OtoRhinoLaryngology News

Παρασκευή 20 Οκτωβρίου 2017

Risk of Venous Thromboembolism Among Otolaryngology Patients vs General Surgery and Plastic Surgery Patients.

Risk of Venous Thromboembolism Among Otolaryngology Patients vs General Surgery and Plastic Surgery Patients.

JAMA Otolaryngol Head Neck Surg. 2017 Oct 19;:

Authors: Cramer JD, Dilger AE, Schneider A, Smith SS, Samant S, Patel UA

Abstract
Importance: Venous thromboembolism (VTE), which includes deep venous thrombosis or pulmonary embolism, is the number 1 cause of preventable death in surgical patients. Current guidelines from the American College of Chest Physicians provide VTE prevention recommendations that are specific to individual surgical subspecialties; however, no guidelines exist for otolaryngology.
Objective: To examine the rate of VTE for various otolaryngology procedures compared with an established average-risk field (general surgery) and low-risk field (plastic surgery).
Design, Setting, and Participants: This cohort study compared the rate of VTE after different otolaryngology procedures with those of general and plastic surgery in the American College of Surgeons National Surgical Quality Improvement Program from January 1, 2005, through December 31, 2013. We used univariate and multivariable logistic regression analysis of clinical characteristics, cancer status, and Caprini score to compare different risk stratification of patients. Data analysis was performed from May 1, 2016, to April 1, 2017.
Exposures: Surgery.
Main Outcomes and Measures: Thirty-day rate of VTE.
Results: A total of 1 295 291 patients, including 31 896 otolaryngology patients (mean [SD] age, 53.9 [16.7] years; 14 260 [44.7%] male; 21 603 [67.7%] white), 27 280 plastic surgery patients (mean [SD] age, 50.5 [13.9] years; 4835 [17.7%] male; 17 983 [65.9%] white), and 1 236 115 general surgery patients (mean [SD] age, 54.9 [17.2] years; 484 985 [39.2%] male; 867 913 [70.2%] white) were compared. The overall 30-day rate of VTE was 0.5% for otolaryngology compared with 0.7% for plastic surgery and 1.2% for general surgery. We identified a high-risk group for VTE in otolaryngology (n = 3625) that included free or regional tissue transfer, laryngectomy, composite resection, skull base surgery, and incision and drainage. High-risk otolaryngology patients experienced similar rates of VTE as general surgery patients across all Caprini risk levels. Low-risk otolaryngology patients (n = 28 271) experienced lower rates of VTE than plastic surgery patients across all Caprini risk levels. Malignant tumors were associated with VTE; however, the rates varied by cancer type and were 11-fold greater for cancers of the upper aerodigestive tract compared with thyroid cancers (odds ratio, 10.97; 95% CI,7.38-16.31). Venous thromboembolism was associated with a 14-fold higher 30-day mortality among otolaryngology patients (5.1% mortality with VTE vs 0.4% mortality without VTE; difference, 4.7%; 95% CI of the difference, 2.2%-9.3%).
Conclusions and Relevance: Most patients undergoing otolaryngology procedures are at low risk of VTE, indicating that guidelines for a low-risk population could be adapted to otolaryngology. Patients undergoing high-risk otolaryngology procedures should be considered as candidates for more aggressive VTE prophylaxis.

PMID: 29049530 [PubMed - as supplied by publisher]

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Skull Base Neuroendoscopic Training Model Using a Fibrous Injectable Tumor Polymer and the Nico Myriad.

Skull Base Neuroendoscopic Training Model Using a Fibrous Injectable Tumor Polymer and the Nico Myriad.

J Craniofac Surg. 2017 Oct 18;:

Authors: Gagliardi F, Chau AM, Mortini P, Caputy AJ, Gragnaniello C

Abstract
The Myriad is an innovative, high precision tool for tumor resection, designed to work within narrow endoscopic corridors. Due to its application in technically demanding situations, the learning curve associated with its use might be extremely challenging and time-consuming.The authors describe the application of an already validated training model, the skull base injectable tumor model (ITM), to allow trainees to practice with the use of the Myriad during endoscopic skull base procedures.A formalin embalmed cadaveric head was used for technical assessment. Stratathane resin ST-504 derived polymer was injected to mimic skull base tumors and Myriad was used for tumor resection during different endoscopic procedures.An endoscopic endonasal transsphenoidal, a trans-planum trans-tuberculum, and a trans-clival approach have been performed after ITM injection. The Myriad was used for tumor debulking and blunt manipulation, qualitatively evaluating the technical challenges in performing the surgical dissection.Injectable tumor model demonstrates to be a valuable educational tool to train surgeons in the use of Myriad, potentially speeding up the learning curve in the acquirement of necessary technical skills in manipulating the instrument, even in case of demanding surgical situation.

PMID: 29049148 [PubMed - as supplied by publisher]

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Virtual Reality Model of the Three-Dimensional Anatomy of the Cavernous Sinus Based on a Cadaveric Image and Dissection.

Virtual Reality Model of the Three-Dimensional Anatomy of the Cavernous Sinus Based on a Cadaveric Image and Dissection.

J Craniofac Surg. 2017 Oct 18;:

Authors: Qian ZH, Feng X, Li Y, Tang K

Abstract
OBJECTIVE: Studying the three-dimensional (3D) anatomy of the cavernous sinus is essential for treating lesions in this region with skull base surgeries. Cadaver dissection is a conventional method that has insurmountable flaws with regard to understanding spatial anatomy. The authors' research aimed to build an image model of the cavernous sinus region in a virtual reality system to precisely, individually and objectively elucidate the complete and local stereo-anatomy.
METHODS: Computed tomography and magnetic resonance imaging scans were performed on 5 adult cadaver heads. Latex mixed with contrast agent was injected into the arterial system and then into the venous system. Computed tomography scans were performed again following the 2 injections. Magnetic resonance imaging scans were performed again after the cranial nerves were exposed. Image data were input into a virtual reality system to establish a model of the cavernous sinus. Observation results of the image models were compared with those of the cadaver heads.
RESULTS: Visualization of the cavernous sinus region models built using the virtual reality system was good for all the cadavers. High resolutions were achieved for the images of different tissues. The observed results were consistent with those of the cadaver head. The spatial architecture and modality of the cavernous sinus were clearly displayed in the 3D model by rotating the model and conveniently changing its transparency.
CONCLUSION: A 3D virtual reality model of the cavernous sinus region is helpful for globally and objectively understanding anatomy. The observation procedure was accurate, convenient, noninvasive, and time and specimen saving.

PMID: 29049147 [PubMed - as supplied by publisher]

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Book Review: Endoscopic Approaches to the Paranasal Sinuses and Skull Base: A Step-by-Step Anatomic Dissection Guide.

Book Review: Endoscopic Approaches to the Paranasal Sinuses and Skull Base: A Step-by-Step Anatomic Dissection Guide.

Neurosurgery. 2017 Oct 18;:

Authors: Yim B, Zada G

PMID: 29048494 [PubMed - as supplied by publisher]

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Influence of the State of the Subarachnoid Space of the Cranial Base in Hydrocephalus Resolution after Endoscopy.

Influence of the State of the Subarachnoid Space of the Cranial Base in Hydrocephalus Resolution after Endoscopy.

J Neurol Surg A Cent Eur Neurosurg. 2017 May;78(3):255-259

Authors: Sanchez Rodriguez JJ, Torres-Corzo J, Cervantes DS, Rodriguez-DellaVecchia R, Gordillo-Moscoso A, Vinas-Rios JM, Sanchez-Aguilar M

Abstract
Objective To compare the resolution rate of hydrocephalus after endoscopy (predominantly endoscopic third ventriculostomy [ETV]) using flexible endoscopes during a 5-year period in patients with a permeable and a nonpermeable subarachnoid space (SAS). Material and Methods We conducted a retrospective cohort study of the videos and records of 150 hydrocephalic patients chosen randomly who underwent ETV (and other endoscopic procedures) with a flexible endoscope. The patients were classified into two groups based on the neuroendoscopic findings. The first group included patients with a permeable SAS, and the second group included patients with a nonpermeable SAS. A normal SAS or one with slight arachnoiditis was considered permeable. Adhesive arachnoiditis and immature or mechanically obliterated SASs were considered nonpermeable. Results We found a success rate of 70% in patients with a permeable SAS versus 33% in patients with a nonpermeable SAS. The baseline characteristics of both groups were homogeneous. We obtained a statistically significant difference (p < 0.0001) with hazard ratio (HR) 3.42 (95% confidence interval [CI], 1.88-6.22). Another important factor involved was age that showed a statistically significant difference (p < 0.0018) with HR 3.28 (95% CI, 1.55-6.93). Conclusion The permeability of the SAS is an important prognostic factor in the resolution rate of hydrocephalus after ETV (and other endoscopic procedures) using flexible neuroendoscopes. Therefore we recommend that the characteristics of the SAS be examined following every endoscopic procedure for hydrocephalus to identify patients at risk of recurrence.

PMID: 27684061 [PubMed - indexed for MEDLINE]

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Implant placement under existing removable dental prostheses and its effect on masticatory performance.

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Implant placement under existing removable dental prostheses and its effect on masticatory performance.

