Hyperbaric oxygen therapy effectively alleviates D-galactose-induced-age-related cardiac dysfunction via attenuating mitochondrial dysfunction in pre-diabetic rats.

Currently, the prevalence of obesity in aging populations is fast growing worldwide. Aging induced by D-galactose (D-gal) is proven to cause the worsening of cardiac dysfunction in pre-diabetic rats via deteriorating cardiac mitochondrial function. Hyperbaric oxygen therapy (HBOT) has been shown to attenuate D-gal-induced cognitive deterioration through decreased inflammation and apoptosis. We tested the hypothesis that HBOT alleviates D-gal induced cardiac dysfunction via improving mitochondrial function in pre-diabetic rats. Wistar rats (n=56) were fed normal diet or high-fat diet for 12 weeks. For subsequent 8 weeks, they were subcutaneously injected either vehicle (0.9% normal saline) or D-gal (150mg/kg/day). Rats were randomly subdivided into 7 groups at week 21: sham-treated (normal diet fed rats with vehicle (NDV), high-fat diet fed rats with vehicle (HFV), normal diet fed rats with D-gal (NDDg), high-fat diet fed rats with D-gal (HFDg)) and HBOT-treated (HFV, NDDg, HFDg). Sham rats received ambient pressure of oxygen while HBOT-treated ones received 100% oxygen given once daily for 60 minutes at 2 atmosphere absolute. HBOT reduced metabolic impairments, mitochondrial dysfunction and increased autophagy, resulting in an improvement of cardiac function in aged pre-diabetic rats.

Hyperbaric oxygen therapy restores cognitive function and hippocampal pathologies in both aging and aging-obese rats.

The population of obese-elderly has increased prominently around the world. Both aging and obesity are major factors of neurodegeneration. The present study hypothesizes that HBOT attenuates metabolic disturbance, cognitive decline, hippocampal pathologies in aging and aging-obese model. Sixty Wistar rats were separated into 2 groups to receive normal-diet (ND) or high-fat diet (HFD) for 22 weeks. At week 13, ND rats were divided into two subgroups to receive vehicle (0.9 % NSS, s.c) or d-gal (150 mg/kg/d, s.c) for total 10 weeks. HFD rats were injected only d-gal (150 mg/kg/d, s.c; HFDD) for total 10 weeks. At week 20, rats in each subgroup were given sham-treatment (1ATA, 80 L/min, 80 min/day), or HBOT (2ATA, pure O2, 250 L/min, 80 min/day) for 14 days. Novel object location test, metabolic parameters, and hippocampal pathologies were determined after HBOT. d-gal induced insulin resistance, increased oxidative stress, autophagy impairment, microglial hyperactivation, apoptosis, synaptic dysplasticity which resulted in cognitive impairment. d-gal-treated HFD-fed rats had the highest levels of oxidative stress, apoptosis, dendritic spine loss. HBOT attenuated insulin resistance, cognitive impairment, hippocampal aging and pathologies in both models. These findings suggest that HBOT restored insulin sensitivity, hippocampal functions, cognition in aging and aging-obese models.

Sinonasal papilloma in Chiang Mai University Hospital.

OBJECTIVE: To study sinonasal papilloma patients in terms of clinical characteristics, treatment, outcome, and complications. MATERIAL AND METHOD: A retrospective descriptive study was done. Sinonasalpapilloma data were gathered between 1999 and 2009. There were 63 available patients from the 82 cases. RESULTS: There were nine cases of nasal papilloma (14.3%) and 54 of inverted papilloma (85.7%). The mean age of the inverted papilloma group was higher than the nasal papilloma group (54 +/- 12.97 years vs. 42.4 +/- 24.8 years). The most common symptom was unilateral nasal obstruction. There were three cases of synchronous malignancy in the inverted papilloma and two metachronous (9.3%). Thirty-nine patients (72%) could be followed-up for more than three months. Recurrence was more common in the inverted papilloma group than nasal papilloma (37% vs. 11.1%). The 50% recurrent time of the endoscopic group was 51 weeks and the external group was 14 weeks. The recurrence of the external approach group was 1.59 times the endoscopic group. Ten surgical complications were found in eight inverted papilloma patients (16%) and included three in the endoscopic and five in the external group. Most of them were minor They were hypoesthesia and epiphora. CONCLUSION: Sinonasal inverted papilloma was common, able to recur and associated with malignancy. Though this was a limited retrospective study, it showed lower recurrence on the endoscopic approach. The life-long follow-up is needed in all cases.

Impact of Clinical and Histo-Pathological Prognostic Factors on T1-2N0-1 Oral Tongue Carcinoma.

