Utility of voice therapy in the management of vocal fold polyps and cysts.

OBJECTIVE: To evaluate the efficacy of voice therapy in the management of vocal fold polyps and cysts. STUDY DESIGN AND SETTING: Retrospective review of vocal fold cysts and polyps undergoing voice therapy in a tertiary care center. Symptom resolution or persistence resulting in surgical intervention was the main outcome measure. RESULTS: Fifty-seven patients were identified, of which 49.1% achieved symptom resolution with voice therapy alone. Patients with complete glottal closure and muscle tension dysphonia did not have a better response than those with incomplete glottal closure and without muscle tension dysphonia (P = 0.1, chi(2), respectively). Patients with translucent polyps more commonly responded to voice therapy than fibrotic, hyaline, or hemorrhagic polyps, 81.8% versus 15.4% and 25.0% response rate, respectively (P = 0.002, chi(2)). CONCLUSIONS: Voice therapy is an effective treatment modality for vocal fold polyps and cysts. SIGNIFICANCE: A multidisciplinary approach including a trial of voice therapy is warranted.     

Crigler-Najjar Syndrom Typ I infolge segmentaler paternaler Isodisomie 2

Ohne Zusammenfassung     

Morbidität nach Herztransplantation

The morbidity in the long-term course following heart transplantation in childhood is mainly determined by the morbidity of the transplanted graft, by side effects caused by immunosuppression and by psychosocial morbidity due to the special situation of life and growing up with a transplanted heart. Transplant vasculopathy as a specific disease of the transplanted organ itself, is a common complication following heart transplantation and is an important factor of morbidity and mortality, considerably limiting the long-term prognosis. Progressive disturbance of renal function and cumulative incidence of malignant tumors is a further factor limiting prognosis caused by the side effects of immunosuppression.     

Medikamentöse Kopfschmerztherapie

Ohne Zusammenfassung     

Area postrema-lesions increase operant responding to sucrose in rats

Rats with lesions of the area postrema (APX) are known to exhibit an enhanced intake of highly palatable foods such as sweetened condensed milk and cookies. These observations suggest the possibility that APX rats find these foods more rewarding and will work harder to obtain these foods. Sham and APX rats were tested on fixed ratio (FR) and progressive ratio (PR) schedules. APX rats consistently pressed more times to receive sucrose solution and attained both FR 3 and FR 5 criteria significantly faster than sham-lesioned control rats. Furthermore, rats with APX had significantly higher break points than sham-lesioned control rats on a progressive ratio schedule. These results support the hypothesis that rats with lesions of the area postrema will consistently work harder to obtain a highly palatable food reward.     

Aberrant chromatin at genes encoding stem cell regulators in human mixed-lineage leukemia

Mixed-lineage leukemia (MLL) fusion proteins are potent inducers of leukemia, but how these proteins generate aberrant gene expression programs is poorly understood. Here we show that the MLL-AF4 fusion protein occupies developmental regulatory genes important for hematopoietic stem cell identity and self-renewal in human leukemia cells. These MLL-AF4-bound regions have grossly altered chromatin structure, with histone modifications catalyzed by trithorax group proteins and DOT1 extending across large domains. Our results define direct targets of the MLL fusion protein, reveal the global role of epigenetic misregulation in leukemia, and identify new targets for therapeutic intervention in cancer.     

Virus persists in beta cells of islets of Langerhans and infection is associated with chemical manifestations of diabetes. II. Morphologic observations.

Persistence of lymphocytic choriomeningitis (LCM) virus in the islets of Langerhans was associated with mild hyperglycemia and abnormal glucose tolerance test results. Early histopathologic events consisted of occasional perivascular inflammatory mononuclear cells around both islet and acinar cells. Morphometric studies showed an increase in the size of islets from virus-infected mice. By electron microscopy, LCM virions were found within infected beta cells. Cytolytic injury of beta cells was minimal and did not account for the abnormalities of glucose metabolism. In contrast to the findings in islets, ultrastructural studies of acinar cells revealed LCM virions in abundance, vacuolar degeneration, and intracytoplasmic inclusions. This study extends the previous observation that LCM virus infection may persist in beta cells of the islets of Langerhans without causing structural injury but be associated with abnormalities resembling the chemical and histopathologic features of the early stage of Type II (adult-onset) human diabetes mellitus.     

Motor nerves of salivary myoepithelial cells in dogs

1. The pressures in the ducts of the parotid and submaxillary glands were recorded in dogs under chloralose-urethane anaesthesia. A single stimulus applied to the parasympathetic nerve regularly caused a pressure rise of short duration. Usually it did not evoke secretion.2. In both glands a single stimulus applied to the vagosympathetic trunk usually caused a pressure response of short duration. It had no secretory effect.3. In the parotid gland, repetitive vagosympathetic stimulation caused a sustained increase of pressure in the duct, usually without inducing secretion.4. In the submaxillary gland, repetitive vagosympathetic stimulation caused a sustained pressure rise, even when the secretory response had been abolished by propranolol.5. It is concluded that the salivary myoepithelial cells of dogs are supplied with fibres from both sympathetic and parasympathetic divisions of the autonomic nervous system and both can cause the cells to contract.