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Gottman DC, Corbisiero MF, Sus R, Fink DS. The Impact of Tracheal Stenosis on Distal Airway Pressure with Jet Ventilation. Laryngoscope 2024; 134:2300-2305. [PMID: 37933801 DOI: 10.1002/lary.31150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE This study investigates the effects of tracheal stenosis on distal airway pressure during low-frequency jet ventilation (LFJV) in tracheal stenosis resection procedures, focusing on variables like stenosis size, depth, scope type, and inlet pressure. METHODS A 3D-printed human airway model was employed, featuring inserted tracheal stenoses of varied sizes and depths. Distal airway pressure was measured with 16 pressure transducers, and data were processed via MATLAB. The study varied stenosis size, depth, scope type, and inlet pressure during five sequential jet bursts under LFJV. RESULTS Using a subglottiscope resulted in significantly reduced distal airway pressure compared to a laryngoscope. Interestingly, neither stenosis size nor depth significantly influenced distal airway pressure. However, increased distance between the scope and stenosis raised normalized pressure. A linear rise in normalized distal airway pressure was noted with increased inlet pressure, regardless of stenosis dimensions. CONCLUSION In this model, scope type and inlet pressure were noted to be significant determinants of distal airway pressure, while stenosis size and depth were not. The distance between the scope and the stenosis did influence distal pressures. These findings may have clinical implications for managing airway pressures in patients undergoing LFJV, potentially reducing the risk of ventilator-induced lung injury. LEVEL OF EVIDENCE NA (Basic Research) Laryngoscope, 134:2300-2305, 2024.
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Affiliation(s)
- Drew C Gottman
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, U.S.A
| | - Michaele Francesco Corbisiero
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, U.S.A
| | - Ruba Sus
- Department of Bioengineering, University of Colorado Denver, Aurora, Colorado, U.S.A
| | - Daniel S Fink
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, U.S.A
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2
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Takatsuki E, Kono T, Tomisato S, Ozawa H. Low-Dose Cisplatin-Based Radiation Therapy for Refractory Recurrent Respiratory Papillomatosis. Laryngoscope 2024; 134:2335-2337. [PMID: 37812337 DOI: 10.1002/lary.31096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Recurrent respiratory papilloma (RRP) often presents multiple lesions in the respiratory tract and sometimes becomes fatal because of severe airway obstruction. We report the case of a 69-year-old woman who had juvenile-onset RRP in the trachea that was refractory to surgical treatment, and complete remission was achieved by low-dose cisplatin combined with de-escalated radiotherapy without any side effects. This case report is the first to illustrate the data on low-dose cisplatin for refractory benign RRP, and our experience reinforces the opinion that low-dose cisplatin combined with de-escalated radiotherapy can be an effective and safe treatment alternative for uncontrollable and lethal RRP. Laryngoscope, 134:2335-2337, 2024.
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Affiliation(s)
- Eri Takatsuki
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takeyuki Kono
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shuta Tomisato
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
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3
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Fockens MM, Dawood Y, Zwart MJ, Docter D, Hagoort J, Dikkers FG, de Bakker BS. Micro-CT Imaging of Tracheal Development in Down Syndrome and Non-Down Syndrome Fetuses. Laryngoscope 2024. [PMID: 38676421 DOI: 10.1002/lary.31468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Down syndrome (DS) is associated with airway abnormalities including a narrowed trachea. It is uncertain whether this narrowed trachea in DS is a consequence of deviant fetal development or an acquired disorder following endotracheal intubation after birth. This study aimed to compare the tracheal morphology in DS and non-DS fetuses using microfocus computed tomography (micro-CT). METHODS Twenty fetal samples were obtained from the Dutch Fetal Biobank and divided into groups based on gestational age. Micro-CT images were processed to analyze tracheal length, volume, and cross-sectional area (CSA). RESULTS Mean tracheal length and tracheal volume were similar in DS and non-DS fetuses for all gestational age groups. Mean, minimum, and maximal tracheal CSA were statistically significantly increased in the single DS fetus in the group of 21-24 weeks of gestation, but not in other gestational age groups. In 90% of all studied fetuses, the minimum tracheal CSA was located in the middle third of the trachea. CONCLUSION Tracheal development in DS fetuses was similar to non-DS fetuses between 13 and 21 weeks of gestation. This suggests that the narrowed tracheal diameter in DS children may occur later in fetal development or results from postnatal intubation trauma. The narrowest part of the trachea is in majority of DS and non-DS fetuses the middle third. LEVEL OF EVIDENCE Level 3 Laryngoscope, 2024.
