The aetiopathologies of Ménières disease: a contemporary review

La Sindrome di Ménière, una condizione descritta nel 1800, è stata unarea di grande interesse clinico e di ricerca scientifica negli ultimi decenni. Le linee guida pubblicate dall American Academy of Otolaryngology-Head and Neck Surgery sono rimaste pressoché invariate per quasi 20 anni, benché la ricerca scientifica sugli aspetti eziopatologici sia indubbiamente molto progredita nel frattempo. La presente revisione della letteratura evidenzia gli importanti progressi compiuti nella comprensione della fisiopatologia di questa malattia enigmatica. Le evidenze discusse sono inoltre accompagnate da una documentazione iconografica istopatologica. Lobiettivo della presente trattazione è fornire al lettore un quadro aggiornato ed accurato sulle teorie inerenti la Sindrome di Ménière

Dysfunction of the cochlea contributing to hearing loss in acoustic neuromas: an underappreciated entity

There is significant degeneration of cochlear structures in ears with VS. Cochlear dysfunction may be an important contributor to the hearing loss caused by VS and can explain certain clinically observed phenomena in patients with VS

Blockage of longitudinal flow in Meniere's disease: A human temporal bone study

Conclusion: Blockage of the endolymphatic duct is a significant finding in Meniere's disease. The position of the utriculo-endolymphatic valve (UEV) and blockage of the ductus reuniens in the temporal bones were not found to be directly indicative of Meniere's disease. Objective: Comparison of blockage of the longitudinal flow of endolymph between ears affected by Meniere's disease and normal ears. Methods: We examined 21 temporal bones from 13 subjects who had Meniere's disease and 21 normal temporal bones from 12 controls. Results: The endolymphatic duct was blocked in five (23%) ears affected by Meniere's disease (p = 0.016). The utricular duct was blocked in 16 (76%) ears affected by Meniere's disease and 11 (52%) normal ears (p = 0.112). The saccular duct was blocked in 6 (28%) of ears affected by Meniere's disease and 16 (76%) normal ears (p = 0.001). The ductus reuniens was blocked in 10 (47%) ears affected by Meniere's disease and 10 (47%) normal ears (p = 1.000)

Relationship between SCUBE1 levels and echocardiography and electrocardiography findings and epicardial adipose tissue/carotid intima-media thickness in patients receiving renal replacement therapy

PubMedID: 30777551Objectives: In patients with advanced-stage chronic kidney disease, renal insufficiency, arterial stiffness, and vascular calcification are strong predictors of cardiovascular risk. Signal peptide-CUB-EGF-like protein-1 (SCUBE1) levels increase during platelet activation and acute ischemic events. Here, we evaluated associations between SCUBE1 levels and electrocardiographic/echocardiographic findings, epicardial adipose tissue thickness, and carotid intima-media thickness in patients with chronic kidney disease. Materials and Methods: Our study included 21 renal transplant recipients, 20 peritoneal dialysis patients, 20 hemodialysis patients, 20 predialysis patients with glomerular filtration rate < 30 mL/min, and 16 healthy volunteers. Results: We found no differences in SCUBE1 levels between patient groups and healthy volunteers, regardless of history of diabetes mellitus, myocardial infarction, cerebrovascular events, and hypertension. SCUBE1 levels correlated with C-reactive protein in renal transplant recipients; magnesium in peritoneal dialysis patients; erythrocyte sedimentation rate in predialysis patients; and parathyroid hormone, platelet count, calcium-phosphate product, and calcium in hemodialysis patients. No associations were shown between SCUBE1 levels and electrocardiographic/echocardiographic findings. Elevated C-reactive protein in predialysis patients was associated with cardiac valvular pathologies. In hemodialysis patients, SCUBE1 levels increased after hemodialysis (P = .007). Levels were higher in healthy individuals with normal echocardiography and pre-dialysis patients with left ventricular diastolic dysfunction. Positive correlations were found between carotid intima-media thickness and SCUBE1 levels in dialysis patients (P < .05), but no study groups showed correlations regarding epicardial adipose tissue thickness. Conclusions: Hemodialysis may contribute to cardiovascular events because of increased SCUBE1 levels after hemodialysis; however, no association was shown between SCUBE1 and electrocardiography/ echocardiography findings. We found no correlations between epicardial adipose tissue thickness and SCUBE1 levels, and levels were significantly higher in healthy patients and in predialysis patients without left ventricular diastolic dysfunction. However, correlations were shown between SCUBE1 levels and carotid intima-media thickness and secondary hyperparathyroidism markers, indicating associations with atherosclerosis and bone mineral disease in dialysis patients. © Başkent University 2019 Printed in Turkey. All Rights Reserved.TTU-2017-8016From the the 1Department of Internal Medicine, the 2Department of Cardiology, the 3Department of Neprology, and the 4Department of Public Health, Cukurova University Faculty of Medicine, Adana, Turkey; and the 5Kahta State Hospital, Adiyaman, Turkey Acknowledgements: The authors have no conflicts of interest to declare. This study was supported by Çukurova University Research Fund (TTU-2017-8016). Corresponding author: Saime Paydas, Cukurova University Faculty of Medicine, Department of Nephrology, Adana, Turkey Phone: +90 322 3386060 ext: 3136 E-mail: [email protected]

Clinical Study Reactive Oxygen Species Production in Peripheral Blood Neutrophils of Obstructive Sleep Apnea Patients

Obstructive sleep apnea (OSA) as well as obesity is associated with increased production of reactive oxygen species (ROS). Neutrophils produce great amounts of ROS. The aim was to evaluate peripheral blood neutrophils ROS production in men with OSA and to establish relations with disease severity and obesity. Methods. Forty-six men with OSA and 10 controls were investigated. OSA was confirmed by polysomnography (PSG), when apnea/hypopnea index was &gt;5/h. Body mass index (BMI) was evaluated. Neutrophils were isolated from peripheral blood in the morning after PSG. Dihydrorhodamine-123 was used for ROS detection. Data is presented as median (25th and 75th percentiles). All subjects were divided into four groups: nonobese mild-to-moderate OSA, obese mild-to-moderate OSA, nonobese severe OSA, and obese severe OSA. Results. Neutrophil ROS production was higher in nonobese severe OSA group compared to nonobese mild-to-moderate OSA (mean fluorescence intensity (MFI) 213.4 (89.0-238.9) versus 44.5 (20.5-58.4), &lt; 0.05). In obese patient groups, ROS production was more increased in severe OSA compared to mild-to-moderate OSA group .8), &lt; 0.05). It did not differ in the groups with different BMI and the same severity of OSA. Conclusion. Increased neutrophil ROS production was related to more severe OSA but not obesity