Pharynx Region Research Articles

Serotonergic elements in the nervous system of parasite of acipenserid fishes, Acrolichanus auriculatus (Digenea: Allocreadiidae)

The trematode Acrolichanus auriculatus is a widely distributed intestine parasite of acipenserid fishes. For the first time the localization and distribution of the serotonergic nerve elements in A. auriculatus was studied using immunocytochemical method and confocal laser scanning microscopy. The study revealed the presence of biogenic amine, serotonin, in the central and peripheral nervous systems of A. auriculatus, that is in the neurons and neurites of the brain ganglia, brain commissure, the longitudinal nerve cords, and the connective nerve commissures. The innervation of the attachment organs, pharynx, oesophagus and distal regions of the reproductive system by the serotonergic nerve elements is observed. The distribution of serotonergic neurons in A. auriculatus is schematically marked. The comparative analysis of findings obtained in A. auriculatus with those recorded for other digeneans reveals the presence of both conservative and distinctive features in the organization of the serotonergic nervous system in various representatives of trematodes.

Refining computer tomography data with super-resolution networks to increase the accuracy of respiratory flow simulations

Accurately computing the flow in the nasal cavity with computational fluid dynamics (CFD) simulations requires highly resolved computational meshes based on anatomically realistic geometries. Such geometries can only be obtained from computer tomography (CT) data with high spatial resolution, i.e., featuring a ≤1mm slice thickness. In practice, CT images are, however, recorded at a lower resolution to not expose patients to high radiation and to reduce the overall costs. To overcome this problem and to provide patients with a detailed physics-based diagnosis, e.g., for surgery planning, the potential of super-resolution networks (SRNs) to increase the CT resolution is analyzed. Therefore, an SRN is developed and trained on CT data. Its predictive performance is improved by an automated hyperparameter optimization technique. The training time is further reduced without predictive accuracy degradation by oversampling images with challenging regions. The performance of the SRN is assessed by an analysis of the reconstructed 3D surfaces of the human upper airway and by comparing results of CFD simulations. That is, surfaces and simulation results based on SRN-generated CT data at 1mm resolution are compared to those obtained from unmodified CT data-sets at low (3mm) and high (1mm) resolution, as well as from CT data interpolated to a 1mm resolution from coarse data. The findings reveal the SRN-based approach to have the lowest deviations in the surfaces and CFD results when compared to those based on the original high-resolution data. The pressure loss between the inflow (nostrils) and outflow (pharynx) regions averaged for three test patients differs by only 1.3%, compared to 8.7% and 8.8% in the coarse and interpolated cases. It is concluded that the SRN-based method is a promising tool to enhance underresolved CT data to yield reliable numerical results of respiratory flows.

Comparative morphology of the oropharyngeal denticles in the order Rhinopristiformes and its functional implications (Chondrichthyes: Batoidea).

Guitarfishes and sawfishes are included in the order Rhinopristiformes, which currently encompasses five families: Pristidae, Rhinobatidae, Trygonorrhinidae, Rhinidae and Glaucostegidae. Considering the low number of studies focused on oral structures in Rhinopristiformes and the need to better understand their internal morphology, this study aimed to(1) evaluate and describe the morphological variation of the oropharyngeal denticles of guitarfishes and sawfish; (2) evaluate and describe the ontogenetic and sexual variation of the oropharyngeal denticles of Zapteryx brevirostris; (3) propose characters potentially useful for taxonomic and systematic purposes and (4) discuss the possible functions and advantages of these structures. Tissue samples were taken from the oropharyngeal region of specimens preserved in 70% alcohol and then prepared for visualization in scanning electron microscopy. A new method for sampling the pharynx region is proposed herein. Considerable morphological variation between families and genera was observed. However, no variation between conspecifics was found. Regional variations of denticles when examining a single individual were observed in shape, ornamentation, and orientation. In Zapteryx brevirostris, males had a significantly higher density of denticles in the ventral region than females and lower densities were observed in juveniles. The four characters discussed here are based on the presence of keels, number of cusps, distal end elongation and width/length ratio of the oropharyngeal denticles. Among the possible functions and advantages of these structures are the improvement of food adherence, tissue protection against food abrasion and parasitism, and attenuation of hydrodynamic drag in the oropharyngeal cavity during food ingestion.

