PURPOSE: This study aimed to assess the impact of positional changes on upper airway obstruction patterns during drug-induced sleep endoscopy (DISE) in patients with obstructive sleep apnea (OSA) and identify the airway regions most responsive to this change. Special focus was placed on the tongue base, a critical area in OSA pathophysiology. METHODS: This prospective study was conducted from June 2021 to June 2024. DISE was performed in patients with obstructive sleep apnea (OSA) in supine and lateral positions to simulate the effect of positional therapy. Findings were evaluated using the VOTE classification. RESULTS: The examination was performed on 186 patients, with a median Apnea-Hypopnea Index (AHI) of 19.3. In the supine position, complete obstructions were noted at the soft palate (88.2%), oropharynx (33.3%), tongue base (53.2%), and epiglottis (15.6%). Lateral positioning significantly reduced obstructions, particularly at the tongue base, where obstruction resolved in 94/99 of cases (94.9%). This improvement was significantly more pronounced at the tongue base than at other sites (p < 0.001). CONCLUSION: These results suggest that DISE can identify airway regions responsive to positional changes, potentially guiding clinical decisions on positional therapy. The findings show a significant reduction in tongue base obstruction during lateral positioning in DISE. Since tongue base obstruction is a key contributor to airway collapse in OSA, this improvement suggests a practical, non-invasive treatment approach. While these findings highlight an acute association between lateral positioning and reduced obstruction, further studies are needed to evaluate its long-term clinical efficacy.

• MeSH
• dospělí MeSH
• endoskopie * metody   MeSH
• jazyk patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obstrukce dýchacích cest terapie   MeSH
• obstrukční spánková apnoe * terapie   patofyziologie   MeSH
• orofarynx patofyziologie   MeSH
• patro měkké patofyziologie   MeSH
• polohování pacienta * metody   MeSH
• polysomnografie MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Mouth breathing (MB), a risk factor of oral dysbiosis and halitosis, is linked with craniofacial anomalies and pediatric obstructive sleep apnea. Here, we aimed to analyze tongue microbiota in children from the perspective of their breathing pattern before/during orthodontic treatment. METHODS: This prospective case-control study included 30 children with orthodontic anomalies, 15 with MB and 15 with nasal breathing (NB), matched by age, sex, and body mass index. All underwent orthodontic examination and sleep apnea monitoring. Tongue swabs were collected before starting (timepoint M0) and approx. six months into the orthodontic therapy (timepoint M6). Oral candidas and bacteriome were analyzed using mass spectrometry technique and 16S rRNA sequencing, respectively. RESULTS: MB was associated with higher apnea-hypopnea index. At M0, oral candidas were equally present in both groups. At M6, Candida sp. were found in six children with MB but in none with NB. No significant differences in bacterial diversity were observed between groups and timepoints. However, presence/relative abundance of genus Solobacterium was higher in children with MB than NB at M0. CONCLUSIONS: Significant links between MB and the presence of genus Solobacterium (M0) as well as Candida sp. (M6) were found in children with orthodontic anomalies, highlighting the risk of halitosis in them.

• MeSH
• dítě MeSH
• dýchání ústy * MeSH
• halitóza mikrobiologie   MeSH
• jazyk * mikrobiologie   MeSH
• lidé MeSH
• mikrobiota * MeSH
• prospektivní studie MeSH
• RNA ribozomální 16S analýza   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• ankyloglosie * chirurgie   diagnóza   klasifikace   terapie   MeSH
• dítě MeSH
• kojenec MeSH
• kojení MeSH
• lidé MeSH
• neprospívání etiologie   prevence a kontrola   MeSH
• novorozenec MeSH
• orální frenektomie metody   MeSH
• podjazyková uzdička chirurgie   růst a vývoj   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• přehledy MeSH

Orální restrikci můžeme považovat za problematiku, která spadá do dikce mnoha odborností, jako např. pediatra, laktační poradkyně, stomatologa, logopeda, ortodontisty, fyzioterapeuta, ORL lékaře a dalších. Je potřeba na ni nahlížet komplexně v širším časovém horizontu. Článek shrnuje dopady orální restrikce na pacienta v průběhu jeho vývoje a poukazuje na oblasti, které by mohly být diagnostickým vodítkem k odhalení orální restrikce a jejímu řešení z pohledu multidisciplinárního týmu. Čím je pacient starší, tím více odborníků se bude na jeho léčbě podílet. Tímto příspěvkem si klademe za cíl vzbudit zájem o problematiku u různých odborníků, a předcházet tak nepříznivým dopadům na zdraví jedinců. Orální restrikce jsou sice svým rozsahem malé tkáňové struktury, ale mohou velmi negativně ovlivnit kvalitu našeho života.

