scholarly journals Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia—Molecular and Clinical Aspects

2021 ◽  
Vol 22 (8) ◽  
pp. 4255
Author(s):  
Mikołaj Dąbrowski ◽  
Łukasz Kubaszewski

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of the ligaments of the cervical spine; in some cases, it may result in dysphagia. The condition is more common in men over 50 years of age with metabolic disorders, and it is often asymptomatic and not a major issue for patients. The etiology of DISH is poorly understood, and known genetic factors indicate multiple signal pathways and multigene inheritance. In this review, we discuss the epidemiological, clinical, and etiological aspects of DISH with a special focus on dysphagia.

2021 ◽  
pp. 219256822098827
Author(s):  
Giorgio Lofrese ◽  
Alba Scerrati ◽  
Massimo Balsano ◽  
Roberto Bassani ◽  
Michele Cappuccio ◽  
...  

Study Design: Retrospective multicenter. Objectives: diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. Methods: Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. Results: 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. Conclusion: The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.


2021 ◽  
Vol 13 (1) ◽  
pp. 98-103
Author(s):  
Agnieszka Pawłowska-Kamieniak ◽  
Paulina Krawiec ◽  
Elżbieta Pac-Kożuchowska

Acute pancreatitis (AP) appears to be rare disease in childhood. In children, it has a different aetiology and course, and requires different management than in adult patients. The diagnosis of AP is based on at least two of the three criteria, which include typical clinical symptoms, abnormalities in laboratory tests and/or imaging studies of the pancreas. There are many known causes leading to AP in children including infections, blunt abdominal trauma, genetic factors, gallstone disease, metabolic disorders, anatomical defects of the pancreas, systemic diseases, as well as drugs, including antiepileptic drugs, and especially preparations of valproic acid. In our study, we present four cases of young patients diagnosed with acute pancreatitis as a complication of valproic acid therapy and we present a review of the literature. We believe that the activity of pancreatic enzymes should be monitored in children treated with valproate preparations in the case of clinical symptoms suggesting AP.


Author(s):  
Uday Kiran Katari

<p class="abstract">Dysphagia may occur in various pathological, inflammatory diseases of esophagus. It may also occur due to motility disorders of esophagus, benign and malignant diseases of mediastinum, cervical spine diseases. Dysphagia secondary to compression of esophagus by a cervical osteophyte is rare. The most common causes of osteophyte (bony outgrowth) in the cervical spine are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), and cervical spondylosis. Patients with cervical osteophytes are mostly asymptomatic. Hence, when considering cervical osteophytes as a cause of dysphagia other pathologic entities in the esophagus (e.g. tumors, webs, rings, strictures) should be excluded. We present a 68 year female patient who presented with complaints of dysphagia and neck stiffness since 3 months. She has been evaluated and found that dysphagia is due to large anterior cervical osteophytes compressing pharynx at C2/C3 and esophagus at C5/C6 and C6/C7 vertebral levels respectively. The objective of this case report is to emphasize the importance of anterior cervical osteophyte as a cause of dysphagia in elderly.</p>


2003 ◽  
Vol 86 (3-5) ◽  
pp. 265-274 ◽  
Author(s):  
Wei Yue ◽  
Ji-Ping Wang ◽  
Mark R. Conaway ◽  
Yuebai Li ◽  
Richard J. Santen

Oncology ◽  
2003 ◽  
Vol 65 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Xian-Zhong Ding ◽  
Wei-Gang Tong ◽  
Thomas E. Adrian

2018 ◽  
Vol 17 (9) ◽  
pp. 680-688 ◽  
Author(s):  
M.D. Pandareesh ◽  
Hemanth Kumar Kandikattu ◽  
Sakina Razack ◽  
Narayanappa Amruta ◽  
Ramesh Choudhari ◽  
...  

