Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis.

Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis.

Laryngoscope. 2016 Jan 9;

Authors: Steele TO, Detwiller KY, Mace JC, Strong EB, Smith TL, Alt JA

Abstract
OBJECTIVES/HYPOTHESIS: We sought to evaluate preoperative and postoperative productivity losses and quality of life (QOL) impairment reported by patients with recurrent acute rhinosinusitis (RARS) as compared to patients with chronic rhinosinusitis without nasal polyposis (CRSsNP).
STUDY DESIGN: Prospective, multi-institutional, nested case-control.
METHODS: Participants with RARS (n = 20) and CRSsNP (n = 20) undergoing endoscopic sinus surgery (ESS) were enrolled as part of a prospective cohort study. For comparison, participants diagnosed with RARS cases were age/gender-matched to control participants diagnosed with CRSsNP using a 1:1 ratio.
RESULTS: RARS and CRSsNP participants were followed for ∼14 months postoperatively. Productivity losses were reported as the number of days missed from normal productive activities out of the previous 90 days. RARS participants reported similar baseline productivity losses (12.6 ± 27.1 [standard deviation]) as participants with CRSsNP (11.7 ± 20.9; P = .314). Postoperatively, improvement in productivity losses was similar between RARS participants and CRSsNP controls (-6.7 ± 20.0 vs. -9.8 ± 19.1; P = .253). Preoperative and postoperative disease-specific QOL measures (Sino-Nasal Outcomes Test-22 and Rhinosinusitis Disability Index) were similar between the two groups. RARS participants reported a significant decrease in days of previous antibiotic (P = .009) and nasal decongestant (P = .004) use following ESS, whereas participants with CRSsNP reported a significant decrease in antibiotic (P = .002) and oral corticosteroid use (P = .002).
CONCLUSIONS: RARS patients report baseline productivity losses and disease-specific QOL impairment to levels that parallel those with CRSsNP. Patients with RARS report improvement in QOL following ESS in all disease-specific QOL measures and in several medication measures. Productivity losses and postoperative improvements are similar between patients with RARS and CRSsNP.
LEVEL OF EVIDENCE: 3b Laryngoscope, 2015.

PMID: 26749066 [PubMed - as supplied by publisher]

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A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

Int J Oral Maxillofac Surg. 2015 Dec 31;

Authors: Ye ZX, Yang C, Chen MJ, Abdelrehem A

Abstract
Resecting neoplasms involving the infratemporal space has a high risk of damaging critical nerves and vessels, in addition to joint form and function. The purpose of this study was to introduce a novel approach to lesions medial to the condyle, which comprises a condylectomy with anterior displacement of the condyle. The indications evaluated using digital surgical simulation, the critical surgical technique, and the preliminary clinical effects are presented here. Five cases underwent this approach between January 2006 and December 2014. The common characteristics of the five masses were (1) that they were non-malignant neoplasms involving the posterior-medial region of the condyle; (2) the upper and lower borders were between the skull base and the lingula, while the anterior border did not exceed the coronoid process. All masses were resected successfully with no damage to any critical nerves or vessels. The average follow-up period was 29.8 months (range 6-56 months). There was no recurrence, secondary deformity, or facial paralysis. The average mouth opening improved from an original 27mm to 34mm after surgery. The condyles were well fixed, with no resorption, as shown on computed tomography scans.

PMID: 26748864 [PubMed - as supplied by publisher]

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Review on clinical update of essential tremor.

Review on clinical update of essential tremor.

Neurol Sci. 2016 Jan 9;

Authors: Chunling W, Zheng X

Abstract
Essential tremor (ET) is considered a benign disease without any pathological changes. Nevertheless, this point of view has recently been challenged. In recent years, studies have shown that ET occurs with other non-motor symptoms, such as cognitive deficits, depression, anxiety, balance disorder, hearing impairment, olfactory dysfunction and sleep problems. Advancements in neuroimaging have revealed widespread alterations in the brain, and cerebellar involvement was the most consistent finding. In addition, studies have also shown that ET patients might experience poor quality of life, reflecting motor or non-motor symptoms. Both pharmacotherapy and non-pharmacotherapy have recently been suggested for the treatment of ET. This review briefly describes the current information on ET, including the non-movement symptoms, neuroimaging findings, the impact on daily life and ET therapy.

PMID: 26749268 [PubMed - as supplied by publisher]

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Analysis of circulating CD14+/CD16+ monocyte-derived macrophages (MDMs) in the peripheral blood of patients with oral squamous cell carcinoma.

Analysis of circulating CD14+/CD16+ monocyte-derived macrophages (MDMs) in the peripheral blood of patients with oral squamous cell carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 4;

Authors: Grimm M, Feyen O, Coy JF, Hofmann H, Teriete P, Reinert S

Abstract
OBJECTIVES: Monocytes/macrophages are regarded as the first line of defense in tumors. Therefore, analyzing monocyte subtypes in oral squamous cell carcinoma (OSCC) may be of value in disease monitoring and to explore immunotherapeutic strategies for cancer patients.
STUDY DESIGN: Circulating peripheral blood CD14+/CD16+ monocyte-derived macrophages (MDMs) were evaluated in OSCC patients with oral squamous cell carcinoma (n = 44) compared with controls (n = 85). Moreover, epitope detection in monocytes (EDIM) technology was used to detect biomarkers Apo10 and transketolase-like-1 in CD14+/CD16+ MDMs.
RESULTS: Compared with controls, no significant (P = .3646) difference (control group 9.8%, OSCC group 8.8%) in CD14+/CD16+ MDM were noted in OSCC. However, EDIM-Apo10 and EDIM-TKTL1 scores detected in the CD14+/CD16+ MDMs were increased in OSCC compared with controls (P < .0001).
CONCLUSIONS: Analyzing CD14+/CD16+ MDMs represents a stable cell population for detecting biomarkers in cancer disease monitoring.

PMID: 26747736 [PubMed - as supplied by publisher]

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Head and Neck Schwannomas: 20-Year Experience of a Single Institution Excluding Cutaneous and Acoustic Sites.

Head and Neck Schwannomas: 20-Year Experience of a Single Institution Excluding Cutaneous and Acoustic Sites.

Head Neck Pathol. 2016 Jan 8;

Authors: Butler RT, Patel RM, McHugh JB

Abstract
While head and neck sites comprise the most common location of schwannomas, clinicopathologic data regarding those tumors occurring in non-acoustic and non-cutaneous locations are relatively sparse. In this study, therefore, we sought to examine retrospectively the clinical and pathologic features of head and neck schwannomas excised at our institution over a 20-year period. During this period, we identified a total cohort of 85 patients, which included 36 males (42.4 %) and 49 females with average age of 41.3 years, the majority of which presented asymptomatically with a mass. Localized symptoms were, however, associated with all of the schwannomas that arose in the oral cavity and larynx, while tumors within or adjacent to bone were often associated with neurologic complaints (7 of 15 such tumors [46.7 %]). Clinical follow-up data was available in 86.4 % of all cases and demonstrated no recurrences or mortality. Pathologically, the microscopic features were characteristic of those well-described for schwannomas in other sites, including alternating Antoni A and B areas and the presence of degenerative changes. Tumor encapsulation, however, was variable and was completely absent in schwannomas of the nasal cavity, paranasal sinuses, and larynx. Additionally, a significant minority of the tumors (28.2 %) exhibited foci that resembled neurofibroma. Non-acoustic, non-cutaneous schwannomas of the head and neck appear to have clinicopathologic features similar to their soft tissue counterparts with some subsite variation in presentation and/or microscopic features.

PMID: 26747460 [PubMed - as supplied by publisher]

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[Current methods for modelling voice production].

[Current methods for modelling voice production].

HNO. 2016 Jan 8;

Authors: Döllinger M, Kniesburges S, Kaltenbacher M, Echternach M

Abstract
BACKGROUND: Many details of the phonatory process are not yet fully understood. Besides observational research, scientists have long since been trying to explain the physical fundamentals of voicing using simulations. This approach is commonly called modeling. However, the knowledge gained often failed to find its way to professionals working with the voice, such as singing teachers, voice therapists, and voice coaches, and sometimes also to otorhinolaryngologists and phoniatricians. The reason for this is that scientific publications on this topic mostly contain very detailed mathematical and physical descriptions, which are often hard to understand.
OBJECTIVE: A simplified presentation and explanation of current methods for modeling the phonatory process, which have contributed greatly to uncovering and understanding the relationships involved in voicing during recent years.
METHODS: The presented methods cover a wide spectrum, ranging from numerically rather simple to mathematically highly complex models. Experimental models are based on self-oscillating silicon or static vocal folds. Cadaver models have the advantage of being representative of the natural phonation process.
RESULTS: An overview of different kinds of models is given to show the diversity of modeling approaches without going into mathematical or physical details.
CONCLUSION: Numerical and experimental models for simulating the phonatory process enable causalities and correlations to be uncovered, which can be used in the future to adapt conservative and surgical voice therapies, or even to suggest entire new treatment strategies.

PMID: 26746639 [PubMed - as supplied by publisher]

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Evaluating the Need for Daily Image Guidance in Head and Neck Cancers Treated with Helical Tomotherapy: A Retrospective Analysis of a Large Number of Daily Imaging-based Corrections.

Evaluating the Need for Daily Image Guidance in Head and Neck Cancers Treated with Helical Tomotherapy: A Retrospective Analysis of a Large Number of Daily Imaging-based Corrections.

