Medicine by Sfakianakis Alexandros: 04/24/16

Κυριακή 24 Απριλίου 2016

Pyogenic spondylodiscitis and osteoradionecrosis of the cervico-thoracic spine: a rare complication after surgery and radiation for hypopharyngeal cancer.

Pyogenic spondylodiscitis and osteoradionecrosis of the cervico-thoracic spine: a rare complication after surgery and radiation for hypopharyngeal cancer.

Acta Biomed. 2013 Apr;84(1):72-5

Authors: Gradoni P, Oretti G, Ferri A, Ferri T

Abstract
OBJECTIVE: To describe a rare case of osteoradionecrosis and pyogenic spondylodiscitis of the cervico-thoracic spine after surgery and radiotherapy for hypopharyngeal cancer.
METHODOLOGY: Diagnostic clues are presented and critically discussed with particular regard to computed tomography, magnetic resonance and positron emission tomography features advising the association between and osteoradionecrosis and spondylodiscitis.
RESULTS AND CONCLUSIONS: Pathogen isolation via CT-guided biopsy provided the definite diagnosis and indicated the targeted therapy. Successful recovery was obtained with conservative treatment.

PMID: 24189767 [PubMed - indexed for MEDLINE]

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Report of a case of Marjolin's Ulcer in a patient with multiple burn scars during Plastic Surgical Treatment: surgical resolution aimed at maintaining functional knee.

Report of a case of Marjolin's Ulcer in a patient with multiple burn scars during Plastic Surgical Treatment: surgical resolution aimed at maintaining functional knee.

Acta Biomed. 2013 Apr;84(1):61-3

Authors: Bocchi F, Zermani R

Abstract
Marjolin's ulcer is an epithelial neoplasm of the skin that can appear in a multitude of slow-tosolve cutaneous lesions. It is a relatively rare condition, with an estimated 3-5% occurrence among all squamocellular carcinomas of the skin (1). We present the clinical case of a female patient with previous third-degree burn scars who had already undergone numerous surgical procedures and presented recurring ulcers, above all on the extensor surface of the lower limbs. She was placed under our care so that she could undergo procedures for the debridement of these lesions, histological examinations and skin autografting. The clinic case described here is designed to underline the importance of the early monitoring and treatment of skin lesions that are difficult to heal in order to prevent malignant neoplastic degeneration, or at least halt its progress.

PMID: 24189764 [PubMed - indexed for MEDLINE]

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Dancing eye syndrome as first symptom of neuroblastoma.

Dancing eye syndrome as first symptom of neuroblastoma.

Acta Biomed. 2013 Aug;84(2):162-6

Authors: Venturelli C, Guerra A, Paolucci P, Iughetti L

Abstract
BACKGROUND: "Dancing eye syndrome", also called Kinsbourne syndrome or Opsoclonus-Myoclonus-Ataxia Syndrome (OMS) is a rare neurological disorder that in children is frequently associated to occult, low-grade neuroblastoma (NB) (>50% of the cases). OMS may also be triggered by infections and it is often associated to developmental impairment and disability.
CASE PRESENTATION: We discuss the case of a 16 months old female with acutely onset of OMS associated to occult stage III NB.
CONCLUSIONS: OMS represents a diagnostic challenge for pediatric clinicians. The suspect of OMS imposes the search for an occult NB in order to promptly treat a life-threatening event like tumor and to prevent the neurological sequels linked to OMS.

PMID: 24165466 [PubMed - indexed for MEDLINE]

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Saddle pulmonary tumor embolus secondary to renal cell carcinoma.

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Saddle pulmonary tumor embolus secondary to renal cell carcinoma.

JAAPA. 2013 Nov;26(11):37-9

Authors: Khouzam RN, Soufi MK, Farah V

Abstract
Most pulmonary tumor emboli are microscopic and occlude small arteries and arterioles with subsequent insidious clinical presentation. These emboli usually need conservative treatment. Emboli that spread to large proximal pulmonary arteries, although rare, can be life-threatening. This article focuses on the importance of prompt recognition, diagnosis, and appropriate management of pulmonary tumor emboli.

PMID: 24153090 [PubMed - indexed for MEDLINE]

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Unusual myelomas: a review of IgD and IgE variants.

Unusual myelomas: a review of IgD and IgE variants.

Oncology (Williston Park). 2013 Aug;27(8):798-803

Authors: Pandey S, Kyle RA

Abstract
Immunoglobulin D multiple myeloma (IgD MM) accounts for almost 2% of all myeloma cases. It is associated with an increased frequency of undetectable or small monoclonal (M)-protein levels on electrophoresis; osteolytic lesions; extramedullary involvement; amyloidosis; a lambda (lambda) light chain predilection; renal failure; hypercalcemia; and, often, advanced disease at diagnosis. Immunoglobulin E (IgE) MM is rare, with fewer than 50 cases reported in the literature. IgE MM presents with features similar to those of IgD MM, along with a higher incidence of plasma cell leukemia. The hallmark of IgE MM is t(11;14) (q13;q32). IgD and IgE levels are generally very low and hence may escape detection; thus, it is important that, when myeloma is suspected, patients be screened for the presence of IgD and IgE if they have an apparently free monoclonal immunoglobulin light chain in the serum. Although survival of patients with IgD MM or IgE MM is shorter in comparison to those with immunoglobulin G (IgG) MM or immunoglobulin A (IgA) MM, the outcome for patients with IgD and IgE subtypes is improving with the use of novel agents and autologous transplantation.

PMID: 24133829 [PubMed - indexed for MEDLINE]

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[Secondary pulmonary embolism to right atrial myxoma].

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[Secondary pulmonary embolism to right atrial myxoma].

Semergen. 2013 Oct;39(7):e54-6

Authors: Vico Besó L, Zúñiga Cedó E

Abstract
A case of pulmonary thromboembolism secondary to atrial myxoma right. The myxoma is a primary cardiac tumor, namely, has his origin in the cardiac tissue. Primary cardiac tumors are rare, including myxomas, the most common type. Have a predilection for females and the most useful tool for diagnosis is echocardiography. About 75% of myxomas occur in the left atrium of the heart and rest are in the right atrium. Right atrial myxomas in some sometimes associated with tricuspid stenosis and atrial fibrillation. The most common clinical manifestations include symptoms of this neoplasm constitutional, and embolic phenomena resulting from the obstruction to the flow intracavitary. The treatment of this condition is surgical.

PMID: 24095171 [PubMed - indexed for MEDLINE]

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[Mucosecretor adenocarcinoma of the lung with pleural involvement presenting as a pneumothorax. Presentation of a clinical case].

[Mucosecretor adenocarcinoma of the lung with pleural involvement presenting as a pneumothorax. Presentation of a clinical case].

Semergen. 2013 Oct;39(7):391-5

Authors: Hermida Pérez JA, Hernández Guerra JS, Bermejo Hernandez Á, Sobenes Gutierrez RJ

Abstract
The combination of a pneumothorax and lung cancer is rare and diagnosis is complex. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, as well as the clinical significance, the recommended diagnostic approach, and therapeutic guidelines.

PMID: 24095167 [PubMed - indexed for MEDLINE]

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Acute lymphoblastic leukemia with a late- appearing Philadelphia chromosome: case report and review of the literature.

Acute lymphoblastic leukemia with a late- appearing Philadelphia chromosome: case report and review of the literature.

Gulf J Oncolog. 2013 Jul;1(14):81-6

Authors: Adriana Z, Al Bahar S, Pandita R

Abstract
UNLABELLED: We describe a rare presentation of acute lymphoblastic leukemia in a young adult male who at the beginning of the disease lacked the Philadelphia chromosome in bone marrow and blood cells and fluorescence in situ hybridization was negative for the presence of a clone with the BCR-ABL1 rearrangement. The patient initially had pancytopenia with a blast cell count of 5% in the peripheral blood that evolved to a phase with progressive leukocytosis and a sudden rise in blast cells 7 months later. At this time, his bone marrow aspirate showed the presence of a neartriploid karyotype containing two Philadelphia chromosomes. The multiple karyotypic changes observed in our patient support the notion that leukemic progression involves several cytogenetic evolutionary processes, the first step of which may not necessarily involve acquisition of the Philadelphia chromosome.
KEYWORDS: Late-appearing Philadelphia chromosome, adolescent ALL, BCR-ABL1, dasarinib.

PMID: 23996872 [PubMed - indexed for MEDLINE]

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BRCA1 gene Molecular Alterations in Omani Breast Cancer Patients.

