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BMJ Case Reports Jul 2015A 75-year-old woman presented with left-sided weakness. There was no speech disturbance or reported swallowing difficulties. CT of the head revealed infarction in the...
A 75-year-old woman presented with left-sided weakness. There was no speech disturbance or reported swallowing difficulties. CT of the head revealed infarction in the territory of the right middle cerebral artery. The patient was transferred to the acute stroke unit and a nasogastric tube was placed following a failed swallow screening test. The following day, on assessment, there was considerable pain on swallowing. The tone and quality of the patient's voice had deteriorated and there was significant dysphagia. Seven days later a plastic item, later identified as the patient's denture, was expectorated. Following this, the dysphagia, dysphonia and sore throat rapidly resolved. The case highlights the importance of considering foreign body in the differential, and oral cavity examination in the assessment of a patient with dysphagia and sore throat is essential.
Topics: Aged; Deglutition; Deglutition Disorders; Dentures; Diagnosis, Differential; Dysphonia; Female; Foreign Bodies; Hoarseness; Humans; Infarction, Middle Cerebral Artery; Intubation, Gastrointestinal; Pharyngitis; Pharynx; Stroke; Voice
PubMed: 26150638
DOI: 10.1136/bcr-2015-210091 -
Medicine Mar 2024Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a...
BACKGROUND
Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a traditional Chinese medicine compound, have been found to be effective in providing relief from symptoms associated with AP.
METHODS
The chemical components of SHG were screened using Traditional Chinese Medicine Systems Pharmacology database, HERB database, and China National Knowledge Infrastructure. The targets of the granules were predicted using SwissTargetPrediction database. A network was constructed based on the targets of AP obtained from Genecards database, and protein-protein interaction analysis was performed on the intersection targets using STRING database. Key targets were screened for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and the binding activity of components and targets was predicted using AutoDockTools-1.5.7.
RESULTS
A total of 65 components of SHG that met the screening criteria were retrieved, resulting in 867 corresponding targets. Additionally, 1086 AP target genes were retrieved, and 272 gene targets were obtained from the intersection as potential targets for SHG in the treatment of AP. Molecular docking results showed that the core components genkwanin, acacetin, apigenin, quercetin can stably bind to the core targets glyceraldehyde 3-phosphate dehydrogenase, interleukin 6, tumor necrosis factor, serine/threonine protein kinase, tumor protein 53, and epidermal growth factor receptor.
CONCLUSION
The research results preliminarily predict and verify the mechanism of action of SHG in the treatment of AP, providing insights for further in-depth research.
Topics: Humans; Molecular Docking Simulation; Network Pharmacology; Pharyngitis; Pharynx; Neck; Drugs, Chinese Herbal; Medicine, Chinese Traditional
PubMed: 38552049
DOI: 10.1097/MD.0000000000037674 -
Chinese Journal of Cancer Jun 2016For patients with nasopharyngeal carcinoma (NPC) who undergo re-irradiation with intensity-modulated radiotherapy (IMRT), lethal nasopharyngeal necrosis (LNN) is a... (Clinical Trial)
Clinical Trial
BACKGROUND
For patients with nasopharyngeal carcinoma (NPC) who undergo re-irradiation with intensity-modulated radiotherapy (IMRT), lethal nasopharyngeal necrosis (LNN) is a severe late adverse event. The purpose of this study was to identify risk factors for LNN and develop a model to predict LNN after radical re-irradiation with IMRT in patients with recurrent NPC.
METHODS
Patients who underwent radical re-irradiation with IMRT for locally recurrent NPC between March 2001 and December 2011 and who had no evidence of distant metastasis were included in this study. Clinical characteristics, including recurrent carcinoma conditions and dosimetric features, were evaluated as candidate risk factors for LNN. Logistic regression analysis was used to identify independent risk factors and construct the predictive scoring model.
RESULTS
Among 228 patients enrolled in this study, 204 were at risk of developing LNN based on risk analysis. Of the 204 patients treated, 31 (15.2%) developed LNN. Logistic regression analysis showed that female sex (P = 0.008), necrosis before re-irradiation (P = 0.008), accumulated total prescription dose to the gross tumor volume (GTV) ≥145.5 Gy (P = 0.043), and recurrent tumor volume ≥25.38 cm(3) (P = 0.009) were independent risk factors for LNN. A model to predict LNN was then constructed that included these four independent risk factors.
CONCLUSIONS
A model that includes sex, necrosis before re-irradiation, accumulated total prescription dose to GTV, and recurrent tumor volume can effectively predict the risk of developing LNN in NPC patients who undergo radical re-irradiation with IMRT.
Topics: Adult; Aged; Female; Humans; Logistic Models; Male; Middle Aged; Models, Biological; Multivariate Analysis; Nasopharyngeal Neoplasms; Nasopharynx; Necrosis; Radiation Injuries; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; Re-Irradiation; Retrospective Studies; Risk Factors
PubMed: 27357728
DOI: 10.1186/s40880-016-0124-0 -
Polish Journal of Pathology : Official... Dec 2015Follicular dendritic cell sarcoma (FDCS) is often misdiagnosed as a carcinoma or malignant lymphoma due to morphological variability. In FDCS application of routine...
Follicular dendritic cell sarcoma (FDCS) is often misdiagnosed as a carcinoma or malignant lymphoma due to morphological variability. In FDCS application of routine antibody panels without CD21 and CD23 increases the misdiagnosis rate, because the tumor cells often show focal positivity for usual immunohistochemical markers. Our new case showed a distinct picture due to the uncommon tumor architecture, with extensive areas of necrosis and hemorrhage, the presence of nuclear atypia, and an increased mitotic count and Ki-67 index. These features suggest the classification of this tumor in the category of high-risk malignancies, with uncommon features of FDCSs.
Topics: Adult; Carcinoma; Dendritic Cell Sarcoma, Follicular; Diagnosis, Differential; Female; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Palatine Tonsil; Tonsillar Neoplasms
PubMed: 27003778
DOI: 10.5114/pjp.2015.57262 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Dec 2021In recent years, with the increase of magnetic toys, the intake of magnetic foreign bodies is an increasing problem in pediatric emergency.The strong suction of the...
In recent years, with the increase of magnetic toys, the intake of magnetic foreign bodies is an increasing problem in pediatric emergency.The strong suction of the magnetic foreign body can lead to necrosis, perforation, and infection of surrounding tissues.The site of magnetic foreign body injury is mainly the esophagus, intestines, stomach, a few in the pharynx, etc.This requires early assessment and appropriate intervention to avoid further harm.Because of its unique physical properties, magnetic foreign bodies in bilateral nasal cavity are rarely reported. Now we have a case of a bilateral magnetic foreign body in the nasal cavity.
Topics: Child; Esophagus; Foreign Bodies; Humans; Magnetic Phenomena; Nasal Cavity; Pharynx
PubMed: 34886632
DOI: 10.13201/j.issn.2096-7993.2021.12.017 -
BMJ Case Reports Aug 2016A previously well 30-year-old woman presented at 17:30 with a sudden onset of dizziness, ataxia and headache. She was initially investigated with a CT scan of the brain...
A previously well 30-year-old woman presented at 17:30 with a sudden onset of dizziness, ataxia and headache. She was initially investigated with a CT scan of the brain and lumbar puncture, which yielded no diagnosis. Subsequent MR scan revealed multiple posterior circulation infarcts, along with a previously undiagnosed Arnold-Chiari 2 malformation with an associated syrinx of her cervical and thoracic spine. The infarct involved one of the herniated cerebellar tonsils. Oedema of an infarct in the herniated tonsils caused compression of the medulla at the foramen magnum, with associated neurological symptoms including Lhermitte's phenomenon and headache on valsalva manoeuvre. Owing to these symptoms a surgical decompression was performed. The most likely aetiology of her stroke was determined to be a paradoxical embolus via patent foramen ovale.
Topics: Adult; Arnold-Chiari Malformation; Ataxia; Dizziness; Female; Foramen Ovale, Patent; Headache; Humans; Infarction; Intracranial Embolism; Palatine Tonsil
PubMed: 27489065
DOI: 10.1136/bcr-2016-215299 -
Asian Pacific Journal of Cancer... 2015This study was conducted to analyze positron emission tomography (PET) / computed tomography (CT) and magnetic resonance imaging (MRI) performance with oropharyngeal...
BACKGROUND
This study was conducted to analyze positron emission tomography (PET) / computed tomography (CT) and magnetic resonance imaging (MRI) performance with oropharyngeal non-Hodgkin's lymphoma (ONHL).