Clin Oncol (R Coll Radiol). 2015 Dec 30;

Authors: Saha A, Mallick I, Das P, Shrimali RK, Achari R, Chatterjee S

Abstract
AIMS: Clinical implementation of image-guided intensity-modulated radiotherapy is rapidly evolving. Helical tomotherapy treatment delivery involves daily imaging before intensity-modulated radiotherapy delivery. This can be a time consuming resource-intensive process, which may not be essential in head and neck radiotherapy, where effective immobilisation is possible. This study aimed to evaluate whether an offline protocol implementing the shifts derived from the first few fractions can be an acceptable alternative to daily imaging for helical tomotherapy.
MATERIALS AND METHODS: We retrospectively analysed the set-up data of 2858 fractions of 100 head and neck cancer patients who were treated with daily online image guidance. Using summary data from all treatment fractions, we calculated the systematic error (∑) and random error (σ) in each of the three axes, i.e. mediolateral (x), craniocaudal (y), anteroposterior (z). We also calculated the translational vector of each fraction of individual patients. We then simulated two no-action-level offline protocols where set-up errors of the first three (protocol F3) or five fractions (protocol F5) were averaged and implemented for the remaining fractions. The residual errors in each axis for these fractions were determined together with the residual ∑ and σ. Planning target volume (PTV) margins using the van Herk formula were generated based on the uncorrected errors as well as for the F3 and F5 protocols. For each scenario, we tabulated the number of fractions where the residual errors were more than 5 mm (our default PTV margin). We also tried to evaluate whether errors tended to differ based on intent (radical or adjuvant), anatomical subsite or weight loss during treatment.
RESULTS: Analysis from this large dataset revealed that in the tomotherapy platform, the highest set-up errors were in the anteroposterior (z) axis. The global mean was 5.4 mm posterior shift, which can be partly attributed to couch sag on this system. Uncorrected set-up errors resulted in systematic and random errors of ∑x,y,z of 1.8, 1.7 and 2 mm and σx,y,z of 1.7, 1.5 and 1.9 mm, with a required PTV margin in x, y, z axes of 5.7, 5.3 and 6.2 mm. Implementing average shifts from the first three or five fractions resulted in a substantial reduction in the residual systematic errors, whereas random errors remained constant. The PTV margins required for the residual errors after three and five fraction corrections were 3.8, 3.4 and 5.1 mm for F3 and 3.3, 2.9, 4.8 mm for F5. The proportions of fractions where there was >5 mm residual error were 1.6%, 1.1%, 2.9% in x, y and z axes in the F3 protocol and 1.5%, 0.8% and 2.6% with the F5 protocol. Although there was no difference in residual shifts > 5 mm, there was a statistically higher chance of residual errors > 3 mm larynx/hypopharynx subsites versus other sites. In patients who had more than 5% weight loss, there was no significant increase in residual errors with the F5 protocol and the required PTV margin was within our default PTV margins expansion.
CONCLUSIONS: Correction of systematic errors by implementing average shifts from the first five fractions enables us to safely avoid daily imaging in this retrospective analysis. If this is validated in a prospective group it could lead to implementation of a resource sparing image-guided radiotherapy protocol both in terms of time and imaging dose. Patients with larynx/hypopharynx subsites may require more careful evaluation and daily online matching.

PMID: 26746002 [PubMed - as supplied by publisher]

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Altered expression and signalling of EP2 receptor in nasal polyps of AERD patients: role in inflammation and remodelling.

Altered expression and signalling of EP2 receptor in nasal polyps of AERD patients: role in inflammation and remodelling.

Rhinology. 2016 Jan 9;

Authors: Machado-Carvalho L, Torres R, Perez-Gonzalez M, Alobid I, Mullol J, Pujols L, Roca-Ferrer J, Picado C

Abstract
BACKGROUND: Down-regulation of the E-prostanoid (EP)2 receptor has been reported in aspirin exacerbated respiratory disease (AERD). We aimed to evaluate the expression and activation of EP receptors in AERD and their role in prostaglandin (PG) E2 signalling.
METHODS: Samples were obtained from nasal mucosa of control subjects (NM-C, n=7) and from nasal polyps of AERD patients (NP-AERD, n=7). Expression of EP1-4 was assessed at baseline. Fibroblasts were stimulated with receptor agonists to measure cAMP levels, cell proliferation and granulocyte-macrophage colony-stimulating factor (GM-CSF) release.
RESULTS: NM-C and NP-AERD samples and fibroblasts expressed EP2, EP3 and EP4 at baseline. Lower expression of EP2 and higher expression of EP4 was observed in NP-AERD compared with NM-C. Stimulation with PGE2 and butaprost caused a higher increase in cAMP in NM-C than in NP-AERD. On the contrary, CAY10598 produced a higher production of cAMP in NP-AERD compared with NM-C. The anti-proliferative effect of PGE2 and butaprost was lower in NP-AERD than in NM-C fibroblasts. Similarly, the capacity of PGE2 and butaprost to inhibit GM-CSF release was lower in NP-AERD than in NM-C.
CONCLUSIONS: The altered expression of EP2 in AERD may contribute to reduce the capacity of PGE2 to mediate anti-proliferative and anti-inflammatory effects.

PMID: 26747755 [PubMed - as supplied by publisher]

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Cellular phenotyping of chronic rhinosinusitis with nasal polyps.

Cellular phenotyping of chronic rhinosinusitis with nasal polyps.

Rhinology. 2016 Jan 9;

Authors: Lou H, Meng Y, Piao Y, Zhang N, Bachert C, Wang C, Zhang L

Abstract
BACKGROUND: Defining the phenotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) with prognosis may lead to delivery of personalized treatment. This study aimed to identify cellular phenotypes of CRSwNP using cluster analysis and define an algorithm for different clusters associated with polyp recurrence.
METHODS: Overall, 366 patients with CRSwNP were enrolled in this retrospective analysis. Eighteen variables, including clinical characteristics and tissue/peripheral inflammatory cells assessments, were selected for factor analysis. Unsupervised cluster analysis was performed after variables reduction and standardization and differences in polyp recurrence during follow-up for a minimum of 24 months were analysed among clusters. Discriminant analysis was further used to develop a clinically useful algorithm for predicting clustering.
RESULTS: Five phenotypic clusters were identified. Clusters 1 and 2 were plasma cell-dominant and lymphocyte-dominant phenotypes, respectively. Cluster 3 revealed a mixed inflammatory pattern. Cluster 4 was characterized by infiltration of predominantly neutrophils. Cluster 5 was characterized by a marked tissue eosinophilia and highest recurrence rate of 98.5%. The clinical algorithm predicted clustering with 93.7% accuracy.
CONCLUSIONS: Chinese CRSwNP patients may be classified into five phenotypes with different polyp recurrence rates, based on the presence of predominantly plasma cells, lymphocytes, neutrophils, eosinophils or mixed inflammatory cells in polyps.

PMID: 26747641 [PubMed - as supplied by publisher]

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Three-dimensional analysis of the accuracy of optic and electromagnetic navigation systems using surface registration in live endoscopic sinus surgery.

Three-dimensional analysis of the accuracy of optic and electromagnetic navigation systems using surface registration in live endoscopic sinus surgery.

Rhinology. 2016 Jan 9;

Authors: Chang CM, Jaw FS, Lo WC, Fang KM, Cheng PW

Abstract
BACKGROUND: This study presents the first report in the same patients on the time efficiency of surface registration as well as the navigational accuracy using optic and electromagnetic tracking systems.
METHODS: Thirty patients with bilateral chronic paranasal pansinusitis underwent endoscopic sinus surgery. After surface registration, the surgeries were performed on one side using optic navigation guidance and on the other side using electromagnetic navigation guidance. The intraoperative measurements performed included the time taken for the surface registration and surgical procedure on each side, as well as the navigation errors at the different locations.
RESULTS: The time for surface registration was significantly longer in the optic navigation group than the electromagnetic group. A comparison of the navigation errors along the 3 axes showed that the deviation in the medial-lateral direction was significantly less than that in the anterior-posterior and cranial-caudal directions in the optic navigation group as well as the electromagnetic group.
CONCLUSIONS: The procedure for surface registration in both optic and electromagnetic guidance is efficient and convenient. The accuracy of both navigation systems is comparable and within acceptable ranges for clinical use. In addition, the best accuracy was measured in the medial-lateral direction compared with the other two axes.

PMID: 26747431 [PubMed - as supplied by publisher]

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Device Life of Two Generations of Provox Voice Prostheses.

Device Life of Two Generations of Provox Voice Prostheses.

Ann Otol Rhinol Laryngol. 2016 Jan 7;

Authors: Thylur DS, Villegas BC, Fisher LM, Sinha UK, Kokot N

Abstract
BACKGROUND: Tracheoesophageal voice prostheses are invaluable for speech rehabilitation in patients who have received total laryngectomy, but device failure impedes communication and creates psychosocial and financial burdens. This study compares the Provox 2 and Provox Vega voice prostheses on the parameter of device life.
METHODS: This was a retrospective observational study of 21 patients with 181 device replacements at an academic tertiary care medical center. Disparity in device life and factors that may influence device life were analyzed.
RESULTS: The mean device life for Provox 2, at 115.6 days (SE = 5.8), was longer than for Provox Vega, at 65.1 days (SE = 7.5) (P < .001).
CONCLUSIONS: Device longevity was greater for Provox 2 over Provox Vega. These results will facilitate the design of prospective studies to assess reasons for variations in device life between patients and device types.

PMID: 26747630 [PubMed - as supplied by publisher]

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Myeloperoxidase-Antineutrophil Cytoplasmic Antibody-Positive Otitis Media and Rhinosinusitis With Pathological Features of Immunoglobulin G4-Related Disease: A Case Report.

Myeloperoxidase-Antineutrophil Cytoplasmic Antibody-Positive Otitis Media and Rhinosinusitis With Pathological Features of Immunoglobulin G4-Related Disease: A Case Report.

Ann Otol Rhinol Laryngol. 2016 Jan 7;

Authors: Ohno K, Matsuda Y, Arai T, Sugihara T, Iga S, Kimura Y

Abstract
BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have different clinical and pathological features. However, differentiation between these 2 disorders is sometimes difficult.
OBJECTIVE: To report a case involving a patient with characteristics of both IgG4-RD and AAV.
METHODS: Case report with literature review.
RESULTS: We report a case of myeloperoxidase-ANCA-positive otitis media and rhinosinusitis with pathological features of IgG4-RD in a 73-year-old man. The patient was first clinically suspected to have granulomatosis with polyangiitis. All of the main characteristic pathological features of IgG4-RD were present: dense lymphoplasmacytic infiltration, increased numbers of IgG4-positive plasma cells, storiform-type fibrosis, and obliterative phlebitis.
CONCLUSIONS: The simultaneous presence of the characteristics of both IgG4-RD and AAV makes diagnosis and treatment difficult.

