Resection of giant ethmoid osteoma with orbital and skull base extension followed by duraplasty

<p>Abstract</p> <p>Background</p> <p>Osteomas of ethmoid sinus are rare, especially when they involve anterior skull base and orbit, and lead to ophthalmologic and neurological symptoms.</p> <p>Case presentation</p> <p>The present case describes a giant ethmoid osteoma. Patient symptoms and signs were exophthalmos and proptosis of the left eye, with progressive visual acuity impairment and visual fields defects. CT/MRI scanning demonstrated a huge osseous lesion of the left ethmoid sinus (6.5 cm × 5 cm × 2.2 cm), extending laterally in to the orbit and cranially up to the anterior skull base. Bilateral extensive polyposis was also found. Endoscopic and external techniques were combined to remove the lesion. Bilateral endoscopic polypectomy, anterior and posterior ethmoidectomy and middle meatus antrostomy were performed. Finally, the remaining part of the tumor was reached and dissected from the surrounding tissue via a minimally invasive Lynch incision around the left middle canthus. During surgery, CSF rhinorrhea was observed and leakage was grafted with fascia lata and coated with bio-glu. Postoperatively, symptoms disappeared. Eighteen months after surgery, the patient is still free of symptoms.</p> <p>Conclusion</p> <p>Before management of ethmoid osteomas with intraorbital and skull base extension, a thorough neurological, ophthalmological and imaging evaluation is required, in order to define the bounders of the tumor, carefully survey the severity of symptoms and signs, and precisely plan the optimal treatment. The endoscopic procedure can constitute an important part of surgery undertaken for giant ethmoidal osteomas. In addition, surgeons always have to take into account a possible CSF leak and they have to be prepared to resolve it.</p

Metallic foreign body in middle ear: an unusual cause of hearing loss

This is a rare case report of a foreign metallic body found in the middle ear. During the use of an electric welding by a metalworker, a glowing drop of dissolved metal overrun, burning the skin of his external auditory meatus, perforated the tympanic membrane and finally was implanted around the ossicles as a foreign body. Due to difficulty of the physical examination and the moderate symptoms (hearing loss and sense of fullness), the foreign body was detected six months after the incident, by CT scanning and it was removed by a transcanal approach under general anesthesia. A successful ossiculoplasty-tympanoplasty was followed four weeks later

SHMT1 1420 and MTHFR 677 variants are associated with rectal but not colon cancer

<p>Abstract</p> <p>Background</p> <p>Association between rectal or colon cancer risk and serine hydroxymethyltransferase 1 (<it>SHMT1</it>) C1420T or methylenetetrahydrofolate reductase (<it>MTHFR</it>) C677T polymorphisms was assessed. The serum total homocysteine (HCY), marker of folate metabolism was also investigated.</p> <p>Methods</p> <p>The <it>SHMT1 </it>and <it>MTHFR </it>genotypes were determined by real-time PCR and PCR-RFLP, respectively in 476 patients with rectal, 479 patients with colon cancer and in 461 and 478, respective controls matched for age and sex. Homocysteine levels were determined by HPLC kit. The association between polymorphisms and cancer risk was evaluated by logistic regression analysis adjusted for age, sex and body mass index. The population stratification bias was also estimated.</p> <p>Results</p> <p>There was no association of genotypes or diplotypes with colon cancer. The rectal cancer risk was significantly lower for <it>SHMT1 </it>TT (OR = 0.57, 95% confidence interval (CI) 0.36-0.89) and higher for <it>MTHFR </it>CT genotypes (OR = 1.4, 95%CI 1.06-1.84). A gene-dosage effect was observed for <it>SHMT1 </it>with progressively decreasing risk with increasing number of T allele (p = 0.014). The stratified analysis according to age and sex revealed that the association is mainly present in the younger (< 60 years) or male subgroup. As expected from genotype analysis, the <it>SHMT1 </it>T allele/<it>MTHFR </it>CC diplotype was associated with reduced rectal cancer risk (OR 0.56, 95%CI 0.42-0.77 vs all other diplotypes together). The above results are unlikely to suffer from population stratification bias. In controls HCY was influenced by <it>SHMT1 </it>polymorphism, while in patients it was affected only by Dukes' stage. In patients with Dukes' stage C or D HCY can be considered as a tumor marker only in case of <it>SHMT1 </it>1420CC genotypes.</p> <p>Conclusions</p> <p>A protective effect of <it>SHMT1 </it>1420T allele or <it>SHMT1 </it>1420 T allele/<it>MTHFR </it>677 CC diplotype against rectal but not colon cancer risk was demonstrated. The presence of <it>SHMT1 </it>1420 T allele significantly increases the HCY levels in controls but not in patients. Homocysteine could be considered as a tumor marker in <it>SHMT1 </it>1420 wild-type (CC) CRC patients in Dukes' stage C and D. Further studies need to clarify why <it>SHMT1 </it>and <it>MTHFR </it>polymorphisms are associated only with rectal and not colon cancer risk.</p

