Wednesday, October 20, 2021

Role of Nitric Oxide in Regulating Epidermal Permeability Barrier Function

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Abstract

Nitric oxide (NO), a free radical molecule synthesized by nitric oxide synthases (NOS), regulates multiple cellular functions in a variety of cell types. These NOS, including endothelial NOS (eNOS), inducible NOS (iNOS) and neural NOS (nNOS), are expressed in keratinocytes. Expression levels of both iNOS and nNOS decrease with aging, and insufficient NO has been linked to the development of a number of disorders such as diabetes and hypertension, and to the severity of atherosclerosis. Conversely, excessive NO levels can induce cellular oxidative stress, but physiological levels of NO are required to maintain the normal functioning of cells, including keratinocytes. NO also regulates cutaneous functions, including epidermal permeability barrier homeostasis and wound healing, through its stimulation of keratinocyte proliferation, differentiation and lipid metabolism. Topical applications of a diverse group of agents which generate nitric oxide (called NO donors) such as S-nitroso-N -acetyl-D,L-penicillamine (SNAP) can delay permeability barrier recovery in barrier-disrupted skin, but iNOS is still required for epidermal permeability barrier homeostasis. This review summarizes the regulatory role that NO plays in epidermal permeability barrier functions and the underlying mechanisms involved.

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The important role of mechanical microenvironment on macrophages dysfunction during keloid pathogenesis

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Abstract

Keloid is considered as a tumor-like skin disease with multiple etiologies including immunological factors and mechanical microenvironment. Macrophages are plastic and diverse immune cells that play a critical role in maintaining tissue homeostasis by removing dead cells, debris, pathogens and repairing tissues after inflammation. The imbalance of M1/M2 macrophages and disturbances in macrophage functions can steer the progression of chronic inflammation and lead to the development of pathological fibrosis in keloid disease. Recently, it has been shown that macrophages are sensitive to mechanical signals, especially stretching tension and tissue stiffness, which can determine macrophages polarization and functions. Higher stretching tension is known to be an important pathogenic factor of keloid, and the formation of keloid will lead to an increase in tissue stiffness. As little is known about the underlying reasons of macrophages dysfunction in keloid, an understanding of how the mechanical microenvironment interacting with macrophages and affecting their behaviors may help provide mechanism insights into keloid pathogenesis. We thus hypothesize that the synergistic effect of stretching tension and matrix stiffness may contribute to the major pathophysiological niche attributes of macrophages' in vivo mechanical microenvironment in keloids. These mechanism insights of how macrophages sense and respond to their mechanical microenvironment would propel the development of novel strategies for keloid treatment.

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Influence of carpal-ulnar translation on clinical outcome after scaphocapitate arthrodesis for the treatment of late-stage Kienböck disease

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J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00418-6. doi: 10.1016/j.bjps.2021.08.031. Online ahead of print.

ABSTRACT

BACKGROUND: This study sought to compare postoperative outcomes after scaphocapitate arthrodesis (SCA) for the treatment of late-stage Kienböck disease according to the amount of ulnar translation of the carpus and to identify surgical factors associated with carpal-ulnar translation.

METHODS: Thirty-nine patients diagnosed with Kienböck disease (Lichtman stages III-IV) and treated with SCA were retrospectively reviewed. They were divided into the translated group (n=28) and untranslated group (n=11) according to the presence of carpal-ulnar translation. The following surgical factors in the patients were assessed: excision of the lunate, postoperative carpal height ratio, and radioscaphoid angle (RSA). Pain Visual Analog scale (VAS) score, wrist range of motion, grip strength, modified Mayo wrist s core (MMWS), the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and progression of radioscaphoid osteoarthritis were also assessed.

RESULTS: All patients showed functional improvement after a mean postoperative follow-up period of 40 months (VAS: 4.1 vs. 1.1, p <0.001; grip strength, 42.3 vs. 51.2 lb., p = 0.002; MMWS, 52.6 vs. 69.5, p <0.001; QuickDASH, 33.7 vs. 21.5, p <0.001). No statistically significant differences were found between the two groups in terms of outcome measures. Among the assessed surgical factors, the mean postoperative RSA was significantly smaller in the translated group than in the untranslated group (34.8° vs. 46.8°, p = 0.008). The proportion of patients with postoperative RSA <30° was significantly higher in the translated group than in the untranslated group (54.5% vs. 0%, p<0.001).

