Radiofrequency ablation (RFA) of intrahepatic tumors induces distant tumor growth through activation of interleukin 6/signal transducer and activator of transcription 3 (STAT3)/hepatocyte growth ...factor (HGF)/tyrosine-protein kinase Met (c-MET) pathway. Yet, the predominant cellular source still needs to be identified as specific roles of the many types of periablational infiltrating immune cells requires further clarification. Here we report the key role of activated myofibroblasts in RFA-induced tumorigenesis and successful pharmacologic blockade. Murine models simulating RF tumorigenic effects on a macrometastatic tumor and intrahepatic micrometastatic deposits after liver ablation and a macrometastatic tumor after kidney ablation were used. Immune assays of ablated normal parenchyma demonstrated significantly increased numbers of activated myofibroblasts in the periablational rim, as well as increased HGF levels, recruitment other cellular infiltrates; macrophages, dendritic cells and natural killer cells, HGF dependent growth factors; fibroblast growth factor-19 (FGF-19) and receptor of Vascular Endothelial Growth Factor-1 (VEGFR-1), and proliferative indices; Ki-67 and CD34 for microvascular density. Furthermore, macrometastatic models demonstrated accelerated distant tumor growth at 7d post-RFA while micrometastatic models demonstrated increased intrahepatic deposit size and number at 14 and 21 days post-RFA. Multi-day atorvastatin, a selective fibroblast inhibitor, inhibited RFA-induced HGF and downstream growth factors, cellular markers and proliferative indices. Specifically, atorvastatin treatment reduced cellular and proliferative indices to baseline levels in the micrometastatic models, however only partially in macrometastatic models. Furthermore, adjuvant atorvastatin completely inhibited accelerated growth of macrometastasis and negated increased micrometastatic intrahepatic burden. Thus, activated myofibroblasts drive RF-induced tumorigenesis at a cellular level via induction of the HGF/c-MET/STAT3 axis, and can be successfully pharmacologically suppressed.
Background and Aim: Selecting the optimum nasal passage for nasotracheal intubation is quite important in the maxillofacial surgeries for the success of intubation and the reduction of potential ...complications such as nasal mucosal laceration, epistaxis, avulsion of the inferior and middle turbinates, and septal laceration. Materials and Methods: The present study evaluates standard panoramic radiographs (PR) and posteroanterior cephalometric radiographs (PACR) to determine the optimal nasal passage for nasotracheal intubation and compares the results with those of routine anesthesiological occlusion and spatula tests (ST). The results of occlusion tests (OT), ST, and radiological assessments of 60 patients prior to nasotracheal intubation were compared with the nasal endoscopic assessment results, and complications were evaluated. Results: There was no significant association between the OT and nasal endoscopy results (P = 0.075). A significant association was found between the ST and nasal endoscopy results (P = 0.000), and between the radiological assessments and the nasal endoscopy results (P = 0.000). Compatibility with nasal endoscopy was 54% when the occlusion and ST were evaluated together, 75% when the OT and radiological assessments were evaluated together, and 86% when the ST and radiological assessments were evaluated together. The highest level of compatibility was 92% when all the tests were evaluated together. Conclusion: The simple tests alone were found to be inadequate for the selection of the optimal nasal passage. Evaluation of PR and PACR, which are commonly used in maxillofacial surgeries, together with simple anesthesiological examination tests would increase nasotracheal intubation success and decrease complications.
Abstract The aim of this study was to investigate and compare changes in the nasomaxillary complex substructures following orthopaedic rapid maxillary expansion (RME) and surgically assisted RME ...(SARME). 10 patients received RME, 10 patients received SARME, and 10 patients served as an untreated control group. Lateral and posteroanterior cephalograms were obtained for each individual at pre-expansion/pre-control (T1) and post-expansion/post-control (T2). Descriptive parameters and transversal measurements on maxillo-mandibular dentoalveolar structures and skeletal bases, right and left nasal cavity angles (NC/Lom/VL and CN/Lom/VL, respectively), total nasal cavity angle (NC/Lom/CN), nasal cavity width (NC-CN) and nasal septum angle (sn/Lom/VL) were also calculated. Paired t -tests were used to evaluate changes within groups following treatment/control. Analysis of variance (ANOVA) and Duncan's tests were used to compare changes between groups. With the exception of nasal septum deviation, all nasal parameters significantly increased following RME and SARME. The increases in the SARME group were greater than in the other groups, but no statistically significant differences were recorded between the RME and SARME groups. Neither RME nor SARME created positional changes in the nasal septum.
