Palatine Tonsils Research Articles

A Tissue Ignored In Cervical Ultrasound: Relationship of Palatine Tonsil Size with Age, Sex, Body Mass Index, and Body Surface Area in the Pediatric Population

A Tissue Ignored In Cervical Ultrasound: Relationship of Palatine Tonsil Size with Age, Sex, Body Mass Index, and Body Surface Area in the Pediatric Population

Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer

Efforts are underway to deintensified treatment protocols for patients with human papillomavirus virus-associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) to achieve similar excellent oncologic outcomes while reducing treatment-related adverse effects. Transoral robotic surgery (TORS) as primary treatment often requires adjuvant therapy due to the high incidence of nodal metastasis. Treatment with neoadjuvant chemotherapy followed by TORS and neck dissection (NECTORS), reserving radiation therapy for salvage, yields excellent oncologic outcomes. To assess patient-reported quality of life (QOL) and functional outcomes among patients with HPV-OPSCC who undergo NECTORS. This was a multicenter prospective cohort study of patients with HPV-OPSCC treated with the NECTORS protocol in 2017 to 2022. Consecutive patients with stage III or IVa HPV-OPSCC treated with NECTORS in 2017 to 2022 who had completed the primary QOL questionnaire at baseline and at least once during the 24-month follow-up period were included. Ninety-four patients were eligible, and 67 were included in the analyses. QOL questionnaires at baseline, and at month 1, 3, 6, 12, 18, and 24 posttreatment. Global score on the 30-item European Organization for Research and Treatment of Cancer Core quality of life questionnaire (EORTC QLQ-C30) was the primary outcome; the head and neck extension module (EORTC QLQ-HN35); the MD Anderson Dysphagia Inventory for dysphagia-related QOL; and the Decision Regret Scale were also used. Paired t tests assessed change between the baseline and 12- or 24-month patient-reported outcomes. Among the study population of 67 patients (median [range] age, 63 [58-67] years; 54 [80.6%] male) with HPV-OPSCC, the most frequent cancer subsites were palatine tonsil (41 [61%]) and base of tongue (26 [39%]); none required adjuvant RT. Global QOL at 24 months improved compared with baseline (mean difference, 9.49; 95% CI, 2.45 to 16.53). All EORTC QLQ-C30 functional scores returned to baseline or improved within 3 to 6 months posttreatment and remained stable at 24 months. EORTC QLQ-HN35 symptom scale scores improved or were stable at 24 months. The MD Anderson Dysphagia Inventory scores demonstrated no significant difference between baseline and month 12 for global scores (mean difference, 6.15; 95% CI, -4.18 to 16.49) and composite scores (mean difference, 2.73; 95% CI, -1.62 to 7.09). Median (range) score on the Decision Regret Scale was 5 of 100 (0-30), representing mild overall regret. The findings of this multicenter cohort study indicate that use of the NECTORS protocol is associated with excellent QOL outcomes. QOL measures returned to baseline levels or were better than baseline, which represents positive outcomes for patients with HPV-OPSCC who undergo this treatment regimen.

Incision and Drainage Versus Needle Aspiration for Peritonsillar Abscess: A Prospective Randomized Controlled Trial

Background and Objectives Peritonsillar abscess (PTA) is an accumulation of pus between the palatine tonsil and pharyngeal constrictor muscle. It is a common cause of emergency on-call consultations among ENT doctors and occurs due to the possibility of sepsis, airway obstruction, and progression to deep neck infection. This study aims to compare the effectiveness of needle aspiration (NA) to incision & drainage (I&D) for the treatment of PTA.Subjects and Method From September 2018 to March 2020, 58 patients with PTA were admitted to our ENT Department. After a comprehensive diagnostic procedure, 38 patients were enrolled in the study and they underwent either I&D (20 patients) or NA (18 patients) treatment. Patients were discharged when edema decreased on the endoscopic findings and their symptoms improved, with a visual analogue scale (VAS) score <3 points. For each patient, we evaluated the abscess volume, age, body mass index, hypertension, diabetes mellitus, smoking and drinking history, abscess size, and duration of hospitalization. White blood cell (WBC) count, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were estimated on the 1st, 3rd, and 5th days of hospitalization.Results The mean age of participants was 42.8±15.5 years and 40.3±14.7 years in the I&D and NA groups, respectively. Except for ESR, the mean hospitalization duration, initial volume of abscess size, VAS pain score, WBC count and the CRP level were not different between the groups.Conclusion Our study revealed no significant differences in hospital stay duration, VAS score, WBC counts or in the CRP level among patients admitted for PTA, whether they underwent I&D or NA.