PMID: 26747629 [PubMed - as supplied by publisher]

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Book Review: A Century of Progress in Head & Neck Cancer.

Book Review: A Century of Progress in Head & Neck Cancer.

Ann Otol Rhinol Laryngol. 2016 Feb;125(2):177

Authors: Palma GL

PMID: 26747429 [PubMed - as supplied by publisher]

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Book Review: Facial Paralysis: A Comprehensive Rehabilitative Approach.

Book Review: Facial Paralysis: A Comprehensive Rehabilitative Approach.

Ann Otol Rhinol Laryngol. 2016 Feb;125(2):177

Authors: Free N

PMID: 26747428 [PubMed - as supplied by publisher]

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Rat model of chronic tympanic membrane perforation: Ventilation tube with mitomycin C and dexamethasone.

Rat model of chronic tympanic membrane perforation: Ventilation tube with mitomycin C and dexamethasone.

Int J Pediatr Otorhinolaryngol. 2016 Jan;80:61-8

Authors: Wang AY, Shen Y, Liew LJ, Wang JT, von Unge M, Atlas MD, Dilley RJ

Abstract
OBJECTIVE: Chronic tympanic membrane perforation (TMP) in a clinical setting may attract surgical intervention. With the advent of modern biomaterials, new options are available for myringoplasty but safety and efficacy need evaluation in a chronic TMP animal model. The aim of this study was to evaluate the efficacy of ventilation tube (VT) insertion in conjunction with topical application of mitomycin C/dexamethasone (M/D) for the creation of chronic TMP in rats.
METHODS: Thirty male Sprague-Dawley rats underwent myringotomy of the right tympanic membrane (TM) and were divided into three experimental groups: spontaneous healing (myringotomy control), VT insertion for 2 weeks and VT insertion for 2 weeks in conjunction with topical application of M/D (VT-M/D). All TMs were regularly assessed by otoscopy for 10 weeks and then animals were sacrificed for histological evaluation.
RESULTS: In the VT-M/D group, seven out of ten (70%) perforations were patent at 10 weeks (mean patency, 57.9 days; P<0.01). The VT group had two out of ten (20%) perforations patent at 10 weeks (mean patency, 26.5 days; P<0.01), while all TMPs from the myringotomy control group were closed by day 9 (mean patency, 7.2 days). Histologically, the TMPs patent at week 10 had a stratified squamous epithelialized rim, keratinocyte layer thickening around the perforation edge as well as increased collagen deposition and macrophage infiltration.
CONCLUSION: Chronic TMP in a rat model was successfully created by VT insertion and the efficacy was increased in combination with topical application of M/D.

PMID: 26746614 [PubMed - in process]

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Otorhinolaryngological, audiovestibular and swallowing manifestations of patients with Niemann-Pick disease Type C.

Otorhinolaryngological, audiovestibular and swallowing manifestations of patients with Niemann-Pick disease Type C.

Int J Pediatr Otorhinolaryngol. 2016 Jan;80:1-4

Authors: Senirli RT, Kuşçu O, Akyol U, Topçu M, Yiğit Ö, Aksoy S, Demir N

Abstract
OBJECTIVES: The aim of this study is to evaluate audiovestibular and swallowing impairment of patients with NPC.
METHODS: Audiovestibular and swallowing evaluation were performed on patients with Niemann-Pick disease type C (NPC) at Hacettepe University between 20013 and 2015 prospectively. Pure-tone audiometry (PTA), Auditory Brain stem response (ABR), Flexible endoscopic evaluation of swallowing (FEES) test and posturography were done. Hearing, swallowing and balance states were measured.
RESULTS: There were 16 patients (5 male and 11 female, with a median age of 6.5 years old). The most common ABR abnormalities observed were absent waves I and III (%70 absent I waves, %43.75 absent III waves). Twelve of sixteen patients (%75) had an ABR abnormality in at least one ear, of these, four patients had normal hearing and three of them had periferal hearing loss. 12 (75%) patients had complaint of postural imbalance. 11(69%) of patients had peripheral and one (6%) patient had central impairment. Nine of sixteen patients (56.25%) show some degree of dysphagia (either penetration or aspiration). Two patients (12.5%) showed aspiration both liquid and viscous nutrition. Three patients (18.75%) showed aspiration primarily in liquids and two of them had penetration with viscous nutrition. Three patients (18.75%) had penetration with no aspiration neither liquid nor viscous nutrition (PEN-ASP score was 3, 3, 5, respectively).
CONCLUSION: There is no curative treatment for this devastating and fatal disorder and hearing impairment, balance and swallowing disorders can be seen especially late onset form of disease.

PMID: 26746602 [PubMed - in process]

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Otorhinolaryngological, audiovestibular and swallowing manifestations of patients with Niemann-Pick disease Type C.

Otorhinolaryngological, audiovestibular and swallowing manifestations of patients with Niemann-Pick disease Type C.

Int J Pediatr Otorhinolaryngol. 2016 Jan;80:1-4

Authors: Senirli RT, Kuşçu O, Akyol U, Topçu M, Yiğit Ö, Aksoy S, Demir N

Abstract
OBJECTIVES: The aim of this study is to evaluate audiovestibular and swallowing impairment of patients with NPC.
METHODS: Audiovestibular and swallowing evaluation were performed on patients with Niemann-Pick disease type C (NPC) at Hacettepe University between 20013 and 2015 prospectively. Pure-tone audiometry (PTA), Auditory Brain stem response (ABR), Flexible endoscopic evaluation of swallowing (FEES) test and posturography were done. Hearing, swallowing and balance states were measured.
RESULTS: There were 16 patients (5 male and 11 female, with a median age of 6.5 years old). The most common ABR abnormalities observed were absent waves I and III (%70 absent I waves, %43.75 absent III waves). Twelve of sixteen patients (%75) had an ABR abnormality in at least one ear, of these, four patients had normal hearing and three of them had periferal hearing loss. 12 (75%) patients had complaint of postural imbalance. 11(69%) of patients had peripheral and one (6%) patient had central impairment. Nine of sixteen patients (56.25%) show some degree of dysphagia (either penetration or aspiration). Two patients (12.5%) showed aspiration both liquid and viscous nutrition. Three patients (18.75%) showed aspiration primarily in liquids and two of them had penetration with viscous nutrition. Three patients (18.75%) had penetration with no aspiration neither liquid nor viscous nutrition (PEN-ASP score was 3, 3, 5, respectively).
CONCLUSION: There is no curative treatment for this devastating and fatal disorder and hearing impairment, balance and swallowing disorders can be seen especially late onset form of disease.

PMID: 26746602 [PubMed - in process]

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Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population.

Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population.

J Neurointerv Surg. 2016 Jan 8;

Authors: Durst CR, Ornan DA, Reardon MA, Mehndiratta P, Mukherjee S, Starke RM, Wintermark M, Evans A, Jensen ME, Crowley RW, Gaughen J, Liu KC

Abstract
BACKGROUND AND PURPOSE: While recent literature has described the prevalence of transverse sinus stenosis in patients with idiopathic intracranial hypertension, tinnitus, and refractory headaches, it is unclear what the prevalence is in the general population. This study evaluates the prevalence of venous sinus stenosis and hypoplasia in the general patient population.
MATERIALS AND METHODS: 355 of 600 consecutive patients who underwent CT angiography of the head met the inclusion criteria. The diameters of the dural venous sinuses were recorded. Each study was evaluated by a neuroradiologist for the presence of stenoses. Univariate and multivariate statistical analyses were performed by a statistician.
RESULTS: The prevalence of unilateral transverse sinus stenosis or hypoplasia in a sample of patients representing the general population was 33%, the prevalence of bilateral transverse sinus stenosis was 5%, and the prevalence of unilateral stenosis with contralateral hypoplasia was 1%. A multivariate analysis identified arachnoid granulations as a predictor of stenosis (p<0.001). Gender trended toward significance (p=0.094). Race was not a significant predictor of stenosis (p=0.745).
CONCLUSIONS: The prevalence of bilateral transverse sinus stenosis in the general population is not trivial. These data may be used as a reference for understanding the mechanistic role of stenoses in idiopathic intracranial hypertension, tinnitus, and refractory headaches.

PMID: 26747875 [PubMed - as supplied by publisher]

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Tinnitus and its current treatment-Still an enigma in medicine.

Tinnitus and its current treatment-Still an enigma in medicine.

J Formos Med Assoc. 2015 Dec 30;

Authors: Swain SK, Nayak S, Ravan JR, Sahu MC

Abstract
Tinnitus is a phantom auditory perception that occurs in humans. Tinnitus, which is a distressing problem affecting many people around the world, is commonly referred to as ringing in the ears. No effective drug therapy is available for this elusive disease, although much research work into mechanism and possible treatment is underway. As yet, there are no Food and Drug Administration approved drugs available and the quest for a new treatment option for tinnitus focus on important challenges in tinnitus management. A number of options have been used to treat patients with tinnitus, but outcomes have been limited. A new, curative modality will provide a turning point in the management of tinnitus. The purpose of this review article is to discuss the pathophysiology, global burden, current treatment, and prevention of tinnitus, with future prospective studies in new drug therapy for this elusive condition.

PMID: 26747828 [PubMed - as supplied by publisher]

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The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using (99m)Tc-ECD SPECT.

The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using (99m)Tc-ECD SPECT.