Effects of the deformation and size of the upper airway on the deposition of aerosols

Aerosol drug delivery in the human airway is significantly affected by the morphology and size of the airway. This work developed a CFD-DEM model to simulate and analyze air flow and powder dynamics in combined inhaler-airway systems with different degrees of airway deformation (non-deformed, 50%, and 75% deformed) and sizes (adult, 0.80, and 0.62 scaled). The airways were generated based on a regular airway constructed from the MRI images through finite element method (for deformed airways) or scaling-down (for smaller airways). The airways were connected to Turbuhaler® through a connector. The results showed that under the same flow rate, the variation in the airway geometry and size had a minimum impact on the flow field and powder deposition in the device and the connector. However, deformation caused more particle deposition in the deformed region. Notably, the airway with 50% deformation had the most particles passing through the airway with the largest particle sizes due to its lower air velocity in the deformed area. Reducing airway size resulted in more powder deposition on the airway, particularly at the pharynx and mouth regions. This was because, with the same flow rate, the flow velocity in the smaller airway was higher, causing more particle–wall collisions in the mouth and pharynx regions. More importantly, the deposition efficiency in the 0.62-scaled airway was significantly higher than the other two airways, highlighting the importance of the different administration of aerosol drugs for young children.

ДВА НОВЫХ ДЛЯ НАУКИ ВИДА ОНХОЛАЙМИД (NEMATODA, ENOPLIDA, ONCHOLAIMIDAE) С КОРАЛЛОВЫХ РИФОВ ВО ВЬЕТНАМЕ

Two new for science species of the family Oncholaimidae Dujardin, 1845, found in coral reefs in Vietnam, are described and illustrated. Oncholaimus securus sp. n. is close to O. longispiculosus Gerlach, 1955 according to presence of papilla on tail and spicules length. It differs from it by the longer and thinner body, shorter pharynx and wider labial region. Viscosia graciloides sp. n. in body size and length of spicules is close to V. erasmi Furstenberg, Vincx, 1989, V. macrobursata Keppner, 1987 and V. dossena Leduc, Zhan, 2023. It differs from these species by the form of outer labial sensillae, thinner body, narrower labial region and shorter stoma.

Head-and-Neck Necrotizing Fasciitis in Adults

Abstract Head-and-neck necrotizing fasciitis (NF) is a life-threatening medical and surgical emergency that is strongly associated with high mortality. NF of the head and neck occurs only rarely and might mimic abscess or cellulitis. The most common sites for this infection are the pharynx, teeth, or submandibulocervical region. Odontogenic infection is the most frequent cause of head-and-neck NF; other causes, such as peritonsillar abscess, tonsilitis, or salivary gland infections, have been documented. The most prevalent comorbidity of this life-threatening condition is diabetes mellitus. Ideally, it is diagnosed clinically; however, other laboratory and imaging modalities help to support the diagnosis. Furthermore, NF causes serious complications, specifically airway compromise. Overall, surgical intervention is the modality of choice for treating NF. This review article gathers updated data about NF of the head and neck.

Oral Submucous Fibrosis and Scleroderma: A Review of the Etiopathogenesis, Clinicopathological Correlation, and Management Aspects.