Efficacy, safety, and tissue penetration of solithromycin in Japanese patients with otorhinolaryngological infections

ObjectiveTo assess the efficacy, safety, and tissue penetration of solithromycin for the treatment of otorhinolaryngological infections, we conducted three studies: a tissue penetration study with patients scheduled to undergo otorhinolaryngological tissue removal, an open-label study comprising patients with otitis media, pharyngitis, laryngitis, and tonsillitis, and a non-inferiority study compared with high-dose cefcapene-pivoxil (CFPN-PI). MethodsTissue penetration study; 17 patients with chronic rhinosinusitis, chronic otitis media, chronic tonsillitis, or palatine tonsillar hypertrophy, who required resection or removal of their tissue, were enrolled. Solithromycin was administered orally, and otorhinolaryngological tissues were collected 3.5–6 h after drug administration; blood was collected within 15 min before and after drug administration. The collected tissues and blood concentrations were measured at a central laboratory. Open-label study; 55 patients who were diagnosed with acute otitis media, laryngopharyngitis, or tonsillitis were enrolled. Solithromycin was administered orally 800 mg on Day 1, while on days 2–7, 400 mg of the drug was administered once daily. The primary endpoint is the clinical response at Test-of-Cure (TOC: 5–10 days after completion) Non-inferiority study; 283 patients with acute rhinosinusitis or acute exacerbation of chronic rhinosinusitis were randomized into either the solithromycin group or CFPN-PI group. Solithromycin was administered 800 mg once daily on Day 1 and 400 mg once daily while on Days 2–7 in solithromycin group, and CFPN-PI was administered 150 mg three times a day while on Days 1–7 in CFPN-PI group. The primary endpoint is the clinical response at TOC. ResultsIn the tissue penetration study, the tissue concentration ratios (tissue concentration/plasma concentration) of solithromycin were 4.19 in the sinonasal mucosa, 1.33 in the middle ear mucosa, and 6.12 in the palatine tonsil tissue. In the open-label study, the efficacy rates at the TOC were 97.0 % for acute otitis media, 100 % for laryngopharyngitis, and 81.8 % for tonsillitis. In the non-inferiority study comprising patients with rhinosinusitis, the efficacy rate at the TOC was 87.7 % for solithromycin and 89.7 % for CFPN-PI. The difference in the efficacy rate (95 % confidence interval) was -2.0 % (-9.4 % to 5.4 %), verifying the non-inferiority of solithromycin to CFPN-PI. The most common adverse events in patients administered solithromycin were diarrhea (20.7 %), nausea and nasopharyngitis (3.6 %,), pharyngitis and elevated hepatic function test results (3.1 %), and abnormal hepatic function (2.1 %). ConclusionBased on the findings, it is suggested that solithromycin is useful for the treatment of otorhinolaryngological infections.

Acute myelomonoblastic leukemia in children, the particularities of extramedullary infiltration based on a clinical case

