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Journal of Biomedical Optics Aug 2023The vocal folds are critically important structures within the larynx which serve the essential functions of supporting the airway, preventing aspiration, and phonation....
SIGNIFICANCE
The vocal folds are critically important structures within the larynx which serve the essential functions of supporting the airway, preventing aspiration, and phonation. The vocal fold mucosa has a unique multilayered architecture whose layers have discrete viscoelastic properties facilitating sound production. Perturbations in these properties lead to voice loss. Currently, vocal fold pliability is inferred clinically using laryngeal videostroboscopy and no tools are available for objective assessment.
AIM
The main objective of the present study is to evaluate viability of Brillouin microspectroscopy for differentiating vocal folds' mechanical properties against surrounding tissues.
APPROACH
We used Brillouin microspectroscopy as an emerging optical imaging modality capable of providing information about local viscoelastic properties of tissues in noninvasive and remote manner.
RESULTS
Brillouin measurements of the porcine larynx vocal folds were performed. Elasticity-driven Brillouin spectral shifts were recorded and analyzed. Elastic properties, as assessed by Brillouin spectroscopy, strongly correlate with those acquired using classical elasticity measurements.
CONCLUSIONS
These results demonstrate the feasibility of Brillouin spectroscopy for vocal fold imaging. With more extensive research, this technique may provide noninvasive objective assessment of vocal fold mucosal pliability toward objective diagnoses and more targeted treatments.
Topics: Animals; Swine; Vocal Cords; Larynx; Phonation; Elasticity; Spectrum Analysis
PubMed: 37560326
DOI: 10.1117/1.JBO.28.8.087002 -
Proceedings of the National Academy of... Aug 2023Electronic detection of DNA oligomers offers the promise of rapid, miniaturized DNA analysis across various biotechnological applications. However, known all-electrical...
Electronic detection of DNA oligomers offers the promise of rapid, miniaturized DNA analysis across various biotechnological applications. However, known all-electrical methods, which solely rely on measuring electrical signals in transducers during probe-target DNA hybridization, are prone to nonspecific electrostatic and electrochemical interactions, subsequently limiting their specificity and detection limit. Here, we demonstrate a nanomechanoelectrical approach that delivers ultra-robust specificity and a 100-fold improvement in detection limit. We drive nanostructural DNA strands tethered to a graphene transistor to oscillate in an alternating electric field and show that the transistor-current spectra are characteristic and indicative of DNA hybridization. We find that the inherent difference in pliability between unpaired and paired DNA strands leads to the spectral characteristics with minimal influence from nonspecific electrostatic and electrochemical interactions, resulting in high selectivity and sensitivity. Our results highlight the potential of high-performance DNA analysis based on miniaturized all-electronic settings.
Topics: DNA; Nucleic Acid Hybridization; DNA Probes; Graphite; Hybridization, Genetic; Biosensing Techniques
PubMed: 37549255
DOI: 10.1073/pnas.2306130120 -
Journal of Plastic, Reconstructive &... Oct 2023To date, few comparative studies exist for partial hypopharyngeal defect reconstruction following total laryngectomy. In the absence of objective evidence from...
BACKGROUND
To date, few comparative studies exist for partial hypopharyngeal defect reconstruction following total laryngectomy. In the absence of objective evidence from comparative studies, the ideal flap choice remains controversial, leading to heterogeneity in institutional treatment protocols. Comparative studies between different reconstructive techniques are required. Therefore, this study compared postoperative outcomes of pectoralis major myocutaneous (PMMC) and myofascial (PMMF) flaps.
METHODS
A single-center retrospective cohort study was performed between 2000 and 2022, which included all consecutive patients who underwent a PMMC or PMMF flap reconstruction following total laryngectomy and partial hypopharyngectomy. Primary outcomes were suture line leakages (conservative management), fistulas (surgical management), and strictures. Secondary outcomes included flap failure, donor-site morbidity, and the start of oral intake.
RESULTS
In total, 122 patients were included (109 PMMC and 13 PMMF flap reconstructions). The incidence of suture line leakage was significantly higher (p = 0.007) after PMMC flaps (57%) compared with PMMF flaps (15%). Between PMMC and PMMF flaps, fistula (19% vs. 0%) and stricture rates (22% vs. 15%) did not differ significantly. No differences in flap failure, donor-site morbidity, or start of oral intake were observed.
