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1.
Mol Psychiatry ; 29(10): 3064-3075, 2024 Oct.
Article in English | MEDLINE | ID: mdl-38664490

ABSTRACT

Depression in older adults with cognitive impairment increases progression to dementia. Microbiota is associated with current mood and cognition, but the extent to which it predicts future symptoms is unknown. In this work, we identified microbial features that reflect current and predict future cognitive and depressive symptoms. Clinical assessments and stool samples were collected from 268 participants with varying cognitive and depressive symptoms. Seventy participants underwent 2-year follow-up. Microbial community diversity, structure, and composition were assessed using high-resolution 16 S rRNA marker gene sequencing. We implemented linear regression to characterize the relationship between microbiome composition, current cognitive impairment, and depressive symptoms. We leveraged elastic net regression to discover features that reflect current or future cognitive function and depressive symptoms. Greater microbial community diversity associated with lower current cognition in the whole sample, and greater depression in participants not on antidepressants. Poor current cognitive function associated with lower relative abundance of Bifidobacterium, while greater GABA degradation associated with greater current depression severity. Future cognitive decline associated with lower cognitive function, lower relative abundance of Intestinibacter, lower glutamate degradation, and higher baseline histamine synthesis. Future increase in depressive symptoms associated with higher baseline depression and anxiety, lower cognitive function, diabetes, lower relative abundance of Bacteroidota, and lower glutamate degradation. Our results suggest cognitive dysfunction and depression are unique states with an overall biological effect detectable through gut microbiota. The microbiome may present a noninvasive readout and prognostic tool for cognitive and psychiatric states.


Subject(s)
Cognition , Cognitive Dysfunction , Depression , Feces , Gastrointestinal Microbiome , Humans , Gastrointestinal Microbiome/physiology , Female , Male , Aged , Depression/microbiology , Cognition/physiology , Cognitive Dysfunction/microbiology , Cognitive Dysfunction/physiopathology , Feces/microbiology , Aged, 80 and over , RNA, Ribosomal, 16S/genetics , Middle Aged
2.
J Appl Microbiol ; 126(1): 230-241, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30267608

ABSTRACT

AIMS: Atopic dermatitis (AD) is a chronic inflammatory skin disease, with a steadily increasing prevalence. Lactic acid bacteria (LAB) have been widely used in the food industry and are an attractive option for preventing and treating allergic skin diseases. We previously isolated new LABs including Lactococcus lactis KR-050L from Gajuknamu kimchi, and showed the anti-inflammatory effects of extract of L. lactis KR-050L culture broth (LLK). In this study, we investigated the effects of LLK on AD. METHODS AND RESULTS: For the in vitro study, we used human keratinocytes (HaCaT) and mast cells (RBL-2H3). In vivo study, we investigated the effects of LLK on Dermatophagoides farinae extract (DFE) and 2,4-dinitrochlorobenzene (DNCB)-induced atopic skin inflammation in mice. LLK suppressed expression of pro-inflammatory cytokines and chemokines by down-regulation of p38 MAPK, STAT1 and nuclear translocation of NF-κB in keratinocytes. Topical application of LLK suppressed AD symptoms based on reduction in ear thickness, serum IgE levels and immune cell infiltration. Furthermore, LLK inhibited serum histamine levels and mast cells infiltration in vivo, and reduced mast cells activation in vitro. CONCLUSIONS: These results suggest that LLK inhibits AD symptoms through inhibition of keratinocytes and mast cells activation. SIGNIFICANCE AND IMPACT OF THE STUDY: LLK is a potential therapeutic candidate for AD treatment.