Eur Radiol. 2016 Jan 8;

Authors: Laureano MR, Onishi ET, Bressan RA, Neto PB, Castiglioni ML, Batista IR, Reis MA, Garcia MV, de Andrade AN, Sanchez ML, Moreira HC, de Almeida RR, Garrido GJ, Jackowski AP

Abstract
OBJECTIVE: Investigate the effect of acupuncture on brain perfusion using ethyl cysteinate dimer single-photon emission computed tomography ((99m)Tc-ECD SPECT) in patients with tinnitus.
METHODS: This randomized, single-blind, sham-control study examined patients (18-60 years old) with normal hearing and chronic, idiopathic, continuous tinnitus. Fifty-seven subjects were randomly assigned to true (n = 30) or sham (n = 27) acupuncture (ACP); (99m)Tc-ECD SPECT examinations were performed before and after 12 twice-weekly ACP sessions. Secondary outcomes included changes in the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), Hamilton Anxiety Scale (HAS) and Beck Depression Inventory (BDI). Imaging data were analysed using Statistical Parametric Mapping (SPM8) software. Regression models were used to examine secondary outcomes via two paradigms: intention-to-treat (ITT; where multiple imputations were conducted because of study attrition) and complete cases.
RESULTS: No between-group brain perfusion differences were observed. However, a significant improvement in THI scores was observed at the end of true ACP treatment for all domains (all p values < 0.01) except the catastrophic scale.
CONCLUSIONS: ACP might reduce the effects of tinnitus on daily life; however, additional studies should be conducted to verify the effects of ACP on the neural architecture and brain function of tinnitus patients.
KEY POINTS: • Efficacy of acupuncture on brain perfusion and symptoms of tinnitus patients. • Acupuncture improved the Tinnitus Handicap Inventory scores in tinnitus patients. • No significant changes in brain perfusion were observed after 12 twice-weekly sessions. • Perfusion changes would reflect changes in neuronal function.

PMID: 26747258 [PubMed - as supplied by publisher]

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[The role of microRNAs in head and neck squamous cell carcinoma : Biomarkers for prognosis, therapy selection, and novel therapeutics].

[The role of microRNAs in head and neck squamous cell carcinoma : Biomarkers for prognosis, therapy selection, and novel therapeutics].

HNO. 2016 Jan 8;

Authors: Heß AK, Weichert W, Budach V, Tinhofer I

Abstract
Despite recent advances in radiochemotherapy, treatment of locally advanced head and neck squamous cell carcinoma is still challenging, and survival rates have improved only slightly. This is due to the high frequency of metastases and local and/or regional tumor recurrences that have acquired radio- or chemoresistance. MiRNAs regulate diverse processes in tumorigenesis, metastasis, and therapy resistance in head and neck squamous cell carcinoma. Hence, miRNAs are highly valued in biomarker studies. Establishment of the miRNA profiles of oropharyngeal tumors enables personalized treatment selection, since expression of distinct miRNAs can predict the response to two different radiochemotherapy regimens. Development of novel miRNA therapeutics has a high clinical potential for further improving treatment of cancerous disease. The use of nanoparticles with distinct surface modifications as miRNA vectors permits prolonged bioavailability, high efficacy in tumor targeting, and low toxicity. Nevertheless, the efficacy of miRNA therapy has only been shown in animal models to date.

PMID: 26746640 [PubMed - as supplied by publisher]

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[Current methods for modelling voice production].

[Current methods for modelling voice production].

HNO. 2016 Jan 8;

Authors: Döllinger M, Kniesburges S, Kaltenbacher M, Echternach M

Abstract
BACKGROUND: Many details of the phonatory process are not yet fully understood. Besides observational research, scientists have long since been trying to explain the physical fundamentals of voicing using simulations. This approach is commonly called modeling. However, the knowledge gained often failed to find its way to professionals working with the voice, such as singing teachers, voice therapists, and voice coaches, and sometimes also to otorhinolaryngologists and phoniatricians. The reason for this is that scientific publications on this topic mostly contain very detailed mathematical and physical descriptions, which are often hard to understand.
OBJECTIVE: A simplified presentation and explanation of current methods for modeling the phonatory process, which have contributed greatly to uncovering and understanding the relationships involved in voicing during recent years.
METHODS: The presented methods cover a wide spectrum, ranging from numerically rather simple to mathematically highly complex models. Experimental models are based on self-oscillating silicon or static vocal folds. Cadaver models have the advantage of being representative of the natural phonation process.
RESULTS: An overview of different kinds of models is given to show the diversity of modeling approaches without going into mathematical or physical details.
CONCLUSION: Numerical and experimental models for simulating the phonatory process enable causalities and correlations to be uncovered, which can be used in the future to adapt conservative and surgical voice therapies, or even to suggest entire new treatment strategies.

PMID: 26746639 [PubMed - as supplied by publisher]

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Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

Eur Arch Otorhinolaryngol. 2016 Jan 7;

Authors: Özgür A, Serdaroğlu Beyazal M, Terzi S, Coşkun ZÖ, Dursun E

Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p < 0.001). There was no correlation between the clinical and laboratory findings and VEMP findings in patients with ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

PMID: 26742904 [PubMed - as supplied by publisher]

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Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

Eur Arch Otorhinolaryngol. 2016 Jan 7;

Authors: Özgür A, Serdaroğlu Beyazal M, Terzi S, Coşkun ZÖ, Dursun E

Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p < 0.001). There was no correlation between the clinical and laboratory findings and VEMP findings in patients with ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

PMID: 26742904 [PubMed - as supplied by publisher]

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Effect of body posture on involuntary swallow in healthy volunteers.

Effect of body posture on involuntary swallow in healthy volunteers.

Physiol Behav. 2015 Dec 29;

Authors: Shiino Y, Sakai S, Takeishi R, Hayashi H, Watanabe M, Tsujimura T, Magara J, Ito K, Tsukada T, Inoue M

Abstract
Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and whiteout time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow.

PMID: 26742532 [PubMed - as supplied by publisher]

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Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings.

Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings.

J Laryngol Otol. 2016 Jan;130(1):32-37

Authors: Badran K, Ansari S, Al Sam R, Al Husami Y, Iyer A

Abstract
OBJECTIVES: This study aimed to compare the interpretations of temporal bone computed tomography scans by an otologist and a radiologist with a special interest in temporal bone imaging. It also aimed to determine the usefulness of this imaging modality.
METHODS: A head and neck radiologist and an otologist separately reported pre-operative computed tomography images using a structured proforma. The reports were then compared with operative findings to determine their accuracy and differences in interpretations.
RESULTS: Forty-eight patients who underwent pre-operative computed tomography scans in a 30-month period were identified. Six patients were excluded because complete operative findings had not been recorded. Positive and negative predictive values and accuracy of the anatomical and pathological findings were calculated for 42 patients by both reporters. The accuracy was found to be less than 80 per cent, except for identification of the tegmen and lateral semicircular canal erosion. Overall, there was no significant difference in interpretations of computed tomography scans between reporters. There was a slight difference in interpretation for tympanic membrane retraction, facial canal erosion and lateral semicircular canal fistula and/or erosion.
CONCLUSION: Pre-operative computed tomography scanning of the temporal bone is useful for predicting anatomy for surgical planning in patients with chronic otitis media, but its reliability remains questionable.

PMID: 26745138 [PubMed - as supplied by publisher]

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Topical aural antibiotic use in the UK - time for a change of policy?

Topical aural antibiotic use in the UK - time for a change of policy?

J Laryngol Otol. 2016 Jan;130(1):1

Authors: Youngs R, Fisher E, Hussain M, Fishman J

PMID: 26745137 [PubMed - as supplied by publisher]

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Thiamine deficiency in tachypnoeic Cambodian infants.

Thiamine deficiency in tachypnoeic Cambodian infants.

Paediatr Int Child Health. 2015 Nov;35(4):312-8

Authors: Keating EM, Nget P, Kea S, Kuong S, Daly L, Phearom S, Enders F, Cheryk LA, Topazian M, Fischer PR, Kumar V

Abstract
BACKGROUND: Beriberi is endemic in South-east Asia. Diagnosis is based on clinical findings, but correlation of clinical features with blood thiamine concentrations is uncertain.
OBJECTIVES: To investigate in tachypnoeic Cambodian infants the correlation between whole blood thiamine diphosphate (TDP) concentrations, clinical findings and blood TDP levels after therapy.
METHODS: Infants hospitalised with tachypnoea were enrolled from October 2011 to January 2012. Initial clinical features, diagnostic test results and final diagnoses were recorded. Blood for TDP determination was collected prior to treatment and at discharge. Matched infants from the general outpatient clinic with minor complaints were enrolled as controls. Thiamine was administered at the discretion of the treating paediatrician.
RESULTS: Of the 47 tachypnoeic and 47 control infants, median initial blood TDP concentrations were 83 and 93 nmol/L, respectively (P = 0·69), and were below the estimated limit of normal (<70 nmol/L) in 43% vs 34% (P = 0·40). Median initial TDP levels were 72 and 91 nmol/L in tachypnoeic infants who did or did not receive thiamine, respectively (P = 0·56); at hospital discharge, median TDP concentration had increased by 107 and 3·5 nmol/L in these two subgroups (P<0·001). Classical findings of beriberi such as dysphonia, tachycardia and hepatomegaly did not correlate with low initial TDP concentrations, but infant age, Tiger Balm use, absence of wheezing and low blood CRP levels were associated with low initial TDP levels. Use of infant formula was associated with higher initial TDP levels.
CONCLUSIONS: Thiamine deficiency is common in tachypnoeic Cambodian infants, but routine clinical assessments do not accurately identify those with low blood TDP concentrations. Parenteral thiamine administration markedly increases TDP levels. Empirical thiamine treatment should be considered for tachypnoeic infants in regions with endemic thiamine deficiency.

PMID: 26744155 [PubMed - in process]

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Metastatic Cancer to the Larynx: A Case Report and Update.

Metastatic Cancer to the Larynx: A Case Report and Update.

