to establish more predictive CpG sites in the BRCA promoter regions to optimize the MS-MLPA assay for the detection of germline hypermethylation as an effective pre-screening tool for whole-BRCA genetic analysis in HBOC, because we can not rule out the existence of germline promoter hypermethylation in BRCA.

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Aortoiliac Dissection After Blunt Abdominal Trauma

Publication date: Available online 4 February 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Dennis Hundersmarck, Raechel J. Toorop

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Cochlear implants and 1.5 T MRI scans: the effect of diametrically bipolar magnets and screw fixation on pain

The probability that a patient will need an MRI scan at least once in a lifetime is high. However, MRI scanning in cochlear implantees is associated with side effects. Moreover, MRI scan-related artifacts, dis...

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Cavernous sinus involvement is not a risk factor for the primary tumor site treatment outcome of Sinonasal adenoid cystic carcinoma

Sinonasal adenoid cystic carcinoma is a rare malignancy of the head and neck. Cavernous sinus invasion from sinonasal adenoid cystic carcinoma and its related management have rarely been investigated. This stu...

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"Otolaryngol Head Neck Surg"[jour]; +31 new citations

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

"Otolaryngol Head Neck Surg"[jour]

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PubMed comprises more than millions of 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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Commentary on Burke TF et al. “Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya when No Anesthetist is Available: An Analysis of 1216 Consecutive Operative Procedures”

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Acute Limb Ischemia Secondary to Native Artery Occlusion: Results of a Contemporary Case Series

Abstract

Background

The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate the current results of the management of ALI secondary to a native artery occlusion.

Methods

Retrospective study of 220 consecutive patients (mean age 78 years; 49% male) was conducted between 2007 and 2015. ALI secondary to trauma or grafts/stents occlusions were excluded. Statistical analysis was performed with logistic regression.

Results

A total of 141 cases (64.1%) were attributed to embolism and 79 (35.9%) to acute arterial thrombosis. Peripheral neuro-ischemic impairment occurred in 135 patients (61.4%), being severe in 42 (19.1%). ALI treatment included anticoagulation (n = 27; 12.3%), regional fibrinolysis (n = 2; 1%), embolectomy/thrombectomy (n = 129; 58.6%), angioplasty/stenting (n = 8; 3.6%), bypass (n = 47; 21.3%) or direct major limb amputation (n = 7; 3.2%). Limb salvage and survival rates at 30/90 days were 95%/95% and 82.3%/74.1%, respectively. Independent risk factors for major amputation were diabetes, severe neuro-ischemic impairment, acute arterial thrombosis and treatment delay >1 day after vascular consultation. In addition, age, chronic peripheral arterial disease, any neuro-ischemic impairment and a hospitalization for any other reason simultaneous to the ALI were independently associated with mortality.

Conclusions

Regardless of excellent limb salvage rates, patients currently suffering from an ALI are, when compared to previous studies, older than before and with an increased rate of mortality. Risk factors do not appear to be modifiable once the ALI appears so prevention strategies should be aimed to avoid the episode.

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Interdisciplinary Telemedicine in the Management of Dysphagia in Head and Neck

Abstract

The study considered the feasibility and impact of interdisciplinary telemedicine discussions in the management of post-treatment dysphagia in patients with head and neck tumors. This is a retrospective analysis of patients with persistent dysphagia after treatment for head and neck pathology, at an institute in India. The cases were discussed in the telemedicine meeting conducted between host institute and a second unit in the United States. A monthly meeting was organized, using an internet-based video conference system. The ongoing swallowing problems and management were presented, and through discussions, a plan for further management was formulated and carried out. The Functional Oral Intake Scale (FOIS) was measured before and after the implementation of the plan. Twenty-six patients were discussed, out of which, 22 were head and neck malignancies. The recommendations concurred with that of the host unit in 18, differed for three and additive in five patients. The pre-treatment mean FOIS was 1.46 with a standard deviation of 0.989 and post-treatment mean improved to 3.92 with a standard deviation of 1.809 (p < 0.0001). The present study supports the success of an interdisciplinary telemedicine meeting to manage difficult cases of dysphagia in head and neck. The outcome in terms of the FOIS score improved significantly after implementing them. In addition to the direct patient benefits, the meeting helped to facilitate interdepartmental collaboration between two units treating similar sets of patients across the globe, in specialized clinical areas like dysphagia management.

