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Competing Interests: The authors declare that they have no conflict of interest.

Mycoplasma synoviae is a pathogen of poultry that causes upper respiratory tract disease. MS-H is a live attenuated temperature-sensitive vaccine that effectively control M. synoviae infection in chickens. However, the mechanisms underpinning protection have not been described previously. In this study, specific-pathogen-free chickens were vaccinated at 3 weeks of age with MS-H vaccine and challenged with field strain M. synoviae 94011/v-18d at 6 weeks of age. Tracheal mucosal inflammation was characterised by the assessment of thickness, histopathological lesions, cellular infiltrates and cytokine transcription. Tracheal lesion scores of unvaccinated-challenged (-V+C) birds were higher than that of vaccinated-challenged (+V+C) birds. +V+C birds displayed early upregulation of IL-4, consistent with a Th-2-skewed response, followed by a later increase in IFN-γ transcription, indicating transition to a Th-1-skewed response. -V+C birds displayed a concurrent early Th-2 and Th-17 response characterised by increase expression of IL-4 and IL-17A respectively, and late T regulatory response characterised by increased IL-10 transcription. +V+C chickens had more cytotoxic T cells (CD8 + T cells) at 7- and 21 days post-challenge (dpc), while -V+C chickens had higher numbers of infiltrating CD4 + CD25 + at 7 and 21 dpc. Overall, these observations suggest that the immune response in +V+C chickens had an inflammation characterised by an early Th-2 skewed response followed closely by a Th-1 response and infiltration of cytotoxic T cells, while the response in -V+C chickens was an early Th-2/Th-17-skewed response closely followed by a T regulatory response., Competing Interests: Declaration of Competing Interest The authors expressed no conflicts of interest related to the research reported here., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background and Aims: Based on the porcine natural antireflux mechanism, we developed a novel endoscopic procedure to build an antireflux mucosal flap to block acid reflux and treat GERD., Methods: The antireflux mucosal valvuloplasty (ARMV) procedure is performed by releasing and reconstructing three-fourths of the circumference of cardiac mucosa at the lesser curvature side into a double-layer mucosal flap. The mucosal flap works together with cardiac scarring to block reflux. We retrospectively reviewed 30 patients who underwent ARMV from 2019 to 2021. Subjective and objective data evaluating GERD were collected before and after ARMV., Results: All 30 ARMV procedures were performed successfully, with a mean operation time of 72.6 ± 20.3 minutes. One patient had postoperative bleeding that required endoscopic hemostasis. The mean follow-up time was 28.9 ± 13.9 months. Twenty-five of 30 patients (83.3%) and 23 of 26 patients (88.5%) reported discontinuation or reduction in proton pump inhibitor therapy 3 months and 1 year after ARMV, respectively. GERD questionnaire and GERD Health-Related Quality of Life questionnaire scores improved significantly from 14.0 ± 2.6 and 48.7 ± 15.0, respectively, before ARMV to 7.7 ± 2.5 and 10.2 ± 5.9, respectively, 12 months after ARMV (P < .0001 in both comparisons). Eleven patients received 24-hour esophageal pH monitoring before and after ARMV. The mean acid exposure time and DeMeester score dropped from 56.9% ± 23.7% and 167.1 ± 80.1, respectively, before ARMV to 5.5% ± 3.0% and 18.6 ± 11.9, respectively, after ARMV (P < .0001 in both comparisons)., Conclusions: This pilot study showed that ARMV is a safe, feasible, and effective procedure for GERD patients. Further prospective and comparative trials are needed to confirm its role among endoscopic antireflux therapies., Competing Interests: Disclosure All authors disclosed no financial relationships., (Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Satoki Shichijo has received honoraria for lectures from Olympus, Boston Scientific Japan, EA Pharma, AstraZeneca, AI Medical Service, and Janssen Pharmaceutical. Yoji Takeuchi has received honoraria for lectures from Olympus, Boston Scientific Japan, Takeda Pharmaceutical, EA Pharma, Zeria Pharmaceutical, and Viatris. Noriya Uedo has received honoraria for lectures from Olympus, FUJIFILM, Boston Scientific Japan, Daiichi-Sankyo, Takeda Pharmaceutical, EA Pharma, Otsuka Pharmaceutical, AstraZeneca, Miyarisan Pharmaceutical, and AI Medical Service.

