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Aim and Background. This study aims to explore alternative diagnostic methods to assess thyroid function in patients unable to undergo blood tests for thyroid-stimulating hormones (TSH) and thyroxine (T4), such as individuals with trypanophobia, severe medical conditions, or coagulopathy. Considering the impact of thyroid dysfunction on mitochondrial metabolism and the essential role of proper mitochondrial function in ciliary motility, we postulate that assessing nasal ciliary function could serve as a surrogate diagnostic approach for thyroid dysfunction. Methods. This cross-sectional study was performed on individuals with no history of thyroid diseases. The primary endpoint was the diagnostic value of the nasal mucociliary (NMC) test using Iranica Picris (Asteraceae) aqueous extract in differentiating hypo- or hyperthyroidism cases from euthyroid cases. Results. 232 individuals were recruited (71% females, 86% euthyroid). Receiver operating characteristic (ROC) analysis showed a good diagnostic value for the NMC test in differentiating overt hypothyroidism (area under the ROC curve [AUROC] = 0.82, p = 0.004) and its fair value in diagnosing subclinical hyperthyroidism (AUROC = 0.78, p = 0.01) from the euthyroid condition. The NMC test had a significant positive correlation with TSH (r = 0.47, p < 0.001) and a significant negative correlation with T4 (r = -0.32, p < 0.001). The NMC rate was significantly different in distinct thyroid function groups (p < 0.001). Compared with euthyroid cases, the post-hoc analysis showed that the NMC test is significantly higher in overt hypothyroidism (15.06 vs. 21.07 min, p = 0.003) and significantly lower in subclinical hyperthyroidism (15.05 vs. 10.9 min, p = 0.02). Conclusions. The Iranica Picris-based NMC test might serve as a diagnostic method to distinguish overt hypothyroidism and subclinical hyperthyroidism.
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Nasal Septal Deviation (NSD) is a common sign in otorhinolaryngology that can lead to facial asymmetry. In this case-control observational study, we assessed the role of EMG and NCS in the diagnosis of NSD and its effect on neuromuscular function. Participants were divided into two groups based on paranasal sinus computed tomography scan (PNS CT) results: NSD cases (n = 21) and controls without NSD (n = 13). EMG and NCS were performed on both groups to assess nasal alar muscles at the root of the zygomatic nerve. Our findings showed a significant correlation between NSD and EMG/NCS tests (P-value = 000) and a significant association between septal deviation and nasal alar lateralization (P-value = 000). EMG/NCS can be useful in assessing NSD by providing a better understanding of related neuromuscular structures and neuromuscular function of the nasal alar dilator muscles and aid in the diagnosis of NSD. Nasal Septal Deviation, EMG (electromyography), NCS (nerve conduction studies), Neuromuscular function, Facial asymmetry, Otorhinolaryngology, Paranasal sinus, Computed tomography, Nasal alar muscles, Zygomatic nerve, Nasal Obstruction, Nasal alar lateralization, Diagnosis.
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Mesoporous silica nanoparticles (MSNPs) have been reported as an effective system to co-deliver a variety of different agents to enhance efficiency and improve biocompatibility. This study was aimed at the preparation, physicochemical characterization, antimicrobial effects, biocompatibility, and cytotoxicity of vancomycin and meropenem co-loaded in the mesoporous silica nanoparticles (Van/Mrp-MSNPs). The prepared nanoparticles were explored for their physicochemical features, antibacterial and antibiofilm effects, biocompatibility, and cytotoxicity. The minimum inhibitory concentrations (MICs) of the Van/Mrp-MSNPs (0.12-1 µg/mL) against Staphylococcus aureus isolates were observed to be lower than those of the same concentrations of vancomycin and meropenem. The minimum biofilm inhibitory concentration (MBIC) range of the Van/Mrp-MSNPs was 8-64 µg/mL, which was lower than the meropenem and vancomycin MBICs. The bacterial adherence was not significantly decreased upon exposure to levels lower than the MICs of the MSNPs and Van/Mrp-MSNPs. The viability of NIH/3T3 cells treated with serial concentrations of the MSNPs and Van/Mrp-MSNPs were 73-88% and 74-90%, respectively. The Van/Mrp-MSNPs displayed considerable inhibitory effects against MRSA, favorable biocompatibility, and low cytotoxicity. The Van/Mrp-MSNPs could be a potential system for the treatment of infections.
