Posterior fossa decompression for children with Chiari I malformation and hydrocephalus

xlomafota13 shared this article with you from Inoreader Posterior fossa decompression for children with Chiari I malformation and hydrocephalus Via leak of cerebrospinal fluid Childs Nerv Syst. 2021 Oct 20. doi: 10.1007/s00381-021-05377-4. Online ahead of print. ABSTRACT INTRODUCTION: Chiari I malformation (CMI) and hydrocephalus often coexist, with no clear understanding of the cause-and-effect relationship. In the absence of other associated etiologies, the traditional teaching has been to treat the hydrocephalus first, partly to minimize the risk of cerebrospinal fluid (CSF) leak from CMI decompression in the setting of elevated ICP. We describe a series of consecutive pediatric patients with CMI and hydrocephalus, the majority of whom were managed with posterior fossa decompression. METHODS: A retrospective review was conducted on consecutive children who presented to the senior author with both hydrocephalus and CMI, with emphasis on rationale for and outcomes of surgical intervention, including the need for additional surgery. RESULTS: There were 14 patients aged 2 weeks to 16 years (median 2 year s) who presented with Chiari I and hydrocephalus. Four of these underwent posterior fossa decompression without duraplasty (PFD) as first-line therapy (one of whom eventually required duraplasty), 7 had PFD with duraplasty (PFDD), 1 received a ventriculoperitoneal shunt (VPS), and two had endoscopic third ventriculostomy (ETV). Of the 11 who had PFD/D, 9 (90%) had significant symptom improvement/resolution, 7 (55%) showed decrease in ventricle size, and 1 (10%) required VPS placement for persistent hydrocephalus. Both ETV patients improved clinically, and 1 showed decrease in ventricle size. There were no pseudomeningoceles, infections, or neurological deficits. One CSF leak occurred after an ETV and was successfully treated with wound revision. CONCLUSION: In patients with both CMI and hydrocephalus, treating the CMI first in an effort to avoid a shunt can be safe and effective. In this series, PFDD in the setting of hydrocephalus did not result in CSF leak or pseudomeningoce le. While limited by a small sample size, these data support a causative relationship between CMI and hydrocephalus. PMID:34671850 | DOI:10.1007/s00381-021-05377-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Iatrogenic Cervical Epidermoid Cyst Following Tracheostomy

xlomafota13 shared this article with you from Inoreader Iatrogenic Cervical Epidermoid Cyst Following Tracheostomy Via ear nose throat Ear Nose Throat J. 2021 Oct 20:1455613211053423. doi: 10.1177/01455613211053423. Online ahead of print. ABSTRACT Epidermoid cysts are generally benign lesions surrounded by squamous epithelium with cystic contents. The lining of the cysts produce keratin, which resemble a cheese-like material. They typically occur in the skin and mucous membranes and are congenital in origin; iatrogenic epidermoid cysts are rare. Epidermoid cysts are usually painless and asymptomatic, and the ir diagnosis is based on histological examination. This paper aims to present the case report of a 23-year-old patient with an iatrogenic epidermoid cyst that occurred following tracheostomy. The importance of preoperative radiological imaging in the diagnosis of epidermoid cysts is also highlighted. PMID:34670428 | DOI:10.1177/01455613211053423 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Jaw-retraction exercise increases anterior hyoid excursion during swallowing in older adults with mild dysphagia

