Segmental mandibular reconstruction in patients with poor lower extremity perfusion, vessel-depleted necks and/or profound medical frailty

xlomafota13 shared this article with you from Inoreader Segmental mandibular reconstruction in patients with poor lower extremity perfusion, vessel-depleted necks and/or profound medical frailty Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Options for segmental mandibular reconstruction in patients poorly suited to undergo fibula free flap (FFF). Recent findings Although FFF is the current 'gold standard' for segmental mandibular reconstruction, other reconstructive options must be considered when FFF is contraindicated or disfavoured and/or patient frailty precludes a lengthy anaesthetic. In addition to various nonvascularized and soft tissue only reconstructions, excellent osseous free flap alternatives for functional segmental mandibular reconstruction may be employed. The subscapular system free flaps (SSSFF) may be ideal in frail and/or elderly patients, as SSSFF allows for early mobility and does not alter gait. In extensive and/or symphyseal defects, functional mandibular reconstruction in lieu of a free flap is extremely limited. Pedicled segmental mandibular reconstructions remain reasonable options, but limited contemporary literature highlights unpredictable bone graft perfusion and poor long-term functional outcomes. Summary There are several excellent free flap alternatives to FFF in segmental mandibular reconstruction, assuming adequate cervical recipient vessels are present. On the basis of the current literature, the optimal mandibular reconstruction for the medically frail, elderly and/or patients with extreme vessel-depleted necks is limited and debatable. In qualifying (i.e. limited, lateral) defects, soft tissue only reconstructions should be strongly considered when osseous free flaps are unavailable. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Response of canine thyroid carcinomas to radioiodine

xlomafota13 shared this article with you from Inoreader Response of canine thyroid carcinomas to radioiodine Via radioactive iodine Vet Comp Oncol. 2021 Sep 2. doi: 10.1111/vco.12770. Online ahead of print. ABSTRACT Radioactive iodine (131 I) has previously been reported to prolong survival in dogs with thyroid carcinoma. This study aimed to describe tumour response and progression-free interval (PFI) in dogs with thyroid carcinomas treated with 131 I. Secondary aims were to describe overall survival time (OST) and prognostic factors. A bi-institutional retrospective review of records iden tified 66 dogs with thyroid carcinoma treated with 131 I from January 2010-April 2020. Response was described using RECIST, or a subjective response assessment where specific tumour measurements were not available. Forty-eight dogs (72.7%) were treatment-naïve and 18 dogs (27.3%) had received prior therapy at the time of 131 I treatment. Objective responses were available for 34 dogs and subjective responses for 58 dogs. The overall response rate (ORR) was 35.3% (4 complete and 8 partial responses). Improvement of clinical signs was seen in 76.2% of dogs (32/42). Kaplan-Meier-estimated median PFI (95%CI) was 301 (217-578) days and OST (95%CI) was 564 (421-865) days. Prior therapy was associated with a lower hazard for progression (HR 0.260 95%CI 0.123-0.548, P=0.0004). Treatment of thyroid carcinoma using 131 I can effectively alleviate clinical signs and reduce disease burden in a proportion of dogs. This article is protected by copyright. All righ ts reserved. PMID:34476889 | DOI:10.1111/vco.12770 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between the circulating superoxide dismutase and obstructive sleep apnea: a meta-analysis