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This study was conducted to extract the essential oils (EOs) of Caccinia macranthera identify their phytochemicals, evaluate their phytotoxicity, antimicrobial activity and enzyme inhibition effects using in silico molecular docking technique. EOs of aerial parts, seeds, and roots of C. macranthera were extracted and analyzed via Gas chromatography-Mass Spectrometry. The antibacterial activity of EOs were determined on nine microorganisms via disk diffusion and microbroth dilution assays. In addition, the allelopathic properties of EOs were investigated by calculating the IC50s for inhibition of germination, seedling length and seedling weight growth of Cuscuta campestris seeds. In order to assess the possible inhibitory effect of major components of C. macranthera EOs on enzymes inhibiting germination and plant growth, molecular docking was employed against the glutamine synthetase (GS), acetohydroxyacid synthetase (AHAS), and 4-hydroxyphenyl pyruvate dioxygenase (HPPD) enzymes. The main compounds of EOs from aerial parts, seeds, and roots EOs were dihydrocarveol (29.5%), Trimethyl-2-Pentadecanone (13.6%), and Palmitic acid (16.8%), respectively. The maximum antibacterial effect was related to the aerial parts EO against Staphylococcus epidermidis. Phytotoxicity analysis exhibited a concentration-dependent increase (p ≤ 0.05) activity. The aerial parts EO demonstrated a substantial allelopathy effect, with IC50 values of 0.22 ± 0.026, 0.39 ± 0.021, and 0.20 ± 0.025 mg/mL, respectively, on inhibitory germination, seedling length and seedling weight growth of Cuscuta campestris seeds. Molecular docking analyzes showed that Oleic acid was suitable for dynamic stabilization of HPPD (-6.552 kJ/mol) and GS (-7.265 kJ/mol) and Eupatoriochromene had the inhibitory potential against AHAS, with docking score of -4.189 kJ/mol. The current research demonstrated that C. macranthera EOs from its aerial parts have an acceptable phytotoxic activity against Cuscuta campestris weed. The major components of EOs, Oleic acid and Eupatoriochromene, presented the strongest binding with HPPD, GS, and AHAS active sites causing disturbance in germination, photosynthesis and weed growth suggesting it as a natural herbicide for controlling the weeds.
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BACKGROUND: Low-level laser therapy (LLLT) has been clinically accepted to accelerate the nerve regeneration process after a nerve injury or transection. We aimed to investigate the neuronal basis and the influence of LLLT on brain functional networks in traumatic patients with olfactory dysfunction. METHODS: Twenty-four Patients with traumatic anosmia/hyposmia were exposed to pleasant olfactory stimuli during a block-designed fMRI session. After a 10-week period, patients as control group and patients who had completed the sessions of LLLT were invited for follow-up testing using the same fMRI protocol. Two-sample t-tests were conducted to explore group differences in activation responding to odorants (p-FDR-corrected <0.05). Differences of functional connectivity were compared between the two groups and the topological features of the olfactory network were calculated. Correlation analysis was performed between graph parameters and TDI score. RESULTS: Compared to controls, laser-treated patients showed increased activation in the cingulate, rectus gyrus, and some parts of the frontal gyrus. Shorter pathlength (p = 0.047) and increased local efficiency (p = 0.043) within the olfactory network, as well as decreased inter-network connectivity within the whole brain were observed in patients after laser surgery. Moreover, higher clustering and local efficiency were related to higher TDI score, as manifested in increased sensitivity to identify odors. CONCLUSIONS: The results support that low-level laser induces neural reorganization process and make new connections in the olfactory structures. Furthermore, the connectivity parameters may serve as potential biomarkers for traumatic anosmia or hyposmia by revealing the underlying neural mechanisms of LLLT.
