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ACS Omega Mar 2024The integration of low-dimensional nanomaterials with microscale architectures in flexible pressure sensors has garnered significant interest due to their outstanding...
The integration of low-dimensional nanomaterials with microscale architectures in flexible pressure sensors has garnered significant interest due to their outstanding performance in healthcare monitoring. However, achieving high sensitivity across different magnitudes of external pressure remains a critical challenge. Herein, we present a high-performance flexible pressure sensor crafted from biomimetic hibiscus flower microstructures coated with silver nanowires. When compared with a flat electrode, these microstructures as electrodes display significantly enhanced sensitivity and an extended stimulus-response range. Furthermore, we utilized an ionic gel film as the dielectric layer, resulting in an enhancement of the overall performance of the flexible pressure sensor through an increase in interfacial capacitance. Consequently, the capacitive pressure sensor exhibits an extraordinary ultrahigh sensitivity of 48.57 [Kpa] within the pressure range of 0-1 Kpa, 15.24 [Kpa] within the pressure range of 1-30 Kpa, and 3.74 [Kpa] within the pressure range of 30-120 Kpa, accompanied by a rapid response time (<58 ms). The exceptional performance of our flexible pressure sensor serves as a foundation for its numerous applications in healthcare monitoring. Notably, the flexible pressure sensor excels not only in detecting subtle physiological signals such as finger and wrist pulse signals, vocal cord vibrations, and breathing intensity but also demonstrates excellent performance in monitoring higher pressures, such as plantar pressure. We foresee that this flexible pressure sensor possesses significant potential in the field of wearable electronics.
PubMed: 38559999
DOI: 10.1021/acsomega.3c08044 -
Journal of Cancer Research and... Jan 2024Extramedullary plasmacytoma of the larynx is an extremely rare entity accounting for 0.04-0.45% of malignant tumours of the larynx. The objective of this clinical case...
Extramedullary plasmacytoma of the larynx is an extremely rare entity accounting for 0.04-0.45% of malignant tumours of the larynx. The objective of this clinical case report is to highlight the diagnosis and management of a unique case such as this. A 77-year-old gentleman presented with complaints of hoarseness for 1 year. Computed tomography image revealed a soft tissue mass lesion involving the right true vocal cord. Direct laryngoscopic biopsy was performed and subjected to histopathological examination, which showed collection of plasma cells. Immunohistochemistry confirmed the presence of Kappa and Lambda cells. Multiple myeloma (MM) was ruled out. The patient received radical intent radiation therapy using 3DCRT technique with a dose of 50Gy in 25# over 5 weeks. He experienced improvement in hoarseness on subsequent follow-up visits. At 1-year follow up, positron emission tomography computed tomography showed near total resolution of disease with no progression to MM. Radiation therapy alone is known to achieve good local control, recurrence free survival, and organ preservation in such cases.
Topics: Male; Humans; Aged; Plasmacytoma; Hoarseness; Laryngeal Neoplasms; Larynx; Vocal Cords; Multiple Myeloma
PubMed: 38554374
DOI: 10.4103/jcrt.JCRT_1640_20 -
Journal of Cancer Research and... Jan 2024Kaposi's sarcoma (KS) is an angiogenic tumor. KS lesions frequently develop in the skin and oral cavity mucosa in the head and neck regions, and pure laryngeal...
Kaposi's sarcoma (KS) is an angiogenic tumor. KS lesions frequently develop in the skin and oral cavity mucosa in the head and neck regions, and pure laryngeal localization is extremely rare. We reported a 64-year-old male patient without HIV, HBV, and HCV positivity presented with a hemangiomatous lesion detected incidentally in the right vocal cord. Biopsy was taken for histopathological and immunohistochemical evaluation. Examination revealed that spindle cells were of vascular origin and expressed HHV-8, a specific marker associated with Kaposi's sarcoma-associated herpesvirus. Positron emission tomography-computed tomography (PET/CT) demonstrated an increased fluorodeoxyglucose (FDG) uptake in the vocal cord. The patient was treated with a 30 Gy volumetric arc plan. Disease-free follow-up continues in the first year after low-dose definitive RT. This is the first case report of KS in the vocal cord in which the most detailed data about RT were shared.
