Endonasal Endoscopic and Hybrid Surgery Techniques for Blunt Trauma Fractures of the Skull Base With Cerebrospinal Fluid Leaks

xlomafota13 shared this article with you from Inoreader Endonasal Endoscopic and Hybrid Surgery Techniques for Blunt Trauma Fractures of the Skull Base With Cerebrospinal Fluid Leaks Via leak of cerebrospinal fluid J Craniofac Surg. 2021 Jun 30. doi: 10.1097/SCS.0000000000007932. Online ahead of print. ABSTRACT Cerebrospinal fluid (CSF) leakage caused by skull base fracture represents high risks of bacterial meningitis, and a rate of mortality of 8.9%. Endoscopic endonasal repair of CSF leaks is quite safe and effective procedure with high rates of success. The aim of this study is to describe our technique for management of skull base CSF leaks secondary to craniofacial trauma based on the anatomic location of the leak. This is a retrospective case series of 17 patients with diagnosis of craniofacial trauma, surgically treated with sole endonasal endoscopic and combined endonasal/transcranial approaches with diagnosis of CSF leak secondary to skull base fractures. Seventeen patients met inclusion criteria for this study. Mean age was 46 years old. Most common etiology was motor vehicle. Early surgery was performed in 8 patients, and late surgery in 9 p atients. The most common site of CSF leak was at ethmoid cells or at the fronto-ethmoid junction in 9 patients. Thirteen patients (76.4%) were treated only with endonasal endoscopic technique, and 4 (23.5%) with hybrid surgery, combining endonasal endoscopic and cranial bicoronal approaches with nasal and pericranial vascularized flaps, and nasal mucosal free flaps. Mean hospital stay was 23.7 days.The mean follow-up time was 25.6 months. When surgical reconstruction is indicated for CSF leaks secondary to skull base fractures, endonasal endoscopic techniques should be part of the surgical management either as a sole procedure, or in combination with classical transcranial approaches with high rates of success and low morbidity. PMID:34224458 | DOI:10.1097/SCS.0000000000007932 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

LncRNA MSC‐AS1 motivates the development of melanoma by binding to miR‐302a‐3p and recruiting IGF2BP2 to elevate LEF1 expression

xlomafota13 shared this article with you from Inoreader LncRNA MSC‐AS1 motivates the development of melanoma by binding to miR‐302a‐3p and recruiting IGF2BP2 to elevate LEF1 expression Via Experimental Dermatology Abstract Melanoma is considered as the most common malignancy among skin cancers. The roles of many long non-coding RNAs (lncRNAs) have been clearly identified in multiple tumors. Nevertheless, lncRNA MSC antisense RNA 1 (MSC-AS1) has not been deeply investigated melanoma. In the present study, RT-qPCR and western blot analyses were used to measure the expression of RNAs and proteins. Functional and in vivo assays were implemented to detect the function of genes in melanoma. RNA pull down, RIP and luciferase reporter assays were applied for determining interactions between RNA and protein molecules. It was observed that MSC-AS1 and lymphoid enhancer binding factor 1 (LEF1) were remarkably up-regulated while microRNA-302a-3p (miR-302a-3p) down-regulated in melanoma cell lines. The silencing of MSC-AS1 hindered cell proliferation, migration and epithelial-mesenchymal transition (EMT) in vitro and tumor growth in vivo. Furthermore, MSC-AS1 regulated LEF1 expression through sponging miR-302a-3 p and recruiting insulin like growth factor 2 mRNA binding protein 2 (IGF2BP2). Eventually, LEF1 overexpression rescued cell progression impaired by MSC-AS1 knockdown. In summary, our research identified the MSC-AS1/miR-302a-3p/IGF2BP2/LEF1 axis in melanoma development, which indicated that MSC-AS1 is a potential biomarker in the treatment of melanoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunohistochemical markers for histopathological diagnosis and differentiation of acute cutaneous graft‐versus‐host disease

