Κυριακή 27 Φεβρουαρίου 2022

Anatomical features of the iliocapsularis muscle: a dissection study

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Surg Radiol Anat. 2022 Feb 26. doi: 10.1007/s00276-022-02905-y. Online ahead of print.

ABSTRACT

PURPOSE: Iliocapsularis (IC) overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty. Previously believed to be part of iliacus, few publications describe the prevalence, attachments, fibre direction, blood supply, innervation, and size of IC. This study was aimed to determine these anatomical features using embalmed bodies and whether they vary between sides, sex, and age.

METHODS: Thirty-eight formalin-fixed adult bodies were dissected and the prevalence, presence of a connective tissue raphe, attachments, fibre direction, blood supply, and innervation, were documented. Length and width were measured, and significant differences were investigated with t tests.

RESULTS: Iliocapsularis was present in all bodies examined, originating from the inferior border of the anterior inferior iliac spine, and inserting 20 mm distal to the lesser trochanter in 54 muscles (71%). Iliocapsularis was supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins. Muscle fibre direction was from superolateral to inferomedial. Mean length was 116.8 ± 11.2 mm and width was 12.8 ± 3.1 mm, with no significant differences between sides, sex, and age.

CONCLUSION: This was the first study to document the venous drainage and compare the di mensions with sides, sex, and age, using adult bodies. However, the true function of IC is still unknown. Iliocapsularis is a constant muscle, distinct from iliacus, which is relevant to orthopaedic surgeons and physical rehabilitation specialists, particularly for postoperative patient care.

PMID:35218407 | DOI:10.1007/s00276-022-02905-y

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Can cystic lesions of the jaws be considered as the cause of mandibular asymmetry?

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Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e159-e163. doi: 10.4317/medoral.25134.

ABSTRACT

BACKGROUND: The aim of this study is to investigate the presence of condylar and ramal asymmetry in patients with a cyst larger than 10 mm in the maxilla or mandible.

MATERIAL AND METHODS: Condylar and ramal asymmetry index measurements of 47 patients (mean age: 28.85 ± 15.348) in the study group and 40 patients in the control group (mean age: 33.73 ± 13.095) were performed using panoramic radiographs. The study group consists of patients with cysts larger than 10 mm in diameter in the maxilla or mandible. The control group consisted of patients with no radiolucent lesions and no history of trauma. The possible statistical difference between the groups was evaluated by the Mann-Whitney U test.

RESULTS: No statistically significant difference was observed in asymmetry indices according to gender and the jaw (maxilla or mandible) in which the cyst was located. However, it was determined that CAI and RAI values were statistically significantly different between the study and control groups (p = 0.047 and p = 0.016, respectively).

CONCLUSIONS: The presence of intraosseous cysts larger than 10 mm in the jaws was found to be associated with condylar and ramal asymmetry.

PMID:35218644 | DOI:10.4317/medoral.25134

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MutSα expression predicts a lower disease-free survival in malignant salivary gland tumors: an immunohistochemical study

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Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e164-e173. doi: 10.4317/medoral.25138.

ABSTRACT

BACKGROUND: Appropriate DNA replication is vital to maintain cell integrity at the genomic level. Malfunction on DNA repair mechanisms can have implications related to tumor behavior. Our aim was to evaluate the expression of key complexes of the DNA mismatch-repair system MutSα (hMSH2-hMSH6) and MutSβ (hMSH2-hMSH3) in a panel comprising the most common benign and malignant salivary gland tumors (SGT), and to determine their association with disease-free survival.

MATERIAL AND METHODS: Ten cases of normal salivary gland (NSG) and 92 of SGT (54 benign and 38 malignant) were retrieved. Immunohistochemistry was performed for hMSH2, hMSH3, hMSH6. Scanned slides were digitally analyzed based on the percentage of positive cells with nuclear staining. Cases were further classified in MutSαhigh and MutSβhigh based on hMSH2-hMSH6 and hMSH3- hMSH6 expression, respectively.

RESULTS: hMSH3 expression was lower in malignant SGT compared to NSG and benign cases. Adenoid cystic carcinoma (ACC) cases with perineural invasion presented a lower percentage of hMSH3 positive cells. hMSH6 was downregulated in both benign and malignant SGT compared to NSG. Malignant SGT cases with MutSαhigh expression had lower disease-free survival compared to MutSαlow cases. A 10.26-fold increased risk of presenting local recurrence was observed.

CONCLUSIONS: Our findings suggest that a lack of hMSH3 protein function is associated with a more aggressive phenotype (malignancy and perineural invasion) and that MutSα overexpression predicts a poor clinical outcome in malignant SGT.

PMID:35218645 | DOI:10.4317/medoral.25138

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Πέμπτη 24 Φεβρουαρίου 2022

Endotype-based surgical treatment of chronic rhinosinusitis

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb 7;57(2):130-135. doi: 10.3760/cma.j.cn115330-20210819-00561.

NO ABSTRACT

PMID:35196755 | DOI:10.3760/cma.j.cn115330-20210819-00561

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A case of Smith-Magenis syndrome

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本文分析1例Smith-Magenis综合征患儿在耳鼻咽喉方面的临床特点。患儿,女,9岁,因"反复咽痛约1个月"就诊于吉林大学第二医院。平日睡眠周期短,动作多,说话声音嘶哑。体检见身体多个部位发育异常包括独特的面部特征如方脸、眼睛深陷、下颚偏大、鼻梁塌陷、唇外翻、下颌前突,短指/趾畸形,身材矮小,睡眠障碍,刻板行为发育迟缓、智力低下,语言能力发育迟滞及隐性脊柱裂。常规染色体核型为46,XX,高分辨染色体核型分析17号染色体短臂p11.2存在大小约3.5M缺失,分子核型为46,XX,arr17p11.2(16705818-20178312)*1。因其发病率低,在耳鼻咽喉方面极少报道,本文通过对所收治的1例SMS患儿的全身特点及耳鼻咽喉方面的特征进行分析,以期提高对该病的认知。.

