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Κυριακή 26 Δεκεμβρίου 2021

Anterior Palatoplasty With Expansion Sphincter Pharyngoplasty for All Type of Pharyngeal Collapse

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Objectives/Hypothesis

This study was aimed to compare the efficiency of the anterior palatoplasty and expansion sphincter pharyngoplasty (APwESP) technique for all patterns of velopharyngeal obstruction (anterior–posterior [APPC], lateral [LPC], or combined circular pharyngeal collapse [CPC]).

Study Design

The study was designed as a randomized prospective trial at Kâtip Çelebi University, Atatürk Training, and Research Hospital.

Methods

Patients only with velopharyngeal obstruction were included. Three groups were created according to the obstruction pattern (APPC, LPC, and CPC) for the study. Outcome parameters included patient's demographics, apnea-hypopnea index (AHI), lowest oxygen saturation (LOS), Stanford subjective scale of snoring (SSSS), and Epworth sleepiness scale (ESS).

Results

Thirty-one (34.1%) patients were in APPC group, while 30 (33.0%) patients were in LPC, and 30 (33.0%) were in CPC group. Preoperatively for all patients, on average, AHI was 33.4 ± 13.6, SSSS was 8.3 ± 1.0, ESS was 16.5 ± 2.6, and LOS was determined as 85.5 ± 3.6. There was a significant postoperative improvement in all parameters for all patients. There was no significant difference in outcome parameters between the groups according to obstruction pattern postoperatively. After APwESP surgery, obstruction pattern was not a significant factor for AHI (P = .234), SSSS (P = .180), and LOS (P = .280) (repeated measure analysis of variance test). The rate of surgical success was detected similarly for both of the study groups (P = .435). The rate of successful surgery for severe obstructive sleep apnea in the APPC group was 72.2%, 88.2% in the LPC group, and 75.0% in the CPC group (P =& nbsp;.472).

Conclusion

A combination of APwESP surgery can manage all types of pharyngeal obstruction confidently.

Level of Evidence

3 Laryngoscope, 2021

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Paeonol suppresses lipid formation and promotes lipid degradation in adipocytes

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Exp Ther Med. 2022 Jan;23(1):78. doi: 10.3892/etm.2021.11001. Epub 2021 Nov 25.

ABSTRACT

Paeonol can regulate a variety of physiological and pathological processes such as thrombosis, oxidative stress, inflammation and atherosclerosis. However, its potential role and underlying mechanisms in obesity and lipid metabolism remain to be elucidated. In the present study, 3T3-L1 cells were differentiated and collected on days 4, 6 and 8. The expression levels of fatty-acid-binding protein 4 (FABP4) and microRNA (miR)-21 were detected using reverse transcription-quantitative PCR and western blot analyses. Cell viability was assessed using a Cell Counting Kit-8 assay. A miR-21 mimic was constructed and transfected into 3T3-L1 preadipocytes. Adipocyte differentiation was detected using Oil Red O staining. The proteins CD36, glucose transporter 4, peroxisome proliferator-activated receptor γ (PPAR-γ) and adipocyte protein 2 (Ap2) were detected using western blot analysis. The expression levels of FABP4 and miR-21 were increased in differentiated 3T3-L1 cells. Paeonol exhibited no effects on cell activity, whereas it inhibited the expression levels of miR-21 in the 3T3-L1 differentiated adipocytes. Paeonol suppressed the differentiation of 3T3-L1 adipocytes and its effect was partially reversed by the overexpression of miR-21. In addition, paeonol promoted the lipid degradation of 3T3-L1 adipocytes, increased the expression levels of PPAR-γ and Ap2, and suppressed triglyceride synthesis in these cells. These effects were partially reversed by the overexpression of miR-21. In conclusion, the findings of the present study indicated that paeonol may exert protective effects against lipid formation and promote lipid degradation in adipocytes. These data provide evidence of the regulatory effect of paeonol on adipocyte differentiation and highlight its pathological significance.

PMID:34938364 | PMC:PMC8688932 | DOI:10.3892/etm.2021.11001

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Role and mechanism of the Dectin-1-mediated Syk/NF-κB signaling pathway in Talaromyces marneffei infection

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Exp Ther Med. 2022 Jan;23(1):84. doi: 10.3892/etm.2021.11007. Epub 2021 Nov 25.

