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Kakurina GV, Kolegova ЕS, Shashova ЕЕ, Velikaya VV, Startseva ZА, Cheremisina ОV, Kondakova IV, Choinzonov ЕL. Association of mRNA Expression Levels of LRP1 and Actin-Binding Proteins with the Development of Laryngeal and Laryngopharyngeal Squamous Cell Carcinoma. Bull Exp Biol Med 2020; 169:802-805. [PMID: 33108559 DOI: 10.1007/s10517-020-04983-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Indexed: 11/26/2022]
Abstract
We analyzed the association of the level of mRNA expression of the main endocytosis receptor LRP1 and actin-binding proteins (ezrin, profilin-1, cofilin-1, and adenylyl cyclase-associated protein 1) with the development and metastasis of laryngeal and laryngopharyngeal squamous cell carcinoma. The mRNA expression was evaluated in paired tissue samples using quantitative reverse transcription real-time PCR (RT-qPCR) and SYBR Green reagents. The study included 38 patients with stage T1-4N0-1M0 laryngeal and laryngopharyngeal squamous cell carcinoma and 10 patients with chronic hyperplastic laryngitis or grade II-III epithelial dysplasia. The expression of LRP1 in patients with laryngeal and laryngopharyngeal squamous cell carcinoma depended on the stage of the tumor process. Against the background of low expression of LRP1 mRNA, the relationship between cofilin 1 and profilin 1 expression became stronger (r=0.08; p=0.05) and a correlation between cofilin 1 and esrin expression (r=0.7; p=0.05) appeared. Studies on a larger patient cohort are required to make a definite conclusion on the role of LRP1 in the development of laryngeal and laryngopharyngeal squamous cell carcinoma.
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Affiliation(s)
- G V Kakurina
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia.
| | - Е S Kolegova
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Е Е Shashova
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - V V Velikaya
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Zh А Startseva
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - О V Cheremisina
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - I V Kondakova
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Е L Choinzonov
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
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Abstract
The aim of this study was to determine changes that momentary low pH with or without pepsin causes in gene expression in laryngeal fibroblasts. Cell cultures were established from human false vocal fold (FVF) and postcricoidal (PC) mucosae. Using a real-time polymerase chain reaction, we analyzed messenger RNA gene expression of growth factors (transforming growth factor β1, vascular endothelial growth factor, fibroblast growth factor 2), matrix metalloproteinases (MMP-1, MMP-2), and decorin in normal media, pH 4 media, and pH 5 media with and without pepsin. The FVF fibroblast gene expression differed substantially from the PC fibroblast gene expression. No significant interaction effects for acid and pepsin were found in the FVF culture, but in PC cultures we found a significant overexpression interaction effect for vascular endothelial growth factor, fibroblast growth factor 2, MMP-1, MMP-2, and decorin. These results imply that PC tissue is more sensitive than FVF tissue to the noxious effects of gastric contents. Furthermore, there appears to be a synergistic effect for acid and pepsin exposure in the posterior larynx.
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Affiliation(s)
- Riitta Ylitalo
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
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Eckley CA, Michelsohn N, Rizzo LV, Tadokoro CE, Tadakoro CE, Costa HO. Salivary Epidermal Growth Factor Concentration in Adults with Reflux Laryngitis. Otolaryngol Head Neck Surg 2016; 131:401-6. [PMID: 15467608 DOI: 10.1016/j.otohns.2004.01.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: The mechanisms involved in the muco-sal alterations of laryngopharyngeal reflux (LPR) have not been well established. Reports indicate a decrease in the salivary epidermal growth factor (EGF) of patients with reflux esophagitis, but there are no reports of its behavior in LPR. Our objective was to determine the salivary concentration of EGF in adults with LPR. STUDY DESIGN AND SETTING: Salivary EGF concentration of 26 patients with LPR and 20 healthy controls was determined using a commercially available ELISA kit. Patients with LPR were graded according to endoscopic and laryngoscopic criteria. RESULTS: Salivary EGF concentration was significantly lower in the LPR group when compared with controls ( P = 0.002). No correlation between the severity of laryngeal findings or esophagitis and salivary EGF concentration could be determined. CONCLUSIONS: The decreased salivary concentration of EGF in adults with LPR suggests that a deficiency in this polypeptide could be associated to the disease.
