Platelet-Rich Plasma Injection in Patients with Atrophic Rhinitis.

OBJECTIVE: To investigate the effect of platelet-rich plasma (PRP) injection in patients with atrophic rhinitis. METHODS: Prepared PRP was injected into the inferior turbinate bilaterally, and nasal bacterial cultures were conducted. Improvement of symptoms was assessed with the Nasal Obstruction Symptom Evaluation (NOSE) and the Sino-Nasal Outcome Test-22 (SNOT-22). Nasal mucociliary clearance was assessed using the saccharin transit time (STT). RESULTS: In the PRP-injected group (group A), NOSE (throughout the study) and SNOT-22 (1 month after injection) scores were significantly decreased during the study. However, the saline spray group (group B) showed no significant nasal symptom improvement during the study period. In group A, the STT was improved until 3 months after the injection. In contrast, group B showed STT improvement after 2 months that was maintained throughout the study. CONCLUSION: PRP injections can improve nasal symptoms and nasal mucociliary function in patients with atrophic rhinitis.

Controlled Crystal Growth of All-Inorganic CsPbI2Br via Sequential Vacuum Deposition for Efficient Perovskite Solar Cells.

Vacuum deposition of perovskites is a promising method for scale-up fabrication and uniform film growth. However, improvements in the photovoltaic performance of perovskites are limited by the fabrication of perovskite films, which are not optimized for high device efficiency in the vacuum evaporation process. Herein, we fabricate CsPbI2Br perovskite with high crystallinity and larger grain size by controlling the deposition sequence between PbI2 and CsBr. The nucleation barrier for perovskite formation is significantly lowered by first evaporating CsBr and then PbI2 (CsBr-PbI2), followed by the sequential evaporation of multiple layers. The results show that the reduced Gibbs free energy of CsBr-PbI2, compared with that of PbI2-CsBr, accelerates perovskite formation, resulting in larger grain size and reduced defect density. Furthermore, surface-modified homojunction perovskites are fabricated to efficiently extract charge carriers and enhance the efficiency of perovskite solar cells (PeSCs) by modulating the final PbI2 thickness before thermal annealing. Using these strategies, the best PeSC exhibits a power conversion efficiency of 13.41% for a small area (0.135 cm2), the highest value among sequential thermal deposition inorganic PeSCs, and 11.10% for a large area PeSC (1 cm2). This study presents an effective way to understand the crystal growth of thermally deposited perovskites and improve their performance in optoelectronic devices.

Efficacy of chemiluminescence in the diagnosis and screening of oral cancer and precancer: a systematic review and meta-analysis.

INTRODUCTION: Early detection of potentially malignant oral cavity disorders is critical for a good prognosis, and it is unclear whether the use of chemiluminescence as an adjunctive diagnostic screening method improves diagnostic accuracy. OBJECTIVE: This systematic review and meta-analysis was performed to assess the accuracy of chemiluminescence for diagnosis of oral cancer and precancerous lesions. METHODS: Sixteen prospective and retrospective studies from PubMed, Cochrane database, SCOPUS, Web of Science, Embase, and Google Scholar were reviewed. Oral mucosal disorder, as detected by chemiluminescence, was compared with oral mucosal disorder detected by toluidine blue or visual examination. True-positive, true-negative, false-positive, and false-negative rates were extracted for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool (ver. 2). RESULTS: Sensitivity, specificity, negative predictive value, and diagnostic odds ratio (DOR) of the use of toluidine blue were 0.832 (95% confidence interval [CI] 0.692-0.917), 0.429 (95% CI 0.217-0.672), 0.747 (95% CI 0.607-0.849), and 4.061 (95% CI 1.528-10.796; I2=9.128%), respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.743. Compared with toluidine blue, as used in 12 studies, chemiluminescence had a higher sensitivity (0.831 vs. 0.694); it had a lower specificity (0.415 vs. 0.734), negative predictive value (0.674 vs. 0.729), and DOR (3.891 vs. 7.705). Compared with clinical examination, as used in three studies, chemiluminescence had lower DOR (4.576 vs. 5.499) and area under the curve (0.818 vs. 0.91). CONCLUSION: Although chemiluminescence itself has good sensitivity for diagnostic work-up of oral cancer and precancer, the diagnostic accuracy of chemiluminescence is comparable to or worse than toluidine blue and clinical examination. Diagnostic accuracy was therefore insufficient for reliable use of chemiluminescence alone.

