RESUMEN
Bilateral vocal fold paralysis (BVFP) refers to neurological causes of reduced or absent movement of both vocal folds. It is characterized by inspiratory dyspnea due to narrowing of the airway at the glottic level with both vocal folds assuming a paramedian position. It is an uncommon condition among patients who underwent thyroidectomy. However, BVFP can be life threatening especially when the onset is acute. Meanwhile, the preservation of the external branch of the superior laryngeal nerve (EBSLN) is also important during thyroidectomy.The EBSLN injury, which innervates the cricothyroid muscle, results in vocalization difficulty of high pitched sound and the frequent fatigue of voice. We will discuss the cases when BVFP and the injury of EBSLN may occur after thyroidectomy, and review the management for these cases including surgical options and voice therapy.
RESUMEN
Ubiquitin C-terminal hydrolase L1 (UCH-L1) is a deubiquitinating enzyme that is highly expressed in neurons, and gathering evidence indicates that UCH-L1 may play pathogenic roles in many neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease (PD). Additionally, lipid rafts have attracted interest in neurodegeneration as playing a common role in many neurodegenerative diseases. In the present study, we demonstrated that UCH-L1 associates with lipid rafts as with other PD-associated gene products. In addition, UCH-L1 regulates lipid raft-dependent endocytosis and it is not dependent on the expression and degradation of caveolin-1 or flotillin-1. Finally, UCH-L1 regulates cell-to-cell transmission of α-synuclein. This study provides evidence that many PD-associated gene products share common signaling pathways to explain the pathogenesis of PD.