CONCLUSION: These results suggest that sufficient pain relief and functional improvement can be achieved after SCA for the treatment of late-stage Kienböck disease disregarding the occurrence of carpal-ulnar translation. In this study, overcorrection to RSA <30° induced more frequent carpal-ulnar translation after SCA.

PMID:34666943 | DOI:10.1016/j.bjps.2021.08.031

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Overall survival is improved with total thyroidectomy and radiation for male patients and patients older than 55 with T2N0M0 Stage 1 classic papillary thyroid cancer

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Surgery. 2021 Oct 16:S0039-6060(21)00796-0. doi: 10.1016/j.surg.2021.08.025. Online ahead of print.

ABSTRACT

BACKGROUND: We examine whether surgery extent and radiation administration affect overall survival for cT2N0M0 classic papillary thyroid cancer according to age and sex.

METHODS: Patients with cT2N0M0 classic papillary thyroid cancer tumors in the National Cancer Data Base (2004-2016) were selected. Multivariable Cox regression analysis compared patients (combined male + female cohorts) having lobectomy to those having total thyroidectomy with or without radiation (primarily radioactive iodine) for ages: 18 to 45, 46 to 55, and >55 years. In addition, 1:1 propensity score matching and Kaplan-Meier curves with 10-year overall survival estimates, and log-rank test were stratified by age and sex.

RESULTS: Lobectomy had equivalent overall survival to total thyroidectomy without and with radiation for patients (combined male + female cohorts) aged 18 to 45 and 46 to 55 years on multivariable analysis. On propensity score matching there was overall survival advantage for total thyroidectomy with radiation over both lobectomy and total thyroidectomy for men (ages 18-90+ combined) and overall survival advantage in patients (combined male + female cohort) aged >55 years having total thyroidectomy with radiation versus lobectomy. On propensity score matching there were no overall survival differences in women (ages 18-90+ combined) or patients (combined male + female cohort) aged 18 to 45 and 46 to 55 years having either lobectomy, total thyroidectomy, or total thyroidectomy with radiation.

CONCLUSION: For cT2N0M0 classic papillary thyroid cancer, total thyroidectomy with radiation improves 10-year overall survival for patients (combined male + female cohort) aged >55 years and men (ages 18-90+ combined).

PMID:34666913 | DOI:10.1016/j.surg.2021.08.025

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Intranasal Dexmedetomidine increases the successful sedation of children with autism for out-patient auditory brainstem response hearing tests

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Publication date: Available online 19 October 2021

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Carolina Grau Luque, Cheryl Atkins-Labelle, Julie Pauwels, Rhodri Costello, Frederick K. Kozak, Neil K. Chadha

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'The Accessory Ethmoidal Canal Does Not Necessarily Contain an Arterial Structure'

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Ear Nose Throat J. 2021 Oct 19:1455613211049656. doi: 10.1177/01455613211049656. Online ahead of print.

ABSTRACT

Introduction: The aim of our study is to describe the prevalence of the accessory ethmoidal artery in endonasal endoscopic cadaver dissections and to identify its intraorbital origin. Material and Methods: From 2018 to 2020, thirty-four nasal dissections were performed in seventeen adult cadaveric heads. We performed a complete ethmoidectomy to ident ify the ethmoidal canals. Then, we removed the bony canal and the lamina papiracea to verify the injected vessel and to confirm the vascular structure inside the canal. Results: We found the anterior ethmoidal canal (AEC) and the posterior ethmoidal canal (PEC) in 100% of nasal cavities (34/34). We identified 4 accessory ethmoidal canals (AcEC) in the 34 nasal fossae dissected (12%). All AEC contained an arterial vessel. The AcEC contained an arterial vascular structure in 2 cases, a neural structure in other specimen, and in the fourth case no structure could be verified. In 32 of 34 nasal cavities, the PEC contained an artery and only in 2 cases the PEC did not contain any vascular structure. In these specimens, we observed that the AcEC with an arterial vessel inside (6%) was closer to the posterior canal than the anterior canal. Conclusion: According to our findings, we can suggest that the presence of a canal does not necessarily imply the presence of an arterial vessel, and that presence of the accessory ethmoidal artery could be associated with the absence of posterior ethmoidal artery.

PMID:34666559 | DOI:10.1177/01455613211049656

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LncRNA TUG1 aggravates cardiomyocyte apoptosis and myocardial ischemia/reperfusion injury

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Histol Histopathol. 2021 Oct 20:18381. doi: 10.14670/HH-18-381. Online ahead of print.

