Streptococcal Serology in Children With Stuttering.

Introduction: Stuttering is a pronunciation disorder represented by repetitive perpetuations, duplications, or freezes of spoken words or syllables, as well as nervousness and cognitive shunning. Group A beta-hemolytic Streptococcus (GABHS) can lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Many case reports have proposed that stuttering is the result of a PANDAS, and that it can be identified together with Tourette syndrome, which shares many clinical characteristics with stuttering. Aim: The purpose of this study was to examine the association between streptococcal serology and stuttering in children. Method: The participants in this study are 26 children who stutter (CWS; mean age = 8.3 + 3.1 years) and 25 children who do not stutter (CWNS; mean age = 9.2 + 2.9 years). Participants were matched in terms of age (±3 months) and gender. We analyzed serum antistreptococcal antibodies [antistreptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and antistreptokinase] in both groups. Results: In the CWS group, ASO, anti-DNase B, and antistreptokinase were significantly higher than in the CWNS group (P < .0001, P < .0001, P < .0001). Conclusion: The higher serum antistreptococcal antibody amounts in CWS suggest that an increased autoimmune response against GAHBS may be the etiology of childhood stuttering. It has been suggested that CWS should be examined for autoimmune reactions, especially to GAHBS.

Which stimulus should be used for auditory brainstem response in newborns; CE-Chirp® level specific versus Click stimulus.

OBJECTIVES: Auditory Brainstem Response (ABR), the electrical responses in the neuronal pathways extending from the inner ear to the auditory cortex, are evaluated with auditory stimuli. ABR analysis evaluates waves I, III and V's absolute-latencies, amplitude values, interpeak-latencies, interaural-latency differences, and morphologies. This study aims to reveal the advantages of CE-Chirp® LS stimulus and its clinical uses to increase by comparing the amplitude, latency, and interpeak-latency differences of waves I, III, and V at 80 dB nHL and wave V at 60, 40, 20 dB nHL by using click and CE-Chirp® LS stimuli. METHODS: 100 (54 boys, 46 girls) infants with normal hearing were included in the National Newborn Hearing Screening Program. With the click and CE-Chirp® LS ABR, the absolute latency and amplitude values of wave V at 20, 40, and 60 dB nHL, and the absolute-latency, interpeak-latency, and amplitude values of waves I, III, and V at 80 dB nHL are determined between stimuli and right-left ear. RESULTS: When the wave V latency and amplitudes obtained at 80, 60, 40, and 20 dB nHL levels were examined between genders, and according to the risk factor, no significant difference was found between click and CE-Chirp® LS stimuli (p > 0.05). Waves I, III, and V absolute-latency, amplitudes were compared at 80 dB nHL and wave V absolute-latency, amplitudes at 60, 40, and 20 dB nHL; the amplitudes measured with CE-Chirp® LS were significantly higher than the click stimulus (p < 0.05). When two stimuli were compared for I-III and III-V interpeak-latency values at 80 dB nHL level, no significant difference was found between the two stimuli (p > 0.05). However, the I-V interpeak-latency value was statistically significantly decreased for two stimuli, regardless of the ear (p < 0.05). CONCLUSIONS: It is suggested to increase the use of CE-Chirp® LS stimulus with better morphology and amplitude in clinics, believing that it facilitates clinicians' interpretation.

Urinary AASA excretion is elevated in patients with molybdenum cofactor deficiency and isolated sulphite oxidase deficiency.

Analysis of α-aminoadipic semialdehyde is an important tool in the diagnosis of antiquitin deficiency (pyridoxine-dependent epilepsy). However continuing use of this test has revealed that elevated urinary excretion of α-aminoadipic semialdehyde is not only found in patients with pyridoxine-dependent epilepsy but is also seen in patients with molybdenum cofactor deficiency and isolated sulphite oxidase deficiency. This should be taken into account when interpreting the laboratory data. Sulphite was shown to inhibit α-aminoadipic semialdehyde dehydrogenase in vitro.

Atypical lipomatous tumor in the submental region.

A 54-year-old male patient presented to our outpatient clinic complaining of a mass under his chin, which appeared nearly 1 year earlier. Pathologic diagnosis was atypical lipomatous tumor. To the best of our knowledge, this is the first reported case to localize subcutaneously in the head and neck region. Atypical lipomatous tumors/well-differentiated liposarcomas are rarely reported in the head and neck. We review the clinical and management features of atypical lipomatous tumors.

The presence of Helicobacter pylori in the larynx pathologies.

OBJECTIVE: The well-known relation of Helicobacter pylori to the MALT-lymphoma and gastric carcinoma suggested a possible presence in the laryngeal tissues of patients with squamous cell carcinoma of the larynx by using Polymerase Chain Reaction (PCR) investigations, and PCR results of benign laryngeal pathologies were compared. METHODS: Polymerase Chain Reaction investigations were carried out in biopsy samples of 21 patients with squamous cell carcinoma of the larynx and of 19 patients with benign laryngeal pathologies like vocal polyp and nodules. RESULTS: The PCR results of 17 out of the 21 samples (80.9%) of the patients with laryngeal squamous cell carcinoma were positive for H. pylori. Moreover, any genomic material of H. pylori was not found in the PCR results of the 19 patients with benign laryngeal pathology. It was also determined that the presence of the H. pylori in the patients with laryngeal squamous cell carcinoma was statistically significant (p=0.0001). In the patients with laryngeal squamous cell carcinoma, the comparison of the H. pylori presence within the normal and tumoral tissues revealed that 16 normal tissue samples (76.19%) were positive, while 9 of the tumoral tissue samples (42.85%) were positive. The ratio of bacterial presence in both the normal and tumor tissue samples was 38.09% (8 patients). The rates of presence revealed a statistically significant difference between the normal and tumoral tissue samples (p=0.039). CONCLUSIONS: The presence of the genomic material of H. pylori within the laryngeal tissue of patients with squamous cell carcinoma of the larynx is a proof of the colonization of the bacterium in that tissue. While this may suggest a possible relation of the bacterium to the development of laryngeal squamous cell carcinoma, no conclusion is possible to be drawn about the mechanism of the process.