Medicine by Sfakianakis G. Alexandros: 12/01/18

Saturday, December 1, 2018

The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.

The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.

Acta Otorhinolaryngol Ital. 2018 Nov 09;:

Authors: Re M, Gioacchini FM, Scarpa A, Cassandro C, Tulli M, Cassandro E

Abstract
The aim of this study was to systematically review publications that investigated the prognostic role of E-cadherin immunostaining in patients affected by laryngeal squamous cell carcinoma. An appropriate string was run on PubMed to retrieve articles dealing with this topic. A double cross-check was performed on citations and full-text articles by two authors independently to analyse all manuscripts and perform a comprehensive quality assessment. Among 89 abstracts identified, 13 articles were included. These studies reported on 1,121 patients with histologically confirmed diagnosis of laryngeal squamous cell carcinoma. Overall, there were 10 studies that showed a significant correlation between E-cadherin immunohistochemical expression and at least one of the clinical and histopathological parameters considered by the authors. In particular E-cadherin expression was significantly associated with N stage (five studies), grading (four studies) and disease-free survival/disease-specific survival (six studies). In conclusion, the findings of our review appear similar to the results published by other authors on the putative role of E-cadherin in progression of malignancy. In fact, for laryngeal squamous cell carcinoma it seems that lower levels of E-cadherin correlate with increased tumoural aggressiveness and worse prognosis. Nevertheless, further high-quality prospective studies should be carried out to clarify if E-cadherin expression may be considered as an independent prognostic factor for patients affected by laryngeal cancer.

PMID: 30499566 [PubMed - as supplied by publisher]

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Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.

Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):476-479

Authors: Testani E, De Corso E, Losurdo A, Fiorita A, Vollono C, Marca GD, Scarano E

Abstract
Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCO2, which decreased from 52.3 mmHg before surgery to 42.0 mmHg after surgery. It is conceivable that, due to long-lasting severe OSAS, our patient lowered his chemosensitivity to PCO2. Consequently, the resolution of obstructive apnoeas and the restoration of normal nocturnal values of PCO2 may have reduced the nocturnal PCO2 to the point of being inadequate to stimulate ventilation.

PMID: 30498277 [PubMed - in process]

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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.

Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):468-475

Authors: Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH

Abstract
Hearing preservation surgery constitutes a considerable branch of cochlear implantation surgery and is being steadily developed and perfected. The aim of the study was to verify if insertion of a cochlear implant electrode according to individually calculated linear insertion depth improves hearing preservation. We evaluated the relations between the size of a cochlea, insertion depth angle, linear insertion depth and hearing preservation rate (HP) according to Hearing Preservation Classification in a retrospective case review of 54 patients implanted with a slim straight electrode Nucleus CI422 in 2008-2011. Group HP was 0.75 at activation, 0.67 at 12 months (for 53 patients) and 0.60 at 24 months. In 53 cases, the mean insertion depth angle was 375° (SD 17°); mean calculated cochlear duct length 35.87 mm (SD 1.95); mean calculated linear insertion depth 23.14 mm (SD 1.68). There was no significantly relevant relation between HP values and angular insertion depth or insertion depth. Preoperative measurements of cochlea and specific parameters such as linear insertion depth have no effect on hearing preservation. Poor hearing preservation in some deep insertion cases cannot be explained entirely by the electrode position.

PMID: 30498276 [PubMed - in process]

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Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.

Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):460-467

Authors: Casani AP, Guidetti G, Schoenhuber R, Consensus Conference Group

Abstract
Ménière's disease is a disorder of the inner ear that causes vertigo, tinnitus, fullness and hearing loss. Although several treatments are available, the success rate is reported to be around 70%, similar to placebo. Betahistine, a weak H1 receptor agonist and an effective H3 receptor antagonist, is frequently prescribed for Ménière's disease, especially to reduce recurrent vertigo attacks. The effects of this drug on hearing and other audiological symptoms remains unclear. Given the inconclusive reports in the literature, we proposed a consensus conference on the use of betahistine in Ménière's disease. The aim was to define best practice criteria for therapy for Ménière's disease, improve clinical suitability and reduce heterogeneity of the therapeutic approach. The consensus conference on betahistine for Ménière's disease involved a group of Italian experts in vestibular disorders who were asked a series of questions prepared by opinion leaders. The Delphi method, an iterative investigation method, was used to increase consensus. Via a tele-voting system, each participant anonymously evaluated all statements using a Likert 5-point scale. Betahistine was considered useful for the treatment of dizziness and vertigo during the intercritical phase of the disease (87% agreeing answers). However, during the acute phase of the disease betahistine was considered less effective and useful only when associated with other drugs (71% agreement). Similarly, the efficacy of the drug was considered low when used to reduce progressive hearing loss, tinnitus, and ear fullness. The experts advocated the use of betahistine during the intercritical phase of Ménière's disease to reduce the number and severity of vertigo attacks. Its use seems to be at low risk of major side effects.

PMID: 30498275 [PubMed - in process]

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Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.

Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):453-459

Authors: Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M

Abstract
The present study aims to obtain a probability model allowing prediction of auditory recovery in patients affected by sudden sensorineural hearing loss treated exclusively with intratympanic steroids. A monocentric retrospective chart review of 381 patients has been performed. A Probit model was used to investigate the correlation between the success of treatment (marked or total recovery according to Furuashi's criteria) and the delay between onset of disease and beginning of therapy. The age of patients and audiometric curve shapes were included in the analysis. The results show that delay is negatively correlated with variable success. Considering the entire sample, each day of delay decreases the probability of success by 3%. The prediction model shows that for each day that passes from the onset of the disease the probability of success declines in absence of the medical treatment, hence we conclude that early treatment is strongly recommended.

PMID: 30498274 [PubMed - in process]

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Cochlear implantation in far-advanced otosclerosis: hearing results and complications.

Cochlear implantation in far-advanced otosclerosis: hearing results and complications.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):445-452

Authors: Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D

Abstract
Severe forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, complications and hearing outcomes. FAO patients were diagnosed based on medical history, examination and CT scan. Thirty-five ears from FAO patients were compared to 38 control ears. Audiometric results were assessed at least 12 months after implantation by pure tone average, speech reception threshold, monosyllabic and disyllabic word recognition score (WRS) and Central Institute for the Deaf (CID) sentences test. Complications and surgical difficulties were compiled. CT scan findings were categorised within 3 grades of otosclerotic extension. No significant difference was found between FAO and non-FAO hearing outcomes, except that monosyllabic WRS were lower for FAO patients, especially those who underwent previous stapedotomy. Facial nerve symptomatology occurred in 8.6% of FAO patients; among these, one required explantation-reimplantation surgery. 86% of FAO implanted patients had retrofenestral extension on CT. These were associated with poorer disyllabic WRS (51% vs 68%, p < 0.05) than those with only fenestral involvement. Although not significant, high grade of severity on CT tended to be associated with surgical difficulties and complications. Cochlear implantation in FAO patients is an effective treatment technique. Though the overall complication rate is low, it tends to be higher in cases of severe extension on CT. Patient counselling should be adjusted accordingly.

PMID: 30498273 [PubMed - in process]

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Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.

Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):439-444

Authors: Procacci P, Lanaro L, Molteni G, Marchioni D, Lonardi F, Fusetti S, Nocini PF, Albanese M

Abstract
Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option.

PMID: 30498272 [PubMed - in process]

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The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.

The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):431-438

Authors: Bugova G, Janickova M, Uhliarova B, Babela R, Jesenak M

Abstract
Exposure to tobacco smoke is associated with a higher risk of respiratory tract diseases. The aim of this study was to determine the influence of passive smoking on selected characteristics of children with adenoid hypertrophy. Sixty-one children with adenoid hypertrophy were enrolled in the prospective study. Differences in bacterial colonisation of middle nasal meatus and nasopharynx and changes in selected laboratory immune and inflammatory markers according to the tobacco smoke exposure were analysed. Exposure to tobacco smoke was associated with significantly higher colonisation of pathogenic bacteria and polymicrobial growth of pathogenic bacteria (≥ 2 bacteria) in middle nasal meatus compared to non-exposed children (P = 0.045, P = 0.032, respectively). Identification of pathogenic bacteria in the middle nasal meatus did not correlate with isolation of pathogenic bacteria in the nasopharynx in either group of children. Parameters of humoral immunity in serum, IgA and IgG, were detected at higher concentrations in children exposed to tobacco smoke (P = 0.047, P = 0.031, respectively). Differences in selected parameters of cellular immunity in peripheral blood according to passive smoking were not observed. Tobacco smoke exposure is related to increased colonisation by pathogenic bacteria in middle nasal meatus and elevation of IgA and IgG in peripheral blood, but does not seem to influence markers of cellular immunity parameters in children with adenoid hypertrophy. Avoidance of passive smoking could be recommended as a universal preventive strategy against microbial colonisation of the upper airways and development of various inflammatory diseases in children, e.g. adenoid hypertrophy.

PMID: 30498271 [PubMed - in process]

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Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.

Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):424-430

Authors: Milovanovic J, Vukasinovic M, Jotic A, Vlajinac H, Milovanovic A, Pavlovic B, Banko B, Maksimovic J

Abstract
The aim of our study was to compare socio-demographic characteristics of vocal fold nodules, polyps and oedema. The study included patients diagnosed for the first time with vocal fold nodules, polyps and oedema at the Communication Disorders Care Center of Clinic for Otorhinolaryngology and Maxillofacial Surgery in Clinical Center of Serbia, Belgrade. Diagnosis was made on the basis of symptoms, clinical otorhinolaryngological and phoniatric examination and endovideolaryngostroboscopic findings. A self-administered questionnaire was used to collect the following data: socio-demographic status, exposure to occupational noise and air pollution, occupational voice demands, health habits, symptoms of the present voice problems and voice problems in the family. By multivariate logistic regression analyses, nodules and oedema were more frequent in women than men in comparison with polyps (p < 0.001). Patients with nodules and polyps were younger than those with oedema (p < 0.001). Patients with nodules were more frequently lecturers, singers and actors compared with polyp patients (p = 0.006), had occupational voice demands more frequently than patients with oedema (p = 0.037) and were less frequently smokers than patients with polyps (p = 0.043) and those with oedema (p < 0.001). Patients with oedema were more frequently current smokers than patients with nodules and those with polyps (p < 0.001). Hoarseness as the main symptom was more frequent among patients with nodules than among patients with polyps (p = 0.040) and those with oedema (p = 0.001).Voice problems in the family was more frequently reported by oedema patients than by patients with polyps (p = 0.005). These findings are in agreement with majority of previous studies and may be of help in investigations on the aetiology of the disease.

PMID: 30498270 [PubMed - in process]

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Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.

Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):417-423

Authors: Fiz I, Koelmel JC, Piazza C, Fiz F, Di Dio D, Bittar Z, Peretti G, Sittel C

Abstract
Idiopathic progressive subglottic stenosis is a rare cause of tracheal narrowing. Partial cricotracheal resection and anastomosis can cure idiopathic stenosis, even if some patients may require multiple interventions and experience voice and swallowing deterioration. We investigated risk factors for retreatment and assessed the impact of crico-tracheal resection on functional parameters. We conducted a retrospective multicentric study on 44 female patients (mean age 52.6 ± 13.1 years) affected by idiopathic stenosis and treated by crico-tracheal resection between 2002 and 2016. Functional outcomes after crico-tracheal resection were assessed by the airway-dyspnoea-voice-swallowing score (range 1-5, with "1" expressing normal and "5" completely altered function). Previous treatments, grade of stenosis, site, airway comorbidities, age and resection length were tested as predictors of postoperative complications and number of additional treatments, using bivariate and multivariate analysis. The overall decannulation rate was 97.3%. The dyspnoea score improved (mean variation 1.4 ± 1.0; p < 0.001), while voice and swallowing were negatively affected (mean variation 1.6 ± 0.9 and 0.5 ± 0.7, respectively; p < 0.001). Airway comorbidities were associated with a higher rate of complications (p < 0.05). Retreatments were more frequent in patients with postoperative complications (p < 0.05). The length of resection correlated with the number of subsequent treatments (R = 0.52; p < 0.01). At multivariate analysis, post-operative complications were predicted by comorbidities and disease stage (p < 0.05); number of retreatments was linked to the length of resection (p < 0.05) as well as with the application of mitomycin C (p < 0.001). Crico-tracheal resection for idiopathic progressive subglottic stenosis offers good functional results in terms of airway patency. These data suggest that a higher complication rate can be expected in patients affected by comorbidities. Moreover, more extensive surgical resection seems to be associated with the occurrence and number of subsequent retreatments. On the contrary, the local application of an anti-proliferative drug does not seem to be of use in preventing recurrences.

PMID: 30498269 [PubMed - in process]

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Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.

Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):399-408

Authors: Staderini E, Patini R, De Luca M, Gallenzi P

Abstract
The aim of this systematic review is to analyse the quality and clinical evidence in the literature analysing, through 3D stereophotogrammetry, the nasolabial soft tissue modifications that may occur after rapid maxillary expansion (RME). This systematic literature review was based on the PRISMA-P statement and was registered in the PROSPERO database with the following protocol ID: CRD42017079875. Pubmed, Cochrane, EBSCO, Scopus, Web of Science databases were searched with no restriction of year or publication status. Selection criteria were: randomised clinical trials, controlled clinical trials, cohort studies, cross-sectional studies, case-control studies on patients with unilateral/bilateral crossbite, transverse maxillary deficiency and crowding, treated with RME and monitored by 3D stereophotogrammetry. 652 articles were retrieved in the initial search. After the review process, 11 full-text articles met inclusion criteria. After the evaluation process, 4 publications were included for the present literature review. Due to the heterogeneous methodology meta-analysis was not possible; consequently, a systematic assessment of the studies and summary of the findings from the available evidence were used to answer the research question. The maximum widening of the alar cartilage is 1.41 ± 0.95 mm, whose clinical significance is open to question. The effect of RME on the mouth width remains controversial. In Altindis et al., the difference between pre-treatment and post-treatment mouth width (1.80 mm increment in the banded RME group) was statistically significant, while in Baysal 1.86 mm was considered a non-significant value. Inconsistencies and limitations in the study population and measurement protocols were detected between studies. These data underline the necessity for updated guidelines that allow to standardise, for this type of study, sample selection, measurement methods and collection of results.

