The association of functional polymorphisms in the aryl hydrocarbon receptor (AHR) gene with the risk of vitiligo in Han Chinese populations

BACKGROUND

Vitiligo is an acquired depigmentation disorder resulting from selective destruction of melanocytes. The aryl hydrocarbon receptor (AHR) is vital to the regulation of melanogenesis and melanocyte proliferation and differentiation through modulating the expressions of melanogenesis-related genes. AHR mutations may negatively affect AHR proteins and its target genes. Therefore, we hypothesized that AHR polymorphisms might be involved in vitiligo by impacting the transcriptional activities of related genes as mentioned above.

OBJECTIVES

  To evaluate the potential association between AHR polymorphisms and vitiligo susceptibility.

METHODS

We performed a hospital-based, case-control study of 1000 patients with vitiligo and 1000 vitiligo-free but age- and gender-matched controls. Two single nucleotide polymorphisms of the AHR gene (rs10249788 and rs2066853) were selected and genotyped using a polymerase chain reaction-restriction fragment length polymorphism method.

RESULTS

A statistically significantly decreased risk of vitiligo was found to be associated with the TT and CT genotypes of rs10249788 [odds ratio (OR) 0·59, 95% confidence interval (CI) 0·38-0·93; P = 0·028 and OR 0·82, 95% CI 0·68-0·98; P = 0·032, respectively] as well as among subgroups: male, active, nonsegmental vitiligo, and onset age ≤ 20 years. Moreover, subjects with the combined (CT + TT)/GG genotype or T/G haplotype (rs10249788/rs2066853) showed a decreased risk for vitiligo (OR 0·57, 95% CI 0·37-0·87, P = 0·009 and OR 0·78, 95% CI 0·64-0·96, P = 0·033, respectively).

CONCLUSIONS

These results suggest that the T allele of rs10249788 located in the promoter of the AHR gene is associated with a protective effect on vitiligo in Han Chinese populations.

Double-bend needle modification for transthyrohyoid vocal fold injection

Our objective was to describe an injection needle modification for awake in-office vocal fold injections through a percutaneous transthyrohyoid approach. Two separate 45° angle bends are created at the hub and 1 cm from the needle tip of a 25-gauge, 1.5-inch needle. After adequate endolaryngeal anesthesia, the needle is passed via the thyrohyoid membrane into the airway. The needle tip is at a 90° angle to the syringe, providing access to the entire vocal fold surface, regardless of chin position or thyroid cartilage angulation. The bend at 1 cm also serves as a marker to measure the depth of the needle within the soft tissue. The double-bend needle modification allows for complete access to the entire length of the true vocal fold in one pass as well as a marker to measure depth of the needle in the tissue. Limitations may include bleeding from the injection site, insufficient needle length in patients with a long anterior-posterior dimension of the larynx, and potential difficulty passing a needle through a calcified thyrohyoid membrane.

The Effect of Singing on Laryngopharyngeal Reflux

Objective: While there has been widespread conjecture regarding the role of laryngopharyngeal reflux in singing, there remains no objective data demonstrating that voice use causes increased reflux. We attempted to objectively analyze pharyngeal pH changes during singing to better understand how it is affected by singing.

Method: Eight singers underwent 24-hour pharyngeal pH probe testing with the Restech Dx-pH measurement systemTM, one hour of which was spent singing. The mean pH and number of pH drops were recorded. A one-tailed t test was used to compare the mean pH of the time singing with the 2 control values.

Results: The mean pH for the control time was 6.8347, for the control time without the time supine was 6.9164, and for the time singing was 7.0286. We were thus able to reject the null hypothesis that singing decreases laryngeal pH ( P = .035). There was an increase in mean pH during the time singing as compared with the 2 control groups.

Conclusion: While singers may have increased reflux complaints, our data suggest that the singing itself does not cause an increase in acid exposure to the laryngopharynx.

Cricopharyngeal Dysphagia: An Evidence-Based Approach to Diagnosis and Management