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Affiliation(s)
- Claudia A Eckley
- Otolaryngology Department, Santa Casa School of Medicine of São Paulo, Brasil.
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Morozov SV, Gibadullina LV, Isakova VA, Svistushkin VM. [Optimal diagnostic criteria of ENT manifestations of GERD]. Eksp Klin Gastroenterol 2011:8-18. [PMID: 22629749 DOI: pmid/22629749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND GERD has a number of extraesophageal manifestations (EEM) such as ENT, pulmonary etc. 24-hours pH monitoring in distal esophagus is widely used to confirm the diagnosis but its cut-off values for the diagnosing of extraesophageal manifestations of GERD (for example ENT) are unknown. AIM To evaluate the optimal cut-off values for mean pH, time pH < 4 a day in the proximal esophagus and number of high gastroesophageal refluxes (HGR) in regard to presence of extraesophageal manifestations of GERD. METHODS Ninety one GERD patients (50 men, 41 women, 42.33 +/- 16.1 y.o.) were examined using dual-probe 24-hours pH monitoring. The proximal probe was placed in the upper 1/3 part of esophagus over the upper esophageal sphincter. To confirm the presence of ENT manifestations of GERD all the patients were examined by qualified ENT-specialist; special ENT tests (laryngoscopy, pharyngoscopy with cytology and bacteriology) were performed. Toxic, allergic and infectious etiology of ENT were exclusion criteria. ROC curve analysis was used to evaluate optimal cut-off values of pH-studies. The cut-off values were chosen by the optimal diagnostic sensitivity (DSp)/specificity (DSp) ratio. RESULTS ENT diseases were found in 59 of all the examined patients (chronic pharyngitis in 79.66% of them). HGR was found in 76.27% of patients in ENT group and in 43.75% of controls (consisted of GERD patients without signs of ENT pathology, n = 32), p = 0.0026. Mean number of HGRs was higher in ENT group compared to controls: (M +/- s) 12.51 +/- 18.56 vs 2.84 +/- 7.11 respectively, p (Mann-Whitney U-test) = 0.0003. Mean pH levels in the proximal esophagus were lower in the ENT group: (M +/- m) 6.32 +/- 0.52 vs 6.58 +/- 0.42, p = 0.011. Mean time pH <4 in the proximal esophagus differed significantly between ENT and GERD patients without ENT: 3.19 +/- 6.76 min in ENT group compared to 2.42 +/- 10.02 min in controls, p = 0.003. The calculated cut-off values for the number of high GER were 2 (DSn 71.19%, DSp 68.75%) or 3 (DSn = 61.02%, DSp = 71.88%); for mean pH in the proximal esophagus--6.3 (DSn = 75%, DSp = 51.47) or 6.4 (DSn = 68.75%, DSp = 58.82%); for time pH < 4--optimal value was 25 sec (DSn = 72.88%, DSp = 68.75%). CONCLUSIONS Proximal pH monitoring may be useful in diagnosing extraesophageal manifestation of GERD. Optimal cut-off values of number of high GER are 2 to 3, mean pH 6.3-6.4 and time pH < 4 - 25 sec.
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Ukhankova NI, Sotskaia TI. [Potentialities of the vegetative resonance test for diagnostics of hyperplastic processes in vocal folds]. Vestn Otorinolaringol 2010:48-50. [PMID: 21108502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of the present study was to evaluate potentialities of the vegetative resonance test (VRT) for the elucidation of metabolic aspects of the inflammatory process in different forms of chronic vocal fold hyperplasty. The proposed diagnostic criteria characterize the inflammatory process in the larynx, specific features of metabolism in patients presenting with catarrhal and oedematopolypous laryngitis, characteristic changes in oedematofibrous and fibrous polyps. The use of VRT allowed diagnostic criteria for precarcinogenic conditions in the larynx to be developed.
