Transoral Endoscopic Examination of the Oropharynx With Tongue Protrusion, Phonation, and Open Mouth

2021 ◽  
Vol 1 (5) ◽  
pp. 427-434
Author(s):  
RYOTA TOMIOKA ◽  
HIROKI SATO ◽  
ISAKU OKAMOTO ◽  
AKIRA SHIMIZU ◽  
KIYOAKI TSUKAHARA
Keyword(s):  
Early Detection ◽  
Diagnostic Performance ◽  
Endoscopic Examination ◽  
Post Treatment ◽  
Tongue Protrusion ◽  
Transnasal Endoscopy ◽  
Palatine Tonsils ◽  
Open Mouth ◽  
Adjacent Mucosa ◽  
Healthy Participants

Background/Aim: We examined the diagnostic performance of the tongue protrusion with phonation and open mouth (TOPPOM) method for visualizing structures of the oropharynx. Patients and Methods: Transoral endoscopy was performed on 20 healthy participants to evaluate 12 oropharynx subsites under three conditions: open mouth (OM), phonation with open mouth (POM), and TOPPOM. Each subsite was scored from 0 to 2 depending on subsite visualization, and the scores were summed. Images of subsite-adjacent mucosa were similarly scored. Results: The total scores were significantly higher for TOPPOM than for POM and for POM than for OM. Such scores were observed for both the palatine arches, both palatine tonsils, the left lingual tonsillar sulcus, and the vallecula. Conclusion: TOPPOM enables visualization of the oropharynx through transoral endoscopic examination, and TOPPOM with conventional transnasal endoscopy may enable early detection of oropharyngeal carcinomas and lesions and improve the performance of pre- and post-treatment evaluations.

Methylation of FBN1, SPG20, ITF2, RUNX3, SNCA, MLH1, and SEPT9 genes in circulating cell-free DNA as biomarkers of colorectal cancer

2021 ◽  
pp. 1-30
Author(s):  
Maryam Alizadeh-Sedigh ◽  
Mohammad Sadegh Fazeli ◽  
Habibollah Mahmoodzadeh ◽  
Shahin Behrouz Sharif ◽  
Ladan Teimoori-Toolabi
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Diagnostic Performance ◽  
Methylation Status ◽  
Melting Curve ◽  
Melting Curve Analysis ◽  
Promoter Regions ◽  
Cell Free Dna ◽  
Free Dna ◽  
Tumor Tissues

BACKGROUND: Investigating aberrant tumor-specific methylation in plasma cell-free DNA provides a promising and noninvasive biomarker for cancer detection. OBJECTIVE: We aimed to investigate methylation status of some promoter regions in the plasma and tumor tissues to find biomarkers for early detection of colorectal cancer. METHODS: This case-control study on seventy colorectal cancer patients and fifty matched healthy controls used Methylation-Specific High-Resolution Melting Curve analysis to evaluate the methylation of the selected promoter regions in converted genomic tissue DNA and plasma cfDNA. RESULTS: The methylation levels in selected regions of SPG20 (+24375 to +24680, +24209 to +24399, and +23625 to +23883), SNCA (+807 to +1013, +7 to +162, and -180 to +7), FBN1 (+223 to +429, +1 to +245, and -18 to -175), ITF2 (+296 to +436 and -180 to +55), SEPT9 (-914412 to -91590 and -99083 to -92264), and MLH1 (-13 to +22) were significantly higher in tumor tissues compared with normal adjacent tissues. The methylation levels of FBN1, ITF2, SNCA, and SPG20 promoters were significantly higher in the patient’s plasma compared to patient’s normal tissue and plasma of healthy control subjects. FBN1, SPG20, and SEPT9 promoter methylation had a good diagnostic performance for discriminating CRC tissues from normal adjacent tissues (AUC > 0.8). A panel of SPG20, FBN1, and SEPT9 methylation had a higher diagnostic value than that of any single biomarker and other panels in tissue-based assay (AUC > 0.9). The methylation of FBN1(a) and SPG20(a) regions, as the closest region to the first coding sequence (CDS), had a good diagnostic performance in plasma cfDNA (AUC > 0.8) while a panel consisted of FBN1(a) and SPG20(a) regions showed excellent diagnostic performance for CRC detection in plasma cfDNA (AUC > 0.9). CONCLUSION: Methylation of FBN1(a) and SPG20(a) promoter regions in the plasma cfDNA can be an excellent simple, non-invasive blood-based test for early detection of CRC.

