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Lin Chuang Er Bi Yan Hou Tou Jing Wai... Oct 2021To observe the effect of nasal mucosa flap in the repair of nasopharyngeal skull base bone exposure after radiotherapy for nasopharyngeal carcinoma, and to provide a...
To observe the effect of nasal mucosa flap in the repair of nasopharyngeal skull base bone exposure after radiotherapy for nasopharyngeal carcinoma, and to provide a basis for the repair with nasal mucosa flap in skull base bone exposure after radiotherapy. The clinical data of 8 patients who underwent nasal endoscopic surgery were analyzed retrospectively. The survival of mucosal flap, the mucosal epithelialization of bone defect or exposed site, the improvement of main clinical symptoms and complications were followed up after operation. Severe mucosal flap necrosis and bone exposure occurred in 1 case after operation, in the other 7 cases, the mucosal flap survived and the mucosal epithelium of nasopharynx recovered well. After operation, most of the patients' clinical symptoms such as headache and nasal odor were improved compared with those before operation. Nasal mucosal flap is a safe and minimally invasive autogenous material with good biocompatibility. It has a good application prospect in repairing bone defect or exposure of nasopharyngeal skull base after radiotherapy and is worth popularizing in clinic.
Topics: Humans; Nasal Mucosa; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Plastic Surgery Procedures; Retrospective Studies; Skull Base
PubMed: 34628818
DOI: 10.13201/j.issn.2096-7993.2021.10.014 -
Developmental and Comparative Immunology Feb 2017Although the Tumor necrosis factor gene superfamily seems to be very conserved in vertebrates, phylogeny, tissue expression, genomic and gene organization, protein...
Although the Tumor necrosis factor gene superfamily seems to be very conserved in vertebrates, phylogeny, tissue expression, genomic and gene organization, protein domains and polymorphism analyses showed that a strong change has happened mostly in invertebrates in which protochordates were a constraint during the immune-molecules history and evolution. RT PCR was used to investigate differential gene expression in different tissues. The expression shown was greater in the pharynx. Single-nucleotide polymorphism has been investigated in Ciona intestinalis Tumor necrosis factor alpha (CiTNFα) mRNA isolated from the pharynx of 30 ascidians collected from Licata, Sicily (Italy), by denaturing gradient gel electrophoresis (DGGE). For this analysis, CiTNFα nucleotide sequence was separated into two fragments, TNF-1 and -2, respectively, of 630 and 540 bp. We defined 23 individual DGGE patterns (named 1 to 10 for TNF-1 and 1 to 13 for TNF-2). Five patterns for TNF-1 accounted for <10% of the individuals, whereas the pattern 13 of TNF-2 accounted for >20% of the individuals. All the patterns were verified by direct sequencing. Single base-pair mutations were observed mainly within COOH-terminus, leading to 30 nucleotide sequence variants and 30 different coding sequences segregating in two main different clusters. Although most of the base mutations were silent, four propeptide variants were detected and six amino acid replacements occurred within COOH-terminus. Statistical tests for neutrality indicated negative selection pressure on signal and mature peptide domains, but possible positive selection pressure on COOH-terminus domain. Lastly we displayed the in silico 3D structure analysis including the CiTNFα variable region.
Topics: Animals; Biological Evolution; Cells, Cultured; Ciona intestinalis; Cloning, Molecular; Computer Simulation; Gene Expression Profiling; Genome; Pharynx; Phylogeny; Polymorphism, Single Nucleotide; RNA, Messenger; Selection, Genetic; Sequence Alignment; Tumor Necrosis Factor-alpha
PubMed: 27829139
DOI: 10.1016/j.dci.2016.11.005 -
Medicine Jan 2022The nature of pharyngeal swallowing function during the course of recovery of dysphagia due to lateral medullary syndrome (LMS) is unclear. Vacuum swallowing is a...
INTRODUCTION
The nature of pharyngeal swallowing function during the course of recovery of dysphagia due to lateral medullary syndrome (LMS) is unclear. Vacuum swallowing is a compensatory swallowing method that improves the pharyngeal passage of a bolus by creating negative pressure during swallowing in the esophagus in patients with dysphagia due to LMS. We present a case involving a patient with dysphagia due to LMS who involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.