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Khamidova FM, Blinova SA. [Tissue reactions of the laryngeal mucous membrane and its regulatory structures in experimental chronic laryngitis]. Morfologiia 2010; 137:40-43. [PMID: 21500431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Experimental chronic laryngitis (ECL) was induced in 34 adult male rabbits by placement of fosta nylon thread into their trachea. Changes in the laryngeal mucous membrane in ECL were studied at days 30-90 using histological, histochemical and morphometric methods. ECL resulted in the thickening of both the epithelium and lamina propria of the laryngeal mucous membrane. In the ECL dynamics, the thickness of stratified squamous epithelium was increased insignificantly, however, it demonstrated the stimulation of the focal hyperplastic processes. Lamina propria, underlying this epithelium, was found to become thicker throughout the whole experiment (days 30-90). At the same time, progressive growth of the thickness of both pseudostratified ciliated epithelium and the lamina propria beneath was observed. This was accompanied by the hyperplasia of laryngeal endocrine cells and the increase of their secretory activity.
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Eckley CA, Rios LDS, Rizzo LV. Salivary egf concentration in adults with reflux chronic laryngitis before and after treatment: preliminary results. Braz J Otorhinolaryngol 2008; 73:156-60. [PMID: 17589721 PMCID: PMC9450656 DOI: 10.1016/s1808-8694(15)31060-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Accepted: 02/15/2007] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED The Laryngopharyngeal Reflux (LPR) physiopathology is still unknown. The Epidermal Growth Factor (EGF) is a biologically active salivary protein that aids in the rapid regeneration of the oropharyngeal and upper digestive tract mucosas. Salivary deficiency of this protein in patients with LPR has been demonstrated in previous studies. AIM To compare salivary EGF concentration in patients with LPR before and after treatment. MATERIALS AND METHODS In this prospective study twelve patients with GERD and moderate LPR were studied. Whole saliva samples were collected before and after treatment and salivary EGF concentration was determined using a commercially available ELISA kit (Quantikine). RESULTS There were eleven females and one male among the patients, the mean age was 49 years. The mean pre-treatment salivary EGF concentration was 2,867.6 pg/mL and the mean post treatment EGF concentration was 1,588.5 pg/mL. This difference was statistically significant (p=0.015). DISCUSSION AND CONCLUSIONS Although salivary EGF concentrations are higher before LPR treatment, the concentration is still much lower than the mean salivary EGF concentration in normal individuals without LPR, which suggests a primary disorder of this defense factor in individuals with LPR.
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Lekomtseva OI, Sharaev PN. [A role of determination of sialic acids in the biological fluids of children with stenosing laryngotracheitis]. Klin Lab Diagn 2006:46-7. [PMID: 16875131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Akbayir N, Sökmen HM, Caliş AB, Bölükbaş C, Erdem L, Alkim C, Sakiz D, Mungan Z. Heterotopic gastric mucosa in the cervical esophagus: could this play a role in the pathogenesis of laryngopharyngeal reflux in a subgroup of patients with posterior laryngitis? Scand J Gastroenterol 2005; 40:1149-56. [PMID: 16265772 DOI: 10.1080/00365520510023468] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Acid secretion produced by a heterotopic gastric mucosal patch (HGMP) in the proximal esophagus, instead of gastric acid, may be responsible for laryngopharyngeal reflux (LPR), passing the upper esophageal sphincter. The aim of this study was to investigate the prevalence of HGMP in the proximal esophagus in patients with posterior laryngitis indicating the presence of LPR in comparison with a control group and to elucidate the possible role of this lesion in the pathogenesis of LPR. MATERIAL AND METHODS A total of 36 consecutive patients with posterior laryngitis diagnosed on laryngoscopic examination were enrolled in the study. Esophagoscopy and ambulatory 24-h intra-esophageal dual-probe pH monitoring were performed in all patients. During endoscopy, special attention was paid to the proximal part of the esophagus, and the proximal electrode for pH monitoring was placed in this region under endoscopic view. The control group comprised 660 consecutive patients who had undergone upper gastrointestinal endoscopy for the usual indications. When HGMP was found, biopsies were taken for histological confirmation. RESULTS HGMP was detected in 5 out of 36 patients. One out of five patients with patches was excluded from the study because the histopathology of this patient's patch revealed antral-type mucosa, which is not capable of acid secretion. Thus a total of 35 patients were included in the study, yielding a HGMP prevalence of 11.4% (4/35). Compared with the prevalence of the control group (1.6%), a significant difference was observed (p<0.005). pH monitoring showed that 45.4% of the patients had abnormal proximal acid reflux. All of four HGMP (+) patients with posterior laryngitis revealed significantly higher abnormal proximal reflux compared to the patients without patches (p<0.05). CONCLUSIONS This first preliminary study may suggest that HGMP in the cervical esophagus could play a role in the pathogenesis of LPR, at least in a minor group of patients with posterior laryngitis, depending on its capability to produce acid in situ, although isolated proximal reflux could not be demonstrated. This finding may need to be supported by further studies with larger patient populations and using acid stimulation tests.