Subject(s)
Dermatitis, Atopic/metabolism , Keratinocytes/drug effects , Lactococcus lactis/chemistry , Mast Cells/drug effects , Pyroglyphidae/chemistry , Animals , Biological Products/pharmacology , Cytokines/analysis , Cytokines/metabolism , Keratinocytes/metabolism , Mast Cells/metabolism
3.
J Obstet Gynaecol ; 39(3): 434-436, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30744435

ABSTRACT

Approximately 15% of couples are infertile, with half of these cases being due to a male factor. Testis-specific cytoplasmic poly(A) polymerase beta (PAPOLB) is known to be critical for spermatogenesis. In mice, the loss of function of the Papolb gene results in the arrest of spermiogenesis and in male infertility. To analyse the role of the PAPOLB gene in human male infertility, this study investigated the relevance of this gene to human Sertoli-cell-only syndrome (SCOS) with azoospermia. Mutation analysis of the PAPOLB coding region was performed on 139 Japanese patients by PCR and direct sequence analysis. No critical mutations directly causing SCOS were detected, but three single-nucleotide polymorphisms (SNPs; SNP1 (c1101C > T), SNP2 (c1347T > C) and SNP3 (c1903C > A)) were found in the coding region. However, there were no significant associations in the allelic and genotypic distributions of these three SNPs between the SCOS and control groups (p>.05). This study suggests a lack of association of PAPOLB with azoospermia due to SCOS in humans.


Subject(s)
Azoospermia/etiology , Sertoli Cell-Only Syndrome/complications , Animals , Asian People , Azoospermia/genetics , Case-Control Studies , DNA Polymerase beta , Humans , Japan , Male , Mice , Polymorphism, Single Nucleotide , Retrospective Studies , Sertoli Cell-Only Syndrome/genetics
4.
Lupus ; 27(6): 930-938, 2018 May.
Article in English | MEDLINE | ID: mdl-29308729

ABSTRACT

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with various clinical manifestations and serologic markers. In this study, we analyzed nine polyamine (PA) profiles of plasma from patients with SLE and healthy controls (HCs), and the relationship between the PA profiles and disease activity. PA alterations in plasma of 44 patients with SLE and fever were investigated using gas chromatography mass spectrometry (GC-MS) in selected ion monitoring mode using N-ethoxycarbonyl/ N-pentafluoropropionyl derivatives, and compared with those of 43 HCs. Patients with SLE and HCs showed differences in five of nine PA profiles. Among five changed PA levels, four PAs, namely N1-acetylcadaverine, spermidine, N1-acetylspermidine, and spermine, were dramatically decreased. However, the level of cadaverine was increased in patients with SLE. In the partial correlation with PA profiles and disease activity markers of SLE, several disease activity markers and nutritional markers were correlated with cadaverine, spermidine, and N 8-acetylspermidine. Thus, our results provide a comprehensive understanding of the relationship between PA metabolomics and disease activity markers in patients with SLE.


Subject(s)
Fever/blood , Lupus Erythematosus, Systemic/blood , Polyamines/blood , Adult , Biomarkers/blood , Case-Control Studies , Female , Fever/diagnosis , Gas Chromatography-Mass Spectrometry , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/physiopathology , Male , Metabolomics/methods , Middle Aged , Nutritional Status , Prospective Studies , Severity of Illness Index , Young Adult
5.
Oral Dis ; 24(6): 1037-1041, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29566451

ABSTRACT

OBJECTIVE: To identify the molecular genetic etiology of an individual with a dysmorphic face, unusual teeth mobility, and root resorption. SUBJECTS AND METHODS: DNA samples were collected from a trio of family members, and whole-exome sequencing was performed. RESULTS: Mutational analysis revealed a de novo mutation (c.6787C>T) in the last exon of the NOTCH2 gene. This mutation would introduce a premature stop codon [p.(Gln2263*)] and generate a truncated protein without C-terminus, escaping from the nonsense-mediated decay system. Sanger sequencing confirmed that this mutation was generated spontaneously. CONCLUSIONS: In this study, we identified a novel nonsense mutation in the last exon of the NOTCH2 gene causing Hajdu-Cheney syndrome. We described the genotype and phenotype correlation and the related dental complications. These results will advance the understanding of the NOTCH2 signaling in periodontitis and root resorption.