ABSTRACT

Dendritic cell-associated C-type lectin-1 (Dectin-1), a C-type lectin receptor, serves a critical role in host antifungal immunity. However, the molecular mechanism and function of Dectin-1-mediated signaling in response to infection by the pathogenic fungus Talaromyces marneffei remains unclear. To understand the role of Dectin-1 signaling against T. marneffei infection, the phosphorylation of spleen tyrosine kinase (Syk), nuclear factor of κ light polypeptide gene enhancer in B-cells inhibitor, α (IκBα) and NF-κB were analyzed using western blotting, and the secretion of cytokines was detected using ELISA. Upon sporular or hyphal heat-killed T. marneffei stimulation, Dectin-1 in THP-1 macrophages recognized and induced the activation of Syk, and in turn triggered phosphorylation of downstream molecules IκBα and NF-κB, thus increasing the secretion of TNF-α and IL-8. Conversely, knockdown of Dectin-1 in THP-1 macrophages downregulated the phosphorylation of Syk, IκBα and NF-κB molecules, and significantly decreased the production of TNF-α and IL-8. These results indicated that Dectin-1 may have a crucial role in inducing the inflammatory response via increasing levels of TNF-α and IL-8 induced by T. marneffei, whereas NF-κB may be the key downstream molecule involved in the response to T. marneffei infection. Subsequently, THP-1 macrophages could orchestrate the innate immune system by releasing the cytokines TNF-α and IL-8. Therefore, it was hypothesized that regulation of the Dectin-1 signaling pathway may effectively interfere with the defense ability of the host against T. marneffei infection.

PMID:34938366 | PMC:PMC8688926 | DOI:10.3892/etm.2021.11007

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Telemedicine for Patients With Sudden Hearing Loss

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This prospective cohort study examines the utility of a teleme dicine model to will assist in the evaluation of new-onset unilateral sudden hearing loss among patients who do not have access to medical resources during the COVID-19 pandemic.
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Primary Diffuse Large B-Cell Lymphoma of the Tongue Base With Acute Airway Obstruction

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Ear Nose Throat J. 2021 Dec 23:1455613211066664. doi: 10.1177/01455613211066664. Online ahead of print.

NO ABSTRACT

PMID:34939459 | DOI:10.1177/01455613211066664

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Association of Maternal Thyroid Function with Gestational Hypercholanemia

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Thyroid, Ahead of Print.
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Intracorporeal Cortical Telemetry as a Step to Automatic Closed-Loop EEG-Based CI Fitting: A Proof of Concept

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Audiol Res. 2021 Dec 13;11(4):691-705. doi: 10.3390/audiolres11040062.

ABSTRACT

Electrically evoked auditory potentials have been used to predict auditory thresholds in patients with a cochlear implant (CI). However, with exception of electrically evoked compound action potentials (eCAP), conventional extracorporeal EEG recording devices are still needed. Until now, built-in (intracorporeal) back-telemetry options are limited to eCAPs. Intracorporeal recording of auditory responses beyond the cochlea is still lacking. This study describes the feasibility of obtaining longer latency cortical responses by concatenating interleaved short recording time windows used for eCAP recordings. Extracochlear reference electrodes were dedicated to record cortical responses, while intracochlear electrodes were used for stimulation, enabling intracorporeal telemetry (i.e., without an EEG device) to assess higher cortical processing in CI recipients. Simulta neous extra- and intra-corporeal recordings showed that it is feasible to obtain intracorporeal slow vertex potentials with a CI similar to those obtained by conventional extracorporeal EEG recordings. Our data demonstrate a proof of concept of closed-loop intracorporeal auditory cortical response telemetry (ICT) with a cochlear implant device. This research breaks new ground for next generation CI devices to assess higher cortical neural processing based on acute or continuous EEG telemetry to enable individualized automatic and/or adaptive CI fitting with only a CI.

PMID:34940020 | DOI:10.3390/audiolres11040062< /p>

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Going Beyond Rote Auditory Learning: Neural Patterns of Generalized Auditory Learning

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J Cogn Neurosci. 2021 Dec 23:1-20. doi: 10.1162/jocn_a_01805. Online ahead of print.