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Terapia com Luz de Baixa Intensidade , Transtornos do Olfato , Humanos , Imageamento por Ressonância Magnética/métodos , Anosmia , Transtornos do Olfato/diagnóstico por imagem , Transtornos do Olfato/etiologia , Encéfalo/diagnóstico por imagemRESUMO
Background and Aims: SARS-CoV-2, as a new pandemic disease, affected the world. Short-chain fatty acids (SCFAs) such as acetic, propionic, and butyric acids are the main metabolites of human gut microbiota. The positive effects of SCFAs have been shown in infections caused by respiratory syncytial virus, adenovirus, influenza, and rhinovirus. Therefore, this study aimed to evaluate the concentration of SCFAs in patients with SARS-CoV-2 compared with the healthy group. Methods: This research was designed based on a case and control study. Twenty healthy individuals as the control group and 20 persons admitted to the hospital with a positive test of coronavirus disease (COVID-19) real-time polymerase chain reaction were included in the study as the patient group from September 2021 to October 2021, in Tabriz, Iran. Stool specimens were collected from volunteers, and analysis of SCFAs was carried out by a high-performance liquid chromatography system. Results: The amount of acetic acid in the healthy group was 67.88 ± 23.09 µmol/g, while in the group of patients with COVID-19 was 37.04 ± 13.29 µmol/g. Therefore, the concentration of acetic acid in the patient group was significantly (p < 0.001) lower than in the healthy group. Propionic and butyric acid were present in a higher amount in the control group compared with the case group; however, this value was not statistically significant (p > 0.05). Conclusion: This study showed that the concentration of acetic acid as the metabolite caused by gut microbiota is significantly disturbed in patients with COVID-19. Therefore, therapeutic interventions based on gut microbiota metabolites in future research may be effective against COVID-19.
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Nanocarrier-based drug delivery systems have been designed into various structures that can effectively prevent cancer progression and improve the therapeutic cancer index. However, most of these delivery systems are designed to be simple nanostructures with several limitations, including low stability and burst drug release features. A nano-in-nano delivery technique is explored to address the aforementioned concerns. Accordingly, this study investigated the release behavior of a novel nanoparticles-in-nanofibers delivery system composed of capsaicin-loaded alginate nanoparticles embedded in polycaprolactone-chitosan nanofiber mats. First, alginate nanoparticles were prepared with different concentrations of cationic gemini surfactant and using nanoemulsion templates. The optimized formulation of alginate nanoparticles was utilized for loading capsaicin and exhibited a diameter of 19.42 ± 1.8 nm and encapsulation efficiency of 98.7 % ± 0.6 %. Likewise, blend polycaprolactone-chitosan nanofibers were prepared with different blend ratios of their solutions (i.e., 100:0, 80:20, 60:40) by electrospinning method. After the characterization of electrospun mats, the optimal nanofibers were employed for embedding capsaicin-loaded alginate nanoparticles. Our findings revealed that embedding capsaicin-loaded alginate nanoparticles in polycaprolactone-chitosan nanofibers, prolonged capsaicin release from 120 h to more than 500 h. Furthermore, the results of in vitro analysis demonstrated that the designed nanoplatform could effectively inhibit the proliferation of MCF-7 human breast cells while being nontoxic to human dermal fibroblasts (HDF). Collectively, the prepared nanocomposite drug delivery platform might be promising for the long-term and controlled release of capsaicin for the prevention and treatment of cancer.
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Quitosana , Nanofibras , Nanopartículas , Humanos , Quitosana/química , Nanofibras/química , Capsaicina , Alginatos , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Nanopartículas/químicaRESUMO
Background: Noise-induced hearing loss (NIHL) is one of the most common causes of sensorineural hearing loss. The prevention of NIHL in musicians requires a better understanding of its contributing exposure factors. We aimed to determine typical sound exposure levels received by professional musicians during solitary practice and calculate the maximum safe practice time (MSPT) for the main Iranian musical instruments. Methods: We conducted a cross-sectional study on 185 professional musicians (147 men and 38 women) between April 2018 and April 2019. The MSPT was calculated for each instrument if the mean sound level was below 85 dB in all musicians, and the music was considered a safe instrument; if it was >85 dB, it was considered a high-risk instruments and some other instruments had different mean sound level (in some participants <85 dB and some other players >85 dB), so these instruments were considered as borderline instruments. Results: The mean age of the participants was 36.66 ± 0.85 years and their mean daily practice time was 2.89 ± 0.13 hours. The daily practice was significantly higher in plucked string instruments as compared to other instruments (p<0.001). The mean sound level of every instrument varied from 67.77 to 100.77 dB in the right ear and 67.20 to 100.12 dB in the left ear. The highest sound level was in sorna and the lowest one in zanburak. Conclusion: It seems musicians observe the MSPT of each instrument as much as possible. It is recommended to determine the comprehensive protocol for each instrument to prevent hearing loss in musicians.