Subject(s)
Hajdu-Cheney Syndrome/genetics , Receptor, Notch2/genetics , Adolescent , Child , Child, Preschool , Codon, Nonsense , Female , Hajdu-Cheney Syndrome/complications , Hajdu-Cheney Syndrome/diagnosis , Humans , Malocclusion/etiology , Root Resorption/etiology , Tooth Mobility/etiology
6.
Indoor Air ; 27(2): 487-499, 2017 03.
Article in English | MEDLINE | ID: mdl-27444389

ABSTRACT

Previous research has shown that indoor benzene levels in homes with attached garages are higher than homes without attached garages. Exhaust ventilation in attached garages is one possible intervention to reduce these concentrations. To evaluate the effectiveness of this intervention, a randomized crossover study was conducted in 33 Ottawa homes in winter 2014. VOCs including benzene, toluene, ethylbenzene, and xylenes, nitrogen dioxide, carbon monoxide, and air exchange rates were measured over four 48-hour periods when a garage exhaust fan was turned on or off. A blower door test conducted in each garage was used to determine the required exhaust fan flow rate to provide a depressurization of 5 Pa in each garage relative to the home. When corrected for ambient concentrations, the fan decreased geometric mean indoor benzene concentrations from 1.04 to 0.40 µg/m3 , or by 62% (P<.05). The garage exhaust fan also significantly reduced outdoor-corrected geometric mean indoor concentrations of other pollutants, including toluene (53%), ethylbenzene (47%), m,p-xylene (45%), o-xylene (43%), and carbon monoxide (23%) (P<.05) while having no impact on the home air exchange rate. This study provides evidence that mechanical exhaust ventilation in attached garages can reduce indoor concentrations of pollutants originating from within attached garages.


Subject(s)
Air Pollution, Indoor/prevention & control , Environmental Exposure/analysis , Housing , Vehicle Emissions/prevention & control , Ventilation/methods , Air Pollution, Indoor/analysis , Benzene/analysis , Environmental Monitoring/methods , Humans , Ontario , Random Allocation , Seasons , Vehicle Emissions/analysis
7.
Br Poult Sci ; 58(3): 272-277, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28100065

ABSTRACT

1. A dose-response experiment was conducted with male Korean native ducklings (KND) to evaluate the total sulphur amino acid (TSAA) requirement from hatch to 21 d of age. 2. A completely randomised design with 7 dietary TSAA concentrations (0.62%, 0.65%, 0.68%, 0.71%, 0.74%, 0.77% and 0.80%) were used with 6 replications per treatment. 3. Body weight (BW) and feed intake were measured weekly to calculate average daily gain (ADG), average daily feed intake (ADFI) and feed conversion ratio (FCR). One duckling per pen (n = 6) was killed by cervical dislocation to weigh empty body and drumsticks at the conclusion of experiment. 4. BW was improved significantly with increasing TSAA content, in a non-linear manner. A significant decrease of FCR was shown with increasing TSAA contents. TSAA requirement was determined by taking a mean value after fitting the data to both a linear-plateau and a quadratic-plateau model. Estimated TSAA requirements were 0.70%, 0.70%, 0.66% and 0.70% for the maximum BW, ADG and ADFI and for the minimum FCR, respectively. Increasing TSAA content improved quantity of full body weight (FBW), empty body weight (EBW) and drumstick weight (DSW), but there was no effect on proportion of DSW in relation to EBW and proportion of EBW to FBW. 5. In conclusion, the growth of male KND during 1 to 21 d of age was improved with increasing TSAA content, suggesting optimal TSAA requirements estimated by two analysis models.


Subject(s)
Amino Acids, Sulfur/metabolism , Ducks/physiology , Energy Metabolism , Nutritional Requirements , Weight Gain , Animal Feed/analysis , Animals , Diet/veterinary , Dose-Response Relationship, Drug , Ducks/genetics , Ducks/growth & development , Male , Random Allocation
8.
Indoor Air ; 26(5): 687-701, 2016 10.
Article in English | MEDLINE | ID: mdl-26340686

ABSTRACT

Traffic emissions have been associated with a wide range of adverse health effects. Many schools are situated close to major roads, and as children spend much of their day in school, methods to reduce traffic-related air pollutant concentrations in the school environment are warranted. One promising method to reduce pollutant concentrations in schools is to alter the timing of the ventilation so that high ventilation time periods do not correspond to rush hour traffic. Health Canada, in collaboration with the Ottawa-Carleton District School Board, tested the effect of this action by collecting traffic-related air pollution data from four schools in Ottawa, Canada, during October and November 2013. A baseline and intervention period was assessed in each school. There were statistically significant (P < 0.05) reductions in concentrations of most of the pollutants measured at the two late-start (9 AM start) schools, after adjusting for outdoor concentrations and the absolute indoor-outdoor temperature difference. The intervention at the early-start (8 AM start) schools did not have significant reductions in pollutant concentrations. Based on these findings, changing the timing of the ventilation may be a cost-effective mechanism of reducing traffic-related pollutants in late-start schools located near major roads.