PATIENT CONCERNS
We report a unique case involving a 52-year-old patient with dysphagia due to LMS. His dysphagia was severe but improved gradually with swallowing rehabilitation. The patient involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.
DIAGNOSIS
The patient presented with dysphagia due to left LMS. A videofluoroscopic examination of swallowing revealed pharyngeal residue.
INTERVENTIONS
Forty-five days after the onset of the dysphagia, the swallowing pressure along the pharynx and esophagus was measured using high-resolution manometry.
OUTCOMES
Vacuum swallowing was observed in six out of 19 swallows (32.5%). The velopharyngeal contractile integral (CI) and mesohypopharyngeal CI values increased during swallowing, reflecting prolonged and increased pharyngeal contraction. We named this swallowing method "prolonged swallowing."
CONCLUSION
The findings in this case indicate that vacuum and prolonged swallowing may be compensatory swallowing methods observed in individuals recovering from dysphagia due to LMS. Further research is needed to clarify the relationship between these swallowing methods and the pathophysiology, prognosis, and treatment of dysphagia in patients with LMS.
Topics: Deglutition Disorders; Humans; Lateral Medullary Syndrome; Manometry; Middle Aged; Pharynx; Pressure; Vacuum
PubMed: 35029918
DOI: 10.1097/MD.0000000000028524 -
Arquivos Brasileiros de Cirurgia... 2018Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit.
BACKGROUND
Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit.
AIM
To present a surgical technique for reconstruction of the upper digestive tract after total esophagectomy and gastrectomy due to esophageal and gastric necrosis.
METHOD
The transit was re-established by means of a pharyngo-ileo-colic interposition with microsurgical arterial and venous anastomosis for augmentation of blood supply. Colo-duodeno-anastomosis and ileo-transverse colic anastomosis were performed for complete digestive transit reconstruction.
RESULT
This procedure was applied in a case of 41 years male attempted suicide by ingesting alkali caustic liquid (concentrated sodium hydroxide). Total necrosis of the esophagus and stomach occurred, which required initially total esophago-gastrectomy, closure at the level of the crico-pharyngeal sphincter and jejunostomy for enteral feeding with a highly deteriorated quality of life . The procedure was performed later and there were no major early and late postoperative complications and normal nutritional conditions were re-stablished.
CONCLUSION
The procedure is feasible and must be managed by multidisciplinary team in order to re-establish a normal quality of life.
Topics: Adult; Anastomosis, Surgical; Burns, Chemical; Caustics; Colon; Esophagectomy; Esophagus; Gastrectomy; Humans; Ileum; Male; Microvessels; Necrosis; Pharynx; Stomach; Suicide, Attempted
PubMed: 29972409
DOI: 10.1590/0102-672020180001e1381 -
Scientific Reports Mar 2018Anemia is a major public health problem in young children. Reports on the role of anemia on infectious diseases remained controversial. We aim to investigate the effect...
Anemia is a major public health problem in young children. Reports on the role of anemia on infectious diseases remained controversial. We aim to investigate the effect of anemia on innate immunity, nasopharyngeal bacterial colonization, and subsequent infectious outcome. Blood tests were examined at the age of 12 months. TLR-induced cytokine production was assessed by ELISA. Bacteria from nasopharyngeal specimens were identified with traditional culture. Clinical infectious diseases were followed yearly until 3 years of age. Result showed that of the 423 infants, 72 had hemoglobin level ≤ 11 g/dL, among which 55% had normal iron level. There was significant association between hemoglobin level and TLR1-2, and 4 induced IL-6 (p = 0.04, 0.02) and that of TLR4 stimulated TNF-α response (p = 0.04). Children with anemia had higher nasopharyngeal colonization with Moxarella catarrhalis. Clinical analysis did not show anemia to be associated with infectious morbidity. However, children who developed LRTIs had mean lower ferritin levels. We speculated that iron might be the key factor related to infectious morbidity. Thus, to investigate the role of anemia in infectious diseases, it is important to first consider the prevalence of iron deficit, since the incidence of iron deficiency-induced anemia may vary among different regions.