Comparison of Narrowband Imaging and White-Light Endoscopy for Diagnosis and Screening of Nasopharyngeal Cancer.

OBJECTIVES: We compared the diagnostic accuracies of narrowband imaging and white-light endoscopy in the detection of nasopharyngeal cancer. DATA SOURCES: Six databases (PubMed, Cochrane Database, Embase, Web of Science, SCOPUS, and Google Scholar). REVIEW METHODS: The 6 databases were thoroughly reviewed by 2 authors (working independently) from their dates of inception to December 2019. Nasopharyngeal mucosal or vascular changes detected by narrowband imaging were compared to those detected by white-light endoscopy. The authors extracted true-positive, true-negative, false-positive, and false-negative parameters for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. The extent of interrater agreement was assessed. RESULTS: Eighteen prospective or retrospective studies were included. The diagnostic odds ratio of narrowband imaging was 77.560 (95% confidence interval [CI], 37.424-160.739). The area under the summary receiver operating characteristic curve was 0.926. The sensitivity, specificity, and negative predictive value were 0.871 (95% CI, 0.808-0.915), 0.905 (95% CI, 0.816-0.953), and 0.955 (95% CI, 0.906-0.979), respectively. The correlation between sensitivity and the false-positive rate was 0.284, indicating that heterogeneity was absent. Narrowband imaging exhibited moderate interrater reliability (0.7037; 95% CI, 0.6558-0.746). Subgroup analysis showed that vascular patterns revealed by endoscopy in a screened subgroup were significantly more diagnostically accurate than mucosal patterns used for surveillance of a recurrent cancer subgroup. CONCLUSIONS: Narrowband imaging exhibits high diagnostic accuracy and should be used in the diagnostic workup of nasopharyngeal cancer. However, further studies are necessary to confirm our results.

Trends in skin prick test according to seasons: Results of a Korean multi-center study.

OBJECTIVE: Allergy is a very common condition. Allergic disease is highly affected by environmental changes. Conditions of the four seasons can change dramatically in Republic of Korea (ROK). To assess changes in rates of aeroallergen positivity according to seasons and environmental factors (temperature, humidity, and precipitation). MATERIALS: A total of 20 hospitals were selected based on population distribution in ROK. A skin prick test (SPT) panel comprising 55 aeroallergens was distributed to 18 hospitals for a prospective study. Results from SPTs done in 2006 and 2010 were collected and analyzed retrospectively from 20 hospitals and 2014/2015 SPT (from June 2014 to May 2015) results from 18 hospitals were collected prospectively. RESULTS: We compared allergen-positive rates among seasons. Positive test rates for several pollens and house dust mites increased significantly in spring and fall. Pollens positive rate varied significantly according to temperature, precipitation, and humidity while mite allergens were less susceptible to environment. CONCLUSION: There are four distinct seasons in ROK. The positivity of pollen allergens were especially affected by temperature and precipitation in spring. House dust mites were less affected by seasons, temperature, precipitation, and humidity less than pollen. Therefore, regular follow-up and re-evaluation of allergic test are essential considering changes of seasons and environment for acceptable diagnosis and treatment.

Effect of endoscopic endonasal skull base surgery on snoring.