Oral submucous fibrosis (OSMF) is a chronic, progressive, insidious premalignant disease with multifactorial etiology affecting any part of the oral cavity and sometimes the pharynx by triggering a rapid onset of trismusand dysphagia due to stiffness at the lips, cheek, pharynx, and upper oesophageal region. Submucous fibrosisresembles many auto-immune, dermatological, mucocutaneous, and fibrotic lesions that include scleroderma, amyloidosis, iron deficiency anemia, and systemic or generalized fibromatosis clinically andhistologically. Several authors established an association between oral submucous fibrosis and sclerodermawith predominant oral manifestations on the basis of similarity in clinical and histological characteristicsdespite different pathogenesis and prognostic aspects.Scleroderma or systemic sclerosis is an autoimmune connective tissue disorder clinically manifested asfibrosis of the skin, blood vessels, and visceral organs with or without the involvement of the oral cavity. Thus,understanding the disease mechanism, appropriate early diagnosis, and clinical management of these twoentities play an important role in disease prognosis and treatment outcomes. The present review wascarried out to briefly present a concise overview of the etiopathogenesis, clinical, histological, diagnosis,and management aspects of OSMF and scleroderma based on the available literature, with specialemphasis on similarities and differences between these two entities subsequently aiding in appropriatetreatment planning.

Influence of pathogens on host genome and epigenome in development of head and neck cancer.

Head and neck cancer (HNSCC) is a heterogeneous group of cancers, affecting multiple regions such as oral cavity, pharynx, larynx, and nasal region, each showing a distinct molecular profile. HNSCC accounts for more than 6 million cases worldwide, soaring mainly in the developing countries. The aetiology of HNSCC is complex and multifactorial, involving both genetic and environmental factors. The critical role of microbiome, which includes bacteria, viruses, and fungi, is under spotlight due to the recent reports on their contribution in the development and progression of HNSCC. This review focuses on the effect of opportunistic pathogens on the host genome and epigenome, which contributes to the disease progression. Drawing parallels from the host-pathogen interactions observed in other tumour types arising from the epithelial tissue such as colorectal cancer, the review also calls attention to the potential explorations of the role of pathogens in HNSCC biology and discusses the clinical implications of microbiome research in detection and treatment of HNSCC. Our understanding of the genomic effects of the microbes on the disease progression and the mechanistic insights of the host-pathogen interaction will pave way to novel treatment and preventive approaches in HNSCC.

A Clinical Study of Post-treatment Nursing Strategy for Venous Malformations in the Pharynx Region

Background: Post-treatment nursing care is essential for patients with venous malformations (VMs) after they have undergone treatment. Effective post-treatment nursing care requires adequate resources, effective communication, patient compliance, and addressing psychological distress. However, the clinical care plan for VMs in the pharyngeal isthmus is not clear. Objectives: The present study aims to explore the clinical nursing strategy after the treatment of VMs in the pharynx area. Methods: In this study, the patients with VM in the pharynx region who received anhydrous ethanol sclerosis injection and/or surgical treatment in our Hospital from January 2013 to November 2018 were recruited. A total of 143 patients who had completed medical records were included in this prospective cohort study. The patients' post-operative vital signs were closely observed, the respiratory tract was maintained, the oral cavity was cleaned, and the nursing care of indwelling endotracheal intubation or tracheotomy was performed. After the clinical follow-ups of one to five years, long-term efficacy was also observed. We summarized their nursing care treatments. Results: The results showed that there were 0 patients rated as grade I, 3 patients rated as grade II, 17 patients rated as grade III, and 123 patients rated as grade IV after long-term efficacy. Conclusion: Appropriate anhydrous ethanol sclerotherapy can be selected for patients with pharyngeal venous malformation, and this method combined with the clinical nursing strategy after treatment concluded in this study can effectively reduce the volume of VM, with fewer side effects, and can effectively improve breathing, swallowing, and vocal function.

Overexpression of Argonaute HIWI Gene in Colorectal Cancer Stem Cells and Colorectal Cancerous Tissue