Competing Interests: The authors declare that they have no conflict of interest.

Swelling in the vocal folds is caused by the local accumulation of fluid, and has been implicated as a phase in the development of phonotraumatic vocal hyperfunction and related structural pathologies, such as vocal fold nodules. It has been posited that small degrees of swelling may be protective, but large amounts may lead to a vicious cycle wherein the engorged folds lead to conditions that promote further swelling, leading to pathologies. As a first effort to explore the mechanics of vocal fold swelling and its potential role in the etiology of voice disorders, this study employs a finite-element model with swelling confined to the superficial lamina propria, which changes the volume, mass, and stiffness of the cover layer. The impacts of swelling on a number of vocal fold kinematic and damage measures, including von Mises stress, internal viscous dissipation, and collision pressure, are presented. Swelling has small but consistent effects on voice outputs, including a reduction in fundamental frequency with increasing swelling (10 Hz at 30 % swelling). Average von Mises stress decreases slightly for small degrees of swelling but increases at large magnitudes, consistent with expectations for a vicious cycle. Both viscous dissipation and collision pressure consistently increase with the magnitude of swelling. This first effort at modeling the impact of swelling on vocal fold kinematics, kinetics, and damage measures highlights the complexity with which phonotrauma can influence performance metrics. Further identification and exploration of salient candidate measures of damage and refined studies coupling swelling with local phonotrauma are expected to shed further light on the etiological pathways of phonotraumatic vocal hyperfunction., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: The authors declare that they have no conflict of interest.

Background: DNA methylation is an epigenetic mechanism through which environmental factors including nutrition and inflammation influence health. Obesity is a major modifiable risk factor for many common diseases including cardiovascular diseases and cancer. In particular, obesity-induced inflammation resulting from aberrantly-methylated inflammatory genes may drive risk of several non-communicable diseases including colorectal cancer (CRC). This study is the first to investigate the effects of weight loss induced by bariatric surgery (BS) on DNA methylation in the rectum and in cell-free DNA (cfDNA) from blood., Subjects and Methods: DNA methylation was quantified in rectal mucosal biopsies and cfDNA from serum of 28 participants with obesity before and 6 months after BS, as well as in 12 participants without obesity (control group) matched for age and sex from the Biomarkers Of Colorectal cancer After Bariatric Surgery (BOCABS) Study. DNA methylation of LEP, IL6, POMC, LINE1, MAPK7 and COX2 was quantified by pyrosequencing., Results: BMI decreased significantly from 41.8 kg/m 2 pre-surgery to 32.3 kg/m 2 at 6 months after BS. Compared with the control group, obesity was associated with lower LEP methylation in both the rectal mucosa and in cfDNA from serum. BS normalised LEP methylation in DNA from the rectal mucosa but not in cfDNA. BS decreased methylation of some CpG sites of LINE1 in the rectal mucosal DNA and in cfDNA to levels comparable with those in participants without obesity. Methylation of POMC in rectal mucosal DNA was normalised at 6 months after BS., Conclusion: BS reversed LINE1, POMC and LEP methylation in the rectal mucosa of patients with obesity to levels similar to those in individuals without obesity. These findings support current evidence of effects of BS-induced weight loss on reversibility of DNA methylation in other tissues. The DNA methylation changes in the rectal mucosa shows promise as a biomarker for objective assessment of effects of weight loss interventions on risk of cancer and other diseases., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Competing Interests: The authors declare that they have no conflict of interest.