Clin Oral Investig. 2016 Dec;20(9):2447-2455

Authors: Wolfart S, Wolf K, Brunzel S, Wolfart M, Caliebe A, Kern M

Abstract
OBJECTIVE: The aim of this within-subject study was to evaluate the outcome with implant-tooth-supported removable partial dental prostheses (RPDP group) and implant-supported removable complete dental prostheses (edentulous group) in terms of masticatory performance and self-assessment.
MATERIALS AND METHODS: Thirty patients participated in this prospective clinical study (RPDP group: n = 12; edentulous group: n = 18). The prostheses were supported in strategically advantageous regions by placing implants with ball attachments and corresponding matrices in the existing dentures. The masticatory performance was evaluated with the Swallowing Threshold Test Index (STTI), the number of chewing strokes, and the time needed until swallowing at pre-treatment and 6 weeks after integration of ball attachments. Additionally, patients scored chewing satisfaction before and after implantation on a visual analogue scale.
RESULTS: The STTI increased significantly (p ≤ 0.05) after implant therapy in the edentulous group but not in the RPDP group. Furthermore, the STTI was significantly higher (p ≤ 0.05) in the RPDP group than in the edentulous group at pre-treatment, however, not after therapy (P > 0.05). All patients were very satisfied after therapy concerning ability of speaking, chewing, and stability of their prosthesis.
CONCLUSIONS: Patients of the edentulous group benefit more from strategically placed implants under the existing dentures than patients from the RPDP group. However, according to the subjective assessment, the chewing satisfaction generally increased for both groups after implant therapy.
CLINICAL RELEVANCE: Patients with a strongly reduced dentition and edentulous patients benefit from strategically placed implants under the existing removable dentures.

PMID: 26936028 [PubMed - indexed for MEDLINE]

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Cerebrospinal fluid leak after bone marrow biopsy.

Cerebrospinal fluid leak after bone marrow biopsy.

Br J Haematol. 2017 Oct 19;:

Authors: Fox TA, Jager R, Ardeshna KM

PMID: 29048111 [PubMed - as supplied by publisher]

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Impact of External Ventricular Drainage Volumes on Shunt Dependency after Subarachnoid Hemorrhage.

Impact of External Ventricular Drainage Volumes on Shunt Dependency after Subarachnoid Hemorrhage.

J Neurol Surg A Cent Eur Neurosurg. 2017 May;78(3):227-230

Authors: Hayek MA, Roth C, Kaestner S, Deinsberger W

Abstract
Background The indication for and the timing of a permanent shunt operation in patients following acute hydrocephalus (HC) after subarachnoid hemorrhage (SAH) remains controversial because risk factors for chronic HC fail to predict permanent shunt dependency. The amount of cerebrospinal fluid (CSF) drained via an external ventricular drain (EVD) may predict shunt dependency. Methods We conducted a retrospective study of our HC database from January 2006 to December 2011. All patients receiving an EVD due to acute HC after SAH were analyzed. The daily amount of drained CSF was documented until the EVD was removed or converted to a permanent shunt either immediately or during a follow-up period of 6 months. Results A total of 139 patients (48 male, 91 female; mean age: 57 ± 14 years) were eligible for the study. Mean duration of EVD was 16 ± 10 days (range: 4-60 days). A permanent shunt was necessary in 32% of cases (n = 45). The mean daily CSF volume was 139 ± 17 mL (range: 15-460 mL). Using repeated-measures analysis of variance, there was a significant difference of daily drained CSF volumes between both the groups in the first 15 days after the EVD. Conclusion Our results suggest that the daily amount of external CSF drainage volume in the acute state of SAH might influence the development of HC.

PMID: 27448196 [PubMed - indexed for MEDLINE]

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Enhanced Irrigant Delivery to the Ethmoid Sinuses Directly Following Ethmoid Punch Sinusotomy.

Enhanced Irrigant Delivery to the Ethmoid Sinuses Directly Following Ethmoid Punch Sinusotomy.

Ann Otol Rhinol Laryngol. 2017 Oct 01;:3489417737323

Authors: Abuzeid WM, Peterson AZ, Rathor A, Xu JC, Velasquez N, Rashan AR, Thamboo A, Nayak JV

Abstract
OBJECTIVES: Ethmoid punch sinusotomy (EPS) is a feasible treatment for ethmoid sinusitis in a subset of chronic rhinosinusitis (CRS) patients per a recent report. This adjunctive work investigates the technical characteristics of EPS and determines if EPS measurably alters the topical delivery of irrigant into the ethmoid sinuses in a cadaveric model.
METHODS: The sinonasal cavities of 10 human cadaver heads were irrigated with a solution containing methylene blue and radio-opaque contrast prior to and following EPS. Procedural characteristics and irrigant distribution were assessed by endoscopy and computed tomography.
RESULTS: Forty EPS procedures were performed through the ethmoid bulla and basal lamella. Compared to controls, EPS enhanced dye distribution into the anterior (90% vs 35%, P < .004) and posterior (90% vs 35%, P < .002) ethmoid sinuses, representing a 157% increase for each of these sites. Contrast was detected in a higher proportion of anterior (65% vs 5%, P < .001) and posterior (60% vs 0%, P < .001) ethmoid sinuses. Endoscopically guided catheter instillation of contrast through the EPS sites achieved radiotracer distribution throughout the ethmoid complex.
CONCLUSIONS: Ethmoid punch sinusotomy sites can be reliably created via micro-minimally invasive procedures. Ethmoid punch sinusotomy improves irrigant delivery to the ethmoid sinuses, providing mechanistic understanding for the clinical outcomes observed in CRS patients.

PMID: 29047295 [PubMed - as supplied by publisher]

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Survival Outcomes for Patients With T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx.

Survival Outcomes for Patients With T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx.

JAMA Otolaryngol Head Neck Surg. 2017 Oct 12;:

Authors: Ko HC, Harari PM, Chen S, Wieland AM, Yu M, Baschnagel AM, Kimple RJ, Witek ME

Abstract
Importance: Radiotherapy (RT)-based organ preservation approaches for patients with advanced laryngeal cancer have been established stepwise through prospective randomized clinical trials. However, broad adoption of these approaches has stimulated discussion about long-term results challenging their applicability in a heterogeneous patient population, most recently for patients with T3 disease.
Objective: To define outcomes in patients with clinical T3N0M0 glottic laryngeal cancer treated with definitive surgical and RT-based approaches.
Design, Setting, and Participants: This retrospective cohort study included patients treated from January 1, 2004, through December 31, 2013, with a median follow-up time of 58 months (range, 0-126.6 months) in the National Cancer Database. Of the 4003 patients with T3N0M0 disease, 2622 received definitive therapy defined by the study protocol. Data were obtained from the clinical oncology database sourced from hospital registry data that are collected from more than 1500 Commission on Cancer-accredited facilities. Data were analyzed from September 14, 2016, through April 24, 2017.
Interventions: Radiotherapy, chemoradiotherapy, surgery, surgery and RT, or surgery and chemoradiotherapy.
Results: A total of 2622 patients (2251 men [85.9%] and 371 women [14.1%]; median age, 64 years [range, 19-90 years]) were included in the analytic cohort. In the overall patient cohort, the adjusted 5-year survival probability was 53%. No statistical differences were observed between the primary surgery (53%; 95% CI, 48%-57%) and primary RT (54%; 95% CI, 52%-57%) cohorts. In multivariate analysis, patient factors associated with decreased overall survival (OS) included age (hazard ratio [HR], 1.04; 95% CI, 1.03-1.04), insurance status (HR, 1.26; 95% CI, 1.06-1.50), and increasing comorbidity (HR, 1.20; 95% CI, 1.02-1.42).
Conclusions and Relevance: Current management of T3N0M0 glottic laryngeal cancer relies largely on RT-based organ preservation approaches. The present study substantiates randomized clinical trial data supporting the use of RT-based organ preservation approaches for patients with T3N0M0 glottic laryngeal cancer without compromising OS.

PMID: 29049434 [PubMed - as supplied by publisher]

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In vivo implantation of a tissue engineered stem cell seeded hemi-laryngeal replacement maintains airway, phonation and swallowing in pigs.

In vivo implantation of a tissue engineered stem cell seeded hemi-laryngeal replacement maintains airway, phonation and swallowing in pigs.

J Tissue Eng Regen Med. 2017 Oct 19;:

Authors: Herrmann P, Ansari T, Southgate A, Varanou Jenkins A, Partington L, Carvalho C, Janes S, Lowdell M, Sibbons P, Birchall MA

Abstract
BACKGROUND: Laryngeal functional impairment relating to swallowing, vocalisation and respiration can be life changing and devastating for patients. A tissue engineering approach to regenerating vocal folds would represent a significant advantage over current clinical practice.
METHOD: Porcine hemi-larynx were de-cellularised under negative pressure. The resultant acellular scaffold was seeded with human bone marrow derived mesenchymal stem cells and primary human epithelial cells. Seeded scaffolds were implanted orthotopically into a defect created in the thyroid cartilage in 8 pigs and monitored in vivo for 2 months. In vivo assessments consisted of mucosal brushing and bronchoscopy at 1, 2, 4 and 8 weeks post implantation followed by histological evaluation post termination.
RESULTS: The implanted graft had no adverse effect on respiratory function in 6 of the 8 pigs, none of the pigs had problems with swallowing or vocalization. Six out of the 8 animals survived to the planned termination date, 2 animals were terminated due to mild stenosis and deep tissue abscess formation respectively. Human epithelial cells from mucosal brushings could only be identified at weeks 1 and 4. The explanted tissue showed complete epithelialization of the mucosal surface and the development of rudimentary vocal folds. However, there was no evidence of cartilage remodelling at the relatively early censor point.
CONCLUSION: Single stage partial laryngeal replacement is a safe surgical procedure. Replacement with a tissue engineered laryngeal graft as a single procedure is surgically feasible and results in appropriate mucosal coverage and rudimentary vocal fold development.