Childhood acute myeloidleukemia (AML) represents approximately 5% of childhood malignancies and 15% to 25% of pediatric acute leukemia. The extramedullary manifestation of infiltrating clonal blast populations in a variety of organs and tissues in acute myeloid leukemia (AML) is defined as a distinct entity in the 2016 WHO classification of myeloid neoplasms, myeloid sarcoma The rate of complete remission after induction chemotherapy was lower in patients with extramedullary infiltration, overall survival and event-free survival were not different between patients with and without extramedullary infiltration. Purpose of the study: Presentation of a clinical case of ALM type M4 with the presence of an extramedullary infiltrate in the tissue of the central nervous system in children. Materials and methods: The clinical, paraclinical, imaging data of the patient were studied in parallel with the specialized literature on similar cases. Results: Boy, 5 years old, goes to the doctor with accusations of bilateral palpebral edema, bilateral temporal region edema and bilateral exophthalmos , more pronounced on the left. In the general analysis of the blood: - Hemoglobin - 89 g/l , Leukocytes - 7.2 x 10^9/l; unsegmented neutrophil - 1%; segmented - 18%; lymphocytes - 44%; monocytes - 20%; blast cells - 16%; Platelets - 70 x 10^9/l;VSH - 44 mm/h. During the physical examination: the peripheral lymph nodes are palpable. No signs of central nervous system damage. It is supposed the diagnosis: Acute myeloid leukemia, sarcoma, or neuroblastoma. A medullary puncture: moderately cellular marrow was determined, with blastcells 15.2%. Morphologically, it is more similar to acute myelo-monoblastic leukemia FAB-M4. Computerized Tomography-multiple, hyperdense pathological foci, with localization with inand bilateral extraorbital, associated with exophthalmos. The formation from the sphenoid sinus extends to the nasopharynx , through the pterygopalatine fossa, with narrowing of the lumen and mass effect on the palatine tonsils. Immunophenotyping: CD45-/+ SS low 8% population, CD36+ 6%CD64+ monoblasts 8%, Promonocytes /monocytes – (CD64+/CD14+) 25%.He underwent treatment according to the AML BFM 2004 program with numerous complications, andcranial radiotherapy. At the moment, the child is in morphological remission. Conclusions. The differential diagnosis of hyperdense intracranial masses may include neuroblastoma, meningioma, lymphoma, metastases, or sarcomas. Correct and early diagnosis and initiation of specific treatment are essential to increase the survival rate in cases of acute leukemia in children.

Sebuah Kasus : Post Tonsilektomi Dengan Komplikasi Syok Hipovolemik

Tonsillitis is inflammation of the palatine tonsils. Infection of the tonsils occurs if antigens, whether inhaled or ingested, easily enter the tonsils and the body resists and a focus of infection forms. Initially, the infection is acute, generally caused by viruses that grow on the mucous membrane, then followed by bacterial infection. As a result of chronic inflammation, the size of the tonsils will increase due to parenchymal hyperplasia or fibrinoid degeneration with tonsillar crypt obstruction. The definitive treatment for chronic tonsillitis is surgical removal of the tonsils or tonsillectomy where one of the complications is bleeding which triggers hypovolemic shock. This case report presents a 19 year old man who complained of pain in swallowing and a feeling of lump in the throat and based on the history, physical examination and supporting examinations that had been carried out, the patient was diagnosed with tonsillitis and planned to undergo a tonsillectomy. After the procedure, the patient experienced hypovolemic shock due to bleeding and died

Laryngopharyngeal Reflux Scoring in a Pediatric Population

In recent years, the prevalence of laryngopharyngeal reflux has risen, especially among pediatric patients. The diagnosis of laryngopharyngeal reflux relies on patient history and clinical assessment using the Reflux Finding Score and Reflux Symptom Index as crucial diagnostic tools. Some studies have proposed a link between pepsin and laryngopharyngeal reflux, potentially triggering palatine tonsil hypertrophy. Our study aimed to investigate the correlation between laryngeal and pharyngeal manifestations of laryngopharyngeal reflux through two questionnaires and the presence of pepsin in saliva and palatine tonsils in a pediatric population. Pepsin in saliva was detected using a Western blot method, while immunohistochemistry assessed its presence in palatine tonsils. Although no statistically significant differences in Reflux Finding Score and Reflux Symptom Index were found between the immunohistochemistry-positive (IHC-positive) and immunohistochemistry-negative (IHC-negative) groups, median reflux symptom index and Reflux Finding Score values consistently trended higher in the IHC-positive group. This suggests a potential connection between elevated index values and pepsin presence in tonsillar tissue. Further investigations are essential to fully comprehend the clinical implications of these findings.