NIS- and pendrin-autoantibodies as diagnostic markers in thyroid disease

Introduction: Iodine is an essential component in thyroid hormone biosynthesis. Iodide transport through thyrocytes is mainly mediated by the basolateral sodium-iodide-symporter (NIS, SLC5A5) and the apical anion exchanger pendrin (PDS, SLC26A4). The role of TPO- and TSH-receptor-autoantibodies in the pathogenesis and diagnosis of autoimmune thyroid disease is well established. However, reports regarding the prevalence and diagnostic utility of autoantibodies (aAb) against NIS and PDS have been contradictory, possibly due to small study groups and underlying methodological differences of the published papers. Methods: We established two novel non-radioactive assays using the full length antigens NIS und PDS. For this purpose, NIS and PDS were recombinantly expressed as fusion protein with firefly-luciferase in stably transfected HEK293 cells. Serum samples from a large cohort of 323 thyroid patients and 400 healthy controls were screened for NIS- and PDS-aAb. Results: Thyroid patients showed an approximately fourfold higher prevalence of NIS-aAb (7.7%) than controls (1.8%), while the prevalence of PDS-aAb was similar in thyroid patients and controls (7.7% vs. 5.0%). The highest prevalence of NIS- and PDS-aAb was seen in the subgroup of Graves’ disease patients (12.3% and 11.0%, respectively). No correlation was found between the investigated aAb-titers and TPO-aAb or TSH-receptor-aAb or selenium or zinc status. The reproducibility of assay signals was verified with respect to linearity, stability and absence of matrix effects. Conclusions: The results are in agreement with recent studies. While a determination of PDS-aAb in thyroid patients does not yet seem to be of diagnostic value, a possible relevance of NIS-aAb for an improved diagnosis of thyroid disease was shown.Einleitung: Iod ist ein essentieller Bestandteil in der Schilddrüsenhormon-Biosynthese. Der Iodid-Transport durch die Thyreozyten erfolgt hauptsächlich durch den basolateralen Natrium-Iodid-Symporter (NIS, SLC5A5) und den apikalen Anionen-Austauscher Pendrin (PDS, SLC26A4). Die Rolle von TPO- und TSH Rezeptor-Autoantikörpern in der Pathogenese und Diagnostik von autoimmunbedingten Schilddrüsenerkrankungen ist gut etabliert. Widersprüchlich zeigen sich allerdings Berichte über die Prävalenz und den diagnostischen Nutzen von Autoantikörpern (aAk) gegen NIS und PDS; dies ist möglicherweise auf die kleinen Studiengruppen und methodische Unterschiede der publizierten Arbeiten zurückzuführen. Methoden: Es erfolgte die Etablierung zweier neuartiger nicht-radioaktiver Assays mit den Antigenen NIS und PDS in voller Länge. Dafür wurden NIS und PDS rekombinant als Fusionsprotein mit Firefly-Luciferase in stabil transfizierten HEK293-Zellen exprimiert. Hiermit wurden Serumproben einer großen Kohorte von 323 Schilddrüsenpatienten und 400 gesunden Kontrollen vermessen. Ergebnisse: Schilddrüsenpatienten zeigten eine ca. viermal höhere Prävalenz für NIS-aAk (7,7 %) als Kontrollen (1,8 %), während die Prävalenz von PDS-aAk bei Schilddrüsenpatienten und Kontrollen ähnlich war (7,7 % vs. 5,0 %). Die höchste Prävalenz von NIS- und PDS-aAk zeigte sich in der Subgruppe der M. Basedow Patienten (12,3 % und 11,0 %). Es zeigte sich keine Beziehung der untersuchten aAk zu den TPO aAk oder TSH-Rezeptor-aAk-Titern bzw. dem Selen- oder Zinkstatus. Die Reproduzierbarkeit der Assaysignale wurde hinsichtlich Linearität, Stabilität und Abwesenheit von Matrixeffekten verifiziert. Schlussfolgerungen: Die Ergebnisse stehen in Übereinstimmung mit aktuellen Studien. Während der Bestimmung von PDS-aAk bei Schilddrüsenpatienten derzeit kein diagnostischer Wert zukommt, zeigte sich eine mögliche Relevanz von NIS-aAk für eine verbesserte Diagnostik von Schilddrüsenerkrankungen