PMID: 29048769 [PubMed - as supplied by publisher]

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[Fast response of subglottic haemangiomas to propranolol].

[Fast response of subglottic haemangiomas to propranolol].

An Pediatr (Barc). 2016 Oct;85(4):210-211

Authors: Krstulovic C, Ibañez-Alcañiz I, Alamar-Velázquez A, López-Andreu J, Evoli-Buselli M

PMID: 26797660 [PubMed - indexed for MEDLINE]

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Assuring children's human right to freedom of opinion and expression in education.

Assuring children's human right to freedom of opinion and expression in education.

Int J Speech Lang Pathol. 2017 Oct 19;:1-8

Authors: Gillett-Swan J, Sargeant J

Abstract
The Universal Declaration of Human Rights elaborated for children through the United Nations Convention on the Rights of the Child, mandates each child's right to participate in all matters affecting them. In particular, Article 19 includes the child's right to freedom of expression and opinion, access to information and communication choice. However, many barriers placed on children's daily lives often restrict or limit the enactment of children's participatory rights in practice, most noticeably in education. It is often the adult who decides what, when and how children can communicate, and the extent children's views and opinions are sought, considered or incorporated. This paper explores how children's daily lives are mediated in ways that restrict their expression, voice and communication rights. Children spend a significant proportion of their daily lives in education settings yet the restrictions on children's access to information and communication choices do not reflect contemporary pedagogical thinking. Many school settings perpetuate the key participation barriers of adult attitude and knowledge, pedagogical tradition, organisational structure and technological advancement. Such barriers to engagement stifle the realisation of the child's communication rights that then limits educational enhancement. Supporting children's right to communicate via a range of media enables pedagogy supporting voice-inclusive practice.

PMID: 29046069 [PubMed - as supplied by publisher]

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Lenvatinib for the treatment of radio-iodine refractory thyroid cancer in real-life practice.

Lenvatinib for the treatment of radio-iodine refractory thyroid cancer in real-life practice.

Thyroid. 2017 Oct 19;:

Authors: Berdelou A, Borget I, Godbert Y, Nguyen T, Garcia ME, Chougnet CN, Ferru A, Buffet C, Chabre O, Huillard O, Leboulleux S, Schlumberger M

Abstract
BACKGROUND: In the SELECT phase III trial in advanced radio-iodine refractory differentiated thyroid cancer (rDTC), lenvatinib improved median progression free survival (PFS) over placebo by almost 15 months and induces an objective response rate of 64.8%, but adverse events occurred in almost all patients. The present study evaluates the efficacy and toxicity of lenvatinib treatment in real-life practice.
METHODS: Clinical charts of 88 consecutive patients treated with lenvatinib from July 2015 to June 2016 in 27 French centers were retrospectively reviewed. Patients treated for other thyroid cancer types (n=11) or previously treated with lenvatinib within a trial (n=2) were excluded and the remaining 75 rDTC patients formed the basis of this report.
RESULTS: 75 rDTC patients were analyzed (33 females, median age: 65 years [35-88]), 12 had ECOG performance status ≥2; 24 cases received lenvatinib as first line systemic treatment; 47 (63%) patients had documented progressive disease prior to treatment initiation. Distant metastases were located in lungs, bones and lymph nodes in 89%, 60% and 69%, respectively. Initial treatment dose was 24 mg in 54 patients and was lower in the other 21 patients. The median follow-up was 7 months, with a median duration of treatment of 6 months [0.3-15]. Median PFS was 10 months. Among the 65 patients with evaluation of tumor response during treatment, best tumor response was a partial response in 23 patients (31%) and stable disease in 38 (51%). Eleven patients (14.7%) discontinued lenvatinib for disease progression. Forty-four (59%) and 23 (31%) patients had dose reduction or interruption of lenvatinib for adverse events (AEs). The most frequent AEs related to treatment were fatigue, hypertension, weight loss, diarrhea and anorexia. Eleven deaths occurred during study (one considered to be drug related). Pneumothorax occurred in 2 patients with lung metastases.
CONCLUSIONS: Real-life patients with rDTC can benefit from lenvatinib treatment. AEs are frequent and should be closely monitored.

PMID: 29048237 [PubMed - as supplied by publisher]

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Modified peroral endoscopic myotomy: a "Push and Pull" technique.

Modified peroral endoscopic myotomy: a "Push and Pull" technique.

Surg Endosc. 2017 Oct 19;:

Authors: Zhang DF, Chen WF, Xu MD, Zhong YS, Zhang YQ, Li QL, Zhou PH

Abstract
BACKGROUND: Peroral endoscopic myotomy (POEM) is a minimally invasive yet challenging procedure for achalasia. Additional technological innovations and improvements are important for simplifying the procedure.
METHODS: We report the successful use of a modified POEM procedure, which utilized a "Push and Pull" technique, on a patient with achalasia.
RESULTS: Our modifications resulted in a short operation time of only 35 min. No complications arose during or after the procedure, up to a follow-up period of 6 months, and symptoms were significantly and quickly improved.
CONCLUSIONS: This modified procedure shortens operation time and lowers the difficulty of the operation, while leaving the safety and efficacy uncompromised.

PMID: 29046961 [PubMed - as supplied by publisher]

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The safety of endoscopic esophageal procedures under general anesthesia.

The safety of endoscopic esophageal procedures under general anesthesia.

Korean J Anesthesiol. 2017 Oct;70(5):555-560

Authors: Kim GE, Kim DK, Choi JW, Chung IS, Jung DW

Abstract
BACKGROUND: With the increasing demand for general anesthesia for endoscopic esophageal procedures, anesthesiologists should understand the clinical characteristics of post-procedural complications (PPCs).
METHODS: We retrospectively investigated the incidence of and risk factors associated with PPCs of endoscopic esophageal procedures performed under general anesthesia from July 2013 to November 2016. The final analysis included 129 patients; 114 who underwent esophageal endoscopic dissection for esophageal tumors and 15 cases of peroral endoscopic myotomy for achalasia. Frank perforation during the procedure was defined as an endoscopically recognizable or clinically detected perforation during the procedures. A multivariable logistic regression analysis was conducted to identify independent risk factors for PPCs.
RESULTS: The overall incidence of PPCs was 19.4% (25/129). All of the PPCs were managed successfully with conservative measures. The most common PPC was symptomatic, radiologically documented atelectasis (11/25, 44.0%), followed by esophageal perforation-related PPCs (symptomatic pneumomediastinum or pneumoperitoneum; 9/25, 36.0%). In the multivariable analysis, frank perforation during the procedure was the only independent risk factor for PPCs (odds ratio, 8.470, 95% CI, 2.051-34.974, P = 0.003). Although frank perforation during the procedure occurred in 13 patients, 38.5% (5/13) of them did not develop any clinical sequelae after their procedures. Compared with patients without PPCs, patients who developed PPCs took longer to their first oral intake and had prolonged hospital stays (P = 0.047 and 0.026, respectively).
CONCLUSIONS: Iatrogenic perforation during endoscopic esophageal procedures under general anesthesia was the only independent risk factor for PPCs; therefore, proactive measures and close follow-up are necessary.

PMID: 29046776 [PubMed]

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Spontaneous spinal epidural hemorrhage following disseminated intravascular coagulation resulting in paraplegia: a case report.

Spontaneous spinal epidural hemorrhage following disseminated intravascular coagulation resulting in paraplegia: a case report.

J Spinal Cord Med. 2017 Oct 19;:1-5

Authors: Dildar N, Ayaz SB, Aamir MO, Ahmad N

Abstract
CONTEXT: Spontaneous spinal epidural hemorrhage (SSEH) mostly presents as low back pain with or without a radiculopathy, and rarely with paraplegia or tetraplegia depending on the site and severity of spinal cord compression. We present here a case who had anemia and developed paraplegia following disseminated intravascular coagulation (DIC) due to a transfusion reaction.
FINDINGS: A 65-year-old lady presented with sudden onset chest pain radiating to nape of the neck followed by loss of sensations and power in legs few hours after a blood transfusion. Her past history was negative for diabetes mellitus, hypertension, coronary artery disease, or a bleeding disorder. Her blood pressure was 90/57 mmHg and she had a normal pulse, respiratory rate, and temperature. On neurological examination, she had no motor power and unevokable muscle stretch reflexes in the lower limbs. The sensations were intact till T3 dermatome. The laboratory evaluation was suggestive of DIC. The magnetic resonance imaging showed a non-enhancing abnormal signal intensity area in the posterior epidural space, extending from CV4 to LV4 causing cervico-dorsal cord compression associated with cord edema. Following diagnosis, urgent decompressive surgery was carried out due to deteriorating neurological status. The patient was transfused with five bags of red cell concentrate, two bags of platelets, and four bags of fresh frozen plasma during the operation. The patient regained consciousness following operation, however, the neurological status did not improve. She, unfortunately, died on the third post-op day due to cardiac arrest.
CONCLUSION: SSEH is a rare cause of paraplegia. Early radiological diagnosis is crucial for timely neurosurgical management and saving patient from permanent neurological deficit or a fatal outcome.