Topics: Male; Humans; Middle Aged; Sarcoma, Kaposi; Vocal Cords; Positron Emission Tomography Computed Tomography; Herpesvirus 8, Human; Skin
PubMed: 38554367
DOI: 10.4103/jcrt.jcrt_226_22 -
Oral Oncology May 2024In clinical practice the assessment of the "vocal cord-arytenoid unit" (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal...
How reliable is assessment of true vocal cord-arytenoid unit mobility in patients affected by laryngeal cancer? a multi-institutional study on 366 patients from the ARYFIX collaborative group.
PURPOSE
In clinical practice the assessment of the "vocal cord-arytenoid unit" (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension.
METHODS
In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated.
RESULTS
Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal.
CONCLUSIONS
The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology.
Topics: Humans; Laryngeal Neoplasms; Male; Female; Middle Aged; Aged; Retrospective Studies; Vocal Cords; Adult; Reproducibility of Results; Aged, 80 and over; Laryngoscopy; Carcinoma, Squamous Cell
PubMed: 38520756
DOI: 10.1016/j.oraloncology.2024.106744 -
International Journal of Surgery Case... Apr 2024Capillary hemangioma of larynx can occur in both pediatric and adult population. However, epiglottic capillary hemangioma in adults is a very rare presentation. Its...
INTRODUCTION AND IMPORTANCE
Capillary hemangioma of larynx can occur in both pediatric and adult population. However, epiglottic capillary hemangioma in adults is a very rare presentation. Its pathophysiological basis involves self limiting and self expanding vascularization and it is a characteristically well delineated benign mass.
CASE PRESENTATION
Here we present a case of a 40-year-old female who presented with complaint of per oral bleed in spitting which was about a teaspoon in quantity since 1 month. There was no associated hoarseness, dysphagia, respiratory distress, hemoptysis or neck swelling. There were no other systemic manifestations i.e. weight loss, fatigue or anemia. There was no familial history.
CLINICAL DISCUSSION
On examination, Indirect Laryngoscopy (IDL) revealed a mass on the posterior surface of epiglottis. 70° view endoscope confirmed the findings of IDL. All other neighboring structures i.e. vocal cords, anterior and posterior commissures and pyriform fossa were normal and no mass or pathology was seen. Imaging studies contrast enhanced CT scan of neck soft tissue window showed isodense opacity in supraglottic region. Surgical excision and hemostasis were carried out using Colorado bipolar cauterization. The histopathological investigation of the mass revealed a benign lesion compatible with capillary hemangioma.
CONCLUSION
As until now, no case of capillary hemangioma of epiglottis has been reported, head and neck surgeons are not well aware of this case. This case report will add valuable insight to the relative surgeons/clinicians.
PubMed: 38518463
DOI: 10.1016/j.ijscr.2024.109564 -
Langenbeck's Archives of Surgery Mar 2024This study aimed to establish an in-vitro alternative to existing in-vivo systems to analyze nerve dysfunction using continuous neuromonitoring (C-IONM).
PURPOSE
This study aimed to establish an in-vitro alternative to existing in-vivo systems to analyze nerve dysfunction using continuous neuromonitoring (C-IONM).
METHODS
Three hundred sixty-three recurrent laryngeal nerves (RLN) (N = 304, N = 59) from food industry cadavers were exposed by microsurgical dissection following euthanasia. After rinsing with Ringer's lactate, they were tempered at 22 °C. Signal evaluation using C-IONM was performed for 10 min at 2 min intervals, and traction forces of up to 2N were applied for a median time of 60 s. Based on their post-traumatic electrophysiological response, RLNs were classified into four groups: Group A: Amplitude ≥ 100%, Group B: loss of function (LOS) 0-25%, Group C: ≥ 25-50%, and Group D: > 50%.
