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Development (Cambridge, England) Sep 2019Developmental defects affecting the heart and aortic arch arteries are a significant phenotype observed in individuals with 22q11 deletion syndrome and are caused by a...
Developmental defects affecting the heart and aortic arch arteries are a significant phenotype observed in individuals with 22q11 deletion syndrome and are caused by a microdeletion on chromosome 22q11. , one of the deleted genes, is expressed throughout the pharyngeal arches and is considered a key gene, when mutated, for the arch artery defects. is expressed in the pharyngeal endoderm and is downregulated in mutant mice. We show here that -deficient mice are born with complex cardiovascular malformations that affect the outflow tract and aortic arch arteries with failure of the 3rd and 4th pharyngeal arch arteries to form correctly. Transcriptome analysis indicated that and may function together, and mice double heterozygous for / presented with a significantly increased incidence of interrupted aortic arch when compared with heterozygous mice. Using a novel allele, we demonstrated that the site of this genetic interaction is the pharyngeal endoderm, therefore revealing that a --controlled signalling mechanism emanating from the pharyngeal endoderm is required for crucial tissue interactions during normal morphogenesis of the pharyngeal arch artery system.
Topics: Animals; Arteries; Branchial Region; Cardiovascular System; Cell Differentiation; Embryo, Mammalian; Endoderm; Gene Deletion; Gene Regulatory Networks; Heterozygote; Mice, Inbred C57BL; Models, Biological; Morphogenesis; Mutation; Neural Crest; PAX9 Transcription Factor; Pharynx; Protein Binding; Signal Transduction; T-Box Domain Proteins
PubMed: 31444215
DOI: 10.1242/dev.177618 -
Science Advances Mar 2024The pharyngeal endoderm, an innovation of deuterostome ancestors, contributes to pharyngeal development by influencing the patterning and differentiation of pharyngeal...
The pharyngeal endoderm, an innovation of deuterostome ancestors, contributes to pharyngeal development by influencing the patterning and differentiation of pharyngeal structures in vertebrates; however, the evolutionary origin of the pharyngeal organs in vertebrates is largely unknown. The endostyle, a distinct pharyngeal organ exclusively present in basal chordates, represents a good model for understanding pharyngeal organ origins. Using Stereo-seq and single-cell RNA sequencing, we constructed aspatially resolved single-cell atlas for the endostyle of the ascidian . We determined the cell composition of the hemolymphoid region, which illuminates a mixed ancestral structure for the blood and lymphoid system. In addition, we discovered a cluster of hair cell-like cells in zone 3, which has transcriptomic similarity with the hair cells of the vertebrate acoustico-lateralis system. These findings reshape our understanding of the pharynx of the basal chordate and provide insights into the evolutionary origin of multiplexed pharyngeal organs.
Topics: Animals; Urochordata; Pharynx; Vertebrates; Biological Evolution; Cell Differentiation
PubMed: 38552007
DOI: 10.1126/sciadv.adi9035 -
Anesthesiology Jun 2015Drugs used for sedation in anesthesia and intensive care may cause pharyngeal dysfunction and increased risk for aspiration. In this study, the authors investigate the...
BACKGROUND
Drugs used for sedation in anesthesia and intensive care may cause pharyngeal dysfunction and increased risk for aspiration. In this study, the authors investigate the impact of sedative doses of morphine and midazolam on pharyngeal function during swallowing and coordination of breathing and swallowing.
METHODS
Pharyngeal function, coordination of breathing and swallowing, and level of sedation were assessed by manometry, videoradiography, measurements of respiratory airflow, and a visual analog scale in 32 healthy volunteers (age 19 to 35 yr). After baseline recordings, morphine (0.1 mg/kg) or midazolam (0.05 mg/kg) was administered intravenously for 20 min, followed by recordings at 10 and 30 min after the end of infusion.
RESULTS
Pharyngeal dysfunction, seen as misdirected or incomplete swallowing or penetration of bolus to the airway, increased after morphine infusion to 42 and 44% of swallows compared with 17% in baseline recordings. Midazolam markedly increased incidence of pharyngeal dysfunction from 16 to 48% and 59%. Morphine prolonged apnea before swallowing, and midazolam increased the number of swallows followed by inspiration.
CONCLUSION
Morphine and midazolam in dosages that produce sedation are associated with increased incidence of pharyngeal dysfunction and discoordinated breathing and swallowing, a combination impairing airway protection and potentially increasing the risk for pulmonary aspirations.