Topics: Anemia; Anemia, Iron-Deficiency; Cells, Cultured; Child, Preschool; Female; Ferritins; Hemoglobins; Humans; Immunity, Innate; Infant; Leukocytes, Mononuclear; Lymphocyte Activation; Male; Nasopharynx; Neisseria; Taiwan; Toll-Like Receptors; Tumor Necrosis Factor-alpha
PubMed: 29559671
DOI: 10.1038/s41598-018-23264-y -
Medicine Mar 2018The aim of this study was to investigate the roles of T follicular helper (Tfh) cells in secretory otitis media (SOM) combined with adenoidal hypertrophy (AH).Patients...
The aim of this study was to investigate the roles of T follicular helper (Tfh) cells in secretory otitis media (SOM) combined with adenoidal hypertrophy (AH).Patients with AH or AH combined with SOM admitted to the Yancheng No. 1 People's Hospital from December 2012 to December 2014 were included. Fourteen age-matched healthy individuals received physical examinations in the hospital served as control. The venous Tfh was determined using flow cytometry, and CD3 + CD4 + CXCR5 + T lymphocytes were defined as Tfh cells. Serum inflammatory factors including IL-8, IL-1b, IL-6, IL-10, TNF, IL-12p70, IL-21, and IgE were determined using commercial kits.Compared with the AH group, the number of CD4 + CXCR5 + T cells in peripheral blood of the AH combined with SOM group showed significant increase. Statistical differences were noticed in the number of the number of CD4 + CXCR5 + T cells in moderate and severe AH groups compared with that of the control group. Statistical differences were identified in the proportion of CD4 + CXCR5 + T cells in the adenoidal tissues between the AH combined with SOM group and AH group (P < .05). For the CD4 + CXCR5 + T cells in adenoidal tissues, no statistical differences were noticed between the moderate and severe AH groups (P > .05). The number of CD4 + CXCR5 + T cells was positively correlated to the serum IL-21. Nevertheless, no correlation was noticed between CD4 + CXCR5 + T cell and serum IL-8, IL-6, IL-10, and IgE.Tfh is involved in the AH combined with SOM in children. Besides, serum IL-21, IL-8, IL-6, IL-10, and IgE may be involved in the onset of SOM in children.
Topics: Adenoids; CD4-Positive T-Lymphocytes; Child; Child, Preschool; Female; Humans; Inflammation Mediators; Interleukins; Male; Nasopharyngeal Diseases; Otitis Media with Effusion; Severity of Illness Index; T-Lymphocytes, Helper-Inducer; Tumor Necrosis Factor-alpha
PubMed: 29595664
DOI: 10.1097/MD.0000000000010211 -
International Journal of Surgery Case... 2020Pedicled flap reconstruction still plays an essential role in head and neck surgery as an alternative to free grafts. Two standard methods are the pectoralis major and...
INTRODUCTION
Pedicled flap reconstruction still plays an essential role in head and neck surgery as an alternative to free grafts. Two standard methods are the pectoralis major and the deltopectoral flap, which are generally characterized by their reliable perfusion. This case describes bilateral arteriosclerosis of the subclavian artery as a possible cause of flap failure.
PRESENTATION OF CASE
We report on a 65-year-old patient with a multilevel carcinoma of the right pharynx. Due to the unique patient history, a free flap reconstruction was not possible. After resection of the primary, we performed reconstruction with a pedicled pectoralis major flap.
DISCUSSION
Postoperatively, we observed necrosis of the pectoralis major flap. Secondary defect reconstructions were performed with a deltopectoral flap first from the right and then, in the case of necrosis, from the left side. Stenosing arteriosclerotic plaques of the subclavian artery on both sides were the cause of flap failure.
CONCLUSION
Preoperative angiography of the subclavian artery is not a standard diagnostic procedure in the surgical planning of pedicled flap reconstruction in the head and neck region. In exceptional cases, we recommend angiographic imaging of the supplying vessels to make a more precise flap selection and avoid complications.