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Affiliation(s)
- Nihat Akbayir
- Department of Gastroenterology, Sişli Etfal Training and Research Hospital, Istanbul, Turkey.
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Kawamura O, Aslam M, Rittmann T, Hofmann C, Shaker R. Physical and pH properties of gastroesophagopharyngeal refluxate: a 24-hour simultaneous ambulatory impedance and pH monitoring study. Am J Gastroenterol 2004; 99:1000-10. [PMID: 15180717 DOI: 10.1111/j.1572-0241.2004.30349.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Frequency occurrence of nonacidic and nonliquid reflux events in the pharynx has not been systematically studied. The aim of the present study was to characterize the physical (liquid, gas, and mixed gas/liquid) and pH properties of the gastroesophagopharyngeal refluxate. METHODS We performed a total of 31 24-h simultaneous ambulatory pharyngoesophageal impedance and pH recordings in 11 GERD patients, 10 patients with reflux-attributed laryngitis, and 10 healthy controls. RESULTS On average, the total number of reflux events (all kinds) in the pharynx was less than half of that in the proximal esophagus (18 +/- 4 vs 50 +/- 4, p < 0.01). Most of the pharyngeal reflux events were gas events and were observed in all three studied groups. Prevalence of these gas reflux events ranged between 0 and 74. The number of gas reflux events accompanied by a minor pH drop in laryngitis patients (1 (0-36)) was significantly higher than those in GERD and controls (0 (0-2) and 0 (0-1), respectively, p < 0.05). There was no significant difference in the number of nonacidic gas reflux events among the three groups (GERD: 10 (2-57), laryngitis: 11.5 (0-51), controls: 10.5 (0-27)). Impedance recording identified a total number of 566 events in the pharynx. Of these, a total of 563 events were compatible with gas reflux events, 101 events were accompanied by minor drops in intrapharyngeal pH, whereas 460 events were not accompanied by any pharyngeal pH change. CONCLUSIONS Concurrent impedance and pH recordings detect significantly more events qualifying as reflux in the pharynx than pH recordings alone. A substantial majority of these events are gaseous refluxes both with and without minor pH drops. Gas reflux events with weak acidity appear to be more common among patients with reflux-attributed laryngeal lesions compared to GERD patients and controls.
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Affiliation(s)
- Osamu Kawamura
- MCW Dysphagia Institute, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Abstract
OBJECTIVES/HYPOTHESIS Determination of intrapharyngeal distribution of gastric acid refluxate is needed to better understand the pathogenesis of reflux-attributed aerodigestive tract disorders. The aims of the study were to determine intrapharyngeal distribution of gastric acid refluxate and to determine whether this distribution can better differentiate patients from control subjects compared with data obtained from a single hypopharyngeal site. METHODS We prospectively studied 10 healthy volunteers, 12 patients with reflux laryngitis, and 15 patients with vasomotor rhinitis using a concurrent dual pharyngeal/dual esophageal pH recording technique. We determined the hypopharyngeal and oropharyngeal pH profile, including number, duration, and distribution of reflux events irrespective of and in correlation with intraesophageal pH profile using four different pH thresholds. RESULTS Few drops in pharyngeal pH were found to be true reflux events based on their correlation with esophageal pH events. For the pharyngeal pH threshold criterion of a drop to 4.0 or less, 6 of 12 patients with reflux laryngitis, 5 of 15 patients with vasomotor rhinitis, and 2 of 10 normal control subjects exhibited a total of 25 (range, 1-5) distal pharyngeal acid reflux events. Overall, 34% of these events reached the oropharyngeal pH recording site. Between-group comparison for all levels of pH threshold criteria did not show any significant difference of reflux parameters in the hypopharyngeal or in the oropharyngeal sites among the studied groups. CONCLUSIONS Reflux of gastric acid into the pharynx may extend to the region of the oropharynx in both patients and control subjects. Overall distribution of acid refluxate to the oropharynx is low but as groups is similar between healthy individuals and patients with reflux laryngitis and those with vasomotor rhinitis. Parameters of oropharyngeal acid reflux such as number and duration do not differentiate patients from control subjects.