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Mitochondrial dysfunction may lead to cardiomyocyte death in trastuzumab (TZM)-induced cardiotoxicity. Accordingly, this study was designed to evaluate the mitochondrial protective effects of curcumin, chrysin and thymoquinone alone in TZM-induced cardiotoxicity in the rats. Forty-eight male adult Wistar rats were divided into eight groups: control group (normal saline), TZM group (2.5 mg/kg I.P. injection, daily), TZM + curcumin group (10 mg/kg, I.P. injection, daily), TZM + chrysin (10 mg/kg, I.P. injection, daily), TZM + thymoquinone (0.5 mg/kg, I.P. injection, daily), curcumin group (10 mg/kg, I.P. injection, daily), chrysin group (10 mg/kg, I.P. injection, daily) and thymoquinone group (10 mg/kg, I.P. injection, daily). Blood and tissue were collected on day 11 and used for assessment of creatine phosphokinase, lactate dehydrogenase (LDH), troponin, malondialdehyde (MDA) amount, glutathione levels and mitochondrial toxicity parameters. TZM increased mitochondrial impairments (reactive oxygen species formation, mitochondrial swelling, mitochondrial membrane potential collapse and decline in succinate dehydrogenase activity) and histopathological alterations (hypertrophy, enlarged cell, disarrangement, myocytes degeneration, infiltration of fat in some areas, hemorrhage and focal vascular thrombosis) in rat heart. As well as TZM produced a significant increase in the level of CK, LDH, troponin, MDA, glutathione disulfide. In most experiments, the co-injection of curcumin, chrysin and thymoquinone with TZM restored the level of CK, LDH, troponin, MDA, GSH, mitochondrial impairments and histopathological alterations. The study revealed the cardioprotective effects of curcumin, chrysin and thymoquinone against TZM-induced cardiotoxicity which could be attributed to their antioxidant and mitochondrial protection activities.
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Cardiotoxicidade , Curcumina , Animais , Antioxidantes/farmacologia , Benzoquinonas , Cardiotoxicidade/prevenção & controle , Curcumina/farmacologia , Doxorrubicina/farmacologia , Flavonoides , Glutationa/metabolismo , Masculino , Mitocôndrias/metabolismo , Estresse Oxidativo , Ratos , Ratos Wistar , Trastuzumab/toxicidade , Troponina/farmacologiaRESUMO
In this study, we fabricated two different arrangements of laminated composite scaffolds based on Alginate:Alginate sulfate hydrogel, PCL:Gelatin electrospun mat, and Kartogenin-PLGA nanoparticles (KGN-NPs). The optimized composite scaffold revealed a range of advantages such as improved mechanical features as well as less potential of damage (less dissipated energy), interconnected pores of hydrogel and fiber with adequate pore size, excellent swelling ratio, and controlled biodegradability. Furthermore, the synthesized KGN-NPs with spherical morphology were incorporated into the composite scaffold and exhibited a linear and sustained release of KGN within 30 days with desirable initial burst reduction (12% vs. 20%). Additionally, the cytotoxicity impact of the composite was evaluated. Resazurin assay and Live/Dead staining revealed that the optimized composite scaffold has no cytotoxic effect and could improve cell growth. Overall, according to the enhanced mechanical features, suitable environment for cellular growth, and sustained drug release, the optimized scaffold would be a good candidate for tissue regeneration.
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Alginatos/química , Portadores de Fármacos/química , Hidrogéis/química , Células-Tronco Mesenquimais/efeitos dos fármacos , Nanofibras/química , Alicerces Teciduais/química , Anilidas/química , Anilidas/farmacologia , Liberação Controlada de Fármacos , Gelatina/química , Humanos , Nanopartículas/química , Ácidos Ftálicos/química , Ácidos Ftálicos/farmacologia , Poliésteres/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Engenharia Tecidual/instrumentação , Engenharia Tecidual/métodosRESUMO
In patients who require a gastric pull-up, despite bilateral injury to the vocal cords and regurgitation, preservation of the larynx can improve their quality of life.
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The aims of the present study were the determination of antimicrobial and antibiofilm effects of meropenem-loaded mesoporous silica nanoparticles (MSNs) on carbapenem resistant Pseudomonas aeruginosa (P. aeruginosa) and cytotoxicity properties in vitro. The meropenem-loaded MSNs had shown antibacterial and biofilm inhibitory activities on all isolates at different levels lower than MICs and BICs of meropenem. The viability of HC-04 cells treated with serial concentrations as MICs and BICs of meropenem-loaded MSNs was 92-100%. According to the obtained results, meropenem-loaded MSNs display the significant antibacterial and antibiofilm effects against carbapenem resistant and biofilm forming P. aeruginosa and low cell toxicity in vitro. Then, the prepared system can be an appropriate option for the delivery of carbapenem for further evaluation in vivo assays.
