Botulinum toxin injection combined with traditional swallowing rehabilitation improved cricopharyngeal dysfunction in neuromyelitis optica spectrum disorder: A case report

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune diseases of the central nervous system, and often influence optic nerve and medulla oblongata. Previous studies found out that brain abnormalities were not rare in these patients. Medulla oblongata (MO) was commonly involved and usually located at dorsal part. Patients who diagnosed NMOSD with MO lesions were more likely to have dysphagia. Previous reports indicated that the symptoms and signs of NMOSD patients could be controlled after immunosuppressive therapy. This patient was a 49-year-old Asian woman presented with recurrent vomiting and diagnosed NMOSD with MO involvement. However, after immunotherapy in other hospital, she still suffered from dysphagia. She then came to our department and completed videofluoroscopic swallowing study (VFSS) and high-resolution pharyngeal manometry (HRPM). Her UES was not opening with aspiration and the UES residue pressure was higher than normal range, we figured that she had cricopharyngeal (CP) dysfunction. Then the SLP gave her traditional treatment, including catheter balloon dilation. But she failed improvement after treatment for 2 weeks. Then the clinicians decided to inject botulinum toxin (BTX) into her CP muscles, which needed specific location and appropriate dosage. Her UES residue pressure decreased after three times BTX injection. During this time, her SLP adjusted the treatment strategies based on her VFSS and HRM results. Combined BTX injection with traditional treatment, she can now eat food orally without restrictions. This case report we presented can provide treatment strategies for similar patients with dysphagia

Infiltrated IL-17A-producing gamma delta T cells play a protective role in sepsis-induced liver injury and are regulated by CCR6 and gut commensal microbes

IntroductionSepsis is a common but serious disease in intensive care units, which may induce multiple organ dysfunctions such as liver injury. Previous studies have demonstrated that gamma delta (γδ) T cells play a protective role in sepsis. However, the function and mechanism of γδ T cells in sepsis-induced liver injury have not been fully elucidated. IL-17A-producing γδ T cells are a newly identified cell subtype.MethodsWe utilized IL-17A-deficient mice to investigate the role of IL-17A-producing γδ T cells in sepsis using the cecum ligation and puncture (CLP) model.ResultsOur findings suggested that these cells were the major source of IL-17A and protected against sepsis-induced liver injury. Flow cytometry analysis revealed that these γδ T cells expressed Vγ4 TCR and migrated into liver from peripheral post CLP, in a CCR6-dependent manner. When CLP mice were treated with anti-CCR6 antibody to block CCR6-CCL20 axis, the recruitment of Vγ4+ γδ T cells was abolished, indicating a CCR6-dependent manner of migration. Interestingly, pseudo germ-free CLP mice treated with antibiotics showed that hepatic IL-17A+ γδ T cells were regulated by gut commensal microbes. E. coli alone were able to restore the protective effect in pseudo germ-free mice by rescuing hepatic IL-17A+ γδ T cell population.ConclusionOur research has shown that Vγ4+ IL-17A+ γδ T cells infiltrating into the liver play a crucial role in protecting against sepsis-induced liver injury. This protection was contingent upon the recruitment of CCR6 and regulated by gut commensal microbes

Characterization of one novel microbial esterase WDEst9 and its use to make l-methyl lactate

Chiral lactic acids and their ester derivatives are crucial building blocks and intermediates for the synthesis of a great variety of valuable functional materials and pharmaceuticals. Before our study, the reports about the enantioselective preparation of pure L-lactic acid and its ester derivatives through direct hydrolysis of racemic substrate were quite rare. Herein, we heterologously expressed and functionally characterized one novel microbial esterase WDEst9 from Dactylosporangium aurantiacum, which exhibited high resistance to diverse metal ions, organic solvents, surfactants, NaCl and KCl. We further utilized WDEst9 as a green biocatalyst in the kinetic resolution of (+/-)-methyl lactate through direct hydrolysis and generated L-methyl lactate with high enantiomeric excess (e.e. >99%) and high yield (>86%) after process optimization. Notably, the enantioselectivity of WDEst9 was opposite than that of two previously reported esterases PHE14 and BSE01701 that can generate D-methyl lactate though kinetic resolution of (+/-)-methyl lactate. Microbial esterase WDEst9 is a promising green biocatalyst in the preparation of valuable chiral chemicals and opens the door for the identification of useful industrial enzymes and biocatalysts from the genus Dactylosporangium