PMID: 29047318 [PubMed - as supplied by publisher]

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Performance Characteristics of Body Fluid Cytology: Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology.

Performance Characteristics of Body Fluid Cytology: Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology.

Arch Pathol Lab Med. 2017 Oct 19;:

Authors: Tabatabai ZL, Nayar R, Souers RJ, Crothers BA, Davey DD

Abstract
CONTEXT: - Body fluid cytology is an important diagnostic tool used to identify various conditions. However, an accurate diagnosis in this setting can sometimes be challenging.
OBJECTIVE: - To identify the performance characteristics of body fluid cytology by analyzing participant responses from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology.
DESIGN: - Participant responses from 5102 slides were analyzed for concordance to the general category (GC) and to the reference diagnosis (RD). Nonlinear mixed models were used to analyze concordance.
RESULTS: - The overall GC concordance was 95.2%. The GC type, participant type, and preparation type were significantly associated with GC concordance (P < .001). Concordance for malignant cases was higher than it was for benign cases. Cytotechnologists had better GC concordance than pathologists did. ThinPrep (Hologic, Marlborough, Massachusetts) slides had the highest GC concordance. Participant type, fluid type, preparation type, and participant interpretation were significantly associated with RD concordance (P < .001). Pathologists performed better than cytotechnologists did for RD concordance. Pericardial fluid had the lowest RD concordance, especially for cases with normal or reactive findings. Modified Giemsa-stained slides performed best for lymphoma and hematopoietic malignancy. Small cell carcinoma had the highest GC concordance, and its RD concordance was higher in pleural than in peritoneal fluids. Adenocarcinoma showed the highest concordance rates for both GC and RD.
CONCLUSIONS: - This study illustrates the challenges associated with interpreting body fluid cytology, particularly in pericardial fluid, and the factors that may affect accurate diagnoses. The results also highlight the value of using multiple preparation types in challenging cases.

PMID: 29048220 [PubMed - as supplied by publisher]

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Immunohistochemistry in Peritoneal Mesothelioma: A Single-Center Experience of 244 Cases.

Immunohistochemistry in Peritoneal Mesothelioma: A Single-Center Experience of 244 Cases.

Arch Pathol Lab Med. 2017 Oct 19;:

Authors: Tandon R, Jimenez-Cortez Y, Taub R, Borczuk AC

Abstract
CONTEXT: - Diagnosis of malignant mesothelioma is more common in the chest than it is in the abdomen. Most published immunohistochemistry data are more applicable to pleural than to peritoneal mesothelioma.
OBJECTIVE: - To clarify the practical utility of 17 immunohistochemistry markers in the differential diagnosis of peritoneal mesothelioma with an emphasis on stains for which there is either contradictory information or a paucity of literature.
DESIGN: - Consultation files of peritoneal mesothelioma diagnoses rendered from 1999 to 2014 were reviewed; 242 cases are identified. The results of immunohistochemistry markers performed were tabulated.
RESULTS: - Immunohistochemistry markers positive in peritoneal mesothelioma in order of sensitivity were calretinin (244 of 244; 100%), WT1 (205 of 218; 94%), CK5/6 (173 of 194; 89%), mesothelin (132 of 150; 88%), and D2-40 (78 of 97; 80%). Markers used to differentiate carcinoma from mesothelioma showed immunoreactivity in peritoneal mesothelioma: estrogen receptor (2 of 84; 2%), B72.3 (6 of 196; 3%), CK20 (5 of 116; 4%), CD15 (7 of 192; 4%), p63 (3 of 62; 5%), carcinoembryonic antigen (9 of 199; 5%), PAX8 (12 of 191; 6%), progesterone receptor (5 of 71; 7%), Ber-EP4 (17 of 209; 8%), and CD138 (9 of 91; 10%). BAP1 loss, increasingly used in the differential diagnosis of benign versus malignant mesothelial proliferation, occurs in 55% (99 of 181) of peritoneal mesothelioma cases.
CONCLUSIONS: - The results support the experience that there is no definitive marker to rule out malignant mesothelioma, including PAX8, estrogen receptor, progesterone receptor, and p63 immunoreactivity. The high rate of immunoreactivity for mesothelin may have a role as a predictive marker for immune targeting. BAP1 loss of 55% in this cohort of peritoneal mesothelioma confirms published observations, and BAP1 retention is seen in a significant proportion of neoplastic cases.

PMID: 29048219 [PubMed - as supplied by publisher]

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Radiotherapy for Patients With Resected Tumor Deposit-Positive Colorectal Cancer: A Surveillance, Epidemiology, and End Results-Based Population Study.

Radiotherapy for Patients With Resected Tumor Deposit-Positive Colorectal Cancer: A Surveillance, Epidemiology, and End Results-Based Population Study.

Arch Pathol Lab Med. 2017 Oct 19;:

Authors: Chavali LB, Llanos AAM, Yun JP, Hill SM, Tan XL, Zhang L

Abstract
CONTEXT: - According to the American Joint Committee on Cancer's Cancer Staging Manual, 7th edition, TNM classification, tumor deposit (TD)-positive colorectal cancers (CRCs) are classified as N1c. The effects of radiotherapy and the effects of the updated American Joint Committee on Cancer 7th edition TNM N1c classification for patients with TD-positive CRC are unclear.
OBJECTIVE: - To investigate outcomes of radiotherapy in patients with resected TD-positive CRC.
DESIGN: - Resected TD-positive CRCs diagnosed from 2010 to 2014 were identified in the Surveillance, Epidemiology, and End Results 18 database. Factors associated with overall survival (OS) and cancer-specific survival (CSS) were investigated using Kaplan-Meier and Cox proportional hazards models.
RESULTS: - We included 2712 qualified CRC patients, who either underwent adjuvant radiotherapy (n = 187; 6.9%) or received no radiotherapy (n = 2525; 93.1%). Univariate Cox proportional models showed improved CSS among all CRC patients who underwent adjuvant radiotherapy (CSS hazard ratio, 0.73; 95% CI, 0.57-0.95) and among rectal cancer patients when separated by location (hazard ratio, 0.57; 95% CI, 0.40-0.83), although these associations were attenuated in multivariable-adjusted models. There was improved OS among rectal cancer patients (hazard ratio, 0.77; 95% CI, 0.59-0.99). In subgroup analyses, radiotherapy was not associated with OS or CSS in either metastatic or nonmetastatic CRC patients. Instead, N1c category (versus N0) was associated with a worse OS (hazard ratio, 1.43; 95% CI, 1.31-1.57) but was not associated with CSS.
CONCLUSIONS: - Radiotherapy did not independently improve OS among TD-positive CRC patients. In this study, classifying TD positivity as N1c was associated with worse OS than classifying TD positivity as N0. The findings seem to challenge the benefits of radiotherapy and the new N1c classification of TD for TD-positive CRC patients.

PMID: 29048218 [PubMed - as supplied by publisher]

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Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial.

Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial.

Am J Audiol. 2017 Oct 10;:1-11

Authors: Pyykko I, Manchaiah V, Kentala E, Levo H, Juhola M

Abstract
Purpose: In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD).
Method: The Norton-Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated.
Results: The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention.
Conclusions: The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.

PMID: 29049634 [PubMed - as supplied by publisher]

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Auditory Scene Analysis: An Attention Perspective.

Auditory Scene Analysis: An Attention Perspective.

J Speech Lang Hear Res. 2017 Oct 17;60(10):2989-3000

Authors: Sussman ES

Abstract
Purpose: This review article provides a new perspective on the role of attention in auditory scene analysis.
Method: A framework for understanding how attention interacts with stimulus-driven processes to facilitate task goals is presented. Previously reported data obtained through behavioral and electrophysiological measures in adults with normal hearing are summarized to demonstrate attention effects on auditory perception-from passive processes that organize unattended input to attention effects that act at different levels of the system. Data will show that attention can sharpen stream organization toward behavioral goals, identify auditory events obscured by noise, and limit passive processing capacity.
Conclusions: A model of attention is provided that illustrates how the auditory system performs multilevel analyses that involve interactions between stimulus-driven input and top-down processes. Overall, these studies show that (a) stream segregation occurs automatically and sets the basis for auditory event formation; (b) attention interacts with automatic processing to facilitate task goals; and (c) information about unattended sounds is not lost when selecting one organization over another. Our results support a neural model that allows multiple sound organizations to be held in memory and accessed simultaneously through a balance of automatic and task-specific processes, allowing flexibility for navigating noisy environments with competing sound sources.
Presentation Video: http://ift.tt/2x8vHwE.

PMID: 29049599 [PubMed - in process]

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Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

J Assoc Res Otolaryngol. 2017 Oct 18;:

Authors: Lauer AM, Larkin G, Jones A, May BJ

Abstract
Increased prevalence of emotional distress is associated with tinnitus and hearing loss. The underlying mechanisms of the negative emotional response to tinnitus and hearing loss remain poorly understood, and it is challenging to disentangle the emotional consequences of hearing loss from those specific to tinnitus in listeners experiencing both. We addressed these questions in laboratory rats using three common rodent anxiety screening assays: elevated plus maze, open field test, and social interaction test. Open arm activity in the elevated plus maze decreased substantially after one trial in controls, indicating its limited utility for comparing pre- and post-treatment behavior. Open field exploration and social interaction behavior were consistent across multiple sessions in control animals. Individual sound-exposed and salicylate-treated rats showed a range of phenotypes in the open field, including reduced entries into the center in some subjects and reduced locomotion overall. In rats screened for tinnitus, less locomotion was associated with higher tinnitus scores. In salicylate-treated animals, locomotion was correlated with age. Sound-exposed and salicylate-treated rats also showed reduced social interaction. These results suggest that open field exploratory activity is a selective measure for identifying tinnitus distress in individual animals, whereas social interaction reflects the general effects of hearing loss. This animal model will facilitate future studies of the structural and functional changes in the brain pathways underlying emotional distress associated with hearing dysfunction, as well as development of novel interventions to ameliorate or prevent negative emotional responses.