xlomafota13 shared this article with you from Inoreader Immunohistochemical markers for histopathological diagnosis and differentiation of acute cutaneous graft‐versus‐host disease Via Experimental Dermatology Abstract Graft-versus-host disease (GvHD) is a major complication following stem-cell or solid-organ transplantation. Accurate diagnosis of cutaneous GvHD is challenging, given that drug eruptions and viral rashes may present with similar clinical/histological manifestations. Specific markers are not available. We performed the histological examination of biopsy samples from acute GvHD (aGvHD; n = 54), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN; n = 27), maculopapular drug eruption (MDE; n = 26) and healthy controls (n = 26). Samples of aGvHD showed a decrease in Langerhans cells (LC, p = 0.0001) and an increase in macrophages (MΦ, p = 0.0001) compared to healthy skin. Compared to SJS/TEN, MDE and healthy skin, aGvHD biopsies contained greater numbers of CD4+ and CD8+ T cells. The majority of CD4+ T-helper cells were localized in the uppe r dermis, whereas cytotoxic CD8+ T cells were found in the epidermis. Increased numbers of CD56+ natural killer (NK) cells in the upper dermis of aGvHD skin (p = 0.007) were not observed in controls or SJS/TEN and MDE. There were no differences in elafin staining between aGvHD and the latter two conditions. Acute GvHD appears to have a distinct inflammatory cell profile (T cells/NK cells) that may aid establishing in a more accurate diagnosis, especially when used to rule out differential diagnoses such as SJS/TEN or MDE. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of a non-personalized optopalatographic device for prospective use in functional post-stroke dysphagia therapy

xlomafota13 shared this article with you from Inoreader Evaluation of a non-personalized optopalatographic device for prospective use in functional post-stroke dysphagia therapy Via swallowing exercises IEEE Trans Biomed Eng. 2021 Jul 2;PP. doi: 10.1109/TBME.2021.3094415. Online ahead of print. ABSTRACT OBJECTIVE: Stroke survivors commonly suffer from dysphagia, originating from oro-facial impairments which affect swallowing function. Functional therapy often employs tongue exercises that require the patient to perform short motion sequences. Evaluating the patients performance on those exercises is difficult, because there is no reliable form of visual feedback. METHODS: We propose an optopalatographic device that does not require a personalized dental retainer and is capable of measuring tongue movement trajectories intraorally. The device features nine optical proximity sensors at 100 Hz and is fixated against the hard palate with a specifically developed palatal adhesive. The sensing capabilities of the device were evaluated on a tongue gesture corpus recorded from nine healthy individuals, containing eight different tongue exercises commonly used in functional dysphagia therapy. RESULTS: The measured tongue trajectories contained temporally and spatially resolved information about the tongue movement and location during each exercise. Furthermore, a simple DTW-kNN classifier was able to distinguish the exercises from one another with an average classification accuracy of 97.9 % and 61.4 % (cross-validation and inter-speaker test accuracy, respectively). CONCLUSION: the device can provide real-time feedback for tongue motion and we obta ined promising gesture recognition results with relatively few sensors, even in the absence of a personalized dental retainer. SIGNIFICANCE: Non-personalized optopalatography is readily available and could aid in improving functional dysphagia therapy by providing visual feedback to both the physician and patient. PMID:34214033 | DOI:10.1109/TBME.2021.3094415 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive, objective evaluation of lower extremity lymphedema severity using shear wave elastography: A preliminary study