Tethered oral tissues can be considered as an issue that belongs under the scope of many specialists, such as paediatricians, lactation consultants, dentists, speech therapists, orthodontists, physiotherapists, ENT doctors and others. It is necessary to look at tethered oral tissues comprehensively in a broader timeframe. The article summarises the impact of tethered oral tissues on the patient throughout their development and highlights areas that could provide diagnostic clues to detect tethered oral tissues and their management from a multidisciplinary team perspective. The older the patient, the more specialists will be involved in their treatment. With this paper, we aim to arouse interest about the issue among different professionals and to prevent adverse effects on the health of the individual. Although tethered oral tissues are short stretches of tissue, they can have a very negative impact on the quality of life.

• MeSH
• ankyloglosie komplikace   MeSH
• dítě MeSH
• lidé MeSH
• malokluze MeSH
• mezioborová komunikace MeSH
• nemoci úst * diagnóza   komplikace   MeSH
• podjazyková uzdička patologie   MeSH
• poruchy artikulace etiologie   MeSH
• poruchy dýchání etiologie   MeSH
• poruchy hlasu etiologie   MeSH
• poruchy příjmu potravy etiologie   MeSH
• primární prevence metody   MeSH
• retní uzdička patologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH

Oral cancer is a paradigm of Slaughter's concept of field cancerization, where tumors are thought to originate within an area of cells containing genetic alterations that predispose to cancer development. The field size is unclear but may represent a large area of tissue, and the origin of mutations is also unclear. Here, we analyzed whole exome and transcriptome features in contralateral tumor-distal tongue (i.e. distant from the tumor, not tumor-adjacent) and corresponding tumor tissues of 15 patients with squamous cell carcinoma of the oral tongue. The number of point mutations ranged from 41 to 237 in tumors and from one to 78 in tumor-distal samples. Tumor-distal samples showed mainly clock-like (associated with aging) or tobacco smoking mutational signatures. Tumors additionally showed mutations that associate with cytidine deaminase AID/APOBEC enzyme activities or a UV-like signature. Importantly, no point mutations were shared between a tumor and the matched tumor-distal sample in any patient. TP53 was the most frequently mutated gene in tumors (67%), whereas a TP53 mutation was detected in only one tumor-distal sample, and this mutation was not shared with the matched tumor. Arm-level copy number variation (CNV) was found in 12 tumors, with loss of chromosome (Chr) 8p or gain of 8q being the most frequent events. Two tumor-distal samples showed a gain of Chr8, which was associated with increased expression of Chr8-located genes in these samples, although gene ontology did not show a role for these genes in oncogenic processes. In situ hybridization revealed a mixed pattern of Chr8 gain and neutral copy number in both tumor cells and adjacent nontumor epithelium in one patient. We conclude that distant field cancerization exists but does not present as tumor-related mutational events. The data are compatible with etiologic field effects, rather than classical monoclonal field cancerization theory. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

• MeSH
• jazyk patologie   MeSH
• lidé MeSH
• nádory jazyka * genetika   MeSH
• nádory úst * patologie   MeSH
• spinocelulární karcinom * patologie   MeSH
• variabilita počtu kopií segmentů DNA MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Interpretable machine learning (ML) for early detection of cancer has the potential to improve risk assessment and early intervention. METHODS: Data from 261 proteins related to inflammation and/or tumor processes in 123 blood samples collected from healthy persons, but of whom a sub-group later developed squamous cell carcinoma of the oral tongue (SCCOT), were analyzed. Samples from people who developed SCCOT within less than 5 years were classified as tumor-to-be and all other samples as tumor-free. The optimal ML algorithm for feature selection was identified and feature importance computed by the SHapley Additive exPlanations (SHAP) method. Five popular ML algorithms (AdaBoost, Artificial neural networks [ANNs], Decision Tree [DT], eXtreme Gradient Boosting [XGBoost], and Support Vector Machine [SVM]) were applied to establish prediction models, and decisions of the optimal models were interpreted by SHAP. RESULTS: Using the 22 selected features, the SVM prediction model showed the best performance (sensitivity = 0.867, specificity = 0.859, balanced accuracy = 0.863, area under the receiver operating characteristic curve [ROC-AUC] = 0.924). SHAP analysis revealed that the 22 features rendered varying person-specific impacts on model decision and the top three contributors to prediction were Interleukin 10 (IL10), TNF Receptor Associated Factor 2 (TRAF2), and Kallikrein Related Peptidase 12 (KLK12). CONCLUSION: Using multidimensional plasma protein analysis and interpretable ML, we outline a systematic approach for early detection of SCCOT before the appearance of clinical signs.