scholarly journals Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy

Medicines ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 53
Author(s):  
Hiroyuki Abe ◽  
Kenya Kamimura ◽  
Yoshihisa Arao ◽  
Junji Kohisa ◽  
Shuji Terai
Keyword(s):  
Gastrointestinal Bleeding ◽  
Esophageal Stenosis ◽  
Endoscopic Examination ◽  
New Techniques ◽  
Transnasal Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Normal Diameter ◽  
Upper Gastrointestinal ◽  
Made In ◽  
Viable Treatment

Acute upper gastrointestinal bleeding (UGIB) is a common disorder and a gastroenterological emergency. With the development of new techniques and devices, the survivability after gastrointestinal bleeding is improving. However, at the same time, we are facing the difficulty of severely complicated cases with various diseases. For example, while endoscopic examination with a normal diameter endoscope is essential for the diagnosis and treatment of UGIB, there are several cases in which it cannot be used. In these cases, transnasal endoscopy (TNE) may be a viable treatment option. This report reviews current hemostatic devices for endoscopic treatment and the safety and efficiency of using TNE in complicated cases. The latter will be demonstrated in a case report where TNE was employed in a patient with severe esophageal stenosis. This review summarizes the advances made in the devices used and will provide further ideas for the physician in terms of combining these devices and TNE.

scholarly journals Screening for Early Gastric Cancer Using a Noninvasive Urine Metabolomics Approach

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2904
Author(s):  
Hyuk Nam Kwon ◽  
Hyuk Lee ◽  
Ji Won Park ◽  
Young-Ho Kim ◽  
Sunghyouk Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Detection ◽  
Performance Test ◽  
Screening Method ◽  
Endoscopic Examination ◽  
Multivariate Statistical ◽  
Metabolic Markers ◽  
Intramucosal Cancer ◽  
Incidence And Mortality ◽  
Urine Metabolomics

The early detection of gastric cancer (GC) could decrease its incidence and mortality. However, there are currently no accurate noninvasive markers for GC screening. Therefore, we developed a noninvasive diagnostic approach, employing urine nuclear magnetic resonance (NMR) metabolomics, to discover putative metabolic markers associated with GC. Changes in urine metabolite levels during oncogenesis were evaluated using samples from 103 patients with GC and 100 age- and sex-matched healthy controls. Approximately 70% of the patients with GC (n = 69) had stage I GC, with the majority (n = 56) having intramucosal cancer. A multivariate statistical analysis of the urine NMR data well discriminated between the patient and control groups and revealed nine metabolites, including alanine, citrate, creatine, creatinine, glycerol, hippurate, phenylalanine, taurine, and 3-hydroxybutyrate, that contributed to the difference. A diagnostic performance test with a separate validation set exhibited a sensitivity and specificity of more than 90%, even with the intramucosal cancer samples only. In conclusion, the NMR-based urine metabolomics approach may have potential as a convenient screening method for the early detection of GC and may facilitate consequent endoscopic examination through risk stratification.

scholarly journals The Castillo-Morales approach to orofacial pathology in Down syndrome

1993 ◽  
Vol 19 (1) ◽  
pp. 30-38
Author(s):  
G. Limbrock ◽  
◽  
R. Castillo-Morales ◽  
H. Hoyer ◽  
B. Stöver ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Masticatory Muscles ◽  
First Year ◽  
Tongue Protrusion ◽  
Open Mouth ◽  
Secondary Conditions ◽  
Clinical Evaluations ◽  
Palatal Plate ◽  
Dental Diseases ◽  
Orofacial Function

Infants with Down syndrome often present with a familiar orofacial disorder which exists at birth or becomes more pronounced by the end of the first year. The primary pathology includes hypotonicity of the perioral muscles, lips, and masticatory muscles and a protruding tongue, later followed by active tongue protrusion. This results in problems with sucking, swallowing, drooling and dentition. Early intervention methods employing the combination of Castillo-Morales Manual Orofacial Therapy and his specially designed palatal plate, can improve orofacial function, facial appearance and prevent secondary conditions like pseudoprognathism, dental diseases, malocclusions, open mouth habit and pseudomacroglossia. This retrospective study examines the outcome of therapy, as prescribed by Castillo-Morales, in 39 children with Down syndrome. Normally, the average age to begin oral therapy is between six to eight months. The children were treated with the Castillo­Morales Manual Orofacial Therapy and his palatal plate for an average of 17.9 months. In this study, clinical evaluations at the beginning and the end of therapy focused only on open mouth posture and tongue protrusion. In addition, the direct stimulating effect of the palatal plate on tongue protrusion was evaluated. Significant positive results were observed in all three areas.