RESULTS
A viable in-vitro neuromonitoring system was established. The median post-traumatic amplitudes were 112%, 88%, 59%, and 9% in groups A, B, C, and D, respectively. A time-dependent further dynamic LOS was observed during the 10 min after cessation of strain. Surprisingly, following initial post-traumatic hyperconductivity, complete LOS occurred in up to 20% of the nerves in group A. The critical threshold for triggering LOS was 2N in all four groups, resulting in immediate paralysis of up to 51.4% of the nerves studied.
CONCLUSION
Consistent with in-vivo studies, RLN exhibit significant intrinsic electrophysiological variability in response to tensile forces. Moreover, nerve damage progresses even after the complete cessation of strain. Up to 20% of nerves with transiently increased post-traumatic amplitudes above 100% developed complete LOS, which we termed the "weepy cry." This time-delayed response must be considered during the interpretation of C-IONM signals.
Topics: Animals; Swine; Cattle; Thyroidectomy; Monitoring, Intraoperative; Recurrent Laryngeal Nerve; Vocal Cord Paralysis; Dissection
PubMed: 38514480
DOI: 10.1007/s00423-024-03240-z -
Brain & Spine 2024Vagus nerve stimulation (VNS) is the most frequently used neuromodulation treatment for Drug-Resistant Epilepsy (DRE) patients. Complications of VNS surgery include...
INTRODUCTION
Vagus nerve stimulation (VNS) is the most frequently used neuromodulation treatment for Drug-Resistant Epilepsy (DRE) patients. Complications of VNS surgery include surgical site infection and unilateral vocal cord paresis. Complication rates vary across studies.
RESEARCH QUESTION
What is the safety profile of VNS related surgeries?
MATERIALS AND METHODS
Retrospective cohort study using patient files of DRE-patients who had undergone primary implantation of a VNS-system, replacement of the VNS pulse generator, replacement of the lead, replacement of both pulse generator and lead, or VNS removal surgery in the Maastricht UMC+. Multiple Imputation was used for missing data. Univariable and multivariable logistic regression analysis were performed to analyze possible risk factors, in case of a small sample size, an independent-samples -test and Fisher's exact test or Pearson's X-test were used. The complication rate was calculated as percentage.
RESULTS
This study included a total of 606 VNS surgical procedures, leading to 67 complications of which 3 permanent complications. Complication rate after primary implantation was 13.4%; 2,5% for pulse generator replacement; 21.4% for lead revision and 27.3% for complete VNS removal. No statistically significant results were found when analyzing the results of adults and children <18 years separately.
DISCUSSION AND CONCLUSION
Complication rates of VNS-related surgeries in our own institutional series are low and comparable to previously reported series. VNS surgery is a relatively safe procedure. The complication rate differs per type of surgery and mean surgery duration was longer for patients with complications after lead revision surgery compared to patients without complications.
PubMed: 38510607
DOI: 10.1016/j.bas.2023.102733 -
Journal of Medical Case Reports Mar 2024Cystadenoma of the salivary glands is a rare benign clinical condition affecting both major and minor salivary glands equally. It constitutes approximately 2% of total...
BACKGROUND
Cystadenoma of the salivary glands is a rare benign clinical condition affecting both major and minor salivary glands equally. It constitutes approximately 2% of total neoplasms and 4.2-4.7% of benign formations in minor salivary glands. Typically presenting as a slow-growing, painless neoplasm, it can be distinguished from Cystadenolymphoma (Whartin's Tumor) by the absence of lymphoid elements in histological examination. While mostly located in the oral cavity and oropharynx, it can also be found in sinonasal mucosa, and rare cases have been identified in the larynx.
