Sunday, December 6, 2020

Navigation-Assisted Resection and Fibula Free-Flap Reconstruction of an Extensive Maxillary Tumor.

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Navigation-Assisted Resection and Fibula Free-Flap Reconstruction of an Extensive Maxillary Tumor.

J Craniofac Surg. 2020 Dec 03;:

Authors: Zavattero E, Ramieri G, Volpe F, Borbon C

Abstract
OBJECTIVE: Tumor resection and reconstruction as a one-step procedure requires accurate definition of the intended safety margins, precise location of osteotomy lines and reliable individual rehabilitation.In recent years, the role of image-guided surgery in the maxillofacial region has increased significantly. As this technology allows the surgeon to track the actual position of each instrument during the operation in real-time, it makes it possible to perform extensive bone structure resections and reconstructions in anatomically distorted or complex areas, such as the head and neck region, without unnecessarily damaging vital structures.The authors described a case of a 26-year-old woman presented to our Clinic with an extensive maxillary squamous cell carcinoma involving the infratemporal fossa. The patient underwent single-step navigation-guided en bloc resection of the tumor and defect reconstruction.The aim of this study is describe and discuss the unusual surgical pla nning and the challenging operative technique adding a new case to the currently limited scientific literature on the computer-assisted head and neck oncologic surgery.

PMID: 33278254 [PubMed - as supplied by publisher]

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Bilateral striatal transplantation of human olfactory stem cells ameliorates motor function, prevents necroptosis-induced cell death and improves striatal volume in the rat model of Huntington's disease.

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Bilateral striatal transplantation of human olfactory stem cells ameliorates motor function, prevents necroptosis-induced cell death and improves striatal volume in the rat model of Huntington's disease.

J Chem Neuroanat. 2020 Dec 02;:101903

Authors: Bayat AH, Saeidikhoo S, Ebrahimi V, Mesgar S, Joneidi M, Soltani R, Aghajanpour F, Mohammadzadeh I, Torabi A, Abdollahifar MA, Bagher Z, Alizadeh R, Aliaghaei A

Abstract
Cellular transplant therapy is one of the most common therapeutic strategies used to mitigate symptoms of neurodegenerative diseases such as Huntington's disease (HD). Briefly, the main goal of the present study was to investigate HD's motor deficits through the olfactory ecto-mesenchymals stem cells (OE-MSC) secretome. OE-MSCs were characterized immunophenotypically by the positive expression of CD73, CD90 and CD105. Also, three specific markers of OE-MSCs were obtained from the nasal cavity of human volunteers. The main features of OE-MSCs are their high proliferation, ease of harvesting and growth factor secretion. All animals were randomly assigned to three groups: control, 3-NP + vehicle treated and 3-NP + Cell groups. In both experimental groups, the subjects received intraperitoneal 3-NP (30 mg/kg) injections once a day for five consecutive days, followed by the bilateral intra-striatal implantation of OE-MSCs in the 3-NP + Cell group. Muscular function w as assessed by electromyography and rotarod test, and the locomotor function was evaluated using the open field test. According to our findings, striatal transplants of OE-MSCs reduced microglial inflammatory factor, the tumor necrosis factor (TNFα) in the 3-NP + Cell group, with a significant reduction in RIP3, the markers of necroptosis in striatum. In addition to the remarkable recovery of the striatal volume after engraftment, the motor activities were enhanced in the 3-NP + cell group compared to the 3-NP + vehicle group. Taken together, our results demonstrated the in vivo advantages of OE-MSCs treatment in an HD rat model with numerous positive paracrine effects including behavioral and anatomical recovery.

PMID: 33278568 [PubMed - as supplied by publisher]

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Biofunctionalization of 3D-printed silicone implants with immunomodulatory hydrogels for controlling the innate immune response: An in vivo model of tracheal defect repair.

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Biofunctionalization of 3D-printed silicone implants with immunomodulatory hydrogels for controlling the innate immune response: An in vivo model of tracheal defect repair.