This study was conducted to investigate the relationship between health professionals' perception of social stigma, and compassion satisfaction, burnout, compassion fatigue and intention to leave the ...profession during the COVID-19 pandemic. This study is a descriptive online study. It was conducted with 420 health professionals working in a university hospital serving as a pandemic hospital in a province of Turkey. The study data were collected through an online questionnaire including the Personal Information Form, Social Stigma Perception Scale, Professional Quality of Life Scale, and Scale of Intentions to Leave the Profession. Social stigma perception was the negative predictor of compassion fatigue, and the positive predictor of burnout, compassion fatigue and intention to leave the profession.
Bifid condyle is a rare entity with a difficult diagnosis and usually identified as an incidental finding on routine radiographic examination. The etiology is not well known, possible causes may be ...developmental, traumatic, vascular, abnormal muscle pulling, nutritional, endocrinal, teratogenic, and infections. The orientation of the condylar heads can behelpful for the etiological diagnosis.This case report describes a 56-year-old woman who suffered from a unilateral, progressively increasing, radiating pain which intensified with the movement of the mandible and includes information about the diagnosis, management, radiographic and three-dimensional model features and review of the literature.
Maxillary sinus septa increase the risk of membrane perforation during sinus floor elevation and grafting operations. This study was designed to evaluate the prevalence, morphology, localisation, ...aetiology, and orientation of maxillary sinus septa in dentate, completely edentulous, and partially edentulous sinus regions using cone beam computed tomography (CBCT), and possible patient-related factors were also assessed. Data from 300 patients (600 sinuses), 160 women and 140 men, with a mean (SD) age of 50.72 (13.99) years (range 20–83), who were undergoing treatment planning for implant-supported restorations in posterior maxillae, were analysed from reformatted CBCT scans. Sinus septa were detected in 132 (44%) patients. A total of 208 septa were found, and 187 (31.17%) single maxillary sinuses presented septa in 600 sinuses. Unilateral septa were found in 77 patients (58.3%) and bilateral septa in 55 patients (41.7%). Out of the 208 septa, 42 (20.19%) were in the anterior third, 124 (59.62%) were in the middle third, and 42 (20.19%) were in the posterior third. Further, 106 (50.96%) septa were in completely edentulous regions, 64 (30.77%) were in partially edentulous regions, and 38 (18.27%) were in dentate regions. The prevalence of septa was significantly higher in the middle third area of the completely edentulous sinus regions. The mean (SD) height of septa was 6.34 (3.05) mm, and the mean orientation was buccopalatal in 204 patients (98.08%). Maxillary sinus septa are common anatomical structures. To avoid possible complications during sinus augmentation, a detailed radiographic identification of anatomical structures in maxillary sinuses is needed.
Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common ...treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after voice therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 voice therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of voice therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of voice quality can be achieved after voice therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If voice therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of voice therapy in the management of benign vocal fold lesions; further studies are needed to confirm these preliminary data.
The objective of this study was to evaluate the reliability of the INFVo scale and its relationship with objective measures and VHI scores in 40 native Italian-speaking patients with substitution ...voice. The maximum phonation time (MPT), diadochokinesis (DDK) of the three syllabic sequence pa/ta/ka, reading of a passage and a single word repetition test were recorded. Each patient completed the Italian version of the VHI. Three speech-language pathologists blindly rated the recordings using the auditory perceptual INFVo scale; one listened and assessed the voice recording twice. The INFVo intra- and inter-rater reliability reached good values. Strong to moderate correlations between the INFVo scale scores and MPT, DDK, distortions in the repetition test, speech rate during reading and the functional subscale of the VHI were found. In conclusion, the INFVo scale is a reliable tool and can be recommended for the perceptual assessment of substitution voices in Italian speaking patients.
Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate ...possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) - as an inflammation marker - and postoperative analgesic demand in patients underwent orthognathic surgery.
We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam - as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR ≥2 was determined for inflammation threshold. Two groups (Group 1 NLR ≥2, Group 2 NLR <2) were compared for analgesic doses, numbers of patients needed analgesic treatment, and other parameters.
Mean administered tenoxicam dose was significantly higher in Group 1 than in Group 2 (P < 0.0001). Further, ratio of patients treated with tenoxicam in Group 1 was significantly higher than that in Group 2 (χ2 = 4.779, P = 0.029).
Preoperatively measured NLR may help to predict postoperative analgesic demand in patients undergoing orthognathic surgery, and thus sufficient postoperative pain control can be achieved with various preventive treatments taken at the perioperative period such as preemptive analgesia, local anesthetic administration at the end of surgery, or early administration of analgesics.
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