J Voice. 2015 Dec 29;

Authors: Zenga J, Mehrad M, Bradley JP

Abstract
OBJECTIVE: The aim of this study was to describe a case of colorectal carcinoma metastatic to the larynx and provide a review of the current literature.
METHODS: A case report with chart review was performed. A review of the current literature was performed by systematically searching PubMed, OVID, CINAHL Plus, and EMBASE.
RESULTS: In 1988, a comprehensive literature review identified melanoma as the most common neoplasm to exhibit laryngeal involvement. Since that study, 41 subsequent cases have been reported, and among these, colorectal adenocarcinoma was the most frequent distant primary (24%). In 25 (58%) cases, curative surgery was attempted, but only 4 patients remained disease-free at last follow up. We report the history of a 52-year-old man who presented with rectal adenocarcinoma metastatic to his larynx 4 years after definitive treatment of the primary site.
CONCLUSIONS: In patients with a laryngeal mass and a history of colorectal cancer, or those at high risk of having an occult colorectal primary, metastatic spread to the larynx must always be considered. Although secondary laryngeal metastasis portends a poor prognosis, for the select patient, surgical intervention can provide long-term disease control.

PMID: 26743607 [PubMed - as supplied by publisher]

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Usefulness Of Glucocorticoids In The Management Of Foreign Body Aspiration.

Usefulness Of Glucocorticoids In The Management Of Foreign Body Aspiration.

Bol Asoc Med P R. 2015 Jul-Sep;107(3):24-7

Authors: Pagán Rivera BL, Anselmi FJ, Torres Mdel M, Segarra A, Rivera JR

Abstract
Foreign body aspiration can be a life-threatening emergency. An aspirated solid or semi-solid object may lodge in the larynx, trachea or other breathing airways. If the object is large enough to cause nearly complete obstruction of the airway, asphyxia may rapidly cause death. We report a 19-year old man admitted with right lower lobe pneumonia who spontaneously expelled a foreign body, one day after admission and glucocorticoids administration. Glucocorticoids should be considered in foreign body aspiration management because improvement of the inflammatory reaction may facilitate expontaneous expulsion or foreign body extraction

PMID: 26742192 [PubMed - in process]

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Gastro-duodenal fluid induced Nuclear Factor-κappaB activation and early pre-malignant alterations in murine hypopharyngeal mucosa.

Gastro-duodenal fluid induced Nuclear Factor-κappaB activation and early pre-malignant alterations in murine hypopharyngeal mucosa.

Oncotarget. 2016 Jan 6;

Authors: Vageli DP, Prasad ML, Sasaki CT

Abstract
We recently described the role of gastro-duodenal fluids (GDFs) in generating changes consistent with hypopharyngeal neoplasia through activation of NF-κB pathway, using an in vitro model of human hypopharyngeal normal keratinocytes. Here, we further provide evidence that gastro-duodenal reflux is a risk factor for early pre-malignant alterations in hypopharyngeal mucosa (HM) related to an activated NF-κB oncogenic pathway, using both an in vitro and a novel in vivo model of C57Bl/6J mice. Histological, immunohistochemical and automated quantitative analysis documents significant NF-κB activation and early pre-malignant alterations in HM topically exposed to GDFs, compared to acid alone and other controls. Early pre-malignant histologic lesions exhibited increased Ki67, CK14 and ΔNp63, cell proliferation markers, changes of cell adhesion molecules, E-Cadherin and β-catenin, and STAT3 activation. The in vivo effect of NF-κB activation is positively correlated with p-STAT3, Ki67, CK14 or β-catenin expression, while GDFs induce significant transcriptional activation of RELA(p65), bcl-2, TNF-α, STAT3, EGFR and wnt5A, in vivo. Our in vivo model demonstrates selectively activated NF-κB in response to topically administrated GDFs, leading to early pre-malignant events in HM.

PMID: 26745676 [PubMed - as supplied by publisher]

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Malignant Neoplasm Burden in Nepal - Data from the Seven Major Cancer Service Hospitals for 2012.

Malignant Neoplasm Burden in Nepal - Data from the Seven Major Cancer Service Hospitals for 2012.

Asian Pac J Cancer Prev. 2015;16(18):8659-8663

Authors: Pun CB, Pradhananga KK, Siwakoti B, Subedi K, Moore MA

Abstract
In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients.

PMID: 26745133 [PubMed - as supplied by publisher]

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Endobronchial laser ablation in the management of epithelial-myoepithelial carcinoma of the trachea.

Endobronchial laser ablation in the management of epithelial-myoepithelial carcinoma of the trachea.

Respir Med Case Rep. 2015;16:151-3

Authors: McCracken D, Wieboldt J, Sidhu P, McManus K

Abstract
A 52 year old, never smoker presented to hospital with progressive shortness of breath and significant stridor over a five month period. He also described the feeling of needing to cough but being unable to expectorate. CT Thorax demonstrated a mass lesion in the trachea just distal to the larynx which was then confirmed on rigid bronchoscopy. Subsequent histology confirmed an epithelial-myoepithelial carcinoma. Only a few case reports document these rare salivary gland tumours occurring in other locations such as the respiratory tract. After staging showed only local disease, the patient was managed with rigid bronchoscopy and laser ablation therapy. We present the first documented case to be treated with endobronchial laser ablation therapy with discussion of the incidence, presentation and characteristics of these tumours including the treatment options, as well as the use of laser ablation in the management of benign and malignant endobronchial lesions.

PMID: 26744686 [PubMed]

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Non-invasive detection and monitoring of experimental hydrocephalus with distortion product otoacoustic emissions.

Non-invasive detection and monitoring of experimental hydrocephalus with distortion product otoacoustic emissions.

Auris Nasus Larynx. 2015 Dec 29;

Authors: Ezerarslan H, Beriat GK, Nurhat RH, Kazancı B, Çelikkan FT, Sabuncuoğlu B, Sabuncuoğlu H

Abstract
OBJECTIVE: We aimed to find out the effects of short term and long term hydrocephalus and intracranial ventricular volume changes on cochlear functions by using distortion product otoacoustic emission (DPOAE) in experimental hydrocephalus rat models for the first time in literature.
METHODS: This study was performed with 48 healthy, adult (8 weeks old), Sprague-Dawley rats which weighed between 200 and 240g. Six groups were formed in this study: short term control, short term sham, short term hydrocephalus, long term control, long term sham and long term hydrocephalus groups. Each group contained eight rats. Short term period was 4 weeks and long term period was 8 weeks after the study started. At the end of these periods, DPOAE measurements were performed and then rats were sacrificed to determine ventricular volumes.
RESULTS: DPOAE values at all frequencies were significantly decreased in the short term hydrocephalus group when compared to the short term control and short term sham groups. DPOAE values at all frequencies were significantly decreased in the long term hydrocephalus group when compared to the long term control and long term sham groups. Besides, long term sham group which had higher ventricular volumes than long term control group also had lower DPOAE measurements. Significant associations were present between DPOAE measurements and ventricular volumes in hydrocephalus models.
CONCLUSION: The functional disturbances in cochlear functions due to hydrocephalus have been demonstrated with DPOAE measurements in this study. DPOAE measurements may be thought as an easily applicable non-invasive method in detection and follow-up of patients with hydrocephalus. Our findings should be supported with clinical studies in humans.

PMID: 26743839 [PubMed - as supplied by publisher]

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Correlation between olfactory acuity and sinonasal radiological findings in adult patients with chronic rhinosinusitis.

Correlation between olfactory acuity and sinonasal radiological findings in adult patients with chronic rhinosinusitis.

Auris Nasus Larynx. 2015 Dec 29;

Authors: Saito T, Tsuzuki K, Yukitatsu Y, Sakagami M

Abstract
OBJECTIVE: This study aimed to clarify the correlation between olfactory disorder severity and radiological findings in patients with chronic rhinosinusitis (CRS) in the preoperative stage.
METHODS: From 2007 to 2014, 272 adult patients (163 men, 109 women; age range 22-80 years) with olfactory disorder due to bilateral CRS who were scheduled to undergo primary endoscopic sinus surgery (ESS) were enrolled. Two groups were studied: eosinophilic CRS (ECRS, n=193); and non-ECRS (n=79). T&T olfactometer recognition and intravenous olfaction tests were used. Computed tomography (CT) scores for sinuses and olfactory clefts (OC) were applied. Correlations between olfactory acuity and CT score were statistically analysed.
RESULTS: In both groups, recognition threshold correlated significantly with CT score. Recognition threshold and CT score were significantly more severe in ECRS than in non-ECRS. CT score at OC showed the strongest correlation with recognition threshold. CT scores for total sinuses and OC in patients showing a positive response to the intravenous olfaction test (239 patients) were significantly milder than those in the negative group (29 patients), but ethmoid CT score was not.
CONCLUSION: Olfactory disorder severity correlated significantly with CT opacification. Olfactory disorder and CT findings were more severe in patients with ECRS than in those with non-ECRS.

PMID: 26743838 [PubMed - as supplied by publisher]

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Temporal bone chondroblastoma totally invisible on MRI.

Temporal bone chondroblastoma totally invisible on MRI.

Auris Nasus Larynx. 2015 Dec 29;

Authors: Hiraumi H, Arakawa Y, Yamamoto N, Sakamoto T, Ito J

Abstract
We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach.

PMID: 26743837 [PubMed - as supplied by publisher]

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Metastatic Cancer to the Larynx: A Case Report and Update.

Metastatic Cancer to the Larynx: A Case Report and Update.

J Voice. 2015 Dec 29;

Authors: Zenga J, Mehrad M, Bradley JP

Abstract
OBJECTIVE: The aim of this study was to describe a case of colorectal carcinoma metastatic to the larynx and provide a review of the current literature.
METHODS: A case report with chart review was performed. A review of the current literature was performed by systematically searching PubMed, OVID, CINAHL Plus, and EMBASE.
RESULTS: In 1988, a comprehensive literature review identified melanoma as the most common neoplasm to exhibit laryngeal involvement. Since that study, 41 subsequent cases have been reported, and among these, colorectal adenocarcinoma was the most frequent distant primary (24%). In 25 (58%) cases, curative surgery was attempted, but only 4 patients remained disease-free at last follow up. We report the history of a 52-year-old man who presented with rectal adenocarcinoma metastatic to his larynx 4 years after definitive treatment of the primary site.
CONCLUSIONS: In patients with a laryngeal mass and a history of colorectal cancer, or those at high risk of having an occult colorectal primary, metastatic spread to the larynx must always be considered. Although secondary laryngeal metastasis portends a poor prognosis, for the select patient, surgical intervention can provide long-term disease control.