scholarly journals Synovial Sarcoma on Magnetic Resonance Imaging: a Retrospective Study on Tumor Configuration and Postoperative Surveillance

2020 ◽  
Author(s):  
Sam Sedaghat ◽  
Frederick Schmitz ◽  
Johannes Berek ◽  
Charlotte Borchers ◽  
Maya Sedaghat
Keyword(s):  
Contrast Enhancement ◽  
Synovial Sarcoma ◽  
False Positive ◽  
Diagnostic Performance ◽  
False Negative ◽  
Post Treatment ◽  
Marked Contrast ◽  
Postoperative Surveillance ◽  
Synovial Sarcomas ◽  
Treatment Changes

Abstract Background: To assess the configuration of primary and recurrent synovial sarcoma on MRI. Additionally, to evaluate postoperative MRI regarding diagnostic performance and locoregional post-treatment changes.Methods: Twenty-five patients with histologically proven synovial sarcomas underwent 1.5-T MRI follow-up between 2012 and 2018. In all, 258 pre- and postoperative MRIs with available radiological and pathological were screened for primary/recurrent synovial sarcoma, diagnostic performance (false-positive/-negative and true-positive/-negative values) and post-treatment changes.Results: The median age of the patients was 40±15.2 years. The median volumes of primary and recurrent synovial sarcomas were 603 cm3 and 806 cm3, respectively. Of the patients 24% presented recurrences (n=6). In two patients false-positive diagnosis was made . There was one false-negative diagnosis of synovial sarcoma. Primary synovial sarcomas were significantly most often polycyclic/multilobulated (p=0.01) and heterogeneous in appearance with marked contrast enhancement. Recurrent synovial sarcomas showed two appearances: ovoid/nodular/homogeneous and polycyclic/multilobulated/heterogeneous, both with marked contrast enhancement. The most common post-treatment changes were subcutaneous (92%; p<0.001) and muscular edema (72%; p<0.001-0.003). Conclusion: While the configuration of primary synovial sarcomas was mainly polycyclic/multilobulated/heterogeneous, recurrent synovial sarcomas showed two shapes: ovoid/homogeneous and polycyclic/multilobulated/heterogeneous. MRI is still a highly valuable imaging modality for the postoperative surveillance of synovial sarcomas. Subcutaneous and muscular edema are common post-treatment changes.

scholarly journals Combined Amino Acid Pet-Mri for Differentiating Recurrence from Radiation Necrosis in Gliomas- Together We Grow

2021 ◽  
Author(s):  
Shumyla Jabeen ◽  
Arpana Arbind ◽  
Dinesh Kumar ◽  
Pardeep kumar Singh ◽  
Jitender Saini ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Radiation Necrosis ◽  
Final Diagnosis ◽  
Post Treatment ◽  
Mr Perfusion ◽  
Spatial Concordance ◽  
Amino Acid Pet ◽  
And Diffusion

Abstract PURPOSE: To compare the diagnostic accuracy of amino acid PET, MR perfusion and diffusion as stand-alone modalities and in combination in differentiating recurrence from radiation necrosis in post-treatment gliomas and to qualitatively assess spatial concordance between the three modalities using simultaneous PET-MR acquisition.METHODS: A retrospective review of 48 cases of post-treatment gliomas who underwent simultaneous PET-MRI using C11 Methionine as radiotracer was performed. MR perfusion and diffusion sequences were acquired during the PET study. The following parameters were obtained: TBRmax, TBRmean, SUVmax and SUVmean from the PET images, rCBV from perfusion, ADCmean and ADCratio from the diffusion images. The final diagnosis was based on clinical/imaging follow-up and histopathology when available. ROC curve analysis in combination with logistic regression analysis was used to compare the diagnostic performance. Spatial concordance between modalities was graded as 0,1 and 2 representing discordance, <50% and >50% concordance respectively.RESULTS: There were 35 cases of recurrence and 13 cases of radiation necrosis. The highest area under curve(AUC) was obtained for TBRmax followed by rCBV and ADCratio. The AUC increased significantly with a combination of rCBV and TBRmax. Amino acid PET showed the highest diagnostic accuracy and maximum agreement with the final diagnosis. There was discordance between ADC and PET in 22.9%, between rCBV and PET in 16.7% and between PET and contrast enhancement in 14.6% cases.CONCLUSIONAmino acid PET had the highest diagnostic accuracy in differentiating radiation necrosis from recurrence. Combination of PET with MRI further increased the AUC thus improving the diagnostic performance.