xlomafota13 shared this article with you from Inoreader Noninvasive, objective evaluation of lower extremity lymphedema severity using shear wave elastography: A preliminary study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00265-5. doi: 10.1016/j.bjps.2021.05.013. Online ahead of print. ABSTRACT BACKGROUND: Increased skin and subcutaneous tissue stiffness in patients with early-stage lymphedema has been reported. The purpose of this study was to examine the use of shear wave elastography (SWE) for evaluating lower extremity lymphedema (LEL). METHODS: For 10 lower extremities of normal controls and 72 limbs of patients with gynecological cancer whose lymphatic function was categorized into six stages based on the range of dermal backflow (DBF) observed in indocyanine green (ICG) lymphography, SWE was performed and shear wave velocity (SWV) of the dermis and three layers of subcutaneous tissue at the thigh and calf were recorded. Twenty-five patients underwent thigh tissue histological and dermal thickness examinations. RESULTS: The strongest correlation between the ICG DBF stage and SWV d uring SWE was observed on the dermal layer of the thigh (p < 0.01, R = 0.67). There was a significant correlation between the dermal thickness of the thigh and the ICG DBF stage (p < 0.01, R = 0.87) and also between the dermal thickness of the thigh and SWV (p < 0.01, R = 0.73). CONCLUSION: Noninvasive, objective evaluation of LEL severity using SWE was well correlated with lymphatic function as determined by ICG lymphography. The DBF changes in the dermis of the thigh best reflected the changes in lymphatic function. Dermal thickness variations may partially account for differences in SWV. PMID:34215544 | DOI:10.1016/j.bjps.2021.05.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap

xlomafota13 shared this article with you from Inoreader Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00273-4. doi: 10.1016/j.bjps.2021.05.021. Online ahead of print. ABSTRACT BACKGROUND/PURPOSE: After total or subtotal maxillectomy, reconstruction using a free rectus abdominis myocutaneous (RAMC) flap is a fundamental and useful option. The purpose of the present study was to clarify the degree of flap volume change and volume distribution change with time after total or subtotal maxillectomy and free RAMC flap reconstruction and to examine the factors affecting the results. METHODS: A total of 20 patients who underwent total or subtotal maxillectomy with free RAMC flap reconstruction were examined, and the flap volume change rate (volume at final evaluation [POD 181-360] / volume at initial evaluation [POD 5-30]) was investigated using the results of imaging tests. Moreover, the flap was divided into four blocks (A-D) in the cranio-caudal direction, and the volume change o f each block was individually analyzed. RESULTS: The overall volume change rate of fat/muscle/total was 0.84 ± 0.21/0.36 ± 0.08/0.67 ± 0.15, at the mean follow-up period of 309±35 days after the operation. The multiple regression analysis revealed that weight loss (for fat), postoperative RT (for fat and muscle), and young age (for muscle) were independently associated with flap volume loss. The results also indicated that the fat volume was stable, whereas the muscle volume decreased to <40% over time, assuming there were no influencing factors. Regarding flap volume distribution change, the fat volume tended to gather toward the central-cranial direction, while the muscle volume gathered toward the cranial direction, and total flap volume gathered toward the central direction. PMID:34215545 | DOI:10.1016/j.bjps.2021.05.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap

xlomafota13 shared this article with you from Inoreader Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00273-4. doi: 10.1016/j.bjps.2021.05.021. Online ahead of print. ABSTRACT BACKGROUND/PURPOSE: After total or subtotal maxillectomy, reconstruction using a free rectus abdominis myocutaneous (RAMC) flap is a fundamental and useful option. The purpose of the present study was to clarify the degree of flap volume change and volume distribution change with time after total or subtotal maxillectomy and free RAMC flap reconstruction and to examine the factors affecting the results. METHODS: A total of 20 patients who underwent total or subtotal maxillectomy with free RAMC flap reconstruction were examined, and the flap volume change rate (volume at final evaluation [POD 181-360] / volume at initial evaluation [POD 5-30]) was investigated using the results of imaging tests. Moreover, the flap was divided into four blocks (A-D) in the cranio-caudal direction, and the volume change o f each block was individually analyzed. RESULTS: The overall volume change rate of fat/muscle/total was 0.84 ± 0.21/0.36 ± 0.08/0.67 ± 0.15, at the mean follow-up period of 309±35 days after the operation. The multiple regression analysis revealed that weight loss (for fat), postoperative RT (for fat and muscle), and young age (for muscle) were independently associated with flap volume loss. The results also indicated that the fat volume was stable, whereas the muscle volume decreased to <40% over time, assuming there were no influencing factors. Regarding flap volume distribution change, the fat volume tended to gather toward the central-cranial direction, while the muscle volume gathered toward the cranial direction, and total flap volume gathered toward the central direction. PMID:34215545 | DOI:10.1016/j.bjps.2021.05.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.