Simultaneous laryngopharyngeal pH monitoring (Restech) and conventional esophageal pH monitoring-correlation using a large patient cohort of more than 100 patients with suspected gastroesophageal reflux disease.

24-hour esophageal pH-metry is not designed to detect laryngopharyngeal reflux (LPR). The new laryngopharyngeal pH-monitoring system (Restech) may detect LPR better. There is no established correlation between these two techniques as only small case series exist. The aim of this study is to examine the correlation between the two techniques with a large patient cohort. All patients received a complete diagnostic workup for gastroesophageal reflux including symptom evaluation, endoscopy, 24-hour pH-metry, high resolution manometry, and Restech. Consecutive patients with suspected gastroesophageal reflux and disease-related extra-esophageal symptoms were evaluated using 24-hour laryngopharyngeal and concomitant esophageal pH-monitoring. Subsequently, the relationship between the two techniques was evaluated subdividing the different reflux scenarios into four groups. A total of 101 patients from December 2013 to February 2017 were included. All patients presented extra-esophageal symptoms such as cough, hoarseness, asthma symptoms, and globus sensation. Classical reflux symptoms such as heartburn (71%), regurgitation (60%), retrosternal pain (54%), and dysphagia (32%) were also present. Esophageal 24-hour pH-metry was positive in 66 patients (65%) with a mean DeMeester Score of 66.7 [15-292]. Four different reflux scenarios were detected (group A-D): in 39% of patients with abnormal esophageal pH-metry, Restech evaluation was normal (group A, n = 26, mean DeMeester-score = 57.9 [15-255], mean Ryan score = 2.6 [2-8]). In 23% of patients with normal pH-metry (n = 8, group B), Restech evaluation was abnormal (mean DeMeester-score 10.5 [5-13], mean Ryan score 63.5 [27-84]). The remaining groups C and D showed corresponding results. Restech evaluation was positive in 48% of cases in this highly selective patient cohort. As demonstrated by four reflux scenarios, esophageal pH-metry and Restech do not necessarily need to correspond. Especially in patients with borderline abnormal 24-hour pH-metry, Restech may help to support the decision for or against laparoscopic anti-reflux surgery.

[Ryan index for detection of laryngopharyngeal reflux diseases].

Objective: To explore the utility of pharyngeal pH monitoring which positive standard is Ryan index in diagnosis of laryngopharyngeal reflux disease. Methods: In a retrospective study, clinical data of 590 patients who had symptoms laryngopharyngeal reflux disease from February 2016 to March 2017 were analyzed. All patients were received electronic laryngoscopy, assessment of reflux symptom index(RSI) and reflux finding score(RFS), and pharyngeal pH monitoring. SPSS 19.0 software was used to analyze the date. Results: There were 94 patients whose Ryan index were positive(15.93%). Among the 94 patients, 70 were positive during upright, 12 during supine and 12 during both upright and supine. There were 40 patients(6.78%)with pH decline events related to symptoms, while those Ryan index were normal. There were 536(90.85%), 417(70.68%), 233(39.49%) and 117(19.83%) patients with pH<6.5, pH<6.0, pH<5.5 and pH<5.0 events respectively. The positive rate of RSI, RFS, RSI and RFS, RSI or RFS were 44.24%, 16.78%, 7.12%, 53.90% respectively. The RFS score in Ryan index positive group was higher than that in Ryan index negative group[(8.2±2.4) vs (4.0±2.9), u=5.424, P<0.05], while the RSI score in Ryan index positive group was not statistically different from that in Ryan index negative group[(11.3±6.2) vs (12.7±5.8), t=1.247, P=0.167]. Conclusions: Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. However, with the Ryan index as a criterion for the diagnosis of laryngopharyngeal reflux disease, partial patients may be missed. Further studies are needed to obtain more accurate and objective laryngopharyngeal pH statistical index for diagnosis of laryngopharyngeal reflux disease.

Selenium-binding protein 1 in head and neck cancer is low-expression and associates with the prognosis of nasopharyngeal carcinoma.

BACKGROUND: Selenium-binding protein 1 (SELENBP1) expression is reduced markedly in many types of cancers and low SELENBP1 expression levels are associated with poor patient prognosis. METHODS: SELENBP1 gene expression in head and neck squamous cell carcinoma (HNSCC) was analyzed with GEO dataset and characteristics of SELENBP1 expression in paraffin embedded tissue were summarized. Expression of SELENBP1 in nasopharyngeal carcinoma (NPC), laryngeal cancer, oral cancer, tonsil cancer, hypopharyngeal cancer and normal tissues were detected using immunohistochemistry, at last, 99 NPC patients were followed up more than 5 years and were analyzed the prognostic significance of SELENBP1. RESULTS: Analysis of GEO dataset concluded that SELENBP1 gene expression in HNSCC was lower than that in normal tissue (P < 0.01), but there was no significant difference of SELENBP1 gene expression in different T-stage and N-stage (P > 0.05). Analysis of pathological section concluded that SELENBP1 in the majority of HNSCC is low expression and in cancer nests is lower expression than surrounding normal tissue, even associated with the malignant degree of tumor. Further study indicated the low SELENBP1 expression group of patients with NPC accompanied by poor overall survival and has significantly different comparing with the high expression group. CONCLUSION: SELENBP1 expression was down-regulated in HNSCC, but has no associated with T-stage and N-stage of tumor. Low expression of SELENBP1 in patients with NPC has poor over survival, so SELENBP1 could be a novel biomarker for predicting prognosis.

Vitellogenin in the honey bee brain: Atypical localization of a reproductive protein that promotes longevity.