xlomafota13 shared this article with you from Inoreader Association between the circulating superoxide dismutase and obstructive sleep apnea: a meta-analysis Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 2. doi: 10.1007/s00405-021-07064-1. Online ahead of print. ABSTRACT PURPOSE: Although it has been reported that superoxide dismutase (SOD) is related to obstructive sleep apnea (OSA), the results are controversial. In addition, the effects of the continuous positive airway pressure (CPAP) treatment on SOD levels are also inconsistent. The primary purpose of the present meta-analysis is to determine the relationship between the circulating SOD levels and OSA. METHODS: The studies included in this meta-analysis were selected from the PubMed, Embase, Cochrane Library, and Scopus databases. Two researchers independently reviewed the studies. Data analysis was performed using Stata 15.1. The overall effects were measured using the standardized mean difference (SMD) with a 95% confidence interval (CI). A random-effects model or a fixed-effects model was used, depending on the heterogeneity of the stu dies. RESULTS: A total of 14 studies were included, comprising 1240 patients and 457 controls. The results showed that the circulating SOD levels of the patients with OSA were significantly lower than that of the control group (SMD = - 1.645, 95% CI = - 2.279 to - 1.011, P < 0.001). We also studied changes in the circulating SOD levels in patients with OSA after the CPAP treatment. No significant difference was observed in the circulating SOD levels after the CPAP treatment (SMD = - 0.028, 95% CI = - 0.218 to 0.162, P = 0.772). CONCLUSION: The results suggested that patients with OSA have reduced levels of SOD and were related to disease severity. The results also indicated that circulating SOD levels may be a reliable marker for detecting systemic oxidative stress in patients with OSA. However, the circulating SOD levels were not affected by the short-term (4-12 weeks) CPAP treatment. Therefore, further large-scale, well-designed randomized controlled trials with a l onger CPAP therapy (more than 6 months preferably) and good adherence to the treatment are needed to investigate this issue. PMID:34476593 | DOI:10.1007/s00405-021-07064-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The new WHO classification of gastrointestinal neuroendocrine tumors and immunohistochemical expression of somatostatin receptor 2 and 5

xlomafota13 shared this article with you from Inoreader The new WHO classification of gastrointestinal neuroendocrine tumors and immunohistochemical expression of somatostatin receptor 2 and 5 Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1179. doi: 10.3892/etm.2021.10613. Epub 2021 Aug 13. ABSTRACT The 2019 World Health Organization (WHO) classification of gastrointestinal tumors defines well-differentiated grade 3 neuroendocrine tumors, the mixed neuroendocrine-non-neuroendocrine tumors (MiNENs) and classifies goblet cell carcinoid as goblet cell adenocarcinoma. The expression of somatostatin receptors (SSTRs) is the foundation for somatostatin analogue therapy. At present, there are only a few studies that have analyzed the immunohistochemical reactivity of SSTRs in gastrointestinal neuroendocrine neoplasms (NENs). The aim of the present study was to evaluate the immunohistochemical expression of SSTR2 and SSTR5 in gastrointestinal NENs and goblet cell adenocarcinomas and the correlation of these markers with clinical and morphological factors. The study included 67 patients with NENs and 4 patients with adenocarcinoma ex-goblet cell carc inoid diagnosed between January 2008 and December 2018. Tumors were reclassified according to the 2019 WHO classification. Immunohistochemical staining for chromogranin A, synaptophysin, Ki-67, p53, SSTR2, and SSTR5 were performed in all the cases. The results showed that, G1 and G2 neuroendocrine tumors were more common SSTR2-positive in comparison with G3 carcinomas (P<0.0001). In addition, 33.3% of neuroendocrine carcinomas and 2 cases of low-grade adenocarcinoma ex-goblet cell carcinoid were SSTR2-positive. Neuroendocrine carcinomas had significantly lower SSTR2 and SSTR5 expression compared with well-differentiated neuroendocrine tumors (P=0.0130; P=0.0437, respectively). The SSTR2 expression in the early tumor stages was 100%, more often than in advanced stages (55.6%; P=0.0011). The results demonstrated the decrease in SSTR2 expression with increasing malignancy and tumor stage. The SSTR2-positive expression in neuroendocrine carcinomas and adenocarcinoma ex-goblet cell ca rcinoid provides evidence for the benefits of somatostatin analog treatment associated with surgery and chemotherapy. PMID:34475969 | PMC:PMC8406677 | DOI:10.3892/etm.2021.10613 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of peak inspiratory flow in the management of acute inspiratory dyspnoea