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Selenite Distribution in Multicomponent System Consisting of Filamentous Fungus, Humic Acids, Bentonite, and Ferric Oxyhydroxides

Abstract

Selenite is an environmental toxicant whose mobility is affected in soil by various natural components, including humic acids, clay minerals, amorphous ferric oxyhydroxides [FeO_x(OH)_y], and microorganisms. However, interactions of selenite with these components are usually evaluated separately. Therefore, we addressed selenite behavior in multicomponent system in this study with emphasis on its immobilization and fungal accumulation. Our results highlighted significant acidification of culture medium by common soil fungus Aspergillus niger's production of protons in selenite presence which affected selenium immobilization. While bentonite and humic acids did not enhanced immobilization efficiency significantly, composite of FeO_x(OH)_y/humic acids was extremely successful in selenium immobilization. This was most likely by enhanced redox transformation of selenite into elemental selenium as the contribution of each component was synergistic. Subsequently, selenium bioavailability in culture medium decreased and negatively affected bioaccumulation efficiency by fungus. Our results highlighted the significance of multicomponent systems in more realistic evaluation of selenium mobility and transfer to microorganisms.

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Ruthenium Counterstaining for Imaging Mass Cytometry

ABSTRACT

Imaging mass cytometry is a novel imaging modality that enables simultaneous antibody-based detection of more than 40 epitopes and molecules in tissue sections at subcellular resolution using isotopically pure metal tags. Essential for any imaging approach where antigen detection is performed is the so-called counterstaining that reveals the overall structure of the tissue. Counterstaining is necessary since antigens of interest are often present only in a small subset of cells while the rest of tissue structures are not visible. Since most biological tissues are nearly transparent or non-fluorescent, chromogenic reagents such as haematoxylin (for immunohistochemistry) or fluorescent dyes such as DAPI (that stains nuclei for epifluorescence and confocal microscopy) are utilized. Here, we describe a metal-based counterstain for imaging mass cytometry based on simple oxidation and subsequent covalent binding of the tissue components to ruthenium tetroxide (RuO₄). RuO₄ counterstaining reveals general tissue structure both in areas with high cell content and in stromal areas with low cellularity and fibrous or hyaline material in a manner analogous to haematoxylin in immunohistochemical counterstaining or eosin or other anionic dyes in conventional histology. Our new counterstain approach is applicable to any metal-based imaging technique and will facilitate the adaptation of imaging mass cytometry for routine applications in clinical and research laboratories.

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Cytoplasmic collagen XIαI as a prognostic biomarker in esophageal squamous cell carcinoma

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Predicting clinical diagnosis in Huntington's disease: An imaging polymarker

Abstract

Objective: Huntington's disease (HD) gene-carriers can be identified prior to clinical diagnosis; however, statistical models for predicting when overt motor symptoms will manifest are too imprecise to be useful at the level of the individual. Perfecting this prediction is integral to the search for disease modifying therapies. This study aimed to identify an imaging marker capable of reliably predicting real-life clinical diagnosis in HD.

Method: A multivariate machine learning approach was applied to resting-state and structural MRI scans from 19 pre-manifest HD gene carriers (preHD, 8 of whom developed clinical disease in the 5 years post-scanning) and 21 healthy controls. A classification model was developed using cross-group comparisons between preHD and controls, and within the preHD group in relation to "estimated" and "actual" proximity to disease onset. Imaging measures were modelled individually, and combined, and permutation modelling robustly tested classification accuracy.

Results: Classification performance for preHDs vs. controls was greatest when all measures were combined. The resulting polymarker predicted converters with high accuracy including those who were not expected to manifest in that timescale based on the currently adopted statistical models.

Interpretation: We propose that a holistic multivariate machine learning treatment of brain abnormalities in the premanifest phase can be used to accurately identify those patients within 5 years of developing motor features of Huntington's disease, with implications for prognostication and preclinical trials. This article is protected by copyright. All rights reserved.

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Αρχειοθήκη ιστολογίου

Δευτέρα 5 Φεβρουαρίου 2018

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