Background: Post-treatment nursing care is essential for patients with venous malformations (VMs) after they have undergone treatment. Effective post-treatment nursing care requires adequate resources, effective communication, patient compliance, and addressing psychological distress. However, the clinical care plan for VMs in the pharyngeal isthmus is not clear. Objectives: The present study aims to explore the clinical nursing strategy after the treatment of VMs in the pharynx area. Methods: In this study, the patients with VM in the pharynx region who received anhydrous ethanol sclerosis injection and/or surgical treatment in our Hospital from January 2013 to November 2018 were recruited. A total of 143 patients who had completed medical records were included in this prospective cohort study. The patients' post-operative vital signs were closely observed, the respiratory tract was maintained, the oral cavity was cleaned, and the nursing care of indwelling endotracheal intubation or tracheotomy was performed. After the clinical follow-ups of one to five years, long-term efficacy was also observed. We summarized their nursing care treatments. Results: The results showed that there were 0 patients rated as grade I, 3 patients rated as grade II, 17 patients rated as grade III, and 123 patients rated as grade IV after long-term efficacy. Conclusion: Appropriate anhydrous ethanol sclerotherapy can be selected for patients with pharyngeal venous malformation, and this method combined with the clinical nursing strategy after treatment concluded in this study can effectively reduce the volume of VM, with fewer side effects, and can effectively improve breathing, swallowing, and vocal function.

Microbiome in Nasal Mucosa of Children and Adolescents with Allergic Rhinitis: A Systematic Review

The human upper respiratory tract comprises the nasal cavity, pharynx and larynx regions and offers distinct microbial communities. However, an imbalance and alterations in the nasal mucosa microbiome enhance the risk of chronic respiratory conditions in patients with allergic respiratory diseases. This is particularly important in children and adolescents once allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa, often associated with an increase in pulmonary allergic inflammation. Therefore, this systematic review aimed to collect scientific data published concerning the microbial community alterations in nasal mucosa of children and adolescents suffering from AR or in association with adenotonsillar hypertrophy (AH) and allergic rhinoconjunctivitis (ARC). The current study was performed using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publications related to microbiome alterations in the nasal mucosa in pediatric age, studies including next-generation sequencing platforms, and studies exclusively written in the English language were some of the inclusion criteria. In total, five articles were included. Despite the scarcity of the published data in this research field and the lack of prospective studies, the genera Acinetobacter, Corynebacterium, Dolosigranulum, Haemophilus, Moraxella, Staphylococcus and Streptococcus dominate the nares and nasopharyngeal microbiome of the pediatric population regardless of their age. However, an imbalance in the resident bacterial community in the nasal mucosa was observed. The genera Acinetobacter, and Pseudomonas were more abundant in the nasal cavity of AR and AH children, while Streptococcus and Moraxella were predominant in the hypopharyngeal region of AR infants. An abundance of Staphylococcus spp. was also reported in the anterior nares and hypopharyngeal region of children and adolescents suffering from AR passive smoke exposure and ARC. These records suggest that different nasal structures, ageing, smoke exposure and the presence of other chronic disorders shape the nasal mucosa microbiome. Therefore, the establishment of adequate criteria for sampling would be established for a deeper understanding and a trustworthy comparison of the microbiome alterations in pediatric age.

Two new species, Parabathylaimus gracilis sp. nov. and Belbolla sinica sp. nov. (Nematoda: Enoplida), from Yangma Island of the Yellow Sea, China

Two new species Parabathylaimus gracilis sp. nov. and Belbolla sinica sp. nov. are described from Yangma Island, Yellow Sea. Parabathylaimus gracilis sp. nov. is characterized by six outer labial setae three-jointed, inner labial setae and cephalic setae unjointed, amphidial fovea unispiral with circular aperture and positioned at middle of buccal cavity, spicules paired and slightly curved, gubernaculum kidney-like and distal end heavily cuticularized with a pointed projection, tail conical without long subterminal setae. Belbolla sinica sp. nov. is characterized by short body length, posterior pharynx region with seven bulbs, spicules straight with proximal and distal end tapered and middle part thickened, gubernaculum short without apophysis, two small wing-shaped precloacal supplements well developed, tail conico-cylindrical with cylindrical portion short.

Steinernema Africanum n. Sp. (Rhabditida, Steinernematidae), a New Entomopathogenic Nematode Species Isolated in the Republic of Rwanda.