Aim: To investigate the healing after heterotopic mucosa transpositioning at dental implants and teeth., Materials and Methods: One hemimandible per dog (n = 4) was allocated to receive 3 implants (test), whereby 3 premolars on the contralateral side served as controls. After osseointegration, a Z-plasty was performed on the buccal aspect of the test and control sites to heterotopically move the zone of keratinized tissue (KT) into a region with non-keratinized tissue (nKT) and vice versa. Clinical measurements were performed before (T0) and at 12 weeks following heterotopic transposition (T1). Thereafter, specimens were processed for histological analysis., Results: Clinical measurements revealed that at T1, a band of KT was reestablished at teeth (mean: 2.944 ± 1.866 mm), whereas at implants, the transpositioned nKT resulted in a mucosa without any signs of keratinization (mean: 0 mm; p < .0001). At implant sites, the probing attachment level loss was more pronounced compared to tooth sites (-1.667 ± 1.195 mm and -1.028 ± 0.878 mm, respectively; p = .0076). Histologically, the transpositioned nKT, was accompanied by the formation of KT at the tooth but not at implant sites. The supracrestal soft tissues were statistically significantly higher at tooth compared to implant sites (2.978 ± 0.483 mm and 2.497 ± 0.455 mm, p = .0083). The transpositioned KT remained mostly unaltered in its morphological characteristics., Conclusions: The findings of this study indicate that: (a) transpositioned KT may retain its morphological characteristics; and (b) transpositioned nKM was accompanied by the formation of KT at the tooth but not at implant sites., (© 2023 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Background: The mechanisms underlying mucosal eosinophilia in chronic rhinosinusitis with nasal polyps (CRSwNP) remain poorly clarified. The nervous system and neuropeptides play an important role in the regulation of immune response. Herein we explore the expression and function of hemokinin‐1 (HK‐1), a newly identified tachykinin, along with its receptor neurokinin 1 receptor (NK1R) in CRSwNP. Methods: HK‐1, NK1R, and C‐C motif chemokine ligand 24 (CCL24) expression in nasal tissues (53 eosinophilic CRSwNP, 32 non‐eosinophilic CRSwNP, and 33 controls) was investigated by quantitative reverse transcript polymerase chain reaction (RT‐PCR) and immunofluorescence staining. THP‐1, a human monocytic leukemia cell line, and eosinophilic polyp tissues were stimulated with HK‐1. Cells, tissues, and culture supernatants were subsequently collected for detection of the production of various inflammatory cytokines and chemokines by quantitative RT‐PCR and enzyme‐linked immunoassay. Results: HK‐1 and NK1R mRNA and protein expression were upregulated in eosinophilic and non‐eosinophilic nasal polyps compared with control tissues, with eosinophilic polyps demonstrating a higher upregulation compared with that of non‐eosinophilic polyps. Eosinophils constituted the major source of HK‐1, whereas macrophages were the predominant cell type exhibiting NK1R in eosinophilic polyps. HK‐1 induced CCL24 production from macrophages differentiated from THP‐1 cells; this was abolished by an NK1R antagonist. HK‐1 also induced CCL24 production from ex vivo‒cultured eosinophilic nasal polyps. CCL24 was expressed by macrophages in eosinophilic but not non‐eosinophilic polyps. The expression level of HK‐1 correlated with CCL24 expression and tissue eosinophilia in eosinophilic nasal polyps. Conclusion: Eosinophil‐derived HK‐1 induces CCL24 production from macrophages and therefore exaggerates eosinophilic inflammation in CRSwNP. [ABSTRACT FROM AUTHOR]

Objectives: Define the morphologic and molecular features of colonic polyps with subtle histologic features.Methods: Two hundred specimens were obtained of surveillance colonoscopies. Endoscopic findings were reviewed. Histologic features of the polyps were compared with the flat mucosa. Next-generation sequencing was performed on 30 study polyps and 20 control samples.Results: Polyps with subtle changes comprised 12% of all polyps. All polyps were sessile and small (<0.5 cm) and were located predominantly in the distal colon (60%). Synchronous hyperplastic, sessile serrated, and dysplastic polyps were found in 30%, 7%, and 51% of patients, respectively. A total of 169 (84.5%) polyps showed wide, nonserrated crypts, increased intraluminal mucus, and patent openings. KRAS alterations were present in 30% of polyps.Conclusions: Most polyps with subtle histologic features have recognizable morphologic changes. About one-third harbored KRAS alterations. These polyps should not be regarded as variants of hyperplastic polyps. [ABSTRACT FROM AUTHOR]

