Determinants of Conductive Hearing Loss in Tympanic Membrane Perforation

ObjectivesTympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients.MethodsForty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location.ResultsPreoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924).ConclusionThe degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid

Feasibility of extended cycles of neoadjuvant chemotherapy in patients with advanced ovarian cancer in terms of prognosis and surgical outcomes.

ObjectiveWe aimed to identify the effect of an extended number of neoadjuvant chemotherapy (NAC) cycles on prognosis and surgical morbidity after interval debulking surgery (IDS) in patients with newly diagnosed advanced ovarian cancer.MethodsMedical records of patients with advanced ovarian cancer treated with NAC and having undergone IDS were retrospectively reviewed. Clinicopathological factors were compared between two groups: conventional (≤4 cycles) and extended (≥5 cycles) NAC groups. Kaplan-Meier analysis was performed to evaluate progression-free survival (PFS) and overall survival (OS).ResultsA total of 156 patients were included, 112 patients in the conventional group and 44 patients in the extended NAC group. The extended NAC group had a significantly higher frequency of cancer antigen (CA)-125 normalization after NAC (59.1% vs. 33.9%, P = 0.004), a lower rate of bowel surgery (18.2% vs. 34.8%, P = 0.042), and a lower rate of transfusion during or after IDS (36.4% vs. 59.8%, P = 0.008) as compared to the conventional group. The complete cytoreduction rate after IDS was similar between the groups. In multivariate Cox regression analysis for PFS, radiologically stable and progressive disease after NAC (Hazard ratio [HR], 1.983; 95% Confidence interval [CI], 1.141-3.446; P = 0.015) and gross residual tumor after IDS (HR, 2.054; 95% CI, 1.414-2.983; P ConclusionOur study showed that extended NAC cycles were not inferior to conventional NAC cycles in terms of survival in patients with advanced ovarian cancer and reduced surgical morbidity such as bowel surgery and transfusion during or after IDS

Pungent chemicals increase cytoplasmic free calcium concentration in mammalian taste receptor cells

Pungent compounds are widely used for seasoning. Hot sensation evoked by pungent chemicals including capsaicin, has been known that it is the result of stimulation of free nerve endings in sensory neurons. However, there has not been rigorous study of its direct effects on the taste receptor cells (TRCs). In the present study, we investigated direct effect of two kinds of pungent chemicals, capsaicin and piperine, on the cytoplasmic free calcium concentration ([Ca^2+]_i) in the isolated rat taste receptor cells using micrspectrofluorimetry technique. The effect of bitter taste and sweets on [Ca^2+]_i was also examined for comparision with those of pungent chemicals. Epithelial sheets rich in taste buds and free of muscle tissue were isolated from the circumvallate papilla of the rat tongue by mixed enzyme treatment following microdissection. After exposure to Ca^2+ -free Tyrode solution, we could get taste buds or single TRCs from the epithelial sheets. In the high K^+ bath solution, [Ca^2+]_i transient was observed, suggestion existence of voltage dependent Ca^2+ channels in TRCs. Capsaicin increased [Ca^2+]_i in a dose dependent manner in these cells. 10㎍M capsaicin little affected on [Ca^2+]_i, but 50㎍M capsaicin increased a small amount of [Ca^2+]_i, 100㎍M capsaicin increased a large amount of [Ca^2+]_i, from 1.04±0.05(Mean±S.E.) to 1.40±0.059(n=28). The effect of piperine on [Ca^2+]_i responses was similar to those of capsacin, but poperine was more potent than capsaicin. 1μM piperine little affected on [Ca^2+]_i responses, but 5μM piperine increased a small amount of [Ca^2+]_i. 10μM piperine increased a large amount of [Ca^2+]_i, from 0.99±0.03 (mean ± S.E.) to 1.43±0.05(n=20). The increase of [Ca^2+]_i evoked by both capsaicin and piperine appears to be due to Ca^2+ influx from the extracelllular medium, since the capsaicin induced [Ca^2+]_i increase was not observed in Ca^2+ free bath solution. Furthermore, 10mM ruthenium red also inhibited this capsaicin induced [Ca^2+]_i increase, suggestion it's mediated by vanilloid receptors. We also confirmed that denatonium, one of bitter taste and sucrose, sweet compound, both increase [Ca^2+]_i in these cells. But the Ca^2+ responses to these two substances were quite different to those evoked by pungent chemicals; Ca^2+ response was even observed in the Ca^2+ free bath solution. All our results suggest that pungent chemicals including capsaicin and poperine could increase [Ca^2+]_i responses of TRCs, presumably via vanilloid receptors