Alternatives to hazardous insecticides are urgently needed for an environmentally friendly and effective management of insect pests. One such option is the use of entomopathogenic nematodes (EPN). To increase the availability of EPN with potential for biocontrol, we surveyed agricultural soils in the Republic of Rwanda and collected two Steinernema isolates. Initial molecular characterization showed that they represent a new species, for which we propose the name S. africanum n. sp. To describe this new species, we reconstructed phylogenetic relationships, calculated sequence similarity scores, characterized the nematodes at the morphological level, conducted crossing experiments, and isolated and characterized their symbiotic bacteria. At the molecular level, S. africanum n. sp. is closely related to S. litorale and S. weiseri. At the morphological level, S. africanum n. sp. differs from closely related species by the position of the nerve ring and also because the stoma and pharynx region is longer. The first-generation males have ventrally curved spicules with lanceolate manubrium and fusiform gubernaculum and the second-generation males have rounded manubrium and anteriorly hook-like gubernaculum. Steinernema africanum n. sp. does not mate or produce fertile progeny with any of the closely related species.

A Nasal Aerodynamics Perspective of Retronasal Olfaction: Rodents vs. Humans.

Odor perception can be achieved through ortho or retronasal routes, with the latter being an important component of flavor perception. There are significant olfactory differences that exist between rats and humans and by understanding the role of structural differences, further insight can be gained into the mechanism of odorant perception via ortho or retronasal routes. 3D human and rat (Sprague Dawley) computational models were used to investigate nasal anatomy impact on ortho vs. retronasal odorant transport to the olfactory epithelium. The nasal pharynx region was modified for human and rat models to probe nasal structure impact on ortho vs retro olfaction. 65 odorant absorption rates to the olfactory epithelium were extracted from each model. For human, the retronasal route provided higher peak odorant absorption compared to orthonasal route (left: 90% higher, right: 45% higher), but substantially lowered peak absorption for rat (medial: 97% lower, lateral: 75% lower). For both models, anatomical modification had minimal impact to orthonasal routes, but substantially modulated the retronasal route: decrease (left: -41.4%, right: -44.2%) for human, and increase to the medial (29.5%) but not to lateral (-14.3%) for rat. There exist key differences between humans and rats regarding retro/orthonasal odorant transport routes, which matched well with experimental olfactory bulb activity data in literature. While humans have equivalent odorant delivery between routes, the difference in retro and orthonasal routes in rodents is substantial and changes to the transverse lamina above the nasopharynx can substantially modulate the retronasal route, but not enough to bridge the gap between the two routes.

New species of hesionid and phyllodocid polychaetes (Annelida, Errantia) from Clipperton Island

The study of marine annelids from oceanic islands has been problematic, especially because of the lack of infrastructure, or of easily accessible logistics for frequent expeditions. In this contribution, some specimens collected during the J.-L. Étienne Expedition to Clipperton Island in 2005, belonging to the families Hesionidae Grube, 1850 and Phyllodocidae Örsted, 1843 are newly described. Type material is deposited in the Muséum national d'Histoire naturelle, Paris, and a few others in El Colegio de la Frontera Sur, Chetumal. Hesionidae includes Psamathe charpyi n. sp. diagnosed by having eyes of similar size and neurochaetal blades 4-10 × longer than wide. In Phyllodocidae an assessment of the affinities within Phyllodoce Savigny in Lamarck, 1818 results in re-establishing its subgenera as distinct genera, and three species are newly described: Anaitides albengai n. sp., Nereiphylla etiennei n. sp., and Pterocirrus bouchardi n. sp. Anaitides albengai n. sp. is separated from more similar species by having the prostomium as long as wide, eyes ¼ as long as prostomial width, and basal pharynx region with 8-9 large papillae per row. Nereiphylla etiennei n. sp. differs from more similar species by having a rectangular prostomium, lateral antennae half as long as prostomial width, and ventral cirri barely longer than neurochaetal lobe. Pterocirrus bouchardi n. sp. separates from more similar species by having antennae of similar length, dorsal cirri tapered not distally constricted, and acicular lobes barely divergent. Keys are included for identifying all World species for each genus.