This article analyzes the clinical characteristics of otolaryngology in a child with Smith-Magenis syndrome. The patient, female, 9 years old, was admitted to the Second Hospital of Jilin University because of "repeated sore throat for about 1 month". On weekdays, the sleep cycle is short, there are many movements, and the voice is hoarse. Physical examination revealed developmental abnormalities in multiple parts of the body including distinctive facial features such as square face, sunken eyes, enlarged jaw, collapsed nasal bridge, lip eversion, mandibular protrusion, brachydactyly, short stature, sleep disturbance, stereotyped behavior Developmental delay, mental retardation, language retardation and spina bifida. The conventional karyotype is 46, XX. The high-resolution karyotype analysis shows that there is a deletion of about 3.5M in the short arm p11.2 of chromosome 17. The molecular karyotype is 46, XX, arr17p11.2 (16705818-20178312)*1. Due to its low incidence, it is rarely reported in the field of ENT. This article analyzes the systemic and ENT characteristics of a patient with SMS in order to improve the awareness of the disease. .

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb 7;57(2):210-211. doi: 10.3760/cma.j.cn115330-20210730-00501.

NO ABSTRACT

PMID:35196768 | DOI:10.3760/cma.j.cn115330-20210730-00501

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Airway management in patients with lingual thyroid: a case report and review of the literature

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Eur Arch Otorhinolaryngol. 2022 Feb 24. doi: 10.1007/s00405-022-07310-0. Online ahead of print.

ABSTRACT

PURPOSE: To review the management of patients with lingual thyroid (LT) causing upper airway obstruction and to suggest a diagnostic and therapeutic workflow.

METHODS: A PubMed review of published cases from January 1980 up to December 2020 of LT causing upper airway obstruction. We selected cases of confirmed LTs that presented with non-state-dependent airway obstruction. An illustrative case report is presented.

RESULTS: Twenty-one articles fulfilling the inclusion criteria were found, reporting 24 cases (7 neonatal, 2 pediatric and 15 adults). The main presenting symptoms was dyspnea with increased work of breathing, followed by dysphagia and stridor most commonly in neonates. At least one imaging modality was performed in all patients. Thyroid function was altered in half the patients and normal in the other half. Th e LT was the only thyroid tissue in all cases except 2. Altogether, 5/24 patients required tracheostomies and two-thirds of the patients underwent surgical resection of the LT (mostly transoral). Also 2/3 of the patients received thyroid replacement therapy. After a median follow-up of 17 months, airway symptoms had fully resolved for all patients but one.

CONCLUSION: While rare, ectopic LTs should be considered in the differential diagnosis of stridor, dyspnea and airway obstruction. In neonates, concomitant presence of hypothyroidism on neonatal screening and airway obstruction should prompt the search for a LT. Early identification and thyroid replacement therapy seem to significantly relieve symptoms of upper airway obstruction, but severe obstruction and concomitant airway lesions may require more definitive management approaches.

PMID:35201391 | DOI:10.1007/s00405-022-07310-0

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Phase II study of apatinib combined with temozolomide in patients with advanced melanoma after failure of immunotherapy

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Objective Treatment for advanced melanoma after progression on immunotherapy is limited. This phase II trial (NCT03422445) was conducted to evaluate the efficacy and safety of apatinib plus temozolomide in patients with advanced melanoma after failure of immunotherapy. Methods Patients with unresectable stage III or stage IV melanoma after progression on immunotherapy were treated with temozolomide 300 mg on days 1–5 and apatinib 500 mg daily every 28-day cycle until disease progression or intolerable toxicities. Besides immunotherapy, prior chemotherapy, targeted therapy, and clinical trials were allowed. The primary endpoint was progression-free survival. Secondary endpoints were objective response rate, disease control rate, overall survival, and safety. Results Of 29 patients, 28 (96.6%) had metastatic diseases, and the predominant subtypes were mucosal [12 (41.4%)] and acral melanoma [eight (27.6%)]. Five (17.2%) patients showed BRAF, CKIT, or NRAS mutation. Five achieved confirmed partial response, with an objective response rate of 17.2%. The disease control rate was 82.8%. The median progression-free survival was 5.0 months [95% confidence interval (CI): 4.7–5.3], and the median overall survival was 10.1 months (95% CI: 5.1–15.0). Grade 3–4 treatment-related adverse events included proteinuria [four (13.8%)], thrombocytopenia [two (6.9%)], hypertension [one (3.4%)], and hyperbilirubinemia [one (3.4%)]. No treatment-related death occurred. Conclusion Apatinib plus temozolomide demonstrated promising efficacy and manageable safety profile in patients with advanced melanoma after progression on immunotherapy. * Li Zhou and Yue Yang contributed equally to the writing of this article and are the co-first authors. Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Received 11 November 2021 Accepted 25 January 2022 Correspondence to Chuanliang Cui, Department of Renal Cancer and Melanoma, Peking University Cancer Hospital and Institute, Beijing, China, Tel: +8610 88196317 -mail: 1008ccl@163.com Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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