Topics: Adult; Airway Management; Analgesics, Opioid; Biomechanical Phenomena; Conscious Sedation; Deglutition; Female; Humans; Hypnotics and Sedatives; Male; Midazolam; Morphine; Pharynx; Pulmonary Ventilation; Radiography; Respiration; Video Recording; Young Adult
PubMed: 25853450
DOI: 10.1097/ALN.0000000000000657 -
Allergy Apr 2016The objective of the study was to compare nasal, pharyngeal, and sputum eosinophil peroxidase (EPX) levels with induced sputum eosinophil percentage in 10 adults with...
The objective of the study was to compare nasal, pharyngeal, and sputum eosinophil peroxidase (EPX) levels with induced sputum eosinophil percentage in 10 adults with poorly controlled asthma and 10 normal controls. EPX was measured using an ELISA and normalized for grams of protein for nasal and pharynx specimens and for mL-gram of protein for sputum. Sputum EPX levels were statistically different between asthma and control subjects (P = 0.024). EPX levels measured in the nasal and pharyngeal swab samples derived from the same patients were also different between asthma and control subjects, each displaying a high degree of significance (P = 0.002). Spearman's correlation coefficients for nasal EPX and pharyngeal EPX levels compared to induced sputum eosinophil percentage were 0.81 (P = 0.0007) and 0.78 (P = 0.0017), respectively. Thus, there is a strong association in a given patient between both nasal and pharyngeal EPX levels and the eosinophil percentage of induced sputum.
Topics: Adult; Asthma; Case-Control Studies; Disease Management; Eosinophil Peroxidase; Eosinophils; Female; Humans; Male; Middle Aged; Nasal Mucosa; Pharynx; Sputum
PubMed: 26645423
DOI: 10.1111/all.12817 -
JAMA Otolaryngology-- Head & Neck... Aug 2017Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a...
IMPORTANCE
Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa.
OBJECTIVE
To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively. The study was performed at the University of Alabama at Birmingham, a tertiary care center. Included patients were those undergoing salvage total laryngectomy who were previously treated with chemoradiotherapy or radiotherapy alone.
EXPOSURES
The ICG dye was injected intraoperatively, and laser-assisted vascular imaging was used to evaluate the native pharyngeal mucosa after the ablative procedure. The center of the native pharyngeal mucosa was used as the reference to compare with the peripheral mucosa, and the lowest mean ICG dye percentage of mucosal perfusion was recorded for each patient.
MAIN OUTCOMES AND MEASURES
The primary outcome was the formation of a postoperative fistula, which was assessed by clinical and radiographic assessment to test the hypothesis formulated before data collection.
RESULTS
A total of 37 patients were included (mean [SD] age, 62.3 [8.5] years; 32 [87%] male and 5 [14%] female); 20 had a history of chemoradiotherapy, and 17 had history of radiotherapy alone. Thirty-four patients (92%) had free flap reconstruction, and 3 had primary closure (8%). Ten patients (27%) developed a postoperative fistula. No significant difference was found in fistula rate between patients who underwent neck dissection and those who did not and patients previously treated with chemoradiotherapy and those treated with radiotherapy alone. A receiver operator characteristic curve was generated to determine the diagnostic performance of the lowest mean ICG dye percentage of mucosal perfusion determined by fluorescence imaging, which was found to be a threshold value of 26%. The area under the curve was 0.85 (95% CI, 0.73-0.97), which was significantly greater than the chance diagonal. The overall mean lowest ICG dye percentage of mucosal perfusion was 31.3%. The mean lowest ICG dye percentage of mucosal perfusion was 22.0% in the fistula group vs 34.9% in the nonfistula group (absolute difference, 12.9%; 95% CI, 5.1%-21.7%).
CONCLUSIONS AND RELEVANCE
Patients who developed postoperative fistulas had lower mucosal perfusion as detected by ICG dye angiography when compared with patients who did not develop fistulas.
Topics: Alabama; Angiography; Cutaneous Fistula; Female; Head and Neck Neoplasms; Humans; Indocyanine Green; Laryngectomy; Lasers; Male; Middle Aged; Pharyngeal Diseases; Pharynx; Postoperative Complications; Salvage Therapy
PubMed: 28520896
DOI: 10.1001/jamaoto.2017.0187 -
AJNR. American Journal of Neuroradiology May 2021Among patients undergoing serial neck CTs, we have observed variability in the appearance of the pharyngolaryngeal venous plexus, which comprises the postcricoid and...
