Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux

xlomafota13 shared this article with you from Inoreader Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 11:34894211037414. doi: 10.1177/00034894211037414. Online ahead of print. ABSTRACT OBJECTIVE: Patients with laryngopharyngeal reflux (LPR) symptoms may not respond to proton pump inhibitors (PPI) if they have an alternative laryngeal diagnosis or high-volume reflux. Transoral incisionless fundoplication (TIF) or TIF with concomitant hiatal hernia repair (cTIF) are effective in decreasing symptoms of gastroesophageal reflux disease (GERD) bu t are not well studied in patients with LPR symptoms. This prospective multicenter study assessed the patient-reported and clinical outcomes after TIF/cTIF in patients with LPR symptoms and proven GERD. METHODS: Patients with refractory LPR symptoms (reflux symptom index [RSI] > 13) and with erosive esophagitis, Barrett's esophagus, and/or pathologic acid reflux by distal esophageal pH testing were evaluated before and after a minimum of 6 months after TIF/cTIF. The primary outcome was normalization of RSI. Secondary outcomes were >50% improvement in GERD-Health-Related Quality of Life (GERD-HRQL), normalization of esophageal acid exposure time, discontinuation of PPI, and patient satisfaction. RESULTS: Forty-nine patients had TIF (n = 26) or cTIF (n = 23) with at least 6 months follow-up. Mean pre- and post TIF/cTIF RSI were 23.6 and 5.9 (mean difference: 17.7, P < .001). Post TIF/cTIF, 90% of patients had improved GERD-HQRL score, 85% normalized RSI, 75 % normalized esophageal acid exposure time, and 80% discontinued PPI. No serious procedure-related adverse events occurred. Patient satisfaction was 4% prior to TIF/cTIF and 73% after TIF/cTIF (P < .001). CONCLUSION: In patients with objective evidence of GERD, TIF, or cTIF are safe and effective in controlling LPR symptoms as measured by normalization of RSI and improvement in patient satisfaction after TIF/cTIF. LEVEL OF EVIDENCE: Level 4. PMID:34378427 | DOI:10.1177/00034894211037414 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CT texture analysis of tonsil cancer: Discrimination from normal palatine tonsils

xlomafota13 shared this article with you from Inoreader CT texture analysis of tonsil cancer: Discrimination from normal palatine tonsils Via Head and neck cancers by Tae-Yoon Kim, Ji Young Lee, Young-Jun Lee, Dong Woo Park, Kyung Tae, Yun Young Choi The purposes of the study were to determine whether there are differences in texture analysis parameters between tonsil cancers and normal tonsils, and to correlate texture analysis with 18F-FDG PET/CT to investigate the relationship between texture analysis and metabolic parameters. Sixty-four patients with squamous cell carcinoma of the palatine tonsil were included. A ROI was drawn, including all slices, to involve the entire tumor. The contralateral normal tonsil was used for comparison with the tumors. Texture analysis parameters, mean, standard deviation (SD), entropy, mean positive pixels, skewness, and kurtosis were obtained using commercially available software. Parameters were compared between the tumor and the normal palatine tonsils. Comparisons were also performed among early tonsil cancer, advanced tonsil cancer, and normal tonsils. An ROC curve analysis was performed to assess discrimination of tumor from normal tonsils. Correlation between texture analysis and 18F-FDG PET/CT was performed. Compared to normal tonsils, the tumors showed a significantly lower mean, higher SD, higher entropy, lower skewness, and higher kurtosis on most filters (p View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Laryngocarcinoma at Different Sites in 16,255 Individuals

xlomafota13 shared this article with you from Inoreader Impact of Laryngocarcinoma at Different Sites in 16,255 Individuals Via ear nose throat Ear Nose Throat J. 2021 Aug 11:1455613211036771. doi: 10.1177/01455613211036771. Online ahead of print. ABSTRACT BACKGROUND: Laryngocarcinoma (LC) is a common malignant tumor of the head and neck, accounting for 1% to 5% of human tumors. The primary objective of the present study was to evaluate the survival time of patients with LC at different sites. METHODS: Information concerning patients with LC was extracted from the Surveillance, Epidemiology, and End Results (S EER) database between 1975 and 2016. RESULTS: In total, 16 255 patients with LC were selected from the SEER database. Among all patients, 80.2% were male; males also predominated in each tumor site subgroup. Most of the patients were aged between 60 and 69 years, had white ethnicity, were single, and had American Joint Committee on Cancer (AJCC) stage I cancer with T1, N0, and M0. The present study investigated the role of interventions in all LCs at different AJCC stages. Across the whole population, regardless of the intervention used, survival increased in patients at any cancer site. CONCLUSIONS: The study found that male sex, age ≥80 years, black ethnicity, single status, T4, N4, M1, and AJCC stage IV were associated with higher mortality rates at all sites of LC. Aggressive interventions, especially surgery and radiotherapy, may improve survival in patients with LC at different sites and with different AJCC stages. PMID:34379550 | DOI:10.1177/01455613211036771 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery

xlomafota13 shared this article with you from Inoreader True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02812-8. Online ahead of print. ABSTRACT The external carotid artery (ECA) commonly ascends in the retromandibular fossa and bifurcates posteromedial to the neck of the mandible into the maxillary (MA) and superficial temporal (STA) arteries. In its course in the neck, the ECA gives off the superior thyroid, lingual (LA), facial (FA), ascending pharyngeal (APA), occipital (OA) and posterior auricular (PAA) arteries. When the computed tomography angiograms of a 65-year-old male were evaluated, extremely rare anatomical variations of both ECAs were found. The right ECA trifurcated terminally at the neck of the mandible into the MA, STA and middle meningeal artery (MMA). A right occipitoauricular trunk was found coursing posterior to the ECA to further divide in the parotid region into the OA and PAA. The left ECA had a terminal pentafurcation, with the FA/APA/OA/MA/STA pattern, and the PAA branched from the STA. This pentafurcation occurred deep to the angle of the mandible and the medial pterygoid muscle, in front of the internal jugular vein. The MA ascended behind the medial pterygoid muscle, deep to the posterior border of the ramus of the mandible and reached the lateral pterygoid muscle to continue normally. The right internal carotid artery (ICA) had a lower medial curvature intercalated between the third cervical vertebra and the pharynx. To the authors' knowledge, a terminally pentafurcated E CA has not been previously recorded, and a terminal trifurcation with an added MMA has only been observed once. Such drastically modified arterial patterns expose the branches emerging from the pentafurcation and pose a risk during surgical approaches within the parotid region. Additionally, a retropharyngeal curvature of the ICA could be subject to compression during deglutition. PMID:34379154 | DOI:10.1007/s00276-021-02812-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Number of fiber bundles in the fetal anterior talofibular ligament

xlomafota13 shared this article with you from Inoreader Number of fiber bundles in the fetal anterior talofibular ligament Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02816-4. Online ahead of print. ABSTRACT PURPOSE: For the anterior talofibular ligament (ATFL), a three-fiber bundle has recently been suggested to be weaker than a single or double fiber bundle in terms of ankle plantarflexion and inversion braking function. However, the studies leading to those results all used elderly specimens. Whether the difference in fiber bundles is a congenital or an acquired morphology is impor tant when considering methods to prevent ATFL damage. The purpose of this study was to classify the number of fiber bundles in the ATFL of fetuses. METHODS: This study was conducted using 30 legs from 15 Japanese fetuses (mean weight, 1764.6 ± 616.9 g; mean crown-rump length, 283.5 ± 38.7 mm; 8 males, 7 females. The ATFL was then classified by the number of fiber bundles: Type I, one fiber bundle; Type II, two fiber bundles; and Type III, three fiber bundles. RESULTS: Ligament type was Type I in 5 legs (16.7%), Type II in 21 legs (70%), and Type III in 4 legs (13.3%). CONCLUSION: The present results suggest that the three fiber bundles of the structure of the ATFL may be an innate structure. PMID:34379153 | DOI:10.1007/s00276-021-02816-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical analysis of 12 patients with primary lymphoepithelial carcinoma of the parotid gland

xlomafota13 shared this article with you from Inoreader Clinical analysis of 12 patients with primary lymphoepithelial carcinoma of the parotid gland Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Aug 11. doi: 10.1007/s00405-021-06947-7. Online ahead of print. ABSTRACT BACKGROUND AND PURPOSE: The WHO recently designated salivary gland lymphoepithelial carcinoma as a unique malignant tumor that most commonly occurs in the parotid gland. This is a rare cancer and there are few reports in the literature. Among 854 patients with parotid gland tumors who were admitted to our institution, we diagnosed 12 patients (1.41%) with parotid lymphoepithelial carcinoma. METHODS: Retrospective analysis of 12 patients with parotid lymphoepithelial carcinoma diagnosed by the Department of Pathology, Xiangya Hospital of Central South University. RESULTS: All 12 patients had unilateral parotid gland disease and 8 had cervical lymph node metastasis. Five patients received PCR testing for the Epstein-Barr virus and two were positive. All patients received surgical treatment, two received surgical resection alone, nine received surgery and postoperative radiotherapy and chemotherapy, and one received surgery and postoperative chemotherapy. The postoperative follow-up time ranged from 13 to 77 months. As of the last follow-up, eight patients were tumor-free, one patient was lost to follow-up, and three patients died. The main cause of death was local tumor recurrence and multiple metastases throughout the body. CONCLUSION: Parotid lymphoepithelial carcinoma is a malignant neoplasm characterized by proliferation, invasion, and inclusion of poorly differentiated or undifferentiated carcinoma, and a high rate of metastasis to ipsilateral cervical lymph nodes. The comprehensive treatment method consists of radical resection combined with postoperative radiotherapy and chemotherapy. After this comprehensive treatment, the 1-year, 3-year, and 5-year overall survival rates of our patients were 100%, 78.8%, and 39.4%. PMID:34379180 | DOI:10.1007/s00405-021-06947-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of low-dose bufalin combined with hydroxycamptothecin on human castration-resistant prostate cancer xenografts in nude mice