PMID: 30498268 [PubMed - in process]

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The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.

The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.

Acta Otorhinolaryngol Ital. 2018 Nov 09;:

Authors: Re M, Gioacchini FM, Scarpa A, Cassandro C, Tulli M, Cassandro E

PMID: 30499566 [PubMed - as supplied by publisher]

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Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.

Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):476-479

Authors: Testani E, De Corso E, Losurdo A, Fiorita A, Vollono C, Marca GD, Scarano E

PMID: 30498277 [PubMed - in process]

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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.

Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):468-475

Authors: Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH

PMID: 30498276 [PubMed - in process]

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Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.

Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):460-467

Authors: Casani AP, Guidetti G, Schoenhuber R, Consensus Conference Group

PMID: 30498275 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2DWmSMA

Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.

Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):453-459

Authors: Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M

PMID: 30498274 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2FSAP0F

Cochlear implantation in far-advanced otosclerosis: hearing results and complications.

Cochlear implantation in far-advanced otosclerosis: hearing results and complications.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):445-452

Authors: Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D

PMID: 30498273 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2rfWBRF

Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.

Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):439-444

Authors: Procacci P, Lanaro L, Molteni G, Marchioni D, Lonardi F, Fusetti S, Nocini PF, Albanese M

PMID: 30498272 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2DWmPjS

The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.

The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):431-438

Authors: Bugova G, Janickova M, Uhliarova B, Babela R, Jesenak M

PMID: 30498271 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2QwqviO

Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.

Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):417-423

Authors: Fiz I, Koelmel JC, Piazza C, Fiz F, Di Dio D, Bittar Z, Peretti G, Sittel C

PMID: 30498269 [PubMed - in process]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2rcjqWs

Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.

Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):399-408

Authors: Staderini E, Patini R, De Luca M, Gallenzi P

PMID: 30498268 [PubMed - in process]

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Comparing serum levels of zinc, copper, certain antioxidant vitamins and dietary intakes in acute lymphoblastic leukemia (ALL) patients before and after chemotherapy.

Comparing serum levels of zinc, copper, certain antioxidant vitamins and dietary intakes in acute lymphoblastic leukemia (ALL) patients before and after chemotherapy.

Am J Blood Res. 2018;8(3):21-28

Authors: Akhgarjand C, Djafarian K, Rezvani H, Azargashb E, Vafa M

Abstract
Acute lymphoblastic leukemia (ALL) is a malignant hematologic disease. Cancer and its treatments can affect biological functions and change the nutritional status of patients. Zinc and copper are important cofactors for several enzymes and play an important role in maintaining the integrity of DNA. In ALL, we have oxidative conditions in the body that can cause oxidative damage to lipids and the production of malondialdehyde (MDA). So that the aim of this study is comparing serum levels of copper, zinc and inflammation before and after chemotherapy. Thirty ALL patients between 15 to 65 years old participated in this study. A blood sample of 10 cc was taken before and after eight course of chemotherapy. We observed a significant increase in serum zinc as well as a significant decrease in serum copper, vitamin D and Malondialdehyde. We have not seen any significant differences in hs-CRP after chemotherapy. These changes might be due to chemotherapy and changing lifestyle of patients toward healthy eating nutrition and serum vitamin D get worse and because of sedentary life style in these patients there is an essential need to anthropometric measurements during treatment.

PMID: 30498622 [PubMed]

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An isolated der(1;21)(q10;q10) translocation in a patient with myelodysplastic syndrome: a case report.

An isolated der(1;21)(q10;q10) translocation in a patient with myelodysplastic syndrome: a case report.

Am J Blood Res. 2018;8(3):17-20

Authors: Manabe M, Tamagaki G, Shimizu K, Michimoto K, Hagiwara Y, Asada R, Momose D, Sugano Y, Mazaki T, Koh KR

Abstract
Whole-arm translocations are relatively rare among hematological malignancies. There are a few reports on myeloid malignancies harboring der(1;21)(q10;q10). A 65-year-old male was referred to our hospital due to squamous cell carcinoma of the lung. Pembrolizumab monotherapy resulted in progression, and so chemotherapy involving nab-paclitaxel and carboplatin was administered thereafter. The patient developed cytopenia, and his bone marrow exhibited dysplasia. Chromosomal analysis revealed a whole-arm translocation, der(1;21)(q10;q10). Thus, the patient was diagnosed with myelodysplastic syndrome. The der(1;21)(q10;q10) translocation is a rare variant of the der(1;7)(q10;p10) translocation, which is an adverse prognostic factor for myeloid neoplasms. Clarifying the clinical features of myeloid neoplasms in patients with der(1;21)(q10;q10) would facilitate the elucidation of their tumorigenic mechanisms.

PMID: 30498621 [PubMed]

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Clinical features of laryngeal myasthenia gravis: A case series.

Clinical features of laryngeal myasthenia gravis: A case series.

Am J Otolaryngol. 2018 Nov 05;:

Authors: Yang X, Niu L, Yang C, Wang L, Liu J, He G

Abstract
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease. Dysarthria, dysphagia, and difficulty swallowing as exclusive initial and primary complaints in MG (laryngeal MG) are rare and seldom reported.
METHODS: Here we review and analyze the largest series of laryngeal MG patients.
RESULTS: A total of 30 patients with laryngeal MG as primary manifestation were found in 20 case reports/series. Dysarthria was the most frequent primary symptom (14/30), followed by dysphagia (11/30), slurred speech (4/30) and dysphonia (1/30). Sixty-three percent visited the otolaryngology department first. Only 23.33% of patients were diagnosed with MG at the first clinic visit. Forty-five percent laryngeal MG patients were acetylcholine receptor (AChR) antibody positive, 52.9% showed decremental response in the repetitive nerve stimulation (RNS) test, and 92.6% were positive in the neostigmine/edrophonium test. Fluctuating weakness was examined in 16 of 30 patients and observed in 14/16 patients.
CONCLUSION: Laryngeal MG is a rare and possibly under-diagnosed condition. The patients can present with dysarthria, dysphagia, or difficulty swallowing. Fluctuation in severity of disease by neostigmine/edrophonium test is a typical feature for MG patients. AChR antibody and RNS tests should be included to evaluate the pathologic changes in the neuromuscular junction.

PMID: 30497698 [PubMed - as supplied by publisher]

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Oral benign neoplasms: A retrospective study of 790 patients over a 14-year period.

Oral benign neoplasms: A retrospective study of 790 patients over a 14-year period.