xlomafota13 shared this article with you from Inoreader Assessment of peak inspiratory flow in the management of acute inspiratory dyspnoea Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 2. doi: 10.1007/s00405-021-07066-z. Online ahead of print. ABSTRACT PURPOSE: Assessment of inspiratory dyspnoea associated with upper airway obstruction is based on subjective clinical and nasal fibreoptic laryngoscopy (NFL) signs. The aim of this study was to determine whether peak inspiratory flow (PIF) measurement could indicate the need for upper airway release surgery in patients with acute inspiratory dyspnoea during emergency. METHODS: A retrospective single-institution study (February 2018-March 2020) of 48 patients with acute inspiratory dyspnoea and PIF measurement (Peak Flow In-Check Dial G16®-Harlow-England) was conducted. The surgical decision was based on the clinical evaluation of the patient's respiratory tolerance and NFL. RESULTS: Forty-eight patients were included in this study. Thirty-five patients underwent surgery (PIF: 36 L/min), and 13 patients did not (PIF: 58 L/min) (p = 0.0009). Three of these 13 patients underwent an operation later (PIF value: 42 L/min versus 63 L/min for the 10 others [p = 0.25]). CONCLUSION: PIF measurement is a quantitative, objective, inexpensive, non-invasive, and quick test that is potentially useful for general practitioners, mobile medical teams, or for ear-nose-and-throat specialists. A threshold of 42 L/min can help doctors in emergency decision making to refer patients to an ear-nose-and-throat specialist to release the upper airway and perform surgery or to choose medical monitoring for patients with emergency inspiratory dyspnoea. PMID:34476594 | DOI:10.1007/s00405-021-07066-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Propofol protects H9C2 cells against hypoxia/reoxygenation injury through miR-449a and NR4A2

xlomafota13 shared this article with you from Inoreader Propofol protects H9C2 cells against hypoxia/reoxygenation injury through miR-449a and NR4A2 Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1181. doi: 10.3892/etm.2021.10615. Epub 2021 Aug 16. ABSTRACT Propofol has been revealed to protect cardiomyocytes against myocardial ischemia injury, although the underlying mechanism remains incompletely understood. H9C2 cells were used to generate a hypoxia/reoxygenation (H/R) in vitro model for the present study. Reverse transcription-quantitative PCR and western blotting were performed to measure the expression levels of microRNA (miR)-449a and nuclear receptor subfamily 4 group A member 2 (NR4A2). The CCK-8, BrdU, EdU, and caspase-3 activity assays and western blot analysis were employed to detect cell viability, proliferation, and apoptosis. The target relationship between miR-449a and NR4A2 was verified through dual-luciferase reporter assays. The results confirmed that exposure of the cells to H/R resulted in severe cell injury. However, the presence of propofol improved cell activity by pro moting cell viability and proliferation and inhibiting cell apoptosis. The beneficial effect of propofol on H/R-mediated injury could be abrogated by the inhibition of NR4A2 mediated by miR-449a. Thus, the present study demonstrated that propofol counteracted cardiomyocyte H/R injury by inhibiting miR-449a to upregulate NR4A2. PMID:34475971 | PMC:PMC8406901 | DOI:10. 3892/etm.2021.10615 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The use of polypropylene mesh in inguinal hernia surgery: A retrospective study

xlomafota13 shared this article with you from Inoreader The use of polypropylene mesh in inguinal hernia surgery: A retrospective study Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1193. doi: 10.3892/etm.2021.10627. Epub 2021 Aug 17. ABSTRACT Previously, inguinal hernia surgery was based exclusively on repairing the abdominal wall defects using the patient's own tissues, which were put in contact with and tensioned to recalibrate the natural orifices. At present, inguinal hernia surgery is based almost solely on mounting an allograft, which has the role of strengthening the weakened groin region that allowed the herniation. This modern method of operation on inguinal hernia can be performed in a classic or laparoscopic manner. The mesh is made of polypropylene, which is a polymer of cyclic hydrocarbons. The aim of the present study was to evaluate the effectiveness, biocompatibility, as well as the immediate and long-term complications in textile allografts used in open surgery of inguinal hernia repair. Another aim was to demonstrate once again the superiority of low-weight meshes wi th large pores by decreasing the number of complications caused by the synthetic material used, but also by a decrease in the tension on the tissues to which it was fixed. The present study included 255 cases submitted to inguinal hernia surgery. Only 1.5% required immediate reintervention before discharge to evacuate hematoma. The short duration of hospitalization, the quality-price ratio, the good postoperative results, as well as the rapid socio-professional reintegration, render the use of polypropylene mesh in inguinal hernia surgery very attractive for patients. PMID:34475983 | PMC:PMC8406872 | DOI:10.3892/etm.2021.10627 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tuberous sclerosis with negative genetic testing and multiple cerebral cavernomas: A new association (Case report)