ABSTRACT

Cardiomyocyte apoptosis is a fundamental pathogenic factor leading to myocardial ischemia/reperfusion (MI/R) injury. The long non-coding RNA (IncRNA) TUG1 regulates apoptosis in various cell types. We report here that TUG1 expression is induced in mouse heart following MI/R injury as well as in cardiomyocytes subjected to simulated ischemia/reperfusion (SI/R) in vitro. Clinically, TUG1 expression is also elevated in plasma from patients with acute myocardial infarction (AMI), which implies its potential application as a disease biomarker. Functionally, TUG1 overexpression promotes, and its knockdown reduces SI/R-induced lactate dehydrogenase (LDH) release and caspase-3 activity in cardiomyocytes in vitro, illustrating that TUG1 exacerbates SI/R-induced apoptosis. Furthermore, in vivo, TUG1 aggravates MI/R injury in a mouse model, and subsequ ent observations show concurrent increased apoptosis of cardiomyocytes. Hence, this study unveils a clinical relevance and functional role of TUG1 in MI/R injury, and also implicates that targeting TUG1 may have therapeutic effects in treating MI/R injury.

PMID:34668176 | DOI:10.14670/HH-18-381

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Vancomycin bone cement in the treatment of radiation-induced neck soft tissue necrosis with sternal and clavicular osteomyelitis after laryngeal cancer surgery: a case report

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep 7;56(9):1000-1002. doi: 10.3760/cma.j.cn115330-20201124-00887.

NO ABSTRACT

PMID:34666456 | DOI:10.3760/cma.j.cn115330-20201124-00887

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Free rectus abdominis myocutaneous flap for the reconstruction of major and complex defects in the craniofacial regions after ablation of advanced sinonasal carcinomas

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep 7;56(9):907-913. doi: 10.3760/cma.j.cn115330-20210601-00320.

ABSTRACT

Objective: To explore the method and plausibility of using free rectus abdominis flap (FRAF) to reconstruct the major and complex defects in the craniofacial regions after ablation of advanced sinonasal carcinoma. Methods: From 2007 to 2018 at No. 980 Hospital of Joint Logistic Supportive Force of People's Liberation Army of China, 13 patients with advanced carcinoma of nasal cavity and paranasal sinuses, including 11 males and 2 females, aged from 33 to 67 years, were treated with FRAF to repair the invasion of skull base, face and orbit. Based on adequate and meticulous preoperative evaluations on patients and tumors, complete resection of tumor bulks was performed. According to the sites, characters and extents of the defects, FRAF was introduced in different ways into reconstruction of major an d complex defects in the craniofacial regions after resection of advanced sinonasal carcinomas, restoring the structure and contour of the craniofacial region. Results: Complete resection of tumors was achieved in all cases. For repairing the major and complex defects resulted from tumor ablation, FRAF graft was conducted in 13 patients with advanced sinonasal carcinomas. The recipient vessels were facial artery and vein in 9 cases, superficial temporal artery and vein in 4 cases. Vascular bridging with the external jugular vein was carried out in 2 cases who underwent submandibular neck dissections, in which facial artery and vein were used as recipient vessels. Free fibular flap was used along with FRAF in a case undergone bilateral maxillectomy. Pedicled galea capitis and periosteal flap were applied simultaneously in 3 cases with dura defects at the skullbase resulted from tumor resection. All flaps used in 13 cases survived uneventfully without major complications, with successful repair of defects, reconstruction of structures and restoration of contour of craniofacial regions. Conclusion: With adequate evaluation of resectability of tumors as well as nature and extent of defects after tumor removal, FRAF transplantation is an ideal method and strategy of choice for reconstructing the major and complex defects in craniofacial regions resulted from tumor ablation of advanced sinonasal carcinomas.

PMID:34666436 | DOI:10.3760/cma.j.cn115330-20210601-00320

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Free rectus abdominis myocutaneous flap for the reconstruction of major and complex defects in the craniofacial regions after ablation of advanced sinonasal carcinomas

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep 7;56(9):907-913. doi: 10.3760/cma.j.cn115330-20210601-00320.