Introduction: The epithelialized palatal graft (EPG), introduced in 1963, has persisted as the gold standard for gingival augmentation, and in the present era, mucosal augmentation around dental implants has become an important concern. A limited body of evidence suggests peri‐implant mucosal augmentation may favorably impact bone and mucosal stability and peri‐implant health under some circumstances. Although more contemporary procedures for peri‐implant mucosal augmentation are often preferred based on convenience and esthetic considerations, EPG augmentation at dental implant sites is distinguishable from methods which do not deepen the vestibule and eliminate unfavorable superficial soft tissue. Implant sites augmented with EPG are qualitatively distinct from sites augmented using other methods. Case Series: Seven generally healthy patients received EPG augmentation before dental implant placement, at implant placement, before implant uncovering, or after implant uncovering. In each case, the patient exhibited a favorable zone of attached peri‐implant mucosa following treatment. Conclusions: Reliable mucosal augmentation with EPG is achievable at multiple phases in the course of dental implant therapy. EPG augmentation offers distinct clinical advantages and may be preferable to other mucosal augmentation strategies at some dental implant sites. [ABSTRACT FROM AUTHOR]

In the chicken bursa of Fabricius (BF), the interfollicular epithelium (IFE) consists of cylindrical- and cuboidal-shaped cells. Among the cylindrical-shaped epithelial cells, mucus-producing and caveolin-1 (Cav-1)-expressing cells can be distinguished. Occasionally, the cuboidal-shaped cells also express Cav-1, which suggests that they are precursors of both mucus-producing and Cav-1-expressing cells. Very virulent infectious bursal disease virus (IBDV) impedes the differentiation of Cav-1-expressing cells and shifts the differentiation of cuboidal cells towards mucus-producing cells. In control birds exclusively, the IFE surface shows a mucous membrane, but after IBDV infection, the surfaces of both IFE and FAE are also covered by a mucous membrane. After IBDV infection, the cells of FAE also produce mucus, providing evidence for cell transformation. In late postinfection (pi ; 28 d pi), the Cav-1 expression returned in the IFE cells, whereas the follicle (the primary lymphoid organ) underwent atrophy. The appearance of the renewed Cav-1-positive cells is similar to that of the normal basal cell, but they randomly locate in different levels of IFE, suggesting the loss of epithelial polarity. Between days 2 and 7 pi, the Cav-1 expression in the endothelial cells of the cortico-medullary capillary web is variable, which may explain the hemorrhage in several infected birds. The IBDV infection stops the Cav-1 expression and subsequently the cholesterol efflux into the bursal lumen. In the infected birds, the high cholesterol level may further worsen the clinical syndrome of IBDV. [ABSTRACT FROM AUTHOR]

Head and neck mucosal melanoma (HNMM) is a rare tumor with a poor outcome. The objective of this study was to assess outcome and prognostic factors for a cohort of patients treated in a head and neck cancer center. In addition, a case series on sentinel lymph node biopsy (SLNB) was included to evaluate it as a method for staging the node-negative neck. A retrospective study design was chosen, and 50 patients who were treated from 1973 to 2015 in our institution for primary HNMM were included. The Kaplan–Meier method was used to estimate survival rates. Uni- and multivariate analyses were used to study the influence of possible risk factors on the patients' outcome. These risk factors included patient demographics, tumor characteristics, and treatment modalities. All patients were treated surgically and 50% received adjuvant treatment. The median disease specific survival (DSS) was 38 months, with a 5-year survival rate of 44%. Positive surgical margin (p = 0.004) and distant failure (p = 0.005) were associated with a worse DSS. The median disease-free survival (DFS) was 27 months, with a 5-year disease-free rate of 12%. Only tumor depth >5 mm (p = 0.002) was associated with a worse DFS. Five clinically node-negative patients received SLNB and only the two SLN-positive individuals suffered from distant failure. Radiotherapy, chemotherapy, and AJCC/UICC stage had no influence on any outcome measure. Positive surgical margin and distant failure are the only independent prognostic factors for DSS. Tumor depth can predict distant failure. SLNB may be a valuable staging tool for the node-negative neck. [ABSTRACT FROM AUTHOR]