The Clinical Significance of Tonsillar Actinomyces in Histopathological Samples after Tonsillectomy.

Actinomyces is a genus of Gram-positive anaerobic or microaerophilic bacteria with a branched filamentous shape. Their presence in tonsil tissue is usually determined by histopathological examination. In the crypts of removed tonsils, they have a prevalence ranging from 0.8% to 61.6%. The role of Actinomyces in diseases of the palatine tonsils is not clearly defined. The aim of the study was to determine the importance of Actinomyces in the pathology of palatine tonsils and to assess the impact of these bacteria on the clinical data. the retrospective analysis of the histopathological findings of patients undergoing tonsillectomy in our hospital from January 2017 to the end of December 2019 was performed in terms of the occurrence of Actinomyces. The data were collected based on the medical history. The study included 481 patients aged 3-82 years. From the study group, 100 adult patients were randomly selected, and a telephone survey was conducted. The questions included the co-occurrence of bronchial asthma, halitosis, tonsilloliths, and cigarette smoking. The questions were related to the complications following tonsillectomy and the severity of postoperative pain. Existence of a relationship was investigated between occurrence of tonsillar Actinomyces and age, sex, body mass index, and medical condition (obstructive sleep apnea, chronic palatine tonsillitis), respectively. The size of the removed tonsils was assessed and compared depending on the presence of the bacteria. patients aged 18 years and older had a higher probability of presenting Actinomyces. The estimated odds ratio for the presence of the bacteria per year of age was 1.023 [1.007, 1.041]. No statistically significant results were found for the other variables. The co-occurrence of the bacteria and halitosis was close to statistical significance (p = 0.064). multivariate analysis of the role of Actinomyces in tonsillar pathology showed that these microorganisms should be considered saprophytes of the oropharyngeal microflora that had no significant relationship with the pathology of palatine tonsils. Further studies on their influence on halitosis are warranted.

Unilateral Tonsillar Enlargement as Initial Presentation of Bilateral Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma.

Unilateral tonsillar enlargement is a common indication for tonsillectomy, but there are varying rates of malignancy among tonsils removed for asymmetry and a lack of clear guidelines for management within the literature. Lymphoma of the palatine tonsils is among the concerns leading to tonsillectomy, but chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) of the tonsil is rare. We report a case of primary CLL/SLL of the palatine tonsil in a 51-year-old gentleman who presented with tonsillar asymmetry and obstructive sleep apnea (OSA) but lacked signs and symptoms suspicious for malignancy, including lymphadenopathy and "B-symptoms." To our knowledge, only 7 cases of CLL/SLL of the palatine tonsil have been reported in the English literature, with the tonsil being the primary site of involvement in only 4 of those cases. Our unique case highlights the importance of thorough physical exam, family history, and tissue biopsy in patients presenting to the otolaryngologist with OSA and asymmetric tonsils.

Clinicopathological and ultrastructural study of African swine fever outbreak in North-East India

The present investigation focuses on examining the clinical, histopathological, and ultrastructural changes that occurred in pig, during an outbreak of African swine fever (ASF) in 2022 in Assam, India. The disease initially manifested as a per-acute case with high mortality but without any evident clinical signs. Subsequently, some animals exhibited an acute form of the disease characterized by high fever (104–106 °F), anorexia, vomiting, respiratory distress, and bleeding from the anal and nasal orifices. During acute African swine fever virus (ASFV) infections, elevated levels of pro-inflammatory IL-1α, IL-1β, IL-6, TNF, CCL2, CCL5, and CXCL10 were detected in the palatine tonsil, lymph nodes, spleen, and kidney using qPCR assay. These molecular changes were associated with haemorrhages, edemas, and lymphoid depletion. Postmortem examinations revealed prominent features such as splenomegaly with haemorrhages, haemorrhagic lymphadenitis, severe petechial haemorrhage in the kidney, pneumonia in the lungs, and necrotic palatine tonsil. Histopathological analysis demonstrated lymphocyte depletion in lymphoid organs, multi-organ haemorrhages, and interstitial pneumonia in the lungs. Scanning electron microscopy (SEM) further confirmed lymphocyte depletion in lymphoid organs through lymphocyte apoptosis and kidney damage with distorted tubules due to red blood cell destruction. Transmission electron microscopy reaffirmed lymphocyte apoptosis by observing chromatin condensation and nucleus margination in lymphocytes of lymphoid organs. These findings provide comprehensive insights into the clinical, histopathological, and ultrastructural aspects of ASF outbreak in pigs. Understanding the pathological changes associated with ASF can contribute to improved diagnosis, prevention, and control measures for this highly contagious and economically devastating viral disease.

