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Immunity Aug 2021Lymphoid stromal cells (LSCs) are essential organizers of immune responses. We analyzed tonsillar tissue by combining flow cytometry, in situ imaging, RNA sequencing,...
Lymphoid stromal cells (LSCs) are essential organizers of immune responses. We analyzed tonsillar tissue by combining flow cytometry, in situ imaging, RNA sequencing, and functional assays, defining three distinct human LSC subsets. The integrin CD49a designated perivascular stromal cells exhibiting features of local committed LSC precursors and segregated cytokine and chemokine-producing fibroblastic reticular cells (FRCs) supporting B and T cell survival. The follicular dendritic cell transcriptional profile reflected active responses to B cell and non-B cell stimuli. We therefore examined the effect of B cell stimuli on LSCs in follicular lymphoma (FL). FL B cells interacted primarily with CD49a FRCs. Transcriptional analyses revealed LSC reprogramming in situ downstream of the cytokines tumor necrosis factor (TNF) and transforming growth factor β (TGF-β), including increased expression of the chemokines CCL19 and CCL21. Our findings define human LSC populations in healthy tissue and reveal bidirectional crosstalk between LSCs and malignant B cells that may present a targetable axis in lymphoma.
Topics: B-Lymphocytes; Cells, Cultured; Chemokine CCL19; Chemokine CCL21; Dendritic Cells; Humans; Integrin alpha1; Lymphoma, Follicular; Palatine Tonsil; Signal Transduction; Stromal Cells; Transforming Growth Factor beta1; Tumor Necrosis Factor-alpha
PubMed: 34166622
DOI: 10.1016/j.immuni.2021.05.019 -
Clinical Toxicology Sep 1971
Clinical Trial
Topics: Aged; Biopsy; Blood Sedimentation; Blood Urea Nitrogen; Carbon Dioxide; Clinical Trials as Topic; Esophagus; Female; Humans; Kidney; Kidney Diseases; Liver; Lung; Myocarditis; Myocardium; Necrosis; Oxygen Consumption; Paraquat; Pharynx; Prednisolone; Pulmonary Atelectasis; Stomach; Time Factors
PubMed: 4950586
DOI: 10.3109/15563657108990492 -
Supportive Care in Cancer : Official... Aug 2018
Topics: Head and Neck Neoplasms; Humans; Low-Level Light Therapy; Necrosis; Oropharynx; Radiation Injuries
PubMed: 29728844
DOI: 10.1007/s00520-018-4228-8 -
American Journal of Otolaryngology 2021The infrahyoid myocutaneous flap (IHMCF) is an often-overlooked flap of the anterior neck used for reconstruction of oral cavity and laryngopharyngeal defects. The...
INTRODUCTION
The infrahyoid myocutaneous flap (IHMCF) is an often-overlooked flap of the anterior neck used for reconstruction of oral cavity and laryngopharyngeal defects. The primary goal of this systematic review is to evaluate the postoperative outcomes and efficacy of this flap.
METHODS
A comprehensive search of PubMed, Biological Abstracts, CINAHL Plus, and Web of Science was conducted. Two researchers independently scrutinized the studies to determine inclusions based on relevance, sample size, and English language publications.
RESULTS
Twenty-eight studies containing 1027 IHMCF cases met the inclusion criteria. Primary outcomes included flap necrosis and postoperative functional outcomes. The rate of flap survival was 99%. Total skin necrosis and partial skin necrosis were minor complications that occurred in 2.5% and 5.8% of cases respectively. Poor speech and swallowing outcomes were reported in 6.4% and 6.5% of cases respectively. The included studies were predominantly retrospective. An average MINORS score of 9.6 suggests moderate bias among the studies.
CONCLUSIONS
The IHMCF is both safe and effective for repairing medium sized mucosal lesions of the head and neck region in carefully selected patients. IHMCF use in oral cavity reconstruction is particularly appealing although functional outcomes remain difficult to statistically assess. Complications of IHMCFs are rare and often minor. To ensure the best outcome, pre-surgical planning needs to be conducted and all contraindications should be respected. Further large prospective multi-centered trials are needed for more accurate analysis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Larynx; Male; Middle Aged; Mouth; Myocutaneous Flap; Otorhinolaryngologic Surgical Procedures; Patient Care Planning; Pharynx; Postoperative Complications; Prospective Studies; Plastic Surgery Procedures; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 34252712
DOI: 10.1016/j.amjoto.2021.103133 -
Anesthesiology Feb 2018
Review
Topics: Anesthesiology; Cicatrix; Endoscopy; Humans; Hypopharyngeal Neoplasms; Necrosis; Pharynx; Respiratory Tract Fistula; Trachea
PubMed: 28837434
DOI: 10.1097/ALN.0000000000001858 -
Endoscopy Jul 2002Uvular necrosis after endotracheal intubation or upper endoscopy is rare. We report here on a case of uvular necrosis and ulceration after endoscopy. The combination of... (Review)
Review
Uvular necrosis after endotracheal intubation or upper endoscopy is rare. We report here on a case of uvular necrosis and ulceration after endoscopy. The combination of ulceration and necrosis suggests uvular ischemia during endoscopy. The uvula may have been sandwiched between the shaft of the endoscope and the gum or hard palate, or may have been pressed against the posterior pharynx, leading to prolonged ischemia and resultant ulceration and necrosis. Uvular trauma can also be caused by oral pharyngeal suction. We recommend that post-endoscopy uvular necrosis should be managed conservatively based on the patient's symptoms. In all reported cases, and in the present case as well, the uvula healed and the symptoms resolved within 2 weeks (5 - 14 days) after the procedure. The uvula regained its normal appearance. Overall, these patients should have a good clinical outcome.