Acta Otorrinolaringol Esp. 2018 Nov 26;:

Authors: da Silva LAB, Monroy EAC, Serpa MS, de Souza LB

Abstract
INTRODUCTION AND OBJECTIVE: Oral benign neoplasms (OBNs) exhibit some features that can guide the professionals to the correct diagnosis and best treatment. Through retrospective studies, medical records can be reviewed to better describe a given population and, furthermore, help clinicians in routine practice. In this context, the objective of this paper was to analyze the cases of OBNs of an oral pathology referral department, from 2003 to 2017, in order to better understand their epidemiological and clinicopathological characteristics.
METHODS: A total of 8355 histopathological reports were analyzed. Lesions diagnosed as OBNs were selected and the following variables were recorded: gender, age, histological type of the lesion, anatomical location, rate and pattern of growth, type of base, color, symptomatology and diagnostic hypotheses on clinical examination.
RESULTS: OBNs represented 9.4% of all lesions diagnosed. The most frequent histopathological types were fibroma (39.9%), papilloma (22%), fibroblastoma (13.1%), lipoma (10.2%) and hemangioma (6.1%). Overall, most cases affected females (n=518; 65.6%) and in the fifth decade of life (n=148; 18.7%). The oral mucosa was the most common site (n=265; 33.5%). The most common features of each OBN were also highlighted.
CONCLUSION: The most common OBNs were fibroma, papilloma, fibroblastoma, lipoma and hemangioma. Overall, the OBN presented common clinical features; however, in particular cases, there are some characteristics that can lead the professionals to the correct diagnosis. Nevertheless, in general, histopathological analysis must be performed to confirm diagnosis. Intraosseous tumors and large lesions may require imaging tests to help diagnosis.

PMID: 30497661 [PubMed - as supplied by publisher]

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Highlights and recent developments in airway diseases in EAACI journals (2017).

Highlights and recent developments in airway diseases in EAACI journals (2017).

Clin Transl Allergy. 2018;8:49

Authors: Bousquet J, Akdis CA, Grattan C, Eigenmann PA, Hoffmann-Sommergruber K, Hellings PW, Agache I

Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2017 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidies, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and metaanalyses have been the highlights of the last year.

PMID: 30498567 [PubMed]

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Role of PET imaging in adaptive radiotherapy for lymphoma.

Role of PET imaging in adaptive radiotherapy for lymphoma.

Q J Nucl Med Mol Imaging. 2018 Dec;62(4):411-419

Authors: Urwin R, Barrington SF, Mikhaeel NG

Abstract
Positron emission tomography/Computed tomography (PET/CT) is an essential part of modern radiotherapy for patients with lymphoma. PET/CT can be used to adapt treatment algorithms in Hodgkin lymphoma, reserving consolidation radiotherapy for patients with residual fluoro-D-glucose (FDG) avidity after treatment with intensive chemotherapy such as escalated BEACOPP and limiting the need for radiotherapy for some patients with complete metabolic response on PET if radiotherapy may be associated with increased toxicity. More importantly, PET/CT is now mandatory to define sites of initial disease for radiotherapy planning where smaller volumes are to be used rather than historical extended field treatments, such as mantle radiotherapy or even involved field radiotherapy. Involved node radiotherapy (INRT) treats only the initially involved nodes and is possible when the pretreatment PET/CT scan has been performed in the radiotherapy treatment position. Involved site radiotherapy (ISRT) builds in a margin for uncertainty when a pretreatment PET/CT is available, but has not been performed in the radiotherapy treatment position. Studies suggest that PET/CT changes radiotherapy volumes in approximately one third of patients by mapping the extent of initial disease better than using CT alone. PET/CT has also been used to adjust radiotherapy dose for patients who may be at increased risk of radioresistance, by virtue of residual FDG avidity post chemotherapy or patients with relapsed disease. This article will discuss the role of PET in selecting patients for radiotherapy, its influence on the choice of target volume and radiotherapy dose and the practicalities of how PET/CT scanning is incorporated into the radiotherapy planning process.

PMID: 30497233 [PubMed - in process]

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Molecular PET imaging in adaptive radiotherapy: brain.

Molecular PET imaging in adaptive radiotherapy: brain.

Q J Nucl Med Mol Imaging. 2018 Dec;62(4):337-348

Authors: Peyraga G, Robaine N, Khalifa J, Cohen-Jonathan-Moyal E, Payoux P, Laprie A

Abstract
INTRODUCTION: Owing to their heterogeneity and radioresistance, the prognosis of primitive brain tumors, which are mainly glial tumors, remains poor. Dose escalation in radioresistant areas is a potential issue for improving local control and overall survival. This review focuses on advances in biological and metabolic imaging of brain tumors that are proving to be essential for defining tumor target volumes in radiation therapy (RT) and for increasing the use of DPRT (dose painting RT) and ART (adaptative RT), to optimize dose in radio-resistant areas.
EVIDENCE ACQUISITION: Various biological imaging modalities such as PET (hypoxia, glucidic metabolism, protidic metabolism, cellular proliferation, inflammation, cellular membrane synthesis) and MRI (spectroscopy) may be used to identify these areas of radioresistance. The integration of these biological imaging modalities improves the diagnosis, prognosis and treatment of brain tumors.
EVIDENCE SYNTHESIS: Technological improvements (PET and MRI), the development of research, and intensive cooperation between different departments are necessary before using daily metabolic imaging (PET and MRI) to treat patients with brain tumors.
CONCLUSIONS: The adaptation of treatment volumes during RT (ART) seems promising, but its development requires improvements in several areas and an interdisciplinary approach involving radiology, nuclear medicine and radiotherapy. We review the literature on biological imaging to outline the perspectives for using DPRT and ART in brain tumors.

PMID: 30497232 [PubMed - in process]

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"Ann Vasc Surg"[jour]; +35 new citations

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Olfactory ensheathing cells in facial nerve regeneration.

Olfactory ensheathing cells in facial nerve regeneration.

Braz J Otorhinolaryngol. 2018 Aug 07;:

Authors: Li M, Zhu Q, Liu J

Abstract
INTRODUCTION: Olfactory ensheathing cell is a unique kind of glia cells, which can promote axon growth. Little is known about the differences between olfactory mucosa-olfactory ensheathing cells and olfactory bulb-olfactory ensheathing cells in the capability to promote nerve regeneration.
OBJECTIVE: To study the recovery of the rat facial nerve after olfactory ensheathing cell transplantation, and to compare the differences between the facial nerve regeneration of olfactory mucosa-olfactory ensheathing cells and olfactory bulb olfactory bulb-olfactory ensheathing cells transplantation.
METHODS: Institutional ethical guideline was followed (201510129A). Olfactory mucosa-olfactory ensheathing cells and olfactory bulb-olfactory ensheathing cells were cultured and harvested after 7 days in vitro. 36 Sprague Dawley male rats were randomly divided into three different groups depending on the transplanting cells: Group A, olfactory mucosa-olfactory ensheathing cells; Group B, olfactory bulb-olfactory ensheathing cells; Group C, DF-12 medium/fetal bovine serum. The main trunk of the facial nerve was transected and both stumps were inserted into a polylactic acid/chitosan conduit, then the transplanted cells were injected into the collagen in the conduits. After 4 and 8 weeks after the transplant, the rats of the three groups were scarified and the facial function score, facial nerve evoked potentials, histology analysis, and fluorescent retrograde tracing were tested and recorded, respectively, to evaluate the facial nerve regeneration and to analysis the differences among the three groups.
RESULTS: Olfactory ensheathing cells can promote the facial nerve regeneration. Compared with olfactory bulb-olfactory ensheathing cells, olfactory mucosa-olfactory ensheathing cells were more effective in promoting facial nerve regeneration, and this difference was more significant 8 weeks after the transplantation than 4 weeks.
CONCLUSION: We discovered that olfactory ensheathing cells with nerve conduit could improve the facial nerve recovery, and the olfactory mucosa-olfactory ensheathing cells are more effective for facial nerve regeneration compared with olfactory bulb-olfactory ensheathing cells 8 weeks after the transplantation. These results could cast new light in the therapy of facial nerve defect, and furnish the foundation of auto-transplantation of olfactory mucosa-olfactory ensheathing cells in periphery nerve injury.