PubMed: 33086164
DOI: 10.1016/j.ijscr.2020.10.030 -
Ear, Nose, & Throat Journal Jan 2017As the treatment of hematopoietic cancers evolves, otolaryngologists will see a higher incidence of opportunistic infections. We discuss a case of invasive fungal...
As the treatment of hematopoietic cancers evolves, otolaryngologists will see a higher incidence of opportunistic infections. We discuss a case of invasive fungal disease that invaded the larynx, pharynx, trachea, and pulmonary parenchyma after chemotherapy. The patient, a 46-year-old woman, presented 1 week after undergoing induction chemotherapy. Her initial symptoms were odynophagia and dysphagia. Despite encouraging findings on physical examination, her health rapidly declined and she required an urgent tracheotomy and multiple operations to address spreading necrosis. Because of her inability to heal, she was not a candidate for laryngectomy, so she was treated with conservative management. The patient was then lost to follow-up, but she returned 5 months later with laryngeal destruction and a complete laryngotracheal separation. While noninvasive fungal laryngitis is routinely encountered, its invasive counterpart is rare. The literature demonstrates that some cases completely resolve with medical therapy alone but that surgery is necessary in others. We recommend surgical debridement of all necrotic tissue.
Topics: Anti-Bacterial Agents; Antifungal Agents; Aspergillosis; Candidiasis; Coinfection; Corynebacterium Infections; Debridement; Deglutition Disorders; Dysphonia; Female; Gram-Positive Bacterial Infections; Humans; Immunocompromised Host; Induction Chemotherapy; Invasive Fungal Infections; Laryngitis; Leukemia, Myeloid, Acute; Lung Abscess; Middle Aged; Myelodysplastic Syndromes; Pharyngitis; Tomography, X-Ray Computed; Tracheotomy
PubMed: 28122110
DOI: 10.1177/014556131709600105 -
PloS One 2016The stromal compartment of secondary lymphoid organs is classicaly known for providing a mechanical scaffold for the complex interactions between hematopoietic cells...
The stromal compartment of secondary lymphoid organs is classicaly known for providing a mechanical scaffold for the complex interactions between hematopoietic cells during immune activation as well as for providing a niche which is favorable for survival of lymphocytes. In recent years, it became increasingly clear that these cells also play an active role during such a response. Currently, knowledge of the interactions between human lymphoid stroma and hematopoietic cells is still lacking and most insight is based on murine systems. Although methods to isolate stromal cells from tonsils have been reported, data on stability in culture, characterization, and functional properties are lacking. Here, we describe a reproducible and easy method for isolation and in vitro culture of functional human lymphoid stromal cells from palatine tonsils. The cells isolated express markers and characteristics of T cell zone fibroblastic reticular cells (FRCs) and react to inflammatory stimuli by upregulating inflammatory cytokines and chemokines as well as adhesion molecules, as previously described for mouse lymphoid stroma. Also, cultured tonsil stromal cells support survival of human innate lymphoid cells, showing that these stromal cells can function as bone fide FRCs, providing a favorable microenvironment for hematopoietic cells.
Topics: Animals; Antigens, CD; Biomarkers; Cell Adhesion Molecules; Cell Communication; Cell Separation; Coculture Techniques; Cytokines; Extracellular Matrix Proteins; Fibroblasts; Flow Cytometry; Gene Expression; Humans; Interferon-gamma; Mice; Palatine Tonsil; Primary Cell Culture; Signal Transduction; Stromal Cells; T-Lymphocytes; Tumor Necrosis Factor-alpha
PubMed: 27907202
DOI: 10.1371/journal.pone.0167555 -
BMJ Case Reports Jul 2019
Topics: Adult; Anti-Bacterial Agents; Blepharoptosis; Cocaine; Cocaine-Related Disorders; Conjunctivitis; Drug Overdose; Fatal Outcome; Fusobacteriaceae Infections; Humans; Male; Nasal Septum; Necrosis; Nose Deformities, Acquired; Palate; Pharynx
PubMed: 31350235
DOI: 10.1136/bcr-2019-231743