Exploring the Efficacy of Four Apiaceae Essential Oils against Nine Stored-Product Pests in Wheat Protection

The Apiaceae family, known for aromatic plants producing bioactive essential oils (EOs), holds significance across sectors, including agrochemicals. This study evaluated the insecticidal potential of four Apiaceae EOs from Crithmum maritimum L., Trachyspermum ammi (L.) Sprague ex Turrill, Smyrnium olusatrum L., and Elwendia persica (Boiss.) Pimenov and Kljuykov against various significant storage pests (Sitophilus oryzae (L.), Trogoderma granarium Everts, Rhyzopertha dominica (F.), Tribolium castaneum (Herbst), T. confusum Jacquelin du Val, Oryzaephilus surinamensis (L.), Alphitobius diaperinus (Panzer), Acarus siro L., and Tenebrio molitor L.) on wheat. Insect mortality rates were monitored at intervals of 1, 2, 3, 4, 5, 6, and 7 days. Smyrnium olusatrum EO exhibited the highest efficacy, followed by T. ammi, C. maritimum, and E. persica EOs, although efficacy varied by species, developmental stage, and concentration. Notably, complete mortality occurred for several pests at 1000 ppm of S. olusatrum and T. ammi EOs. Gas chromatography–mass spectrometry (GC–MS) analysis revealed key compounds in these EOs, including myrcene, germacrone, and curzerene in S. olusatrum EO, and thymol, γ-terpinene, and p-cymene in T. ammi EO. These findings emphasize their potential as botanical insecticides. Smyrnium olusatrum and T. ammi EOs emerge as promising eco-friendly pest management options due to their efficacy, highlighted compound composition, and availability of biomass from both wild and cultivated sources

Blood vessel organoids derived from diabetic patients revealed impaired function based on a subpopulation of endothelial cells

IntroductionImpaired function of blood vessels can lead to cardiovascular diseases (CVDs), which is a major cause of death worldwide. The presence of both endothelial cells (ECs) and mural cells is central to the proper function of blood vessels in health and pathological changes in diseases including diabetes. Although iPSCs-derived vascular organoids (VOs) provide an appealing source for in vitro vascular disease modelling and drug testing, whether these organoids can recapitulate human vascular disease is yet to be determined.MethodsBlood mononuclear cells from six donors with diabetes (DB) and three with non-diabetes (ND) were subjected to reprogramming into iPSCs, and subsequent differentiation to VOs. DB-VOs and ND-VOs were compared using immunohistochemistry, angiogenic array, ROS production assay, acetylated-LDL uptake assay, transmission electron microscopy, western blotting, flow cytometry and single-cell RNA sequencing. Additionally, the regenerative potential of DB-VOs vs ND-VOs was compared by assessment of blood recovery via Laser Doppler imaging in mice ischaemic hindlimb model, and organoid cells’ integration into host vasculature was tracked by Bruker fluorescent imaging.ResultsWe showed diabetic derived-iPSCs-VOs represent impaired vascular function including enhanced ROS level, with higher mitochondrial content and activity, increased pro-inflammatory cytokines, and less regenerative potential in vivo. Using single-cell RNA sequencing, we identified all specialized types of vascular cells (artery, capillary, vein, lymphatic and tip cells, as well as pericytes and vSMCs) within vascular organoids, while demonstrating the dichotomy landscape of ECs and mural cells. Furthermore, we revealed basal heterogeneity within vascular organoids and demonstrated differences between diabetic and non-diabetic VOs. Of note, a subpopulation of ECs significantly enriched for ROS and oxidative phosphorylation hallmarks in DB-VOs, representing early signs of aberrant angiogenesis in diabetes. For the first time, we report that GAP43 (Neuromodulin) is expressed in ECs, and GAP43+ ECs are distinctly increased in DB-VOs. Therefore, GAP43 is possibly a biomarker for the onset and progression of diabetic-related blood vessel dysfunction.<br/