Background and Objective: A steep rise in the incidences of neurodegenerative disorders could be the combined effect of several non-genetic factors such as increased life expectancy, environmental pollutants, lifestyle, and dietary habits, as population-level genetic change require multiple generations. Emerging evidence suggests that chronic over-nutrition induces brain metabolic stress and neuroinflammation, and are individually known to promote neurodegenerative disorders including Alzheimer’s disease (AD), Parkinson’s disease (PD) and Huntington’s disease (HD). Although the association of metabolic disorders such as diabetes, hypertension, dyslipidemia, and atherosclerosis with the dietary habits is well known, neuronal implications of diet and nutritional factors is still in its infancy. Transcriptomics and proteomics-based studies support the view that nutraceuticals target multiple neuroprotective pathways in a slow but effective manner without causing severe adverse effects, and may represent the future of tackling neurodegenerative disorders. Conclusion: In this article we i) review the diet/dietary supplement connection with brain metabolic stress and neuroinflammation and ii) summarize current knowledge of the effects of nutraceuticals on neurodegenerative disorders.


2012 ◽  
Vol 3 (3) ◽  
pp. 168-171
Author(s):  
Prashanth Veerabhadraiah ◽  
Vishal Rao ◽  
Raghavendra Shankar ◽  
Naveen Shivappa ◽  
TM Nagaraj

ABSTRACT Large anterior cervical osteophytes can occur in degeneration of the cervical spine, cervical spondylosis or in diffuse idiopathic skeletal hyperostosis (DISH). Voluminous anterior cervical osteophytes which can develop from C3 to C7 can cause narrowing of the pharyngoesophageal segment by external compression and may cause dysphagia, which may be life threatening when it is associated with aspiration and or dyspnea. The objective of this case report is to highlight how commonly occurring anterior cervical osteophytes may become an unrecognized cause for life-threatening dysphagia. The clinical and radiographic findings in patient with dysphagia and ventral osteophytes of the cervical spine due to degeneration are demonstrated. The anterolateral approach for removal of these osteophytes is described. How to cite this article Veerabhadraiah P, Rao V, Shankar R, Shivappa N, Kumar P, Nagaraj TM. Dysphagia caused by Anterior Cervical Osteophyte: A Rare Entity Revisited. Int J Head and Neck Surg 2012;3(3):168-171.


Pharmacology ◽  
2019 ◽  
Vol 103 (5-6) ◽  
pp. 263-272 ◽  
Author(s):  
Sheng Li ◽  
Yuhua Qu ◽  
Xiu-Yin Shen ◽  
Ting Ouyang ◽  
Wen-Bin Fu ◽  
...  

Background: Crocetin is a carotenoid extracted from the traditional Chinese medical herb saffron. Previous studies have demonstrated that crocetin possesses anticancer properties that are effective against various cancers. As an extension of our earlier study, the present study explored the underlying mechanisms in crocetin’s anticancer effect on KYSE-150 cells. The phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT), Mitogen-activated protein kinases (MAPK), and p53/p21 signal pathways play an important role in carcinogenesis, progression, and metastasis of carcinoma cells. Thus, we investigated crocetin’s effects on the PI3K/AKT, MAPK, and p53/p21 pathways in esophageal squamous carcinoma cell line KYSE-150 cells. Methods: KYSE-150 cells were treated with various concentrations of crocetin. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltertrazolium bromide assay, Annexin V/PI stain as well as Rh123 stain were used to evaluate the cell viability, apoptosis, and MMP. Western blot was used to detect the expression of PI3K, AKT, ERK1/2, p38, c-Jun NH-terminal kinase (JNK), P53, P21, Bcl-2, Bax, and cleaved caspase-3, which were associated with cell proliferation and apoptosis. Results: Our results showed that crocetin significantly inhibited the proliferation of KYSE-150 cells in a dose- and time-dependent manner. Crocetin also markedly induced cell apoptosis. Furthermore, we have found that crocetin not only inhibited the activation of PI3K/AKT, extracellular signal–regulated kinase-1/2 (ERK1/2), and p38 but also upregulated the p53/p21 level. These regulations ultimately triggered the mitochondrial-mediated apoptosis pathway with an eventual disruption of MMP, increased levels of Bax and cleaved caspase-3, and decreased levels of Bcl-2. Conclusions: These findings suggested that crocetin interfered with multiple signal pathways in KYSE-150 cells. Therefore, this study suggested that crocetin could potentially be used as a therapeutic candidate for the treatment of esophageal cancer.


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