ABSTRACT

The ability to generalize across specific experiences is vital for the recognition of new patterns, especially in speech perception considering acoustic-phonetic pattern variability. Indeed, behavioral research has demonstrated that listeners are able via a process of generalized learning to leverage their experiences of past words said by difficult-to-understand talker to improve their understanding for new words said by that talker. Here, we examine differences in neural responses to generalized versus rote learning in auditory cortical processing by training listeners to understand a novel synthetic talker. Using a pretest-posttest design with EEG, participants were trained using either (1) a large inventory of words where no words were repeated across the experiment (generalized learning) or (2) a small inventory of words where words were repeate d (rote learning). Analysis of long-latency auditory evoked potentials at pretest and posttest revealed that rote and generalized learning both produced rapid changes in auditory processing, yet the nature of these changes differed. Generalized learning was marked by an amplitude reduction in the N1-P2 complex and by the presence of a late negativity wave in the auditory evoked potential following training; rote learning was marked only by temporally later scalp topography differences. The early N1-P2 change, found only for generalized learning, is consistent with an active processing account of speech perception, which proposes that the ability to rapidly adjust to the specific vocal characteristics of a new talker (for which rote learning is rare) relies on attentional mechanisms to selectively modify early auditory processing sensitivity.

PMID:34942645 | DOI:10.1162/jocn_a_01805

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Advances in Biomarker-Driven Targeted Therapies in Thyroid Cancer

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Cancers (Basel). 2021 Dec 9;13(24):6194. doi: 10.3390/cancers13246194.

ABSTRACT

Thyroid cancer is the most common type of endocrine malignancy comprising 2-3% of all cancers, with a constant rise in the incidence rate. The standard first-line treatments for thyroid cancer include surgery and radioactive iodine ablation, and a majority of patients show a good response to these therapies. Despite a better response and outcome, approximately twenty percent of patients develop disease recurrence and distant metastasis. With improved knowledge of molecular dysregulation and biological characteristics of thyroid cancer, the development of new treatment strategies comprising novel targets has accelerated. Biomarker-driven targeted therapies have now emerged as a trend for personalized treatments in patients with advanced cancers, and several multiple receptor kinase inhibitors have entered clinical trials (phase I/II/III) to evaluate their safety and efficacy. Most extensively investigated and clinically approved targeted therapies in thyroid cancer include the tyrosine receptor kinase inhibitors that target antiangiogenic markers, BRAF mutation, PI3K/AKT, and MAPK pathway components. In this review, we focus on the current advances in targeted mono- and combination therapies for various types of thyroid cancer.

PMID:34944814 | DOI:10.3390/cancers13246194

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Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report

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Case Rep Oncol. 2021 Nov 8;14(3):1596-1600. doi: 10.1159/000520128. eCollection 2021 Sep-Dec.

ABSTRACT

Neuropsychiatric symptoms, especially acute psychosis (often referred to as myxedema madness or psychosis), are rare but possible clinical presentations of patients with hypothyroidism. A 42-year-old woman with papillary thyroid carcinoma and recent total thyroidectomy had developed flat affect, paranoid delusion, and visual and auditory hallucination during inpatient admission fo r elective radioactive iodine treatment. On admission, her history and physical exam did not reveal symptoms and signs of significant hypothyroidism. Other medical causes of acute psychosis were excluded, and the patient was immediately treated with thyroid hormone replacement therapy. Subsequently, her thyroid function normalized, and her psychotic symptoms gradually improved. Although there is a lack of classic signs and symptoms of hypothyroidism, myxedema madness should be recognized as one of the potentially treatable causes of acute psychosis.

PMID:34950002 | PMC:PMC8647114 | DOI:10.1159/000520128

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Incidence of Spinal CSF Leakage on CT Myelography in Patients with Nontraumatic Intracranial Subdural Hematoma

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Diagnostics (Basel). 2021 Dec 6;11(12):2278. doi: 10.3390/diagnostics11122278.

ABSTRACT

The aim of the present study was to demonstrate the incidence of spinal cerebrospinal fluid (CSF) leaks in patients with nontraumatic intracranial subdural hematoma (SDH) and determine clinical parameters favoring such leaks. This retrospective study was approved by the institutional review board. Patients diagnosed with nontraumatic intracranial SDH who underwent computed tomography (CT) myelography between January 2012 and March 2018 were selected. 60 patients (male: female, 39:21; age range, 20-82 years) were enrolled and divided into CSF leak-positive and CSF leak-negative groups according to CT myelography data. Clinical findings were statistically compared between the two groups. Spinal CSF leak was observed in 80% (48/60) of patients, and it was significantly associated with an age of <69 years (p = 0.006). However, patients aged ≥69 yea rs also had a tendency to exhibit spontaneous intracranial hypotension (SIH)-induced nontraumatic intracranial SDH (60.87%; 14/23). Therefore, CT myelography is recommended to be performed for the evaluation of possible SIH in patients with nontraumatic intracranial SDH, particularly those aged <69 years. Patients aged ≥69 years are also good candidates for CT myelography because SIH tends to occur even in this age group.

PMID:34943515 | DOI:10.3390/diagnostics11122278

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