Program Description: For the past decade, the management of a cricopharyngeal dysphagia including a Zenker’s Diverticulum has predominantly been endoscopic. Recent literature has suggested that long-term outcomes may not be as successful with the endoscopic technique as once believed. The purpose of this miniseminar is to thoroughly review the literature on this topic and present the most up to date, evidence-based court room style debate on this topic. This 90-min miniseminar will review: 1) the normal anatomy of the cricopharyngeus and the upper esophagus. 2) Methods of assessing this area, ie, radiographic, endoscopic, manometry, pH probe. 3) Medical management and its role in this disease process. 4) Surgical techniques: Open techniques: Diverticulectomy with stapled or hand-sewn closure, diverticuloplasty, +/- cricopharyngeal myotomy. Closed (endoscopic) technique: diverticulotomy utilizing stapled, laser, bovie. 5) What is the appropriate management of the patient with a When to botox? When to dilate? What are the long-term results of this management? This miniseminar will be interactive. At numerous times during the discussion questions will be asked of the audience to keep them involved and entertained. The open vs closed surgical debate will be a court-room style debate with the Moderator acting as the judge or arbitrator. Each presenter will have 8 mins to define their side of the argument and to present the data. Four minutes will be allowed for cross examination or rebuttal, 2 mins for the closing argument if needed. The audience will give the verdict at the end. A series of questions will be asked of the jury (audience) at the end. Events/Schedule: Normal anatomy of the cricopharyngeus and its assessment: 10 min (Robert Stachler, MD). Medical and surgical management of cricopharyngeal dysfunction: 20 min (Milan Amin, MD). Introduction of the debate of surgical management: 7 mins (Milan Amin, MD). Presiding Arbitrator: Robert J. Stachler, MD. Courtroom: 30 mins total. Pro-open diverticulectomy: Al Meroti, MD; Pro-endoscopic diverticulectomy: Phil Song, MD, Ramon Franco, MD. Questions and Answers (Case presentation if time allows): 20 mins. Miniseminar Evaluation for the Audience: This should be an interactive presentation with questions for the audience to answer and an opportunity for the audience to give a verdict on which technique seems to have the best evidence. This is not a question of right or wrong. It is a question of best evidence. The jury will be prompted on this very point. Decisions are rendered based on the best evidence only.

Educational Objectives: 1) Appreciate the newest techniques available to manage cricopharyngeal dysphagia. 2) Evaluate and treat cricopharyngeal dysphagia. 3) Become facile with the medical management currently available to treat CP dysphagia.

Recent advances in the molecular and functional characterization of acid/base and electrolyte transporters in the basolateral membranes of gastric and duodenal epithelial cells

All segments of the gastrointestinal tract are comprised of an elaborately folded epithelium that expresses a variety of cell types and performs multiple secretory and absorptive functions. While the apical membrane expresses the electrolyte transporters that secrete or absorb electrolytes and water, basolateral transporters regulate the secretory or absorptive rates. During gastric acid formation, Cl⁻/HCO₃⁻ and Na(+) /H(+) exchange and other transporters secure Cl⁻ re-supply as well as pH and volume regulation. Gastric surface cells utilize ion transporters to secrete HCO₃⁻, maintain pH(i) during a luminal acid load and repair damaged surface areas during the process of epithelial restitution. Na(+)/H(+) exchange and Na(+)/HCO₃⁻ cotransport serve basolateral acid/base import for gastroduodenal HCO₃⁻ secretion. The gastric and duodenal epithelium also absorbs salt and water. Recent molecular information on novel ion transporters expressed in the gastric and duodenal epithelium has exploded; however, a function has not been found yet for all transporters. The purpose of this review is to summarize current knowledge on the molecular identity and cellular function of basolateral ion transporters in the gastric and duodenal epithelium.

Lack of evidence for OSMR and RET gene mutations in a Chinese family with friction melanosis

BACKGROUND

Friction melanosis (FM) is a common dermatological disorder. Although cases have been reported, familial FM is rare. FM and macular amyloidosis (MA) have been hypothesized to be identical clinical conditions, and cutaneous lichen amyloidosis (CLA) is linked to mutations in the OSMR (oncostatin M receptor) or RET (receptor tyrosine kinase) genes.

AIM

To evaluate the OSMR and RET gene mutations in a Chinese family with FM. Methods. We investigated a family with FM with six affected members in four successive generations. All 17 exons of the OSMR and 19 exons of the RET genes were screened for mutation by PCR, and restriction enzyme digestion assays for RET codon 634 mutations were performed for selected members of the family.

RESULTS

Based on the pedigree characteristics, we suggest an autosomal dominant mode of inheritance in this FM family. We did not detect any mutations in the OSMR or RET genes.

CONCLUSIONS

We report a rare case of familial FM. Genes other than OSMR and RET may be involved in the pathogenesis of this family.