ABSTRACT

Objective: To explore the method and plausibility of using free rectus abdominis flap (FRAF) to reconstruct the major and complex defects in the craniofacial regions after ablation of advanced sinonasal carcinoma. Methods: From 2007 to 2018 at No. 980 Hospital of Joint Logistic Supportive Force of People's Liberation Army of China, 13 patients with advanced carcinoma of nasal cavity and paranasal sinuses, including 11 males and 2 females, aged from 33 to 67 years, were treated with FRAF to repair the invasion of skull base, face and orbit. Based on adequate and meticulous preoperative evaluations on patients and tumors, complete resection of tumor bulks was performed. According to the sites, characters and extents of the defects, FRAF was introduced in different ways into reconstruction of major an d complex defects in the craniofacial regions after resection of advanced sinonasal carcinomas, restoring the structure and contour of the craniofacial region. Results: Complete resection of tumors was achieved in all cases. For repairing the major and complex defects resulted from tumor ablation, FRAF graft was conducted in 13 patients with advanced sinonasal carcinomas. The recipient vessels were facial artery and vein in 9 cases, superficial temporal artery and vein in 4 cases. Vascular bridging with the external jugular vein was carried out in 2 cases who underwent submandibular neck dissections, in which facial artery and vein were used as recipient vessels. Free fibular flap was used along with FRAF in a case undergone bilateral maxillectomy. Pedicled galea capitis and periosteal flap were applied simultaneously in 3 cases with dura defects at the skullbase resulted from tumor resection. All flaps used in 13 cases survived uneventfully without major complications, with successful repair of defects, reconstruction of structures and restoration of contour of craniofacial regions. Conclusion: With adequate evaluation of resectability of tumors as well as nature and extent of defects after tumor removal, FRAF transplantation is an ideal method and strategy of choice for reconstructing the major and complex defects in craniofacial regions resulted from tumor ablation of advanced sinonasal carcinomas.

PMID:34666436 | DOI:10.3760/cma.j.cn115330-20210601-00320

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Assessment of the quality of life of mandibular ameloblastoma patients after reconstruction with double-barrel fibula flap

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep 7;56(9):930-935. doi: 10.3760/cma.j.cn115330-20201229-00956.

ABSTRACT

Objective: To analyse the quality of life of patients receiving repair of bone defect with folded fibula flap after removal of mandibular ameloblastoma. Methods: The case data of 39 patients with ameloblastoma admitted to the First Affiliated Hospital of Zhengzhou University from August 2013 to April 2016 were retrospectively analysed, including 21 males and 18 females, from 18 to 58 years old. 3D printing and digital technology were used in flap preparation before surgery in all patients. The folded fibular flaps were used to repair mandibular defects and the implants were placed between 6-9 months after surgery. The short form-36 health survey questionnaire (SF-36) and the university of Washington quality of life questionnaire (UW-QOL) were applied to evaluate the quality of life of patients befo re surgery and at 6 months and 24 months after surgery. The higher the score, the better the condition. SPSS 20.0 was adopted for statistical analysis. Results: The SF-36 survey showed that the mean score of body role before surgery (72.4±11.7) was significantly higher than that at 6 months after surgery (39.6±11.1, t=23.580, P<0.05) or that at 24 months after surgery (59.8±6.4, t=8.358, P<0.001). Compared with the preoperative mean scores of Physical Pain (73.0±11.0), General Health (73.4±10.4) and Health Changes (79.2±3.9) before surgery, the mean scores Physical Pain (53.1±7.7), General Health (53.5±7.5) and Health Changes (63.9±11.7) at 6 months after surgery were decreased significantly respectively (t=13.068, 13.756 and 10.880, respectively, all P<0.05), but the mean scores Physical Pain (78.8±14.0), General Health (80.9±12.6) and Health Changes (84.4±4.6) at 24 months after surgery were increased significan tly respectively (t=-2.904, -4.027 and -7.586, respectively, all P<0.05), with significant differences in the mean scores of Physical Pain, General Health and Health Changes between 6 and 24 months after surgery (t=-14.241, -16.490, -14.294, respectively, all P<0.001). The UW-QOL survey showed that the mean scores of chewing, language and taste functions decreased at 6 months after surgery (53.1±6.7, 53.0±7.7 and 62.2±9.9, respectively), but improved at 24 months after surgery (67.9±3.9, 63.9±2.9 and 68.4±11.1, respectively), with statistically significant difference (t=-16.765, -11.675 and 2.498, respectively, all P<0.001). Conclusion: The application of folded fibula flaps to repair bone defects after sugery of mandibular ameloblastoma can better meet the needs of language and chewing functions and improve the quality of life of patients.

PMID:34666440 | DOI:10.3760/cma.j.cn115330-20201229-00956

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