Molecular laryngology : A new chapter in the understanding of laryngeal diseases

xlomafota13 shared this article with you from Inoreader Molecular laryngology : A new chapter in the understanding of laryngeal diseases Via Laryngologie HNO. 2021 Apr 6. doi: 10.1007/s00106-021-01016-1. Online ahead of print. ABSTRACT BACKGROUND: Despite considerable advances in laryngological research, there is still a plethora of (benign) vocal fold pathologies that cannot be treated causally. This is due to the limited accessibility and sensitive microarchitecture of the vocal folds, which cannot be investigated at a cellular level. Consequently, current pathophysiological knowledge is frequently based on macroscopic findings. The impact of interventions is mainly evaluated endoscopically or via indirect diagnostic methods. OBJECTIVE: The aim of this article is to discuss state-of-the-art biotechnological methods used in laryngological research, illustrated by practical examples. RESULTS: In recent years, animal and in vitro experiments have significantly contributed to a continuous expansion of knowledge in this field, particularly regarding vocal fold inflammation and scar fo rmation. Vocal fold fibroblasts, the most important cellular component of the lamina propria, can be accredited a central role in these processes. CONCLUSION: Our knowledge regarding macroanatomy and macropathophysiology of several pathologies has increased considerably in recent years. In vitro trials have shown, e.g., that vocal fold fibroblasts in an inflammatory setting secrete less profibrotic and proinflammatory cytokines when exposed to vibration. Early vocal exercises after surgical interventions on the vocal folds may therefore promote better wound healing and consequently improved phonation. Research in molecular laryngology should create a solid basis of knowledge for subsequent clinical studies. PMID:33822268 | DOI:10.1007/s00106-021-01016-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function

xlomafota13 shared this article with you from Inoreader Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function Via leak of cerebrospinal fluid Endocrine. 2021 Apr 6. doi: 10.1007/s12020-021-02713-1. Online ahead of print. ABSTRACT BACKGROUND: Non-functioning pituitary macroadenomas (NFPAs) with visual field defects are ideally managed by transsphenoidal tumour resection to improve vision, and long-term postsurgical follow up is necessary to monitor for tumour recurrence. Regular updates from global data are necessary for developing optimal management strategies of these tumours. METHODS: Pre- and postoperative visual and endocrine profile, imaging characteristics and details of surgical interventions among patients with NFPAs managed between 2008 and 2019 in a UK regional centre were assessed. The radiological and surgical outcomes including postoperative complications, recurrence risk and the factors influencing outcomes also were assessed. RESULTS: 105 cases with mean (SD) age 60.1 (14.3) years and follow-up duration 60 (37) months were studied. 67 (64%) patients were male. Five-year recurrence-free survival rate was 71.5% (95% confidence interval [CI] 62.7% to 81.6%) with 33 (31%) tumour recurrences of whom 20 (60%) received radiotherapy and 9 (27%) underwent further surgery. Younger age, tumour volume, and bilateral cavernous sinus extension were the predictors of recurrence on univariate analysis, while younger age was the only factor on multivariate analysis (Hazard ratio 0.95; 95% CI: 0.92, 0.97). 72/78 patients (92%) with preoperative visual field defects improved after surgery, of whom 27 (35%) had full recovery. 20 (24%) patients had recovery of an abnormal hormone axis. 15 patients (16%) developed perioperative complications such as cerebrospinal fluid leak (12 cases), meningitis (2 cases), and bleeding (2 cases). CONCLUSIONS: Five-year recurrence-free survival after transsphenoidal resection for NFPAs was 71.5% with older age at surgery conferring lower risk of recurrence. Visual recovery/ improvement occurred in 92% of cases with preoperative visual defects following surgery. PMID:33822319 | DOI:10.1007/s12020-021-02713-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

REAL ROBOTIC TOTAL MESOPANCREAS EXCISION(TMpE) ASSISTED BY HANGING MANEUVER(HM): STANDARDIZED TECHNIQUE

xlomafota13 shared this article with you from Inoreader REAL ROBOTIC TOTAL MESOPANCREAS EXCISION(TMpE) ASSISTED BY HANGING MANEUVER(HM): STANDARDIZED TECHNIQUE Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Pancreaticoduodenectomy (PD) is one of the most demanding interventions for digestive surgeons. Therefore, minimally invasive approach is still a topic of discussion(1,2). Many authors have described minimally invasive PD (laparoscopic or robotic) as feasible, safe, and reproducible(3–5). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Persistent primitive olfactory artery associated with early bifurcated accessory anterior cerebral artery

