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Acta Otorhinolaryngologica Italica :... Jun 2020
Topics: Adult; Aged; Aged, 80 and over; Female; Free Tissue Flaps; Humans; Male; Middle Aged; Mouth; Myocutaneous Flap; Neck; Oropharynx; Plastic Surgery Procedures; Retrospective Studies; Superficial Musculoaponeurotic System
PubMed: 32773778
DOI: 10.14639/0392-100X-N0538 -
Circulation Aug 2020Supplemental Digital Content is available in the text.
Supplemental Digital Content is available in the text.
Topics: Adult; Antiviral Agents; Betacoronavirus; C-Reactive Protein; COVID-19; Cobicistat; Coronavirus Infections; Darunavir; Electrocardiography; Female; Humans; Hypokinesia; Hypotension; International Normalized Ratio; Myocardium; Nasopharynx; Pandemics; Platelet Count; Pneumonia, Viral; SARS-CoV-2; ST Elevation Myocardial Infarction; Thrombosis; Troponin I; Ventricular Dysfunction, Left
PubMed: 32677840
DOI: 10.1161/CIRCULATIONAHA.120.049294 -
Journal of Voice : Official Journal of... Jan 2022To assess the influence that several factors, such as the amount of obtained biopsies, difficult procedures, biopsy site and the experience of the attending physician,...
OBJECTIVES
To assess the influence that several factors, such as the amount of obtained biopsies, difficult procedures, biopsy site and the experience of the attending physician, have on accuracy of flexible endoscopic biopsy (FEB).
MATERIALS AND METHODS
203 FEB procedures for benign or malignant laryngopharyngeal lesions were prospectively included. During the procedure, three representative biopsies (macroscopically containing vital tumor tissue and not only necrosis or healthy tissue) were obtained. The accuracy of each biopsy was separately analyzed. Difficulties during the procedures leading to failure of acquiring three representative biopsies were recorded and classified into tumor, patient and procedural factors. Histological results of FEB were defined correct when consistent with clinical context, additional biopsies or Positron emission tomography-computed tomography (PET-CT) revealed equivalent pathology, or the lesion was stable or resolved in >6 months follow-up.
RESULTS
The first representative biopsy yielded a correct diagnosis in 65% of the cases. After the second representative biopsy, 78% was correctly diagnosed. The contribution of the third and fourth representative biopsies to accuracy was 3%. The overall accuracy of FEB was 85%. Difficult procedures were more likely to result in misdiagnosis, whereas biopsy site or experience of the attending physician did not influence results.
CONCLUSIONS
FEB was accurate in diagnosing laryngopharyngeal lesions when at least two representative biopsies were obtained. Accuracy of FEB could be further improved by limiting possible constraints during the procedures, for example by selecting, informing, and anesthetizing patients carefully.
Topics: Biopsy; Humans; Hypopharynx; Positron Emission Tomography Computed Tomography
PubMed: 32434679
DOI: 10.1016/j.jvoice.2020.04.015 -
The American Journal of Case Reports Apr 2020BACKGROUND The prevalence of aberrant internal carotid artery (ICA) is extremely low in the general population. It commonly occurs in the neck. Close proximity of the... (Review)
Review
BACKGROUND The prevalence of aberrant internal carotid artery (ICA) is extremely low in the general population. It commonly occurs in the neck. Close proximity of the pulsatile submucosal mass of the aberrant ICA to the nasopharyngeal wall is dangerous. The complications include severe or fatal hemorrhage resulting from a missed diagnosis before intervention in this area, including tonsillectomy, adenoidectomy, eustachian tube dilation, oropharynx biopsy or resection, tracheal intubation, and neck surgery. We report the case of a 66-year-old woman who had a pulsatile mass of the kinked ICA in close proximity to the lateral nasopharyngeal wall, and provide a review of the literature. CASE REPORT The patient presented to our Ear, Nose, and Throat Clinic with persistent cough with phlegm. Endoscopic examination revealed an abnormal pulsatile mass in the lateral nasopharyngeal wall. Subsequent contrast-enhanced computed tomography angiography confirmed the presence of unilateral acute maxillary sinusitis, and a high-grade kinked submucosal mass of the ICA in the ipsilateral nasopharyngeal wall, concomitant with stenosis of the left ICA and left middle cerebral artery occlusion. CONCLUSIONS Pulsating and extremely high-grade kinking of the ICA in the lateral nasopharyngeal wall is a particularly dangerous condition. Clinicians must always consider the possibility of hemorrhage during surgery, especially in older women with arteriosclerosis. Otolaryngologists should perform comprehensive visual examinations before deciding on surgery or other medical interventions in the neck, to prevent severe or fatal hemorrhage as far as possible.