BRCA1 gene Molecular Alterations in Omani Breast Cancer Patients.

Gulf J Oncolog. 2013 Jul;1(14):45-51

Authors: Al-Moundhri MS, Al-Ansari A, Al-Mawali K, Al-Bahrani B

Abstract
BACKGROUND: Breast cancer (BC) is the most common cancer reported in females in Oman and usually occurs at a relatively younger age, presents at an advanced stage and behaves aggressively. BC occurs in hereditary and sporadic forms. Although germ-line mutations in BRCA1 and BRCA2 genes are rare in sporadic cases compared with hereditary cases, molecular alterations, such as loss of heterozygosity, and CpG methylation, are common. In this study, we investigated the types of molecular alterations associated with hereditary and sporadic BRCA1-associated BC in Omani patients.
METHODS: We obtained clinical data and samples from 43 sporadic BC patients. The selection of cases was made based on the following criteria: aged ≤ 40 years, or bilateral breast cancer, or estrogen and progesterone receptor negative status, and HER-2/neu negative (Triple Negative phenotype) status. Screening for molecular alterations was performed by direct sequencing, multiplex ligation-dependent probe amplification (MLPA).
RESULTS: Genomic deletions and duplication in the BRCA1 gene were identified in four female patients. Two patients carried exon 1 and 2 deletions and two showed exon 1 and 2 duplication. Screening for mutation by direct sequencing revealed three polymorphisms in exon 11. Two of these polymorphisms are nonsynonymous (rs1800704, rs799917) and one is synonymous (rs1800740).
CONCLUSION: The current pilot study detected previously described gene rearrangements and polymorphisms involving the BRCA1 gene and no seemingly pathogenic missense mutations were elucidated.
KEYWORDS: BRCA1, breast cancer, mutation, polymorphism, Omani, Arab.

PMID: 23996866 [PubMed - indexed for MEDLINE]

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A rare case of isolated cutaneous metastases of colonic adenocarcinoma.

A rare case of isolated cutaneous metastases of colonic adenocarcinoma.

Br J Hosp Med (Lond). 2013 Aug;74(8):472-3

Authors: Dharamavaram S, Psaltis E, Menon A

PMID: 23958989 [PubMed - indexed for MEDLINE]

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Adult hepatoblastoma.

Adult hepatoblastoma.

Rev Esp Enferm Dig. 2013 Apr;105(4):229-31

Authors: Cienfuegos JA, Labiano T, Pedano N, Zozaya GN, Martí-Cruchaga P, Panizo Á, Rotellar F

Abstract
Adult hepatoblastoma (AHB) is a very rare tumor, having been described 45 cases up to June 2012. In contrast to HB in infancy (IHB), it has poor prognosis. We present the case of a 37-year-old asymptomatic woman who consulted for a large -12 cm diameter- mass involving segments 5 and 6 of the liver, and alfa-fetoprotein of 1,556,30 UI/mL. A bisegmentectomy was carried out. The microscopic study confirmed the AHB diagnosis, revealing the presence of epithelial cells forming clusters, trabecular patterns and tubules. The patient died on the 10th postoperative month due to progression disease.The Wnt/Beta-Catenin signaling pathway mutation has been reported and associated with a poor prognosis in IHB. Due to the AHB poor prognosis, seems reasonable to introduce the therapeutic regimens described in children who have a better outcome.

PMID: 23859453 [PubMed - indexed for MEDLINE]

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Brain Metastasis of Atrial Myxoma: Case report.

Brain Metastasis of Atrial Myxoma: Case report.

Med J Malaysia. 2012 Dec;67(6):613-5

Authors: Badrisyah I, Saiful R, Rahmat H, Naik VR, Tan YC

Abstract
Metastasis of an atrial myxoma to the brain is extremely rare. Thus far there are only 17 cases reported, including our present case. Most of the brain metastases manifest only in 3 to 6 decades, after an average time frame of one to two years after surgical removal of parental tumour. We present a case of brain metastases of atrial myxoma in a teenager of the youngest age among all reported cases, unusually as early as 15 years old. The progress of the metastatic process had been insidious for three years after heart surgery, The imaging demonstrated a rather sizeable tumour by the time when the patient is symptomatic. The location of the metastatic tumour is anyhow superficial to the cortical surface, enabling complete surgical excision of the tumour easily achievable with favourable outcome.

PMID: 23770956 [PubMed - indexed for MEDLINE]

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Primary lacrimal sac lymphoma with recurrence: a case report.

Primary lacrimal sac lymphoma with recurrence: a case report.

Med J Malaysia. 2013 Jun;68(3):269-70

Authors: Chai CK, Tang IP, Tan TY

Abstract
Primary lacrimal sac lymphoma is rare. The common clinical features are epiphora and medial canthal swelling which mimic nasolacrimal duct obstruction. Histological examination is therefore important to avoid delay in diagnosis and treatment. We report a case of primary lacrimal sac lymphoma in a 72-year-old female who developed a metachronous tumour at the hard palate one year after excision of the lacrimal sac tumour.

PMID: 23749022 [PubMed - indexed for MEDLINE]

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Pituitary apoplexy: a rare cause of middle cerebral artery infarction.

Pituitary apoplexy: a rare cause of middle cerebral artery infarction.

Med J Malaysia. 2013 Jun;68(3):264-6

Authors: Radhiana H, Syazarina SO, Shahizon Azura AM, Azizi AB

Abstract
Pituitary apoplexy is a well-known complication of a pituitary adenoma. However, an ischaemic event caused by pituitary apoplexy is rare. We reported a case of pituitary apoplexy with middle cerebral artery infarction in a 44-year old man who presented with a sudden onset of altered sensorium. Vasospasm is the most likely underlying cause of the infarction in this case secondary to transdiaphragmatic rupture of the sella tumour into the subarachnoid space.

PMID: 23749020 [PubMed - indexed for MEDLINE]

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Aggressive ameloblastic fibro-odontoma assessment with CBCT and treatment.

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Aggressive ameloblastic fibro-odontoma assessment with CBCT and treatment.

Eur Arch Paediatr Dent. 2013 Jun;14(3):179-84

Authors: Lúcio PS, Cavalcante RB, Maia RN, Santos ES, Godoy GP

Abstract
BACKGROUND: Ameloblastic fibro-odontomas (AFO) are rare lesions and defined by the World Health Organisation as a tumour composed of a proliferation of odontogenic epithelium immersed in ectomesenchyme reminiscent of the interdental papilla. It also presents inductive processes leading to formation of enamel and dentine, confusing, histopathologically, with odontoma. Despite numerous efforts, there is still considerable confusion over its controversial aetiopathogenesis and treatment. A brief review of the literature on the clinical, pathological and therapeutic features of this lesion is reported.
CASE REPORT: A case of aggressive AFO in a 3-year-old boy was referred to the Oral Diagnostics Service of Hospital General de Fortaleza for evaluation following a 3-months painless swelling in the right mandibular and facial regions. During anamnesis, the patient's carers reported no systemic problem and his medical history was non-contributory. Intra-orally there was a swelling of the right lateral portion of the mandible, adjacent teeth were not mobile and the oral mucosa appeared normal and showed no signs of ulceration. Radiographic examination, with panoramic radiography and cone beam computed tomography with three-dimensional (3D) reconstruction, was better able to identify the extent of bone involvement and showed an expansive hypodense image in the right mandibular region. 3D reconstruction showed expansion of buccal and lingual cortical bone and the preservation of basal bone.
TREATMENT: Enucleation and curettage of the lesion were carried out and care was taken not to fracture the basal bone during the surgical procedure. Tissue specimens were sent for histopathologic analysis. Aspiration performed during surgery was negative for blood and other exudates.
FOLLOW-UP: No recurrence has occurred during a follow-up period of 11 months.
CONCLUSION: A comprehensive diagnosis including all clinical, radiographic and histopathologic features is necessary for the success of therapy, which varies from case to case, thus, improving the quality of life of patients with AFO.

PMID: 23633233 [PubMed - indexed for MEDLINE]

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Intramuscular sternohyoid hemangioma: an unusual neck mass.

Intramuscular sternohyoid hemangioma: an unusual neck mass.