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Affiliation(s)
- Reza Shaker
- Dysphagia Institute, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
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Jecker P, Mann WJ, McWilliam AS, Holt PG. Dendritic cell influx differs between the subglottic and glottic mucosae during acute laryngotracheitis induced by a broad spectrum of stimuli. Ann Otol Rhinol Laryngol 2002; 111:567-72. [PMID: 12126010 DOI: 10.1177/000348940211100701] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinically, the subglottic and glottic mucosae may react differently, eg, during acute laryngotracheitis. In healthy rats, we showed previously that the composition of the mucosal immune system of the larynx also differs between these areas. Neutrophils, lymphocytes, and dendritic cells (DCs) are part of this mucosal immune system. In particular, DCs occupy a key function. They migrate into inflamed mucosae during the early phase of the immune response, which is normally characterized by an influx of neutrophils. Thus, they help to overcome the time lag between the innate and the adaptive immune responses. In the present study, the influx of DCs, neutrophils, and T lymphocytes into the subglottic and glottic mucosae of rats was examined at different time points after challenge with a broad spectrum of stimuli such as dead Moraxella catarrhalis, viable Bordetella pertussis, viable Sendai virus, and the soluble protein ovalbumin. The number of DCs increased rapidly after the application of the antigens. This increase was as rapid as the increase in neutrophils. Depending on the kind of antigen, their number in the mucosa increased up to 1,000 cells per 0.1 mm2 (Sendai virus). The comparison of different mucosal areas shows that an overwhelming number of immunocompetent cells entered the subglottic mucosa, whereas only a few cells migrated into the adjacent glottic mucosa. In conclusion, after inhalation of different kinds of antigens, the subset of immunocompetent cells investigated in this study entered the laryngeal mucosa in high numbers. The number of DCs entering the laryngeal mucosa was higher than the numbers of the other immune cells investigated. This finding underlines their function as first-line sentinels of the mucosal immune system of the larynx. The observation that the number of cells entering the laryngeal mucosa is location-dependent indicates the ability of adjacent laryngeal regions to react differently. This is similar to the clinical observation of a selective subglottic reaction during acute laryngotracheitis.
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Affiliation(s)
- Peter Jecker
- Department of Otolaryngology, Mainz Medical School, Germany
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Abstract
Chronic laryngitis symptoms are commonly seen in otherwise healthy people. This article reviews recent progress in our understanding and effective treatment of chronic laryngitis. Clinical experience and prospective treatment and outcome studies have demonstrated objective evidence of the efficacy of treating patients with chronic laryngitis symptoms with nocturnal antireflux precautions and acid-suppressing medications. The role of pH testing and most common errors in treatment are reviewed.
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Affiliation(s)
- D G Hanson
- Department of Otolaryngology, Head and Neck Surgery, Northwestern University Medical School, Chicago, Illinois 60610, USA
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Pal'chun VT, Kriukov AI, Podmazov AV, Maksimenko BI. [Experimental choice of drugs for pharmacophysical impact on larynx]. Vestn Otorinolaringol 1999:28-31. [PMID: 10453232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The authors validate the necessity of developing the method of laryngeal phonoelectrophoresis for treatment of acute and chronic laryngeal inflammation. Radioisotopes tracing shows high permeability of laryngeal tissue for drugs due to combined effects of phono- and electrophoresis. Maximal permeability of the dialysis membrane UB-20 was determined and optimal stereotypes of laryngeal phonoelectrophoresis with different drugs were proposed.