Subject(s)
Air Pollutants/analysis , Air Pollution, Indoor/analysis , Schools , Time Factors , Vehicle Emissions/analysis , Ventilation/methods , Environmental Monitoring/methods , Humans , Ontario
9.
Oral Dis ; 22(4): 297-302, 2016 May.
Article in English | MEDLINE | ID: mdl-26762616

ABSTRACT

OBJECTIVE: To identify the molecular genetic aetiology of a family with autosomal dominant amelogenesis imperfecta (AI). SUBJECTS AND METHODS: DNA samples were collected from a six-generation family, and the candidate gene approach was used to screen for the enamelin (ENAM) gene. Whole-exome sequencing and linkage analysis with SNP array data identified linked regions, and candidate gene screening was performed. RESULTS: Mutational analysis revealed a mutation (c.561_562delCT and p.Tyr188Glnfs*13) in the DLX3 gene. After finding a recurrent DLX3 mutation, the clinical phenotype of the family members was re-examined. The proband's mother had pulp elongation in the third molars. The proband had not hair phenotype, but her cousin had curly hair at birth. CONCLUSIONS: In this study, we identified a recurrent 2-bp deletional DLX3 mutation in a new family. The clinical phenotype was the mildest one associated with the DLX3 mutations. These results will advance the understanding of the functional role of DLX3 in developmental processes.


Subject(s)
Amelogenesis Imperfecta/genetics , Base Sequence , Homeodomain Proteins/genetics , Sequence Deletion , Transcription Factors/genetics , Adult , Amelogenesis Imperfecta/diagnostic imaging , Child , DNA Mutational Analysis , Exome , Female , Humans , Male , Pedigree , Phenotype , Radiography, Dental
10.
Hum Reprod ; 30(12): 2853-8, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26428212

ABSTRACT

STUDY QUESTION: What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)? SUMMARY ANSWER: Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with testicular germ cell tumors (TGCTs). WHAT IS KNOWN ALREADY: Onco-TESE is a key modality for fertility preservation in cases of inadequate pretreatment sperm collection and azoospermic men with testicular cancer. TGCTs are known to reduce sperm quality such that ∼ 10% of these patients are azoospermic, making surgical TESE at the same time as orchiectomy their only means of fertility preservation. STUDY DESIGN, SIZE, DURATION: This study is a retrospective analysis performed in a single university hospital from 2002 to 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were 102 male patients (104 testes) who underwent inguinal orchiectomy and were diagnosed with a germinoma. In each specimen, the Johnsen Score Count (JSC) in seminiferous tubules at each established distance from the tumor margin (1, 2.5, 5, 7.5, 10 and 12.5 mm) was determined. We analyzed the relations between age, tumor histopathologic type, tumor size (maximum diameter), distance from the tumor, non-tumor tissue width and JSC. MAIN RESULTS AND THE ROLE OF CHANCE: The 104 specimens consisted of 78 seminomas and 26 non-seminomatous TGCTs. The mean ± SD JSC was 4.7 ± 2.4 in seminomas and 3.9 ± 2.5 in non-seminomatous germ cell tumors, with no significant difference between the two subtypes. Single regression analysis showed that tumor diameter was significantly negatively correlated with spermatogenesis (RC = -0.422, P < 0.001). Multiple linear regression analysis also showed that tumor diameter had a negative influence on spermatogenesis (RC = -0.437, P < 0.001). The greater the distance the seminiferous tubules from the tumor, the better the preservation of spermatogenesis. Mature spermatozoa were identified in 93.0% of patients with a NCTW ≥ 7.5 mm and in 41.3% of those with NCTW < 7.5 mm (P < 0.001). LIMITATIONS, REASONS FOR CAUTION: Study data were obtained retrospectively, which might have affected the quality of data. We were unable to compare spermatogenesis determined using preoperative seminograms with that determined histopathologically. It was not possible to evaluate spermatogenesis in the total volume of noncancerous testicular tissue. WIDER IMPLICATIONS OF THE FINDINGS: When Onco-TESE is conducted at sites distant from tumors, the rate of sperm extraction is high and contamination by tumor cells can be prevented. By measuring non-testicular cancerous margin before the operation, the possibility of sperm extraction can be predicted and biopsy of the contralateral testis can be considered based on the results.