Biomaterials. 2020 Nov 24;268:120549

Authors: Barthes J, Lagarrigue P, Riabov V, Lutzweiler G, Kirsch J, Muller C, Courtial EJ, Marquette C, Projetti F, Kzhyskowska J, Lavalle P, Vrana NE, Dupret-Bories A

Abstract
The recent advances in 3D-printed silicone (PDMS: polydimethylsiloxane) implants present prospects for personalized implants with highly accurate anatomical conformity. However, a potential adverse effect, such as granuloma formation due to immune reactions, still exists. One potential way to overcome this problem is to control the implant/host interface using immunomodulatory coatings. In this study, a new cytokine cocktail composed of interleukin-10 and prostaglandin-E2 was designed to decrease adverse immune reactions and promote tissue integration by fixing macrophages into M2 pro-healing phenotype for an extended period of time. In vitro, the cytokine cocktail maintained low levels of pro-inflammatory cytokine (TNF-α and IL-6) secretions and induced the secretion of IL-10 and the upregulation of multifunctional scavenging and sorting receptor stabilin-1, expressed by M2 macrophages. This cocktail was then loaded in a gelatine-based hydrogel to develop an immunomodulator y material that could be used as a coating for medical devices. The efficacy of this coating was demonstrated in an in vivo rat model during the reconstruction of a tracheal defect by 3D-printed silicone implants. The coating was stable on the silicone implants for over 2 weeks, and the controlled release of the cocktail components was achieved for at least 14 days. In vivo, only 33% of the animals with bare silicone implants survived, whereas 100% of the animals survived with the implant equipped with the immunomodulatory hydrogel. The presence of the hydrogel and the cytokine cocktail diminished the thickness of the inflammatory tissue, the intensity of both acute and chronic inflammation, the overall fibroblastic reaction, the presence of oedema and the formation of fibrinoid (assessed by histology) and led to a 100% survival rate. At the systemic level, the presence of immunomodulatory hydrogels significantly decreased pro-inflammatory cytokines such as TNF-α, IFN-γ, CXCL1 and MCP-1 levels at day 7 and significantly decreased IL-1α, IL-1β, CXCL1 and MCP-1 levels at day 21. The ability of this new immunomodulatory hydrogel to control the level of inflammation once applied to a 3D-printed silicone implant has been demonstrated. Such thin coatings can be applied to any implants or scaffolds used in tissue engineering to diminish the initial immune response, improve the integration and functionality of these materials and decrease potential complications related to their presence.

PMID: 33278685 [PubMed - as supplied by publisher]

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Matrix metalloproteinase-7, -8, -9, -15, and -25 in minor salivary gland adenoid cystic carcinoma.

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Matrix metalloproteinase-7, -8, -9, -15, and -25 in minor salivary gland adenoid cystic carcinoma.

Pathol Res Pract. 2020 Nov 22;217:153293

Authors: Hämetoja H, Mäkitie A, Bäck L, Leivo I, Haglund C, Sorsa T, Hagström J

Abstract
Knowledge on the role of matrix metalloproteinases (MMPs) in adenoid cystic carcinoma (ACC) is limited. MMPs are capable of degrading almost all extracellular and pericellular components to promote invasion and metastasis. This study aimed to evaluate the immunohistochemical expression of MMP-7, -8, -9, -15, and -25 in ACC and to relate the results with clinicopathological factors and survival. The study included 68 patients with minor salivary gland ACC treated at the Helsinki University Hospital (Helsinki, Finland) in 1974-2012. Samples from 52 patients were available, consisting of 44 primary tumours and eight recurrent tumours. We scored immunostaining of MMP-7, -8, -9, -15, and -25 and analysed the immunoscore against clinical and pathological parameters using statistical correlation test. MMP-9 immunoexpression in pseudocysts of ACC and in peritumoural inflammatory cells associated with better survival and fewer treatment failures. High tumoural MMP-7 and -25 associated with better survival. High tumoural MMP-15 associated with poorer survival and high tumoural MMP-9 with advanced stage and regional recurrences. Tumour cells did not show MMP-8 immunopositivity. These results suggest that MMP-9 may contribute to ACC carcinogenesis in different roles. MMP-7, -8, and -9 can stimulate signalling pathways that may promote tissue modulation and metastatic potential. MMP-15 and -25 may reflect prognosis.

PMID: 33278774 [PubMed - as supplied by publisher]

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Influence of implant-specific radiation doses on peri-implant hard and soft tissue: An observational pilot study.

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Influence of implant-specific radiation doses on peri-implant hard and soft tissue: An observational pilot study.