PMID: 29047013 [PubMed - as supplied by publisher]

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Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

Neurol Res. 2017 Oct 19;:1-7

Authors: Klersy PC, Arlt F, Hofer M, Meixensberger J

Abstract
OBJECTIVE: A 'wait and see' strategy is an option when managing patients with small vestibular schwannomas (VS). A risk of growth and worsening of hearing may influence a patient's daily quality of life (QOL). Therefore, the present study focused on QOL parameters in patients who are on a 'wait and see' strategy following magnetic resonance imaging (MRI)-based diagnosis of small unilateral VS.
PATIENTS AND METHODS: Sixty-five patients (mean age 64.4 years; male:female, 32:33) who suffered from a small unilateral VS (9.34 mm, range 1.5-23 mm) between 2013 and 2016 were included in a prospective single center study. During follow-up, in addition to clinical and neurological examinations and MRI imaging, all patients answered the Short Form 36 questionnaire once to characterize QOL. Additionally, the severity of tinnitus was determined by the Mini-TQ-12 from Hiller and Goebel.
RESULTS: It was found during follow-up that there was no lowering of QOL in patients with small VS who were on 'wait and see' strategy compared with Germany's general population and no tumor growth was detected in 53 patients (81.5%). Patients with a tumor diameter larger than 10 mm did not suffer from stronger tinnitus, vertigo or unsteadiness than the group with an average tumor size, which is smaller than 10 mm. Sixty-two patients (95.4%) showed ipsilateral hearing loss and three of these reported deafness (4.6%). Severe vertigo or tinnitus is connected with lower levels of mental component scale and physical component scale. These findings reduced the QOL (p = 0.05).
CONCLUSION: In our series, QOL is not influenced in patients with unilateral untreated small VS in comparison to Germany's general population. This is helpful information when advising patients during follow-up and finding out the optimal timing of individual treatment.

PMID: 29048255 [PubMed - as supplied by publisher]

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Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

Neurol Res. 2017 Oct 19;:1-7

Authors: Klersy PC, Arlt F, Hofer M, Meixensberger J

PMID: 29048255 [PubMed - as supplied by publisher]

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Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

J Assoc Res Otolaryngol. 2017 Oct 18;:

Authors: Lauer AM, Larkin G, Jones A, May BJ

PMID: 29047013 [PubMed - as supplied by publisher]

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Antiparkinsonian Efficacy of Guanosine in Rodent Models of Movement Disorder.

Antiparkinsonian Efficacy of Guanosine in Rodent Models of Movement Disorder.

Front Pharmacol. 2017;8:700

Authors: Massari CM, López-Cano M, Núñez F, Fernández-Dueñas V, Tasca CI, Ciruela F

Abstract
Guanosine (GUO) is a guanine-based purine nucleoside with important trophic functions and promising neuroprotective properties. Although the neuroprotective effects of GUO have been corroborated in cellular models of Parkinson's disease (PD), its efficacy as an antiparkinsonian agent has not been fully explored in PD animal models. Accordingly, we evaluated the effectiveness of GUO in reversing motor impairments in several rodent movement disorder models, including catalepsy, tremor, and hemiparkinsonism. Our results showed that orally administered GUO antagonized reserpine-mediated catalepsy, reduced reserpine-induced tremulous jaw movements, and potentiated the number of contralateral rotations induced by L-3,4-dihydroxyphenylalanine in unilaterally 6-hydroxidopamine-lesioned rats. In addition, at 5 and 7.5 mg/kg, GUO inhibited L-DOPA-induced dyskinesia in rats chronically treated with a pro-dopaminergic agent. Overall, we describe the therapeutic potential of GUO, which may be effective not only for reversing parkinsonian motor impairments but also for reducing dyskinesia induced by treatment for PD.

PMID: 29046640 [PubMed]

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Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial.

Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial.

Am J Audiol. 2017 Oct 10;:1-11

Authors: Pyykko I, Manchaiah V, Kentala E, Levo H, Juhola M

PMID: 29049634 [PubMed - as supplied by publisher]

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Auditory Scene Analysis: An Attention Perspective.

Auditory Scene Analysis: An Attention Perspective.

J Speech Lang Hear Res. 2017 Oct 17;60(10):2989-3000

Authors: Sussman ES

PMID: 29049599 [PubMed - in process]

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Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss.

J Assoc Res Otolaryngol. 2017 Oct 18;:

Authors: Lauer AM, Larkin G, Jones A, May BJ

PMID: 29047013 [PubMed - as supplied by publisher]

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KCNK9 imprinting syndrome-further delineation of a possible treatable disorder.

http:--media.wiley.com-assets-7315-19-Wi

KCNK9 imprinting syndrome-further delineation of a possible treatable disorder.

Am J Med Genet A. 2016 Oct;170(10):2632-7

Authors: Graham JM, Zadeh N, Kelley M, Tan ES, Liew W, Tan V, Deardorff MA, Wilson GN, Sagi-Dain L, Shalev SA

Abstract
Patients with KCNK9 imprinting syndrome demonstrate congenital hypotonia, variable cleft palate, normal MRIs and EEGs, delayed development, and feeding problems. Associated facial dysmorphic features include dolichocephaly with bitemporal narrowing, short philtrum, tented upper lip, palatal abnormalities, and small mandible. This disorder maps to chromosomal region 8q24, and it is caused by a specific missense mutation 770G>A in exon 2, replacing glycine at position 236 by arginine (G236R) in the maternal copy of KCNK9 within this locus. KCNK9 (also called TASK3) encodes a member of the two pore- domain potassium channel (K2P) subfamily. This gene is normally imprinted with paternal silencing, thus a mutation in the maternal copy of the gene will result in disease, whereas a mutation in the paternal copy will have no effect. Exome sequencing in four new patients with developmental delay and central hypotonia revealed de novo G236R mutations. Older members of a previously reported Arab-Israeli family have intellectual disability of variable severity, persistent feeding difficulties in infancy with dysphagia of liquids and dysphonia with a muffled voice in early adulthood, generalized hypotonia, weakness of proximal muscles, elongated face with narrow bitemporal diameter, and reduced facial movements. We describe the clinical features in four recently recognized younger patients and compare them with those found in members of the originally reported Arab-Israeli family and suggest this may be a treatable disorder. © 2016 Wiley Periodicals, Inc.

PMID: 27151206 [PubMed - indexed for MEDLINE]

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Novel recessive PDZD7 biallelic mutations in two Chinese families with non-syndromic hearing loss.

Novel recessive PDZD7 biallelic mutations in two Chinese families with non-syndromic hearing loss.

Am J Med Genet A. 2017 Oct 19;:

Authors: Guan J, Wang H, Lan L, Wang L, Yang J, Xie L, Yin Z, Xiong W, Zhao L, Wang D, Wang Q

Abstract
Autosomal recessive non-syndromic hearing loss (ARNSHL) is a highly heterogeneous genetic condition. PDZD7 has emerged as a new genetic etiology of ARNSHL. Biallelic mutations in the PDZD7 gene have been reported in two German families, four Iranian families, and a Pakistani family with ARNSHL. The effect of PDZD7 on ARNSHL in other population has yet to be elucidated. Two Chinese ARNSHL families, each of which had two affected siblings, were included in this study. The families underwent target region capture and high-throughput sequencing to analyze the exonic, splice-site, and intronic sequences of 128 genes. Furthermore, 1751 normal Chinese individuals served as controls, and 122 Chinese families segregating with apparent ARNSHL, who had been previously excluded for variants in the common deafness genes GJB2 and SLC26A4, were subjected to screening for candidate mutations. We identified a novel homozygous missense mutation (p.Arg66Leu) and novel compound heterozygous frameshift mutations (p.Arg56fsTer24 and p.His403fsTer36) in Chinese families with ARNSHL. This is the first report to identify PDZD7 as an ARNSHL-associated gene in the Chinese population. Our finding could expand the pathogenic spectrum and strengthens the clinical diagnostic role of the PDZD7 gene in ARNSHL patients.

PMID: 29048736 [PubMed - as supplied by publisher]

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Prenatal diagnosis of Chudley-McCullough syndrome.

Prenatal diagnosis of Chudley-McCullough syndrome.

Am J Med Genet A. 2016 Sep;170(9):2426-30

Authors: Chapman T, Perez FA, Ishak GE, Doherty D

Abstract
Chudley-McCullough syndrome (CMS) is an autosomal-recessive disorder characterized by a complex brain malformation and profound congenital sensorineural hearing loss. Postnatal brain imaging findings include ventriculomegaly, partial agenesis of corpus callosum, inferior cerebellar dysplasia, arachnoid cysts, and malformations of cortical development including frontal subcortical heterotopia and polymicrogyria. Prenatal diagnosis of CMS is important due to the markedly less severe neurodevelopmental prognosis compared to disorders with similar brain imaging findings. We report prenatal imaging features that help distinguish CMS from other disorders, including slit-like frontal horns, agenesis of the corpus callosum, frontal subcortical heterotopia, arachnoid cysts, and cerebellar dysplasia. © 2016 Wiley Periodicals, Inc.