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Ludemann JP, Manoukian J, Shaw K, Bernard C, Davis M, al-Jubab A. Effects of simulated gastroesophageal reflux on the untraumatized rabbit larynx. J Otolaryngol 1998; 27:127-31. [PMID: 9664240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Gastroesophageal reflux (GER) has been shown, clinically and experimentally, to cause inflammation of traumatized laryngeal mucosa. This study was performed to determine if GER causes inflammation of untraumatized laryngeal mucosa. METHOD Sixteen adult New Zealand white rabbits underwent tube pharyngostomy under general anaesthesia without endotracheal intubation. After 7 days recovery, 1 mL/kg of normal saline or HCl (pH 1.5) with pepsin (0.3 mg/mL) was infused into the piriform sinus while the rabbit was under mild sedation: once, twice, or three times per day, for 14 consecutive days. RESULTS Rabbits that received HCl and pepsin exhibited various degrees of apnea and coughing. Eventually, most developed biphasic stridor on exertion. Histologically, the degree of laryngeal inflammation was greatest when GER was simulated three times per day. Glottic inflammation was greatest in one rabbit, which responded to GER simulation with paroxysmal coughing. CONCLUSION The mechanism of injury in GER laryngitis is postulated to be a combination of chemical trauma (due to HCl and pepsin) and mechanical trauma (due to an individually variable laryngeal chemoreflex). Further study of GER laryngitis in this new animal model is warranted.
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Affiliation(s)
- J P Ludemann
- Division of Pediatric Otolaryngology, Children's Memorial Hospital, Chicago, IL, USA
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Mintegui Raso S, Sánchez Echániz J, Benito Fernández J, Angulo Barreras P, Gastiasoro Cuesta L, Ortiz Andrés A. [Usefulness of oxygen saturation in the assessment of children with moderated laryngitis]. An Esp Pediatr 1996; 45:261-3. [PMID: 9019966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine the usefulness of oxygen saturation (SaO2) in the assessment of a child with moderate laryngitis (croup). PATIENTS AND METHODS A prospective study was carried out on 54 cases of moderate laryngitis (score of 2 to 6 of a possible 16) attended at our emergency department. Clinical score, heart rate, respiratory rate and SaO2 were recorded upon arrival. We analyzed the relationship between SaO2 and the requirement of nebulized epinephrine, parenteral dexamethasone and admission to the hospital. RESULTS Patients who received epinephrine showed SaO2 values lower than those who did not (96.8 +/- 1.9 vs 97.9 +/- 1.7), although this was not a significant difference (p = 0.11). Similar findings were seen when the requirement of parenteral dexamethasone was analyzed (96.7 +/- 1.9 vs 97.3 +/- 1.8, p = 0.28). Children admitted to the hospital showed SaO2 values significantly lower than those discharged (96.5 +/- 1.9 vs 97.6 +/- 1.7, p = 0.03). No differences were seen when heart rate or respiratory rate were analyzed. CONCLUSIONS We conclude that the measurement of is SaO2 useful in initial assessment of a child with acute laryngitis, essentially in order to better identify those patients who require admission to the hospital. It appears reasonable to include it in the initial assessment score.
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Abstract
BACKGROUND & AIMS A variety of otolaryngological abnormalities have been attributed to the contact of gastroesophageal refluxate with respective structures of the aerodigestive tract. The aim of this study was to determine and compare the pharyngoesophageal distribution of gastric acid refluxate between patients with proven laryngitis attributed clinically to gastroesophageal reflux and three control groups. METHODS An ambulatory 24-hour simultaneous three-site pharyngoesophageal pH monitoring technique was used to measure reflux parameters in the pharynx, proximal esophagus, and distal esophagus. RESULTS Between-group comparison showed no significant difference in the reflux parameters in the distal esophagus between the studied groups. A significantly higher percentage of distal reflux episodes reached the proximal esophagus in the laryngitis group than in the control groups (P < 0.01), and the number of pharyngeal reflux episodes and time of acid exposure were significantly higher in the laryngitis group than in the control groups (P < 0.001). CONCLUSIONS Compared with normal controls and patients with gastroesophageal reflux disease, pharyngeal reflux of gastric acid is significantly more prevalent and the ratio of proximal to distal esophageal acid reflux episodes is significantly increased in patients with posterior laryngitis. Simultaneous three-site ambulatory pharyngoesophageal pH monitoring may provide supporting evidence when the diagnosis of reflux-induced aerodigestive tract lesions is considered.