Primary extranodal marginal zone B-cell lymphoma of MALT-type involving the fallopian tube

► We experience one case of MZBL of MALT type in the fallopian tube. ► There was no remarkable inflammatory or infection sign. ► We report this case with a review of related literature

Serum Human Epididymis Protein 4 as a Prognostic Marker in Cervical Cancer

OBJECTIVES: The objective is to evaluate the prognostic value of serum human epididymis protein 4 (HE4) as a tumor marker in patients with cervical cancer. METHODS: Sixty-seven patients with cervical cancer treated at Seoul National University Bundang Hospital from September 2014 to May 2018 were retrospectively reviewed. Serum HE4 levels were measured by immunoassay before starting primary treatment. A mean serum HE4 level of 72.6 pmol/L was used to divide the patients into low and high HE4 groups. Patient characteristics, clinicopathological variables, and survival outcomes were compared between the two groups. RESULTS: The low and high HE4 groups included 55 (82.1%) and 12 (17.9%) patients at diagnosis, respectively. Higher HE4 levels were significantly associated with older age at diagnosis (age <50: .0% vs age ≥50: 100.0%; P = .002), menopause (premenopause: 8.3% vs postmenopause: 91.7%; P = .009), higher FIGO stage (stage I-II: 33.3% vs III-IV: 66.7%; P = .017), large tumor size (<4.0 cm: 41.7% vs ≥4.0 cm: 58.3%; P = .029), positive lymph node metastasis (negative: 41.7% vs positive: 58.3%; P = .049), and involvement of the parametrium (negative: 25.0% vs positive: 75.0%; P = .002). Higher HE4 level was a predictive factor for worse overall survival but not for progression-free survival. Elevated HE4 levels were not independent factors for the prediction of either overall survival or progression-free survival. Subgroup analysis by histological type revealed similar results for patients with squamous cell carcinoma. CONCLUSIONS: High levels of HE4 expression correlated with poor overall survival, indicating that elevated HE4 levels are associated with a poor prognosis for patients with cervical cancer.N

Satellite-Based Evaluation of the Post-Fire Recovery Process from the Worst Forest Fire Case in South Korea

The worst forest fire in South Korea occurred in April 2000 on the eastern coast. Forest recovery works were conducted until 2005, and the forest has been monitored since the fire. Remote sensing techniques have been used to detect the burned areas and to evaluate the recovery-time point of the post-fire processes during the past 18 years. We used three indices, Normalized Burn Ratio (NBR), Normalized Difference Vegetation Index (NDVI), and Gross Primary Production (GPP), to temporally monitor a burned area in terms of its moisture condition, vegetation biomass, and photosynthetic activity, respectively. The change of those three indices by forest recovery processes was relatively analyzed using an unburned reference area. The selected unburned area had similar characteristics to the burned area prior to the forest fire. The temporal patterns of NBR and NDVI, not only showed the forest recovery process as a result of forest management, but also statistically distinguished the recovery periods at the regions of low, moderate, and high fire severity. The NBR2.1 for all areas, calculated using 2.1 μm wavelengths, reached the unburned state in 2008. The NDVI for areas with low and moderate fire severity levels became significantly equal to the unburned state in 2009 (p > 0.05), but areas with high severity levels did not reach the unburned state until 2017. This indicated that the surface and vegetation moisture conditions recovered to the unburned state about 8 years after the fire event, while vegetation biomass and health required a longer time to recover, particularly for high severity regions. In the case of GPP, it rapidly recovered after about 3 years. Then, the steady increase in GPP surpassed the GPP of the reference area in 2015 because of the rapid growth and high photosynthetic activity of young forests. Therefore, the concluding scientific message is that, because the recovery-time point for each component of the forest ecosystem is different, using only one satellite-based indicator will not be suitable to understand the post-fire recovery process. NBR, NDVI, and GPP can be combined. Further studies will require more approaches using various terms of indices

HOXB9 Overexpression Confers Chemoresistance to Ovarian Cancer Cells by Inducing ERCC-1, MRP-2, and XIAP