PMID: 27312216 [PubMed - indexed for MEDLINE]

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Issue Information

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Impaired intestinal barrier function and relapsing digestive disease: Lessons from a porcine model of early life stress

Abstract

Within this issue of Neurogastroenterology and Motility, an article by Pohl et al highlights new insights from a powerful porcine model of the link between early life adversity and relapsing functional gastrointestinal disorders. Early weaning stress closely mimics the early life psychosocial stressors that have been linked to adult onset gastrointestinal dysfunction. This early weaning model provides reproducible and highly translatable outcomes in young stress-challenged pigs. Due to the convincingly comparable neurological and gastroenterological anatomy and physiology between pigs and human beings, gastrointestinal stress and injury studies utilizing swine models will provide invaluable insights to improve our understanding and treatment of gastrointestinal disease in human beings. Future studies to examine mechanisms underlying this link between early life adversity and functional gastrointestinal disorders will explore the roles of gender and hypomaturity in gastrointestinal responses to stress.

This image shows a striking orange coloration as an indication of greatly enhanced blood flow in the cortex as the rectum and descending colon are minimally distended.

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Cover Image

The cover image, by J.W. Park et al., is based on the Original Article Changes of cortical activation in swallowing following high frequency repetitive transcranial magnetic stimulation in older adults, DOI: 10.1111/nmo.13123.

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Idiopathic gastroparesis is associated with specific transcriptional changes in the gastric muscularis externa

Abstract

Background

The molecular changes that occur in the stomach that are associated with idiopathic gastroparesis are poorly described. The aim of this study was to use quantitative analysis of mRNA expression to identify changes in mRNAs encoding proteins required for the normal motility functions of the stomach.

Methods

Full-thickness stomach biopsy samples were collected from non-diabetic control subjects who exhibited no symptoms of gastroparesis and from patients with idiopathic gastroparesis. mRNA was isolated from the muscularis externa and mRNA expression levels were determined by quantitative reverse transcriptase (RT)-PCR.

Key Results

Smooth muscle tissue from idiopathic gastroparesis patients had decreased expression of mRNAs encoding several contractile proteins, such as MYH11 and MYLK1. Conversely, there was no significant change in mRNAs characteristic of interstitial cells of Cajal (ICCs) such as KIT or ANO1. There was also a significant decrease in mRNA-encoding platelet-derived growth factor receptor α (PDGFRα) and its ligand PDGFB and in Heme oxygenase 1 in idiopathic gastroparesis subjects. In contrast, there was a small increase in mRNA characteristic of neurons. Although there was not an overall change in KIT expression in gastroparesis patients, KIT expression showed a significant correlation with gastric emptying whereas changes in MYLK1, ANO1 and PDGFRα showed weak correlations to the fullness/satiety subscore of patient assessment of upper gastrointestinal disorder-symptom severity index scores.

Conclusions and Inferences:

Our findings suggest that idiopathic gastroparesis is associated with altered smooth muscle cell contractile protein expression and loss of PDGFRα⁺ cells without a significant change in ICCs.

qRT-PCR analysis revealed that smooth muscle tissue from idiopathic gastroparesis patients had decreased expression of mRNAs encoding several contractile and regulatory proteins, PDGFRalpha and its ligand PDGFB and Heme oxygenase 1. Conversely, there was no significant change in mRNAs characteristic of interstitial cells of Cajal (ICCs), such as KIT or ANO1. These findings suggest that idiopathic gastroparesis is most commonly associated with transcriptional changes that are indicative of altered smooth muscle cells and PDGFRalpha positive fibroblast cells rather than ICCs.

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Aerosol optical depth retrieval from visibility in China during 1973–2014

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Zhaoyang Zhang, Weiling Wu, Jing Wei, Ying Song, Xiaotong Yan, Lidong Zhu, Quan Wang
Visibility is a widely-used indicator to quantify aerosol loadings. However, there are still some uncertainties in retrieving Aerosol Optical Depth (AOD) from surface visibility data. In this study, a new method, KM-Elterman method, was developed to retrieve AOD based on visibility from 1973 to 2014 and MODIS (Aqua) AOD product from 2002 to 2014. The analysis indicated that KM-Elterman method performed better than previous algorithms, such as Qiu, Elterman, and M-Elterman algorithms. The correlation between inferred AOD and MODIS measurements from 2002 to 2010 reached at 0.942 and the Root Mean Squared Error (RMSE) is about 0.077 for annual inferred AOD. Singular Value Decomposition (SVD) method was used to investigate the consistency of spatio-temporal variations between inferred AOD and MODIS measurements from July 2002 to December 2014. The correlation between Principal Components (PCs) is well above 0.72. The spatial patterns of inferred AOD agreed well with that of MODIS datasets. Long-term AOD trends over China during 1973–2014 were analyzed using the inferred AOD and our results pointed out that rapidly increasing trends of AOD were observed before 1980 in North China Plain (NCP), Yangtze River Delta (YRD), central China, Sichuan Basin (SB), and Pearl River Delta (PRD). Slight decreasing trends were found in southwest China. The inferred AOD can be used to explore aerosol effects on climate change and Earth's radiative budget.

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Analysis of PM2.5 in Córdoba, Argentina under the effects of the El Niño Southern Oscillation

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Bethania L. Lanzaco, Luis E. Olcese, Xavier Querol, Beatriz M. Toselli
In this work, PM2.5 samples were collected in the winter-spring months of 2014–2016 at an urban site in Córdoba. Córdoba is the second largest city in Argentina and is an important industrial and touristic center. The collected samples were individually analyzed for chemical composition using different techniques. The soluble inorganic ions and carbonaceous particles were determined from bulk aerosol samples for the first time in the city. The mass concentrations of PM2.5, organic carbon, elemental carbon, inorganic ions and metals were determined according to the mass balance. The dominant mass components were organic matter and elemental carbon (54.8%), mineral dust (6.1%), secondary inorganic aerosols (3.0%), and salt (1.2%). A principal component analysis was applied to the samples and resulted in five major factors that explained 79% of the variance in PM2.5. These factors represented combustion, industrial sources, soil dust, secondary inorganic aerosol, and salt, and each explained between 11% and 20% of the variance. A comparison with the results from a previous campaign (2010–2011) revealed appreciable changes in the PM2.5 chemical composition. These changes were attributed to the two extreme meteorological conditions that prevailed in the region. The years 2014–2016 were largely dominated by the warm phase of the El Niño–Southern Oscillation, which leads to humid and cold weather in the Córdoba region, while the samples from 2010 to 2011 were collected during the dry and hot years resulting from the La Niña regime.

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Characterization of particulate matter deposited on urban tree foliage: A landscape analysis approach

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Lin Lin, Jingli Yan, Keming Ma, Weiqi Zhou, Guojian Chen, Rongli Tang, Yuxin Zhang
Plants can mitigate ambient particulate matter by cleaning the air, which is crucial to urban environments. A novel approach was presented to quantitatively characterize particulate matter deposited on urban tree foliage. This approach could accurately quantify the number, size, shape, and spatial distribution of particles with different diameters on leaves. Spatial distribution is represented by proximity, which measures the closeness of particles. We sampled three common broadleaf species and obtained images through field emission scanning electron microscopy. We conducted the object-based method to extract particles from images. We then used Fragstats to analyze the landscape characteristics of these particles in term of selected metrics. Results reveal that Salix matsudana is more efficient than Ailanthus altissima and Fraxinus chinensis in terms of the number and area of particles per unit area and the proportion of fine particulate matter. The shape complexity of the particles increases with their size. Among the three species, S. matsudana and A. altissima particles respectively yield the highest and lowest proximity. PM1 in A. altissima and PM10 in F. chinensis and S. matsudana show the highest proximity, which may influence subsequent particle retention. S. matsudana should be generally considered to collect additional small particles. Different species and particle sizes exhibit various proximities, which should be further examined to elucidate the underlying mechanism.

Graphical abstract

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Effect of watershed urbanization on N2O emissions from the Chongqing metropolitan river network, China

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Yixin He, Xiaofeng Wang, Huai Chen, Xingzhong Yuan, Ning Wu, Yuewei Zhang, Junsheng Yue, Qiaoyong Zhang, Yuanbin Diao, Lilei Zhou
Watershed urbanization, an integrated anthropogenic perturbation, is another considerable global concern in addition to that of global warming and may significantly enrich the N loadings of watersheds, which then greatly influences the nitrous oxide (N2O) production and fluxes of these aquatic systems. However, little is known about the N2O dynamics in human-dominated metropolitan river networks. In this study, we present the temporal and spatial variations in N2O saturation and emission in the Chongqing metropolitan river network, which is undergoing intensified urbanization. The N2O saturation and fluxes at 84 sampling sites ranged from 126% to 10536% and from 4.5 to 1566.8 μmol N2O m⁻² d⁻¹, with means of 1780% and 261 μmol N2O m⁻² d⁻¹. The riverine N2O saturation and fluxes increased along with the urbanization gradient and urbanization rate, with disproportionately higher values in urban rivers due to the N2O-rich sewage inputs and enriched in situ N substrates. We found a clear seasonal pattern of N2O saturation, which was co-regulated by both water temperature and precipitation. Regression analysis indicated that the N substrates and dissolved oxygen (DO) that controlled nitrogen metabolism acted as good predictors of the N2O emissions of urban river networks. Particularly, phosphorus (P) and hydromorphological factors (water velocity, river size and bottom substrate) had stronger relationships with the N2O saturation and could also be used to predict the N2O emission hotspots in regions with rapid urbanization. In addition, the default emission factors (EF5-r) used in the Intergovernmental Panel on Climate Change (IPCC) methodology may need revision given the differences among the physical and chemical factors in different rivers, especially urban rivers.