PMID: 30497873 [PubMed - as supplied by publisher]

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Fully endoscopic microvascular decompression for hemifacial spasm.

Fully endoscopic microvascular decompression for hemifacial spasm.

J Neurosurg. 2018 Oct 01;:1-7

Authors:

Abstract
OBJECTIVEHemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment.METHODSThe authors conducted a single-center retrospective study of 27 patients (28 separate E-MVD cases; 1 patient had bilateral E-MVD) diagnosed with HFS who underwent fully E-MVD from January 2013 to October 2016. Intraoperative brainstem auditory evoked potentials and lateral spread resolution were reviewed. Outcome was based on the clinical status of the patient at the last contact point with the senior author. Complications were categorized as facial weakness, hearing loss, ataxia, dysphagia, or any adverse event able to be attributed to the surgical procedure.RESULTSHFS was relieved either completely or partially in the majority of cases (24 of 28, 85.7%). Of the 28 separate procedures, 17 (60.7%) resulted in complete resolution of symptoms, 4 (14.3%) resulted in near-complete resolution, 2 (7.1%) resulted in 50% reduction of symptoms, 1 (3.6%) resulted in minimal reduction, and 4 (14.3%) resulted in no relief. Of the 27 patients, 26 (96%) had no permanent postoperative complications. In multivariate logistic regression, the best predictor of greater than 50% resolution of spasm was resolution of intraoperative lateral spread response.CONCLUSIONSA fully E-MVD for HFS provides a safe and comprehensive view of the neurovascular conflict. Exclusive use of the endoscope in MVD is both safe and feasible in the treatment of HFS. Attention to lateral spread response monitoring remains an integral part of comprehensive neurosurgical management.

PMID: 30497190 [PubMed - as supplied by publisher]

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Rest and the End of Life.

Rest and the End of Life.

J Am Geriatr Soc. 2018 Nov 29;:

Authors: Petriceks AH

PMID: 30499200 [PubMed - as supplied by publisher]

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A Sister's Sacrifice.

A Sister's Sacrifice.

J Am Geriatr Soc. 2018 Nov 29;:

Authors: Kitzman DW

PMID: 30499102 [PubMed - as supplied by publisher]

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Efficacy and tolerability of olive oil-based ketogenic diet in children with drug-resistant epilepsy: A single center experience from Turkey.

Efficacy and tolerability of olive oil-based ketogenic diet in children with drug-resistant epilepsy: A single center experience from Turkey.

Eur J Paediatr Neurol. 2018 Nov 20;:

Authors: Guzel O, Uysal U, Arslan N

Abstract
PURPOSE: Ketogenic diet (KD) is an effective non-pharmacological treatment for drug-resistant epilepsy. The aim of this study was to investigate the efficacy, tolerability and complications of olive oil-based KD in epileptic children.
METHOD: In this single-center, prospective study, patients were followed up at 1, 3, 6 and 12 months after KD initiation. Initially, blood ketone levels were measured daily, and as needed thereafter to maintain the levels between 4 and 5 mmol/L. Patient demographics, seizure frequency, serum biochemistry, abdominal ultrasonography and adverse effects were recorded. Efficacy of KD was defined as ≥50% seizure reduction.
RESULTS: A total of 389 patients with drug-resistant epilepsy receiving KD from 2012 to 2016 were included. One hundred patients (25.7%) stopped the diet for different reasons in the first year, and 369, 314, 225 and 160 patients have been receiving KD treatment for 1, 3, 6 and 12 months, respectively. At 1, 3, 6 and 12th months, 65.8% (243/369), 74.7% (235/314), 70.6% (159/225) and 83.1% (133/160) of the patients were responders, respectively. None of the children had an increased seizure-frequency. Hyperlipidemia (50.8%), selenium deficiency (26.9%), constipation (26.2%), sleep disturbances (20.0%), nephrolithiasis (3.0%), hyperuricemia (3.0) and hepatic side effects (2.6%) were the most common complications of KD. Previous adrenocorticotropic hormone (ACTH) use due to epileptic encephalopathy and presence of constipation at baseline or during KD treatment were found the predictors of treatment efficacy.
CONCLUSION: KD is an effective and well-tolerated treatment option for patients with drug-resistant epilepsy. Previous history of ACTH use and constipation during KD treatment are important factors that affect the efficacy of KD treatment.

PMID: 30497921 [PubMed - as supplied by publisher]

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Molecular Modeling Studies of Halogenated Imidazoles against 14α-Demethylase from Candida albicans for treating Fungal Infections.

Molecular Modeling Studies of Halogenated Imidazoles against 14α-Demethylase from Candida albicans for treating Fungal Infections.

Infect Disord Drug Targets. 2018 Nov 29;:

Authors: Rani N, Kumar P, Singh R

Abstract
Imidazole is one of the most explored and marketed azole utilized for the treatment of fungal infections. Lanosterol 14α-demethylase (Cytochrome P450DM) is the active target site for azole antifungals. This study emphasized on evaluation of a series of halogenated imidazole analogues using molecular docking studies for anti-Candidal activity. Furthermore, the model was refined by molecular dynamic simulation. The imidazole analogues were prepared using Chem sketch and molecular docking was performed using Molergo Virtual Docker program and ADMET study was carried out by using Accelry's Accord for Excel programme. The docking study indicated that all the imidazole analogues (PS1-PS30) and standard drugs i.e., Ketoconazole, Miconazole and Clotrimazole possessed interaction with protein residue, heme cofactor and water molecule positioned above Heme cofactor of 14α-demethylase. Further, the ADMET study indicated that most of the halogenated imidazoles possessed good absorption, human intestinal absorption, aqueous solubility and blood brain penetration.

PMID: 30499421 [PubMed - as supplied by publisher]

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High-level aminoglycoside resistance in Enterococcus faecalis and Enterococcus faecium; as a serious threat in hospitals.

High-level aminoglycoside resistance in Enterococcus faecalis and Enterococcus faecium; as a serious threat in hospitals.

Infect Disord Drug Targets. 2018 Nov 29;:

Authors: Khodabandeh M, Mohammadi M, Abdolsalehi MR, Hasannejad-Bibalan M, Gholami M, Alvandimanesh A, Pournajaf A, Rajabnia R

Abstract
The present work aimed to evaluate the frequency of aminoglycoside-modifying enzymes encoding genes in the E. faecalis and E. faecium and their antibiotic resistance profile. A total of 305 different clinical samples were subjected for identification and antibiotic susceptibility test. High level aminoglycoside resistance was identified by MIC and Kirby Bauer disc diffusion method. The prevalence of aac (6')-Ie-aph (2'')-Ia, aph (3')-IIIa and ant (4')-Ia genes were determined by multiplex- PCR. In total 100 enterococci strains were isolated. The prevalence of E. faecalis and E. faecium isolates were 78% and 22%, respectively. All isolates were susceptible to linezolid. So, all E. faecalis were susceptible to vancomycin but, 36.4% of E. faecium were resistance to it. The prevalence of multiple drug resistance strains were 100% and 67.9% of E. faecium and E. faecalis, respectively. High-level-gentamicin and streptomycin resistant rates were as follows; 26.9% and 73.1% of E. faecalis and 77.3% and 90.1% of E. faecium. The results of the current study showed a high frequency of aac (6')-Ie-aph (2'')-Ia genes among enterococcal isolates. A high rate of resistance to antimicrobials in Enterococcus is obviously problematic, and a novel policy is needed to decrease resistance in these microorganisms.