The purpose of this study was to identify the role of HOXB9 and associated molecular mechanism in acquiring chemoresistance to ovarian cancer cells. After establishing HOXB9-overexpressing cells (HOXB9-OE/SKOV3), cisplatin resistance-induced cells (Cis-R/SKOV3), and an ovarian cancer xenograft mouse model, the effects of HOXB9 were evaluated in vitro and in vivo. Expression levels of ERCC-1, MRP-2, XIAP, and Bax/Bcl-2 were assessed as putative mechanisms mediating chemoresistance. Cisplatin-induced apoptosis was significantly decreased in HOXB9-OE/SKOV3 compared to SKOV3. Cisplatin treatment of SKOV3 strongly induced ERCC-1, MRP-2, and XIAP, and apoptosis was strongly induced through the inhibition of Bcl-2 and activation of Bax. ERCC-1, MRP-2, XIAP, and Bcl-2 were also strongly induced in HOXB9 OE/SKOV3. In contrast to SKOV3, cisplatin treatment alone of HOXB9 OE/SKOV3 did not affect the expression of Bcl-2 and Bax, and consequently, there was no increase in apoptosis. HOXB9 knockdown suppressed the expression of ERCC-1 and XIAP, but did not affect MRP-2 and Bcl-2/Bax expression in HOXB9 OE/SKOV3 and Cis-R/SKOV3, and caused a small increase in apoptosis. Treatment of SKOV3 with both cisplatin and siRNA_HOXB9 led to complete suppression of ERCC-1, MRP-2, and XIAP, and significantly increased apoptosis through inhibition of Bcl-2 expression and activation of Bax. The results observed in Cis-R/SKOV3 were similar to that in HOXB9 OE/SKOV3. Our data suggest that HOXB9 overexpression may cause chemoresistance in ovarian cancer cells by differential induction of ERCC-1, MRP-2, and XIAP depending on the strength of HOXB9 expression through inhibition of the mitochondrial pathway of apoptosis, including Bax/Bcl-2

Predictive models of objective oropharyngeal OSA surgery outcomes: Success rate and AHI reduction ratio.

The aim of this study was to develop a predictive model of objective oropharyngeal obstructive sleep apnea (OSA) surgery outcomes including success rate and apnea-hypopnea index (AHI) reduction ratio in adult OSA patients.Retrospective outcome research.All subjects with OSA who underwent oropharyngeal and/or nasal surgery and were followed for at least 3 months were enrolled in this study. Demographic, anatomical [tonsil size (TS) and palate-tongue position (PTP) grade (Gr)], and polysomnographic parameters were analyzed. The AHI reduction ratio (%) was defined as [(postoperative AHI-preoperative AHI) x 100 / postoperative AHI], and surgical success was defined as a ≥ 50% reduction in preoperative AHI with a postoperative AHI < 20.A total of 156 consecutive OSAS adult patients (mean age ± SD = 38.9 ± 9.6, M / F = 149 / 7) were included in this study. The best predictive equation by Forward Selection likelihood ratio (LR) logistic regression analysis was: [Formula: see text]The best predictive equation according to stepwise multiple linear regression analysis was: [Formula: see text] (TS/PTP Gr = 1 if TS/PTP Gr 3 or 4, TS/PTP Gr = 0 if TS/PTP Gr 1 or 2).The predictive models for oropharyngeal surgery described in this study may be useful for planning surgical treatments and improving objective outcomes in adult OSA patients

Risk Factor and Treatment of Vaginal Intraepithelial Neoplasia After Hysterectomy for Cervical Intraepithelial Neoplasia

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.OBJECTIVES: The aim of the study were to identify the risk factors for recurrent vaginal intraepithelial neoplasia (VaIN)1+ and to evaluate the efficacy of laser vaporization in patients who underwent hysterectomy for the treatment of cervical intraepithelial neoplasia (CIN). METHODS: Medical records of 374 women who underwent hysterectomy for the treatment of CIN were retrospectively reviewed. Recurrence was defined as VaIN1+ diagnosis by colposcopy-directed biopsy. RESULTS: Among 374 patients, 36 (9.6%) had VaIN1+ during a median follow-up of 32 (0-193) months: 13 (3.5%) had VaIN1, 6 (1.6%) VaIN2, 15 (4.0%) VaIN3, and 2 (0.5%) invasive cancer. Multivariate analysis showed that age of greater than 50 years was the only independent risk factor for VaIN1+ recurrence (odds ratio, 3.359; 95% CI, 1.60-7.07; p = .001). Among the 34 patients with VaIN, 21 (61.8%) were treated with laser vaporization and 11 (32.3%) were observed without treatment. Time to second recurrence was longer in the VaIN treated by laser vaporization group than that in the observation group (mean time to subsequent recurrence, 128.7 [95% CI, 101.4-156.0] vs. 41.8 [15.7-67.9] months; p = .003). Moreover, laser vaporization (hazard ratio, 0.125; 95% CI, 0.03-0.59; p = .009) was the only independent good prognostic factor for the second VaIN1+ recurrence. CONCLUSIONS: Patients older than 50 years who underwent hysterectomy for the treatment of CIN might be highly at risk of VaIN1+. Laser vaporization is the only independent prognostic factor that might prevent the second VaIN1+ recurrence.N