Dissection Method and Diathermy Cauterization in Tonsillectomy- A Hospital Based Comparative Study

Tonsillectomy is one of the most common procedures performed by otolaryngologists. It is a surgical operation that removes both palatine tonsils from the tonsillar fossa. It is typically performed in youngers for recurrent tonsillitis and tonsillar hypertrophy. This study was done to compare the dissection and diathermy methods of tonsillectomy and evaluate their advantages and disadvantages during surgery and convalescence. This study was a retrospective analysis of 400 patients from January 2015 to January 2020 in Otorhinolaryngology and Head-Neck Surgery department of Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur. Out of 400 patients 200 patients underwent tonsillectomy by dissection method and rest 200 patients underwent electrocautery method. Total 400 patients were analyzed separately their hospital stay, blood loss per-operatively, complications in each method and overall outcome of the patients. The overall hospital staying in both types was 1-3 days. The average intra operative blood loss was 5-7 ml in cautery and average 50 ml in dissection method. The average operative time was 25-30 minutes in dissection method and 10-15 minutes was in electrocautery. We found higher amounts of blood loss and intra - operative time in dissection method than electrocautery. The chance of secondary haemorrhage was more in electrocautery method than dissection method. Pain, scar formation, odynophagia were more in cauterization method. Complete healing time was more in cauterization method than dissection method. There was no death in both methods. Although per-operative blood loss, operation time were less in cauterization method but post operative bleeding, pain, odynophagia and infection were more in electro cauterization method. In both methods, there were some advantages and some disadvantages. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 40-44

Transoral Ultrasound in the Outpatient Clinic for the Diagnostic Work-Up of Oropharyngeal Cancer: A Feasibility Study.

Magnetic resonance imaging (MRI) is the preferred imaging modality for oropharyngeal cancers (OPCs), but it has difficulties distinguishing between small OPCs and unilateral tonsil hypertrophy. We hypothesized that surgeon-performed transoral ultrasound (US) could be used to accurately detect T-stage OPCs. We performed a single-center prospective diagnostic accuracy study including patients with suspected or biopsy-verified OPCs during outpatient appointments. All patients were offered transoral US and MRI. If transoral US could not be tolerated by the patient, transcervical US was performed. The primary outcome was the diagnostic accuracy of detecting OPCs with US compared to MRI, using histopathology as the reference standard. The secondary outcome was comparing the primary tumor diameters between US and MRI blinded to each other. Out of the 26 patients included in the study, 21 (81%) had OPCs. Transoral US could be performed in 21/21 and 1/5 patients with suspected palatine and lingual tonsil OPCs, respectively. Overall, US diagnostic accuracy was 92%, compared to 81% with MRI (p = 0.37). US and MRI had a high correlation between tumor diameters in the anteroposterior diameter (R = 0.80, p < 0.001), corresponding to the depth axis on US. In conclusion, this small study showed the promise and feasibility of transoral US to improve the initial clinical evaluations of patients with suspected OPCs.

Comparison of innate lymphoid cells from tissue and blood in chronic tonsillitis and tonsillar hypertrophy.