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Carbon sequestration by mangrove forest: One approach for managing carbon dioxide emission from coal-based power plant

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Raghab Ray, Tapan Kumar Jana
Mangroves are known as natural carbon sinks, taking CO2 out of the atmosphere and store it in their biomass for many years. This study aimed to investigate the capacity of world's largest mangrove, the Sundarbans (Indian part) to sequester anthropogenic CO2 emitted from the proximate coal-based thermal power plant in Kolaghat (∼100 km away from mangrove site). Study also includes Kolkata, one of the largest metropolises of India (∼150 km away from mangrove site) for comparing micrometeorological parameters, biosphere-atmosphere CO2 exchange fluxes and atmospheric pollutants between three distinct environments: mangrove-power plant-metropolis. Hourly sampling of atmospheric CO2 in all three sites (late December 2011 and early January 2012) revealed that CO2 concentrations and emission fluxes were maximum around the power plant (360–621 ppmv, 5.6–56.7 mg m⁻²s⁻¹ respectively) followed by the metropolis (383–459 ppmv, 3.8–20.4 mg m⁻²s⁻¹ respectively) and mangroves (277–408 ppmv, −8.9–11.4 mg m⁻²s⁻¹, respectively). Monthly coal consumption rates (41–57, in 10⁴ ton month⁻¹) were converted to CO2 suggesting that 2.83 Tg C was added to the atmosphere in 2011 for the generation of 7469732 MW energy from the power plant. Indian Sundarbans (4264 km²) sequestered total of 2.79 Tg C which was 0.64% of the annual fossil fuel emission from India in the same time period. Based on these data from 2010 to 2011, it is calculated that about 4328 km² mangrove forest coverage is needed to sequester all CO2 emitted from the Kolaghat power plant.

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Air pollutant emissions from straw open burning: A case study in Tianjin

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Yanan Guan, Guanyi Chen, Zhanjun Cheng, Beibei Yan, Li'an Hou
Straw open burning is a primary source of air pollution and difficult to forbid in China. To have a better understanding of the pollution status of straw open burning in Tianjin, an accurate pollutant emission inventory was established based on the county-level statistical data from 1996 to 2014 in Tianjin. Results showed that the emission of CO, VOCs, PM10, PM2.5, CH4, NOx, OC, SO2, NH3 and BC have decreased by 41.66%, 58.74%, 54.55%, 55.01%, 58.42%, 47.03%, 48.71%, 44.85%, 64.60%, 51.56% from 1996 to 2000, and then gradually increased by 44.05%, 53.48%, 59.43%, 59.49%, 51.24%, 55.05%, 53.09%, 22.73%, 56.25%, and 64.29% from 2000 to 2014, respectively. Spatially, counties of Wuqing, Baodi and Jixian were the largest contributors to the total emissions with the contribution of 25.98%, 22.69% and 18.87% respectively through the study period. The Monte Carlo simulation was also used to estimate the uncertainty and its confidence intervals of the pollutant emissions. The uncertainty of total pollutant emissions for each year is within ±80.35%. This study provides more accurate estimation for the pollutant emissions from straw open burning and reliable guidance for the policy formulation to improve the air quality in Tianjin.

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An assessment of cruise NOx emissions of short-haul commercial flights

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Enis T. Turgut, Oznur Usanmaz
Cruise NOx emissions of aircraft are an important input parameter for studies investigating climate change due to their ability to alter the concentrations of certain trace gases, such as ozone, methane, and hydroxyl in the atmosphere, and to induce positive radiative forcing. Therefore, it is of importance to minimize estimation errors on NOx emitted from aircraft engines at high altitude. In this study, the cruise NOx emissions of a frequently-used narrow-bodied aircraft type operating domestic flights in Turkey, are quantified based on numerous actual flight, actual emissions and actual meteorological data. The overall average cruise NOx emissions index is found to be ∼10 g/kg fuel. In addition, newly-developed parameters of the aircraft cruise NOx footprint and NOx intensity are calculated to be 0.5 g/pa-NM and ∼60 g/NM, respectively. Regarding the effects of flight parameters on cruise NOx emissions, while there is a distinct increase in NOx parameters with an increase in aircraft mass, this may differ for altitude. The results reveal that the NOx emissions index tends to increase slightly by 1–2%, particularly above 28,000 ft, whereas NOx intensity decreases at a rate of 2.4–2.7% per 2000 ft of cruise altitude increase.

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Black manganese-rich crusts on a Gothic cathedral

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): Dorothea S. Macholdt, Siegfried Herrmann, Klaus Peter Jochum, A.L.David Kilcoyne, Thomas Laubscher, Jonas H.K. Pfisterer, Christopher Pöhlker, Beate Schwager, Bettina Weber, Markus Weigand, Katrin F. Domke, Meinrat O. Andreae
Black manganese-rich crusts are found worldwide on the façades of historical buildings. In this study, they were studied exemplarily on the façade of the Freiburger Münster (Freiburg Minster), Germany, and measured in-situ by portable X-ray fluorescence (XRF). The XRF was calibrated to allow the conversion from apparent mass fractions to Mn surface density (Mn mass per area), to compensate for the fact that portable XRF mass fraction measurements from thin layers violate the assumption of a homogeneous measurement volume. Additionally, 200-nm femtosecond laser ablation-inductively coupled plasma-mass spectrometry (fs LA-ICP-MS) measurements, scanning transmission X-ray microscopy-near edge X-ray absorption fine structure spectroscopy (STXM-NEXAFS), Raman spectroscopy, and imaging by light microscopy were conducted to obtain further insight into the crust material, such as potential biogenic contributions, element distributions, trace element compositions, and organic functional groups.While black crusts of various types are present at many places on the minster's facade, crusts rich in Mn (with a Mn surface density >150 μg cm⁻²) are restricted to a maximum height of about 7 m. The only exceptions are those developed on the Renaissance-Vorhalle (Renaissance Portico) at a height of about 8 m. This part of the façade had been cleaned and treated with a silicon resin as recently as 2003. These crusts thus accumulated over a period of only 12 years. Yet, they are exceptionally Mn-rich with a surface density of 1200 μg cm⁻², and therefore require an accumulation rate of about 100 μg cm⁻² Mn per year.Trace element analyses support the theory that vehicle emissions are responsible for most of the Mn supply. Lead, barium, and zinc correlate with manganese, indicating that tire material, brake pads, and resuspended road dust are likely to be the element sources. Microscopic investigations show no organisms on or in the Mn-rich crusts. In contrast, Mn-free black crusts sampled at greater heights (>8 m) exhibited fungal and cyanobacterial encrustation. Carbon-rich spots were found by STXM-NEXAFS underneath one of the Mn-rich crusts. However, these carbon occurrences originate from soot and polycyclic aromatic hydrocarbons (PAHs) deposited on top of the crust, rather than from organisms responsible for the crust's formation, as shown by STXM-NEXAFS and Raman spectroscopic measurements. Our results suggest that the crusts develop abiogenically, with vehicle emissions as dominant element sources.

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Atmospheric degradation of 2- nitrobenzaldehyde: Photolysis and reaction with OH radicals

Publication date: December 2017
Source:Atmospheric Environment, Volume 171
Author(s): H. Bouya, M. Al Rashidi, E. Roth, R. Salghi, A. Chakir
This work presents an experimental study of the gas phase kinetics of 2-nitrobenzaldehyde (2-NBA) photolysis and oxidation by OH radicals. The experiments were carried out in an atmospheric simulation chamber coupled to an FTIR spectrometer and CG/MS. The UV spectra of 2-NBA were also measured and the experimentally determined absorption cross sections were used to estimate the atmospheric photo-dissociation constant of 2-NBA with a global quantum yield of 0.5. The obtained results indicate that 2-NBA is a highly photolysable. A mechanism of 2-NBA photolysis was proposed based on the identification of photolysis degradation products. The kinetics of oxidation of 2-NBA by OH radicals was investigated over the temperature range 308–352 K. The obtained rate coefficients exhibits slight negative temperature dependence and the Arrhenius expression obtained is as follows: kOH+2-NBA(T)= (7.00 ± 3.40) × 10⁻¹²exp (577 ± 156/T) cm³ molecule⁻¹ s⁻¹. The calculated rate coefficients lead to tropospheric lifetimes of 2-NBA that are in the order of a few minutes, relative to photolysis, or a few hours, relative to oxidation by OH radicals.