PMID: 26743607 [PubMed - as supplied by publisher]

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Laryngeal primary malignant melanoma: a case report.

Laryngeal primary malignant melanoma: a case report.

Rom J Morphol Embryol. 2015;56(4):1513-6

Authors: Cojocaru O, Aşchie M, Mocanu L, BălŢătescu GI

Abstract
Malignant melanoma of the larynx is a rare cancer that can appear as a primary tumor or as a metastasis from a cutaneous head and neck primary lesion. We present a new case of primary laryngeal malignant melanoma diagnosed by histological examination of an excisional biopsy specimen. The patient was a 53-year-old man with a history of smoking and hoarseness but without any clinical evidence of other cutaneous malignant melanocytic lesions. Microscopically, the tumor consisted of polygonal-epithelioid cells admixed with more elongated, spindle-shaped cells. Some of the tumoral cells demonstrated dark brown cytoplasmic and nuclear melanin. Despite significant ulceration and disruption of the epithelium, in situ malignant melanocytes were recognized within the remaining epithelium. Immunohistochemical stains were strongly positive for S-100 protein, HMB-45 and Melan-A. On the other hand, cytokeratin stains were negative. Based on the clinical and histological findings, a diagnosis of primary malignant melanoma of the larynx was established.

PMID: 26743302 [PubMed - in process]

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[McGRATH® MAC Is Useful to Learn Tracheal Intubation Using a Macintosh Laryngoscope].

[McGRATH® MAC Is Useful to Learn Tracheal Intubation Using a Macintosh Laryngoscope].

Masui. 2015 Oct;64(10):1091-6

Authors: Wakasugi K, Niyama Y, Kita A, Sonoda H, Yamakage M

Abstract
BACKGROUND: Learning tracheal intubation using a Macintosh laryngoscope (McL) is important although video laryngoscope is becoming popular. The purpose of this study was to compare the usefulness as a training device for intubation technique using McL with three devices; McGRATH® MAC (MAC), Airwayscope® (AWS) and McL.
METHODS: In this prospective study, 60 nurses not experienced in tracheal intubation were randomly assigned to MAC, AWS, and McL groups (each group: n=20), and 10 times of practice using each device were carried out. We compared the intubation time using McL and the nurse's anatomical understanding of the larynx before and after the practice.
RESULTS: The intubation time before the practice was comparable among the three groups, but the time after the practice was significantly shorter in the McL and MAC groups compared to the AWS group (P=0.001). The practice significantly improved anatomical understanding of the larynx in all groups (P<0.05), and in particular it was improved in the MAC and AWS groups compared with the McL group (P<0.001).
CONCLUSIONS: The McGRATH® MAC may possess advantages compared to Airwayscope® and Macintosh laryngoscope as a training device for learning intubation technique using Macintosh laryngoscope and understanding anatomy of the larynx.

PMID: 26742418 [PubMed - in process]

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Increasing fat content from 20 to 45 wt% in a complex diet induces lower endotoxemia in parallel with an increased number of intestinal goblet cells in mice.

Related Articles

Increasing fat content from 20 to 45 wt% in a complex diet induces lower endotoxemia in parallel with an increased number of intestinal goblet cells in mice.

Nutr Res. 2015 Apr;35(4):346-56

Authors: Benoit B, Laugerette F, Plaisancié P, Géloën A, Bodennec J, Estienne M, Pineau G, Bernalier-Donadille A, Vidal H, Michalski MC

Abstract
The impacts of high-fat diets (HFDs) on the onset of metabolic endotoxemia and low-grade inflammation are well established in rodent models. However, the dose-effect of dietary lipid intakes on these parameters is not known. We hypothesized that increasing dietary lipid amounts could be linked to parallel increases of endotoxemia, low-grade inflammation, and metabolic and intestinal alterations. Six-week-old male C57BL/6J mice were fed a low-fat diet (LFD, 2.6 wt% of lipids), a moderate HFD (mHFD, 22 wt% of lipids), or a very HFD (vHFD, 45 wt% of lipids) formulated mainly using chow ingredients and milk fat. After 12 weeks, white adipose tissues, liver, intestine, distal colon contents, and plasma were collected. Only vHFD mice significantly increased body weight and fat mass vs LFD mice. This was associated with increases of plasma concentrations of triglycerides, leptin and adiponectin, and liver lipids. No such differences were observed between LFD and mHFD mice. However, mHFD developed metabolic endotoxemia and inflammation, unlike vHFD mice. In turn, vHFD mice showed more goblet cells in all intestine segments vs both other groups and a decrease of Bacteroides-Prevotella in their microbiota vs LFD mice. Finally, mHFD mice colon exhibited a decrease in lactobacilli and in the levels of occludin phosphorylation. Altogether, using complex HFD, no associations were observed between dietary lipid amounts and the magnitude of endotoxemia, inflammation, and physiological alterations developed. These results reveal the impact of the diet composition on intestinal goblet cells and mucus coat, bringing new insights about further consequences on HFD-induced metabolic disorders.

PMID: 25687164 [PubMed - indexed for MEDLINE]

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Erratum: Butter Tolerance in Children Allergic to Cow's Milk.

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Erratum: Butter Tolerance in Children Allergic to Cow's Milk.

Allergy Asthma Immunol Res. 2016 Mar;8(2):178

Authors: Yanagida N, Minoura T, Kitaoka S

Abstract
[This corrects the article DOI: 10.4168/aair.2015.7.2.186.].

PMID: 26739413 [PubMed - as supplied by publisher]

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The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor.

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The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor.

Allergy Asthma Immunol Res. 2016 Mar;8(2):174-7

Authors: Kim YN, Kim JY, Kim JW, Kim JH, Kim HI, Yune S, Choi DC, Lee BJ

Abstract
Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction.

PMID: 26739412 [PubMed]

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Papain Induced Occupational Asthma with Kiwi and Fig Allergy.

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Papain Induced Occupational Asthma with Kiwi and Fig Allergy.

Allergy Asthma Immunol Res. 2016 Mar;8(2):170-3

Authors: Jiang N, Yin J, Wen L

Abstract
Papain is a proteolytic enzyme which is widely used in food industry, pharmaceuticals, and cosmetics. Occupational and non-occupational papain allergies have previously been documented; however, there are limited publications about papain allergy with its relative fruit allergy. Here, we present a case of occupational, IgE-mediated papain allergy with kiwi fruit and fig fruit allergy. A 53-year-old man suffered from rhinitis for several years, with the onset of his symptoms coinciding with the time he started to work at a sausage processing plant where papain is often used as a meat tenderizer. He began to experience symptoms of chest tightness, shortness of breath and wheezing shortly after starting work 5 years ago. Furthermore, he experienced several episodes of oral itching, and tongue and oropharyngeal angioedema after injestion of kiwi fruit and fig fruit. The patient had a lifelong history of allergic conjunctivitis, allergic rhinitis, and childhood asthma. Specific IgE was positive to kiwi fruit, papain and chymopapain (2.95 kUA/L, >100 kUA/L, and 95.0 kUA/L, respectively). Similar bands at 10-15 kDa in blotting with papain and kiwi fruit extracts were found. This patient showed a potential association between papain allergy and sensitization to kiwi fruit. We also reviewed 13 patients with papain allergy published in the literature, with 85% (11/13) of the patients sensitized through the respiratory tract, and 40% (4/11) having atopy. Further studies should focus on the determination of cross-reactive allergens between papain and its fruit relatives, and the prevalence of food allergy in patients with papain allergy should be investigated in a relatively large cohort.

PMID: 26739411 [PubMed]

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Administration of Pigment Epithelium-Derived Factor Inhibits Airway Inflammation and Remodeling in Chronic OVA-Induced Mice via VEGF Suppression.

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Administration of Pigment Epithelium-Derived Factor Inhibits Airway Inflammation and Remodeling in Chronic OVA-Induced Mice via VEGF Suppression.

Allergy Asthma Immunol Res. 2016 Mar;8(2):161-9

Authors: Zha W, Su M, Huang M, Cai J, Du Q

Abstract
PURPOSE: Pigment epithelium-derived factor (PEDF) is a recently discovered antiangiogenesis protein. PEDF possesses powerful anti-inflammatory, antioxidative, antiangiogenic, and antifibrosis properties. It has been reported that PEDF can regulate vascular endothelial growth factor (VEGF) expression. This study aimed to evaluate whether recombinant PEDF protein could attenuate allergic airway inflammation and airway remodeling via the negative regulation of VEGF using a murine model of chronic ovalbumin (OVA)-induced asthma and BEAS-2B human bronchial epithelial cells.
METHODS: In an in vivo experiment, mice sensitized with OVA were chronically airway challenged with aerosolized 1% OVA solution for 8 weeks. Treated mice were given injections of recombinant PEDF protein (50 or 100 μg/kg body weight) via the tail vein. In an in vitro experiment, we investigated the effects of recombinant PEDF protein on VEGF release levels in BEAS-2B cells stimulated with IL-1β.
RESULTS: Recombinant PEDF protein significantly inhibited eosinophilic airway inflammation, airway hyperresponsiveness, and airway remodeling, including goblet cell hyperplasia, subepithelial collagen deposition, and airway smooth muscle hypertrophy. In addition, recombinant PEDF protein suppressed the enhanced expression of VEGF protein in lung tissue and bronchoalveolar lavage fluid (BALF) in OVA-challenged chronically allergic mice. In the in vitro experiment, VEGF expression was increased after IL-1β stimulation. Pretreatment with 50 and 100 ng/mL of recombinant PEDF protein significantly attenuated the increase in VEGF release levels in a concentration-dependent manner in BEAS-2B cells stimulated by IL-1β.
CONCLUSIONS: These results suggest that recombinant PEDF protein may abolish the development of characteristic features of chronic allergic asthma via VEGF suppression, providing a potential treatment option for chronic airway inflammation diseases such as asthma.

