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Black hairy tongue syndrome

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World Journal of Gastroenterology 2014年第31期20卷 10845-10850页

作者： Grigoriy E Gurvits Amy Tan Department of Gastroenterology New York University School of Medicine/Langone Medical Center new york university school of medicine

Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient’s re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

关键词： Black hairy tongue Hyperkeratosis of the tongue Lingua villosa nigra

Video capsule endoscopy and CT enterography in diagnosing adult hypertrophic pyloric stenosis

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World Journal of Gastroenterology 2013年第37期19卷 6292-6295页

作者： Grigoriy E Gurvits Amy Tan Dmitri Volkov Department of Gastroenterology New York University School of Medicine/Langone Medical Center Department of medicine New York University School of Medicine Department of Anesthesiology New York University School of Medicine/Langone Medical Center

Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic ***,patients present with early satiety,abdominal fullness,nausea,epigastric discomfort and *** gastric retention of a video capsule endoscope is diagnostic in differentiating between the two diseases,in the absence of an organic gastric outlet *** case presents the longest video capsule retention in the medical literature to *** is also the first case report of adult hypertrophic pyloric stenosis diagnosed with video capsule endoscopy or a computed tomography ***,an unusual"plugging"of the gastric outlet with free floating capsule has an augmented effect on disease physiology and on patient’s symptoms.

关键词： Video capsule endoscopy Hypertrophic pyloric stenosis Gastroparesis Endoscopy Computed tomography enterography

Early term infants are at increased risk of requiring neonatal intensive care

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World Journal of Pediatrics 2016年第1期12卷 76-81页

作者： Pradeep Vittal Mally Nickolas Theophilos Agathis Sean Michael Bailey new york university school of medicine New York University Langone Medical CenterNew YorkUSA

Background: Increasing evidence is demonstrating thatinfants born early on during the term period are at increasedrisk of morbidity compared with infants born closer to acomplete 40 week gestational pregnancy. The purpose of thisstudy was to compare early term [gestation age (GA): 37-376/7 weeks] neonatal outcomes with those of other full termneonatal intensive care unit (NICU) ***: Retrospective chart review of all term infantsadmitted to the NICU at new york university langoneMedical Center over a 17 month period. Subjects weregrouped and analyzed according to their GA at birth: 1)early term infants (GA between 37 0/7 to 37 6/7 weeks) and2) other term infants (38 0/7 weeks and older).Results: Early term infants were more likely to requireNICU care than other term infants [relative risk: 1.42,95% confidence interval (CI)=1.07-1.88), P=0.01]. In theNICU, they are more likely to manifest respiratory distresssyndrome [odds ratio (OR)=5.7, 95% CI=1.6-19.8, P<0.01]and hypoglycemia (OR=4.6, 95% CI=2.0-10.4, P<0.001).In addition, early term neonates were more likely to beborn via elective cesarean section than other term neonates(OR=4.1, 95% CI=2.0-8.5, P<0.001).Conclusions: Being born at early term is associatedwith increased risk of respiratory disease and hypoglycemiarequiring neonatal intensive care. Further efforts directedat decreasing early term deliveries may be warranted.

关键词： gestational age hypoglycemia neonatology respiratory distress syndrome

Glymphatic imaging and modulation of the optic nerve

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Neural Regeneration Research 2022年第5期17卷 937-947页

作者： Anisha Kasi Crystal Liu Muneeb A.Faiq Kevin C.Chan Department of Ophthalmology NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Department of Radiology NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Neuroscience Institute NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Center for Neural Science College of Arts and ScienceNew York UniversityNew YorkNYUSA

Optic nerve health is essential for proper function of the visual ***,the pathophysiology of certain neurodegenerative disease processes affecting the optic nerve,such as glaucoma,is not fully ***,it was hypothesized that a lack of proper clearance of neurotoxins contributes to neurodegenerative *** ability to clear metabolic waste is essential for tissue homeostasis in mammals,including *** the brain lacks the traditional lymphatic drainage system identified in other anatomical regions,there is growing evidence of a glymphatic system in the central nervous system,which structurally includes the optic *** to acknowledge the supportive role of astroglial cells,this perivascular fluid drainage system is essential to remove toxic metabolites from the central nervous ***,we review existing literature describing the physiology and dysfunction of the glymphatic system specifically as it relates to the optic *** summarize key imaging studies demonstrating the existence of a glymphatic system in the optic nerves of wild-type rodents,aquaporin 4-null rodents,and humans;glymphatic imaging studies in diseases where the optic nerve is impaired;and current evidence regarding pharmacological and lifestyle interventions that may help promote glymphatic function to improve optic nerve *** conclude by highlighting future research directions that could be applied to improve imaging detection and guide therapeutic interventions for diseases affecting the optic nerve.