Med J Malaysia. 2013 Apr;68(2):166-7

Authors: M I, Soleh MN, Abdul Rahman KS, T S SE

Abstract
A neck mass with soft consistency suggests the diagnosis of a cyst which is usually congenital in origin. Needle aspiration yielding blood should alert the physician the possibility of hemangioma although it is very rare. Ultrasonography and computed tomography will delineate the extent and nature of the lesion and provide the roadmap for surgical excision. We report a case of a girl who presented with a painless neck mass which was later found to be a hemangioma originating from the sternohyoid muscle. The morphology and immunohistochemical stain were consistent with hemangioma.

PMID: 23629567 [PubMed - indexed for MEDLINE]

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Blastic plasmacytoid dendritic cell neoplasm in an elderly woman.

Blastic plasmacytoid dendritic cell neoplasm in an elderly woman.

Med J Malaysia. 2013 Apr;68(2):161-3

Authors: Foong HB, Chong M, Taylor EM, Carlson JA, Petrella T

Abstract
Blastic plasmacytoid dendritic cell neoplasm (a.k.a. NK cell lymphoma, CD4+CD56+ haematodermic neoplasm) is a rare aggressive tumour that arises from plasmacytoid dendritic cell precursors. We report the first case from Malaysia of a 79-year-old Chinese woman who presented with purpuric plaques and nodules produced by pleomorphic CD4+, CD56+, CD68+, CD123+ and CD303+, but CD2APmononuclear cell infiltrates. Leukemic dissemination occurred and she succumbed to disease without treatment 4 weeks after diagnosis and 9 months after onset of cutaneous disease.

PMID: 23629565 [PubMed - indexed for MEDLINE]

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Masson's hemangioma: A very rare cause of spinal cord compression.

Masson's hemangioma: A very rare cause of spinal cord compression.

Neurol India. 2013 Jan-Feb;61(1):89-90

Authors: Mozhdehipanah H, Samiei F, Sayadnasiri M

PMID: 23466857 [PubMed - indexed for MEDLINE]

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[Assessing the risk of falls for the elderly in Basic Health Units].

[Assessing the risk of falls for the elderly in Basic Health Units].

Rev Esc Enferm USP. 2012 Apr;46(2):320-7

Authors: de Pinho TA, Silva AO, Tura LF, Moreira MA, Gurgel SN, Smith Ade A, Bezerra VP

Abstract
The world population is aging rapidly, which poses a greater challenge for the institutions involved which, in turn, require new public health policies that include the prevention of falls. The objective of this study was to assess the risk of falls in the elderly. This epidemiological, cross-sectional study was performed at a family health unit, using a quantitative approach. The sample consisted of 150 elderly individuals evaluated from January to April 2009. Data were collected using the Fall Risk Score, which was analyzed using SPSS 17.0. Of all seniors evaluated, 58.8% did not suffer falls. However, 63 seniors did suffer falls, 71.4% of this total experienced 1 to 2 falls, and the main intrinsic cause they reported was dizziness/vertigo, whereas the extrinsic cause was wet or slippery floors. Therefore, it is concluded that it is important to assess the risk of falls among the elderly so that preventive measures can be taken, with a view to maximizing their quality of life.

PMID: 22576534 [PubMed - indexed for MEDLINE]

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[Epidemiological characteristic of the patients presenting with cochleovestibular disorders associated with labyrinthine hydrops].

[Epidemiological characteristic of the patients presenting with cochleovestibular disorders associated with labyrinthine hydrops].

Vestn Otorinolaringol. 2011;(4):40-2

Authors: Levina IuV, Kunel'skaia NL, Krasiuk AA, Baush IaA

Abstract
A total of 1,067 patients complaining of hearing impairment, dizziness, and tympanophony were admitted for the treatment to the Surdological Department of N.I. Pirogov City Clinical Hospital No 1 during the period from 2000 to 2010. As many as 326 (30.5%) patients were preliminarily diagnosed with Meniere's disease based on their medical histories, clinical condition, and the results of questionnaire studies. All of them were subjected to comprehensive audiologic and vestibulogic examination with the use of up-to-date techniques. The data thus obtained allowed to reveal labyrinthine hydrops in 275 (84%) patients. It is concluded that 101 (9.5%) patients presenting with the typical symptoms of Meniere's disease had labyrinthine hydrops.

PMID: 21983667 [PubMed - indexed for MEDLINE]

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Otoacoustic emissions in normal-hearing workers exposed to different noise doses.

Otoacoustic emissions in normal-hearing workers exposed to different noise doses.

Int Tinnitus J. 2012;17(1):74-9

Authors: Boger ME, Sampaio AL, Oliveira CA

Abstract
INTRODUCTION: The otoacoustic emission test is useful in monitoring hearing changes not yet detectable in pure-tone audiometry, as well as in monitoring cochlear damage caused by exposure to noise.
OBJECTIVE: To evaluate distortion product otoacoustic emissions in normal-hearing workers exposed to different occupational noise doses.
MATERIALS AND METHOD: This is a cohort prospective study performed in metalworking industries, in which normal-hearing workers were assessed by being divided into three different groups: GI not exposed, GII sporadically exposed and GIII often exposed to occupational noise.
RESULTS: Otoacoustic emission alterations were found in groups II and III bilaterally. Both in the amplitude and in the signal/noise ratio it was observed that as higher was the frequency, worse were the results of GII and GIII (p > 0.001), and the greater the exposure dose is, the lower the averages found in otoacoustic emission.
CONCLUSION: The otoacoustic emissions are worse in the exposed groups compared to the unexposed group and the greater are the noise dose, worse are the results.

PMID: 23906832 [PubMed - indexed for MEDLINE]

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Perilymphatic Fistula: an approach to diagnosis and management that provides surer diagnosis and provides medical and surgical management options: report of six illustrative recent cases.

Perilymphatic Fistula: an approach to diagnosis and management that provides surer diagnosis and provides medical and surgical management options: report of six illustrative recent cases.

Int Tinnitus J. 2012;17(1):58-63

Authors: Bhatia N, Lehrer JF

Abstract
Perilymphatic Fistula (PLF) remains a controversial topic and its management is challenging. Various etiologic events have been proposed and spontaneous PLF has been described 1. Diagnostic methods and strategies have been reported in the literature but no standard algorithm exists. The most accepted diagnostic method remains intra-operative confirmation of perilymph leak at oval window or round window. However, concerns have been raised regarding excessive surgical intervention given the lack of pre-operative confirmatory tests. We have developed a diagnostic strategy that has been successful in our hands. The aim of this study is to present six patients with PLF who underwent surgical repair. We describe our approach in the evaluation and management of these patients. We discuss the diagnostic tests and the operative technique used in management of these patients and we provide a review of the literature in support of our approach.

PMID: 23906829 [PubMed - indexed for MEDLINE]

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Vertigo and metabolic disorders.

Vertigo and metabolic disorders.

Int Tinnitus J. 2012;17(1):16-20

Authors: Santos MD, Bittar RS

Abstract
INTRODUCTION: Metabolic disorders are accepted by many authors as being responsible for balance disorders. Because of the importance of metabolic disorders in the field of labyrinthine dysfunction, we decided to assess the prevalence of carbohydrates, lipids and thyroid hormones disorders in our patients with vestibular diseases.
MATERIAL AND METHOD: The study evaluates the metabolic profile of 325 patients with vertigo who sought the Otolaryngology Department of the University of São Paulo in the Hospital das Clínicas da Universidade de São Paulo. The laboratory tests ordered according to the classical research protocol were: low-density lipoprotein cholesterol fraction, TSH, T3, T4 and fasting blood sugar level. The metabolic disorders found and the ones that were observed in the general population were compared. The high level of low-density lipoprotein cholesterol, the altered levels of thyroid hormones, the higher prevalence of diabetes mellitus were the most significant changes found in the group of study.
CONCLUSIONS: The higher amount of metabolic disorders in patients with vertigo disease reinforces the hypothesis of its influence on the etiopathogenesis of cochleovestibular symptoms.

PMID: 23906822 [PubMed - indexed for MEDLINE]

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Evidence for cognitive involvement in discriminating speech in babble.

Evidence for cognitive involvement in discriminating speech in babble.