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Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos , Meropeném/farmacologia , Nanopartículas/química , Dióxido de Silício/farmacologia , Antibacterianos/química , Anti-Infecciosos/química , Carbapenêmicos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Humanos , Meropeném/química , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa , Dióxido de Silício/químicaRESUMO
The exposure of Bacteroides fragilis to highly oxygenated tissues induces an oxidative stress due to a shift from the reduced condition of the gastrointestinal tract to an aerobic environment of host tissues. The potent and effective responses to reactive oxygen species (ROS) make the B. fragilis tolerant to atmospheric oxygen for several days. The response to oxidative stress in B. fragilis is a complicated event that is induced and regulated by different agents. In this review, we will focus on the B. fragilis response to oxidative stress and present an overview of the regulators of responses to oxidative stress in this bacterium.
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Bacteroides fragilis/fisiologia , Estresse Oxidativo , Espécies Reativas de Oxigênio/química , Resposta SOS em Genética , Proteínas de Bactérias/fisiologia , Farmacorresistência Bacteriana Múltipla , Ferritinas/fisiologia , Trato Gastrointestinal/microbiologia , Regulação Bacteriana da Expressão Gênica , Fator sigma/fisiologia , Estresse Fisiológico , Fatores de Transcrição/fisiologia , VirulênciaRESUMO
BACKGROUND: The ever-increasing resistance to antimicrobial agents among bacteria associated with nosocomial infections indicate the necessity of new antimicrobial therapy. The nanoparticles are considered as new drug delivery systems to increase the efficiency and decrease the unfavourable effects of the antimicrobial agents. METHODS: Herein we report the preparation and characterization of mesoporous silica nanoparticles (MSNs) loaded with meropenem against carbapenem-resistant Enterobacteriaceae. The antimicrobial effect of meropenem-loaded MSNs was determined against Enterobacteriaceae using the minimum inhibitory (MIC) method. The biocompatibility of meropenem-loaded MSNs was studied by the impact on the haemolysis and sedimentation rates of human red blood cells (HRBCs). Cytotoxicity of the meropenem-loaded MSNs was studied by the MTT test (hBM-MSC cell viability). RESULTS: The meropenem-loaded MSNs have shown antibacterial activity on all isolates at different MIC values lower than MICs of meropenem. Free MSNs did not show any significant antibacterial effect. Meropenem-loaded MSNs have no significant effect on haemolysis and ESR of HRBCs. The viability of hBM-MSC cells treated with serial concentrations of meropenem-loaded MSNs was 92-100%. CONCLUSION: Due to the desirable biocompatibility, low cytotoxicity and the improved antibacterial effect, MSNs can be considered as a promising drug delivery system for meropenem as a potential antimicrobial agent.
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Enterobacteriáceas Resistentes a Carbapenêmicos/química , Teste de Materiais , Meropeném/química , Meropeném/farmacologia , Nanopartículas/química , Dióxido de Silício/química , Dióxido de Silício/toxicidade , Antibacterianos/química , Antibacterianos/farmacologia , Portadores de Fármacos/química , Portadores de Fármacos/toxicidade , Testes de Sensibilidade Microbiana , PorosidadeRESUMO
INTRODUCTION: Inflammatory myofibroblastic pseudotumors are initially described in the lung and various extrapulmonary sites such as the orbits, palatine tonsils, ears, gingiva, pterygomaxillary space, and periodontal tissues. These tumors rarely involve the larynx and predilection to the glottis occurs in an indolent manner. CASE REPORT: This case describes a laryngeal myofibroblastic tumor in a 46-year-old woman who presented with an aggressive tumor that extended to the floor of the mouth and the base of the tongue. Extended supraglottic laryngectomy was undertaken for the patient. The diagnosis was spindle cell proliferation with dense lymphoplasma cell infiltration compatible with inflammatory myofibroblastic tumor (Inflammatory pseudotumor or plasma cell granuloma). Definitive diagnosis was achieved with immunohistochemical (IHC) staining. CONCLUSION: We believe that further IHC studies are required to define the true nature of these tumors especially for those that behave in an aggressive pattern.