关键词： aquaporin-4 cerebrospinal fluid glaucoma glymphatic system hydrocephalus imaging metabolic waste clearance optic nerve perivascular pharmacological and lifestyle interventions

In vivo imaging of structural,metabolic and functional brain changes in glaucoma

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Neural Regeneration Research 2019年第3期14卷 446-449页

作者： Anisha Kasi Muneeb A.Faiq Kevin C.Chan NYU langone Eye Center Department of Ophthalmology NYU School of Medicine NYU Langone Health New York University Department of Radiology NYU School of Medicine NYU Langone Health New York University Center for Neural Science Faculty of Arts and Science New York University

Glaucoma, the world's leading cause of irreversible blindness, is a condition for which elevated intraocular pressure is currently the only modifiable risk factor. However, the disorder can continue to progress even at reduced intraocular pressure. This indicates additional key factors that contribute to the etiopathogenesis. There has been a growing amount of literature suggesting glaucoma as a neurodegenerative disease of the visual system. However, it remains debatable whether the observed pathophysiological conditions are causes or consequences. This review summarizes recent in vivo imaging studies that helped advance the understanding of early glaucoma involvements and disease progression in the brains of humans and experimental animal models. In particular, we focused on the non-invasive detection of early structural and functional brain changes before substantial clinical visual field loss in glaucoma patients; the eye-brain interactions across disease severity; the metabolic changes occurring in the brain's visual system in glaucoma; and, the widespread brain involvements beyond the visual pathway as well as the potential behavioral relevance. If the mechanisms of glaucomatous brain changes are reliably identified, novel neurotherapeutics that target parameters beyond intraocular pressure lowering can be the promise of the near future, which would lead to reduced prevalence of this irreversible but preventable disease.

关键词： glaucoma intraocular pressure eye-brain-behavior relationship irreversible blindness magnetic resonance imaging metabolic brain changes sensitivity disease progression

Anatomic Correlates of Mitral Systolic Anterior Motion in Transposition of the Great Arteries Following Atrial Switch Operation

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Congenital Heart Disease 2023年第3期18卷 267-277页

作者： Norman Aiad Mark V.Sherrid Adam J.Small Youssef Elnabawi Jodi Feinberg Leon Axel Ralph Mosca T.K.Susheel Kumar Michael Argilla Dan G.Halpern Cardiovascular Division Leon H.Charney Division of CardiologyNYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Department of Cardiovascular Disease Medical SchoolThe University of MinnesotaMinneapolisUSA The Lillehei Heart Institute MinneapolisMNUSA Radiology Department NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Cardiothoracic Surgery Department NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Pediatric Cardiology Division NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Department of Internal medicine NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA

Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation(d-TGA/AtS).Methods:Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS(age 42±6 years old,56%male)between 2015–*** data included mitral apparatus anatomy,and CT/MRI data included biventricular dimensions,function,and Haller index(HI)for pectus ***:Patients with leaflet SAM(n=6)compared to patients without SAM(n=13)had higher MV protrusion height(2.3±0.5 vs.1.5±0.4 cm,p≤0.01)and longer anterior MV leaflet length(3.1±0.4 cm vs.2.6±0.3 cm p≤0.05),when compared to those ***/MRI showed higher sub-pulmonic left ventricular ejection fraction(LVEF)in the SAM group(71%±8%vs.54%±7%,respectively).RV size and function,significant chest deformity(HI>3.5),presence of a ventricular lead pacemaker,and septal thickness did not play a role in development of ***:An elongated mitral apparatus is associated with the development of SAM,and the development of left ventricular outflow tract obstruction(LVOTO),in d-TGA/*** hyperkinesia is associated with *** RV dimensions,septal thickness,and degree of chest deformity did not differ significantly between subjects with SAM and those without.