BACKGROUND AND PURPOSE
Among patients undergoing serial neck CTs, we have observed variability in the appearance of the pharyngolaryngeal venous plexus, which comprises the postcricoid and posterior pharyngeal venous plexuses. We hypothesize changes in plexus appearance from therapeutic neck irradiation. The purposes of this study are to describe the CT appearance of the pharyngolaryngeal venous plexus among 2 groups undergoing serial neck CTs-patients with radiation therapy-treated laryngeal cancer and patients with medically treated lymphoma-and to assess for changes in plexus appearance attributable to radiation therapy.
MATERIALS AND METHODS
For this retrospective study of 98 patients (49 in each group), 448 contrast-enhanced neck CTs (222 laryngeal cancer; 226 lymphoma) were assessed. When visible, the plexus anteroposterior diameter was measured, and morphology was categorized.
RESULTS
At least 1 plexus component was identified in 36/49 patients with laryngeal cancer and 37/49 patients with lymphoma. There were no statistically significant differences in plexus visibility between the 2 groups. Median anteroposterior diameter was 2.1 mm for the postcricoid venous plexus and 1.6 mm for the posterior pharyngeal venous plexus. The most common morphology was "bilobed" for the postcricoid venous plexus and "linear" for the posterior pharyngeal venous plexus. The pharyngolaryngeal venous plexus and its components were commonly identifiable only on follow-up imaging.
CONCLUSIONS
Head and neck radiologists should be familiar with the typical location and variable appearance of the pharyngolaryngeal plexus components so as not to mistake them for neoplasm. Observed variability in plexus appearance is not attributable to radiation therapy.
Topics: Adult; Diagnostic Imaging; Female; Head and Neck Neoplasms; Humans; Image Interpretation, Computer-Assisted; Larynx; Male; Middle Aged; Neck; Pharynx; Retrospective Studies; Tomography, X-Ray Computed; Veins
PubMed: 33664114
DOI: 10.3174/ajnr.A7033 -
Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2015Since the advent of antibiotics, major spontaneous tonsillar hemorrhage is extremely rare. The majority of the spontaneous tonsillar hemorrhage events is associated with...
Since the advent of antibiotics, major spontaneous tonsillar hemorrhage is extremely rare. The majority of the spontaneous tonsillar hemorrhage events is associated with acute or chronic tonsillitis, coagulopathies, or tonsillar cancer. A 36-year-old female patient was admitted to the otolaryngology department with the complaint of tonsillar hemorrhage. The patient had no history of prior trauma, coagulopathy, malignancy and infection sign. Preoperatively, carotid angiography was performed to detect any arteriovenous malformation of tonsillar vessels. The carotid angiography results were within normal ranges. The patient underwent tonsillectomy and no perioperative complication was occurred. Management of idiopathic spontaneous tonsillar hemorrhage may be challenging for the clinician and may require tonsillectomy.
Topics: Adult; Angiography; Diagnosis, Differential; Female; Hemorrhage; Humans; Palatine Tonsil; Tonsillectomy
PubMed: 25935066
DOI: 10.5606/kbbihtisas.2015.34438 -
ORL; Journal For Oto-rhino-laryngology... 2022Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study...
INTRODUCTION
Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study was aimed to evaluate the surgical efficacy of modified arytenoid adduction with fenestration of the thyroid cartilage in the management of patients with UVFP, including voice and aspiration outcomes, and to summarize the postoperative complications.
METHODS
A retrospective analysis was performed on a total of 21 patients who underwent modified arytenoid adduction operation with fenestration of the thyroid cartilage for UVFP from July 2012 to June 2017. The scores of Grade, Roughness, Breathiness, Asthenia, Strain scale (GRBAS), voice self-satisfaction, dynamic laryngoscopy and the voice acoustic data (fundamental frequency [F0], fundamental frequency perturbation [jitter], loudness, amplitude perturbation [shimmer], and maximal phonatory time [MPT], etc.) were statistically analyzed preoperatively and 3-6 months postoperatively. The occurrence of postoperative complications was also summarized.
RESULTS
The voice subjective perception of 21 patients was significantly improved after operation. The rate of voice self-satisfaction was 90.5%. The mean values of voice acoustics parameters were significantly improved. The MPT was significantly longer (p < 0.001), and the ratings of postoperative aspiration were significantly decreased compared with the preoperation. Among the 21 patients, 15 cases had sense of laryngeal obstruction, 8 cases had of 1-2° laryngemphraxis (recovered after 10-15 days). There were 2 cases of laryngeal stridor, 1 case of incision infection, 1 case of pharyngeal fistula, and 1 case of falsetto (corrected by voice training). No patient had laryngeal hematoma, neck hematoma, or laryngospasm.