Decoding the Genetic Alterations in Genes of Fibroblast Growth Factor Family and Their Possible Association with HNSCC

Introduction: HNSCC is a type of cancer in the oral and pharynx region. Several mutations/variations are observed in these cancer phenotypes. Fibroblast growth factor belongs to the family of heparin binding growth factors. FGFs are multifunctional proteins with a wide variety of effects; they are most commonly mitogens. Their expression pattern correlates with invasion of HNSCC.
 Aim: To assess the genetic alterations in genes of the fibroblast growth factor family and their association with HNSCC.
 Materials and Methods: The demographic data and samples of 528 HNSCC patients was collected from the cBioportal database. Oncoprint analysis was done to assess the amplification and genetic alterations of the members of the FGF gene family. String analysis was performed to evaluate the protein-protein interaction. The information about previous reported mutation and correlation with novel and reported mutation was obtained using GnomAD analysis.
 Results and Discussion: FGF3,4 and 19 genes showed maximum variation (25%). FGF4 and FGF19 genes showed maximum amplification in addition to deletion mutation. Excitingly FGF3, FGF4 and FGF19 genes showed similar amplification patterns in most of the HNSCC patients. Statistical significant difference in the gene expression of FGF3 9.578 x 10-3 observed between normal and primary tumour. S. Findings showed many novel mutations and also 4 reported mutations ie:FGF1, FGF12, FGF20, FGF21
 Conclusion: Our present study concludes that more evidence is required to confirm their association with HNSCC.

Angioedema without wheals: a clinical update

Angioedema without wheals (urticaria) represents a heterogeneous group of clinically indistinguishable diseases of hereditary or acquired etiology. Hereditary angioedema is a rare inherited condition leading to recurrent, sometimes life-threatening angioedema attacks in subcutaneous tissues and gastrointestinal and oropharyngeal mucosa dating back to childhood or adolescence. Most of these patients have mutations in the SERPING1 gene, causing either low C1 inhibitor production (hereditary angioedema with C1 inhibitor deficiency type I) or the production of dysfunctional C1 inhibitor (hereditary angioedema with C1 inhibitor deficiency type II). Hereditary angioedema with normal C1 inhibitor has been defined later. Although C1 inhibitor concentration and function are in the normal range, it leads to typical hereditary angioedema symptoms owing to mutations in FXII, PLG, ANGPT1, KNG1, and MYOF genes. Patients who exhibit none of these genetic mutations despite having a similar clinical presentation are classified as having unknown hereditary angioedema. Fewer than 1 in 10 patients with C1 inhibitor deficiency have acquired angioedema with C1 inhibitor deficiency. The clinical presentation is very similar to that of hereditary angioedema, making it difficult to distinguish these 2 conditions clinically. Unlike hereditary angioedema, there are no genetic mutations, and family history and symptoms tend to appear later in life. Acquired angioedema with C1 inhibitor deficiency is commonly associated with lymphoproliferative and autoimmune diseases. Angioedema attacks might start 1 year before the underlying disease in acquired angioedema with C1 inhibitor deficiency. Approximately half of the patients admitted to the hospital for acute angioedema are patients receiving angiotensin-converting enzyme (ACE) inhibitor therapy. Angioedema typically occurs on the lips, tongue, mouth, pharynx, and subglottic regions. Patients may require hospitalization and intensive care monitoring owing to airway involvement. Idiopathic histaminergic acquired angioedema may be diagnosed only when any possible causes of histaminergic angioedema are excluded (foods, drugs, animal dander, aeroallergens, insect stings, latex, and others), and the symptoms respond well to antihistamine treatment. Idiopathic nonhistaminergic acquired angioedema should be considered when all other types of recurrent angioedema have been ruled out and patients do not respond to high-dose antihistamines. The lack of a standard biochemical laboratory test for patients with idiopathic histaminergic acquired angioedema, idiopathic nonhistaminergic acquired angioedema, angiotensin-converting enzyme inhibitor-induced acquired angioedema, and hereditary angioedema with normal C1 inhibitor makes the diagnosis more challenging. Future efforts should focus on increasing awareness of all the rare types of angioedema among physicians and developing more straightforward and more accessible diagnostic methods.