BACKGROUND: As the number of endoscopic skull base surgeries has increased, postoperative changes in quality of life require attention, including evaluation of whether snoring symptoms change. OBJECTIVE: To investigate the effect of endoscopic endonasal skull base surgery on snoring and nasal symptom scores. METHODS: Between February 2009 and September 2018, 510 patients underwent skull base tumor resection via an endoscopic endonasal approach and were included in this study. Nasal symptoms were scored using the Nasal Obstruction Symptoms Evaluation (NOSE) scale and snoring symptoms were subjectively scored from 0 to 10 by partners using a visual analog scale (VAS). Computational fluid dynamics (CFD) was employed for pilot patient analysis. RESULTS: A pituitary adenoma was the most common surgical pathology encountered over the past 10 years (81.6% of all tumors). The NOSE scores increased significantly after surgery (pre-surgery, 3.28 ± 3.18; post-surgery, 4.09 ± 3.61; P < .001). The snoring VAS score decreased significantly postoperatively (pre-surgery, 2.91 ± 2.74; post-surgery, 2.43 ± 2.45; P < .001). A positive correlation was apparent between the NOSE and snoring score changes (r = 0.374; P < .001). CONCLUSIONS: Snoring improved after endoscopic endonasal skull base surgery, associated with changes in nasal symptoms. LEVEL OF EVIDENCE: 4.

The diagnostic value of detecting sudden smell loss among asymptomatic COVID-19 patients in early stage: The possible early sign of COVID-19.

IMPORTANCE: The newly emerged coronavirus disease 19 (COVID-19), is threatening the world. Olfactory or gustatory dysfunction is reported as one of the symptoms worldwide. As reported so far, different clinical features have been reported according to outbreak sites and gender; most of the patients, who complained of anosmia or hyposmia, were Europeans. We had a fast review for novel articles about COVID-19 infection and olfactory function. OBSERVATIONS: Rapid reviews for COVID-19 or other viral infection and olfactory and/or gustatory dysfunctions were done in this review. Up to date, a lot of reports have shown that olfactory dysfunction is related to viral infections but no exact mechanism, clinical course, and definite treatment have been discovered, which is also same in COVID-19. In general, intranasal steroid (INS) and oral steroid for short time help improve the recovery of the olfactory function in case of olfactory dysfunction after virus infection. Considering severe respiratory complications and immunocompromised state of COVID-19, the use of steroid should be limited and cautious because we do not have enough data to support the usage of steroid to treat olfactory dysfunction in the clinical course of COVID-19. CONCLUSIONS AND RELEVANCE: In the days of pandemic COVID-19, we should keep in mind that olfactory dysfunctions, even without other upper respiratory infection or otolaryngologic symptoms, might be the early signs of COVID-19.

α-Lipoic acid prevents against cisplatin cytotoxicity via activation of the NRF2/HO-1 antioxidant pathway.

The production of reactive oxygen species (ROS) by cisplatin is one of the major mechanisms of cisplatin-induced cytotoxicity. We examined the preventive effect of α-lipoic acid (LA) on cisplatin-induced toxicity via its antioxidant effects on in vitro and ex vivo culture systems. To elucidate the mechanism of the antioxidant activity of LA, NRF2 was inhibited using NRF2 siRNA, and the change in antioxidant activity of LA was characterized. MTT assays showed that LA was safe at concentrations up to 0.5 mM in HEI-OC1 cells and had a protective effect against cisplatin-induced cytotoxicity. Intracellular ROS production in HEI-OC1 cells was rapidly increased by cisplatin for up to 48 h. However, treatment with LA significantly reduced the production of ROS and increased the expression of the antioxidant proteins HO-1 and SOD1. Ex vivo, the organs of Corti of the group pretreated with LA exhibited better preservation than the group that received cisplatin alone. We also confirmed the nuclear translocation of NRF2 after LA administration, and that NRF2 inhibition decreased the antioxidant activity of LA. Together, these results indicate that the antioxidant activity of LA was through the activation of the NRF2/HO-1 antioxidant pathway.

