Induced Regenerative Elastic Matrix Repair in LOXL1 Knockout Mouse Cell Cultures: Towards Potential therapy for Pelvic Organ Prolapse.

Impaired elastic matrix remodeling occurs in reproductive tissues after vaginal delivery. This has been linked to development of pelvic organ prolapse (POP) for which there currently is no pharmacologic therapy. Hyaluronan oligomers and transforming growth factor beta 1 (termed elastogenic factors, EFs) have been shown to significantly enhance tropoelastin synthesis, elastic fiber assembly, and crosslinking by adult vascular smooth muscle cells (SMCs). The goal of this study was to ascertain if these factors similarly improve the quantity and quality of elastic matrix deposition by vaginal SMCs (VSMCs) isolated from lysyl oxidase like-1 knock out (LOXL1 KO) mouse model of POP. Cells isolated from whole vagina of a LOXL1 KO mouse (multiparous, stage 3 prolapse) were cultured and identified as SMCs by their expression of various SMC markers. Passage 2 vaginal SMCs (VSMCs; 3×104/10 cm2) were cultured for 21 days with EFs. Cell layers and spent medium aliquots were assessed for elastin content and quality. EF-treated VSMCs proliferated at a similar rate to untreated controls but synthesized more total elastin primarily in the form of soluble matrix elastin. Elastin mRNA was also increased compared to controls. The elastic matrix was significantly denser in EF-treated cultures, which was composed of more mature, non-interrupted elastic fibers that were absent in controls. The results are promising towards development of a therapy to enhance regenerative elastic matrix repair in post-partum female pelvic floor tissues.

A rare cause of reversible sensorineural hearing loss.

A unilateral sensorineural hearing loss that acutely develops should raise suspicion. A thorough work-up is indicated as a few reversible causes exist. Drug therapy represents probably the most common cause of a reversible sensorineural hearing loss, with a few medical conditions contributing to the list of etiologic factors. We present a case of unilateral sensorineural hearing loss in an otherwise asymptomatic patient that was attributed to non-Hodgkin's lymphoma, which reversed following chemotherapy.

Hydroxylapatite canal wall reconstruction in patients with otologic dilemmas.

Posterior canal wall reconstruction using porous hydroxylapatite (HA), Grote canal wall prosthesis (Richards), has been recommended for obliteration of troublesome "canal-wall-down" procedures. The same method has been utilized during the management of diverse otologic problems. The results obtained encourage the further utilization of this technique in the management of various otologic dilemmas. Indications for reconstruction of the posterior canal wall using HA are suggested.

Rhinoscleroma.

We have described a case of rhinopharyngeal rhinoscleroma, and reviewed the clinical behavior and management of this disease. Selective long-standing antibiotic treatment was successful in halting the process. Treatment of the advanced cicatrix with carbon-dioxide laser vaporization yielded excellent results.

Oral dantrolene sodium for tonsillectomy pain: a double-blind study.

Tonsillectomy in adults and older children is typically accompanied by 7 to 14 days of pain. On the basis of clinical observations of patients treated perioperatively with dantrolene sodium for malignant hyperthermia, we hypothesized that pharyngeal muscle spasms are a major factor in tonsillectomy pain. We entered 113 patients, 11 years of age and older, into a double-blind, placebo-controlled study to evaluate the effectiveness of dantrolene sodium in reduction of tonsillectomy pain. Patients were randomly assigned either dantrolene (1.5 mg/kg per day) or placebo orally four times a day for 5 days postoperatively. On a standardized questionnaire, the patient recorded pain, diet, activity level, analgesics, and side effects, daily for 2 weeks. Also, alkaline phosphatase (alk phos) and serum aspartate aminotransferase (SGOT) levels were determined before the operation and 2 weeks after. Patients who received dantrolene had no significant differences in subjective pain, diet, or activity level scores from those of patients who received placebo. Dantrolene patients did, however, require significantly less analgesic use than placebo patients (p = 0.034, 0.015, and 0.005 for postoperative days 2, 3, and 4, respectively). There was no significant difference in side effects or changes in liver enzyme between the dantrolene and placebo groups. We conclude that dantrolene sodium, given in the dosage noted, is effective in reduction of analgesic requirements after tonsillectomy.

Carcinoma of the oral cavity and oropharynx.

A high index of suspicion in smokers, coupled with inspection and palpation, is necessary for early diagnosis of cancer of the oral cavity and the oropharynx. Surgery or radiotherapy, or a combination of those modalities, is usually successful, except in advanced cases of cancer of the tongue base and the oropharynx.

Atypical facial pain and orbital cancer.

A patient complaining of facial pain was found to have primary squamous cell cancer of the orbit. The treatment included surgery and radiotherapy. The patient having this extremely rare disease has been followed up for seven years with no evidence of recurrence.