PMID: 30499420 [PubMed - as supplied by publisher]

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What are the ethical obligations when a colleague has provided suboptimal care?

What are the ethical obligations when a colleague has provided suboptimal care?

J Am Dent Assoc. 2018 Dec;149(12):1081-1082

Authors: Burns JM

PMID: 30497577 [PubMed - in process]

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Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature.

Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature.

J Am Dent Assoc. 2018 Dec;149(12):1073-1080

Authors: Abdalla-Aslan R, Friedlander-Barenboim S, Aframian DJ, Maly A, Nadler C

Abstract
BACKGROUND AND OVERVIEW: Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings.
CASE DESCRIPTION: In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years.
CONCLUSIONS AND PRACTICAL IMPLICATIONS: This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.

PMID: 30497576 [PubMed - in process]

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Correction.

Correction.

J Am Dent Assoc. 2018 Dec;149(12):1010

Authors:

PMID: 30497575 [PubMed - in process]

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Correction.

Correction.

J Am Dent Assoc. 2018 Dec;149(12):1010

Authors:

PMID: 30497574 [PubMed - in process]

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Engaging clinicians in research.

Engaging clinicians in research.

J Am Dent Assoc. 2018 Dec;149(12):1007-1008

Authors: Gilbert GH, Cochran DL, Fellows JL, Gordan VV, Makhija SK, Meyerowitz C, Rindal DB

PMID: 30497573 [PubMed - in process]

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Distinguishing between law and ethics.

Distinguishing between law and ethics.

J Am Dent Assoc. 2018 Dec;149(12):1005-1006

Authors: Elster N, Elliott TC

PMID: 30497572 [PubMed - in process]

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Promoting the importance of oral health: where are our patients' voices?

Promoting the importance of oral health: where are our patients' voices?

J Am Dent Assoc. 2018 Dec;149(12):1003-1004

Authors: Glick M

PMID: 30497571 [PubMed - in process]

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Mitofusin-2 acts as biomarker for predicting poor prognosis in hepatitis B virus related hepatocellular carcinoma.

Mitofusin-2 acts as biomarker for predicting poor prognosis in hepatitis B virus related hepatocellular carcinoma.

Infect Agent Cancer. 2018;13:36

Authors: Wang X, Liu Y, Sun J, Gong W, Sun P, Kong X, Yang M, Zhang W

Abstract
Objective: To investigate the expression of Mitofusin-2 (MFN2) in HCC tissues and its role in the development of HCC.
Methods: A total of 107 HCC specimens were collected for tissue microarray analysis and immunohistochemistry (IHC) analysis. The relationship between MFN2 expression and clinical features of patients with HCC was analyzed.
Results: Expression level of MFN2 in HCC tissues was 0.92 ± 0.78, significantly lower than that of matched paracancerous liver tissues (1.25 ± 0.75). Patients with low expression of MFN2 had significantly higher rates of cirrhosis than those with high expression of MFN2 (P = 0.049). Kaplan-Meier survival analysis showed that HCC patients with low expression of MFN2 had a worse prognosis in overall survival than HCC patients with high expression of MFN2 (P = 0.027). Patients with high expression of MFN2 had a better prognosis in disease-free survival compared with HCC patients with low expression of MFN2 (P = 0.047). Vascular invasion and MFN2 expression were shown to be prognostic variables for overall survival in patients with HCC. Multivariate analysis showed that vascular invasion (P < 0.001) and MFN2 expression (P = 0.045) were independent prognostic factors for overall survival. Vascular invasion (P < 0.001) and MFN2 expression (P = 0.042) were independent risk factors associated with disease-free survival.
Conclusion: Our data revealed that MFN2 expression was decreased in HCC samples. High MFN2 expression was correlated with longer survival times in patients with HCC and served as an independent factor for better outcomes. Our study therefore provides a promising biomarker for the prognostic prediction of HCC and a potential therapeutic target for the disease.

PMID: 30498519 [PubMed]

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Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.

Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.

Acta Otorhinolaryngol Ital. 2018 Oct;38(5):424-430

Authors: Milovanovic J, Vukasinovic M, Jotic A, Vlajinac H, Milovanovic A, Pavlovic B, Banko B, Maksimovic J

PMID: 30498270 [PubMed - in process]

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Ablation of cancer stem cells by therapeutic inhibition of the MDM2-p53 interaction in mucoepidermoid carcinoma.

Ablation of cancer stem cells by therapeutic inhibition of the MDM2-p53 interaction in mucoepidermoid carcinoma.

Clin Cancer Res. 2018 Nov 29;:

Authors: Andrews A, Warner K, Rodriguez-Ramirez C, Pearson AT, Nör F, Zhang Z, Kerk S, Kulkarni AS, Helman JI, Brenner JC, Wicha MS, Wang S, Nör JE

Abstract
PURPOSE: Unique cells characterized by multipotency, self-renewal and high tumorigenic potential have been recently discovered in mucoepidermoid carcinomas (MEC). These cells are defined by high aldehyde dehydrogenase activity and high CD44 expression (ALDHhighCD44high) and function as cancer stem cells. It has been recently shown that p53 regulates cell differentiation, suggesting that induction of p53 by therapeutic blockade of the MDM2-p53 interaction may constitute a novel strategy to ablate cancer stem cells. Here, we evaluated the effect of a small molecule inhibitor of MDM2-p53 interaction (MI-773) on the fraction of cancer stem cells in mucoepidermoid carcinoma.
EXPERIMENTAL DESIGN: Human mucoepidermoid carcinoma cells (UM-HMC-1,-3A,-3B) were used to assess the effect of MI-773 on cell survival, cell cycle, fraction of cancer stem cells and expression of p53, p21, MDM2, and Bmi-1 (key regulator of self-renewal). Mice bearing xenograft tumors generated with these MEC cells were treated with MI-773 to determine the effect of MDM2-p53 inhibition on cancer stem cells in vivo.
RESULTS: MDM2 is highly expressed in human MEC tissues. MI-773 induced expression of p53 and its downstream targets p21 and MDM2, caused G1 cell cycle arrest, and induced MEC tumor cell apoptosis in vitro. Importantly, a marked decrease in expression of Bmi-1 and in the fraction of ALDHhighCD44high (cancer stem cells) was caused by MI-773 in vitro and in mice harboring MEC xenografts.
CONCLUSION: Collectively, these data demonstrate that MI-773 reduces the fraction of cancer stem cells, suggesting that patients with mucoepidermoid carcinoma might benefit from therapeutic inhibition of the MDM2-p53 interaction.

PMID: 30498096 [PubMed - as supplied by publisher]

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SOX10 Immunoexpression in Basaloid Squamous Cell Carcinomas: A Diagnostic Pitfall for Ruling out Salivary Differentiation.