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Affiliation(s)
- M Matthijs Fockens
- Department of Otorhinolaryngology Head and Neck Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Yousif Dawood
- Department of Obstetrics and Gynaecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Mika J Zwart
- Department of Medical Biology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Daniël Docter
- Department of Obstetrics and Gynaecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Department of Pediatric Surgery, Amsterdam UMC location University of Amsterdam - Emma Children's Hospital, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Jaco Hagoort
- Department of Medical Biology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Frederik G Dikkers
- Department of Otorhinolaryngology Head and Neck Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Bernadette S de Bakker
- Department of Obstetrics and Gynaecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Department of Pediatric Surgery, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
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4
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Wei H, Wang W, Bai Q, Li Z. Primary Vocal Cord Aspergillosis Can Involve the Trachea and Bronchus in Previously Healthy Patients: A Case Report. Ear Nose Throat J 2024:1455613241249097. [PMID: 38676418 DOI: 10.1177/01455613241249097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Primary vocal cord aspergillosis is extremely rare in immunocompetent individuals, in whom lesions are mainly confined to the larynx, with the possibility of tracheal and bronchial infection largely ignored. In this article, we present a case of primary vocal cord aspergillosis involving the trachea and bronchus in a previously healthy 55-year-old woman. Our case highlights that vocal cord aspergillosis can involve the trachea and bronchus and that laryngoscopy alone may be insufficient to secure a comprehensive diagnosis in healthy patients presenting with hoarseness, pharyngalgia, and normal chest radiography. Furthermore, influenza B virus infection may be a risk factor for this rare disease.
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Affiliation(s)
- Huasheng Wei
- Department of Respiratory and Critical Care Medicine, Dazhou Central Hospital, Dazhou, China
| | - Weilin Wang
- Department of Respiratory and Critical Care Medicine, Dazhou Central Hospital, Dazhou, China
| | - Qinwen Bai
- Department of Respiratory and Critical Care Medicine, Dazhou Central Hospital, Dazhou, China
| | - Zhihui Li
- Department of Respiratory and Critical Care Medicine, Dazhou Central Hospital, Dazhou, China
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5
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O'Dowd K, Isham IM, Vatandour S, Boulianne M, Dozois CM, Gagnon CA, Barjesteh N, Abdul-Careem MF. Host Immune Response Modulation in Avian Coronavirus Infection: Tracheal Transcriptome Profiling In Vitro and In Vivo. Viruses 2024; 16:605. [PMID: 38675946 DOI: 10.3390/v16040605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Infectious bronchitis virus (IBV) is a highly contagious Gammacoronavirus causing moderate to severe respiratory infection in chickens. Understanding the initial antiviral response in the respiratory mucosa is crucial for controlling viral spread. We aimed to characterize the impact of IBV Delmarva (DMV)/1639 and IBV Massachusetts (Mass) 41 at the primary site of infection, namely, in chicken tracheal epithelial cells (cTECs) in vitro and the trachea in vivo. We hypothesized that some elements of the induced antiviral responses are distinct in both infection models. We inoculated cTECs and infected young specific pathogen-free (SPF) chickens with IBV DMV/1639 or IBV Mass41, along with mock-inoculated controls, and studied the transcriptome using RNA-sequencing (RNA-seq) at 3 and 18 h post-infection (hpi) for cTECs and at 4 and 11 days post-infection (dpi) in the trachea. We showed that IBV DMV/1639 and IBV Mass41 replicate in cTECs in vitro and the trachea in vivo, inducing host mRNA expression profiles that are strain- and time-dependent. We demonstrated the different gene expression patterns between in vitro and in vivo tracheal IBV infection. Ultimately, characterizing host-pathogen interactions with various IBV strains reveals potential mechanisms for inducing and modulating the immune response during IBV infection in the chicken trachea.