Sporadic colon cancer accounts for approximately 80% of colorectal cancer (CRC) with high incidence in Western societies strongly linked to long-term dietary patterns. A unique mouse model for sporadic CRC results from feeding a purified rodent Western-style diet (NWD1) recapitulating intake for the mouse of common nutrient risk factors each at its level consumed in higher risk Western populations. This causes sporadic large and small intestinal tumors in wild-type mice at an incidence and frequency similar to that in humans. NWD1 perturbs intestinal cell maturation and Wnt signaling throughout villi and colonic crypts and decreases mouse Lgr5hi intestinal stem cell contribution to homeostasis and tumor development. Here we establish that NWD1 transcriptionally reprograms Lgr5hi cells, and that nutrients are interactive in reprogramming. Furthermore, the DNA mismatch repair pathway is elevated in Lgr5hi cells by lower vitamin D3 and/or calcium in NWD1, paralleled by reduced accumulation of relevant somatic mutations detected by single-cell exome sequencing. In compensation, NWD1 also reprograms Bmi1+ cells to function and persist as stem-like cells in mucosal homeostasis and tumor development. The data establish the key role of the nutrient environment in defining the contribution of two different stem cell populations to both mucosal homeostasis and tumorigenesis. This raises important questions regarding impact of variable human diets on which and how stem cell populations function in the human mucosa and give rise to tumors. Moreover, major differences reported in turnover of human and mouse crypt base stem cells may be linked to their very different nutrient exposures. [ABSTRACT FROM AUTHOR]

Background: Persisting low-grade inflammation is suggested to play a role in postinfectious functional gastrointestinal disorders (PI-FGIDs). The present study examined alterations in duodenal mucosal lymphocytes during and after Giardia gastroenteritis in patients who did, or did not, develop PI-FGIDs.Methods: Duodenal mucosal intraepithelial lymphocytes (IELs) and lamina propria CD3, CD4, CD8, and CD20 lymphocytes were quantified in 28 patients with chronic giardiasis (CG), 66 patients with persistent abdominal symptoms after acute Giardia infection (PI-FGID), 19 recovered controls (RCs), and 16 healthy volunteers (HCs). Associations with illness duration, abdominal symptoms, and histology grade were assessed.Results: Duodenal CD4 IELs were significantly elevated in CG, then decreased, followed by an upward trend after 1 year in both the PI-FGID and RC groups. Duodenal lamina propria crypt CD4 T cells were decreased in CG, and stayed low for about 14 months before normalizing in both the PI-FGID and RC groups. Lamina propria CD20 cells were persistently elevated in all 3 Giardia-exposed groups. Biopsies with microscopic inflammation showed increased lamina propria CD20 levels.Conclusions: Duodenal mucosal lymphocyte alterations were prolonged after Giardia infection, but similar in patients who developed PI-FGID and recovered asymptomatic controls. [ABSTRACT FROM AUTHOR]

Background: The mucous membrane of the maxillary sinus is very sensitive to foreign bodies and infections. Any triggering may lead to mucous membrane thickening (MMT). Residual bone thickness (RBT) is the remaining bone apical to the periodontal defect until the floor of the maxillary sinus acts as a barrier for the periodontal infections to reach the sinus. The aim of our current study was to evaluate the minimal RBT to prevent periodontal infection to reach Schneiderian membrane using cone-beam computed tomography (CBCT). Materials and Methods: In this descriptive study, 144 maxillary sinus exposure records of 100 patients were collected retrospectively. Patients with minimum one sinus exposure were considered. MMT and RBT were calculated with the CBCT assistance. Statistical analysis was done using Mann–Whitney U-test , Kruskal–Wallis and Chi-square test. (P < 0.05) was considered as statistically significant. Results: Significant difference (P < 0.001) was observed in MMT among three RBT groups. Significantly, higher mean MMT was observed with <2 mm and 2–4 mm RBT groups. The prevalence of MMT with >4 mm group is less (7%) compared to <2 mm group and 2–4 mm RBT groups (91.2% and 90.2%, respectively). Furthermore, there is no significant difference in MMT between angular and furcation defects (P = 0.890). Conclusion: Probability of MMT was increased if RBT is <4 mm. Early detection and prompt periodontal treatments associated with regenerative procedures can be instituted wherever possible to improve RBT and to reduce MMT. Further, microbiological studies are required to confirm the analysis. [ABSTRACT FROM AUTHOR]