Recurrent tonsillitis and tonsillar hypertrophy are two common diseases in children for which tonsillectomy is the definitive solution. The underlying causes of both diseases are not fully known. The aim of this study was to identify the predominant innate lymphoid cells in both diseases of the palatine tonsils, which are known to play an important role in the immune system. Children who underwent tonsillectomy were divided into two groups as recurrent tonsillitis and tonsillar hypertrophy according to the indication for surgery. The proportions of innate lymphoid cell (ILC) groups and IFN-gamma, IL-10 and IL-17 secreting T lymphocyte cells were determined in tonsil and blood samples obtained during surgery. Local and peripheral immune responses were evaluated. Innate immune responses and acquired immune responses were compared. The results of our study showed that the proportions of the innate lymphoid cell 1 group (ILC1) were similar in tonsil tissue in patients with recurrent tonsillitis and tonsil hypertrophy, with no statistically significant difference. It was observed that the innate lymphoid cell 2 group (ILC2) was the predominant group in tonsil hypertrophy, the innate lymphoid cell 3 group (ILC3) was the predominant innate lymphoid cell group in recurrent tonsillitis, and the proportion of IL-17 secreting T lymphocytes in blood and tonsillar mononuclear cells was higher in recurrent tonsillitis patients than in tonsil hypertrophy patients. With the results obtained, the predominant innate lymphoid cells in the pathogenesis of both diseases were identified and local and peripheral responses were compared. These findings may be a guide for possible medical treatments for both diseases in the future.

The correlation between tonsillectomy and Covid-19 infection

Background: The role of tonsillectomy history on the course of COVID-19 infection has not been determined, including COVID-19 colonization in the tonsillar tissue and reduce the cytokine activity of palatine tonsil tissue and the immune response of humoral with cellular immune.&#x0D; Objective: To determine the effect of tonsillectomy in the development of COVID-19 infection.&#x0D; Patients and Methods: It was collected 150 cases diagnosed with COVID-19 and they admitted to Diyala Hospitals. Data including age, gender, smokers, and symptom status were collected.&#x0D; Results: The total number of the patients who were positive COVID-19 was 150, the 102 (68%) of them were males and 48 (32 %) were females. It was found that the highest incidence rate was noticed among non-smoking patients (114 cases) compare to smokers (36 cases) (p&lt;0.0001). It was appeared a significant difference (p&lt;0.0001) of the symptoms of COVID-19 patients with tonsillectomy relative to the patients without tonsillectomy history.&#x0D; Conclusion: Patients that infected with COVID-19 and they have a history of tonsillectomy have more systemic response including fever, chills and other symptoms compare to the patients without tonsillectomy history.

Paracrine Factors Released from Tonsil-Derived Mesenchymal Stem Cells Inhibit Proliferation of Hematological Cancer Cells Under Hyperthermia in Co-culture Model.

Mesenchymal stem cells (MSCs) are promising biological therapeutic candidates in cancer treatment. As a source of MSCs, palatine tonsil tissue isone of the secondary lymphoid organs that form an essential part of the immune system, and the relation betweenthe secondary lymphoid organs and cancer progression leads us to investigate the effect of tonsil-derived MSCs (T-MSC) on cancer treatment. We aimed to determine the anti-tumoral effects of T-MSCs cultured at the febrile temperature (40°C) on hematological cancer cell lines. The co-culture of cancer cells with T-MSCs was carried out under fever and normal culture conditions, and then the cell viability was determined by cell counting. In addition, apoptosis rate and cell cycle arrest were determined by flow cytometry. We confirmed the apoptotic effect of T-MSC co-culture at the transcriptional level by using real-time polymerase chain reaction (RT-PCR). We found that co-culture of cancer cells with T-MSCs significantly decreased the viable cell number under the febrile and normal culture conditions. Besides, the T-MSC co-culture induced apoptosis on K562 and MOLT-4 cells and induced the cell cycle arrest at the G2/M phase on MOLT-4 cells. The apoptotic effect of T-MSC co-culture under febrile stimulation was confirmed at thetranscriptional level. Our study has highlighted the anti-tumoral effect of the cellular interaction between the T-MSCs and human hematological cancer cells during in vitro co-culture under hyperthermia.