Int Tinnitus J. 2012;17(1):8-15

Authors: Rembrand R, Tetin-Schneider S

Abstract
INTRODUCTION: Speech in Background babble Discrimination (SIBD) is a recognized challenge. Stochastic Resonance (SR) is offered as the cognitive mechanism for speech discrimination.
OBJECTIVE: We hypothesize that SIBD has the hallmarks of SR processing because it is a non-linear transformation that includes frequency spreading and allows for brain processing without a priori knowledge of the incoming signal.
MATERIALS AND METHODS: To test the hypothesis we created two sets of HINT based, Hagerman style vocabulary, tests. The stochastic signal used is a recording of speech induced emission noise. The first set determines the SR transformation settings using a multi-dimensional optimum search. The second set measures the actual improvement in speech recognition for normally hearing and hearing impaired subjects.
RESULTS: The tests show an improvement of approximately 2 to 3 dB SNR of speech intelligibility. The improvement is much more significant for Hearing Impaired (HI) subjects.
CONCLUSION: SR lowers the detection threshold of auditory signals by an order of magnitude. We show that these results, using emissions noise, show higher discrimination rate than reported results using non-matched noise. SR processing is a cognitive process as demonstrated by the sample sentences. OAE is suggested as the brain's mechanism of SR processing.

PMID: 23906821 [PubMed - indexed for MEDLINE]

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Current and Future Issues in Pediatric and Adolescent Urologic Oncology.

Current and Future Issues in Pediatric and Adolescent Urologic Oncology.

Urology. 2016 May;91:174

Authors: Cost NG, Stock JA

PMID: 27107195 [PubMed - as supplied by publisher]

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Venezuelan equine encephalitis virus non-structural protein 3 (nsP3) interacts with RNA helicases DDX1 and DDX3 in infected cells.

Venezuelan equine encephalitis virus non-structural protein 3 (nsP3) interacts with RNA helicases DDX1 and DDX3 in infected cells.

Antiviral Res. 2016 Apr 19;

Authors: Amaya M, Brooks-Faulconer T, Lark T, Keck F, Bailey C, Raman V, Narayanan A

Abstract
The mosquito-borne New World alphavirus, Venezuelan equine encephalitis virus (VEEV) is a Category B select agent with no approved vaccines or therapies to treat infected humans. Therefore it is imperative to identify novel targets that can be targeted for effective therapeutic intervention. We aimed to identify and validate interactions of VEEV nonstructural protein 3 (nsP3) with host proteins and determine the consequences of these interactions to viral multiplication. We used a HA tagged nsP3 infectious clone (rTC-83-nsP3-HA) to identify and validate two RNA helicases: DDX1 and DDX3 that interacted with VEEV-nsP3. In addition, DDX1 and DDX3 knockdown resulted in a decrease in infectious viral titers. Furthermore, we propose a functional model where the nsP3:DDX3 complex interacts with the host translational machinery and is essential in the viral life cycle. This study will lead to future investigations in understanding the importance of VEEV-nsP3 to viral multiplication and apply the information for the discovery of novel host targets as therapeutic options.

PMID: 27105836 [PubMed - as supplied by publisher]

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Clinical Indicators of Psychosocial Distress Predict for Acute Radiation-Induced Fatigue in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer: An Analysis of Patient-Reported Outcomes.

Clinical Indicators of Psychosocial Distress Predict for Acute Radiation-Induced Fatigue in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer: An Analysis of Patient-Reported Outcomes.

Int J Radiat Oncol Biol Phys. 2016 Feb 11;

Authors: Kishan AU, Wang PC, Sharif J, Kupelian PA, Steinberg ML, McCloskey SA

Abstract
PURPOSE: To assess the magnitude and predictors of patient-reported fatigue among breast cancer patients receiving radiation therapy (RT).
METHODS AND MATERIALS: Patients receiving breast RT completed a survey querying fatigue at each weekly on-treatment visit. Patient-reported fatigue severity and interference was assessed on an ordinal scale of 0 to 4, using a validated scoring system. Baseline anxiety and depression scores were also obtained. The kinetics of mean fatigue scores per week and the maximum fatigue scores over the course of the entire treatment were assessed, and clinical predictors were identified by univariate and multivariate regression.
RESULTS: The average fatigue severity and interference scores were 0.6 and 0.46. The average fatigue scores increased to an equivalent extent from week to week, with expected increases of 0.99 in fatigue severity and 0.85 in interference over 7 weeks. Patients treated with hypofractionated RT (HF-RT) versus conventionally fractionated RT (CF-RT) had significantly fewer maximum fatigue severity or interference scores that were >2 (ie, severe or very severe; 29% vs 10% for severity, and 26% vs 8% for interference, P<.01). Age ≤45 years, presence of psychiatric/pain-related comorbidities, and baseline sadness and anxiety severity were predictive of average and maximum fatigue scores (P<.05), but variables related to treatment intensity (eg, mastectomy vs lumpectomy, chemotherapy use, radiation target volumes) and other host factors (working, children, marital status, proximity to RT facility) were not.
CONCLUSION: Patient-reported fatigue modestly increases over RT courses, with less maximum fatigue reported with HF-RT. Younger age and baseline sadness, anxiety, and psychiatric/pain-related comorbidities are powerful predictors of fatigue, whereas other factors, such as treatment intensity, are not. Future studies will investigate interventions for patients at high risk for fatigue.

PMID: 27105720 [PubMed - as supplied by publisher]

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Ovarian cancer in children and adolescents: A rare disease that needs more attention.

Ovarian cancer in children and adolescents: A rare disease that needs more attention.

Maturitas. 2016 Jun;88:3-8

Authors: Baert T, Storme N, Van Nieuwenhuysen E, Uyttebroeck A, Van Damme N, Vergote I, Coosemans A

Abstract
Ovarian cancer is rare in childhood. This explains why there are only scattered reports on it in the literature and why there is a lack of specific pediatric treatment. This paper gives an overview of the Belgian data from 2004 to 2013 and reviews the literature. To index ovarian masses and malignancies in children better in the future, worldwide data collection should be improved and reproducible definitions of 'childhood', 'malignancy' and 'ovarian mass' need to be adopted.

PMID: 27105689 [PubMed - in process]

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Epigenetic regulation of cell signaling pathways in acute lymphoblastic leukemia.

Epigenetic regulation of cell signaling pathways in acute lymphoblastic leukemia.

Epigenomics. 2013;5(5):525-38

Authors: San Jose-Eneriz E, Agirre X, Rodríguez-Otero P, Prosper F

Abstract
Acute lymphoblastic leukemia (ALL) is a heterogeneous cancer that is characterized by rapid and uncontrolled proliferation of immature B- or T-lymphoid precursors. Although ALL has been regarded as a genetic disease for many years, the crucial importance of epigenetic alterations in leukemogenesis has become increasingly evident. Epigenetic mechanisms, which include DNA methylation and histone modifications, are critical for gene regulation during many key biological processes. Here, we review the cell signaling pathways that are regulated by DNA methylation or histone modifications in ALL. Recent studies have highlighted the fundamental role of these modifications in ALL development, and suggested that future investigation into the specific genes and pathways that are altered by epigenetic mechanisms can contribute to the development of novel drug-based therapies for ALL.

PMID: 24059799 [PubMed - indexed for MEDLINE]

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3H dendrimer nanoparticle organ/tumor distribution.

3H dendrimer nanoparticle organ/tumor distribution.

Pharm Res. 2004 Mar;21(3):476-83

Authors: Nigavekar SS, Sung LY, Llanes M, El-Jawahri A, Lawrence TS, Becker CW, Balogh L, Khan MK

Abstract
PURPOSE: To determine the in vivo biodistribution for differently charged poly(amidoamine) (PAMAM) dendrimers in B16 melanoma and DU145 human prostate cancer mouse tumor model systems.
METHODS: Neutral (NSD) and positive surface charged (PSD) generation 5 (d = 5 nm) PAMAM dendrimers were synthesized by using 3H-labeled acetic anhydride and tested in vivo. Dendrimer derivatives were injected intravenously, and their biodistribution was determined via liquid scintillation counting of tritium in tissue and excretory samples. Mice were also monitored for acute toxicity.
RESULTS: Both PSD and NSD localized to major organs and tumor. Dendrimers cleared rapidly from blood, with deposition peaking at 1 h for most organs and stabilizing from 24 h to 7 days postinjection. Maximal excretion occurred via urine within 24 h postinjection. Neither dendrimer showed acute toxicity.
CONCLUSIONS: Changes in the net surface charge of polycationic PAMAMs modify their biodistribution. PSD deposition into tissues is higher than NSD, although the biodistribution trend is similar. Highest levels were found in lungs, liver, and kidney, followed by those in tumor, heart, pancreas, and spleen, while lowest levels were found in brain. These nanoparticles could have future utility as systemic biomedical delivery devices.

PMID: 15070099 [PubMed - indexed for MEDLINE]

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A reciprocal regulatory circuit between CD44 and FGFR2 via c-myc controls gastric cancer cell growth.