Efficacy of chemiluminescence in the diagnosis and screening of oral cancer and precancer: a systematic review and meta-analysis / Eficácia da quimioluminescência no diagnóstico e rastreamento de câncer oral e pré-câncer: uma revisão sistemática e metanálise

Abstract Introduction Early detection of potentially malignant oral cavity disorders is critical for a good prognosis, and it is unclear whether the use of chemiluminescence as an adjunctive diagnostic screening method improves diagnostic accuracy. Objective This systematic review and meta-analysis was performed to assess the accuracy of chemiluminescence for diagnosis of oral cancer and precancerous lesions. Methods Sixteen prospective and retrospective studies from PubMed, Cochrane database, SCOPUS, Web of Science, Embase, and Google Scholar were reviewed. Oral mucosal disorder, as detected by chemiluminescence, was compared with oral mucosal disorder detected by toluidine blue or visual examination. True-positive, true-negative, false-positive, and false-negative rates were extracted for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool (ver. 2). Results Sensitivity, specificity, negative predictive value, and diagnostic odds ratio (DOR) of the use of toluidine blue were 0.832 (95% confidence interval [CI] 0.692-0.917), 0.429 (95% CI 0.217-0.672), 0.747 (95% CI 0.607-0.849), and 4.061 (95% CI 1.528-10.796; I2 = 9.128%), respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.743. Compared with toluidine blue, as used in 12 studies, chemiluminescence had a higher sensitivity (0.831 vs. 0.694); it had a lower specificity (0.415 vs. 0.734), negative predictive value (0.674 vs. 0.729), and DOR (3.891 vs. 7.705). Compared with clinical examination, as used in three studies, chemiluminescence had lower DOR (4.576 vs. 5.499) and area under the curve (0.818 vs. 0.91). Conclusion Although chemiluminescence itself has good sensitivity for diagnostic work-up of oral cancer and precancer, the diagnostic accuracy of chemiluminescence is comparable to or worse than toluidine blue and clinical examination. Diagnostic accuracy was therefore insufficient for reliable use of chemiluminescence alone.

Resumo Introdução A detecção precoce de distúrbios orais potencialmente malignos é fundamental para um bom prognóstico e não está claro se o uso da quimioluminescência como método auxiliar de triagem diagnóstica melhora a eficácia do diagnóstico. Objetivo Avaliar a precisão da quimioluminescência para o diagnóstico de câncer oral e pré-câncer. Método Foram revisados 16 estudos prospectivos e retrospectivos dos bancos de dados PubMed, Cochrane, Scopus, Web of Science, Embase e Google Scholar. Os distúrbios da mucosa oral detectados por quimioluminescência foram comparados com os distúrbios da mucosa oral detectados pelo azul de toluidina ou pelo exame visual. Taxas de resultados verdadeiro-positivos, verdadeiro-negativos, falso-positivos e falso-negativos foram extraídas de cada estudo. A qualidade metodológica foi avaliada com a ferramenta Quality Assessment of Diagnostic Accuracy Studies-versão 2 (QUADAS-2). Resultados Sensibilidade, especificidade, valor preditivo negativo e odds ratio diagnóstico do uso do azul de toluidina foram 0,832 (intervalo de confiança de 95%: 0,692-0,917), 0,429 (IC95%: 0,217-0,672), 0,747 (IC95%: 0,607-0,849) e 4,061 (intervalo de confiança 95%: 1,528-10,796; I2 = 9,128%), respectivamente. A área sob a curva SROC, do inglês summary receiver operating characteristic, foi de 0,743. Comparada ao azul de toluidina, como usado em 12 estudos, a quimioluminescência apresentou uma sensibilidade mais alta (0,831 vs. 0,694) e especificidade (0,415 vs. 0,734), valor preditivo negativo (0,674 vs. 0,729) e odds ratio diagnóstico (3,889 vs. 7,705) mais baixos. Comparado com o exame clínico, como usado em três estudos, a quimioluminescência apresentou menor odds ratio diagnóstico (4.576 vs. 5.499) e área sob a curva (0,818 vs. 0,91). Conclusão Embora a quimioluminescência em si tenha boa sensibilidade para o diagnóstico de câncer oral e pré-câncer, sua precisão diagnóstica é comparável ou pior do que o azul de toluidina e o exame clínico. A precisão do diagnóstico foi, portanto, insuficiente para o uso isolado confiável da quimioluminescência.