xlomafota13 shared this article with you from Inoreader Tuberous sclerosis with negative genetic testing and multiple cerebral cavernomas: A new association (Case report) Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1183. doi: 10.3892/etm.2021.10617. Epub 2021 Aug 16. ABSTRACT Tuberous sclerosis complex (TSC) is an autosomal dominant disorder with multisystemic involvement usually resulting from mutations in the tuberous sclerosis 1 (TSC1) or TSC2 genes. However, 10 to 25% of patients do not exhibit these mutations. Cerebral cavernous malformations (CCMs) are capillary-venous malformations that can be asymptomatic or cause variable neurological manifestations, including seizures. Familial CCMs are recognized. In both conditions, specific dermatological lesions are associated. We present the case of a 31-year-old female with TSC diagnosed at the age of 18 years who presented with negative genetic testing. She was admitted to our department in 2019 for a sudden increased frequency of focal seizures. Patient examination revealed multiple facial and intraoral angiofibroma, diplopia, right hemihypoesthesia, br isk deep tendon reflexes, and distal leg paresthesia. VideoEEG indicated a frontal paramedian epileptogenic focus. Cerebral magnetic resonance imaging (MRI) and angioMRI identified multiple fronto-parietal cortical tubers, as well as multiple CCMs, with evidence of bleeding in one. Under antiepileptic drug (AED) and mTOR inhibitor treatment, the seizure frequency significantly improved in a short period of time. This is the first reported case of tuberous sclerosis with negative genetic testing associated with multiple cerebral cavernoma. Such complex patients require multidisciplinary management and detailed genetic testing for increasing knowledge on neuro-cutaneous disorders. PMID:34475973 | PMC:PMC8406763 | DOI:10.3892/etm.2021.10617 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of mitochondrial coupling factor 6 in placental tissues from preeclamptic pregnancies and its influence on biological behavior of trophoblast cells

xlomafota13 shared this article with you from Inoreader Detection of mitochondrial coupling factor 6 in placental tissues from preeclamptic pregnancies and its influence on biological behavior of trophoblast cells Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1185. doi: 10.3892/etm.2021.10619. Epub 2021 Aug 16. ABSTRACT Increased levels of mitochondrial coupling factor 6 (CF6) are present in the peripheral blood of patients with preeclamptic pregnancies, and are particularly evident in cases of early-onset or severe preeclampsia. The present study examined the location and expression levels of CF6 in the placental tissue and its effect on the biological behavior of trophoblast cells. Placental tissue microarrays, including placental villous cytotrophoblast and extravillous cytotrophoblast microarrays, were used to detect the location and relative expression levels of CF6 in the placenta using immunohistochemistry. It was found that CF6 was expressed in both the normal and preeclamptic placenta, but its levels were higher in the preeclamptic tissues. In addition, the effects of the hypoxic environment on the biological behaviors of trophoblast cells were investig ated in the JAR and JEG-3 cell lines. Following induction of hypoxia, the expression levels of CF6 were increased. Moreover, exogenous addition of human recombinant CF6 attenuated cell invasion, but exerted no effect on cell proliferation. At the molecular level, the expression levels of MMP-2 were decreased and were accompanied with a reduction in cell invasion following addition of exogenous CF6. In conclusion, the increased expression levels of CF6 and its effects in reducing the invasive abilities of trophoblast cells may be involved in the pathogenesis of severe preeclampsia. PMID:34475975 | PMC:PMC8406808 | DOI:10.3892/etm.2021.10619 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rosuvastatin protects PC12 cells from hypoxia/reoxygenation-induced injury by inhibiting endoplasmic reticulum stress-induced apoptosis