Subject(s)
Fertility Preservation , Neoplasms, Germ Cell and Embryonal/physiopathology , Sperm Retrieval , Spermatogenesis/physiology , Testicular Neoplasms/physiopathology , Testis/physiopathology , Adult , Humans , Male , Middle Aged , Neoplasms, Germ Cell and Embryonal/pathology , Retrospective Studies , Testicular Neoplasms/pathology , Testis/pathology , Young Adult
11.
Soft Matter ; 11(18): 3653-9, 2015 May 14.
Article in English | MEDLINE | ID: mdl-25812081

ABSTRACT

Helical nanofilaments (HNFs) have attracted much interest because of their unique optical properties, but there have been many hurdles to overcome in using them for the practical applications due to their structural complexity. Here we demonstrate that the molecular configuration and layer conformation of a modulated HNF (HNFs(mod)) can be studied using a physicochemical confinement system. The layer directions affected by the chemical affinity between the mesogen and surface were drastically controlled in surface-modified nanochannels. Furthermore, an in situ experiment using grazing-incidence X-ray diffraction (GIXD) was carried out to investigate in detail the structural evolution through thermal transitions. The results demonstrate that the HNF(mod) structure can be perfectly controlled for functional HNF device applications, and a combined system with chemical and physical confinement effects will be helpful to better understand the fundamentals of soft matter.

12.
Br J Anaesth ; 111(4): 667-72, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23719767

ABSTRACT

BACKGROUND: Curcumin, the active ingredient of turmeric (Curcuma longa), has a wide range of beneficial effects including anti-inflammation and analgesia. However, poor bioavailability of curcumin hinders its clinical application. To overcome this limitation, we modified the structure of curcumin and synthesized new derivatives with favourable pharmacokinetic profiles. Recently, curcumin has been shown to have an antagonizing effect on transient receptor potential vanilloid type 1 (TRPV1) ion channels. We investigated the antinociceptive activity of KMS4034 which had the most favourable pharmacokinetics among the tested curcumin derivatives. METHODS: To evaluate the mechanism of the antinociceptive effects of KMS4034, capsaicin (I(CAP))- and heat (I(heat))-induced currents in TRPV1 expressing HEK293 cells were observed after the application of KMS4034. Nociceptive behavioural measurement using the hot-plate test, formalin test, and chronic constriction injury (CCI) model were evaluated in mice. Also, calcitonin gene-related peptide (CGRP) was stained immunohistochemically in the L4/5 dorsal horns in mice with neuropathic pain. RESULTS: I(CAP) (P<0.01) and I(heat) (P<0.05) of TRPV1 were significantly blocked by 10 µM KMS4034. Behaviourally, noticeable antinociceptive effects after 10 mg kg(-1) of KMS4034 treatment were observed in the first (P<0.05) and second phases (P<0.05) of the formalin and hot-plate tests. The mechanical threshold of CCI mice treated with 10 mg kg(-1) KMS4034 was significantly increased compared with control. Immunohistochemical CGRP expression was decreased in the lamina I-II of the lumbar dorsal horns in KMS4034-treated CCI mice compared with the control (P<0.05). CONCLUSIONS: KMS4034 may be an effective analgesic for various pain conditions.


