Wireless mobile ultrasonography-assisted parotid duct stone removal.

Ultrasonography is highly sensitive for the diagnosis of sialoliths. Recently, wireless mobile ultrasonography was developed. We describe the case of a 49-year-old man who presented with painful postprandial left cheek swelling. Computed tomography detected a solitary 5-mm parotid duct stone with infection at the anterior portion of the left masseter muscle. Transoral stone removal was planned, although difficulty was expected in view of the surrounding infection. Surgery was performed under the guidance of mobile ultrasonography, and the stone was removed safely.

SERPINB2 is a novel indicator of stem cell toxicity.

The toxicological evaluation of potential drug candidates is very important in the preclinical phase of drug development. Toxic materials may cause serious decline in stem cell function and loss of stemness. Indeed, we found that toxic exposure more profoundly suppressed the growth of stem cells than terminally differentiated fibroblasts. Importantly, toxic exposure suppressed stem cell migration and multi-lineage differentiation potential in vitro and in vivo. Moreover, early-response genes involved in stem cell properties such as self-renewal and differentiation capabilities can be used as specific markers to predict toxicity. In the present study, we also identified a labile toxic response gene, SERPINB2, which is significantly increased in response to various toxic agents in human stem cells in vitro and in vivo. Consistently, self-renewal, migration, and multi-lineage differentiation potential were markedly decreased following SERPINB2 overexpression. To the best of our knowledge, this is the first study to focus on the functions of SERPINB2 on the regenerative potential of stem cells in response to various existing chemicals, and the findings will facilitate the development of promising toxicity test platforms for newly developed chemicals.

The Effect of Human Adipose Tissue-Derived Mesenchymal Stem Cells in Rat's Subglottic Stenosis Model.

OBJECTIVE: Subglottic stenosis remains a clinical challenge. The aim of this study was to evaluate the effect of human adipose tissue-derived mesenchymal stem cells (hAMSCs) in rat model of subglottic stenosis. SUBJECTS AND METHODS: Ninety-six 13-week-old male rats were enrolled in this study. They were divided into 3 groups as normal control (NC) group, a subglottic injury and media injection (SM) group, and a subglottic injury and media-stem cell injection (SMSC) group. The hAMSCs were immediately injected into subglottis after injury. Histologic characteristics of subglottis; the mRNA expressions of interleukin-1ß, cyclooxygenase-2, tumor growth factor-ß and basic fibroblast growth factor; and hAMSCs' survival were evaluated. RESULTS: The hAMSCs survived in the subglottis of the rat until 10 days after implantation. The NC and SMSC groups had a significantly wider subglottic lumen and thinner lamina propria than the SM group at 56 days after injury. Collagen intensity of subglottis was significantly higher in the SM group than in the NC and SMSC groups at 28 days after injury. Gene expression didn't show significant difference between the SM group and the SMSC group. CONCLUSIONS: The hAMSCs injection was found to be helpful for preventing subglottic stenosis in a rat model.

Is Surgical Navigation Useful for Treating Zygomatic Arch Fractures?

OBJECTIVE: To report the case of a 58-year-old man with a zygomatic arch fracture, which was well localized and reduced using a surgical navigation system. METHODS: In this clinical report, the authors suggest intraoperative surgical navigation systems are useful diagnostically and for localizing sites of zygomatic arch fractures. RESULTS: The patient underwent successful closed reduction of zygomatic arch fractures using a surgical navigation system. CONCLUSIONS: Surgical navigation is a useful tool for identifying the locations of zygomatic arch fractures and for guiding closed reduction. Surgical navigation is recommended for localizing the sites of zygomatic fractures.

Age-Related Changes in Nuclear Factor Erythroid 2-Related Factor 2 and Reactive Oxygen Species and Mitochondrial Structure in the Tongues of Fischer 344 Rats.