SOX10 Immunoexpression in Basaloid Squamous Cell Carcinomas: A Diagnostic Pitfall for Ruling out Salivary Differentiation.

Head Neck Pathol. 2018 Nov 29;:

Authors: Rooper LM, McCuiston AM, Westra WH, Bishop JA

Abstract
SOX10 immunoexpression is increasingly recognized in salivary gland tumors, including but not limited to those with myoepithelial, serous acinar, and intercalated duct differentiation. However, SOX10 expression has not been extensively evaluated in other epithelial tumors that can mimic salivary origin. Basaloid squamous cell carcinoma (SCC) is a unique variant of SCC that shows morphologic overlap with several salivary tumors, including adenoid cystic carcinoma, basal cell adenocarcinoma, and myoepithelial carcinoma. We performed SOX10 immunohistochemistry on 22 basaloid SCCs and 280 non-basaloid SCCs. If tissue was available, we also performed immunohistochemistry for S100 and p16, and in-situ hybridization for high-risk HPV RNA. SOX10 was positive in 13/22 basaloid SCCs (59%), including 5/6 (83%) that were HPV-positive and 6/12 (50%) that were HPV-negative. Only 2/12 basaloid SCC (17%) demonstrated focal S100 expression. All non-basaloid SCCs were SOX10 negative. Frequent positivity for SOX10 in basaloid SCC presents a significant diagnostic pitfall for distinguishing these tumors from various basaloid salivary carcinomas. The preponderance of SOX10 expression in the basaloid variant of HPV-positive SCC also presents a diagnostic challenge in separating it from HPV-related multiphenotypic sinonasal carcinoma. SOX10 may be more broadly considered a marker of basal differentiation and should not be assumed to be specific for salivary origin in epithelial head and neck tumors.

PMID: 30498968 [PubMed - as supplied by publisher]

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Cerebrolysin Reduces Astrogliosis and Axonal Injury and Enhances Neurogenesis in Rats After Closed Head Injury.

Cerebrolysin Reduces Astrogliosis and Axonal Injury and Enhances Neurogenesis in Rats After Closed Head Injury.

Neurorehabil Neural Repair. 2018 Nov 30;:1545968318809916

Authors: Zhang Y, Chopp M, Zhang ZG, Zhang Y, Zhang L, Lu M, Zhang T, Winter S, Doppler E, Brandstäetter H, Mahmood A, Xiong Y

Abstract
BACKGROUND: Cerebrolysin is a neuropeptide preparation with neuroprotective and neurotrophic properties. Our previous study demonstrates that cerebrolysin significantly improves functional recovery in rats after mild traumatic brain injury (mTBI).
OBJECTIVE: To determine histological outcomes associated with therapeutic effects of cerebrolysin on functional recovery after TBI.
METHODS: In this prospective, randomized, blinded, and placebo-controlled study, adult Wistar rats with mild TBI induced by a closed head impact were randomly assigned to one of the cerebrolysin dose groups (0.8, 2.5, 7.5 mL/kg) or placebo, which were administered 4 hours after TBI and then daily for 10 consecutive days. Functional tests assessed cognitive, behavioral, motor, and neurological performance. Study end point was day 90 after TBI. Brains were processed for histological tissue analyses of astrogliosis, axonal injury, and neurogenesis.
RESULTS: Compared with placebo, cerebrolysin significantly reduced amyloid precursor protein accumulation, astrogliosis, and axonal damage in various brain regions and increased the number of neuroblasts and neurogenesis in the dentate gyrus. There was a significant dose effect of cerebrolysin on functional outcomes at 3 months after injury compared with saline treatment. Cerebrolysin at a dose of ⩾0.8 mL/kg significantly improved cognitive function, whereas at a dose of ⩾2.5 mL/kg, cerebrolysin also significantly improved sensorimotor function at various time points. There were significant correlations between multiple histological and functional outcomes 90 days after mTBI.
CONCLUSIONS: Our findings demonstrate that cerebrolysin reduces astrogliosis and axonal injury and promotes neurogenesis, which may contribute to improved functional recovery in rats with mTBI.

PMID: 30499355 [PubMed - as supplied by publisher]

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Reliable manifestations of increased intracranial pressure in patients with syndromic craniosynostosis.

Reliable manifestations of increased intracranial pressure in patients with syndromic craniosynostosis.

J Craniomaxillofac Surg. 2018 Nov 12;:

Authors: Kim SY, Choi JW, Shin HJ, Lim SY

Abstract
PURPOSE: Systematic examination of increased intracranial pressure (ICP) is important during the follow-up period after surgical repair of syndromic craniosynostosis. In these patients, postoperative progress can be unclear due to the involvement of multiple sutures and the high incidence of relapse due to the progressive nature of the disease and to genetic variability. In this study, we investigated the clinical manifestations of increased ICP in syndromic craniosynostosis patients before and after surgery.
MATERIALS AND METHODS: We collected pre- and post-operative data from patients with syndromic craniosynostosis from January 2004 and December 2014 on the clinical manifestations of increased ICP, namely, the presence of 1) subjective symptoms, 2) visual disturbances and papilledema, 3) thumbprinting phenomenon (beaten copper appearance) on skull x-ray, and 4) hydrocephalus on computed tomography.
RESULTS: A total of 17 syndromic craniosynostosis patients were included in this study, and three distinct patterns of disease progress were noted. Among all patients who underwent cranioplasty, the significant finding with regards to clinical manifestations was amelioration of the beaten copper appearance on skull x-ray after surgery. Likewise, among patients with recurrent increased ICP during the postoperative follow-up period, numerous clinical manifestations were noted, including subjective symptoms (33.3%), papilledema (50%), ventricular dilation (66.6%), and a beaten copper appearance on skull x-ray (100%).
CONCLUSION: Close monitoring to detect increased ICP is important during follow-up of patients with syndromic craniosynostosis. Among non-invasive methods for indirectly assessing ICP post-operatively, a beaten copper appearance on skull x-ray may be a reliable indicator of increased ICP.

PMID: 30497950 [PubMed - as supplied by publisher]

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A simple method to estimate the linear length of the orbital floor in complex orbital surgery.

A simple method to estimate the linear length of the orbital floor in complex orbital surgery.

J Craniomaxillofac Surg. 2018 Nov 09;:

Authors: Natsis K, Piagkou M, Chryssanthou I, Skandalakis GP, Tsakotos G, Piagkos G, Politis C

Abstract
BACKGROUND: The orbital floor (OrF) and infraorbital rim (IOR) repair in cases of complete destruction is challenging mainly due to the fact that the defect length cannot be measured. The aim of the current study is to develop a method of calculating the Orf length by using the gender and the lengths of the medial, superior and lateral orbital walls (OrW) of the same orbit.
MATERIAL AND METHODS: Ninety-seven (59 male and 38 female) European adult dry skulls were classified according to age: 20-39, 40-59 and 60 years and above. The length of each OrW was measured by using the direct distance between the optic foramen and a landmark in each orbital rim.
RESULTS: A side asymmetry was detected for the lengths of the inferior, superior and medial OrW. Although a gender dimorphism was detected, no correlation with the age was found. Using the Stepwise multiple regression analysis two formulas were developed, one for the right and one for the left OrF with coefficient of determination R2 0.43 and 0.57, respectively.
CONCLUSIONS: The proposed formulas represent a simple, applicable and individualized method to calculate the OrF linear length in cases of complete destruction of the IOR and OrF, with accuracy and without the use of expertise material. Such data may improve the surgery planning of orbital floor fractures and complex orbital reconstructions.