xlomafota13 shared this article with you from Inoreader Effects of low-dose bufalin combined with hydroxycamptothecin on human castration-resistant prostate cancer xenografts in nude mice Via Experimental and therapeutic medicine Exp Ther Med. 2021 Sep;22(3):1015. doi: 10.3892/etm.2021.10447. Epub 2021 Jul 15. ABSTRACT Prostate cancer is the most prevalent tumor found in men worldwide. Despite the efficiency of primary endocrine prostate cancer therapies, more efficient drugs are needed to tackle the most advanced and resistant forms of this condition. The present study investigated the antitumor effects of low-dose bufalin combined with hydroxycamptothecin on castration-resistant prostate cancer (CRPC) in mice, as well as the possible mechanisms of apoptosis induction. CRPC xenograft tumors were generated in mice and, subsequently, mice received appropriate doses of bufalin, hydroxycamptothecin or a combination of the two drugs. Tumors from each treatment group were removed, and the tumor volume, weight and inhibition rate of each group was determined. Hematoxylin and eosin staining was performed for pathological analysis and TUNEL staining was used to assess the level of apoptosis in the xenografts. Immunohistochemistry was used for the analysis of proliferating cell nuclear antigen expression and the expression of Bax, Bcl-XL, p53, programmed cell death 4 (PDCD4), phosphorylated (p)-AKT and glycogen synthase kinase (GSK)-3β was determined by western blotting. Treatment with bufalin significantly (P<0.05) reduced tumor volumes compared with the negative control group, reducing tumor volumes to lower levels when combined with hydroxycampothecin. The combination of bufalin (0.6 or 0.8 mg/kg) and hydroxycampothecin significantly (P<0.05) induced higher levels of cell apoptosis compared with the administration of bufalin or hydroxycampothecin alone. The combination of bufalin and hydroxycampothecin also increased the expression of apoptosis-related proteins Bax, p53, PDCD4 and GSK-3β, and decreased the expression of Bcl-XL and p-AKT compared with a single drug treatment. The present study suggested that the combination of bufalin an d hydroxycampothecin improved the inhibitory effects of both drugs on CRPC tumors in vivo, potentially via the regulation of the PI3K/AKT/GSK-3β and p53-dependent apoptosis signaling pathways. PMID:34373701 | PMC:PMC8343571 | DOI:10.3892/etm.2021.10447 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Repetitive transcranial magnetic stimulation increases neurological function and endogenous neural stem cell migration via the SDF-1α/CXCR4 axis after cerebral infarction in rats

xlomafota13 shared this article with you from Inoreader Repetitive transcranial magnetic stimulation increases neurological function and endogenous neural stem cell migration via the SDF-1α/CXCR4 axis after cerebral infarction in rats Via Experimental and therapeutic medicine Exp Ther Med. 2021 Sep;22(3):1037. doi: 10.3892/etm.2021.10469. Epub 2021 Jul 19. ABSTRACT Neural stem cell (NSC) migration is closely associated with brain development and is reportedly involved during recovery from ischaemic stroke. Chemokine signalling mediated by stromal cell-derived factor 1α (SDF-1α) and its receptor CXC chemokine receptor 4 (CXCR4) has been previously documented to guide the migration of NSCs. Although repetitive transcranial magnetic stimulation (rTMS) can increase neurological function in a rat stroke model, its effects on the migration of NSCs and associated underlying mechanism remain unclear. Therefore, the present study investigated the effects of rTMS on ischaemic stroke following middle cerebral artery occlusion (MCAO). All rats underwent rTMS treatment 24 h after MCAO. Neurological function, using modified Neurological Severity Scores and grip strength test and NSC migration, which were measured using immunofluorescence staining, were analysed at 7 and 14 days after MCAO, before the protein expression levels of the SDF-1α/CXCR4 axis was evaluated using western blot analysis. AMD3100, a CXCR4 inhibitor, was used to assess the effects of SDF-1α/CXCR4 signalling. In addition, neuronal survival was investigated using Nissl staining at 14 days after MCAO. It was revealed that rTMS increased the neurological recovery of rats with MCAO, facilitated the migration of NSC, augmented the expression levels of the SDF-1α/CXCR4 axis and decreased neuronal loss. Furthermore, the rTMS-induced positive responses were significantly abolished by AMD3100. Overall, these results indicated that rTMS conferred therapeutic neuroprotective properties, which can restore neurological function after ischaemic stroke, in a manner that may be associated with the activation of the SDF-1α/CXCR4 axis. PMID:34373723 | PMC:PMC8343462 | DOI:10.3892/etm.2021.10469 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aging reduces kisspeptin receptor (GPR54) expression levels in the hypothalamus and extra-hypothalamic brain regions