OBJECTIVES: Previously the authors reported age-related changes in the activities of anti-oxidative enzyme activities and protein expressions in the tongues of rats. Because more information is required about relations between aging and oxidative stress and anti-oxidative enzyme efficiency, the authors investigated differences between the expression of master regulator of anti-oxidative enzymes (nuclear factor erythroid 2-related factor 2 [Nrf2]), levels of reactive oxygen species (ROS), and mitochondrial structures in the tongues of young and aged Fischer 344 rats. METHODS: Age-dependent changes in Nrf2 protein and ROS were determined by Western blotting and using chemical kits, respectively. Tongue specimens were examined by electron microscopy. The study was conducted using rats aged 7 months (young, n=8) or 22 months (old, n=8). RESULTS: Nrf2 protein levels in the tongues of aged rats were lower than in young rats. ROS levels were higher in older rats and mitochondrial structural deficits were observed their tongues. Three young rats showed moderate mitochondrial degeneration, whereas profound degeneration with mitochondrial cristae disruption, swelling, rupture, or intramitochondrial vacuole formation was observed in all 8 old rats. Notably, mitochondrial rupture was observed in 5 old rats. CONCLUSION: Antioxidant defense systems of old rats were compromised by Nrf2 deficiency, which could lead to the deleterious accumulation and release of ROS and probably mitochondrial structural deficits in aged tongue tissues.

Failed septal extension graft in a patient with a history of radiotherapy.

BACKGROUND: This report describes the authors' experience of "melting" septal cartilage after placement of a septal extension graft in a nasopharyngeal cancer patient that had been previously undergone radiation therapy, and provides a review of the literature. METHODS: Electronic medical records were used to obtain details of the patient's clinical history. RESULTS: A 32-year-old woman, who had previously undergone radiotherapy for nasopharyngeal cancer, visited our department to for rhinoplasty. Rhinoplasty was performed using a septal extension graft to raise the nasal tip (first operation). Five days after surgery, it was found that the septal extension graft was melting without any signs of infection, that is, the graft had softened, lost elasticity, thinned, and partially disappeared without any sign of infection at 5 days, and thus, the nasal tip was reconstructed with conchal cartilage (second operation). Five months after surgery, it was found that almost all septal cartilage had disappeared without any sign of infection, and thus, the entire nasal septum was reconstructed using 2-mm costal cartilage and an onlay graft was used for tip augmentation (third operation). CONCLUSIONS: After cartilage has been exposed to radiotherapy, its patency should be viewed with suspicion. Further studies are needed for determine the mechanism responsible for cartilage damage after radiotherapy.

Efficacy of Posterior Canal Wall Reconstruction Using Autologous Auricular Cartilage and Bone Pâté in Chronic Otitis Media with Cholesteatoma.

OBJECTIVE: This study was designed to investigate the long-term results using the technique of canal wall up mastoidectomy and reconstruction of the posterior canal wall using bone pâté and auricular cartilage in the treatment of chronic otitis media with cholesteatoma. MATERIALS AND METHODS: A retrospective review was performed on 42 patients who underwent canal wall up mastoidectomy and posterior canal wall reconstruction at a single institution between November 2005 and November 2012. RESULTS: Of the 42 patients, postoperative tympanic membranes were normal in 38 (90.5%), perforated in 1 (2.4%), and retracted in 3 (7.1%). Mean preoperative and postoperative values of the air-bone gap (ABG) were 29.4±12.8 and 23.4±11.7 dB, respectively, which represented a significant average improvement. For patients with ossiculoplasty (n=24), the mean preoperative and postoperative ABG values were 34.7±6.0 and 27.5±8.0 dB, respectively, which also represented a significant average improvement. Thirty-one (73.8%) of the patients were followed up without any complication, but 5 had otorrhea (11.9%), 4 had dizziness (9.5%), and 2 had facial palsy (4.8%). CONCLUSION: A canal wall up mastoidectomy with reconstruction of the posterior canal wall using auricular cartilage and bone pâté provides successful preservation of the anatomic structure and a significant improvement in hearing without the long-term disadvantages of a canal wall down mastoidectomy.

Health-Related Quality of Life in Korean Adults with Hearing Impairment: The Korea National Health and Nutrition Examination Survey 2010 to 2012.