Topics: Aged; Carotid Artery, Internal; Carotid Stenosis; Computed Tomography Angiography; Cough; Female; Humans; Infarction, Middle Cerebral Artery; Nasopharynx
PubMed: 32282788
DOI: 10.12659/AJCR.921967 -
Journal of Immunology (Baltimore, Md. :... May 2020The adaptive immune system of all jawed vertebrates relies on the presence of B and T cell lymphocytes that aggregate in specific body sites to form primary and...
The adaptive immune system of all jawed vertebrates relies on the presence of B and T cell lymphocytes that aggregate in specific body sites to form primary and secondary lymphoid structures. Secondary lymphoid organs include organized MALT (-MALT) such as the tonsils and Peyer patches. -MALT became progressively organized during vertebrate evolution, and the TNF superfamily of genes has been identified as essential for the formation and maintenance of -MALT and other secondary and tertiary lymphoid structures in mammals. Yet, the molecular drivers of -MALT structures found in ectotherms and birds remain essentially unknown. In this study, we provide evidence that TNFSFs, such as lymphotoxins, are likely not a universal mechanism to maintain -MALT structures in adulthood of teleost fish, sarcopterygian fish, or birds. Although a role for TNFSF2 (TNF-α) cannot be ruled out, transcriptomics suggest that maintenance of -MALT in nonmammalian vertebrates relies on expression of diverse genes with shared biological functions in neuronal signaling. Importantly, we identify that expression of many genes with olfactory function is a unique feature of mammalian Peyer patches but not the -MALT of birds or ectotherms. These results provide a new view of -MALT evolution in vertebrates and indicate that different genes with shared biological functions may have driven the formation of these lymphoid structures by a process of convergent evolution.
Topics: Adaptive Immunity; Animals; B-Lymphocytes; Biological Evolution; Immunity, Mucosal; Lymphoid Tissue; Mucous Membrane; Neural Conduction; Palatine Tonsil; Peyer's Patches; T-Lymphocytes; Transcriptome; Tumor Necrosis Factor-alpha; Tumor Necrosis Factors; Vertebrates
PubMed: 32238457
DOI: 10.4049/jimmunol.1901059 -
PloS One 2020Memory B cell (mBC) induction and maintenance is one of the keys to long-term protective humoral immunity. MBCs are fundamental to successful medical interventions such...
Human CD27+ memory B cells colonize a superficial follicular zone in the palatine tonsils with similarities to the spleen. A multicolor immunofluorescence study of lymphoid tissue.
BACKGROUND
Memory B cell (mBC) induction and maintenance is one of the keys to long-term protective humoral immunity. MBCs are fundamental to successful medical interventions such as vaccinations and therapy in autoimmunity. However, their lifestyle and anatomic residence remain enigmatic in humans. Extrapolation from animal studies serves as a conceptual basis but might be misleading due to major anatomical distinctions between species.
METHODS AND FINDINGS
Multicolor immunofluorescence stainings on fixed and unfixed frozen tissue sections were established using primary antibodies coupled to haptens and secondary signal amplification. The simultaneous detection of five different fluorescence signals enabled the localization and characterization of human CD27+CD20+Ki67- mBCs for the first time within one section using laser scanning microscopy. As a result, human tonsillar mBCs were initially identified within their complex microenvironment and their relative location to naïve B cells, plasma cells and T cells could be directly studied and compared to the human splenic mBC niche. In all investigated tonsils (n = 15), mBCs appeared to be not only located in a so far subepithelial defined area but were also follicle associated with a previous undescribed gradual decline towards the follicular mantle comparable to human spleen. However, mBC areas around secondary follicles with large germinal centers (GCs) in tonsils showed interruptions and a general widening towards the epithelium while in spleen the mBC-containing marginal zones (MZ) around smaller GCs were relatively broad and symmetrical. Considerably fewer IgM+IgD+/- pre-switch compared to IgA+ or IgG+ post-switch mBCs were detected in tonsils in contrast to spleen.