Effect of inhalation on oropharynx collapse via flow visualisation

Computational fluid dynamics (CFD) modelling has made significant contributions to the analysis and treatment of obstructive sleep apnoea (OSA). While several investigations have considered the flow field within the airway and its effect on airway collapse, the effect of breathing on the pharynx region is still poorly understood. We address this gap via a combined experimental and numerical study of the flow field within the pharynx and its impacts upon airway collapse. Two 3D experimental models of the upper airway were constructed based upon computerised tomography scans of a specific patient diagnosed with severe OSA; (i) a transparent, rigid model for flow visualisation, and (ii) a semi-flexible model for understanding the effect of flow on pharynx collapse. Validated simulation results for this geometry indicate that during inhalation, negative pressure (with respect to atmospheric pressure) caused by vortices drives significant narrowing of the pharynx. This narrowing is strongly dependent upon whether inhalation occurs through the nostrils. Thus, the methodology presented here can be used to improve OSA treatment by improving the design methodology for personalised, mandibular advancement splints (MAS) that minimise OSA during sleep.

The neuroactive substances and associated muscle system in Rhipidocotyle campanula (Digenea, Bucephalidae) from the intestine of the pike Esox lucius.

We report about the muscular system and the serotonergic and FMRFamidergic components of the nervous system of the Bucephalidae trematode, Rhipidocotyle campanula, an intestinal parasite of the pike. We use immunocytochemical methods and confocal scanning laser microscopy (CLSM). The musculature is identified by histochemical staining with fluorescently labeled phalloidin. The body wall musculature of R. campanula contains three layers of muscle fibres - the outer thin circular, intermediate longitudinal and inner diagonal muscle fibres running in two opposite directions. The digestive system of R. campanula possess of a well-developed musculature: radial, longitudinal and circular muscle elements are detected in the pharynx, circular and longitudinal muscle filaments seen in the oesophagus, and longitudinal and the circular muscle fibres were found in the intestinal wall. Specific staining indicating the presence of actin muscle filaments occurs in the cirrus sac localized in the posterior body region. The frontal region of anterior attachment organ, the rhynchus, in R. campanula is represented by radial muscle fibres. The posterior part of the rhynchus comprise of radial muscles forming the organ's wall, and several strong longitudinal muscle bundles. Serotonergic and FMRFamidergic structures are detected in the central and peripheral compartments of the nervous system of R. campanula, that is, in the paired brain ganglia, the brain commissure, the longitudinal nerve cords, and connective nerve commissures. The innervations of the rhynchus, pharynx, oesophagus and distal regions of the reproductive system by the serotonergic and FMRFamidergic nervous elements are revealed. We compare our findings obtained on R. campanula with related data for other trematodes.

Analysis of Mortality from Carcinomas Primary Localized in Region of Lip, Oral Cavity and Pharynx in Central Serbia, 1999-2015

Lip, oral cavity, and pharyngeal cancers have been globally estimated to account for about 3.8% of all cancer cases and 3.6% of cancer deaths. Mortality of these cancers is generally higher in developing than in developed countries. Overall cancer mortality rate in Serbia is one of the highest in the world. The aim of this study was to determine the mortality rate trends and the most common localization of lip, oral and pharyngeal cancers in Serbia. The study was conducted in 2018 as descriptive epidemiological study and included years from 1999 to 2015. The differences in standardized mortality rates and number of deaths were analyzed with regard to age, gender, and tumor localization. Linear trend and regression were used to determine mortality rate trend. There was statistically significant difference in the number of deaths between men and women in the ages of 40 and over (P < 0.01); male/female cancer mortality ratio was 4.56:1. Generally, the most common localization of this carcinoma was hypopharynx. There was no statistically significant increase of mortality rates from these cancers for both genders (males: y = 4.77 + 0.42x, P = 0.069 % change = +20.35; females: y = 1.03 + 0.01x, P = 0.40 % change = +4) during 17-year period. Promotion of healthy habits, life-styles and regular inspection of mouth by patients and health professionals should be better prioritized especially in developing countries where implementing and improving national health prevention programs are essential.