Conditioned media of tonsil derived mesenchymal stem cells shows different rates of cytotoxicity on solid cancer cells

Aims: Mesenchymal stem cells (MSCs) are the apple of the eye of cancer studies. It was indicated that the secreted factors, especially released by MSCs, have tumoral or anti-tumoral effects on tumor progression. MSCs obtained from different sources show different anti-tumoral effects, while MSCs originating from the same source also show different tumoral effects in different cancer cells. Here, we investigated the anti-tumor effects of soluble factors secreted from palatine tonsil MSCs (TMSC) as a new source of MSC on human lung carcinoma (A549) and pancreatic cancer (PANC-1) cell lines.&#x0D; Methods: Conditioned medium (CM) was obtained from TMSCs isolated from palatine tonsil tissue, and the cytotoxic effect of CM on the growth of A549 and PANC-1 in a dose-dependent manner was demonstrated by MTT analysis. In addition, the function of CM treatment on the cell cycle status of cancer cells and the apoptosis process were investigated through cell cycle analysis with propidium iodide (PI) and Annexin-V/PI detection method by flow cytometry analysis, respectively. &#x0D; Results: We demonstrated that TMSC-CM treatment significantly decreased the viability of A549 and PANC-1 cell lines in a dose-dependent manner post-48 hours. In addition, CM treatment differentially induced the apoptosis on A549 and PANC-1 cells and also, caused G2/M arrest in the cells.&#x0D; Conclusion: In light of these findings, our study is the first to show that TMSC-CM has an anti-tumoral effect by stimulating apoptosis on A549 and PANC-1 cells. These findings reveal that the usage of CM has a cell-free cellular therapeutic potential.

Incompetent lip seal and nail biting as risk factors for malocclusion in Japanese preschool children aged 3–6 years

BackgroundMalocclusion is a multifactorial condition associated with genetic and environmental factors. The purpose of this study was to investigate the prevalence of occlusal traits, oral habits, and nose and throat conditions by age and to assess the association between malocclusion and its environmental factors in Japanese preschool children.MethodsA total of 503 Japanese children (258 boys and 245 girls aged 3–6 years) were recruited. Occlusal traits were assessed visually to record sagittal, vertical, and transverse malocclusion, and space discrepancies. Lip seal was recorded by an examiner, and oral habits (finger sucking, lip sucking or lip biting, nail biting, chin resting on a hand) and nose and throat conditions (tendency for nasal obstruction, allergic rhinitis, palatine tonsil hypertrophy) were assessed by a questionnaire completed by the parents. The prevalence of each item was calculated, and binary logistic regression was used to examine the factors related to malocclusion.Results62.0% of preschool children in the present study exhibited malocclusion, and 27.8% exhibited incompetent lip seal. Nail biting was the most frequent oral habit with a prevalence of 18.9%. Nasal obstruction was recorded in 30.4% of children. The results of binary logistic regression showed that incompetent lip seal was significantly related to malocclusion, and that nail biting was significantly negatively related.ConclusionsIncompetent lip seal is significantly associated with malocclusion, but nail biting may not necessarily be a deleterious habit for the occlusion in Japanese preschool children.

Evaluation of Presumptive Normal Feline Tonsils with Low-Field Magnetic Resonance Imaging: A Preliminary Retrospective Study.

Palatine tonsils are lymphoid organs, whose anatomic localization gives them a role against antigens entering the body during feeding and breathing. In human medicine, MRI is used to investigate tonsillar diseases. In veterinary medicine, a recent study on healthy dogs described the MRI appearance of canine palatine tonsils, with no available reports about feline ones. Due to the similarities between animals and humans, and based on the study on canine tonsils, the authors aimed to evaluate the feasibility of low-field MRI to detect and describe presumed normal features of feline palatine tonsils, assessing the finding's reproducibility. Low-field MRI of the heads of 14 cats was reviewed, and qualitative findings (visualization, shape, margins, signal intensity, and pattern) and size of each tonsil were recorded. Each observer recorded 71% of the expected tonsils. Most of them were classified as oval, ill-defined, and hyperintense structures with both homogeneous and heterogeneous signal patterns; the overall agreement was considered good. Low-field MRI is potentially a useful imaging modality to visualize palatine tonsils in cats, and their normal appearance has been described for the first time. The authors recommend the evaluation of tonsils in the transverse plane and consider the most accurate estimation of the short axis.