In comparative gerontology, highly social insects such as honey bees (Apis mellifera) receive much attention due to very different and flexible aging patterns among closely related siblings. While experimental strategies that manipulate socio-environmental factors suggest a causative link between aging and social signals and behaviors, the molecular underpinnings of this linkage are less well understood. Here we study the atypical localization of the egg-yolk protein vitellogenin (Vg) in the brain of the honey bee. Vg is known to influence honey bee social regulation and aging rate. Our findings suggest that Vg immunoreactivity in the brain is specifically localized within the class of non-neuronal glial cells. We discuss how these results can help explain the socially-dependent aging rate of honey bees.

Engineered hypopharynx from coculture of epithelial cells and fibroblasts using poly(ester urethane) as substratum.

Porous polymeric scaffolds have been much investigated and applied in the field of tissue engineering research. Poly(ester urethane) (PEU) scaffolds, comprising pores of 1-20 µ m in diameter on one surface and ≥ 200 µ m on the opposite surface and in bulk, were fabricated using phase separation method for hypopharyngeal tissue engineering. The scaffolds were grafted with silk fibroin (SF) generated from natural silkworm cocoon to enhance the scaffold's hydrophilicity and further improve cytocompatibility to both primary epithelial cells (ECs) and fibroblasts of human hypopharynx tissue. Coculture of ECs and fibroblasts was conducted on the SF-grafted PEU scaffold (PEU-SF) to evaluate its in vitro cytocompatibility. After co-culture for 14 days, ECs were lined on the scaffold surface while fibroblasts were distributed in scaffold bulk. The results of in vivo investigation showed that PEU porous scaffold possessed good biocompatibility after it was grafted by silk fibroin. SF grafting improved the cell/tissue infiltration into scaffold bulk. Thus, PEU-SF porous scaffold is expected to be a good candidate to support the hypopharynx regeneration.

[A pilot study on diagnosing laryngopharyngeal reflux disease by pH monitoring in laryngopharynx].

OBJECTIVE: To analyze the significance of pH monitoring and reflux symptom index (RSI) in the diagnosis of laryngopharyngeal reflux disease (LPRD) and the characteristics of LPRD in symptoms and pH monitoring. METHODS: RSI questionnaire survey and laryngopharyngeal pH monitoring were conducted on. 31 patients with laryngopharyngeal reflux-related symptoms, 15 males aged (50 +/- 13) years and 16 females aged (48 +/- 11) years, Gastroscopy was conducted on 13 patients to detect reflux esophagitis. The patients with the RSI scores > or = 13 were suspected as with LPRD and those with the reflux times > or = 7 or reflux area index (RAI) > or = 6.3 were diagnosed as with LPRD. McNemar test and Kappa test were performed on the RSI scores and reflux area indexes. RESULTS: Seventeen patients met the pH criteria. There were 8 patients suffering from voice disorders, 17 from clearing throat, 13 from excess throat mucus, 11 from dysphagia, 9 from cough after eating or with supine posture, 9 from dyspnea, 13 from cough, 12 from foreign body sensation, and 14 from digestive symptoms with the foregoing symptoms' mean scores of 1.4, 3.1, 2.1, 2.0, 1.1, 1.6, 1.8, 2.9, and 2.9 respectively. The P value with McNemar test on pH monitoring and RSI scoring was 0.289, and the P value with kappa test was 0.007. RSI was correlated with RAI(r(s) = 0.302, P = 0.049), reflux time (r(s) = 0.454, P = 0.005), and reflux time percentage (r(s) = 0.439, P = 0.007), but not correlated with the reflux frequency (r(s) = 0.252, P = 0.086). Supine reflux was seen in only 7 of the 224 reflux events in 17 patients, lasting only 96 seconds during the 84.6 minutes' supine acid exposure time. CONCLUSION: The common symptoms of LPRD are clearing throat, digestive symptoms, excess throat mucus, and foreign body sensation. Laryngopharyngeal pH monitoring and RSI scoring have the same value in diagnosing LPRD. Acid exposure in laryngopharynx is correlation to patients' self-report symptom. Almost all reflux events occur when the patients are in upright position.

[24 hour pH monitoring of the hypopharymx]. / 24-h-pH-Metrie des Hypopharynx.

Monitoring of pH of the esophagus is a routine diagnostic procedure, whereas until now pH-monitoring of the hypopharynx has been used only for scientific research. In the present study a critical evaluation scale was used to record the results of 112 patients who underwent pH monitoring to determine possible reflux. Since high refluxes often remain unnoticed clinically, further study is required in certain cases. The extent of reflux in the esophagus may not represent pathological changes in the hypopharynx. In such cases 24-h pH monitoring of the hypopharynx can be a useful diagnostic procedure and may also help detect the pathogenesis of "gastric laryngitis".

Distribution of SP- and CGRP-immunoreactivity in the cat's larynx.

The distribution of substance P (SP) and calcitonin gene-related peptide (CGRP) immunoreactive (ir) fibres in the cat's larynx was investigated utilizing immunohistochemistry. Many SP- and CGRP-ir fibres with varicosities were found within and below the epithelium and along the basement membrane of the mucosa of all different regions except in the membranous portion of the vocal fold. In the subepithelium, some SP- and CGRP-ir nerve bundles and nerve fibres were recognized around the vessels and glands. In the mucosa, the pattern of distribution and the density of SR-ir fibres were similar to those of CGRP-ir fibres. These reactive fibres were denser in the supraglottic region than in the subglottic region. In the taste bud-like structures, only SP-ir fibres appeared, whereas in the motor endplates, CGRP-reaction was found exclusively. The present findings suggest that the regional distribution of SP- and CGRP-immunoreactivity might be related with sensory and autonomic innervation in the larynx.