Graphical abstract

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Bleomycin-induced chromosomal damage and shortening of telomeres in peripheral blood lymphocytes of incident cancer patients

Abstract

Disruption of genomic integrity due to deficient DNA repair capacity and telomere shortening constitute hallmarks of malignant diseases. Incomplete or deficient repair of DNA double-strand breaks (DSB) is manifested by chromosomal aberrations (CAs) and their frequency reflects inter-individual differences of response to exposure to mutagenic compounds. In this study, we investigated chromosomal integrity in peripheral blood lymphocytes (PBL) from newly diagnosed cancer patients, including 47 breast (BC) and 44 colorectal cancer (CRC) patients and 90 matched healthy controls. Mutagen sensitivity was evaluated by measuring chromatid breaks (CTAs) induced by bleomycin and supplemented by the chemiluminescent measurement of γ-H2AX phosphorylation in 19 cancer patients (11 BC, 8 CRC). Relative telomere length (RTL) was determined in 22 BC, 32 CRC and 64 controls. We observed statistically significant increased level of CTAs (p=0.03) and increased percentage of aberrant cells (ACs) with CTAs (p=0.05) in CRC patients compared to controls after bleomycin treatment. No differences were observed between BC cases and corresponding controls. CRC and BC patients with shorter RTL (below median) exhibited significantly higher amount of ACs (p=0.02), CTAs (p=0.02) and cells with high frequency of CTAs (≥12 CTAs/PBL; p=0.03) after bleomycin treatment. No such associations were observed in healthy controls. γ-H2AX phosphorylation after bleomycin treatment in PBL did not differ between CRC and BC patients. Our results suggest that altered DSB repair measured by sensitivity towards mutagen in PBL occurs particularly in CRC carcinogenesis. Irrespective of cancer type, telomere shortening may be associated with a decreased capacity to repair DSB. This article is protected by copyright. All rights reserved.

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Food protein-induced enterocolitis syndrome by fish: Not necessarily a restricted diet

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow′s milk or soy. Recent researches show that fish is one of the most important triggers of FPIES in the Mediterranean countries. Due to the risk of multiple-food-FPIES, avoiding foods in the same category or that often occur together may be reasonable.

The aim of this study was to evaluate the evolution and follow-up of FPIES related to fish over a period of 20 years. We describe the clinical features of our population, discuss different approaches to oral food challenges and analyse the possibility of introducing the culprit fish or other non-related fish in order to avoid unnecessary restricted diets.

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The longitudinal impact of Probiotic and Peanut Oral Immunotherapy (PPOIT) on health related quality of life (HRQL)

Abstract

Background

We previously reported that Probiotic and Peanut Oral Immunotherapy (PPOIT) was effective at inducing sustained unresponsiveness compared with placebo in a double-blind, placebo-controlled randomized trial. This study evaluated the impact of PPOIT on health related quality of life (HRQL).

Method

Fifty-one participants (PPOIT 24; Placebo 27) from the PPOIT trial completed Food Allergy Quality of Life Questionnaire (FAQLQ-PF) and Food Allergy Independent Measure (FAIM) at pre-treatment, end-of-treatment and 3-months after end-of-treatment. 42 participants (20 PPOIT; 22 Placebo) completed measures at 12 months post-treatment. Changes over time in PPOIT and Placebo groups were examined by repeated measures analysis of variance and paired t-tests.

Results

PPOIT was associated with significant improvement in FAQLQ-PF (F=3.63, p=0.02), with Mean Difference 0.8 at 3 months post-treatment (p=0.05) and 1.3 at 12 months post-treatment (p=0.005), exceeding the 0.5 minimal clinically important difference for FAQLQ-PF. For FAIM, mean difference was 0.5 (p=0.03) at 3 months and 0.4 (p=0.04) at 12 months. In placebo group, post-treatment FAQLQ and FAIM remained unchanged from pre-treatment. Improvement in FAQLQ-PF and FAIM scores related specifically to acquisition of sustained unresponsiveness rather than to receiving PPOIT treatment or participation in the trial.

Conclusions

PPOIT has a sustained beneficial effect on psychosocial impact of food allergy at 3 months and 12 months after end-of-treatment. Treatment was not associated with reduced HRQL relative to baseline in either PPOIT or placebo groups, indicating that PPOIT was well tolerated and psychological wellbeing was not negatively impacted. Improved HRQL was specifically associated with acquisition of sustained unresponsiveness.

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Different Functional Genes of Upper Airway Microbiome Associated with Natural Course of Childhood Asthma

Summary

Background

Microbial colonization of the airway plays a role in the pathogenesis of asthma; however, the effect of the upper airway microbiome on childhood asthma is not fully understood. We analyzed the metagenome of airway microbiome to understand the associated role of upper airway microbiome with the natural course of childhood asthma.

Methods

Nasopharyngeal swabs were collected from children with asthma, those in asthma remission, and control groups. High-throughput sequencing was used to examine the structure and functional dynamics of the airway microbiome with respect to asthma phenotypes.

Results

The composition of microbiota differed among healthy control, asthma, and remission groups. The relative abundance of Streptococcus was negatively associated with FEV_1% predicted (p = 0.023), and that of Staphylococcus was negatively associated with methacholine PC₂₀ (p = 0.013). Genes related to arachidonic acid metabolites, lysine residues, and glycosaminoglycans in the microbiome could be associated with airway inflammation. In particular, genes related to synthesis of anti-inflammatory prostaglandin E2 were not detected from the airway microbiome in the asthma group.

Conclusions

These data suggest that alterations in the composition and function of the upper airway microbiome could be related with the natural course of asthma in children.

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Pulmonary Langerhans cell histiocytosis “de novo” after lung transplantation

A pulmonary Langerhans cell histiocytosis is presented in a 40 year-old woman two years after bilateral lung transplantation for emphysema without any signs of Langerhans cells proliferation in the explanted lungs. A microsatellite molecular analysis showed the proliferating cells were generated in a recipient cellular clone. The patient did not quit smoking after transplantation. No signs of disease were detected in the implanted lungs before surgery. Strict control of immunosupressive drug levels stabilized the disease. A "de novo" monoclonal origin of stem cells, probably from the bone marrow is suggested. The reason she did not develop disease in the native lungs is unknown, although we suggest an interaction between tobacco or some other antigens and local cellular receptors.

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Binaural integration: a challenge to overcome for children with hearing loss.

Purpose of review: Access to bilateral hearing can be provided to children with hearing loss by fitting appropriate hearing devices to each affected ear. It is not clear, however, that bilateral input is properly integrated through hearing devices to promote binaural hearing. In the present review, we examine evidence indicating that abnormal binaural hearing continues to be a challenge for children with hearing loss despite early access to bilateral input. Recent findings: Behavioral responses and electrophysiological data in children, combined with data from developing animal models, reveal that deafness in early life disrupts binaural hearing and that present hearing devices are unable to reverse these changes and/or promote expected development. Possible limitations of hearing devices include mismatches in binaural place, level, and timing of stimulation. Such mismatches could be common in children with hearing loss. One potential solution is to modify present device fitting beyond providing audibility to each ear by implementing binaural fitting targets. Summary: Efforts to better integrate bilateral input could improve spatial hearing in children with hearing loss. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Πέμπτη 19 Οκτωβρίου 2017

Butyrate promotes visceral hypersensitivity in an IBS-like model via enteric glial cell-derived nerve growth factor

Abstract

Background

Altered visceral sensation is common in irritable bowel syndrome (IBS) and nerve growth factor (NGF) participates in visceral pain development. Sodium butyrate (NaB) could induce colonic hypersensitivity via peripheral up-regulation of NGF in animals. Enteric glial cells (EGCs) appear to be an important source of NGF. Whether butyrate could induce visceral hypersensitivity via increased EGC-derived NGF is still unknown.

Methods

CRL-2690 cells were used for transcriptome analyses after butyrate treatment. Rats received butyrate enemas to induce colonic hypersensitivity. Colorectal distention test was performed to assess visceral sensitivity. Immunofluorescence studies were used to evaluate the co-expression of glial fibrillary acidic protein (GFAP) and NGF or growth associated protein 43 in animal model. NGF expression in rat colon was also investigated. In vitro, CRL-2690 cells were stimulated with NaB or trichostatin A (TSA). NGF or GFAP expression was also examined.

Key Results

Transcriptome analyses showed that butyrate induced marked changes of genes expression related to neurotrophic signaling pathways. NaB-treated rats showed increased visceral sensitivity. An improved NGF expression level was observed in NaB-treated rats. Meanwhile, a 2.1-fold increase in co-expression of GFAP and NGF was also determined in rats received NaB enemas. In cultured cells, both NaB and TSA treatment could cause obvious NGF expression. Thus, butyrate might regulate EGC function via histone deacetylase inhibition.

Conclusions & Inferences

Butyrate-EGC interplay may play a pivotal role in regulation of NGF expression and the development of colonic hypersensitivity in IBS-like animal model.

Our study illustrated that butyrate promoted the secretion of NGF from enteric glial cells (EGCs) and contributed to visceral hypersensitivity in rats. The results clarified the potential unignorable source of NGF from EGC and highlighted the important role of EGC in pathogenesis of irritable bowel syndrome (IBS).

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Association of imbalance of effector T cells and regulatory cells with the severity of asthma and allergic rhinitis in children

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Evaluation of beclomethasone dipropionate (80 and 160 micrograms/day) delivered via a breath-actuated inhaler for persistent asthma

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Αρχειοθήκη ιστολογίου

Παρασκευή 20 Οκτωβρίου 2017

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Πέμπτη 19 Οκτωβρίου 2017

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