Subject(s)
Analgesics, Non-Narcotic/therapeutic use , Curcumin/analogs & derivatives , Inflammation/drug therapy , Neuralgia/drug therapy , TRPV Cation Channels/antagonists & inhibitors , Analgesics, Non-Narcotic/blood , Analgesics, Non-Narcotic/pharmacology , Animals , Calcitonin Gene-Related Peptide/metabolism , Cells, Cultured , Curcumin/pharmacology , Curcumin/therapeutic use , Drug Evaluation, Preclinical/methods , Formaldehyde , Hot Temperature , Inflammation/blood , Inflammation/chemically induced , Inflammation/metabolism , Male , Mice , Mice, Inbred ICR , Neuralgia/blood , Neuralgia/metabolism , Patch-Clamp Techniques , Physical Stimulation/methods , Posterior Horn Cells/metabolism , Reaction Time/drug effects , TRPV Cation Channels/physiology
13.
Nat Genet ; 21(2): 191-4, 1999 Feb.
Article in English | MEDLINE | ID: mdl-9988271

ABSTRACT

The laboratory mouse is the premier model system for studies of mammalian development due to the powerful classical genetic analysis possible (see also the Jackson Laboratory web site, http://www.jax.org/) and the ever-expanding collection of molecular tools. To enhance the utility of the mouse system, we initiated a program to generate a large database of expressed sequence tags (ESTs) that can provide rapid access to genes. Of particular significance was the possibility that cDNA libraries could be prepared from very early stages of development, a situation unrealized in human EST projects. We report here the development of a comprehensive database of ESTs for the mouse. The project, initiated in March 1996, has focused on 5' end sequences from directionally cloned, oligo-dT primed cDNA libraries. As of 23 October 1998, 352,040 sequences had been generated, annotated and deposited in dbEST, where they comprised 93% of the total ESTs available for mouse. EST data are versatile and have been applied to gene identification, comparative sequence analysis, comparative gene mapping and candidate disease gene identification, genome sequence annotation, microarray development and the development of gene-based map resources.


Subject(s)
Genes/genetics , Mice/genetics , Animals , Computational Biology , Databases, Factual , Expressed Sequence Tags , Gene Library , Genome , Sequence Analysis, DNA/statistics & numerical data
15.
J Vet Cardiol ; 48: 1-6, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37269624

ABSTRACT

A 5-year-old, 7.9 kg castrated male Miniature Dachsund presented with heart enlargement on radiography. The dog was asymptomatic. Echocardiography revealed a tubular structure running along the posterior wall of the left atrium and connecting to the right atrium on the caudal side of the left atrium and annulus, which was presumed to be a dilated coronary sinus. After confirming a shunt between the left atrium and coronary sinus by cardiovascular catheterization, an unroofed coronary sinus was diagnosed. Open-heart surgery using cardiopulmonary bypass was performed through left atriotomy. The defect between the left atrium and the coronary sinus was closed by suturing. The cardiac enlargement improved after surgery. The dog was still alive 1227 days after surgery without clinical signs.


Subject(s)
Cardiac Surgical Procedures , Coronary Sinus , Coronary Vessel Anomalies , Dog Diseases , Heart Septal Defects, Atrial , Male , Dogs , Animals , Coronary Sinus/diagnostic imaging , Coronary Sinus/surgery , Vena Cava, Superior/surgery , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Atrial/veterinary , Heart Atria , Cardiac Surgical Procedures/veterinary , Coronary Vessel Anomalies/veterinary , Dog Diseases/diagnostic imaging , Dog Diseases/surgery
16.
Cureus ; 15(2): e34662, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36909076

ABSTRACT

A cervicogenic headache (CH) originates from a cervical source. Multiple diagnostic criteria and treatment strategies for CH are present. Rimegepant is a calcitonin gene-related peptide receptor (CGRP) antagonist. We present a case series of three patients with CH who reported varying degrees of decreased headache intensity after using rimegepant.

17.
Cureus ; 15(3): e36783, 2023 Mar.
Article in English | MEDLINE | ID: mdl-37123671

ABSTRACT

Zenker's diverticulum (ZD) is a type of esophageal diverticulum, a relatively rare disease in the pharyngoesophageal area. It is a pulsion diverticulum, or false diverticulum, located dorsally at the wall between the pharynx and esophagus. This area is known as Killian's triangle or dehiscence and is a region of relative weakness. Common symptoms of ZD include dysphagia, choking, persistent cough, loss of weight, hoarseness, halitosis, regurgitation of undigested food, and borborygmi within the cervical region. We are reporting a case of oropharyngeal dysphagia due to a ZD in a 65-year-old man with a history of worsening dysphagia for two years. Clinical presentation, diagnosis, and treatment options for ZD are discussed, along with the underlying pathophysiology of this condition.