xlomafota13 shared this article with you from Inoreader Rosuvastatin protects PC12 cells from hypoxia/reoxygenation-induced injury by inhibiting endoplasmic reticulum stress-induced apoptosis Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1189. doi: 10.3892/etm.2021.10623. Epub 2021 Aug 17. ABSTRACT The endoplasmic reticulum stress (ERS) response serves an important role in cerebral ischemia-reperfusion injury (CIRI). However, to the best of the our knowledge, the effect of rosuvastatin on the ERS response in CIRI has not yet been studied. In the present study, the effect of rosuvastatin on cell damage in CIRI was investigated; furthermore, the effect of rosuvastatin on the ERS response was explored. Firstly, a hypoxia/reoxygenation (H/R)-induced cell damage model was established in PC12 cells. Cell viability was subsequently detected by a Cell Counting Kit-8 assay. A lactate dehydrogenase kit was used to detect cytotoxicity. TUNEL assay was then used to measure the extent of cell apoptosis, and western blotting was used to analyze the expression levels of the apoptosis-associated proteins Bax, Bcl-2, cleaved caspase-3 and cleaved caspase-9. In addition, western blotting was used to detect the expression levels of ERS-associated proteins, including phosphorylated (p)-protein kinase R-like endoplasmic reticulum kinase (PERK), p-eukaryotic initiation factor 2α and other proteins. Treatment with rosuvastatin led to an increased activity of H/R-induced PC12 cells and a decrease in their cytotoxicity. Rosuvastatin also led to an inhibition in apoptosis and ERS in H/R-induced PC12 cells. After administration of the ERS response activator thapsigargin (TG), TG was found to reverse the protective effect of rosuvastatin on injury of H/R-induced PC12 cells. Taken together, these findings have shown that rosuvastatin is able to protect PC12 cells from H/R-induced injury via inhibiting ERS-induced apoptosis, providing a strong theoretical basis for the use of rosuvastatin in the clinical treatment of CIRI. PMID:34475979 | PMC:PMC8406900 | DOI:10.3892/etm.2021.10623 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of the acid suppressor omeprazole on the proliferation, migration, invasion and cell cycle of esophageal squamous cell carcinoma cells via the aryl hydrocarbon receptor pathway

xlomafota13 shared this article with you from Inoreader Effect of the acid suppressor omeprazole on the proliferation, migration, invasion and cell cycle of esophageal squamous cell carcinoma cells via the aryl hydrocarbon receptor pathway Via Experimental and therapeutic medicine Exp Ther Med. 2021 Oct;22(4):1187. doi: 10.3892/etm.2021.10621. Epub 2021 Aug 17. ABSTRACT Esophageal cancer is a malignant tumor type with one of the highest mortality rates worldwide. The aryl hydrocarbon receptor (AHR), which has been investigated in recent years, has been confirmed to be associated with the occurrence and development of esophageal cancer. AHR has a variety of different ligands, which regulate its activity following binding. The widely known acid inhibitor omeprazole (OME) also affects AHR and its downstream proteins (such as the cytochrome P450 family) by non-ligand binding; however, the mechanisms have remained to be fully elucidated. Therefore, the aim of the present study was to investigate the role of OME in esophageal squamous cell carcinoma (ESCC), whether the mechanism proceeds via the AHR pathway and how OME regulates AHR to affect the occurrence and development of esophageal carcinoma. The AHR-selective re gulator OME was used to treat the ESCC cell lines TE1 and KYSE150. Western blot analysis was used to verify the effect of OME on AHR and proliferating cell nuclear antigen (PCNA) protein expression levels, while Cell Counting Kit (CCK)-8, wound-healing and Transwell assays were used to determine the proliferation, migration and invasion of the ESCCs, respectively, following treatment with OME. In addition, flow cytometry was used to investigate the cell cycle distribution of the ESCCs following incubation with OME. AHR was highly expressed in the ESCCs and following treatment with OME, the protein expression levels of AHR and PCNA were downregulated. The CCK-8 assay indicated that the proliferation of the ESCCs was also reduced following treatment with OME. Furthermore, flow cytometry revealed a notable block of the cells in G1/G0 phase, while the results of the wound-healing and Transwell assays respectively suggested that cell migration and invasion were redu ced. In conclusion, OME inhibited the proliferation, migration and invasion of ESCC cells and blocked the cell cycle via the AHR pathway, which may provide a therapeutic effect on esophageal squamous cell cancer. PMID:34475977 | PMC:PMC8406681 | DOI:10.3892/etm.2021.10621 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.