MR imaging findings of a rare pediatric parotid tumor: Mammary analogue secretory carcinoma.

We present magnetic resonance imaging findings of an 11-year-old girl with a mammary analogue secretory carcinoma (MASC) of the parotid gland. MASC is a recently described tumor of the salivary glands that is genetically and histologically similar to secretory breast carcinoma. To date, a few cases have been reported in the pediatric population, with limited information of its imaging characteristics. We suggest that decreased T2 signal of the solid component of the MASC representing cellular components with associated complex cystic parts may be a helpful imaging finding and can make a substantial contribution in differentiating this new entity from other rare pediatric parotid masses. Although there are no characteristic imaging findings at this time, MASC should be considered in the differential of salivary gland tumors in the pediatric population as well.

Multidisciplinary management of oculo-auriculo-vertebral spectrum.

PURPOSE OF REVIEW: Oculo-auriculo-vertebral spectrum (OAVS) is a complex disorder that is represented by wide variations in phenotypic presentation. Recent publications and systematic reviews of the available literature are presented here. RECENT FINDINGS: Treatment strategies vary among craniofacial centers across the country. Advances in presurgical planning, virtual surgical planning, and computer-aided manufacturing have been incorporated in the treatment of patients. The psychosocial effect of OAVS with longitudinal follow-up is now being studied. SUMMARY: Optimal evaluation and management of the OAVS patient requires an awareness of the phenotypic and genetic differences and involves a multidisciplinary team in order to effectively and appropriately diagnose and treat such patients.

What are we putting in our ears? A consumer product analysis of aural foreign bodies.

OBJECTIVES/HYPOTHESIS: Rapid identification of foreign bodies may be crucial in deciding the appropriate course of action; and knowledge of consumer products that most commonly become aural foreign bodies (AFB) may potentially guide patient education strategies. Our objectives were to estimate the nationwide incidence of emergency department (ED) visits for consumer products presenting as AFBs and describe products encountered, demographic trends, general outcomes, and other reported aspects of injury. METHODS: The authors searched the National Electronic Injury Surveillance System for AFB ED visits from 2008 to 2012. Consumer product, patient demographics, and outcomes were analyzed. RESULTS: There were 9,472 case entries amounting to an estimated 280,939 ED visits for AFBs. Of these, 49.3% of patients were male and 50.7% were female, with 98.2% of all patients being treated/examined and then released. Jewelry was the most common foreign body (39.4%), followed by cotton swabs/first aid equipment, paper products, pens/pencils, and desk supplies. Children between 2 and 8 years of age were most commonly affected, with jewelry as the most common item. Cotton swabs/first aid equipment predominated among adults. CONCLUSIONS: Aural foreign bodies considerably affect health care expenditures; over 250,000 ED visits over a 5-year span were noted. Age- and gender-specific patterns reported in this analysis can serve as a valuable adjunct for history taking and clinical examination. Jewelry products predominated among children, while cotton swab/first aid products, hearing aids, and other ear-specific accessories significantly affected adults. Although children were most commonly affected, these findings highlight the need for sustained education and prevention strategies among all age groups.

Cleft lip - a comprehensive review.

Orofacial clefts comprise a range of congenital deformities and are the most common head and neck congenital malformation. Clefting has significant psychological and socio- economic effects on patient quality of life and require a multidisciplinary team approach for management. The complex interplay between genetic and environmental factors play a significant role in the incidence and cause of clefting. In this review, the embryology, classification, epidemiology, and etiology of cleft lip are discussed. The primary goals of surgical repair are to restore normal function, speech development, and facial esthetics. Different techniques are employed based on surgeon expertise and the unique patient presentations. Pre-surgical orthopedics are frequently employed prior to definitive repair to improve outcomes. Long term follow up and quality of life studies are discussed.

Participation of Kv1 channels in control of membrane excitability and burst generation in mesencephalic V neurons.

The function and biophysical properties of low threshold Kv1 current in control of membrane resonance, subthreshold oscillations, and bursting in mesencephalic V neurons (Mes V) were examined in rat brain stem slices (P8-P12) using whole cell current and voltage patch-clamp methods. alpha-dendrotoxin application, a toxin with high specificity for Kv1.1, 1.2, and 1.6 channels, showed the presence of a low-threshold K(+) current that activated rapidly around -50 mV and was relatively noninactivating over a 1-s period and had a V(1/2)max of -36.2 mV. Other toxins, specific for individual channels containing either Kv 1.1, 1.2, or 1.3 alpha-subunits, were applied individually, or in combination, and showed that Kv1 channels are heteromeric, composed of combinations of subunits. In current-clamp mode, toxin application transformed the high-frequency resonant properties of the membrane into a low-pass filter and concomitantly reduced the frequency of the subthreshold membrane oscillations. During this period, rhythmical bursting was transformed into low-frequency tonic discharge. Interestingly, in a subset of neurons that did not show bursting, low doses of alpha-dendrotoxin (alpha-DTX) sufficient to block 50% of the low threshold Kv1 channels induced bursting and increased the resonant peak impedance and subthreshold oscillations, which was replicated with computer simulation. This suggests that a critical balance between inward and outward currents is necessary for bursting. This was replicated with computer simulation. Single cell RT-PCR and immunohistochemical methods confirmed the presence of Kv1.1, 1.2, and 1.6 alpha-subunits in Mes V neurons. These data indicate that low threshold Kv1 channels are responsible for membrane resonance, contribute to subthreshold oscillations, and are critical for burst generation.