Clin Oral Implants Res. 2020 Dec 05;:

Authors: Neckel N, Wagendorf P, Sachse C, Stromberger C, Vach K, Heiland M, Nahles S

Abstract
OBJECTIVES: The aim of this study was to investigate the influence of real implant-bed-specific radiation doses on peri-implant tissue health in head and neck cancer (HNC) patients after radiotherapy.
MATERIAL AND METHODS: Specific radiation doses in the area of 81 implants, in 15 irradiated HNC patients, were analyzed by matching data from the radiotherapy planning system with those of three-dimensional follow-up scans after implantation. Peri-implant bone resorption was measured radiographically after one and three years, and peri-implant tissue health was evaluated clinically. Individual parameters, such as age, gender, and localization, regarding the implant-specific radiation dose distribution were analyzed statistically.
RESULTS: The mean implant bed-specific radiation dose was high, with 45.95 Gy to the mandible and 29.02 Gy to the maxilla, but significantly lower than the mean total dose to the tumor bed. Peri-implant bone resorption correlated with local inflammation and plaque. After one year, women temporarily showed significantly more bone loss than men and implant-specific radiation dose had a significant impact on peri-implant bone loss after 3 years.
CONCLUSIONS: The presented method is a feasible option to define precise implant-bed-specific radiation doses for research or treatment planning purposes. Implant-based dental restoration after radiotherapy is a relatively safe procedure, but a negative radiation-dose-dependent long-term effect on peri-implant bone resorption calls for interdisciplinary cooperation between surgeons and radio-oncologists to define high-risk areas.

PMID: 33278849 [PubMed - as supplied by publisher]

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Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.

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Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.

Brain Sci. 2020 Dec 02;10(12):

Authors: Chen CH, Huang CY, Chang CY, Cheng YF

Abstract
STUDY OBJECTIVE: Tinnitus is a common disorder characterized by sound in the ear in the absence of external or internal stimuli. Low-level laser therapy (LLLT) was discovered enhancing tissue repair via increasing the blood microcirculation and cell proliferation in 1960s. In the last two decades, LLLT delivered to the cochlea has frequently been used to reduce the severity of tinnitus. However, whether LLLT effectively attenuates the severity of tinnitus remains controversial. We aimed to evaluate the efficacy of low-level laser therapy on adult patients with complaints of tinnitus.
DESIGN: Systematic review and meta-analysis with trial sequential analysis.
INTERVENTIONS: Low-level laser therapy (LLLT).
MEASUREMENTS: Tinnitus Handicap Inventory (THI) score; improvement rates of the visual analog scale (VAS), verbal rating scale (VRS) and numeric rating scale (NRS) scores.
METHODS: We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception through 17 September 2020. Randomized control trials that involved adult patients with complaints of tinnitus, compared LLLT to a placebo and provided sufficient information for meta-analysis were considered eligible.
MAIN RESULTS: Overall, 11 studies involving 670 patients were included. No significant difference in the overall effect according to the THI score (mean difference (MD), -2.85; 95% CI, -8.99 to 3.28; p = 0.362; I2 = 0%) and the rating scale score improvement rate (risk ratio (RR), 1.35; 95% CI, 0.81 to 2.27; p = 0.250; I2 = 67%) was demonstrated between patients receiving LLLT and those receiving a placebo. None of the subgroup analyses showed significant differences, regardless of underlying sensorineural hearing loss, the number of irradiation sessions or the wavelength used.
CONCLUSIONS: Our meta-analysis suggests that the value of LLLT in controlling the severity of tinnitus remains unclear, in part due to the relatively small number of patients and underlying heterogeneity. More large-scale investigations of LLLT for tinnitus related to inner ear disease are required to further elucidate the therapeutic effects.

PMID: 33276501 [PubMed - as supplied by publisher]

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Occupational Noise: Auditory and Non-Auditory Consequences.

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Occupational Noise: Auditory and Non-Auditory Consequences.

Int J Environ Res Public Health. 2020 Dec 02;17(23):

Authors: Sheppard A, Ralli M, Gilardi A, Salvi R

Abstract
Occupational noise exposure accounts for approximately 16% of all disabling hearing losses, but the true value and societal costs may be grossly underestimated because current regulations only identify hearing impairments in the workplace if exposures result in audiometric threshold shifts within a limited frequency region. Research over the past several decades indicates that occupational noise exposures can cause other serious auditory deficits such as tinnitus, hyperacusis, extended high-frequency hearing loss, and poor speech perception in noise. Beyond the audiogram, there is growing awareness that hearing loss is a significant risk factor for other debilitating and potentially life-threatening disorders such as cardiovascular disease and dementia. This review discusses some of the shortcomings and limitations of current noise regulations in the United States and Europe.