PMID: 26739410 [PubMed]

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Diagnostic Value of Specific IgE to Peanut and Ara h 2 in Korean Children with Peanut Allergy.

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Diagnostic Value of Specific IgE to Peanut and Ara h 2 in Korean Children with Peanut Allergy.

Allergy Asthma Immunol Res. 2016 Mar;8(2):156-60

Authors: Kim HY, Han Y, Kim K, Lee JY, Kim MJ, Ahn K, Kim J

Abstract
PURPOSE: The purpose of this study was to establish the diagnostic decision point (DDP) of peanut specific IgE (sIgE) for predicting the outcome of oral food challenge (OFC). We also evaluated the usefulness of sIgE to peanut components (Ara h 1, 2, 3, 8, and 9) in diagnosing peanut allergy.
METHODS: Korean children aged over 12 months with a suspected peanut allergy were enrolled. Diagnosis of peanut allergy was confirmed by an open OFC or through the convincing history of anaphylaxis. Cutoff levels of sIgE to peanut and peanut components were determined by analyzing receiver operating characteristic curves.
RESULTS: Forty-eight children (22 boys and 26 girls) with a suspected peanut allergy were enrolled. The previously established DDP for peanut-sIgE antibodies (14 kU/L) showed a sensitivity of 22.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 60.4% in our study population. The median levels of peanut-sIgE (5.4 kU/L vs 1.1 kU/L, P<0.001) and Ara h 2-sIgE (0.8 kU/L vs 0 kU/L, P<0.001) were significantly higher in the peanut allergy group than in the peanut tolerance group. The peanut-sIgE concentration indicating a PPV of 100% was 10.3 kU/L. The Ara h 2-sIgE level of 4.0 kU/L had a PPV of 100%.
CONCLUSIONS: Our results showed that the cutoff levels for peanut (10.3 kU/L) and Ara h 2 (4.0 kU/L) established in this study is useful for the diagnosis of peanut allergy in Korean children.

PMID: 26739409 [PubMed]

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Defining Chronic Cough: A Systematic Review of the Epidemiological Literature.

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Defining Chronic Cough: A Systematic Review of the Epidemiological Literature.

Allergy Asthma Immunol Res. 2016 Mar;8(2):146-55

Authors: Song WJ, Chang YS, Faruqi S, Kang MK, Kim JY, Kang MG, Kim S, Jo EJ, Lee SE, Kim MH, Plevkova J, Park HW, Cho SH, Morice AH

Abstract
PURPOSE: Recent evidence suggests a global burden of chronic cough in general populations. However, the definitions vary greatly among epidemiological studies, and none have been validated for clinical relevance. We aimed to examine previous epidemiological definitions in detail and explore the operational characteristics.
METHODS: A systematic review was conducted for epidemiological surveys that reported the prevalence of chronic cough in general adult populations during the years 1980 to 2013. A literature search was performed on Pubmed and Embase without language restriction. Epidemiological definitions for chronic cough were classified according to their components, such as cutoff duration. Meta-analyses were performed for the male-to-female ratio of chronic cough prevalence to explore operational characteristics of epidemiological definitions.
RESULTS: A total of 70 studies were included in the systematic review. The most common epidemiological definition was identified as 'cough ≥3 months' duration without specification of phlegm (n=50); however, it conflicted with the cutoff duration in current clinical guidelines (cough ≥8 weeks). Meta-analyses were performed for the male-to-female ratio of chronic cough among 28 studies that reported sex-specific prevalence using the most common definition. The pooled male-to-female odds ratio was 1.26 (95% confidence interval 0.92-1.73) with significant heterogeneity (I²=96%, P<0.001), which was in contrast to clinical observations of female predominance from specialist clinics. Subgroup analyses did not reverse the ratio or reduce the heterogeneity.
CONCLUSIONS: This study identified major issues in defining chronic cough in future epidemiological studies. The conflict between epidemiological and clinical diagnostic criteria needs to be resolved. The unexpected difference in the gender predominance between the community and clinics warrants further studies. Clinical validation of the existing definition is required.

PMID: 26739408 [PubMed]

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The Potential for Poverty to Lower the Self-Efficacy of Adults With Asthma: An Australian Longitudinal Study.

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The Potential for Poverty to Lower the Self-Efficacy of Adults With Asthma: An Australian Longitudinal Study.

Allergy Asthma Immunol Res. 2016 Mar;8(2):141-5

Authors: Callander EJ, Schofield DJ

Abstract
PURPOSE: It is known that strong feelings of self-efficacy are linked with better management of asthma. However, it is not known whether the experience of poverty can detrimentally impact the self-efficacy feelings of asthma patients. This paper aims to determine whether falling into income or multidimensional poverty lowers self-efficacy among people diagnosed with asthma.
METHODS: Longitudinal analysis of Waves 7 to 11 (2007 to 2011) of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey using generalized linear models. The analysis was limited to those who had been diagnosed with asthma. The Freedom Poverty Measure was used to identify those in multidimensional poverty.
RESULTS: People with asthma who fell into income poverty had significantly lower self-efficacy scores-23% lower (95% CI: -35.1 to -9.1), after falling into income poverty for 3 or 4 years between 2007 and 2011 compared to those who were never in income poverty. Those who fell into multidimensional poverty also had significantly lower self-efficacy scores-25% lower (95% CI: -42.8 to -2.0), after being in multidimensional poverty for 3 or 4 years between 2007 and 2011 compared to those who were never in poverty.
CONCLUSIONS: Asthmatics who fall into poverty are likely to experience a decline in their feelings of self-efficacy. The findings of this study show that experiencing poverty should be a flag to identify those who may need extra assistance in managing their condition.

PMID: 26739407 [PubMed]

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Increased Expression of miR-146a in Children With Allergic Rhinitis After Allergen-Specific Immunotherapy.

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Increased Expression of miR-146a in Children With Allergic Rhinitis After Allergen-Specific Immunotherapy.

Allergy Asthma Immunol Res. 2016 Mar;8(2):132-40

Authors: Luo X, Hong H, Tang J, Wu X, Lin Z, Ma R, Fan Y, Xu G, Liu D, Li H

Abstract
PURPOSE: MicroRNAs (miRs) were recently recognized to be important for immune cell differentiation and immune regulation. However, whether miRs were involved in allergen-specific immunotherapy (SIT) remains largely unknown. This study sought to examine changes in miR-146a and T regulatory cells in children with persistent allergic rhinitis (AR) after 3 months of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT).
METHODS: Twenty-four HDM-sensitized children with persistent AR were enrolled and treated with SCIT (n=13) or SLIT (n=11) for 3 months. Relative miR-146a and Foxp3 mRNA expression, the TRAF6 protein level, and the ratio of post-treatment to baseline IL-10+CD4+ T cells between the SCIT and SLIT groups were examined in the peripheral blood mononuclear cells (PBMCs) of AR patients using quantitative reverse transcription polymerase chain reaction (qRT-PCR), flow cytometry, and Western blot analysis, respectively. Serum levels of IL-5 and IL-10 were determined using ELISA.
RESULTS: After 3 months of SIT, both the TNSS and INSS scores were significantly decreased compared to the baseline value (P<0.01). The relative expression of miR-146a and Foxp3 mRNA was significantly increased after both SCIT and SLIT (P<0.01). The ratio of post-treatment to baseline IL-10⁺CD4⁺ T cells and the serum IL-10 level were significantly increased in both the SCIT and SLIT groups (P<0.01), whereas the TRAF6 protein level and serum IL-5 level were significantly decreased (P<0.01). No significant differences in these biomarkers were observed between the SCIT and SLIT groups.
CONCLUSIONS: Our findings suggest that miR-146a and its related biomarkers may be comparably modulated after both SCIT and SLIT, highlighting miR-146a as a potential therapeutic target for the improved management of AR.

PMID: 26739406 [PubMed]

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Mimotopes for Api g 5, a Relevant Cross-reactive Allergen, in the Celery-Mugwort-Birch-Spice Syndrome.

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Mimotopes for Api g 5, a Relevant Cross-reactive Allergen, in the Celery-Mugwort-Birch-Spice Syndrome.

Allergy Asthma Immunol Res. 2016 Mar;8(2):124-31

Authors: Lukschal A, Wallmann J, Bublin M, Hofstetter G, Mothes-Luksch N, Breiteneder H, Pali-Schöll I, Jensen-Jarolim E

Abstract
PURPOSE: In the celery-mugwort-birch-spice syndrome, a significant proportion of IgE is directed against high molecular weight (HMW) glycoproteins, including the celery allergen Api g 5. BIP3, a monoclonal antibody originally raised against birch pollen, recognizes HMW allergens in birch and mugwort pollens, celery, and Apiaceae spices. Our aim was to generate mimotopes using BIP3 for immunization against the HMW allergens relevant in the celery-mugwort-birch-spice cross reactivity syndrome.
METHODS: Mimotopes were selected from a random-peptide display library by BIP3 and applied in IgE inhibition assays. The 3 phage clones with the highest inhibitory capacity were chosen for immunization of BALB/c mice. Mouse immune sera were tested for IgG binding to blotted birch pollen extract and used for inhibiting patients' IgE binding. Furthermore, sera were tested for binding to Api g 5, to horseradish peroxidase (HRP) as a second glycoprotein, or to non-glycosylated control allergen Phl p 5 in ELISA, and the specific Api g 5-specific IgG titers were determined.
RESULTS: Three rounds of biopanning resulted in phage clones exhibiting 7 different sequences including 1 dominant, 1-6-cyclo-CHKLRCDKAIA. Three phage clones had the capacity to inhibit human IgE binding and induced IgG to the HMW antigen when used for immunizing BALB/c mice. The induced BIP3-mimotope IgG reached titers of 1:500 specifically to Api g 5, but hardly reacted to glycoprotein HRP, revealing a minor role of carbohydrates in their epitope.
CONCLUSIONS: The mimotopes characterized in this study mimic the epitope of BIP3 relevant for Api g 5, one of the cross-reactive HMW allergens relevant in the celery-mugwort-birch-spice syndrome. BIP3 mimotopes may be used in the future for hyposensitization in this clinical syndrome by virtue of good and specific immunogenicity.