A reciprocal regulatory circuit between CD44 and FGFR2 via c-myc controls gastric cancer cell growth.

Oncotarget. 2016 Apr 16;

Authors: Park J, Kim SY, Kim HJ, Kim KM, Choi EY, Kang MS

Abstract
Despite their suggested importance, the mechanistic roles of FGFR2 and gastric cancer stem cell (GCSC) marker CD44 remain unclear. We investigated cross talk between CD44 and FGFR2. FGFR2 and CD44 positively regulate each other's expression. While FGFR2 suppresses c-Myc transcription, CD44 activates it. c-Myc in turn augments FGFR2 transcription. CD44 knockdown (KD) depleted FGFR2 and other GCSC markers, decreased c-Myc and Sox2 expression, and suppressed tumor growth, whereas CD44 activation led to FGFR2 induction. FGFR2 KD decreased most GCSC marker expression, including CD44, but increased c-Myc and Sox2 expression and attenuated tumor growth. FGFR2 kinase inhibitor and FGFR2 neutralizing antibody decreased the CD44+/hi GCSC fraction. Conversely, FGFR2 overexpression increased CD44 and accelerated tumor growth in mice. FGFR2 was co-expressed and colocalized diffusively with CD44, EpCAM, and LGR5. In contrast, phospho-FGFR2 colocalized densely with CD44, forming an aggregated signaling complex that was prevented by FGFR2 inhibition. The c-Myc KD depleted FGFR2 but not CD44. Similarly to CD44+/hi phenotypes, sorted FGFR+/hi cells had larger volumes, formed more tumor spheres, grew faster in vivo with bigger tumor mass, and expressed more CD44, EpCAM, and HER2. These findings suggest that FGFR2+/hi cells have stemness properties. Moreover, in situ FGFR2 expression in patient-derived gastric cancer tissue correlated with tumorigenic potential in a xenograft model. In conclusion, CD44 and FGFR2 maintain stemness in gastric cancer by differentially regulating c-Myc transcription.

PMID: 27107424 [PubMed - as supplied by publisher]

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NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer.

Oncotarget. 2016 Apr 16;

Authors: Lin Y, Ma C, Liu C, Wang Z, Yang J, Liu X, Shen Z, Wu R

Abstract
Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients.

PMID: 27107423 [PubMed - as supplied by publisher]

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Hsp90 inhibition increases SOCS3 transcript and regulates migration and cell death in chronic lymphocytic leukemia.

Hsp90 inhibition increases SOCS3 transcript and regulates migration and cell death in chronic lymphocytic leukemia.

Oncotarget. 2016 Apr 16;

Authors: Chen TL, Gupta N, Lehman A, Ruppert AS, Yu L, Oakes CC, Claus R, Plass C, Maddocks KJ, Andritsos L, Jones JA, Lucas DM, Johnson AJ, Byrd JC, Hertlein E

Abstract
Epigenetic or transcriptional silencing of important tumor suppressors has been described to contribute to cell survival and tumorigenesis in chronic lymphocytic leukemia (CLL). Using gene expression microarray analysis, we found that thousands of genes are repressed more than 2-fold in CLL compared to normal B cells; however therapeutic approaches to reverse this have been limited in CLL. Following treatment with the Hsp90 inhibitor 17-DMAG, a significant number of these repressed genes were significantly re-expressed. One of the genes significantly repressed in CLL and up-regulated by 17-DMAG was suppressor of cytokine signaling 3, (SOCS3). SOCS3 has been shown to be silenced in solid tumors as well as myeloid leukemia; however little is known about the regulation in CLL. We found that 17-DMAG induces expression of SOCS3 by via the activation of p38 signaling, and subsequently inhibits AKT and STAT3 phosphorylation resulting in downstream effects on cell migration and survival. We therefore suggest that SOCS3 is an important signaling protein in CLL, and Hsp90 inhibitors represent a novel approach to target transcriptional repression in B cell lymphoproliferative disorders which exhibit a substantial degree of gene repression.

PMID: 27107422 [PubMed - as supplied by publisher]

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X chromosome-wide identification of SNVs in microRNA genes and non-obstructive azoospermia risk in han chinese population.

X chromosome-wide identification of SNVs in microRNA genes and non-obstructive azoospermia risk in han chinese population.

Oncotarget. 2016 Apr 16;

Authors: Ji J, Qin Y, Zhou R, Zang R, Huang Z, Zhang Y, Chen M, Wu W, Song L, Ling X, Shen H, Hu Z, Xia Y, Lu C, Wang X

Abstract
Human X chromosome has higher densities of microRNAs (miRNAs) compared to the average densities on autosomes. Given that numbers of X-linked miRNAs can escape from meiotic sex chromosome inactivation (MSCI) silencing, it is proposed that X-linked miRNAs may play critical roles in the process of spermatogenesis. To test the hypothesis, we performed DNA capture sequencing of human X-linked miRNAs, which was followed by a two-stage case-control study to identify the non-obstructive azoospermia (NOA) related single nucleotide variants (SNVs) in 1107 NOA cases and 1191 fertile healthy controls. Eventually, we found rs5951785, located near hsa-miRNA-506/507, increased the risk of NOA, while rs1447393, near hsa-miRNA-510, decreased the risk of NOA. Functional analysis revealed that rs5951785 significantly inhibited cell proliferation and induced cell apoptosis. Taken together, our results demonstrated that X-linked miRNAs played important roles in the pathogenesis of NOA.

PMID: 27107421 [PubMed - as supplied by publisher]

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Pinin facilitated proliferation and metastasis of colorectal cancer through activating EGFR/ERK signaling pathway.

Pinin facilitated proliferation and metastasis of colorectal cancer through activating EGFR/ERK signaling pathway.

Oncotarget. 2016 Apr 15;

Authors: Wei Z, Ma W, Qi X, Zhu X, Wang Y, Xu Z, Luo J, Wang D, Guo W, Li X, Xin S, Yu J, Li G

Abstract
Increasing emphasis has been put on the influence of desmosome related proteins on progress of colorectal cancer (CRC). Pinin (PNN) is a desmosome-associated molecule that has been reported its overexpression could increase desmoglein 2 (DSG2) and E-cadherin (E-ca) levels. However, it was documented that DSG2 and E-ca had opposite functions in CRC. Thus, we attempted to elucidate function and mechanism of PNN in CRC. Herein, we revealed that overexpression of PNN was significantly correlated with the aggressive characteristics and indicated poor overall survival of CRC patients. In addition, the proliferation, invasion in vitro, and tumorigenic growth, metastasis in vivo were also promoted by the up-regulation of PNN. It was also verified that up-regulation of PNN increased the expression of DSG2 and activated the EGFR/ERK signaling pathway. Our findings suggested that PNN, as a valuable marker of prognosis, has important influence on the progression of CRC.

PMID: 27107420 [PubMed - as supplied by publisher]

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Essential role for acid sphingomyelinase-inhibited autophagy in melanoma response to cisplatin.

Essential role for acid sphingomyelinase-inhibited autophagy in melanoma response to cisplatin.

Oncotarget. 2016 Apr 14;

Authors: Cervia D, Assi E, De Palma C, Giovarelli M, Bizzozero L, Pambianco S, Di Renzo I, Zecchini S, Moscheni C, Vantaggiato C, Procacci P, Clementi E, Perrotta C

Abstract
The sphingolipid metabolising enzyme Acid Sphingomyelinase (A-SMase) has been recently shown to inhibit melanoma progression and correlate inversely to tumour grade. In this study we have investigated the role of A-SMase in the chemo-resistance to anticancer treatmentusing mice with melanoma allografts and melanoma cells differing in terms of expression/activity of A-SMase. Since autophagy is emerging as a key mechanism in tumour growth and chemo-resistance, we have also investigated whether an action of A-SMase in autophagy can explain its role. Melanoma sensitivity to chemotherapeutic agent cisplatin in terms of cell viability/apoptosis, tumour growth, and animal survival depended directly on the A-SMase levels in tumoural cells. A-SMase action was due to inhibition of autophagy through activation of Akt/mammalian target of rapamycin (mTOR) pathway. Treatment of melanoma-bearing mice with the autophagy inhibitor chloroquine restored sensitivity to cisplatin of tumours expressing low levels of A-SMase while no additive effects were observed in tumours characterised by sustained A-SMase levels. The fact that A-SMase in melanomas affects mTOR-regulated autophagy and plays a central role in cisplatin efficacy encourages pre-clinical testing on the modulation of A-SMase levels/activity as possible novel anti-neoplastic strategy.