xlomafota13 shared this article with you from Inoreader Persistent primitive olfactory artery associated with early bifurcated accessory anterior cerebral artery Via radiol anat Surg Radiol Anat. 2021 Apr 6. doi: 10.1007/s00276-021-02744-3. Online ahead of print. ABSTRACT Five types of persistent primitive olfactory artery (PPOA), a rare variation of the proximal anterior cerebral artery (ACA), have been reported. Type 1 is most common, generally following an extreme anteroinferior course and taking a hairpin turn before continuing to the distal A2 segment of the ACA. Triple ACAs are a common variation of the A2 segment of the ACA, and a centrally l ocated artery is called an "accessory ACA" or "median artery of the corpus callosum". This artery usually does not bifurcate or else bifurcates distally and continues to the pericallosal artery. We herein report a 74-year-old woman with type 1 PPOA and early bifurcated accessory ACA, an extremely rare combination of ACA variations, that was diagnosed using magnetic resonance angiography. PMID:33825050 | DOI:10.1007/s00276-021-02744-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Esophageal Tuberculosis: A Systematic Review

xlomafota13 shared this article with you from Inoreader Esophageal Tuberculosis: A Systematic Review Via Otolaryngology Indian Abstract Involvement of esophagus with tuberculous infection is a rare form of extrapulmonary tuberculosis. Secondary esophageal tuberculosis is much more common than primary TB. The most common source of secondary esophageal involvement is tuberculous mediastinal lymphadenitis. Esophageal tuberculosis mimics carcinoma esophagus. Clinical features are same and it is difficult on imaging studies also to differentiate the two pathologies. Misdiagnosis is common. The disease is medically curable; therefore, it is essential to make all efforts to diagnose the pathology with non-surgical diagnostic modalities in suspected cases so as to save patients from the trauma of major surgical resection. Surgical intervention is indicated for failed medical therapy and complications. A total of 133 cases of esophageal TB have been reported till date. The authors encountered 4 cases of esophageal TB between April 2011 and March 2019. The aim of this article is to present our data and to provide comprehensive review of the available literature on this pathology in order to gain a better understanding of diagnostic methods and provide guidelines for the diagnosis and management of esophageal TB. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endaural Over-Underlay Cartilage Tympanoplasty for Repair of Dry Subtotal Perforations

xlomafota13 shared this article with you from Inoreader Endaural Over-Underlay Cartilage Tympanoplasty for Repair of Dry Subtotal Perforations Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Apr 7:34894211007218. doi: 10.1177/00034894211007218. Online ahead of print. ABSTRACT OBJECTIVES: We explored the auditory and anatomical success of grafting when the cartilage perichondrium (CP) was prepared using two different methods. METHODS: Patients with subtotal or total perforation underwent tympanoplasty with a CP graft. A V-shaped groove for the handle of the malleus was prepared for CP grafts in patients in group 1. Pati ents in group 2 did not have a groove on the graft. The anatomical success of the graft was evaluated as success, partial success, or failure. Results of auditory evaluations were compared between the two groups. RESULTS: A total of 195 patients were included in the study. The total CP graft integration rate was 96% for both groups. Significant changes were detected in all hearing criteria evaluated 12 months after surgery compared to the preoperative period (P < .05). There were no significant differences between the groups in terms of the relationship between graft technique and postoperative hearing results. However, rates of partial success were significantly higher for group 1 than group 2 (P = .033). CONCLUSION: Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation. Partial failures are rare, but when they occur, they most often involved anterior graft medialization. Wh en a piece of cartilage is removed at the malleus interface there may be a higher rate of partial failure. PMID:33825491 | DOI:10.1177/00034894211007218 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Persistent mdx diaphragm alterations are accompanied by increased expression and activity of calcium and muscle-specific proteins

xlomafota13 shared this article with you from Inoreader Persistent mdx diaphragm alterations are accompanied by increased expression and activity of calcium and muscle-specific proteins Via Cellular and Molecular Biology Histol Histopathol. 2021 Apr 7:18334. doi: 10.14670/HH-18-334. Online ahead of print. ABSTRACT The mdx mouse model of Duchenne Muscular Dystrophy (DMD) presents sarcolemma instability and develops a mild multi-stage dystrophinopathy characterized by intense myonecrosis with inflammatory infiltrate at 4-weeks; muscular regeneration at 12-weeks and persistent fibrosis onwards. Mdx diaphragm muscle has a more severe phenotype with structural and functional deterioration that closely resembles the diaphragm impairment responsible for DMD human patients' morbidity. Herein, we compared calcium deposits, activity of calcium-related proteases, and expression of muscle-specific proteins in mdx diaphragm at 4-weeks and 12-weeks. We found increased calcium deposits mainly at 12-weeks, concomitant with high activity of calpains and matrix metaloprotease-9, but decreased expression of Myhc4 (Myhc IIb) and Atpa2a1 (SERCA1), and high expression of th e myogenic regulatory factors Myod1 and Myog. Our results suggest that increased calcium deposits and persistent activity of calcium dependent proteases throughout the disease are involved in the degeneration and regeneration processes in the mdx diaphragm. PMID:33825181 | DOI:10.14670/HH-18-334 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.