CONCLUSIONS
PMMF flaps have inherent advantages (e.g., reduced bulk, increased pliability) over conventional PMMC flaps and have non-inferior results compared to the latter in terms of postoperative complications. Although the final choice for reconstruction should be patient-tailored, a PMMF flap can be considered a reliable primary choice that is feasible in most patients.
Topics: Humans; Myocutaneous Flap; Laryngectomy; Pectoralis Muscles; Retrospective Studies; Postoperative Complications; Fistula
PubMed: 37459670
DOI: 10.1016/j.bjps.2023.06.050 -
Frontiers in Cardiovascular Medicine 2023Calcific aortic valve disease (CAVD) is the most frequent valvular heart disorder, and the one with the highest impact and burden in the elderly population. While the... (Review)
Review
Calcific aortic valve disease (CAVD) is the most frequent valvular heart disorder, and the one with the highest impact and burden in the elderly population. While the quality and standardization of the current aortic valve replacements has reached unprecedented levels with the commercialization of minimally-invasive implants and the design of procedures for valve repair, the need of supplementary therapies able to block or retard the course of the pathology before patients need the intervention is still awaited. In this contribution, we will discuss the emerging opportunity to set up devices to mechanically rupture the calcium deposits accumulating in the aortic valve and restore, at least in part, the pliability and the mechanical function of the calcified leaflets. Starting from the evidences gained by mechanical decalcification of coronary arteries in interventional cardiology procedures, a practice already in the clinical setting, we will discuss the advantages and the potential drawbacks of valve lithotripsy devices and their potential applicability in the clinical scenario.
PubMed: 37113704
DOI: 10.3389/fcvm.2023.1160833 -
Journal of Lasers in Medical Sciences 2023Keloid scars and hypertrophic scars are more commonly seen after surgeries, suture placements, or other skin damages. Scars can be treated using a variety of methods,...
Keloid scars and hypertrophic scars are more commonly seen after surgeries, suture placements, or other skin damages. Scars can be treated using a variety of methods, including topical compounds, surgery, and lasers. The aim of this study is to evaluate the effects of plasma exeresis on the treatment of keloid scars. This experimental study was conducted on patients with keloid scars, defined as a treatment-resistant subtype of scars with extension beyond the primary skin defect and cauliflower appearance, in different parts of the body. The patients were treated with 2-to-3-session plasma exeresis. Scars were examined based on the Vancouver scar scale (VSS) before and 5 months after the treatment. A total number of 24 scars were enrolled in this study. The number of patients was 16. There was a decrease in the mean thickness of keloids from 2.20 to 0.54 (=0.000). The mean pigmentation and pliability scores decreased from 1.54 and 2.16 to 0.375 and 0.541, respectively (=0.001, 000). There was a significant reduction in the keloid scar vascularity score from 1.666 to 0.541 (=0.000). There was a decrease from 0.708 to 0.00 (=0.004) in the mean itchiness score. After the intervention, the mean pain score was 0.000, compared to 0.7500 before the intervention (=0.003). There was a decrease in the total score from 8.958 to 2.000 (=0.000). The plasma exeresis procedure is effective in destroying small keloid scars. Furthermore, results in less itching and pain, as well as no significant complications or recurrences.
PubMed: 37089764
DOI: 10.34172/jlms.2023.07 -
Annals of Plastic Surgery Apr 2023As we all know, the numbers of aesthetic surgery are increasing around the world. After the surgery, the scar would be a problematic issue for both the surgeons and the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
As we all know, the numbers of aesthetic surgery are increasing around the world. After the surgery, the scar would be a problematic issue for both the surgeons and the patients. Silicone has proven to be effective for keloids, hypertrophic scars, and prevention of scar formation in many literatures for a long time. In terms of scar prevention, silicone has been used in the form of silicone sheets in early times, which is later improved to be the form of silicone gel with the advantage of easier usage. Although silicone gel has improved greatly in the aspect of appearance and convenience of the silicone sheets, there are still some disadvantages of the gel form. Therefore, the LeniScar silicone stick (AnsCare) is invented.
