Effect of intravascular dexamethasone injection after powered intracapsular tonsillectomy and adenoidectomy in children.

PURPOSE: To compare postoperative pain, nausea and vomiting, and bleeding between intravascular dexamethasone injection group and control group among children undergoing powered intracapsular tonsillectomy and adenoidectomy (PITA). MATERIALS AND METHODS: Retrospective review of medical records was performed for pediatric patients who underwent PITA from March 1, 2017, to February 28, 2021, at a tertiary referral medical center in South Korea. Postoperative pain and nausea were measured using the visual analogue scale (VAS) from the postoperative day (POD) 0 to POD 6. The number of analgesics administered and the number of vomiting episodes were recorded in the same period. The repeatedly measured parameters were statistically analyzed between the dexamethasone group and control group. RESULTS: A total of 71 children with complete questionnaires including 44 boys and 27 girls were included, and the mean age was 7.49 ± 2.44 years. There were 33 patients in the dexamethasone group and 38 in the control group. Postoperative pain (p = 0.169) or nausea (p = 0.460) on the VAS showed no statistically significant difference between the two groups. Postoperative analgesics showed no difference between the groups (p = 0.398), and neither did postoperative vomiting (p = 0.270). In both groups, no child showed signs of postoperative bleeding. CONCLUSIONS: This study indicates that the beneficial effects of intravascular dexamethasone administration in PITA may not be evident. This might be due to the superior outcome of the PITA technique compared to total extracapsular tonsillectomy. Therefore, otolaryngologists performing PITA may not necessarily need to administer dexamethasone in children before surgery.

Therapeutic effects of placenta derived-, umbilical cord derived-, and adipose tissue derived-mesenchymal stem cells in chronic Helicobacter pylori infection: comparison and novel mechanisms.

Supported with significant rejuvenating and regenerating actions of mesenchymal stem cells (MSCs) in various gastrointestinal diseases including Helicobacter pylori (H. pylori)-associated gastric diseases, we have compared these actions among placenta derived-MSCs (PD-MSCs), umbilical cord derived-MSCs (UC-MSCs), and adipose tissue derived-MSCs (AD-MSCs) and explored contributing genes implicated in rejuvenation of H. pylori-chronic atrophic gastritis (CAG) and tumorigenesis. In this study adopting H. pylori-initiated, high salt diet-promoted gastric carcinogenesis model, we have administered three kinds of MSCs around 15-18 weeks in H. pylori infected C57BL/6 mice and sacrificed at 24 and 48 weeks, respectively, in order to either assess the rejuvenating capability or anti-tumorigenesis. At 24 weeks, MSCs all led to significantly mitigated atrophic gastritis, for which significant inductions of autophagy, preservation of tumor suppressive 15-PGDH, attenuated apoptosis, and efficient efferocytosis was imposed with MSCs administration during atrophic gastritis. At 48 weeks, MSCs administered during H. pylori-associated atrophic gastritis afforded significant blocking the progression of CAG, as evidenced with statistically significant reduction in H. pylori-associated gastric tumor (p<0.05) accompanied with significant decreases in IL-1ß, COX-2, STAT3, and NF-κB. Combined together with the changes of stanniocalcin-1 (STC-1), thrombospondin-1 (TSP-1), and IL-10 known as biomarkers reflecting stem cell activities at 48 weeks after H. pylori, PD-MSCs among MSCs afforded the best rejuvenating action against H. pylori-associated CAG via additional actions of efferocytosis, autophagy, and anti-apoptosis at 24 weeks. In conclusion, MSCs, especially PD-MSCs, exerted rejuvenating actions against H. pylori-associated CAG via anti-mutagenesis of IL-10, CD-36, ATG5 and cancer suppressive influences of STC-1, TSP-1, and 15-PGDH.

Transcriptome profiling analysis of the response to walnut polyphenol extract in Helicobacter pylori-infected cells.

Dietary intervention to prevent Helicobacter pylori (H. pylori)-associated gastric diseases seems to be ideal with no risk of bacterial resistance, safe long-term intervention, and correcting pathogenic mechanisms including rejuvenation of precancerous atrophic gastritis and anti-mutagenesis. A transcriptome as set of all RNAs transcribed by certain tissues or cells demonstrates gene functions and reveals the molecular mechanism of specific biological processes against diseases. Here, we have performed RNAseq and bioinformatic analysis to explain proof of concept that walnut intake can rescue from H. pylori infection and explore unidentified mode of actions of walnut polyphenol extract (WPE). As results, BIRC3, SLC25A4, f3 transcription, VEGFA, AZU1, HMOX1, RAB3A, RELBTNIP1, ETFB, INPP5J, PPME1, RHOB, TPI1, FOSL1, JUND.RELB, KLF2, MUC1, NDRG1, ALDOA, ENO1, PFKP, GPI, GDF15, and NRTN genes were newly discovered to be enriched with WPE, whereas CCR4, BLNK, CCR7, CXCR4, CDO1, KLSG1, SELE, RASGRP2, PIK3R3, TSPAN32, HOXC-AS3, HCG8, BTNL8, and CXCL3 genes as inhibitory targets by WPE in H. pylori infection. We identified additional genes what WPE afforded actions of avoiding H. pylori-driven onco-inflammation and rejuvenating precancerous atrophic gastritis. Conclusively, after applying RNAseq analysis in order to document walnut intake for precision medicine against H. pylori infection, significant transcriptomic profiling applicable for validation were drawn.