PMID: 33276507 [PubMed - as supplied by publisher]

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Elevated circulating Glutamate associates with subclinical Atherosclerosis independently of established Risk Markers: a cross-sectional study.

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Elevated circulating Glutamate associates with subclinical Atherosclerosis independently of established Risk Markers: a cross-sectional study.

J Clin Endocrinol Metab. 2020 Dec 05;:

Authors: Lehn-Stefan A, Peter A, Machann J, Schick F, Randrianarisoa E, Heni M, Wagner R, Birkenfeld AL, Fritsche A, Häring HU, Staiger H, Stefan N

Abstract
OBJECTIVE: Elevated plasma glutamate levels associate with an increased risk of cardiovascular disease (CVD). Because plasma glutamate levels also strongly associate with visceral adiposity, NAFLD, insulin resistance and high circulating levels of branched-chain amino acids (BCAA), it is unknown to what extent elevated circulating glutamate is an independent marker of an increased risk of atherosclerosis.
METHODS: Plasma levels of glutamate and BCAA were measured in 102 subjects who were precisely phenotyped for body fat mass and distribution (MR tomography), liver fat content ( 1H-MR spectroscopy), insulin sensitivity [oral glucose tolerance test and hyperinsulinemic, euglycemic clamp (N=57)] and carotid intima-media thickness (cIMT).
RESULTS: Plasma glutamate levels, adjusted for age, sex, body fat mass and visceral fat mass, correlated positively with liver fat content and cIMT (all std.-ß≥0.22, all p≤0.023) and negatively with insulin sensitivity (std.-ß≤-0.31, p≤0.0019). Glutamate levels also associated with cIMT, independently of additional adjustment for liver fat content, insulin sensitivity and BCAA levels (std.-ß≥0.24, p≤0.021). Furthermore, an independent positive association of glutamate and IL-6 levels was observed (N=50; std. ß=0.39, p=0.028). While glutamate, adjusted for age, sex, body fat mass and visceral fat mass, also correlated positively with cIMT in this subgroup (std. ß=0.31, p=0.019), after additional adjustment for the parameters liver fat content, insulin sensitivity, BCAA or IL-6 levels, adjustment for IL-6 most strongly attenuated this relationship (std. ß=0.28, p=0.05).
CONCLUSIONS: Elevated plasma glutamate levels are associated with increased cIMT, independently of established CVD risk factors and this relationship may in part be explained by IL-6-associated subclinical inflammation.

PMID: 33277657 [PubMed - as supplied by publisher]

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Systematic Review of Postcochlear Implant Electrode Migration: What Is Known?

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Systematic Review of Postcochlear Implant Electrode Migration: What Is Known?

Otol Neurotol. 2020 Dec 03;:

Authors: Alenzi S, Khurayzi T, Alshalan A, Almuhawas F, Alsanosi A

Abstract
BACKGROUND AND OBJECTIVES: Electrode migration after cochlear implantation (CI) is a rare complication that accounts for 1to 15% of all revision surgery. This study is a systematic review of the literature for investigating the knowledge and approaches to the incidence of electrode migration after CI.
METHODS: A systematic electronic search of the literature was carried out using PubMed, Cochrane, Virtual Health Library, Scopus and Web of Science (ISI). All original articles that reported electrode migration after CI surgery were included. The Newcastle-Ottawa Scale and CARE checklist were utilized for the assessment of the risk of bias. Descriptive data analysis was performed using SPSS software.
RESULTS: A total of 26 studies including 4,316 patients were included. Out of them, 289 patients had electrode migration following CI. To diagnose electrode migration, traditional computed tomography scan was used in 13 studies, while cone-beam computed tomography was applied in three studies. In addition, electrode migration was detected during intraoperative exploration in eight studies. The most common presenting symptom was change in sound/poor performance (n = 43) followed by pain sensation (n = 15) and facial nerve stimulation (n = 10). Cholesteatoma was the most common associated pathology (n = 10) followed by infection (n = 9) and ossification of the basal turn of the cochlea (n = 8).
CONCLUSION: Electrode migration is a major complication of CI and could be more common than previously thought. As it may occur with or without clinical complaints, long-term follow-up through routine radiological scanning is recommended. Further studies are warranted to identify the underlying mechanism of electrode extrusion and the appropriate fixation method.