A comparative study of telomerase activity and cytologic diagnosis in malignant ascites.

OBJECTIVE: To evaluate telomerase activity as an adjunct in the cytologic diagnosis of malignant ascites. STUDY DESIGN: Malignant ascites collected from 19 gastrointestinal or liver cancer patients with clinical or pathologic evidence of peritoneal metastasis were tested for routine cytology with a liquid-based preparation, and telomerase activity was measured by telomere-repeat amplification protocol (TRAP) and real-time quantitative TRAP (RTQ-TRAP) assays. For comparison, controls from peritoneal washings from 8 early gastric cancer patients were used. RESULTS: Cytological examination detected cancer cells in 8 patients (42%), and 3 cases (16%) were diagnosed as "atypia." With TRAP and RTQ-TRAP assays 16 (84%) and 15 (78%) cases, respectively, were positive for telomerase activity. The sensitivity of telomerase activity by TRAP, RTQ-TRAP assays, and cytology was 84%, 78%, and 58%, respectively. All cases with "atypia" by cytological examination were positive for both TRAP and RTQ-PCR assays. In all negative controls, cytology, TRAP and RTQ-TRAP assays were negative. CONCLUSION: Based on our findings telomerase activity is a more sensitive method than ascitic fluid cytology and therefore can be considered as a useful diagnostic adjunct to current standard diagnostic methods. However, further large cohort studies with clinical correlation are needed to confirm our findings.

Plexiform angiomyxoid myofibroblastic tumor of the stomach: report of two cases and review of the literature.

Plexiform angiomyxoid myofibroblastic tumor (PAMT) of the stomach is a recently recognized entity. Because of its rarity, only 22 cases have been reported in the English-language literature and most of these are single case reports. We report two cases of gastric PAMT. The tumor cells were bland and plexiform arranged in a myxoid stroma, which was positive for alcian blue. Immunohistochemically, the tumor cells were positive for smooth muscle actin, but negative for c-kit, CD34, desmin, S-100 protein, epithelial membrane antigen, neurofilament, and protein kinase C-theta. Mutation analyses for exon 9, 11, 13, and 17 of KIT genes and 12, 14, and 18 of the platelet-derived growth factor receptor alpha (PDGFRA) genes were performed and the tumors were wild-type for mutation.

Comparison of four immunohistochemical tests and FISH for measuring HER2 expression in gastric carcinomas.

AIM: : Accurate testing for HER2 is essential to identify patients who are likely to benefit from trastuzumab therapy. Although comparative studies on the performance of commercially available immunohistochemistry (IHC) antibodies for HER2 have been performed in breast cancer, similar studies have not been done in gastric carcinoma (GC) thus far. METHODS: : Quadruplicate tissue microarrays (TMAs) of 289 advanced GCs were immunostained with HercepTest, A0485, 4B5 and CB11, and the results were compared to those of gene amplification by fluorescence in situ hybridisation (FISH). RESULTS: : HER2 was amplified by FISH in 38 (13.2%) GCs. HER2 overexpression (2+ or 3+) was observed in 40 (13.8%) cases by HercepTest, 46 (15.9%) by A0485, 40 (13.8%) by 4B5 and 27 (9.3%) by CB11. The sensitivity and specificity of IHC compared to FISH was 78.9%/96% for HercepTest, 86.5%/94.4% for A0485, 76.3%/95.6% for 4B5 and 60.5%/98.4% for CB11. Focal HER2 gene amplification was more common in GCs with no (0 and 1+) or low (2+) HER2 expression. Discordant IHC results were seen in 23 cases (8.0%) with the four antibodies. All HER2 3+ cases (n = 22) by HercepTest were positive with A0485 and 4B5, while one was negative with CB11. CB11 was found to be negative in 10 HercepTest 2+ and FISH+ cases. CONCLUSION: : Focal HER2 gene amplification is more common in GCs with no or low expression of HER2. Although the specificity and positive predictive value of CB11 for FISH is highest, it lacks sufficient sensitivity to be used as a first line screening test to assess HER2 status in GCs.