Walnut polyphenol extracts inhibit Helicobacter pylori-induced STAT3Tyr705 phosphorylation through activation of PPAR-γ and SOCS1 induction.

The health beneficial effects of walnut plentiful of n-3 polyunsaturated fatty acid had been attributed to its anti-inflammatory and anti-oxidative properties against various clinical diseases. Since we have published Fat-1 transgenic mice overexpressing 3-desaturase significantly mitigated Helicobacter pylori (H. pylori)-associated gastric pathologies including rejuvenation of chronic atrophic gastritis and prevention of gastric cancer, in this study, we have explored the underlying molecular mechanisms of walnut against H. pylori infection. Fresh walnut polyphenol extracts (WPE) were found to suppress the phosphorylation and nuclear translocation of signal transducer and activator of transcription 3 (STAT3) induced by H. pylori infection in RGM-1 gastric mucosal cells. Notably, H. pylori infection significantly decreased suppressor of cytokine signaling 1 (SOCS1), but WPE induced expression of SOCS1, by which the suppressive effect of walnut extracts on STAT3Tyr705 phosphorylation was not seen in SOCS1 KO cells. WPE induced significantly increased nuclear translocation nuclear translocation of PPAR-γ in RGM1 cells, by which PPAR-γ KO inhibited transcription of SOCS1 and suppressive effect of WPE on p-STAT3Tyr705 was not seen. WPE inhibited the expression of c-Myc and IL-6/IL-6R signaling, which was attenuated in the RGM1 cells harboring SOCS1 specific siRNA. Conclusively, WPE inhibits H. pylori-induced STAT3 phosphorylation in a PPAR-γ and SOCS1-dependent manner.

Long-term results of sleep-related quality-of-life and behavioral problems after adenotonsillectomy.

OBJECTIVES: Improvements in sleep-related quality of life (QOL) and behavioral problems have been observed in children with obstructive sleep apnea (OSA) during a short-term follow-up after adenotonsillectomy. Whether this trend continues beyond the short term remains unclear. Therefore, we aimed to evaluate the long-term effects of surgery in children with OSA. METHODS: The study participants comprised 20 children with OSA who underwent adenotonsillectomy. We used the scores from the Attention Deficit and Hyperactivity Disorder Rating Scale (ADHD-RS) and total scores from the Korean OSA-18 Survey (KOSA-18) before and after adenotonsillectomy to compare and analyze behavioral problems and OSA-specific health-related QOL, respectively, during a long-term follow-up. Respiratory disturbance parameters from standard polysomnography and subjective symptom scores for snoring and apnea were also investigated. RESULTS: The mean patient age was 6.6 ± 3.4 years (range, 3-13), and the male-to-female ratio was 15:5. The mean follow-up period was 54.5 months (range, 27-98). The total scores for both ADHD-RS (from 17.6 to 10.5; P = 0.006) and KOSA-18 (from 74.3 to 40.7; P = 0.001) decreased significantly from before to after surgery. Significant decreases were also observed in the subjective symptom scores for snoring (from 5.4 to 2.4; P = 0.000) and apnea (from 3.3 to 0.8; P = 0.002). CONCLUSION: Significant improvement was observed in sleep-related QOL and behavioral problems in children with OSA during long-term follow-up after adenotonsillectomy. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:546-550, 2020.

Human papillomavirus-related carcinoma with adenoid cystic-like features of the inferior turbinate: a case report.

Sinonasal malignancies are uncommon, but are of many different histologic types. Recently, Human papillomavirus (HPV)-related carcinoma with adenoid cystic features was reported as a new histologic form. Although this histologic type resembles an adenoid cystic carcinoma, it differs from adenoid cystic carcinomas with regard to its association with HPV. Here, we present a case of HPV-related carcinoma with adenoid cystic features in the nasal cavity. We also review the histological characters of the tumor.

Cholesterol granuloma: a rare benign rib tumor.