OBJECTIVE
This article aimed to compare the results of scar treatment and prevention of the AnsCare LeniScar Silicone Stick versus the traditional silicone gel (Dermatix Ultra).
METHODS
This study was a prospective, nonblinded, randomized clinical study. There were a total of 68 patients from September 2018 to January 2020. Patients were divided into 2 groups with AnsCare (n = 43) and Dermatix (n = 25), who both were required to schedule regular outpatient clinic follow-up, and photographs were taken before use, 1, 2, and 3 months later after the usage for the record. The physician assessed the scar condition by the Vancouver Scar Scale (VSS). The scores of the VSS were further analyzed and compared.
RESULTS
The overall P value of total score of VSS was 0.635, which indicates that there is no significant difference in using AnsCare LeniScar Silicone Stick versus Dermatix Ultra silicone gel in terms of scar prevention and treatment. Individual items of VSS such as pliability, height, vascularity, and pigmentation all show no significant statistical difference in the 2 treatment products, with P = 0.980, 0.778, 0.528, and 0.366, respectively.
CONCLUSION
Traditional Dermatix Ultra silicone gel has been effective in the treatment of scar formation. AnsCare LeniScar Silicone Stick is statistically not different from the Dermatix Ultra silicone gel when comparing the treatment results of scar prevention. Furthermore, the AnsCare LeniScar Silicone Stick has the advantages of being time-saving with no need to wait for it to dry and application of precise amount to precise location, preventing waste or overuse.
Topics: Humans; Silicone Gels; Prospective Studies; Cicatrix, Hypertrophic; Keloid; Treatment Outcome
PubMed: 37075300
DOI: 10.1097/SAP.0000000000003393 -
The Journal of Dermatological Treatment Dec 2023Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO fractional... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy and safety of ablative CO fractional laser and narrowband intense pulsed light for the treatment of hypertrophic scars: a prospective, randomized controlled trial.
BACKGROUND AND OBJECTIVES
Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO fractional laser and narrowband intense pulsed light (IPL) compared to IPL alone in the treatment of hypertrophic scars.
MATERIALS AND METHODS
This was a prospective, randomized controlled study enrolled 138 patients with hypertrophic scars. The participants were randomly divided into two groups: CO-IPL and IPL group, and received three sessions at 10-14-week intervals for 3-month follow-up. Two independent plastic surgeons evaluated the treatments using the Patient and Observer Scar Assessment Scales (POSAS). Overall satisfaction was evaluated using the Patient Satisfaction Scale (PSS).
RESULTS
101 subjects completed the study. Compared to single IPL, the combination CO-IPL group showed a significant improvement in itching, color, stiffness, thickness, and irregularity, except for pain, and an enhancement in vascularization, pigmentation, thickness, relief, and pliability of the scar, assessed by POSAS ( < .01). 100% patients in the combination group were satisfied compared to 84% in IPL alone.
CONCLUSION
The combination of CO fractional laser and narrowband IPL efficiently improved the appearance and profile of hypertrophic scars, offering a comprehensive and reliable approach for scar therapy.
Topics: Humans; Cicatrix, Hypertrophic; Cicatrix; Carbon Dioxide; Treatment Outcome; Prospective Studies; Lasers, Gas
PubMed: 37070799
DOI: 10.1080/09546634.2023.2202287 -
Journal of Maxillofacial and Oral... Mar 2023Surgical defects in temporo-parieto-frontal region are challenging to reconstruct (Ransom in Arch Facial Plast Surg, 2012. 10.1001/archfacial.2012.7). The size and site...
Surgical defects in temporo-parieto-frontal region are challenging to reconstruct (Ransom in Arch Facial Plast Surg, 2012. 10.1001/archfacial.2012.7). The size and site of the defect determines its mode of reconstruction (Ransom in Arch Facial Plast Surg, 2012. 10.1001/archfacial.2012.7). A 60-year-old lady presented with basal cell carcinoma (BCC) over the skin of the right temporal region. She underwent wide excision of the lesion resulting in a moderate sized skin and soft tissue defect. Reconstruction of the defect was challenging owing to the size not amenable for primary closure, lack of pliability of adjoining soft tissue and proximity to structures of aesthetic significance. In order to achieve a functional and aesthetic reconstruction, a modified Orticochea three-flap reconstruction technique was used. This case report describes in detail the surgical procedure and outcome.
