Comparison of subcutaneous soft tissue versus temporalis fascia as a tympanoplasty graft material: a retrospective cohort study.

OBJECTIVE: This research compares the efficacy of subcutaneous soft tissue and temporalis fascia in tympanic membrane grafting for large tympanic membrane perforations. METHODS: A retrospective cohort study compared tympanic membrane graft success rate and hearing outcomes in 248 patients who underwent tympanoplasty using subcutaneous soft tissue (n = 118) or temporalis fascia (n = 130) via the post-auricular approach. RESULTS: Comparable results were observed in both groups. Tympanic membrane graft success rate was 98.3 per cent (116 ears) in the subcutaneous soft tissue group and 98.5 per cent (128 ears) in the temporalis fascia group. The rate of air-bone gap closure within 20 dB was 54.2 per cent (64 ears) and 60.0 per cent (78 ears) in the soft tissue and temporalis fascia groups, respectively (p = 0.360). CONCLUSION: Subcutaneous soft tissue is a reliable and readily available tympanic membrane graft material in both revision and primary tympanoplasty for large tympanic membrane perforations.

miRNAs as key modulators between normal cells and tumor microenvironment interactions.

The tumor microenvironment (TME) is well-defined target for understanding tumor progression and various cell types. Major elements of the tumor microenvironment are the followings: endothelial cells, fibroblasts, signaling molecules, extracellular matrix, and infiltrating immune cells. MicroRNAs (miRNAs) are a group of small noncoding RNAs with major functions in the gene expression regulation at post-transcriptional level that have also appeared to exerts key functions in the cancer initiation/progression in diverse biological processes and the tumor microenvironment. This study summarized various roles of miRNAs in the complex interactions between the tumor and normal cells in their microenvironment.

Treatment and outcomes of acute coronary syndrome in the cancer population.

BACKGROUND: Randomized trials have established the benefit of medical therapy and revascularization in the treatment of acute myocardial infarction (MI). Cancer and cardiovascular disease are the 2 most common diseases worldwide. In clinical practice, cancer patients are frequently afflicted with MI. The benefit of medical and/or revascularization therapy in the cancer population with MI is less well known. HYPOTHESIS: Medical and revascularization therapy reduces mortality in cancer patients with MI. METHODS: After approval by the institutional review board, we retrospectively reviewed all patients with a discharge diagnosis of acute MI who were admitted to the University of Texas MD Anderson Cancer Center between December 2000 and October 2006 and evaluated the association between cardiac treatments with survival outcomes. RESULTS: A total of 456 patients with a discharge diagnosis of acute MI were identified and included in the study, of which 386 had non-ST-segment elevation MI (NSTEMI) and 70 had ST-segment elevation MI (STEMI). Compared with patients with NSTEMI, patients who had STEMI were more often prescribed aspirin (66% vs 43%; P = 0.004), ß-blockers (61% vs 46%; P = 0.018), and thrombolytic therapy (9% vs 0.3%; P = 0.0001). In the multivariable analysis, aspirin use was associated with a 23% decreased risk of death (hazard ratio [HR]: 0.77, 95% confidence interval [CI]: 0.60-0.98, P = 0.033) and ß-blocker use was associated with a 36% decreased risk of death (HR: 0.64, 95% CI: 0.51-0.81, P = 0.0002). Statins (HR: 0.82, P = 0.18) and catheter-based revascularization (HR: 0.57, P = 0.09) did not have an impact on the risk of death. Compared with patients with limited cancer, advanced cancer patients were twice as likely to die (HR: 2.12, 95 CI: 1.47-3.04, P < 0.0001). Previous chemotherapy (P = 0.005) and chest radiotherapy (P = 0.017) were associated with increased 1-year mortality, whereas hyperlipidemia (P = 0.018) was protective. CONCLUSIONS: In this study of cancer patients with MI, medical therapy with aspirin and ß-blockers was associated with improved survival. The authors have no funding, financial relationships, or conflicts of interest to disclose.

Effects of an unfixed combination of latanoprost and pilocarpine on the intraocular pressure and pupil size of normal dogs.

OBJECTIVE: To assess changes in intraocular pressure (IOP) and pupil diameter (PD) induced by daily application of an unfixed combination of latanoprost and pilocarpine in normal dogs. ANIMALS STUDIED: Fifteen mixed breed clinically normal dogs of both sexes. PROCEDURES: Three groups of five dogs each were administered in the right eye, one drop of 0.005% latanoprost (group L), 2% pilocarpine (group P), and 0.005% latanoprost with 2% pilocarpine (group LP), respectively. The left eyes received placebo. Drugs were administered once a day at 8 a.m. over a period of 5 days. IOP and PD measurements were conducted daily at 8 a.m., 10 a.m., 12 noon, 2 p.m., and 4 p.m. from 1 day preceding treatment to 7 days following treatment, and the presence of blepharospasm and/or conjunctival hyperemia was noted. RESULTS: Compared to baseline values, mean diurnal IOPs significantly decreased during the treatment period, by 4.4 (24.4%), 5.8 (31.4%), and 6.1 mmHg (35%) in the L, P, and LP groups, respectively. Compared to placebo-treated eyes, reductions of 2.1(14.1%), 3.2 (20.1%), and 4.1 mmHg (26.6%) were observed for the L, P, and LP groups, respectively. Although mean IOPs in the LP group decreased slightly more than the other two groups, these differences were not statistically significant. Miosis and conjunctival hyperemia were observed in the treated eyes of all three groups of animals during the treatment period. CONCLUSIONS: Although both 0.005% latanoprost and 2% pilocarpine individually produced significant decrease in IOP, the topical administration of a combination of latanoprost (0.005%) and pilocarpine (2%) was not associated with a statistically significant synergistic reduction in IOP in dogs; and miosis was the most frequent side effect observed during treatment.