Therapy of tonsillopharyngitis: advantages of an integrated approach. A review

The problem of pain in the pharynx continues to be the focus of attention of scientists and practitioners for many decades. Despite the emergence of modern methods of diagnosis and treatment, the problem of pharyngoalgia is far from being solved. It has now been established that more than 500 possible etiological factors can be the cause of pharyngoalgia, but the leading place is occupied by inflammatory diseases of the pharynx and palatine tonsils. Taking into account the wide distribution of this nosology among the population and the high risk of complications, especially in childhood, the issues related to the search for effective therapeutic regimens and ways to prevent the development of complications are still relevant. Definitely, the treatment should be safe, comprehensive, justified and individually selected in each case. Adequate therapy started in time allows avoiding the development of adverse effects, reducing the treatment time and improving the patient's quality of life. And for a doctor, it is extremely important to know the differences in the clinical picture of pharyngoalgia caused by different types of microorganisms: bacteria, viruses or fungal flora, since these differences will be decisive in the further tactics of treating the patient. This article is devoted to highlighting the issues of the complex use of the lysine salt of ketoprofen in local and systemic form. The parameters of the analgesic and anti-inflammatory action of the lysine salt of ketoprofen are characterized, and a new scheme for the treatment of inflammatory diseases of the pharynx within a single molecule is proposed. The article also pays attention to the prevention of complications and relapses, and discusses the advantages of the drug pidotimod in immunomodulatory therapy.

Spreading Through Air Spaces And Thinking About Lung Metastases.

Spread through air spaces (STAS) is a novel pattern of invasion in primary lung cancers, which was introduced in the 2015 World Health Organization classification. Several studies have validated STAS to be a predictor of clinical outcome in lung adenocarcinoma. However, little is known about STAS as a mode of intraparenchymal diffusion of pulmonary metastases (PMs). The aim of this study was to investigate the incidence of STAS among PMs and the association between STAS and clinicopathological characteristics of PMs. From August 1, 2017 to July 31, 2022, 50 patients underwent pulmonary metastectomy in our center. Clinicopathological characteristics of patients were retrospectively evaluated. Continuous variables were compared by using unpaired Students t-test or MannWhitney test, as appropriate. Categorical variables were compared by using Qui-squared test or Fishers exact test as appropriate. A total of 50 patients with PMs who underwent surgical resection were analyzed, 68% being male. The median age of the study population was 60 years (range 24-80). Most patients had primary cancer originating from epithelial tissue (n=45) and the remaing from mesenchymal tissue (n=5). Colorectal cancer was the most frequent primary site of PMs (n= 32), followed by kidney (n=4) and osteosarcoma (n=3). 60% of patients (n=30) underwent sublobar resection (wedge resection or anatomic segmentectomy). STAS was observed in 10 patients (20%): 7 patients with PMs from CRC, 1 with PM from palatine tonsil, 1 from kidney and 1 from uterus. STAS was more frequent in elder patients (62 years, SD=7.099 vs 60 years, SD= 13.889; p = 0.034). Notably, STAS was significantly more frequent in PMs with larger dimension (2.8 cm, SD=2.049 vs 2.03 SD=1.104; p = 0.010), patients with lymph node metastases (p = 0.004) and in patients who underwent lobectomy rather than sublobar resection (70% vs 32.5%; p = 0.03). Although without statistically significant difference, locorregional recurrence and mortality was higher in patients with STAS+ (40% vs 22.5% and 40% vs 20%, respectively). VSTAS is nowadays considered to be a lung-specific tumour invasion pattern and is commonly observed in PMs of different origins.