BACKGROUND: As the global population ages, disabling hearing impairment (HI) have been increased rapidly. The impact of HI on health-related quality of life (HRQoL) is of great importance to aid the development of strategic plans and to guide therapeutic interventions. PURPOSE: To evaluate HRQoL in Korean adults with different degrees of HI using EuroQol five-dimensional (EQ-5D) and EQ-visual analogue scale (VAS), the preference-based generic measures of HRQoL. METHODS: Using a representative dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) from January 2010 to December 2012, EQ-5D questionnaire and EQ- VAS scores of subjects with HI were compared with those of subjects without HI. Logistic regression analysis, with adjustment for covariates, was used to evaluate the impact of HI on HRQoL scales. HI was defined according to the hearing thresholds of pure-tone averages at 0.5, 1, 2, and 3 kHz of the better hearing ear as follows; mild HI (26 to < 40 dB) and moderate to severe HI (≥ 40 dB). RESULTS: Of the 16,449 Korean adults in KNHANES (age, 45.0 ± 0.2 years; male, 49.7%), 1757 (weighted prevalence, 7.6%) had mild HI and 890 (3.6%) had moderate to severe HI. Subjects with HI had impaired HRQoL as compared with subjects without HI (EQ-5D, 0.96 ± 0.00 vs. 0.88±0.00 vs. 0.86 ± 0.01 for control vs. mild HI vs. moderate to severe HI, p < 0.001; EQ-VAS, 75.10 ± 0.18 vs. 67.48 ± 0.63 vs. 66.24 ± 0.92 for control vs. mild HI vs. moderate to severe HI, p < 0.001). After adjusting for socio-demographic factors (age, gender, household income, education level, presence of spouse) and health-related behaviors (smoking status, alcohol intake, regular exercise), psychological stress, and the presence of comorbidities (diabetes, hypercholesterolemia, hypertension, decreased eGFR, and tinnitus), EQ-VAS remained impaired in the moderate to severe HI group (61.72±1.69) as compared with the control group (65.68 ± 1.26, p = 0.004), but EQ-5D impairment disappeared (0.86 ± 0.02 vs.0.88±0.01 for moderate to severe HI vs. control, p = 0.058). CONCLUSION: After adjusting for socio-demographic and psychosocial factors and comorbidities, Korean adults with moderate to severe HI rated their health statuses lower than subjects without HI.

Age-Related Changes in Antioxidative Enzyme Capacity in Tongue of Fischer 344 Rats.

OBJECTIVES: Antioxidative enzyme efficiency changes in some organs with age. However, no study has been conducted on age-related antioxidant enzyme changes in tongue. In the present study, the authors investigated the activities of four antioxidative enzymes and their protein expressions in the tongues of young and old Fischer 344 rats. METHODS: Age-dependent changes in the enzyme activities of total superoxide dismutase (SOD), Mn-SOD, Cu/Zn-SOD, catalase (CAT), and glutathione peroxidase (GPx) were determined using chemical kits, and the protein expressions levels of these enzymes by Western blotting. The study was conducted using rats aged 7 months (the young group, n=8) and 22 months (the old group, n=8). RESULTS: Total SOD, Cu/Zn-SOD, and GPx activities in the tongues of old rats were lower than in young rats, and similarly, corresponding protein expressions were downregulated in old rats. On the other hand, although the protein expressions of Mn-SOD and CAT were lower in old rats, their enzyme activities were not. CONCLUSION: The results of this study provide a possible mechanism for the tongue aging process, as in old Fischer 344 rats the antioxidant defense system was diminished with respect to enzyme activity levels and protein abundances.

A case of pediatric ectopic thyroid in lateral lymph nodes.

On average, ectopic thyroids are positioned in the embryotic decent path that emerges as a lingual thyroid or a thyroglossal duct cyst. It is uncommon for ectopic thyroids to be located in the lateral neck, which only represents 1%-3% of all cases. Any ectopic thyroids that emerge in the posterior lateral neck in pediatric patients should be regarded as an extremely unique case. We report a 13-year-old boy with ectopic thyroid tissue in the cervical lymph nodes with orthotopic euthyroid thyroid. The masses were located on the left posterior triangle area, which were confirmed as histologic benign thyroid tissue without any malignancy in the head and neck. Authors suggest that this case supports the benign lymphatic transport theory of lateral ectopic thyroid.

Delayed treatment of zygomatic tetrapod fracture.

Since maxillofacial injury is frequently accompanied by other diseases, its evaluation and treatment are open delayed. When the evaluation is delayed, the surgical treatment can be difficult or impossible. A 21-yr-old man presented with right facial swelling and deformity after injury. We planned immediate surgical repair for his right tetrapod fracture, but the operation was delayed for two months due to severe hyperthyroidism. During the operation, we reducted and fixed the deviated bone after refracture of the zygomatic arch with an osteotome to achieve mobility. The facial deformity and difficulty in mouth opening were improved after the operation. Even in the presence of accompanying fractures, early evaluation and proper management can prevent complications and achieve acceptable cosmetic outcomes in maxillofacial trauma patients. In patients with malunion of fracture sites, fixation after refracture using an osteotome can be a good treatment option for obtaining good mobility.