The leaking defects in the temporal bone can be classified into two groups based on etiology: Secondary defects, which occur with trauma, surgery (iatrogenic), or neoplasms invading the skull base; and the less common primary (spontaneous) forms, in which two distinct populations of patients can be described: first, children with congenital malformations of the temporal bone, and, second, adults with no known primary or secondary temporal bone disease. In adults with spontaneous leakage, the location of the defect is most commonly found to be the floor of middle fossa (tegmen tympani or tegmen mastoidian). Increased intracranial pressure may be the predisposing background, and in the normal-pressure group, remnants of the arachnoid granulations may play the causative role. On the other hand, children with spontaneous CSF otorrhea most often have congenital inner ear anomalies associated with hearing loss. High-resolution CT scans are helpful to confirm the diagnosis. CSF leakage through the temporal bone may cause different problems. The most common presenting symptoms consist of serous otitis media, persistent otorrhea after tympanostomy tube placement, and meningitis. There are different imaging methods to locate the leakage site including CT, CT with intrathecal Metrizamide, MRI and radio-isotope studies. In some cases, there might be questions about the precise site of leakage. Using intrathecal Fluorescein during the surgery and doing pressure rising maneuvers are very helpful in this regard. Once the defect is found, various repair methods can be employed, such as middle fossa craniotomy, transcanal vestibular obliteration, and closure of the Eustachian tube and the ear canal. The materials used to seal the defects are muscle, fascia, fat, bone dust and chips and pedicled grafts. We will discuss the different methods of diagnosing and managing CSF otorrhea in children and also the use of Fluorescein in these cases.

Background and purpose: Granulocyte colony-stimulating factor (G-CSF) is routinely used in combination with chemotherapy to battle neutropenia. However, studies suggest that this chemokine may increase the risk of metastasis and malignancy in many cancers. To counteract the adverse effects of G-CSF in cancer, antibodies have been used to block its action. However, antibodies are large and complex molecules which makes their production expensive. Thus in this study, we aim to construct different structure variants of the G-CSF receptor containing different domains and select the best variant that prevents the adverse actions of this chemokine. These novel structures are smaller than antibodies and easier to produce. Experimental approach: Different domains of the G-CSF receptor were designed and cloned into the pET28a expression vector. These recombinant receptor subunits were then expressed in Escherichia coli and purified using standard affinity chromatography techniques. Interaction of recombinant receptor subunits with G-CSF was assessed using enzyme-linked immunosorbent assay and NFS60 cells. Findings / Results: Two recombinant receptor subunits containing D1 + D2 + D3 domains and D2 domain showed the strongest inhibitory activity to G-CSF. Conclusion and implications: These novel recombinant receptor variants could be candidates for further studies in the development of novel therapeutics.

Purpose: Human granulocyte colony-stimulating factor (hG-CSF) is a growth factor that stimulates the proliferation and differentiation of granulocyte progenitor cells, and neutrophilic granulocyte colony formation of bone marrow cells. This factor also induces terminal differentiation of some leukemic myeloid cells. HuG-CSF is produced in human monocyte and macrophage in response to bacterial endotoxin, and also in human cell lines such as oral cavity carcinoma (CHU-2) and bladder carcinoma (5637). The aim of this research was to extract total RNA from stimulated human monocyte cells, synthesis of hG-CSF ds cDNA, and cloning of cDNA in an appropriate cloning vector.Materials and Methods: First, monocyte cells were isolated from normal human peripheral blood. These cells were cultured and simultaneously stimulated by LPS and hIFN-γ. Total RNA was extracted from cells, and hG-CSF signal sequence-containing cDNA and signal sequence-free cDNA were synthesized with specific primers and based on RT-PCR method. Also, both of the mentioned cDNAs were sythesized by extracting total RNA from cultured 5637 carcinoma cells. Both of the monocytic cDNAs were confirmed by the restriction enzyme of StyI that forms three distinct fragments on gel electroforesis. Then, signal sequence-containing cDNA was inserted into the cloning vector of pBluescriptIISK and cloned in E.coli (TOP10F' strain).Results and Discussion: After screening, correct colonies were selected, and recombinant vector was extracted from transformed cells and confirmed by the restriction enzymes of EcoRI, BamHI, NcoI and StyI. Finally, the correct recombinant vector was selected and sequenced. After confirmation of the nucleotide sequence of the cloned cDNA, the signal sequence-free cDNA was synthesized with specific primers, recombinant vector as a templet, and by PCR; and was inserted into pBluescriptIISK and cloned in TOP10F'. Then, the correct clone was selected and confirmed by restriction enzymes.

Introduction: Synthesis of new drugs, including GM-CSF (granulocyte-macrophage colonystimulating factor), is one of the most important use of recombinant DNA technology. GM-CSF is a Molgramostim drug that is widely used in order to reduce the side effects of chemotherapy and enhance the immune system.Treatment of dental abscesses in patients undergoing chemotherapy is one of the most common uses of this drug in dentistry. In addition, GM-CSF has a key role in the treatment of mucositis in patients undergoing chemotherapy and radiotherapy of the oral area. In this review, the different uses of the recombinant molgramostim drugs in treating different diseases were evaluated.Article Explanation: In the current review paper, relevant articles were collected from ISI Web of Science and PubMed databases by using Google Scholar search engine from 1973 to 2014. The articles were analyzed for 8 months. Articles related to the effect of recombinant GM-CSF on treating disease were included in the current paper.Conclusion: The potency of GM-CSF in inducing the production of granulocytes and macrophages in vivo shows that it can clinically increase neutrophil counts and enhance the immune system subsequent to injuries inflicted by conditions such as myelodysplastic syndrome or injuries due to chemotherapeutic agents. In addition, considering the widespread therapeutic use of GM-CSF to boost the immune system, it can be introduced as an important agent for the treatment of dental abscesses in chemotherapy patients.