CASE PRESENTATION
A 75-year-old Caucasian woman presented to the ear, nose, and throat department with complaints of dysphonia and headaches persisting for several months. Dysphonia had developed months after an unspecified vocal cord surgery elsewhere. Flexible laryngoscopy identified a left-sided cystic swelling affecting the supraglottic space, leading to respiratory obstruction and dysphonia. Head and neck computed tomography confirmed a 1.9 × 1.7 cm bilobed cystic mass originating from the left Morgagni ventricle. Microlaryngoscopy with CO laser excision and biopsy revealed a histopathological diagnosis of oncocytic papillary cystadenoma. Post-surgery, the patient fully recovered from dysphonia, with no significant complications noted. Long-term clinical surveillance was advised to detect potential recurrences promptly.
CONCLUSION
Ectopic minor salivary gland tumors, both benign and malignant, should be taken into consideration as potential differential diagnosis for any swelling arising within the upper digestive tract mucosa. Ears, nose, and throat clinical examination completed by videolaryngoscopy can easily point out the location of the mass. Imaging is mandatory for differential diagnosis and for surgical planning. Surgical excision can provide both diagnosis and definitive cure.
Topics: Female; Humans; Aged; Cystadenoma, Papillary; Dysphonia; Salivary Glands; Salivary Gland Neoplasms; Larynx
PubMed: 38504337
DOI: 10.1186/s13256-024-04425-2 -
Fa Yi Xue Za Zhi Feb 2024
Topics: Humans; Vocal Cord Paralysis; Dysphonia
PubMed: 38500473
DOI: 10.12116/j.issn.1004-5619.2022.220306 -
Strahlentherapie Und Onkologie : Organ... May 2024This study aimed to assess the margin for the planning target volume (PTV) using the Van Herk formula. We then validated the proposed margin by real-time magnetic...
PURPOSE
This study aimed to assess the margin for the planning target volume (PTV) using the Van Herk formula. We then validated the proposed margin by real-time magnetic resonance imaging (MRI).
METHODS
An analysis of cone-beam computed tomography (CBCT) data from early glottic cancer patients was performed to evaluate organ motion. Deformed clinical target volumes (CTV) after rigid registration were acquired using the Velocity program (Varian Medical Systems, Palo Alto, CA, USA). Systematic (Σ) and random errors (σ) were evaluated. The margin for the PTV was defined as 2.5 Σ + 0.7 σ according to the Van Herk formula. To validate this margin, we accrued healthy volunteers. Sagittal real-time cine MRI was conducted using the ViewRay system (ViewRay Inc., Oakwood Village, OH, USA). Within the obtained sagittal images, the vocal cord was delineated. The movement of the vocal cord was summed up and considered as the internal target volume (ITV). We then assessed the degree of overlap between the ITV and the PTV (vocal cord plus margins) by calculating the volume overlap ratio, represented as (ITV∩PTV)/ITV.
RESULTS
CBCTs of 17 early glottic patients were analyzed. Σ and σ were 0.55 and 0.57 for left-right (LR), 0.70 and 0.60 for anterior-posterior (AP), and 1.84 and 1.04 for superior-inferior (SI), respectively. The calculated margin was 1.8 mm (LR), 2.2 mm (AP), and 5.3 mm (SI). Four healthy volunteers participated for validation. A margin of 3 mm (AP) and 5 mm (SI) was applied to the vocal cord as the PTV. The average volume overlap ratio between ITV and PTV was 0.92 (range 0.85-0.99) without swallowing and 0.77 (range 0.70-0.88) with swallowing.
CONCLUSION
By evaluating organ motion by using CBCT, the margin was 1.8 (LR), 2.2 (AP), and 5.3 mm (SI). The margin acquired using CBCT fitted well in real-time cine MRI. Given that swallowing during radiotherapy can result in a substantial displacement, it is crucial to consider strategies aimed at minimizing swallowing and related motion.
Topics: Humans; Cone-Beam Computed Tomography; Magnetic Resonance Imaging, Cine; Glottis; Male; Laryngeal Neoplasms; Middle Aged; Female; Adult; Aged; Organ Motion; Computer Systems; Radiotherapy Planning, Computer-Assisted; Reproducibility of Results; Sensitivity and Specificity
PubMed: 38488899
DOI: 10.1007/s00066-024-02204-y