To determine predictive factors which affect local and regional recurrence of T1-2N0-1M0 oral tongue carcinoma (OTC). Records of 42 patients with T1-2N0-1 M0 OTC were reviewed. The clinical characteristics, histo-pathological data, disease recurrence and survival rate were analyzed. Descriptive statistics and Kaplan-Meier survival analysis were used. The median follow up was 38 months. The 2-year overall survival and disease-free survival rates were 85.7 and 55.6 % respectively. At the 2 year analysis, there were surgical margin <5 mm (p value = 0.01), tumor thickness >7 mm (p value = 0.03), perivascular and perilymphatic invasion (p value = 0.01) affected on local recurrence and perivascular and perilymphatic invasion were also predictors for regional recurrence (p value = 0.04). The surgical margin status, tumor thickness, perivascular and perilymphatic invasion represented significant predictive factors for local recurrent OTC. Postoperative adjuvant therapy should be considered in these groups.

Deep neck infection in Northern Thailand.

The aim of this retrospective study, conducted by the Department of Otolaryngology, Chiang Mai University, Thailand, is to understand the clinical characteristics of patients with deep neck infection (DNI), especially in immunocompromised hosts, as well as to analyze the factors that influence multiple spaces' involvement and complications. The data collected (January 2004-July 2009) from 177 patients with DNI, excluding peritonsillar abscess, were reviewed, including demography, clinical presentation, etiology, involved fascial spaces, bacteriology, treatment, and complications. SPSS (15.0) was used to analyze the data. A p value of <0.05 was considered statistically significant. Among 177 DNI patients, there were 30 diabetic and 4 HIV infected patients, who were considered immunocompromised. Furthermore, two characteristics (complications and the Hb level) were statistically significant (p value <0.05) in the immunocompromised and immunocompetent groups. The 87 patients who presented with multiple space involvement were predicted by the level of white blood cell count (<5,000 or >12,000/µl) (OR 2.62; 95% CI 1.38-4.96) in univariate analysis. Complications were affected by both host immunity and abnormal Hb level (<10 or >15 g/dl), in univariate analysis, but Hb level was the only risk factor (OR 4.46; 95% CI 1.81-10.99) in multivariate analysis. Comorbidities such as diabetes mellitus and HIV infection required certain clinical assessment because of potential complications. In addition, blood tests (WBC and Hb levels) are the most important investigations necessary in patients suspected of having multiple space involvement and complications.

Actinomycosis presenting as a parotid tumor.

Actinomycosis of the parotid gland is a rare chronic infection and can present with a slow-growing mass mimicking a tumor. The authors report five cases of parotid actinomycosis. All patients presented as having enlarging masses at the parotid area for 2-6 months without a history of obvious dental infection, trauma, or immunocompromised condition. Retrograde bacterial spread from colonization in the oral cavity via Stensen's duct is the possible pathophysiology. The diagnosis was made histopathologically by fine needle aspiration biopsy (FNAB). Treatment consisted of 1.5 months of intravenous penicillin, followed by 4.5 months of oral penicillin, with excellent results.

Oral cavity cancers at a young age: analysis of patient, tumor and treatment characteristics in Chiang Mai University Hospital.

Oral cavity cancer is predominantly a disease of middle-aged men who use tobacco and alcohol. Nearly 95% of carcinomas occur after the age of 45, with an average age of approximately 60 years. In recent years, oral cavity cancers have increased at a younger age, especially in females who never consumed alcohol or smoked. The purpose of this study is to provide the information of these cancers in young patients treated in our hospital during a 5-year period. As well as to describe the treatment modalities and their results. We reviewed the medical records of oral cavity cancer patients occurring before the age of 45 who were treated at Chiang Mai University Hospital from 1999 to 2003. All the demographic data, histopathology, treatment modalities and their results were recorded. Follow up range from 0.7 to 4.4 years (mean 2.6 year). A total of 20 patients were studied. There were 12 male (60%) and 8 female (40%). The mean age was 34.4 year (20-40 year). The most common site was oral tongue (15 patients, 75%). Fifty-five percent of patients were stage III and IV. Only 6 patients (30%) were treated by surgery alone, 8 patients (40%) were treated by surgery and post-operative radiotherapy, 4 patients (20%) were subjected to radiotherapy alone, and 2 patients (10%) were treated by radiochemotherapy. The results of primary treatment in all modalities were acceptable with 5 patients (25%) developing loco-regional recurrence of disease within 10.8 months (2-36). At the time of analysis, 13 patients (65%) had no evidence of disease. The demographic data of oral cavity in younger patients in our hospital were different from the elderly, with oral tongue commonly occurring. Most of the patients were locally advanced stage. The results of all treatment modalities provided fair loco-regional control suggested more aggressive treatment in this group of patients.