PubMed: 37041954
DOI: 10.1007/s12663-022-01825-z -
Journal of Maxillofacial and Oral... Mar 2023Secondary reconstruction is requested by patients who have completed their head and neck cancer treatment. The reason for the request for reconstruction may be to... (Review)
Review
OBJECTIVE
Secondary reconstruction is requested by patients who have completed their head and neck cancer treatment. The reason for the request for reconstruction may be to improve the functional deficits, achieve aesthetic refinements or most commonly both. The article looks at various issues related to reconstruction in the secondary setting and suggesting the ways to approaching patients requesting secondary reconstruction.
DISCUSSION
While considering secondary reconstruction, various factors need to be considered. These include issues related to the disease, the treatment received as well as the patient's comorbid conditions. Aggressive disease and multiple recurrences should deter from undertaking complex reconstructions. Lack of tissue pliability resulting in a woody neck due to radiation makes dissection difficult and wound healing poor. The reconstructive requirements include release of contractures inside the mouth, reconstruction of the missing jaws, replacement of the missing volume of the tongue and correction of the incompetent angle of mouth. Goals of reconstruction should be prioritized by the surgical team. Free soft tissue or bone containing flaps would be provided ideal tissue to meet the reconstructive requirements in secondary reconstruction. However, several impediments could exist for their safe use. Release of contractures and provision of adequate soft tissue should be given priority and must be addressed before bony reconstruction is contemplated.
CONCLUSION
Bony reconstruction of both mandible and maxilla is possible, with the former being more difficult to deliver good results due to the associated soft tissue fibrosis. Virtual surgical planning with the aid of Stereo lithographic models and planning software will improve the quality of bony reconstruction. Detailed counseling sessions involving patient and the family are essential before embarking on secondary reconstruction as the patient expectations and the surgical outcome may not be easy to match. However excellent improvement in function and appearance will be possible in many patients with appropriate reconstructive procedure.
PubMed: 37041953
DOI: 10.1007/s12663-023-01875-x -
Skin Research and Technology : Official... Mar 2023The skin is a protective barrier of the body against external factors, and its damage leads to a loss of integrity. Normal wound healing results in a correct, flat,...
BACKGROUND
The skin is a protective barrier of the body against external factors, and its damage leads to a loss of integrity. Normal wound healing results in a correct, flat, bright, and flexible scar. Initial skin damage and patient specific factors in wound healing contribute that many of these scars may progress into widespread or pathologic hypertrophic and keloid scars. The changes in cosmetic appearance, continuing pain, and loss of movement due to contracture or adhesion and persistent pruritis can significantly affect an individual's quality of life and psychological recovery post injury. Many different treatment methods can reduce the trauma and surgical scars. Manual scar treatment includes various techniques of therapy. The most effectiveness is a combined therapy, which has a multidirectional impact. Clinical observations show an effectiveness of manual scar therapy.
MATERIAL AND METHODS
The aim of this work was to evaluate effectiveness of the scar manual therapy combined with complementary methods on the postoperative scars. Treatment protocol included two therapies during 30 min per week for 8 weeks. Therapy included manual scar manipulation, massage, cupping, dry needling, and taping.
RESULTS
Treatment had a significant positive effect to influence pain, pigmentation, pliability, pruritus, surface area, and scar stiffness. Improvement of skin parameters (scar elasticity, thickness, regularity, color) was also noticed.
CONCLUSION
To investigate the most effective manual therapy strategy, further studies are needed, evaluating comparisons of different individual and combined scar therapy modalities.
Topics: Humans; Cicatrix, Hypertrophic; Keloid; Pain; Pruritus; Quality of Life; Cicatrix; Wound Healing; Therapy, Soft Tissue; Cupping Therapy; Complementary Therapies; Dry Needling
PubMed: 36973982
DOI: 10.1111/srt.13272