PMID: 27107419 [PubMed - as supplied by publisher]

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Hypermethylated in cancer 1(HIC1) suppresses non-small cell lung cancer progression by targeting interleukin-6/Stat3 pathway.

Hypermethylated in cancer 1(HIC1) suppresses non-small cell lung cancer progression by targeting interleukin-6/Stat3 pathway.

Oncotarget. 2016 Apr 14;

Authors: Wang X, Wang Y, Xiao G, Wang J, Zu L, Hao M, Sun X, Fu Y, Hu G, Wang J

Abstract
Non-small cell lung cancer (NSCLC), which accounts for more than 80% of lung cancers, is a leading cause of cancer mortality worldwide. However, the mechanism underlying its progression remains unclear. Here we found that HIC1 promoter was heavily methylated in NSCLC cell lines and tissues contributing to its low expression compared to normal controls. Restoring HIC1 expression inhibited migration, invasion and promoted inducible apoptosis of NSCLC cells. Notably, HIC1 is a tumor suppressor through inhibiting the transcription of IL-6 by sequence-specific binding on its promoter. Restoring IL-6 expression could partially rescue these phenotypes induced by HIC1 in vitro and in vivo. Mechanistic analyses show that autocrine secretion of IL-6 induced by loss of HIC1 activated STAT3 through IL-6/JAK pathway and was associated with NSCLC progression. The HIC1/IL-6 axis may serve as a prognostic biomarker and provide an attractive therapeutic target for NSCLC.

PMID: 27107418 [PubMed - as supplied by publisher]

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SUMOylation of HP1α supports association with ncRNA to define responsiveness of breast cancer cells to chemotherapy.

SUMOylation of HP1α supports association with ncRNA to define responsiveness of breast cancer cells to chemotherapy.

Oncotarget. 2016 Apr 14;

Authors: Lin FM, Kumar S, Ren J, Karami S, Bahnassy S, Li Y, Zheng X, Wang J, Bawa-Khalfe T

Abstract
Epigenetic reprogramming allows cancer cells to bypass normal checkpoints and potentiate aberrant proliferation. Several chromatin regulators are subject to reversible SUMO-modification but little is known about how SUMOylation of chromatin-remodelers modulates the cancer epigenome. Recently, we demonstrated that SUMO-protease SENP7L is upregulated in aggressive BCa and maintains hypoSUMOylated heterochromatin protein 1-α (HP1α). Canonical models define HP1α as a "reader" of repressive H3K9m3 marks that supports constitutive heterochromatin. It is unclear how SUMOylation affects HP1α function in BCa cells. This report shows HP1α SUMO-dynamics are closely regulated in a complex with SENP7L and SUMO-E3 Polycomb-2 (PC2/CBX4). This complex accumulates at H3K9m3 sites, hypoSUMOylates HP1α and PC2, and reduces PC2's SUMO-E3 activity. HyperSUMO conditions cause complex dissociation, SUMOylation of PC2 and HP1α, and recruitment of SUMOylated HP1α to multiple DNA-repair genes including Rad51C. SUMOylated HP1α's enrichment at euchromatin requires chromatin-bound non-coding RNA (ncRNA), reduces Rad51C protein, and increases DNA-breaks in BCa cells. Hence, HP1α SUMOylation and consistently low SENP7L increase efficacy of DNA-damaging chemotherapeutic agents. BCa patients on chemotherapy that express low SENP7L exhibit greater survival rates than patients with high SENP7L. Collectively, these studies suggest that SUMOylated HP1α is a critical epigenetic-regulator of DNA-repair in BCa that could define chemotherapy responsiveness.

PMID: 27107417 [PubMed - as supplied by publisher]

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Atlas on substrate recognition subunits of CRL2 E3 ligases.

Atlas on substrate recognition subunits of CRL2 E3 ligases.

Oncotarget. 2016 Apr 14;

Authors: Wang S, Xia W, Qiu M, Wang X, Jiang F, Yin R, Xu L

Abstract
The Cullin2-type ubiquitin ligases belong to the Cullin-Ring Ligase (CRL) family, which is a crucial determinant of proteasome-based degradation processes in eukaryotes. Because of the finding of von Hippel-Lindau tumor suppressor (VHL), the Cullin2-type ubiquitin ligases gain focusing in the research of many diseases, especially in tumors. These multisubunit enzymes are composed of the Ring finger protein, the Cullin2 scaffold protein, the Elongin B&C linker protein and the variant substrate recognition subunits (SRSs), among which the Cullin2 scaffold protein is the determining factor of the enzyme mechanism. Substrate recognition of Cullin2-type ubiquitin ligases depends on SRSs and results in the degradation of diseases associated substrates by intracellular signaling events. This review focuses on the diversity and the multifunctionality of SRSs in the Cullin2-type ubiquitin ligases, including VHL, LRR-1, FEM1b, PRAME and ZYG11. Recently, as more SRSs are being discovered and more aspects of substrate recognition have been illuminated, insight into the relationship between Cul2-dependent SRSs and substrates provides a new area for cancer research.

PMID: 27107416 [PubMed - as supplied by publisher]

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miR-1207-5p suppresses lung cancer growth and metastasis by targeting CSF1.

miR-1207-5p suppresses lung cancer growth and metastasis by targeting CSF1.

Oncotarget. 2016 Apr 13;

Authors: Dang W, Qin Z, Fan S, Wen Q, Lu Y, Wang J, Zhang X, Wei L, He W, Ye Q, Yan Q, Li G, Ma J

Abstract
We previously reported that miR-1207-5p can inhibit epithelial-mesenchymal transition (EMT) induced by growth factors such as EGF and TGF-β, but the exact mechanism is unclear. Here we identified that Colony stimulating factor 1 (CSF1) is a target gene of miR-1207-5p. CSF1 controls the production, differentiation and function of macrophage and promotes the release of proinflammatory chemokines. We showed that miR-1207-5p inhibited lung cancer cell A549 proliferation, migration and invasion in vitro, and suppressed the STAT3 and AKT signalings. miR-1207-5p overexpression can increase HUVEC angiogenesis, and can modulate the M2 phenotype of macrophage. miR-1207-5p also significantly inhibited A549 cells metastasis in a nude mouse xenograft model. miR-1207-5p and CSF1 expression levels and their relationship with lung cancer survival and metastasis status were assayed by means of a lung cancer tissue microarray. Macrophage is an essential part of the tumor microenvironment, thus the miR-1207-5p-CSF1 axis maybe a new regulator of lung cancer development through modulating the tumor microenvironment.

PMID: 27107415 [PubMed - as supplied by publisher]

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Human papillomavirus infection on initiating synchronous esophageal neoplasia in patients with head and neck cancer.

Human papillomavirus infection on initiating synchronous esophageal neoplasia in patients with head and neck cancer.

Laryngoscope. 2016 May;126(5):1097-1102

Authors: Wang WL, Wang YC, Chang CY, Lo JL, Kuo YH, Hwang TZ, Wang CC, Mo LR, Lin JT, Lee CT

Abstract
OBJECTIVES/HYPOTHESIS: Human papillomavirus (HPV) is a risk factor for head and neck squamous cell carcinoma (HNSCC) as well as esophageal squamous cell carcinoma (ESCC). We aimed to investigate whether HPV infection underlies the field cancerization phenomenon over upper aerodigestive tract to develop synchronous multiple cancers.
STUDY DESIGN: A case control study.
METHODS: The presence and subtype of HPV-DNA sequence in cancers were examined by polymerase chain reaction and sequencing in a prospective cohort with 100 HNSCCs, 50 of which had synchronous ESCCs. The clinicopathologic characteristics were further analyzed according to the presence of HPV.
RESULTS: Twelve patients were HPV-positive, of which 11 were positive for HPV-16. The prevalence of HPV infection were not different between the synchronous and HNSCC alone groups (P = 0.357). Testing for HPV in paired HNSCC and ESCC tissues from the same patient revealed that none were concomitantly HPV-positive. Multivariate logistic regression showed drinking alcohol (odds ratio [OR], 18.75; P = 0.030), alcohol flushing (OR, 2.53; P = 0.041), and body mass index (OR, 0.77; P = 0.001) but not HPV infection were independent risk factors for synchronous phenotype. The patients with synchronous ESCCs had significantly poorer survival than those with HNSCC alone (5-year overall survival: 30% vs. 70%; log-rank P < 0.001). However, patients with HPV-positive HNSCC tend to have favorable outcome than those with HPV-negative HNSCC.
CONCLUSIONS: HPV infection plays little role in field cancerization phenomenon to initiate synchronous SCC. The synchronous HNSCC and ESCC from the same patients had no clonal relationship. Routine endoscopic examination of the esophagus should be recommended for patients with risk factors identified.
LEVELS OF EVIDENCE: NA. Laryngoscope, 126:1097-1102, 2016.