Teaching Transnasal Endoscopy to Graduate Students Without a Hospital or Simulation Laboratory: Pool Noodles and Cadavers

2017 ◽  
Vol 26 (3) ◽  
pp. 709-715 ◽  
Author(s):  
Shari Salzhauer Berkowitz
Keyword(s):  
Graduate Students ◽  
Student Development ◽  
Qualitative Data ◽  
Graduate Programs ◽  
Endoscopic Examination ◽  
Speech Language Pathology ◽  
Transnasal Endoscopy ◽  
Training Opportunity ◽  
Language Pathology

Purpose This study reports on a training opportunity in endoscopy in which speech-language pathology graduate students use inanimate objects and cadavers. Best practices for transnasal endoscopy in vivo require a physician to be nearby, but many graduate programs do not have this access. Method Endoscopy was offered as a graduate elective. Students (13 women) initially learned to manipulate the endoscope through the lumen of a swimming pool noodle that was embedded with trinkets. Endoscopic examination of inanimate objects became increasingly complex, followed by endoscopic examination of a cadaver. Results Pre- and postexamination measures and qualitative data from the 13 students revealed that students increased in confidence and in interest in this aspect of the field. All students met practical competencies for handling the endoscope, passing the endoscope on a narrow tube, and visualizing objects. Some students had the opportunity to pass the endoscope on a peer and did so successfully. Conclusion For programs with a cadaver lab available, this protocol offers an affordable option compared with purchasing a simulator. For those with neither a cadaver lab nor a simulation lab, passing the endoscope on inanimate objects alone is beneficial to student development and learning.

scholarly journals Circulating MicroRNA Biomarkers for Lung Cancer Detection in East Asian Populations

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 415 ◽  
Author(s):  
Haixin Yu ◽  
Zhong Guan ◽  
Katarina Cuk ◽  
Yan Zhang ◽  
Hermann Brenner
Keyword(s):  
Lung Cancer ◽  
Early Detection ◽  
Diagnostic Performance ◽  
East Asian ◽  
Area Under The Curve ◽  
Population Characteristics ◽  
Circulating Microrna ◽  
Circulating Mirnas ◽  
Asian Populations ◽  
Tumor Stages

Background: Lung cancer (LC) is the leading cause of cancer-related death in Eastern Asia. The prognosis of LC highly depends on tumor stages and early detection could substantially reduce LC mortality. Accumulating evidence suggested that circulating miRNAs in plasma or serum may have applications in early LC detection. We thus conducted a systematic literature review on the diagnostic value of miRNAs markers for LC in East Asian populations. Methods: PubMed and ISI Web of Knowledge were searched to retrieve relevant articles published up to 17 September 2018. Information on study design, population characteristics, investigated miRNAs and diagnostic accuracy (including sensitivity, specificity and area under the curve (AUC)) were independently extracted by two reviewers. Results: Overall, 46 studies that evaluated a total of 88 miRNA markers for LC diagnosis in East Asian populations were identified. Sixteen of the 46 studies have incorporated individual miRNA markers as panels (with 2–20 markers). Three promising miRNA panels with ≥90% sensitivity and ≥90% specificity were discovered, two of which were externally validated. Diagnostic performance of circulating miRNAs in East Asian populations was comparable to previously summarized performance in Western populations. Forty-four miRNAs were reported in both populations. No major differences in diagnostic performance by ethnicity of the same miRNA was observed. Conclusions: Circulating miRNAs or miRNA panels, possibly in combination with other promising molecular markers including epigenetic and genetic markers, may be promising candidates for noninvasive LC early detection. However, large studies with samples collected prospectively in true screening settings are required to validate the promising markers or marker panels.

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