Rib tumors are uncommon, constituting only 5% to 10% of all bony neoplasms. Cholesterol granuloma is also rare and is described as inflammatory granulation that occurs in response to the deposition of cholesterol crystals. Cholesterol granulomas are found most commonly in the paranasal sinuses or temporal bones, but there are also rare reports of their occurrence in the peritoneum, parotid gland, lymph nodes, thyroglossal duct, kidney, liver, and spleen. Involvement of the ribs has rarely been described previously. We report a rare case of cholesterol granuloma involving the second rib of a 38-year-old-woman who presented with a slowly growing lesion of the anterior aspect of the chest.

Rotational pectoral musculocutaneous flap for the repair of gastric conduit necrosis in cervical esophagogastrostomy.

We experienced a case of wide necrosis of the cervical gastric conduit during esophageal cancer surgery. We attempted to repair this defect with various methods including conservative care, stents two times, and sternocleidomastoid muscle flap without successful results. Finally, we were able to reconstruct the gastric conduit defect with rotational pectoralis major musculocutaneous (PMM) flap. PMM flap is thought to be a reconstruction method applicable to the intractable gastric conduit defect.

Sodium (Na+) concentration effects on metabolic pathway and estimation of ATP use in dark fermentation hydrogen production through stoichiometric analysis.

Batch experiments were conducted to investigate the effects of Na(+) concentration on hydrogen production with dark fermentation. The Na(+) concentration was varied from 0 to 8 g/L in the mixed culture using an anaerobic sludge treated by acid. The maximum hydrogen production was achieved with 1 g-Na(+)/L, whereas the hydrogen production was decreased over 2 g-Na(+)/L due to the inhibitory of Na(+). The mechanisms of Na(+) inhibition to the hydrogen production are studied using pure culture of Clostridium butyricum by calculating the energy balance. At a high sodium concentration, C. butyricum used a greater proportion of the ATP generated via fermentation for cell maintenance rather than for cell synthesis. Additionally, higher Na(+) concentrations shifted the fermentation process toward the acetate synthesis pathway instead of the butyrate pathway, and the value of Y(X/ATP) decreased. With high Na(+) concentrations, a greater ratio of hydrogen was produced via the oxidation of NADH. Excess hydrogen production decreased as the Na(+) concentration increased.

Kinetics and simulations of substrate interactions during the biodegradation of benzene, toluene, p-xylene and styrene.

Air streams commonly emitted from industrial sources generally contain various mixtures of volatile organic compounds (VOCs), and these complex mixtures can present challenges with respect to bioreactor design and applications. In this study, therefore, a modified Monod-type model using interaction parameters was employed to describe the biodegradation kinetics of mixtures of aromatic compounds by a Pseudomonas isolate. In addition, the model and estimated parameters were utilized to predict the performance of a bubble-column bioreactor for the treatment of mixtures of benzene, toluene, p-xylene, and styrene (BTXS). Benzene, toluene and styrene, as individual substrates, were actively degraded by the bacterial culture, whereas p-xylene was not degraded as a single substrate. Relative to the single substrate experiments, the degradation of benzene and toluene was inhibited by the other compounds, while the degradation of styrene was significantly stimulated in the presence of the other BTXS compounds. The cometabolic degradation of p-xylene was observed in the presence of benzene and toluene. The estimated interaction parameters indicated that the degradation of benzene was substantially inhibited in the presence of styrene, whereas the degradation of styrene was strongly stimulated by toluene. The kinetic coefficients and interaction parameters were used to successfully predict the biodegradation kinetics and performance of a bioreactor subjected to the quaternary mixture. Overall, the model was able to provide reasonable predictions when substrate interactions, including inhibition, stimulation, and cometabolism, play significant roles in biodegradation processes.

Iron and organo-bentonite for the reduction and sorption of trichloroethylene.

Hybrid barriers using dechlorination and immobilization were studied to remove trichloroethylene (TCE) in this study. Hybrid barriers of iron filings and organo (hexadecyltrimethylammonium, HDTMA)-bentonite were simulated in columns to assess the performance of the hybrid barriers. TCE reduction rate for the mixture of zero valent iron (ZVI) and HDTMA-bentonite was approximately seven times higher than that for ZVI, suggesting the reduction of TCE was accelerated when HDTMA-bentonite was mixed with ZVI. For the column of two separate layers of iron and HDTMA-bentonite, TCE reduction rate was nearly similar to that for ZVI alone, but the partition coefficient (Kd) was 4.5 times higher than that for ZVI only. TCE was immobilized in the first layer with HDTMA-bentonite due to sorption, and then dechlorinated in the second layer with iron filings due to reduction. The HDTMA-bentonite and minimally-desorbed HDTMA from the organo-bentonite are believed to contribute the increase in TCE concentration on iron surface so that more TCE could be available for reduction. Therefore, the incorporation of HDTMA-bentonite into ZVI not only can effectively retard the transport of chlorinated organic contaminants from landfill leachate or oil shock in subsurface environment, also can expedite the reduction rate of TCE.