Copyright of Gastroenterologia (2308-2097) is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inhalation injury is an independent risk factor in burn mortality, imparting a 20% increased risk of death. Yet there is little information on the natural history, functional outcome, or pathophysiology of thermal injury to the laryngotracheal complex, limiting treatment progress. This paper demonstrates a case series (n = 3) of significant thermal airway injuries. In all cases, the initial injury was far exceeded by the subsequent immune response and aggressive fibroinflammatory healing. Serial examination demonstrated progressive epithelial injury, mucosal inflammation, airway remodeling, and luminal compromise. Histologic findings in the first case demonstrate an early IL-17A response in the human airway following thermal injury. This is the first report implicating IL-17A in the airway mucosal immune response to thermal injury. Their second and third patients received Azithromycin targeting IL-17A and showed clinical responses. The third patient also presented with exposed tracheal cartilage and underwent mucosal reconstitution via split-thickness skin graft over an endoluminal stent in conjunction with tracheostomy. This was associated with rapid abatement of mucosal inflammation, resolution of granulation tissue, and return of laryngeal function. Patients who present with thermal inhalation injury should receive a thorough multidisciplinary airway evaluation, including early otolaryngologic evaluation. New early endoscopic approaches (scar lysis and mucosal reconstitution with autologous grafting over an endoluminal stent), when combined with targeted medical therapy aimed at components of mucosal airway inflammation (local corticosteroids and systemic Azithromycin targeting IL-17A), may have potential to limit chronic cicatricial complications. [ABSTRACT FROM AUTHOR]

Abstract Purpose: This study examined the incidence of oral mucosa pressure ulcers (PUs) in intensive care unit (ICU) patients and the relationship between biomechanical and physiological variables in onset of PUs. Methods: A prospective observational descriptive study design was used. We recruited patients over 18 years of age with endotracheal tube (ETT) insertion in three ICUs in a tertiary hospital in Korea. We analysed 113 patient-days of data. Patient assessments and medical record reviews were conducted to gather biomechanical and physiological data. Fisher's exact tests and χ2 test and Spearman's rank correlations were used to compare data. Results: The highest incidence of oral mucosa PUs occurred in lower oral mucosa (36.3%). There was a significant relationship between lower oral mucosa PU stage and bite-block or airway use (r =.20, p =.036), commercial ETT holder use (r = 0.19, p =.048), sedative use (r = −0.22, p =.022), and plasma protein (r = 0.20, p =.033). Upper oral mucosa PU stage was related to commercial ETT holder use (r = 0.19, p =.044), haemoglobin(r = 0.24, p =.011), haematocrit (r = 0.27, p =.004), and serum albumin (r = −0.24, p =.012). Stage was related to commercial ETT holder use in both sites (r = 0.28, p =.003), haematocrit (r = 0.19, p =.039), and serum albumin (r = −0.23, p =.015). Conclusion: Oral mucosa PUs developed more frequently and healed more quickly than general skin PUs. Taken together, these data indicate that biomechanical and haematological variables are risk factors associated with PU incidence should be considered in intensive care patients. Highlights • Oral mucosa PUs occur more frequently at multiple sites, and they may develop and heal repeatedly and overlap. • This study has shown the necessity of oral mucosa PU classification by stages to estimate more precise incidence rates. • Biomechanical factors, such as non-commercial and commercial ETT holders; and physiological variables, such as sedative use, haemoglobin, haematocrit, and serum albumin, are associated with oral mucosa PU incidence. [ABSTRACT FROM AUTHOR]