CONCLUSIONS
This study extends existing insights into the anatomic residence of human mBCs showing structural similarities of the superficial follicular area in human spleen and tonsil. Our data support the debate of renaming the human splenic MZ to 'superficial zone' in order to be aware of the differences in rodents and, moreover, to consider this term equally for the human palatine tonsil.
Topics: Adolescent; Adult; Aged; B-Lymphocytes; Cellular Microenvironment; Child; Germinal Center; Humans; Middle Aged; Palatine Tonsil; Spleen; Tumor Necrosis Factor Receptor Superfamily, Member 7
PubMed: 32187186
DOI: 10.1371/journal.pone.0229778 -
EBioMedicine Mar 2020Human immunology research is often limited to peripheral blood. However, there are important differences between blood immune cells and their counterparts residing in...
BACKGROUND
Human immunology research is often limited to peripheral blood. However, there are important differences between blood immune cells and their counterparts residing in secondary lymphoid organs, such as in the case of germinal center (GC) T follicular helper (Tfh) cells and GC B cells.
METHODS
We developed a versatile ex vivo lymphoid organ culture platform that is based on human pharyngeal tonsils (adenoids) and allows for drug testing. We systematically phenotyped Tfh and GC B cell subsets in explant- and suspension cultures using multicolor flow cytometry and cytokine multiplex analysis.
FINDINGS
Phenotypic changes of certain ex vivo cultured immune cell subsets could be modulated by cytokine addition. Furthermore, we optimized an activation-induced marker assay to evaluate the response to T cell stimulation. We provide proof-of-concept that Tfh and GC B cells could be modulated in these cultures by different anti-inflammatory drugs in unstimulated states and upon activation with vaccine-derived antigens. For example, GC B cells were lost upon CD40L blockade, and clinically approved JAK inhibitors impacted Tfh and GC B cells, including down-regulation of their key transcription factor BCL6. BCL6 regulation was affected by IL-6 signaling in T cells and IL-4 in B cells, respectively. Furthermore, we demonstrated that JAK signaling and TNF signaling contributed to the stimulation-induced activation of tonsil-derived T cells.
INTERPRETATION
Our optimized methods, assays, and mechanistic findings can contribute to a better understanding of human GC responses. These insights may be relevant for improving autoimmune disease therapy and vaccination efficacy.
FUNDING
This work was supported by a project grant under the joint research cooperation agreement of LMU Munich, LMU University Hospital, and Sanofi-Aventis Deutschland GmbH, as well as by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - Emmy Noether Programme BA 5132/1-1 and BA 5132/1-2 (252623821), SFB 1054 Project B12 (210592381), and SFB 914 Project B03 (165054336).
Topics: Adenoids; Anti-Inflammatory Agents; B-Lymphocytes; Cells, Cultured; Child; Child, Preschool; Germinal Center; Humans; Immunophenotyping; Interleukins; Janus Kinases; Proto-Oncogene Proteins c-bcl-6; T Follicular Helper Cells; Tissue Culture Techniques; Tumor Necrosis Factor-alpha
PubMed: 32114393
DOI: 10.1016/j.ebiom.2020.102684 -
FEBS Open Bio May 2020Adenoidal hypertrophy (AH) is a common disorder in the pediatric population, with common symptoms including mouth breathing, nasal congestion, hyponasal speech, snoring...
Adenoidal hypertrophy (AH) is a common disorder in the pediatric population, with common symptoms including mouth breathing, nasal congestion, hyponasal speech, snoring and obstructive sleep apnea. Although the pathogenesis of AH has not been fully elucidated, recent studies have indicated that immune responses may play an important role in AH. Tumor necrosis factor-alpha (TNF-α)-induced protein-8 like-2 (TIPE2) is a newly identified protein that negatively regulates the activation of inflammatory pathways. Here, we investigated the effect of TIPE2 in AH in children. We observed that the levels of TNF-α and interleukin-6 were greater in the adenoid tissue of AH children than in healthy control subjects (P < 0.01), and this increase was positively correlated with the severity of AH. The level of TIPE2 expression was decreased compared with control and was negatively correlated with AH. TIPE2 overexpression in primary human monocytes (isolated from adenoid tissue of children with AH) inhibited the activation of nuclear factor-κB and the expression of TNF-α and interleukin-6. These results suggest that overexpression of TIPE2 may attenuate AH through inactivation of the nuclear factor-κB signaling pathway.