Topics: Endoscopy, Gastrointestinal; Humans; Ischemia; Male; Middle Aged; Necrosis; Ulcer; Uvula
PubMed: 12170416
DOI: 10.1055/s-2002-33208 -
The Surgical Clinics of North America Aug 1974
Topics: Body Fluids; Cephalothin; Esophageal Stenosis; Female; Hair; Humans; Ischemia; Male; Methods; Necrosis; Pharynx; Postoperative Complications; Skin; Skin Transplantation; Surgical Wound Infection; Sutures; Time Factors; Transplantation, Autologous
PubMed: 4610839
DOI: 10.1016/s0039-6109(16)40380-4 -
Clinical Otolaryngology and Allied... Oct 1981
Topics: Carcinoma, Squamous Cell; Cartilage Diseases; Emergencies; Fistula; Humans; Hypopharynx; Laryngeal Neoplasms; Laryngectomy; Neck Dissection; Necrosis; Pharyngeal Diseases; Postoperative Care; Radiation Injuries; Skin Diseases
PubMed: 7318230
DOI: 10.1111/j.1365-2273.1981.tb01810.x -
Surgery, Gynecology & Obstetrics Dec 1983From January 1975 through July 1981, ten patients with mediastinitis complicating an oropharyngeal infection, that is, a form of mediastinitis best termed as DNM, were...
From January 1975 through July 1981, ten patients with mediastinitis complicating an oropharyngeal infection, that is, a form of mediastinitis best termed as DNM, were encountered at our institution. Based upon rather relatively stringent diagnostic criteria, 21 other instances were found in the literature from 1960 to 1980, a time period well into the antibiotic era. The predominant underlying oropharyngeal infection was of odontogenic origin, specifically, infection involving the mandibular molars. Bacteriologically, DNM is most frequently a polymicrobial process, with anaerobes playing a major role. Although there has been a decline in the over-all incidence of DNM since the introduction of antibiotics, its morbid and lethal nature persists, as evidenced by the present prohibitive mortality of approximately 42 per cent. Delayed diagnosis and inadequate drainage procedures are the primary underlying factors contributing to this high mortality. At present, CT scan is the single most important tool for the early diagnosis of DNM. This noninvasive procedure also helps determine the adequacy of the surgical drainage procedure performed. However, with all the presently available diagnostic tools, it is still the high index of suspicion by physicians toward patients with unrelenting oropharyngeal or deep neck infection that is of utmost importance for making an early diagnosis of DNM. In view of our experience and that of others, we believe that only through aggressive combined medical and surgical management can the highly morbid, if not lethal, course of DNM be reversed. It should be emphasized that, to accomplish successful operative intervention, a thorough knowledge of the complex anatomy of the region is crucial.
Topics: Abscess; Adult; Anti-Bacterial Agents; Drainage; Female; Humans; Male; Mandible; Mandibular Diseases; Mediastinitis; Necrosis; Oropharynx; Pharyngeal Diseases; Tooth Extraction; Tracheotomy
PubMed: 6648776
DOI: No ID Found -
The Journal of Laryngology and Otology Oct 1999Lipomas of the parapharyngeal space provide both a diagnostic and therapeutic challenge. They are extremely rare with only a few cases having been reported. We present...
Lipomas of the parapharyngeal space provide both a diagnostic and therapeutic challenge. They are extremely rare with only a few cases having been reported. We present the case of a right parapharyngeal space lipoma in a 69-year-old man that was excised via a transcervical approach.
Topics: Aged; Coronary Artery Bypass; Head and Neck Neoplasms; Humans; Lipoma; Male; Myocardial Infarction; Pharynx; Tomography, X-Ray Computed
PubMed: 10664715
DOI: 10.1017/s0022215100145645