xlomafota13 shared this article with you from Inoreader Aging reduces kisspeptin receptor (GPR54) expression levels in the hypothalamus and extra-hypothalamic brain regions Via Experimental and therapeutic medicine Exp Ther Med. 2021 Sep;22(3):1019. doi: 10.3892/etm.2021.10451. Epub 2021 Jul 15. ABSTRACT Aging leads to the diminished pulsatile secretion of hypothalamic gonadotropin-releasing hormone (GnRH). Kisspeptin (Kp), the upstream regulator of the hypothalamic-pituitary-gonadal (HPG) axis, regulates GnRH synthesis and release through its cognate receptor, G-protein coupled receptor 54 (GPR54). In turn, GnRH regulates GPR54 expression. GnRH administration into the third ventricle has been shown to induce neurogenesis in different brain regions in old age. However, aging-associated changes in hypothalamic and extra-hypothalamic GPR54 expression were unclear. Therefore, the expression levels of GPR54 were evaluated in various brain regions of adult (age, 3-4 months) and old (age, 20-24 months) male Wistar rats in the present study. In the hypothalamus, mRNA and protein levels of Kp and GPR54 were identified to be significantly decreased in old age. Furthermore, GnRH1 expression in the hypothalamus was analyzed to observe the functional consequence of a reduced Kp-GPR54 system in the hypothalamus. It was found that hypothalamic GnRH1 levels were significantly decreased in old age. As GnRH regulates GPR54 levels, GPR54 was examined in extra-hypothalamic regions. GPR54 levels were found to be significantly decreased in the hippocampus and medulla and pons in old-age rats when compared to adult rats. Notably, GPR54 expression was observed in the frontal lobe, cortex, midbrain and cerebellum of adult and old-age rats; however, the difference between the two groups was not statistically significant. To the best of our knowledge, this is the first study that provides the quantitative distribution of GPR54 in different brain regions during aging. Thus, the reduced levels of Kp and its receptor, GPR54 in the hypothalamus could be cumulatively responsible for reduced levels of GnRH observed in old age. PMID:34373705 | PMC:PMC8343700 | DOI:10.3892/etm.2021.10451 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dexmedetomidine facilitates the expression of nNOS in the hippocampus to alleviate surgery-induced neuroinflammation and cognitive dysfunction in aged rats

xlomafota13 shared this article with you from Inoreader Dexmedetomidine facilitates the expression of nNOS in the hippocampus to alleviate surgery-induced neuroinflammation and cognitive dysfunction in aged rats Via Experimental and therapeutic medicine Exp Ther Med. 2021 Sep;22(3):1038. doi: 10.3892/etm.2021.10470. Epub 2021 Jul 20. ABSTRACT Postoperative cognitive dysfunction (POCD) is a common complication in the postoperative nervous system of elderly patients. Surgery-induced hippocampal neuroinflammation is closely associated with POCD. Dexmedetomidine (DEX) is an effective α2-adrenergic receptor agonist, which can reduce inflammation and has neuroprotective effects, thereby improving postoperative cognitive dysfunction. However, the mechanism by which DEX improves POCD is currently unclear. The purpose of the present study was therefore to identify how DEX acted on POCD. Male Sprague Dawley rats with exposed carotid arteries were used to mimic POCD. Locomotor activity was accessed by the open field test and the Morris water maze was performed to estimate spatial learning, memory and cognitive flexibility. Following animal sacrifice, the hippocampus was collected and cell apopt osis was determined by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling staining. Subsequently, the expression of apoptosis-related proteins Bax, Bcl-2, cleaved caspase-3 and cleaved caspase-9 was determined by western blotting and the concentrations of TNF-α, IL-6, IL-1β and IL-10 were measured in serum using ELISA. Nitric oxide synthase and neuronal nitric oxide synthase activities in the hippocampus were also measured. The T lymphocyte subsets were analyzed by flow cytometry to evaluate the immune function in each group. Compared with the surgery group, DEX ameliorated POCD by improving cognitive dysfunctions and immune function loss, and attenuated neuroinflammation and neuronal apoptosis. PMID:343 73724 | PMC:PMC8343769 | DOI:10.3892/etm.2021.10470 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.