Topics: Adenoids; Child; Child, Preschool; China; Female; Humans; Hypertrophy; Inflammation; Interleukin-6; Intracellular Signaling Peptides and Proteins; Male; Monocytes; RNA, Messenger; Signal Transduction; Tumor Necrosis Factor-alpha
PubMed: 32100476
DOI: 10.1002/2211-5463.12821 -
PloS One 2019Tonsil-derived mesenchymal stem cells (TMSC) have characteristics of MSC and have many advantages. In our previous studies, intraperitoneal (IP) injection of TMSC in...
Tonsil-derived mesenchymal stem cells (TMSC) have characteristics of MSC and have many advantages. In our previous studies, intraperitoneal (IP) injection of TMSC in acute and chronic colitis mouse models improved the disease activity index, colon length, and the expression levels of proinflammatory cytokines. However, TMSC were not observed to migrate to the inflammation site in the intestine. The aim of this study was to verify the therapeutic effect of conditioned medium (CM) released by TMSC (TMSC-CM) in a mouse model of dextran sulfate sodium (DSS)-induced chronic colitis. TMSC-CM was used after seeding 5×105 cells onto a 100 mm dish and culturing for 5-7 days. TMSC-CM was concentrated (TMSC-CM-conc) by three times using a 100 kDa cut-off centrifugal filter. Seven-week-old C57BL/6 mice were randomly assigned to the following 5 groups: 1) normal, 2) colitis, 3) TMSC, 4) TMSC-CM, and 5) TMSC-CM-conc. Chronic colitis was induced by continuous oral administration of 1.5% dextran sulfate sodium (DSS) for 5 days, followed by 5 additional days of tap water feeding. This cycle was repeated two more times (total 30 days). Phosphate buffered saline (in the colitis group), TMSC, TMSC-CM, and TMSC-CM-conc were injected via IP route 4, 4, 12, and 4 times, respectively. Reduction of disease activity index, weight gain, recovery of colon length, and decreased in the expression level of the proinflammatory cytokines, interleukin (IL)-1β, IL-6, and IL-17 were observed at day 30 in the treatment groups, compared to control. However, histological colitis scoring and the expression level of tumor necrosis factor α and IL-10 did not differ significantly between each group. TMSC-CM showed an equivalent effect to TMSC related to the improvement of inflammation in the chronic colitis mouse model. The data obtained support the use of TMSC-CM to treat inflammatory bowel disease without any cell transplantation.
Topics: Animals; Anti-Inflammatory Agents; Cell Proliferation; Chronic Disease; Colitis; Colon; Culture Media, Conditioned; Cytokines; Dextran Sulfate; Disease Models, Animal; Humans; Inflammation; Mesenchymal Stem Cells; Mice, Inbred C57BL; Palatine Tonsil; Protective Agents; Spleen
PubMed: 31790467
DOI: 10.1371/journal.pone.0225739 -
BMJ Case Reports Nov 2019Nasopharyngeal carcinoma (NPC), an uncommon malignancy in Western Countries and Radiotherapy, remains an effective treatment. Its side effects are classified as either...
Nasopharyngeal carcinoma (NPC), an uncommon malignancy in Western Countries and Radiotherapy, remains an effective treatment. Its side effects are classified as either immediate or late; postradiation necrosis is as an important late side effect with a strong impact on the prognosis in patients with NPC. We report the case of 65-year-old Caucasian man presenting with a deep necrotic ulcer of the nasopharynx and osteoradionecrosis of the skull base that appeared 3 months after radiotherapy for nasopharyngeal carcinoma. Conservative treatment was applied with surgical management of the ulcer. Clinical and radiological outcomes are presented. Radiotherapy remains a good treatment option with varying degrees of side effects, in particular, postradiation necrosis and ulcer. Multiple options of treatment have been described. However, the surgical management could be indicated in cases of deep ulcer with life-threatening prognosis.
Topics: Aged; Endoscopy; Humans; Male; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Osteoradionecrosis; Radiation Injuries; Skull Base; Treatment Outcome; Ulcer
PubMed: 31694827
DOI: 10.1136/bcr-2019-230700