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Affiliation(s)
- R Shaker
- Medical College of Wisconsin Dysphagia Institute, Department of Medicine, Milwaukee, USA
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Pinto S, Gallo O, Dilaghi M, Gallina E, Giannini A, Coppo M, Paniccia R, Prisco D, Abbate R. Prostaglandins in squamous cell carcinoma of the larynx: tumor and peritumor synthesis. Prostaglandins Leukot Essent Fatty Acids 1990; 39:53-7. [PMID: 2339137 DOI: 10.1016/0952-3278(90)90172-h] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Prostaglandin (PG) E2, 6ketoPGF1 alpha and Thromboxane B2 (TxB2) production by the tumor, peritumor and control tissue were investigated in specimens from patients (n = 11) with squamous cell carcinoma of the larynx, in relation to the extension and infiltration of the neoplasm and to the presence of inflammation, fibrosis and necrosis. In all specimens detectable amounts of 6ketoPGF1+ and TxB2 were found, but the predominant metabolite was PGE2. No differences in the levels of TxB2 and 6ketoPGF1 alpha were observed, but the only patient with lymphnodal involvement showed the lowest levels of 6ketoPGF1 alpha both in tumor and peritumor tissue. Higher amounts (p less than 0.05) of PGE2 were synthesized by peritumor tissues in comparison to control mucosa and tumor tissue independently of the occurrence of reactive infiltration. PGs synthesis did not correlate with inflammation, fibrosis, necrosis or staging of the neoplasm. However the two cases in stage T4 showed PGE2 generation at the highest levels both in neoplastic and perineoplastic tissue. These findings indicate that in squamous cell carcinoma of the larynx an increased production of PGE2 occurs, stemming not only from inflammatory cells but at least in part from neoplastic cells. This suggests that the study of arachidonic acid metabolism may contribute to characterization of the primary cancer and lead to better understanding of the mechanisms of tumor growth and diffusion.
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Affiliation(s)
- S Pinto
- Clinica Medica I, University of Florence, Italy
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Soboczyński A, Grzegorowski M, Wesołowski Z. [Cortisol blood level in children with subglottic laryngitis (author's transl)]. HNO 1978; 26:346-9. [PMID: 711518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Clinical observations have shown that fear of suffocation aggravates respiratory tract occlusion in children with subglottic laryngitis (s.l.). In similar situations of emotional stress, changes occur in the function of the adrenal glands. The author's observations lead to the conclusion that rapid intravenous injection of glucocorticoids results in the alleviation of symptoms endangering a child's life so that in a majority of cases a tracheotomy is no longer necessary. Cortisol blood level was estimated by the technique of de Moor as modified by Derech and Golebiowska. These levels were then determined in 20 children with s.l. not treated with glucocorticoids before hospitalization and 10 children in a control group. In children with s.l., high levels of cortisol were detected at the time of admission. In a few cases 100 microgram/100 ml. After symptoms of s.l. subsided, levels of cortisol resembled those of the control group as seen on primary examination. Administration of ACTH induced a more pronounced increase in cortisol level in children with s.l. than in children of the control group.
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Biegański T, Maśliński C. Histamine, putrescine and benzylamine oxidation during subcutaneous tissue inflammation in guinea-pig. Agents Actions 1974; 4:190-1. [PMID: 4213141 DOI: 10.1007/bf01970269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Tarasov DI, Zagarskikh MG, Ababii II. [The glococorticoid function of the adrenal cortex during complex treatment of acute stenosing laryngotracheitis in children]. Vestn Otorinolaringol 1973; 34:43-8. [PMID: 4713897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wesley AG. The acid-base balance of infective croup. S Afr Med J 1972; 46:729-31. [PMID: 5075604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Benko J, Szabová I, Gasparová K, Richterová O. [Observation of acid-base equilibrium in acute childhood encephalitides]. Cesk Pediatr 1970; 25:575-8. [PMID: 5489338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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