Background: Congenital, traumatic, or developmental bony vault deformities may require additional interventions rather than classical osteotomies to correct the surface structure or angulations of the nasal bones in rhinoplasty.Objectives: The aim of the study was to determine the effects of the additional osteotomies applied for the correction of the nasal vault asymmetries retrospectively.Methods: Twenty-one patients among 512 primary rhinoplasty cases between 2011 and 2016 with bony vault asymmetries were included in the study. Three patients had bilateral convex, 6 patients had unilateral convex, and 7 patients had unilateral concave surface deformities. Five patients had concave deformity on one side and convex deformity on the other side. Double-layer lateral osteotomies and caudal transverse osteotomies were conducted for the correction of the severe surface anatomy deformities of the nasal bones. The caudal transverse osteotomy was delicately performed with a special osteotome, which was designed to protect inner periosteum and mucosa of the nasal bone, and to prevent uncontrolled fracture formation with thinned edge.Results: Twenty patients (95.2%) had favorable results with restoration of a symmetric bony and cartilaginous nasal vault configuration. None of the bone fragments showed any rotation or malposition. One (4.8%) patient with a crooked nose had suboptimal dorsal geometry without requiring revisional surgery at the level of the cartilaginous nasal vault.Conclusions: The author described the morphology, clinical relevance, and correction methods of the nasal vault and the changes that occur in this area during rhinoplasty in patients with concave, convex, or combined three-dimensional nasal bone deformities. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Digestion and absorption describe the breakdown of food into small particles and their movement from the gastrointestinal lumen into the body. The main groups of nutrients absorbed from food are carbohydrates, proteins and lipids. Water, minerals and vitamins are also absorbed by the gastrointestinal (GI) tract. Carbohydrates are enzymatically broken down into monosaccharides, which are absorbed across the small intestinal epithelium by passive (fructose) and active (glucose and galactose) mechanisms. Similarly, proteins are broken down from polypeptide chains into individual amino acids or dipeptides and tripeptides. Their absorption depends on their chemical properties and also occurs via passive and active processes that utilize a variety of membrane transporters. Lipids and lipid-soluble vitamins require bile salts for emulsification to aid absorption. Water follows osmotic gradients generated by the absorption of nutrients. Since the processes of digestion and absorption require mechanical and chemical processes that can damage the mucosa, the GI tract has evolved a number of defence mechanisms, including a mucous barrier and regular renewal of the epithelial lining. [ABSTRACT FROM AUTHOR]

The article summarizes the results of long-term improvement of differentiated approaches to the treatment of chronic gastroduodenal diseases associated with disorders of other digestive organs. Under supervision there were 1,386 children aged 7 to 15 years with disorders of the digestive system. Examination of patients was complete and included clinical, laboratory and instrumental methods. 100 % of patients were diagnosed with chronic gastroduodenal diseases (982 — chronic gastroduodenitis, 268 — chronic gastritis, 136 — chronic duodenitis). Comprehensive examination of the patients revealed the pathological changes in other digestive organs: in 94.7 %, disease of the biliary system was diagnosed, in 43.6 % — of the pancreas, in 38.1 % — of the colon, in 79.17 % — intestinal dysbiosis. The article describes the differentiated approach to the treatment of combined pathology of the digestive system, depending on the state of the mucous membranes of the upper alimentary canal, acid-forming function of the stomach, pancreas, bile ducts and the intestine. In the comorbidity of gastroduodenal zone and the pancreas, the use of enzyme preparation ­Pangrol® 10000 was effective.

Objectives Metastasis of melanoma to the head and neck mucosa is a very unusual condition. The aim of this study was to report four cases of patients with metastatic melanoma in the head and neck mucosa treated at a single institution. Methods Clinical data were obtained from the medical records. All cases were histologically reviewed to confirm the diagnosis, and immunohistochemical reactions were performed in the cases submitted to biopsy. Results All patients were males and the mean age was 40.5 years old. The sites of the metastatic tumors were gingival mucosa, floor of the mouth, oropharynx, and larynx. Two tumors appeared as submucosal nodules with normal color; one lesion was a blackish nodular lesion, and one was shown to be an ulcerated lesion. The size of tumors ranged from 2.0 to 4.0 cm. All patients had developed systemic disease at time of diagnosis of metastatic tumor in the head and neck mucosa. Survival rates ranged from 2 to 19 months after the diagnosis of the metastatic mucosal melanoma in the head and neck region. Conclusion Although rare, patients with melanoma must be closely and regularly followed up, with careful routine examination of head and neck, because metastatic tumors in this region seem to be part of a lethal widespread metastatic disease.