• MeSH
• jazyk MeSH
• krevní proteiny MeSH
• lidé MeSH
• nádory jazyka * diagnóza   MeSH
• spinocelulární karcinom * diagnóza   MeSH
• strojové učení MeSH
• ubikvitinligasy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Příspěvek shrnuje aktuální teoretické poznatky v oblasti zkrácené retní a jazykové uzdičky s důrazem na novorozenecký a kojenecký věk. První část příspěvku se zaměřuje na kojení, druhá vymezuje poznatky spojitosti ankyloglosie a artikulace. Součástí článku je případová studie dítěte, kterému je poskytována předoperační logopedická péče od 18. měsíce věku. V případové studii jsou zmíněny diagnostické závěry, na které navazuje poskytovaná logopedická péče a které jsou podstatné pro pooperační péči.

The paper summarises current theoretical findings in the field of shortened labial and lingual frenulum, with an emphasis on newborn and infant ages. The first part of the post focuses on breastfeeding, the second defines the knowledge of the connection between ankyloglossia and articulation. Part of the article is a case study of a child who is provided with preoperative speech therapy care from the age of 18 months. In the case study, we focus on the diagnostic conclusions that are followed by the speech therapy care provided and which is essential after postoperative care.

• MeSH
• ankyloglosie * diagnóza   terapie   MeSH
• kojenec MeSH
• kojení MeSH
• lidé MeSH
• nemoci rtu terapie   MeSH
• podjazyková uzdička patofyziologie   MeSH
• poruchy artikulace MeSH
• předoperační péče metody   MeSH
• řečová terapie * metody   MeSH
• retní uzdička patofyziologie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Úvod: Kompartmentová chirurgia pri karcinóme jazyka je chirurgická metóda, ktorej cieľom je štandardizovane odstrániť nádorom postihnutú polovicu jazyka a regionálne krčné lymfatické uzlíny vcelku, a tým znížiť možnosť vzniku lokoregionálnej recidívy. Materiál a metodika: V práci je popísaná chirurgická technika, prehľad literatúry a prezentácia prvých skúseností na súbore 11 pacientov. Výsledky: Z 11 pacientov, 9 mužov a 2 žien s ochorením I.–IV. klinického štádia, sa lokoregionálna kontrola dosiahla u 9 pacientov (81,8 %). Jedna pacientka mala lokálnu recidívu, 1 pacientka regionálnu recidívu. Piati pacienti zomreli, 1 pacientka s regionálnou recidívou, 2 pacienti so vzdialenými metastázami, 1 pacient na metachrónnu duplexnú malignitu a 1 pacient na inú príčinu. R0 resekcia bola u 8 pacientov a blízky resekčný okraj mali ostatní 3 pacienti v rôznych štádiách ochorenia. Pooperačný defekt sa rekonštruoval u 10 pacientov infrahyoidným muskulokutánnym stopkatým lalokom a u 1 pacienta pektorálnym muskulokutánnym stopkatým lalokom. Záver: Kompartmentová chirurgia jazyka sa v indikovaných prípadoch javí ako dobrá metóda na dosiahnutie lokoregionálnej kontroly a negatívnych okrajov. Údaje je potrebné potvrdiť na väčšom súbore pacientov so zhodnotením aj ďalších, najmä funkčných parametrov.

Introduction: Compartmental tongue surgery is a surgical method that aims at removing of the tumor-affected half of the tongue and the regional lymph nodes en bloc in a standardized way to decrease an option of the locoregional recurrence. Material and methods: Description of the surgical technique, review of the literature and our first experience in the group of 11 patients is presented. Results: Out of 11 patients, 9 males and 2 females, with disease of the clinical stage I–IV, locoregional control has been achieved in 9 patients (81.8%). One female had a local recurrence, 1 female a regional recurrence. Five patients died, one female patient with regional recurrence, 2 patients with distant metastases, 1 patient due to duplex malignancy and 1 patient due to other reasons. R0 resection was detected in 8 patients and the other 3 patients had a close resection margin at different stages of the disease. The postoperative defect was reconstructed in 10 patients with an infrahyoid myocutaneous pedicled flap and in 1 patient with pectoralis myocutaneous flap. Conclusions: Compartment tongue surgery in indicated cases seems to be a good method for achievement of the locoregional control of the disease and negative margins. The data need to be confirmed on a larger group of patients with evaluation of other, particularly functional, parameters.

• MeSH
• glosektomie * metody   MeSH
• jazyk chirurgie   patologie   MeSH
• lidé MeSH
• nádory jazyka * chirurgie   MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH

• MeSH
• COVID-19 * komplikace   MeSH
• jazyk MeSH
• lidé MeSH
• SARS-CoV-2 MeSH
• vřed MeSH
• vředy v ústech * etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH

• MeSH
• jazyk diagnostické zobrazování   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidní obezita MeSH
• obstrukční spánková apnoe * chirurgie   MeSH
• tracheostomie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH