-
Acta Leprologica 1978
Topics: Bone and Bones; Clofazimine; Humans; Larynx; Lepromin; Leprosy; Mucous Membrane; Mycobacterium leprae; Nasal Mucosa; Neuritis; Peripheral Nerves; Pharynx; Prognosis; Rifampin; Skin; Sulfones
PubMed: 104538
DOI: No ID Found -
International Journal of Radiation... Oct 2009To evaluate the relationship between C-reactive protein (CRP) levels or the erythrocyte sedimentation rate (ESR) and the grade of acute radiation-induced mucositis in...
PURPOSE
To evaluate the relationship between C-reactive protein (CRP) levels or the erythrocyte sedimentation rate (ESR) and the grade of acute radiation-induced mucositis in patients with head-and-neck cancer.
METHODS AND MATERIALS
This study was performed in 40 patients who received intensity-modulated radiation therapy as a radical treatment of primary laryngo-pharyngeal cancer. Serum CRP level and ESR were initially checked on the day of radiotherapy simulation and were measured every week during the irradiation schedule and two times biweekly after radiotherapy. Mucosal reactions were evaluated by radiation oncologists on days of blood sampling.
RESULTS
The distribution of the most severe mucositis was Grade I mucositis in 10% of the patients, Grade II in 60% of the patients and Grade III in 30% of the patients. Statistical analysis indicated a significant rise in the CRP level (p < 0.001) according to radiation fraction number and grade of mucositis. A change of the mean CRP level was correlated with progression of mean grade of mucositis according to fraction number. The ESR did not show any statistically significant relationship with radiotherapy fraction number and grade of acute mucositis.
CONCLUSIONS
There was a significant correlation between the presence of acute mucositis and CRP level in this study. The CRP level could be conveniently determined along with evaluation of mucosal reactions during or after radiotherapy to provide further information on radiation-induced mucositis.
Topics: Acute Disease; Aged; Biomarkers; Blood Sedimentation; C-Reactive Protein; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mouth Mucosa; Mucositis; Radiation Injuries; Radiotherapy, Intensity-Modulated
PubMed: 19362778
DOI: 10.1016/j.ijrobp.2008.11.012 -
Radiographics : a Review Publication of... Mar 1987This superbly illustrated article is an invaluable guide to the interpretation of double contrast pharyngograms.
This superbly illustrated article is an invaluable guide to the interpretation of double contrast pharyngograms.
Topics: Barium Sulfate; Humans; Mucous Membrane; Pharyngeal Diseases; Pharyngeal Neoplasms; Pharynx; Radiography
PubMed: 3448633
DOI: 10.1148/radiographics.7.2.3448633 -
The Journal of Laryngology and Otology Oct 2018Lipoid proteinosis is a rare autosomal recessive disorder caused by mutations in the extracellular matrix protein 1 gene. It is characterised by deposition of hyaline...
BACKGROUND
Lipoid proteinosis is a rare autosomal recessive disorder caused by mutations in the extracellular matrix protein 1 gene. It is characterised by deposition of hyaline material in the skin and mucous membranes. This paper describes the management of two cases with laryngopharyngeal disease.
METHODS
Two patients with a biopsy diagnosis of lipoid proteinosis were identified from the surgical pathology archive covering the period 2004-2016. Their notes were reviewed.
RESULTS
An adult male and an adult female were identified. Both had dysphonia and laryngopharyngeal lesions. The patients underwent interval laser microlaryngoscopy to debulk disease but minimise mucosal injury and scarring, using a 'pepper pot' technique. Both had adequate symptom control.
CONCLUSION
Lipoid proteinosis is a rare genetic condition, which typically presents in infancy with dysphonia and subsequent skin involvement. Two cases are presented to demonstrate that laryngotracheal symptoms can be controlled with interval laser debulking and the 'pepper pot' technique without causing stenosis.
Topics: Adult; Diagnosis, Differential; Dysphonia; Female; Hoarseness; Humans; Hyalin; Hypopharynx; Laryngoscopy; Laser Therapy; Lipoid Proteinosis of Urbach and Wiethe; Male; Middle Aged; Mucous Membrane; Treatment Outcome
PubMed: 30099970
DOI: 10.1017/S0022215118001329 -
European Archives of... Dec 2016The auditory tube plays a fundamental role in regulating middle ear pressure. A "system" sensitive to a pressure gradient between the middle ear and the ambient...
The auditory tube plays a fundamental role in regulating middle ear pressure. A "system" sensitive to a pressure gradient between the middle ear and the ambient environment is necessary. The presence of mechanoreceptors in the middle ear and the tympanic membrane has been studied, but the presence of these receptors in the nasopharyngeal region remains unclear. The aim of this study is to confirm the presence of pressure sensitive corpuscles in the nasopharynx. An experimental study was conducted on five fresh and unembalded human cadavers. The pharyngeal ostium of the auditory tube and its periphery was removed in one piece by video-assisted endonasal endoscopy. Samples were fixed in formaldehyde solution, embedded in paraffin, and cut. Slides were analyzed by HES (Hematoxyline Eosine Safran) coloration, by S100 protein and neurofilament protein immunostaining. Encapsulated nerve endings were researched and identified by slides analysis. Eight samples were included in our study. On seven samples, Ruffini corpuscles were identified in the mucosa of the posterior area of the pharyngeal ostium, with a higher concentration in the pharyngeal recess and in the posterior nasopharyngeal wall. Our study identified nasopharyngeal mechanoreceptors that could detect the nasopharyngeal pressure and, by extension, the atmospheric pressure. These findings support the theory of the neuronal reflex arc of isobaric system of the middle ear, based on the existence of a "system" sensitive to a pressure gradient between the middle ear and the ambient environment. Understanding of this system has been helpful in the diagnosis and management of middle ear diseases.
Topics: Aged, 80 and over; Cadaver; Eustachian Tube; Female; Humans; Male; Mechanoreceptors; Microscopy; Mucous Membrane; Nasopharynx
PubMed: 27164946
DOI: 10.1007/s00405-016-4069-3 -
Annals of Clinical Microbiology and... Feb 2022Protothecosis is a rare infection in humans and animals caused by the achlorophyllic algae Prototheca species. More than half of the protothecosis cases are cutaneous...
BACKGROUND
Protothecosis is a rare infection in humans and animals caused by the achlorophyllic algae Prototheca species. More than half of the protothecosis cases are cutaneous infections, and most cases are observed in immunocompromised individuals.
CASE PRESENTATION
We report a case of Prototheca wickerhamii infection in the mucosa of the pharynx in a 53-year-old immunocompetent woman with an incidentally found mass lesion at the left tongue base. Histopathological findings of the mass lesion suggested cryptococcosis, but P. wickerhamii was identified from the oropharynx scrape culture based on DNA sequencing. After surgical resection, fosfluconazole treatment was initiated, and subsequently, treatment was switched to topical amphotericin B. The residual mass lesion did not deteriorate during the 4-month antifungal treatment and 1-year observational period.
CONCLUSIONS
Prototheca species can be easily misdiagnosed as yeasts because of their morphological and pathological similarities. Prototheca, in addition to Cryptococcus should be considered if slow-growing, large Gram-positive organisms are encountered. Lactophenol cotton blue staining of the colony helps distinguish these organisms. Further study is needed to determine the appropriate treatment according to the infection focus.
Topics: Animals; Diagnosis, Differential; Female; Humans; Middle Aged; Mucous Membrane; Pharyngeal Neoplasms; Pharynx; Prototheca; Sequence Analysis, DNA; Skin; Skin Diseases, Infectious; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 35164794
DOI: 10.1186/s12941-022-00495-6 -
Surgical Endoscopy May 2024Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is...
INTRODUCTION
Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is important. However, detailed endoscopic observation of the entire pharyngeal mucosa under conscious sedation is difficult. We examined the usefulness of endoscopic surveillance with narrow band imaging (NBI) and lugol staining for detection of pharyngeal sublesions during ER for pharyngeal SCC under general anesthesia (endoscopic surveillance during treatment; ESDT).
METHODS
From January 2021 through June 2022, we examined 78 patients who were diagnosed with superficial pharyngeal SCC and underwent ER. They underwent the ESDT and for patients who were diagnosed with new lesions of pharyngeal SCC or high-grade dysplasia (HGD) that were not detected in the endoscopic examination before treatment, ER were performed simultaneously for new lesions and the main lesions. The primary endpoint of this study was the detection rate of new lesions of pharyngeal SCC or HGD in the ESDT.
RESULTS
Fifteen of the 78 patients were diagnosed as having undetected new pharyngeal lesions in the ESDT and 10 (12.8%) (95% CI 6.9-22.2%) were histopathologically confirmed to have new lesions of pharyngeal SCC or HGD. Among the 13 lesions of SCC or HGD, 8 were found by NBI observation; however, 5 were undetectable using NBI but detectable by lugol staining. All of the 13 lesions had endoscopic findings of pink color sign on lugol staining.
CONCLUSIONS
Endoscopic surveillance for pharyngeal sublesions during ER for pharyngeal SCC is feasible and useful.
Topics: Humans; Male; Female; Pharyngeal Neoplasms; Prospective Studies; Aged; Middle Aged; Narrow Band Imaging; Carcinoma, Squamous Cell; Mucous Membrane; Iodides; Aged, 80 and over; Endoscopic Mucosal Resection; Pharynx
PubMed: 38466423
DOI: 10.1007/s00464-024-10747-5 -
Journal of Biomechanics Apr 2018The development of innovative experimental approaches is necessary to gain insights in the complex biomechanics of swallowing. In particular, unraveling the mechanisms...
The development of innovative experimental approaches is necessary to gain insights in the complex biomechanics of swallowing. In particular, unraveling the mechanisms of formation of the thin film of bolus coating the pharyngeal mucosa after the ingestion of liquid or semi-liquid food products is an important challenge, with implication in dysphagia treatment and sensory perceptions. The aim here is to propose an original experimental model of swallowing (i) to simulate the peristaltic motions driving the bolus from the oral cavity to the esophagus, (ii) to mimic and vary complex physiological variables of the pharyngeal mucosa (lubrication, deformability and velocity) and (iii) to measure the thickness and the composition of the coatings resulting from bolus flow. Three Newtonian glucose solutions were considered as model food boli, through sets of experiments covering different ranges of each physiological parameter mimicked. The properties of the coatings (thickness and dilution in saliva film) were shown to depend significantly on the physical properties of food products considered (viscosity and density), but also on physiological variables such as lubrication by saliva, velocity of the peristaltic wave, and to a lesser extent, the deformability of the pharyngeal mucosa. The biomechanical peristalsis simulator developed here can contribute to unravel the determinants of bolus adhesion on pharyngeal mucosa, necessary both for the design of alternative food products for people affected by swallowing disorders, and for a better understanding of the dynamic mechanisms of aroma perception.
Topics: Deglutition; Food; Humans; Models, Biological; Mouth Mucosa; Peristalsis; Pharynx; Saliva; Viscosity
PubMed: 29559243
DOI: 10.1016/j.jbiomech.2018.03.006 -
Journal For Immunotherapy of Cancer Mar 2018Pembrolizumab is an anti-programmed death 1 (PD-1) receptor monoclonal antibody that has shown activity as second line treatment for metastatic head and neck squamous...
BACKGROUND
Pembrolizumab is an anti-programmed death 1 (PD-1) receptor monoclonal antibody that has shown activity as second line treatment for metastatic head and neck squamous cell carcinoma (HNSCC). Immune-related adverse events are now well described complications of PD-1 inhibitors and most organ sites have been shown to be potentially affected.
CASE PRESENTATION
We describe a 69-year old patient with a relapsed squamous cell carcinoma of the supraglottic larynx with lung metastasis after receiving adjuvant concurrent cisplatin and radiotherapy. This patient was treated with pembrolizumab and benefitted from therapy with major radiological improvement of disease. After 14 cycles of pembrolizumab 200 mg IV each 3 weeks, he experienced dysphagia that evolved to a grade 4 oral cavity and pharynx mucositis and esophagitis. Histologic analysis showed ulcerative esophagitis associated with granulation tissue. Pembrolizumab was discontinued and IV methylprednisolone 2 mg/kg/day was initiated. Two days later, the patient reported a 50% recovery in his symptoms which were completely resolved after 2 weeks. Methylprednisolone was switched to oral prednisone and a taper was planned over 8 weeks. During the fourth week of taper, the patient presented recurrence of grade 1 oral mucositis. Prednisone was increased 2 mg/kg/day for 2 weeks followed by slower tapering over a period of 5 months. Pembrolizumab was not reinitiated.
CONCLUSION
This is the first described case of grade 4 immune mucositis and esophagitis associated with pembrolizumab. Because the use of pembrolizumab is increasing in oncology, pharmacists and physicians should be aware of this rare manifestation.
Topics: Aged; Anti-Inflammatory Agents; Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; Esophageal Mucosa; Glucocorticoids; Head and Neck Neoplasms; Humans; Larynx; Male; Mouth Mucosa; Mucositis; Prednisone; Programmed Cell Death 1 Receptor; Squamous Cell Carcinoma of Head and Neck
PubMed: 29548299
DOI: 10.1186/s40425-018-0332-z -
Applied and Environmental Microbiology Jun 2010The research described here was aimed at the selection of oral bacteria that displayed properties compatible with their potential use as probiotics for the pharyngeal... (Comparative Study)
Comparative Study
The research described here was aimed at the selection of oral bacteria that displayed properties compatible with their potential use as probiotics for the pharyngeal mucosa. We included in the study 56 bacteria newly isolated from the pharynges of healthy donors, which were identified at the intraspecies level and characterized in vitro for their probiotic potential. The experiments led us to select two potential probiotic bacterial strains (Streptococcus salivarius RS1 and ST3) and to compare them with the prototype oral probiotic S. salivarius strain K12. All three strains efficiently bound to FaDu human epithelial pharyngeal cells and thereby antagonized Streptococcus pyogenes adhesion and growth. All were sensitive to a variety of antibiotics routinely used for the control of upper respiratory tract infections. Immunological in vitro testing on a FaDu layer revealed different responses to RS1, ST3, and K12. RS1 and ST3 modulated NF-kappaB activation and biased proinflammatory cytokines at baseline and after interleukin-1beta (IL-1beta) induction. In conclusion, we suggest that the selected commensal streptococci represent potential pharyngeal probiotic candidates. They could display a good degree of adaptation to the host and possess potential immunomodulatory and anti-inflammatory properties.
Topics: Anti-Bacterial Agents; Antibiosis; Bacterial Adhesion; Bacterial Typing Techniques; Cluster Analysis; Cytokines; DNA Fingerprinting; Epithelial Cells; Humans; Microbial Sensitivity Tests; Mucous Membrane; NF-kappa B; Pharynx; Probiotics; Random Amplified Polymorphic DNA Technique; Streptococcus; United States
PubMed: 20418429
DOI: 10.1128/AEM.00109-10