xlomafota13 shared this article with you from Inoreader Jaw-retraction exercise increases anterior hyoid excursion during swallowing in older adults with mild dysphagia Via swallowing exercises Gerodontology. 2021 Oct 20. doi: 10.1111/ger.12595. Online ahead of print. ABSTRACT OBJECTIVES: The present study aimed to evaluate the effectiveness of a newly designed jaw-retraction exercise for strengthening the geniohyoid muscle and thus improving the anterior movement of the hyoid bone during swallowing. BACKGROUND: Although previous studies suggest a relationship between anterior hyoid excursion and upper esophageal sphincter (UES) opening, there are currently no repor ts of physical exercises without the use of special equipment that can effectively improve this movement of the hyoid bone during swallowing. MATERIALS AND METHODS: This before-after study included patients presenting to the authors' hospital with mild dysphagia (Level 5 on the Dysphagia Outcome and Severity Scale). The participants were instructed to perform a jaw-retraction exercise designed to strengthen the geniohyoid muscle. Each participant was instructed to perform two sets of the exercise daily for four weeks, with each set consisting of five repetitions. Before and after the four-week training period, videofluoroscopic swallowing studies were performed and later analysed. RESULTS: Twenty-five patients with a median age of 77 were included. The median peak anterior hyoid position before and after exercise were 129.82 and 132.74 (%C2-C4 length), respectively, and this increase was found to be significant (P = .007). The median extent of UES opening before and afte r exercise were 8.6 and 9.3 (mm), respectively, and this increase was also found to be significant (P = .040). CONCLUSION: Our findings demonstrate that the jaw-retraction exercise can effectively improve the anterior movement of the hyoid bone. This exercise may be effective in individuals with oral frailty when signs of swallowing disorders are observed. PMID:34672024 | DOI:10.1111/ger.12595 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High FITM2 expression promotes cell migration ability of hepatocellular carcinoma by regulating the formation of caveolae and indicates poor patient survival

xlomafota13 shared this article with you from Inoreader High FITM2 expression promotes cell migration ability of hepatocellular carcinoma by regulating the formation of caveolae and indicates poor patient survival Via Cellular and Molecular Biology Histol Histopathol. 2021 Oct 21:18382. doi: 10.14670/HH-18-382. Online ahead of print. ABSTRACT BACKGROUND: Hepatocellular carcinoma (HCC) is among the most malignant tumors with high recurrence and low 5-year survival rate. Lipid metabolism is essential in tumor metastasis, although how altered lipid metabolism promotes HCC progression has not been well elucidated. Fat Storage Inducing Transmembrane Protein 2 (FITM2) is a gene involved in lipid homeostasis and cytoskeletal organization; however, its role in regulating tumor biological behavior has not been evaluated. METHODS: In this study, immunohistochemistry was performed to evaluate the expression of FITM2 in HCC. Univariate and multivariate analysis was performed to identify the prognostic factors. RNA interference wound healing and transwell experiments were performed to analyze the biological role of FITM2. Western blot analysis was performed to investigate the potential downstream signaling. RESULTS: The results revealed that FITM2 was highly expressed in the intratumoral tissues of HCC. Expression of intratumoral FITM2 was associated with microvascular invasion. FITM2 is an independent risk factor of HCC disease-free survival and overall survival. In vitro studies revealed that knockdown of FITM2 significantly inhibited the migration ability of HCC cells. FITM2 promotes HCC cell migration by regulating the expression of caveolin-1 and promoting the formation of caveolae. These results indicate that high intratumoral expression of FITM2 is associated with poor HCC prognosis, which may be applied to develop a new adjuvant therapy. PMID:34672358 | DOI:10.14670/HH-18-382 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia

xlomafota13 shared this article with you from Inoreader Message: A 14-year-old girl presented with progressive swelling of the jaw. Six weeks before this admission, a nonpainful lump in the left lower jaw developed. The mass increased in size, and swelling of the left side of the face and neck developed. A biopsy specimen from the mass showed abundant giant cells. The calcium level was 11.8 mg per deciliter. Giant cell, also called Langhans giant cell, large cell characterized by an arc of nuclei toward the outer membrane. The cell is formed by the fusion of epithelioid cells, which are derived from immune cells called macrophages. Once fused, these cells share the same cytoplasm, and their nuclei become arranged in an arc near the outer edge of the cell. Langhans giant cells typically form at the centre of granulomas (aggregates of macrophages) and are found in the tubercle, or primary focus of infection, in tuberculosis, in lesions of syphilis, leprosy, and sarcoidosis, and in fungal infections. Large cells that form by fusion in reaction to the presence in the body of foreign substances differ from Langhans giant cells in that their many nuclei are scattered throughout the cell. In giant-cell tumours of bone and tendon the cells have many nuclei crowded together. The megakaryocytes, the normal bone-marrow cells thought to be the source of the blood platelets, are also called giant cells. Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia Via The New England Journal of Medicine: Otolaryngology Presentation of Case. Dr. Austin Be (Surgery): A 14-year-old girl was admitted to this hospital because of swelling of the left jaw. The patient had been well until 6 weeks before this admission, when she noticed a lump in the left lower jaw; there was no pain, tenderness, or discomfort in the jaw.… View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.