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INTRODUCTION: Mucous retention cysts are a subtype of intracordal vocal cysts that may occur spontaneously or may be associated with poor vocal hygiene, and which require optimal treatment. The objective of this study was to present a new laser-assisted microsurgery technique for treating intracordal mucous retention cysts and to describe the final outcomes. MATERIALS AND METHODS: In this prospective study, we assessed the pre-operative and post-operative acoustic analysis, maximum phonation time (MPT), and voice handicap index (VHI) of four patients with a diagnosis of mucous retention cyst. The island flap technique was applied to all patients without any complications. In this procedure, we favored the super-pulse mode using a 2-W power CO2 laser to remove the medial wall of the cyst, before clearing away the lateral wall margins of the cyst using repeat-pulse mode and a 2-W power CO2 laser. Indeed, we maintained the underlying epithelium and lamina propria, including the island flap attached to the vocal ligament. RESULTS: There was a statistically significant improvement in the MPT (pre-op,11.05 s; post-op,15.85 s; P=0.002) and the VHI (pre-operative, 72/120; post-operative,27/120; P=0.001) in all patients. Moreover, jitter and shimmer were refined after surgery, but there was no statistically significant relationship between pre-operative and post-operative data (P=0.071) (P=0.622). In the follow-up period (median, 150 days), there was no report of recurrence or mucosal stiffness. CONCLUSION: The island flap procedure in association with CO2 laser microsurgery appears to be a safe and effective treatment option for intracordal mucous retention cysts, but needs further investigation to allow comparison with other methods.
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Tympanic membrane (TM) perforation is still one of the most common otology complications. New designs of biomaterials, and lately tissue-engineered composites and grafts, have thoroughly revolutionized the management of TM perforation. In this study, we examined a biologically modified collagen-immobilized polydimethyl siloxane patch to repair TM perforation. In vitro potential of the aforementioned patch as a scaffold to support fibroblast cell growth and adhesion was assessed. An in vivo assay of the patch for initiating repair of TM perforations also was investigated. In vitro assay showed that the patch has significantly increased cell adhesion and growth in comparison with unmodified ones (p < 0.05). In vivo study also showed an overall closure rate of TM perforation of 70% and an average gain of 15.75 ± 4.29 dB in air-bone gap. This study shows that the preliminary in vivo evaluation of a modified siloxane patch in humans had promising results and is comparable to existing biomaterial patches.
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Colágeno/metabolismo , Engenharia Tecidual/métodos , Transplantes , Perfuração da Membrana Timpânica/cirurgia , Membrana Timpânica/patologia , Membrana Timpânica/cirurgia , Materiais Biocompatíveis/química , Materiais Biocompatíveis/metabolismo , Linhagem Celular , Colágeno/química , Humanos , Teste de Materiais , Resultado do Tratamento , CicatrizaçãoRESUMO
BACKGROUND: The most common laryngeal mass in children is recurrent respiratory papillomatosis (RRP). Studies have attempted to correlate viral typing and its aggressiveness. METHOD: 29 patients with histologically confirmed RRP enrolled in adjuvant therapies. Patients underwent several surgical interventions. RESULTS: HPV genotyping demonstrated 45% HPV-6 and 55% HPV-11. The mean age at the first surgical intervention was 52.39 months (SD=102.28) (range from 4 months to 426 months). The mean number of surgical intervention was 10.39 (SD=7.76) (range from 2 to 30). The mean time of surgical intervals was 4.63 months (SD=4.02) (range from 2 to 24 months). In fourteen patients (48%) tracheotomy was done. All patients who had tracheotomy received alpha-interferon. One of our cases was a male who had pulmonary extension with HPV-6. CONCLUSION: A review of patients with RRP was regarding to HPV genotyping and need for adjuvant therapy and tracheostomy. Mean number of surgical procedure was 10/40 and nearly fourteen patients (48%) need to tracheotomy. The clinical differences between HPV6 and HPV11 disease may not be accurately predictable. Patients with less age and with HPV-11 seemed to have more severe problems, but these differences were not statistically significant which needs much more investigations for reasonable starting point of evaluation for these differences.
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Laryngeal spindle cell neoplasms are uncommon tumors, frequently misdiagnosed as reactive lesions or mesenchymal malignancies. One of the rare mesenchymal tumors of the larynx is myxoid spindle cell tumor (angiomyxoma), a benign proliferative lesion. It is considered the laryngeal counterpart of the aggressive angiomyxoma of the pelvis and perineum. Although benign, angiomyxomas have a propensity for local recurrence due to their tendency to infiltrate surrounding tissues. They commonly appear encapsulated, but simple enucleation does not provide adequate treatment; excision should include a margin of normal tissue around the tumor. We describe a case of laryngeal angiomyxoma in a 40-year-old man that, to the best of our knowledge, is only the second such case reported in the literature. The tumor in our case showed no histologic evidence of aggressive behavior, but because of the potential for local recurrence, close follow-up was warranted.