CONCLUSION
The modified arytenoid adduction operation with fenestration of the thyroid cartilage can significantly improve the vocal function of patients with UVFP and effectively reduce the aspiration, with fewer postoperative complications, less trauma, and more convenient advantages.
Topics: Arytenoid Cartilage; Hematoma; Humans; Laryngeal Diseases; Laryngoplasty; Retrospective Studies; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 34384083
DOI: 10.1159/000517561 -
Journal of Immunology (Baltimore, Md. :... Jun 2021ChipCytometry is a multiplex imaging method that can be used to analyze either cell suspensions or tissue sections. Images are acquired by iterative cycles of...
ChipCytometry is a multiplex imaging method that can be used to analyze either cell suspensions or tissue sections. Images are acquired by iterative cycles of immunostaining with fluorescently labeled Abs, followed by photobleaching, which allows the accumulation of multiple markers on a single sample. In this study, we explored the feasibility of using ChipCytometry to identify and phenotype cell subsets, including rare cell types, using a combination of tissue sections and single-cell suspensions. Using ChipCytometry of tissue sections, we successfully demonstrated the architecture of human palatine tonsils, including the B and T cell zones, and characterized subcompartments such as the B cell mantle and germinal center zone, as well as intrafollicular PD1-expressing CD4 T cells. Additionally, we were able to identify the rare tonsillar T cell subsets, mucosal-associated invariant T (MAIT) and γδ-T cells, within tonsil tissue. Using single-cell suspension ChipCytometry, we further dissected human tonsillar T cell subsets via unsupervised clustering analysis as well as supervised traditional manual gating. We were able to show that PD1CD4 T cells are comprised of CXCR5BCL6 follicular Th cells and CXCR5BCL6 pre-follicular Th cells. Both supervised and unsupervised analysis approaches identified MAIT cells in single-cell suspensions, confirming a phenotype similar to that of blood-derived MAIT cells. In this study, we demonstrate that ChipCytometry is a viable method for single-cell suspension cytometry and analysis, with the additional benefit of allowing phenotyping in a spatial context using tissue sections.
Topics: B-Lymphocytes; Germinal Center; Humans; Palatine Tonsil; T-Lymphocyte Subsets; T-Lymphocytes, Helper-Inducer
PubMed: 34099545
DOI: 10.4049/jimmunol.2100063 -
The Nigerian Postgraduate Medical... 2022Upper gastrointestinal endoscopy (UGIE) using pharyngeal anesthesia, with or without sedation to improve tolerance and acceptance, is now standard practice but the...
BACKGROUND
Upper gastrointestinal endoscopy (UGIE) using pharyngeal anesthesia, with or without sedation to improve tolerance and acceptance, is now standard practice but the unsedated examination is easier to perform, costs less and is associated with fewer complications. It is, therefore, attractive in resource-limited settings like sub-Saharan Africa but studies about tolerance and acceptance of unsedated UGIE there are limited.
OBJECTIVE
The objective of this study was to report the tolerance and acceptance of unsedated UGIE in a tertiary institution in Kaduna, Nigeria.
METHODS
Consecutive patients referred for diagnostic UGIE were requested to report the overall level of discomfort for the procedure on verbal and visual analogue scales and to indicate whether they would accept the procedure in the future. Their pulse rate, oxygen saturation and blood pressure were monitored.
RESULTS
Of 306 patients (mean age: 45.5 years, 39.2% <40 years, 57.5% of females), 51.3% reported no or mild discomfort and only 5.6% reported severe and intolerable discomfort. Overall, 232 (75.8%) tolerated the procedure well and 229 (79.5%) accepted to have the same procedure in the future. Patients <40 years and those with secondary/post-secondary education were significantly less likely to tolerate the procedure well than older patients (81.1% vs. 87.9%, P = 0.006) and those with lower education (72.7% vs. 86.2%, P = 0.032), respectively. 79.5% accepted to have the procedure in the future, with males significantly more so than females (86.9% vs. 74.4%, P = 0.019).
CONCLUSION
Most patients undergoing unsedated diagnostic UGIE in Kaduna, Nigeria, tolerated the procedure well and accepted to have the same procedure in the future.
Topics: Endoscopy, Gastrointestinal; Female; Humans; Male; Middle Aged; Nigeria; Pain Measurement; Pharynx
PubMed: 35488582
DOI: 10.4103/npmj.npmj_697_21