PMID: 27107411 [PubMed - as supplied by publisher]

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Laryngeal ultrasound and vocal fold movement in the pediatric cardiovascular intensive care unit.

Laryngeal ultrasound and vocal fold movement in the pediatric cardiovascular intensive care unit.

Laryngoscope. 2016 Apr 23;

Authors: Ongkasuwan J, Ocampo E, Tran B

Abstract
OBJECTIVES/HYPOTHESIS: Vocal fold motion impairment (VFMI) is a known sequela of cardiovascular surgery. The gold standard for the evaluation of vocal fold movement is flexible nasolaryngoscopy (FNL). Although safe, FNL does cause measurable physiologic changes. Noxious stimuli in cardiovascular intensive care unit (CVICU) neonates may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse. The goals of this project were to determine the accuracy of laryngeal ultrasound (LUS) compared to FNL to identify VFMI in CVICU neonates and compare their physiologic impact.
STUDY TYPE: Case control.
DESIGN: Prospective case-control study.
METHODS: Forty-six consecutive infants from the CVICU were recruited, 23 with VFMI and 23 without based on FNL findings. They then underwent LUS, which was subsequently reviewed by two pediatric radiologists blinded to the FNL results. Physiologic parameters were recorded before and after the procedures. Data analysis was performed with Cohen's kappa and Wilcoxon signed-rank test.
RESULTS: Agreement between LUS and FNL was substantial (κ = 0.78). Laryngeal ultrasound had a sensitivity of 0.84 and specificity of 0.95 for identifying VFMI. In terms of physiologic impact, LUS caused statistically significantly less change in diastolic blood pressure (P = 0.01), pulse (P = 0.001), and O2 saturation (P = 0.004) compared to FNL. Arytenoid rotation could be seen clearly, and the vocal fold-arytenoid angle in abduction was most predictive of symmetry and movement (P = 0.17). However, it was difficult to determine vocal fold closure patterns with LUS.
CONCLUSION: Laryngeal ultrasound is a comparable to FNL for evaluating vocal fold mobility with less physiologic impact.
LEVEL OF EVIDENCE: 3b. Laryngoscope, 2016.

PMID: 27107409 [PubMed - as supplied by publisher]

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Manual laryngeal reposturing as a primary approach for mutational falsetto.

Manual laryngeal reposturing as a primary approach for mutational falsetto.

Laryngoscope. 2016 Apr 23;

Authors: Roy N, Peterson EA, Pierce JL, Smith ME, Houtz DR

Abstract
OBJECTIVES/HYPOTHESIS: Mutational falsetto is a functional voice disorder characterized by failure of the male high-pitched preadolescent voice to transition to the lower pitch of adolescence and adulthood. Few objective outcomes data exist regarding the effectiveness of voice therapy for this poorly understood disorder. This study examined the immediate effects of a single therapy session using manual laryngeal reposturing as a primary approach in the management of mutational falsetto.
STUDY DESIGN: Retrospective case series, pre-/posttreatment.
METHODS: Manual circumlaryngeal techniques, including digital laryngeal reposturing maneuvers, were used as the primary approach to treat 12 consecutive males with mutational falsetto (mean age 17.5 yrs., range 14-25 years). Pre- and posttreatment audiorecordings of connected speech and sustained vowel samples were submitted to auditory-perceptual and acoustic analysis to assess the effects of a single voice therapy session. Acoustic estimates of severity in both connected speech and sustained vowel productions were computed using the Cepstral Spectral Index of Dysphonia (CSID), a multivariate dysphonia summary tool that incorporates cepstral and spectral measures.
RESULTS: Pre- and posttreatment comparisons confirmed a significant change in the direction of normal vocal function within a single treatment session for both listener- and CSID-based estimates of dysphonia severity.
CONCLUSION: Behavioral therapy using manual laryngeal reposturing by an experienced voice clinician is an effective and efficient primary approach for mutational falsetto.
EVIDENCE LEVEL: 4. Laryngoscope, 2016.

PMID: 27107407 [PubMed - as supplied by publisher]

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Minithyrotomy with radiofrequency-induced thermotherapy (RFITT) for the treatment of adductor spasmodic dysphonia.

Minithyrotomy with radiofrequency-induced thermotherapy (RFITT) for the treatment of adductor spasmodic dysphonia.

Laryngoscope. 2016 Apr 23;

Authors: Desai SC, Park AM, Chernock RD, Paniello RC

Abstract
OBJECTIVES/HYPOTHESIS: A simple, safe and effective surgical alternative for treating adductor spasmodic dysphonia (ADSD) would appeal to many patients. This study evaluates a new option, using radiofrequency-induced thermotherapy (RFITT) of the thyroarytenoid muscle (TA) via the minithyrotomy approach to reduce the force of adduction.
METHODS: Fifteen dogs were used. In part 1, the optimal RFITT power settings, exposure time, probe location, and number of passes were determined. Part 2 compared laryngeal adductor pressures (LAPs) at baseline; immediately postintervention; and at 1, 3, or 6 months postintervention. Interventions included RFITT via the transcervical minithyrotomy approach (n = 15), transoral RFITT (n = 3), botulinum toxin (Botox) injection (n = 3), or no-intervention controls (n = 3). Postintervention induced phonation and histologic analyses were performed as well.
RESULTS: In the minithyrotomy RFITT group, the mean LAP was 30.3% of baseline immediately posttreatment. At 1, 3, and 6 months postoperatively, the mean LAPs were 24.9%, 44.8%, and 43.5%, respectively. Transoral RFITT reduced LAP to 56.6% of baseline immediately posttreatment, but returned to normal in the 1 and 3 month animals. The Botox injections dropped the LAP to 57% of baseline at 1 month, but returned to normal at 3 months. Mucosal waves, based on induced phonation stroboscopy, were present at the terminal date in all animals. Thirteen of 15 transcervical RFITT preparations (87%) showed no injury to the lamina propria, whereas 80% showed evidence of TA muscle atrophy and fibrosis.
CONCLUSION: Minithyrotomy RFITT is a feasible technique that shows encouraging long-term results for the potential treatment of patients with ADSD.
LEVEL OF EVIDENCE: N/A. Laryngoscope, 2016.

PMID: 27107402 [PubMed - as supplied by publisher]

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Effect of the tracheoesophageal voice resistance test in total laryngectomees.

Effect of the tracheoesophageal voice resistance test in total laryngectomees.

Laryngoscope. 2016 Apr 23;

Authors: Pellicani AD, Ricz H, Iqueda AP, Aguiar-Ricz L

Abstract
OBJECTIVES/HYPOTHESIS: To analyze tracheoesophageal voice resistance in laryngectomized patients by comparing the acoustic, perceptive-auditory and self-evaluation measures before and after the voice resistance test.
STUDY DESIGN: An observational, experimental study with a quantitative and descriptive approach.
METHODS: Nineteen total laryngectomees were submitted for capture of vocal intensity, self-assessment of signs and symptoms of voice fatigue using a visual analogue scale, and perceptive-auditory and acoustic analysis of the tracheoesophageal voice before and after the voice resistance test, which consisted of continuous repeated counting from one to 100.
RESULTS: The mean time of execution of the test was 33.68 minutes. Type II sound signal, voice intensity, voice quality, degree of severity of dysphonia, and the pitch and loudness parameters were maintained after the test. There were no changes in signs and symptoms of vocal fatigue.
CONCLUSIONS: Most of the total laryngectomees performed the voice resistance test for less than 30 minutes. However, the voice resistance test did not induce significant changes in the quality of tracheoesophageal voice of total laryngectomees or in the signs and symptoms of vocal fatigue.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27107400 [PubMed - as supplied by publisher]

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Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings.

Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings.