关键词： d-loop transposition of the great arteries mustard operation senning operation systolic anterior motion of the mitral valve echocardiography cardiac MRI

Burning mouth syndrome

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World Journal of Gastroenterology 2013年第5期19卷 665-672页

作者： Grigoriy E Gurvits Amy Tan Division of Gastroenterology New York University School of Medicine/Langone Medical CenterNew YorkNY 10016United States new york university school of medicine New YorkNY 10016United States

Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of *** common features include a burning painful sensation in the mouth,often associated with dysgeusia and xerostomia,despite normal ***, symptoms are better in the morning,worsen during the day and typically subside at *** etiology is largely multifactorial,and associated medical conditions may include gastrointestinal,urogenital,psychiatric,neurologic and metabolic disorders,as well as drug *** has clear predisposition to peri-/post menopausal *** pathophysiology has not been fully elucidated and involves peripheral and central neuropathic *** diagnosis relies on careful history taking,physical examination and laboratory *** is often tedious and is aimed at correction of underlying medical conditions,supportive therapy,and behavioral *** therapy with alpha lipoic acid,clonazepam,capsaicin,and antidepressants may provide symptom *** may be *** term follow up data is promising,however,long term prognosis with treatment is *** remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment.

关键词： Burning mouth syndrome Glossodynia Glossopyrosis Burning tongue

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Enterolithiasis

World Journal of Gastroenterology 2014年第47期20卷 17819-17829页

作者： Grigoriy E Gurvits Gloria Lan Division of Gastroenterology New York University School of Medicine/Langone Medical CenterNew YorkNY 10016United States Department of medicine New York University School of MedicineNew YorkNY 10016United States

Enterolithiasis or formation of gastrointestinal concretions is an uncommon medical condition that develops in the setting of intestinal stasis in the presence of the intestinal diverticula, surgical enteroanastomoses, blind pouches, afferent loops, incarcerated hernias, small intestinal tumors, intestinal kinking from intra-abdominal adhesions, and stenosing or stricturing Crohn’s disease and intestinal tuberculosis. Enterolithiasis is classified into primary and secondary types. Its prevalence ranges from 0.3% to 10% in selected populations. Proximal primary enteroliths are composed of choleic acid salts and distal enteroliths are calcified. Clinical presentation includes abdominal pains, distention, nausea, and vomiting of occasionally sudden but often fluctuating subacute nature which occurs as a result of the enterolith tumbling through the bowel lumen. Thorough history and physical exam coupled with radiologic imaging helps establish a diagnosis in a patient at risk. Complications include bowel obstruction, direct pressure injury to the intestinal mucosa, intestinal gangrene, intussusceptions, afferent loop syndrome, diverticulitis, iron deficiency anemia, gastrointestinal hemorrhage, and perforation. Mortality of primary enterolithiasis may reach 3% and secondary enterolithiasis 8%. Risk factors include poorly conditioned patients with significant obstruction and delay in diagnosis. Treatment relies on timely recognition of the disease and endoscopic or surgical intervention. With advents in new technology, improved outcome is expected for patients with enterolithiasis.

关键词： Enterolithiasis Gallstone ileus Intestinal obstruction Crohn’ s disease Meckel’ s diverticulum Diverticulosis Intestinal tuberculosis

Current recommendations of managing HBV infection in preconception or pregnancy

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Frontiers of medicine 2014年第2期8卷 158-165页

作者： James S. Park Calvin Pan Division of Gastroenterology Department of Medicine NYU Langone Medical Center NYU School of Medicine New York 10016 USA

Hepatitis B remains a leading cause of cirrhosis, hepatocellular carcinoma and liver transplantation worldwide. Management of chronic hepatitis B during pregnancy is challenging. Transmission of hepatitis B to infants still occurs perinataily although immunoprophylaxis is widely available for infants born to mothers with chronic hepatitis B infection. The emerging data suggest that initiation of antiviral therapy in the beginning of the third trimester in highly viremic mothers can prevent immunoprophylaxis failure in their infants. The available drug safety data show that lamivudine, telbivudine and tenofovir are generally safe to be used during the pregnancy. In order to minimize the fetal exposure to the antiviral medication, antiviral therapy during the pregnancy should be limited to a selected group of patients with cirrhosis, high hepatitis B viral load, or prior history immunoprophylaxis failure. An elective Caesarean section may reduce the risk of perinatal transmission. For those females planning for pregnancy or in early stage of pregnancy, communication and follow-up among obstetrician, gastroenterologist, and primary care physician are important. In this article, we will review the features of hepatitis B infection before, during and after the pregnancy; the risk factors that increase mother-tochild transmission; safety data on antiviral drug use during pregnancy; and the potential role of Caesarean section in selected cases.

关键词： antiviral therapy Caesarean section cirrhosis hepatitis B irnmunoprophylaxis mother-to-child transmission pregnancy prevention