Biometric Recognition8th Chinese Conference, CCBR 2013, Jinan, China, November 16-17, 2013. Proceedings /

XVI, 469 p. 262 illus.online resource

Neuroplasticity Elicited by Modified Pharyngeal Electrical Stimulation: A Pilot Study

Modified pharyngeal electrical stimulation (mPES) is a novel therapeutic method for patients with neurogenic dysphagia and tracheostomy. However, the underlying neural mechanisms are still unclear. This study aims to investigate the impact of mPES on swallowing-related neural networks and involuntary swallowing frequency using functional near-infrared spectroscopy (fNIRS). 20 healthy volunteers participated in this study, including two separate experimental paradigms. Experiment 1: Immediate effect observation, 20 participants (10 female; mean age 47.65 ± 10.48) were delivered with real and sham mPES in random order for 8 repetitions. fNIRS signals were collected during the whole period of Experiments 1. Swallowing frequency was assessed during sham/real mPES. Experiment 2: Prolonged effect observation, 7 out of the 20 participants (4 female; mean age 49.71 ± 6.26) completed real mPES for 5 sessions (1 session/day). 13 of the 20 participants withdrew for personal reasons. Hemodynamic changes were recorded by fNIRS on day 1 and 5. Results show that mPES evoked cortical activation over a distributed network in bilateral primary somatosensory, primary motor, somatosensory association cortex, pre-motor and supplementary motor area, dorsolateral prefrontal cortex, Broca’s area, and supramarginal gyrus part of Wernicke’s area. Meanwhile, the increased frequency of involuntary swallowing was associated with decreased frontopolar activation (frontopolar cortex: Channel 6, p = 0.024, r = −0.529; Channel 23, p = 0.019, r = −0.545). Furthermore, after five days of mPES, decreased cortical activations were observed in the right dorsolateral prefrontal and supramarginal gyrus part of Wernicke’s area, and left frontopolar and M1 areas. Overall, these results might suggest that mPES could elicit changes in neuroplasticity that could reorganize the swallowing-related neural network and increase involuntary swallow frequency

Different Mechanisms of Two Subtypes of Perforating Artery Infarct in the Middle Cerebral Artery Territory: A High-Resolution Magnetic Resonance Imaging Study

Purpose: Perforating Artery Infarcts (PAIs) can be divided into two subtypes based on their etiologies: branch Atheromatous Disease (BAD) and Lacunar Infarct (LI). Recent studies have shown that while both subtypes can be caused by large artery lesions, the different mechanisms that underlie their development are not clear. This study was designed to use High-Resolution Magnetic Resonance Imaging (HRMRI) to explore the differences that contribute to the occurrence of these two subtypes in large artery lesions in the anterior circulation.Methods: Fifty patients with an acute PAI in the anterior circulation were enrolled (32 BAD and 18 LI patients). The ipsilateral middle cerebral artery (MCA) was scanned with HRMRI to analyze the atherosclerosis plaques. Artery remodeling and plaque characteristics of MCA lesions were compared between the two subtypes.Results: The rate of MCA lesions was significantly higher in BAD and substantially lower in LI (P = 0.033). LAs for the lumen areas in Bad, they were smaller than LI (P < 0.001), Additionally, the plaque area (P = 0.001) and plaque burden (P < 0.001) were superior in the BAD group. Most BAD patients displayed non-positive remodeling, while the great majority of LI patients showed positive remodeling (P < 0.001).Conclusion: In the anterior circulation, a considerable amount of BAD and LI share similarities with atherosclerotic plaques in large arteries. BAD patients mainly showed relatively large and stable atherosclerotic plaques in large arteries, while LI patients mainly exhibited relatively small and unstable atherosclerotic plaques.Clinical Trial Registration: This clinical trial is a retrospective study and therefore does not require registration