Laryngoscope. 2016 Apr 23;

Authors: Chang C, Lin WN, Hsin LJ, Lee LA, Lin CY, Li HY, Liao CT, Fang TJ

Abstract
OBJECTIVES/HYPOTHESIS: Direct suspension laryngoscopic biopsy performed under general anesthesia is the conventional management for obtaining pathological diagnosis for neoplasms of the larynx, oropharynx, and hypopharynx. Since the development of distal chip laryngoscopy and digital imaging systems, transnasal flexible laryngoscopy tissue sampling has gained popularity as an office-based procedure. Additional assessment with narrow-band imaging (NBI) can help to increase the diagnostic yield. The aim of the study was to evaluate the accuracy, sensitivity, and specificity of a novel diagnostic tool: office-based NBI (OB-NBI) flexible laryngoscopic tissue sampling.
STUDY DESIGN: Retrospective chart review performed in a tertiary referral medical center in Taiwan.
METHODS: From January 2010 to February 2013, 90 consecutive patients received OB-NBI biopsies. The accuracies of the OB-NBI biopsies were compared among locations, tumor sizes, head and neck cancer histories, and other factors.
RESULTS: All patients had completed the procedure without life-threatening complications. The overall sensitivity and specificity were 97.2% and 100%, respectively, with a diagnostic accuracy of 98.9%. Accuracy was not affected by tumor size, location, learning curves, or previous head and neck cancer history.
CONCLUSIONS: We present an integrated technique that merges the safety and versatility of flexible laryngoscopy with the diagnostic power of NBI to produce a promising method of high accuracy and minimal morbidity.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27107397 [PubMed - as supplied by publisher]

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Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery.

Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery.

Laryngoscope. 2016 Apr 23;

Authors: Wise SC, Carlson ML, Tveiten ØV, Driscoll CL, Myrseth E, Lund-Johansen M, Link MJ

Abstract
OBJECTIVES/HYPOTHESIS: To evaluate outcomes of salvage surgery for vestibular schwannoma (VS) that failed primary stereotactic radiosurgery (SRS).
METHODS: Case-control study of 37 patients who underwent surgical resection of sporadic VS following prior SRS at two tertiary academic referral centers between 2003 and 2015. A cohort of nonirradiated control subjects, matched according to tumor size, age, and treatment center, were used as comparison.
RESULTS: Thirty-seven patients were included. The median time from radiation to surgical salvage was 36 months (range 9.6-153 months). Following tumor progression after SRS, 18 (49%) patients underwent gross total resection, 10 (27%) underwent near-total resection, and nine (24%) underwent subtotal resection. Postoperative complications following salvage surgery included one (3%) case of stroke, four (11%) cases of cerebrospinal fluid leak, and two (5%) cases of meningitis. Twenty-seven (73%) patients had good postoperative facial nerve outcome (House-Brackmann Score I-II) at long-term follow-up. There were no cases of tumor recurrence or regrowth after a median length of 26 months following microsurgical salvage (range 3-114 months). The rate of satisfactory postoperative facial nerve function was not different between study and control subjects (73% vs. 76%; P = 0.8); however, less-than-complete resection was utilized more frequently among previously radiated patients (P = 0.01).
CONCLUSION: Microsurgical salvage of VS following primary radiation therapy is challenging. Less-than-complete resection is required in a greater percentage of patients to preserve facial nerve integrity and prevent neurological complications. Long-term follow-up is needed to determine the risk of delayed progression following incomplete tumor removal.
LEVEL OF EVIDENCE: Level 3. Laryngoscope, 2016.

PMID: 27107262 [PubMed - as supplied by publisher]

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Susceptibility of human tonsillar epithelial cells to enterovirus 71 with normal cytokine response.

Susceptibility of human tonsillar epithelial cells to enterovirus 71 with normal cytokine response.

Virology. 2016 Apr 20;494:108-118

Authors: Xie GC, Guo NJ, Grénman R, Wang H, Wang Y, Vuorenmma M, Zhang Q, Zhang S, Li HY, Pang LL, Li DD, Jin M, Sun XM, Kong XY, Duan ZJ

Abstract
A recent histopathologic study implicated human tonsillar crypt epithelium as an important site for EV71 replication in EV71-caused fatal cases. This study aimed to confirm the susceptibility of human tonsillar epithelium to EV71. Two human tonsillar epithelial cell lines (UT-SCC-60A and UT-SCC-60B) were susceptive to EV71, and PI3K/AKT, p38, ERK1/2, and JNK1/2 signal pathways were activated. Interferon-α, IL-8, IL-1β, IL-6 and IL-12p40 were induced and regulated by PI3K/AKT, p38, ERK1/2, and JNK1/2 signal pathways. PI3K/AKT pathway activation appeared to suppress the induction of TNF-α, which induced cell survival by inhibiting GSK-3β. The activation of NF-κB was observed but inhibited by these pathways in EV71 infection. Furthermore, ERK1/2 and JNK1/2 were essential for efficient EV71 replication. Human tonsillar epithelial cells support EV71 replication and display innate antiviral immunity in vitro, indicating that human tonsillar epithelial cells may be novel targets for EV71 infection and replication in vivo.

PMID: 27107253 [PubMed - as supplied by publisher]

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Phonosurgical resection using submucosal infusion technique for precancerous laryngeal leukoplakia.

Phonosurgical resection using submucosal infusion technique for precancerous laryngeal leukoplakia.

Laryngoscope. 2016 Apr 23;

Authors: Kono T, Saito K, Yabe H, Ogawa K

Abstract
OBJECTIVES/HYPOTHESIS: This study was designed to assess the feasibility of the submucosal infusion technique combined with microflap dissection as a radical therapeutic and diagnostic option for precancerous laryngeal leukoplakia.
STUDY DESIGN: Retrospective study.
METHODS: Severe dysplasia or carcinoma in situ was diagnosed after phonomicrosurgical dissections in 25 patients with unilateral laryngeal leukoplakia. Of these, 15 patients preferred no additional surgery (observation group), whereas 10 patients underwent further laser subligamental cordectomy (additional surgery group). The relationship between the initial surgical margin and histopathological characteristics of additionally excised tissues was assessed to evaluate diagnostic reliability. Disease control was assessed to determine the oncologic efficacy of the therapeutic procedure. Comparative multidimensional vocal assessments were performed in both groups to evaluate functional advantages of one-stage excision.
RESULTS: After the initial phonomicrosurgical resection, three patients had residual dysplastic lesions near the vocal process and anterior commissure, whereas three other patients had lesions suspicious for recurrence. No postoperative malignant transformation was observed in any patient. Although well-preserved vocal function was observed in the observation group, vocal quality deteriorated shortly after laser surgery in the additional surgery group. Regarding acoustics, aerodynamics, and quality-of-life evaluations, statistically equivalent scores were observed between the observation and control groups, whereas scores were inferior in the additional surgery group than in the control group.
CONCLUSIONS: Phonomicrosurgical resection may be a therapeutic option with oncologic efficacy against precancerous laryngeal leukoplakia. This radical management might achieve more satisfactory postoperative vocal function.
LEVEL OF EVIDENCE: NA Laryngoscope, 2016.

PMID: 27107249 [PubMed - as supplied by publisher]

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A validated method of labial minor salivary gland biopsy for the diagnosis of Sjögren's syndrome.

A validated method of labial minor salivary gland biopsy for the diagnosis of Sjögren's syndrome.

Laryngoscope. 2016 Apr 23;

Authors: Kim J, Sun D, Ozl R, Grader-Beck T, Birnbaum J, Akpek EK, Baer AN

Abstract
OBJECTIVES/HYPOTHESIS: To validate a technique and outcomes of labial minor salivary gland biopsy (LSGB) used for the diagnosis of Sjögren's syndrome (SS).
STUDY DESIGN: Prospective cohort study.
METHODS: Clinical data were prospectively obtained pre- and postbiopsy using patient-reported questionnaires. LSGB was performed using described methods. Specimens were analyzed by a pathologist with expertise in SS and assessed using established criteria to determine the focus score. Data were analyzed using cross-tabulations.
RESULTS: Among the 58 patients in the study, 52 (90%) presented with sicca symptoms of dry eyes and/or mouth. Eight patients (14%) had histopathologic findings supportive of a diagnosis of SS. At 1 month postbiopsy, greater than 71% of patients denied any complaints of pain, swelling, numbness. or tingling. Sixteen patients (28%) had only a minor level of complaints. Only one patient complained of severe numbness at the biopsy site. Greater than 70% of patients would consider rebiopsy after the procedure, if requested by their physician.
CONCLUSIONS: We present a safe and effective method of LSGB for the diagnosis of SS.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27107215 [PubMed - as supplied by publisher]

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Κυριακή 24 Απριλίου 2016