First measurements of the absolute neutron spectrum using the magnetic recoil spectrometer at OMEGA (invited)

A neutron spectrometer, called a magnetic recoil spectrometer (MRS), has been built and implemented at the OMEGA laser facility [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)] for absolute measurements of the neutron spectrum in the range of 6-30 MeV, from which fuel areal density (rhoR), ion temperature (T(i)), and yield (Y(n)) can be determined. The results from the first MRS measurements of the absolute neutron spectrum are presented. In addition, measuring rhoR at the National Ignition Facility (NIF) [G. H. Miller et al., Nucl. Fusion 44, S228 (2004)] will be essential for assessing implosion performance during all stages of development from surrogate implosions to cryogenic fizzles to ignited implosions. To accomplish this, we are also developing an MRS for the NIF. As much of the research and development and instrument optimization of the MRS at OMEGA are directly applicable to the MRS at the NIF, a description of the design and characterization of the MRS on the NIF is discussed as well.

Prevalence and severity of asthma and allergies in schoolchildren in Lhasa, Tibet

BACKGROUND

The International Study of Asthma and Allergies in Childhood (ISAAC) demonstrated that large variations existed in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis and eczema throughout the world and that environmental factors and lifestyle customs are major determinants of the prevalence and severity of these diseases. However, the relevant data about children living at high-altitude locations were considered to be underreported.

OBJECTIVE

The ISAAC Phase III programme was carried out in Lhasa, the Tibetan Autonomous Region in China, at an elevation of 3658 m above sea level to examine the occurrence of asthma, allergic rhinoconjunctivitis and eczema in schoolchildren aged 13-14 years.

METHODS

All 3196 schoolchildren in eight public junior high schools in urban Lhasa who were confirmed to be 13-14 years old were invited and participated in both written and video questionnaire investigations, among which 3190 pieces of data (49.8% of boys and 50.2% of girls) were validated and analysed.

RESULTS

Among the overall observations, the prevalence of 'having ever experienced wheezing', 'current wheezing' and 'diagnosed to have asthma' was 1.4%, 0.8% and 1.1%, respectively. The prevalence of current exercise-induced asthma and current nocturnal cough was 7.1% and 4.6%, respectively. The current prevalence of allergic rhinoconjunctivitis and eczema was 5.2% and 0.4%, respectively. In addition, the prevalence of rhinoconjunctivitis symptoms during the past 12 months showed no discernable differences throughout the year.

CONCLUSION

The prevalence of asthma, allergic rhinoconjunctivitis and eczema over the past 12 months was the lowest among the centres, that performed ISAAC worldwide.

An apolipoprotein E-based therapeutic improves outcome and reduces Alzheimer's disease pathology following closed head injury: evidence of pharmacogenomic interaction

Apolipoprotein E (apoE) modifies glial activation and the CNS inflammatory response in an isoform-specific manner. Peptides derived from the receptor-binding region of apoE have been demonstrated to maintain the functional activity of the intact protein, and to improve histological and functional deficits after closed head injury. In the current study, APOE2, APOE3, and APOE4 targeted replacement (TR) mice expressing the human apoE protein isoforms (apoE2, apoE3 and apoE4) were used in a clinically relevant model of closed head injury to assess the interaction between the humanized apoE background and the therapeutic apoE mimetic peptide, apoE(133-149). Treatment with the apoE-mimetic peptide reduced microglial activation and early inflammatory events in all of the targeted replacement animals and was associated with histological and functional improvement in the APOE2TR and APOE3TR animals. Similarly, brain beta amyloid protein (Abeta)(1-42) levels were increased as a function of head injury in all of the targeted replacement mice, while treatment with apoE peptide suppressed Abeta(1-42) levels in the APOE2TR and APOE3TR animals. These results suggest a pharmacogenomic interaction between the therapeutic effects of the apoE mimetic peptide and the human apoE protein isoforms. Furthermore, they suggest that administration of apoE-mimetic peptides may serve as a novel therapeutic strategy for the treatment of acute and chronic neurological disease.

Electrophysiologic laryngeal nerve monitoring in high-risk thyroid surgery

We recently began performing intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve during high-risk thyroidectomies. Neuromonitoring can detect stimulation of these nerves and thereby prevent a mechanical or thermal injury that can result in neurapraxia or axonotmesis. Monitoring is also useful during dissection in an already operated-on field, when performing thyroidectomy on patients who depend on their voice for their livelihood, and when removing a large goiter or mediastinal mass.

Electrophysiologic Laryngeal Nerve Monitoring in High-Risk Thyroid Surgery

We recently began performing intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve during high-risk thyroidectomies. Neuromonitoring can detect stimulation of these nerves and thereby prevent a mechanical or thermal injury that can result in neurapraxia or axonotmesis. Monitoring is also useful during dissection in an already operated-on field, when performing thyroidectomy on patients who depend on their voice for their livelihood, and when removing a large goiter or mediastinal mass.