18.
Cureus ; 15(5): e38898, 2023 May.
Article in English | MEDLINE | ID: mdl-37313071

ABSTRACT

This report describes a case involving the diagnosis and treatment of squamous cell carcinoma (SCC) of the duodenum, which was found to be a metastatic lesion originating from recurrent head and neck cancer (HNC) in a 74-year-old female patient. The patient had a past medical history of gastroesophageal reflux disease (GERD), tonsillar SCC, and recurrent HNC. She presented with symptoms of burning, tingling, and numbness of the throat and left side of the tongue. Upon examination with an esophagogastroduodenoscopy, an ulcerated hard area mass was detected in the third portion of the duodenum. Biopsy results confirmed the mass to be a metastatic poorly differentiated SCC. The incidence of head and neck squamous cell carcinoma (HNSCC) metastasis to the duodenum is rare, likely due to the unique anatomic location and the lack of lymphatic drainage in the area. The patient was treated with a combination of paclitaxel, carboplatin, and pembrolizumab. This case underscores the significance of considering unusual sites of metastasis in HNSCC patients and utilizing advanced imaging modalities and immunotherapy to detect and treat these locations effectively.

19.
J Plast Reconstr Aesthet Surg ; 81: 119-121, 2023 06.
Article in English | MEDLINE | ID: mdl-37141785

ABSTRACT

BACKGROUND: Esthetic upper lateral cutaneous lip reconstruction preserves the apical triangle, nasolabial fold symmetry, and free margin position. The tunneled island pedicle flap (IPF) is a novel single-stage reconstruction to achieve these goals. OBJECTIVES: Describe the technique and patient and surgeon-reported outcomes for the tunneled IPF reconstruction of upper lateral cutaneous lip defects. METHODS: Retrospective chart review of consecutive tunneled IPF reconstruction following Mohs micrographic surgery (MMS) at a tertiary care center between 2014 and 2020. Patients rated their scars using the validated Patient Scar Assessment Scale (PSAS), and independent surgeons rated scars using the validated Observer Scar Assessment Scale (OSAS). Descriptive statistics were generated for patient demographics and tumor defect characteristics. RESULTS: Twenty upper lateral cutaneous lip defects were repaired with the tunneled IPF. Surgeons rated scars with a composite OSAS score of 11.83 ± 4.29 (mean, SD) [scale of 5 (normal skin) to 50 (worst scar imaginable)] and an overall scar score of 2.81 ± 1.11 [scale of 1 (normal skin) to 10 (worst scar imaginable)]. Patients rated their scars with a composite PSAS score of 10 ± 5.39 [scale of 6 (best possible score) to 60 (worst)] and with an overall score of 2.2 ± 1.78 [scale of 1 (normal skin) and 10 (very different from normal skin)]. One flap was surgically revised for pincushioning, but none experienced necrosis, hematoma, or infection. CONCLUSIONS: The tunneled IPF is a single-stage reconstruction for upper lateral cutaneous lip defects with favorable scar ratings by patients and observers.


Subject(s)
Lip , Sleep Apnea, Obstructive , Humans , Lip/surgery , Cicatrix/etiology , Cicatrix/surgery , Retrospective Studies , Surgical Flaps/surgery
20.
Cureus ; 14(10): e30819, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36451637

ABSTRACT

The thrombosis of the superior mesenteric vein (SMV) can result in ischemia of the intestine. A 71-year-old male presented with pain in the abdomen and a black tarry stool. The findings from computed tomography (CT) with the contrast of the abdomen suggest the thrombosis of the SMV. Heparin was administered, followed by thrombectomy and stenting of the SMV. The patient reported no complications and was shifted from heparin to apixaban and then discharged after a five-day hospital stay.

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