Vocal fold myxoma: a case report and review of current literature

Background: Vocal fold myxoma is a rare mesenchymal tumor with unknown exact etiology. The aim of this report is to review current literature on demographic and clinical features of vocal fold myxomas in order to increase awareness among otorhinolaryngologists on management of this rare vocal fold pathology. Case presentation: We report a case of a 46-year-old female teacher presented with 1 year history of progressive dysphonia with no airway obstructive or constitutional symptoms. Flexible laryngoscopy revealed a polypoid mass at the anterior two thirds of the left vocal fold. We proceeded with endolaryngeal microsurgery, where a left vocal fold mass with prominent overlying blood vessels was incompletely excised due to poor plane, in an attempt to prevent injury to vocal ligament. The histopathological findings were consistent with myxoma. No evidence of recurrence was noted at 2 months postoperatively. Conclusions: Vocal fold myxoma should be considered as a differential diagnosis of vocal fold pathology clinically resembling vocal fold polyp, especially in older male adults. Complete excision with removal of a rim of surrounding tissue is the gold-standard treatment to prevent recurrence. If diagnosis is uncertain, intraoperative frozen section can be performed to ensure margins are free from tumor. Life-long follow-up is recommended in incomplete excision of tumor

Nasal leiomyoma presenting as sphenopalatine neuralgia: a case report and literature review

Leiomyoma of the nasal cavity constitutes less than 1% of all leiomyoma cases and is known to occur predominantly among the adult female population. Traditionally, intranasal Leiomyoma presents with nasal obstruction and epistaxis. Herein, we report a case of solid-pattern Leiomyoma arising from the right inferior turbinate, presenting exclusively as unresolved sphenopalatine neuralgia symptoms. Endoscopic excision of the tumour successfully alleviates the patient’s symptoms, requiring no further management. An extensive literature search revealed that intranasal Leiomyoma could be successfully managed by endoscopic excision with no recurrence. We highlight the importance of intranasal endoscopic examination in all patients with persistent neuropathic pain of the head and neck

Pressure-engineered structural and opestical properties of two-dimensional (C4H9NH3)2PbI4 perovskite exfoliated nm-thin flakes

Resolving the structure–property relationships of two-dimensional (2D) organic–inorganic hybrid perovskites is essential for the development of photovoltaic and photoelectronic devices. Here, pressure (0–10 GPa) was applied to 2D hybrid perovskite flakes mechanically exfoliated from butylammonium lead halide single crystals, (C4H9NH3)2PbI4, from which we observed a series of changes of the strong excitonic emissions in the photoluminescence spectra. By correlating with in situ high-pressure X-ray diffraction results, we examine successfully the relationship between structural modifications in the inorganic PbI42– layer and their excitonic properties. During the transition between Pbca (1b) phase and Pbca (1a) phase at around 0.1 GPa, the decrease in ⟨Pb–I–Pb⟩ bond angle and increase in Pb–I bond length lead to an abrupt blue shift of the excitonic bandgap. The presence of the P21/a phase above 1.4 GPa increases the ⟨Pb–I–Pb⟩ bond angle and decreases the Pb–I bond length, leading to a deep red shift of the excitonic bandgap. The total band gap narrowing of ∼350 meV to 2.03 eV at 5.3 GPa before amorphization, facilitates (C4H9NH3)2PbI4 as a much better solar absorber. Moreover, phase transitions inevitably modify the carrier lifetime of (C4H9NH3)2PbI4, where an initial 150 ps at ambient phase is prolongated to 190 ps in the Pbca (1a) phase along with enhanced photoluminescence (PL), originating from pressure-induced strong radiative recombination of trapped excitons.The onset of P21/a phase shortens significantly the carrier lifetime to 53 ps along with a weak PL emission due to pressure-induced severe lattice distortion and amorphization. High-pressure study on (C4H9NH3)2PbI4 nm-thin flakes may provide insights into the mechanisms for synthetically designing novel 2D hybrid perovskite based photoelectronic devices and solar cells.Ministry of Education (MOE)Accepted versionT.T.Y., J.X.Y., and Z.X.S, gratefully acknowledge the Ministry of Education (MOE) for the following grants: AcRF Tier 1 (Reference No: RG103/16); AcRF Tier 2 (MOE2015-T2-1- 148); AcRF Tier 3 (MOE2011-T3-1-005). J.X.Y. is supported by the National Natural Science Foundation of China (Grant No. 11704185) and the Natural Science Foundation of Jiangsu Province, China (Grant No. BK20171021). T.C.S. receives funding from the Ministry of Education Academic Research Fund Tier 1 Grant RG173/16, Tier 2 Grants MOE2015-T2-2- 015 and MOE2016-T2-1-034, and from the Singapore (NRF) through the Singapore−Berkeley Research Initiative for Sustainable Energy (SinBeRISE) CREATE Program and the Competitive Research Program NRF-CRP14-2014-03. S.H.W. is supported by the National Key Basic Research Program of China (2016YFB0700700) and National Natural Science Foundation of China (51672023, 11634003, U1530401). S.J. and J.F. thank Dr. Zhongwu Wang and Dr. Ruipeng Li for their assistance and acknowledge the support from Custom Electronics Inc. and Binghamton University. CHESS was supported by the NSF award DMR-1332208