MATERIALS AND METHODS
The complete image data of 30 ONHL cases were analyzed, all patients were performed PET / CT and MRI examination before the treatment, with the time interval of these two inspections not exceeding 14 days. The distribution, morphology, MRI signal characteristics, enhancement feature, standardized uptake value (SUV) max value and lymph node metastasis way of the lesions were analyzed.
RESULTS
Among the 30 cases, 23 cases were derived from the B-cell (76.7%), 5 cases were derived from the peripheral T cells (16.7%) and 2 cases were derived from the NK/T cells (6.7%). 19 cases exhibited the palatine tonsil involvement (63.3%). As for the lesion appearance, 10 cases appeared as mass, 8 cases were the diffused type and 12 cases were the mixed type. 25 cases exhibited the SUVmax value of PET / CT primary lesions as 11 or more (83.3%). MRI showed that all patients exhibited various degrees of parapharyngeal side-compressed narrowing, but MRI still exhibited the high-signal fat, and the oropharyngeal mucosa was intact. 25 cases were associated with the neck lymph node metastasis, among who 22 cases had no necrosis in the metastatic lymph nodes, while the rest 3 cases exhibited the central necrosis in the metastatic lymph nodes.
CONCLUSIONS
PET / CT and MRI have important value in diagnosing and determining the lesion extent of ONHL.
Topics: Adult; Aged; Cohort Studies; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Lymphoma, B-Cell; Lymphoma, Extranodal NK-T-Cell; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Neck; Necrosis; Oropharyngeal Neoplasms; Oropharynx; Positron-Emission Tomography; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 25921140
DOI: 10.7314/apjcp.2015.16.8.3333 -
PloS One 2016Extra-esophageal carcinogenesis has been widely discussed in relation to the chronic effects of laryngopharyngeal reflux and most prominently with pepsin historically...
BACKGROUND
Extra-esophageal carcinogenesis has been widely discussed in relation to the chronic effects of laryngopharyngeal reflux and most prominently with pepsin historically central to this discussion. With refluxate known to include gastric (pepsin) and duodenal (bile) fluids, we recently demonstrated the mechanistic role of NF-κB in mediating the preneoplastic effects of acidic-bile. However, the role of pepsin in promoting hypopharyngeal premalignant events remains historically unclear. Here, we investigate the in vitro effect of acidic-pepsin on the NF-κB oncogenic pathway to better define its potential role in hypopharyngeal neoplasia.
METHODS
Human hypopharyngeal primary cells (HHPC) and keratinocytes (HHK) were repetitively exposed to physiologic pepsin concentrations (0.1 mg/ml) at pH 4.0, 5.0 and 7.0. Cellular localization of phospho-NF-κB and bcl-2 was determined using immunofluorescence and western blotting. NF-κB transcriptional activity was tested by luc reporter and qPCR. Analysis of DNA content of pepsin treated HHK and HHPC was performed using Fluorescence-activated-cell sorting assay. To explore a possible dose related effect, pepsin concentration was reduced from 0.1 to 0.05 and 0.01 mg/ml.
RESULTS
At physiologic concentration, acidic-pepsin (0.1 mg/ml at pH 4.0) is lethal to most normal hypopharyngeal cells. However, in surviving cells, no NF-κB transcriptional activity is noted. Acidic-pepsin fails to activate the NF-κB or bcl-2, TNF-α, EGFR, STAT3, and wnt5α but increases the Tp53 mRNAs, in both HHPC and HHK. Weakly acidic-pepsin (pH 5.0) and neutral-pepsin (pH 7.0) induce mild activation of NF-κB with increase in TNF-α mRNAs, without oncogenic transcriptional activity. Lower concentrations of pepsin at varying pH do not produce NF-κB activity or transcriptional activation of the analyzed genes.
CONCLUSION
Our findings in vitro do not support the role of acidic-pepsin in NF-κB related hypopharyngeal carcinogenesis.
Topics: Bile; Carcinogenesis; Carcinoma; Cell Proliferation; Cell Survival; Esophageal Neoplasms; Flow Cytometry; Humans; Hydrogen-Ion Concentration; Hypopharynx; Inflammation; Keratinocytes; Microscopy, Fluorescence; Pepsin A; Phenotype; Phosphorylation; Precancerous Conditions; Signal Transduction; Transcription Factor RelA; Tumor Necrosis Factor-alpha
PubMed: 27973541
DOI: 10.1371/journal.pone.0168269 -
Journal of the American Society of... Apr 2017The TNF family member a proliferation-inducing ligand (APRIL; also known as TNFSF13), produced by myeloid cells, participates in the generation and survival of...
The TNF family member a proliferation-inducing ligand (APRIL; also known as TNFSF13), produced by myeloid cells, participates in the generation and survival of antibody-producing plasma cells. We studied the potential role of APRIL in the pathogenesis of IgA nephropathy (IgAN). We found that a significant proportion of germinal centers (GCs) in tonsils of patients with IgAN contained cells aberrantly producing APRIL, contributing to an overall upregulation of tonsillar APRIL expression compared with that in tonsils of control patients with tonsillitis. In IgAN GC, antigen-experienced IgDCD38CD19 B cells expressing a switched IgG/IgA B cell receptor produced APRIL. Notably, these GC B cells expressed mRNA encoding the common cleavable APRIL- but also, the less frequent APRIL-/ mRNA, which encodes a protein that lacks a furin cleavage site and is, thus, the uncleavable membrane-bound form. Significant correlation between TLR9 and APRIL expression levels existed in tonsils from patients with IgAN. , repeated TLR9 stimulation induced APRIL expression in tonsillar B cells from control patients with tonsillitis. Clinically, aberrant APRIL expression in tonsillar GC correlated with greater proteinuria, and patients with IgAN and aberrant APRIL overexpression in tonsillar GC responded well to tonsillectomy, with parallel decreases in serum levels of galactose-deficient IgA1. Taken together, our data indicate that antibody disorders in IgAN associate with TLR9-induced aberrant expression of APRIL in tonsillar GC B cells.
Topics: Adult; B-Lymphocytes; Female; Germinal Center; Glomerulonephritis, IGA; Humans; Male; Palatine Tonsil; Toll-Like Receptor 9; Tumor Necrosis Factor Ligand Superfamily Member 13
PubMed: 27920152
DOI: 10.1681/ASN.2016050496 -
Medicine Nov 2020Hyperthyroidism-related anterior circulation ischemic events have been well documented; however, posterior circulation infarction is rarely reported, not to mention with...
An extensive posterior circulation infarction secondary to primary hyperthyroidism accompanied with superior mesenteric artery syndrome: A case report and description of patho-physiological association.
INTRODUCTION
Hyperthyroidism-related anterior circulation ischemic events have been well documented; however, posterior circulation infarction is rarely reported, not to mention with superior mesenteric artery syndrome (SMAS), which has never been reported concurrently. We describe, to the best of our knowledge, the first case of hyperthyroidism-related cerebellar infarction accompanied with SMAS.
PATIENT CONCERNS
A 22-year-old women presented with palpitation, postprandial vomiting, and acute body weight loss. Enlarged thyroid gland was discovered in physical examination and Graves disease was diagnosed by blood test; therefore, Propylthiouracil and β-blocker were prescribed. Sudden onset conscious disturbance accompanied with apnea was noted during hospitalization.
DIAGNOSIS
Computed tomography (CT) revealed cerebellar infarction with severe cerebellar swelling and tonsil herniation; hence, emergent suboccipital craniotomy and bilateral tonsillectomy were performed.
INTERVENTIONS
Nevertheless, persisted poor passage of liquid diet during nasogastric tube feeding was noted after operation. CT of abdomen showed a sharp aorta-SMA angle (15°) and a short distance between aorta and SMA (6 mm) indicating a diagnosis of SMAS.
OUTCOMES
After parental nutrition supplement and progressive rehabilitation program, she recovered to a modified Rankin Scale of 3.
CONCLUSION
Although rarely reported, hyperthyroidism-related sympathetic hyperstimulation, vasculopathy could result in potentially deadly posterior circulation infarction. Furthermore, SMAS should be considered in the cases of hyperthyroidism with prolonged gastrointestinal symptoms even after treatment and should be treated simultaneously, since SMAS exacerbates depletion of intravascular volume. Further study to clarify the relation between hyperthyroidism and posterior circulation hemodynamic status is suggested.
Topics: Chest Pain; Craniotomy; Female; Humans; Hyperparathyroidism, Primary; Infarction; Palatine Tonsil; Paralysis; Superior Mesenteric Artery Syndrome; Tomography, X-Ray Computed; Vomiting; Young Adult
PubMed: 33181647
DOI: 10.1097/MD.0000000000022664