PMID: 26739405 [PubMed]

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Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study.

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Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study.

Allergy Asthma Immunol Res. 2016 Mar;8(2):115-23

Authors: Ye YM, Park JW, Kim SH, Ban GY, Kim JH, Shin YS, Lee HY, Park HS, PRANA Group

Abstract
PURPOSE: Chronic urticaria (CU) has a substantial impact on the quality of life. Little clinical data on the prognosis of CU has been reported. This study aimed to investigate the control status and remission rate of CU and to explore potential predictors of good responses to the treatment during a 6-month treatment period.
METHODS: A total of 75 patients with chronic spontaneous urticaria (CSU) were enrolled from 3 university hospitals in Korea. Urticaria control state was classified into 2 groups: group I (remission and well-controlled) and group II (partly and uncontrolled). CU-specific quality of life (CU-QoL) and the urticaria activity score (UAS) were measured before and after the treatment. Autologous serum skin test (ASST), and anti-nuclear and anti-thyroid antibodies were measured at the enrollment into the study. Aspirin intolerance was confirmed by an oral provocation test.
RESULTS: Of 59 patients completing the study, 21 (35.6%) arrived at well-controlled status and only 2 (3.4%) achieved remission, whereas 26 (44.1%) remained at partly controlled status and 10 (16.9%) were at uncontrolled status. Mean changes in CU-QoL (36.5±2.7 vs 20.6±4.3, P=0.017) and UAS (-7.9±0.8 vs -3.0±1.0, P=0.001) were significantly different between groups I and II. The presence of serum autoantibodies and aspirin intolerance had no influence on the control of urticaria in this study. However, ASST positivity was identified as a significant predictor of CU control in multivariate analysis (OR=6.106, P=0.017).
CONCLUSIONS: The proportion of CSU patients that achieved remission or a well-controlled state was 39% for the 6 months of stepwise treatment. Longer observations are necessary to assess the exact prognosis of CSU. ASST results may be a useful parameter for predicting a better response to treatment and both UAS and CU-QoL are helpful to monitor therapeutic response.

PMID: 26739404 [PubMed]

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Association Between Obesity, Abdominal Obesity, and Adiposity and the Prevalence of Atopic Dermatitis in Young Korean Adults: the Korea National Health and Nutrition Examination Survey 2008-2010.

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Association Between Obesity, Abdominal Obesity, and Adiposity and the Prevalence of Atopic Dermatitis in Young Korean Adults: the Korea National Health and Nutrition Examination Survey 2008-2010.

Allergy Asthma Immunol Res. 2016 Mar;8(2):107-14

Authors: Lee JH, Han KD, Jung HM, Youn YH, Lee JY, Park YG, Lee SH, Park YM

Abstract
PURPOSE: Whether obesity is a risk factor for atopic dermatitis (AD) remains unclear. The aim of the present study was to investigate the association between obesity and AD in Korean young adults.
METHODS: We included nationally representative data of 5,202 Korean adults aged 19-40 years, obtained from the cross-sectional Korea National Health and Nutrition Examination Survey 2008-2010.
RESULTS: Single (unmarried) status was more frequently observed in AD patients (male, [P=0.0002] and female, [P<0.0001]). AD prevalence exhibited a U-shape trend in relation to body mass index (BMI), waist circumference (WC), and total body fat (BF) percentage, especially in young adult women. Women with BMI ≥25 kg/m², WC ≥80 cm, and highest quartile (Q4) of total BF percentage had the highest prevalence of AD. The odds ratio (OR) for participants with both BMI ≥25 kg/m² and WC ≥80 cm was 3.29 (95% confidence interval [CI] 1.71-3.55); therefore, having both general and abdominal obesity was considered a prominent risk factor for AD in young women. After adjustment for confounding factors, including age, smoking, alcohol drinking, exercise, vitamin D, income level, and single status, high BMI (≥30 kg/m²) (OR=4.08, 95% CI: 1.53-10.93), high WC (≥80 cm) (OR=2.05, 95% CI: 1.07-3.94), and high BF percentage (Q4) (OR=2.10, 95% CI: 1.24-3.57) were shown to be significantly associated with AD in young adult women.
CONCLUSIONS: In this large-scale nation-wide study of Korean adults, obesity was positively related to the presence of AD in women. Our findings suggest that weight management may help prevent AD.

PMID: 26739403 [PubMed]

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Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin?

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Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin?

Allergy Asthma Immunol Res. 2016 Mar;8(2):101-6

Authors: Wong L, Huang CH, Lee BW

Abstract
Crustacean shellfish allergy is an important cause of food allergy and anaphylaxis in Asia. The major allergen in shellfish allergy is tropomyosin, a pan-allergen that is also found in house dust mites and cockroaches. Tropomyosins from house dust mites (HDMs) have a high sequence homology to shellfish tropomyosins, and cross-reactivity between HDM and shrimp tropomyosins has been demonstrated. Exposure to inhaled tropomyosins from house dust mites has been postulated to be the primary sensitizer for shellfish allergy, in a reaction analogous to the oral allergy (inhalant-food) syndrome. This notion is supported by indirect data from the effects of HDM immunotherapy on shellfish allergy, and strong correlations of shellfish and HDM sensitization. HDM immunotherapy has been reported to induce both shrimp allergy in non-allergic patients and shrimp tolerance in shrimp-allergic patients. Epidemiological surveys have also demonstrated a strong correlation between shellfish and HDM sensitization in both hospital-based and community-based studies. Unexposed populations have also been shown to develop sensitization-shellfish sensitization in orthodox Jews with no history of shellfish consumption was associated with HDM sensitization. Reciprocally, HDM sensitization in an Icelandic population living in a HDM-free environment was associated with shrimp sensitization. In vitro IgE inhibition studies on sera in shrimp-allergic Spanish patients indicate that mites are the primary sensitizer in shrimp-allergic patients living in humid and warm climates. Current data supports the hypothesis that tropomyosin is the link between HDM and shellfish allergies. The role of tropomyosin in HDM and shellfish allergies is a fertile field for investigation as it may provide novel immunotherapeutic strategies for shellfish allergy.

PMID: 26739402 [PubMed]

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Environmental Exposure and Genetic Predisposition as Risk Factors for Asthma in China.

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Environmental Exposure and Genetic Predisposition as Risk Factors for Asthma in China.

Allergy Asthma Immunol Res. 2016 Mar;8(2):92-100

Authors: Chen Y, Wong GW, Li J

Abstract
Asthma is the most common chronic pulmonary disease worldwide and places a considerable economic burden on society. China is the world's largest developing country and has the largest population. China has undergone dramatic changes in the past few decades. The traditional lifestyle and living environment have changed in ways that directly affect the prevalence of asthma. The prevalence of asthma is lower in Chinese children and adults than in developed countries, but the prevalence has been on the rise during the past 30 years. The prevalence significantly varies among different parts of China. Polymorphisms of multiple genes, outdoor air pollution caused by PM2.5, PM10, SO₂, NO₂, environmental tobacco smoke, and coal, indoor pollution, and inhaled allergens, such as house dust mites, pollen, and cockroach particles, are risk factors for asthma.

PMID: 26739401 [PubMed]

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Associations of Atopic Dermatitis With Obesity and Unmarried Status in Young Adults: Evidence for Atopic Dermatitis as a Life-Style Disorder With High Social Impact.

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Associations of Atopic Dermatitis With Obesity and Unmarried Status in Young Adults: Evidence for Atopic Dermatitis as a Life-Style Disorder With High Social Impact.

Allergy Asthma Immunol Res. 2016 Mar;8(2):89-91

Authors: Nahm DH

PMID: 26739400 [PubMed]

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Delayed restoration of maximum speech discrimination scores in patients with idiopathic sudden sensorineural hearing loss.

Delayed restoration of maximum speech discrimination scores in patients with idiopathic sudden sensorineural hearing loss.

Auris Nasus Larynx. 2015 Dec 28;

Authors: Noguchi Y, Takahashi M, Ito T, Fujikawa T, Kawashima Y, Kitamura K

Abstract
OBJECTIVE: To assess possible delayed recovery of the maximum speech discrimination score (SDS) when the audiometric threshold ceases to change.
METHODS: We retrospectively examined 20 patients with idiopathic sudden sensorineural hearing loss (ISSNHL) (gender: 9 males and 11 females, age: 24-71 years). The findings of pure-tone average (PTA), maximum SDS, auditory brainstem responses (ABRs), and tinnitus handicap inventory (THI) were compared among the three periods of 1-3 months, 6-8 months, and 11-13 months after ISSNHL onset.
RESULTS: No significant differences were noted in PTA, whereas an increase of greater than or equal to 10% in maximum SDS was recognized in 9 patients (45%) from the period of 1-3 months to the period of 11-13 months. Four of the 9 patients showed 20% or more recovery of maximum SDS. No significant differences were observed in the interpeak latency difference between waves I and V and the interaural latency difference of wave V in ABRs, whereas an improvement in the THI grade was recognized in 11 patients (55%) from the period of 1-3 months to the period of 11-13 months.
CONCLUSION: The present study suggested the incidence of maximum SDS restoration over 1 year after ISSNHL onset. These findings may be because of the effects of auditory plasticity via the central auditory pathway.

PMID: 26739945 [PubMed - as supplied by publisher]

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Research Supported by the Tinnitus Research Consortium.

Research Supported by the Tinnitus Research Consortium.

Hear Res. 2015 Dec 28;

Authors: Ryan AF, Dobie RA, Dubno JR, Lonsbury-Martin BL

PMID: 26739791 [PubMed - as supplied by publisher]

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