Antimicrobial Activity and Cell Selectivity of Synthetic and Biosynthetic Cationic Polymers

The mammalian and microbial cell selectivity of synthetic and biosynthetic cationic polymers has been investigated. Among the polymers with peptide backbones, polymers containing amino side chains display greater antimicrobial activity than those with guanidine side chains, whereas ethylenimines display superior activity over allylamines. The biosynthetic polymer ε-polylysine (εPL) is noncytotoxic to primary human dermal fibroblasts at concentrations of up to 2,000 μg/ml, suggesting that the presence of an isopeptide backbone has greater cell selectivity than the presence of α-peptide backbones. Both εPL and linear polyethylenimine (LPEI) exhibit bactericidal properties by depolarizing the cytoplasmic membrane and disrupt preformed biofilms. εPL displays broad-spectrum antimicrobial properties against antibiotic-resistant Gram-negative and Gram-positive strains and fungi. εPL elicits rapid bactericidal activity against both Gram-negative and Gram-positive bacteria, and its biocompatibility index is superior to those of cationic antiseptic agents and LPEI. εPL does not interfere with the wound closure of injured rabbit corneas. In a rabbit model of bacterial keratitis, the topical application of εPL (0.3%, wt/vol) decreases the bacterial burden and severity of infections caused by Pseudomonas aeruginosa and Staphylococcus aureus strains. In vivo imaging studies confirm that εPL-treated corneas appeared transparent and nonedematous compared to untreated infected corneas. Taken together, our results highlight the potential of εPL in resolving topical microbial infections.NRF (Natl Research Foundation, S’pore)ASTAR (Agency for Sci., Tech. and Research, S’pore)MOH (Min. of Health, S’pore)Published versio

Cornell product is an ECG marker of heart failure with preserved ejection fraction

10.1136/heartasia-2018-011108HEART ASIA11

Factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic: a cross-sectional study in 12 Asian countries

10.1136/bmjopen-2020-046310BMJ OPEN11

Impact of the coronavirus disease 2019 pandemic on irritable bowel syndrome

Background and aim: Gastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS. Methods: We conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated. Results: Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS. Conclusion: Our study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS

Association between well-being and compliance with COVID-19 preventive measures by healthcare professionals: A cross-sectional study

10.1371/journal.pone.0252835PLOS ONE16

The impact of the COVID-19 pandemic on irritable bowel syndrome

Background: Gastrointestinal manifestations of the COVID-19 pandemic may mimic Irritable Bowel Syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with IBS. Methods: We conducted an anonymised survey using MySurvey platform from May to June 2020 in 35 countries. The general public's knowledge, attitudes and practices regarding personal hygiene and social distancing during this COVID-19 pandemic and the psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine the differences in well-being and compliance to social distancing measures between IBS and non-IBS respondents. Factors associated with worsening of IBS symptoms were evaluated. For newly developed IBS-like symptoms, subjects must fulfill ROME IV criteria. Results: Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had IBS and 374 (13.8%) did not know what IBS was. Respondents with IBS reported significantly worse emotional, social and psychological well-being compared to non-IBS respondents and were less compliant to social distancing (28.2% vs 35.3%, p=0.029, table 1). Of the non-IBS respondents, 96 (4.7%) developed new IBS-like symptoms. Among IBS respondents, the majority reported no change in symptom severity (61.6%), while 26.6% reported improvement and 11.8% reported worsening in IBS symptoms. A higher proportion of respondents with no change in the severity of IBS symptoms was willing to practice social distancing indefinitely compared to those who deteriorated (74.9% vs 51.4%, p=0.016, table 2). In multivariate analysis (table 3), willingness to continue social distancing for only another 2–3 weeks was significantly associated with higher odds of worsening IBS while better emotional well-being was associated with lower odds. Conclusions: Our study showed differences in well-being and compliance to social distancing between IBS and non-IBS respondents, and these factors influence the worsening in severity of IBS. Further research will focus on how occupational stress and dietary changes may influence IBS symptoms

Loss of C2orf69 defines a fatal autoinflammatory syndrome in humans and zebrafish that evokes a glycogen-storage-associated mitochondriopathy

Human C2orf69 is an evolutionarily conserved gene whose function is unknown. Here, we report eight unrelated families from which 20 children presented with a fatal syndrome consisting of severe autoinflammation and progredient leukoencephalopathy with recurrent seizures; 12 of these subjects, whose DNA was available, segregated homozygous loss-of-function C2orf69 variants. C2ORF69 bears homology to esterase enzymes, and orthologs can be found in most eukaryotic genomes, including that of unicellular phytoplankton. We found that endogenous C2ORF69 (1) is loosely bound to mitochondria, (2) affects mitochondrial membrane potential and oxidative respiration in cultured neurons, and (3) controls the levels of the glycogen branching enzyme 1 (GBE1) consistent with a glycogen-storage-associated mitochondriopathy. We show that CRISPR-Cas9-mediated inactivation of zebrafish C2orf69 results in lethality by 8 months of age due to spontaneous epileptic seizures, which is preceded by persistent brain inflammation. Collectively, our results delineate an autoinflammatory Mendelian disorder of C2orf69 deficiency that disrupts the development/homeostasis of the immune and central nervous systems