PMID: 33278246 [PubMed - as supplied by publisher]

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Assessment of single isocenter linear accelerator radiosurgery for metastases and base of skull lesions.

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Assessment of single isocenter linear accelerator radiosurgery for metastases and base of skull lesions.

Phys Med. 2020 Dec 02;81:1-8

Authors: Bossart E, Mellon EA, Monterroso I, Elsayyad N, Diwanji T, Samuels S, Dogan N

Abstract
BACKGROUND: Newer technology for stereotactic radiosurgery (SRS) should be assessed for different multi-leaf collimators (MLC).
OBJECTIVE: Assess plan quality of an automated, frameless, linear accelerator based (linac) planning and delivery system (HyperArc) for SRS using both standard MLC (SMLC) and high definition MLC (HDMLC) compared to a cobalt-60 based SRS system (Gamma Knife, GK).
METHODS: We re-planned twenty GK Perfexion-treated SRS patients (27 lesions) for HyperArc using SMLC and HDMLC. We assessed plan quality using the following metrics: gradient index (GI), Paddick and RTOG conformity indices (CIPaddick, CIRTOG), volume receiving half of prescription isodose (PIVhalf) and maximum dose to 0.03 cc for brainstem, optic chiasm and optic nerves, and V12Gy for brain-GTV.
RESULTS: Linac plans had better conformity with HDMLC being most conformal. GK exhibited better GI. PIVhalf demonstrated no statistically significant difference between HDMLC and GK, and SMLC was nominally worse than GK. Mean PIVhalf was generally 0.85 cc larger for SMLC than HDMLC. For TV > 1.0 cc, the relative differences in CIRTOG, GI, and PIVhalf for SMLC vs. HDMLC were less than 21%. For TV less than < 1.0 cc, there were more obvious relative differences for SMLC vs. HDMLC in CIRTOG (mean 146%, max 700%), GI (mean 49%, max 162%), and PIVhalf (mean 77%, max 522%). Organ at risk doses were met in all plans.
CONCLUSIONS: New linac-based plans positively compare to GK plans overall. HDMLC should be strongly considered for treatment of lesions < 1.0 cc given the significant improvements in conformity and PIVhalf over SMLC.

PMID: 33278764 [PubMed - as supplied by publisher]

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Prognostic value of lipid metabolism-related genes in head and neck squamous cell carcinoma.

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Prognostic value of lipid metabolism-related genes in head and neck squamous cell carcinoma.

Immun Inflamm Dis. 2020 Dec 05;:

Authors: Xiong Y, Si Y, Feng Y, Zhuo S, Cui B, Zhang Z

Abstract
BACKGROUND: Altered lipid metabolism is involved in the development of many tumors. However, the role of dissimilar lipid metabolism in head and neck squamous cell carcinoma (HNSCC) is not fully established.
AIMS: Here, we sought to determine the prognostic value of lipid metabolism-related genes in HNSCC.
METHODS: RNA-seq data and clinical features of 545 HNSCC cases were obtained from The Cancer Genome Atlas database. A regulatory network of transcription factors-lipid metabolism genes and a risk prognostic model of lipid metabolism-related genes was developed using bioinformatics and Cox regression modeling. We used tumor immune estimation resource to analyze immune cell infiltration in patients with HNSCC based on the prognostic index (PI) of lipid metabolism-related genes.
RESULTS: A total of 136 differentially expressed lipid metabolism genes were identified. Of these, 23 are related to prognosis. In addition to predicting HNSCC prognosis, 11 lipid metabolism-related genes (ARSI, CYP27B1, CYP2D6, DGKG, DHCR7, LPIN1, PHYH, PIP5K1B, PLA2G2D, RDH16, and TRIB3) also affect HNSCC clinical features (stage, gender, and pathological stage). The PI of lipid metabolism-related genes embodied the state of HNSCC tumor immune microenvironment.

PMID: 33277966 [PubMed - as supplied by publisher]

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