PMID: 30497949 [PubMed - as supplied by publisher]

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The effect of disc repositioning and post-operative functional splint for the treatment of anterior disc displacement in juvenile patients with Class II malocclusion.

The effect of disc repositioning and post-operative functional splint for the treatment of anterior disc displacement in juvenile patients with Class II malocclusion.

J Craniomaxillofac Surg. 2018 Nov 14;:

Authors: Zhu H, He D, Yang Z, Song X, Ellis E

Abstract
PURPOSE: To evaluate the effect of temporomandibular joint (TMJ) disc repositioning and post-operative functional splint for the treatment of anterior disc displacement (ADD) in juvenile patients with Class II malocclusion.
MATERIALS AND METHODS: Juvenile patients (≤20 years) who had bilateral TMJ ADD with and Class II malocclusion treated by disc repositioning and functional splints were included in the study. Magnetic resonance imaging (MRI) and cephalometric radiographs before surgery (T0), immediately after surgery (T1) and more than 3 months after surgery (T3) were obtained in all patients. Cephalometric values including condylar height, overjet, SNA, SNB and pogonion position etc. were measured and compared before and after disc repositioning by statistical analysis. Fourteen patients (13 female, 1 male) were included in this study. Their average age was 16.7 years (range, 12-20 years).
RESULTS: Seven patients with 14 joints had an MRI at least 6 months (6-24 months, mean 14.3) prior to disc repositioning. When compared to the MRI taken just prior to surgery, of those 14 joints, 9 condyles (64.3%) had evidence of bone resorption, 5 condyles (35.7%) had new bone formation mostly at the posterior part of the condyle (21.4%). These MRIs showed the condylar height was reduced 0.81 mm ± 0.61 (P = 0.013). Pre-operative cephalometric radiographs showed increased overjet (P = 0.039). The mean post-operative follow-up was 9.4 months (range, 4-13 months). Postoperative MRI showed the condylar height increased 1.74 ± 0.98 mm after disc repositioning (P < 0.001). Newly generated bone was observed on all condyles. 84.6% of the new bone was formed on the superior and posterior-anterior surfaces. Postoperative cephalometric radiographs showed the SNB angle increased 1.83 ± 1.56°(P < 0.001), pogonion position (pg'-G') moved anteriorly 2.18 ± 3.13 mm (P = 0.028) and incisor overjet decreased 3.55 ± 1.86 mm (P < 0.001), whereas significant changes were not found in SNA, Sn - G Vert, Y-Axis, U1 SN, IMPA (L1-MP) and U1-L1 (P > 0.05).
CONCLUSION: Conservative treatment for ADD with Class II malocclusion in juvenile patients may cause condyle resorption and aggravate the dentofacial deformity. Disc repositioning combined with post-operative functional splints can effectively promote condylar growth and help correct the dentofacial deformity.

PMID: 30497948 [PubMed - as supplied by publisher]

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Clinical Development of Novel Drug-Radiotherapy Combinations.

Clinical Development of Novel Drug-Radiotherapy Combinations.

Clin Cancer Res. 2018 Nov 29;:

Authors: Ahmad SS, Crittenden MR, Tran PT, Kluetz PG, Blumenthal GM, Bulbeck H, Baird RD, Williams KJ, Illidge T, Hahn S, Lawrence TS, Spears PA, Walker AJ, Sharma RA

Abstract
Radiotherapy is a fundamental component of treatment for the majority of patients with cancer. In recent decades, technological advances have enabled patients to receive more targeted doses of radiation to the tumour, with sparing of adjacent normal tissues. There had been hope that the era of precision medicine would enhance the combination of radiotherapy with targeted anticancer drugs, however this ambition remains to be realised. In view of this lack of progress, the FDA-AACR-ASTRO Clinical Development of Drug-Radiotherapy Combinations Workshop was held in February 2018 to bring together stakeholders and opinion leaders from academia, clinical radiation oncology, industry, patient advocacy groups and the FDA in order to discuss challenges to introducing new drug-radiotherapy combinations to the clinic. This "Perspectives in Regulatory Science and Policy" article summarises the themes and action points that were discussed. Intelligent trial design is required to increase the number of studies which efficiently meet their primary outcomes; endpoints to be considered include local control, organ preservation and patient-reported outcomes. Novel approaches including immune-oncology or DNA repair inhibitor agents combined with radiotherapy should be prioritised. In this article, we focus on how the regulatory challenges associated with defining a new drug-radiotherapy combination can be overcome in order to improve clinical outcomes for patients with cancer.

PMID: 30498095 [PubMed - as supplied by publisher]

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Expression of PD-1 by T cells in malignant glioma patients reflects exhaustion and activation.

Expression of PD-1 by T cells in malignant glioma patients reflects exhaustion and activation.

Clin Cancer Res. 2018 Nov 29;:

Authors: Davidson TB, Lee AH, Hsu M, Sedighim S, Orpilla J, Treger J, Mastall M, Roesch S, Rapp C, Galvez M, Mochizuki AY, Antonios JP, Garcia AJ, Kotecha N, Bayless NL, Nathanson DA, Wang AC, Everson RG, Yong WH, Cloughesy TF, Liau LM, Herold-Mende CC, Prins RM

Abstract
PURPOSE: Glioblastoma (GBM) is the most common primary malignant tumor in the central nervous system. Our recent pre-clinical work has suggested that PD-1/PD-L1 plays an important immunoregulatory role to limit effective anti-tumor T cell responses induced by active immunotherapy. However, little is known about the functional role that PD-1 plays on human T lymphocytes in malignant glioma patients.
EXPERIMENTAL DESIGN: In this study, we examined the immune landscape and function of PD-1 expression on T cells from the tumor and peripheral blood in malignant glioma patients.
RESULTS: We found several differences between PD-1+ tumor-infiltrating lymphocytes (TILs) and patient-matched PD-1+ peripheral blood T lymphocytes. Phenotypically, PD-1+ TILs exhibited higher expression of markers of activation and exhaustion than peripheral blood PD-1+ T cells, which instead had increased markers of memory. A comparison of the T cell receptor variable chain populations revealed decreased diversity in T cells that expressed PD-1, regardless of the location obtained. Functionally, peripheral blood PD-1+ T cells had a significantly increased proliferative capacity upon activation compared with PD-1- T cells.
CONCLUSION: Our evidence suggests that PD-1 expression in glioma patients reflects chronically-activated effector T cells that display hallmarks of memory and exhaustion depending on its anatomical location. The decreased diversity in PD-1+ T cells suggests that the PD-1 expressing population has a narrower range of cognate antigen targets compared to the PD-1 non-expression population. This information can be used to inform how we interpret immune responses to PD-1 blocking therapies or other immunotherapies.

PMID: 30498094 [PubMed - as supplied by publisher]

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