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Affiliation(s)
- Kelsey O'Dowd
- Health Research Innovation Centre, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Ishara M Isham
- Health Research Innovation Centre, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Safieh Vatandour
- Department of Animal and Poultry Science, Islamic Azad University, Qaemshahr Branch, Qaem Shahr 4765161964, Iran
| | - Martine Boulianne
- Swine and Poultry Infectious Diseases Research Centre-Fonds de Recherche du Québec (CRIPA-FRQ), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Charles M Dozois
- Swine and Poultry Infectious Diseases Research Centre-Fonds de Recherche du Québec (CRIPA-FRQ), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
- Institut National de Recherche Scientifique-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada
| | - Carl A Gagnon
- Swine and Poultry Infectious Diseases Research Centre-Fonds de Recherche du Québec (CRIPA-FRQ), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
- Molecular Diagnostic and Virology Laboratories, Centre de Diagnostic Vétérinaire de l'Université de Montréal (CDVUM), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Neda Barjesteh
- Swine and Poultry Infectious Diseases Research Centre-Fonds de Recherche du Québec (CRIPA-FRQ), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Mohamed Faizal Abdul-Careem
- Health Research Innovation Centre, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
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Brunet A, Rovira A, Quer M, Sanabria A, Guntinas-Lichius O, Zafereo M, Hartl DM, Coca-Pelaz A, Shaha AR, Marie JP, Vander Poorten V, Piazza C, Kowalski LP, Randolph GW, Shah JP, Rinaldo A, Simo R. Recurrent Laryngeal Nerve Intraoperative Neuromonitoring Indications in Non-Thyroid and Non-Parathyroid Surgery. J Clin Med 2024; 13:2221. [PMID: 38673494 DOI: 10.3390/jcm13082221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Introperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is a well-established technique to aid in thyroid/parathyroid surgery. However, there is little evidence to support its use in non-thyroid or non-parathyroid surgery. The aim of this paper was to review the current evidence regarding the use of IONM in non-thyroid/non-parathyroid surgery in the head and neck and thorax. A literature search was performed from their inception up to January 2024, including the term "recurrent laryngeal nerve monitoring". IONM in non-thyroid/non-parathyroid surgery has mainly been previously described in oesophageal surgery and in tracheal resections. However, there is little published evidence on the role of IONM with other resections in the vicinity of the RLN. Current evidence is low-level for the use of RLN IONM in non-thyroid/non-parathyroid surgery. However, clinicians should consider its use in surgery for pathologies where the RLN is exposed and could be injured.
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Affiliation(s)
- Aina Brunet
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Universitat de Barcelona, 08907 Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Aleix Rovira
- Department of Otorhinolaryngology, Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
| | - Miquel Quer
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
| | - Alvaro Sanabria
- Department of Surgery, Universidad de Antioquia, Hospital Universitario San Vicente Fundación, CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellin 1226, Colombia
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, 07747 Jena, Germany
| | - Mark Zafereo
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Dana M Hartl
- Thyroid Surgery Unit, Department of Otorhinolaryngology Head and Neck Surgery, Institute Gustave Roussy, 94805 Paris, France
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011 Oviedo, Spain
| | - Ashok R Shaha
- Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, Medical College, Cornell University, New York, NY 10065, USA
| | - Jean-Paul Marie
- Department of Otorhinolaryngology Head and Neck Surgery, Institute of Biomedical Research, University Hospital Rouen, 76000 Rouen, France
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Cesare Piazza
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Spedali Civili of Brescha, School of Medicine, University of Brescia, 25123 Brescia, Italy
| | - Luiz P Kowalski
- Department of Otorhinolaryngology Head and Neck Surgery, A.C. Camargo Cancer Center, Faculty of Medicine, University of Sao Paulo, São Paulo 03828-000, Brazil
| | - Gregory W Randolph
- Department of Otorhinolaryngology, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
| | - Jatin P Shah
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, Weil Medical College, Cornell University, New York, NY 10065, USA
| | | | - Ricard Simo
- Department of Otorhinolaryngology, Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
- King's College London, London SE5 8AF, UK
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7
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Cruz DRD, Zheng A, Debele T, Larson P, Dion GR, Park YC. Drug delivery systems for wound healing treatment of upper airway injury. Expert Opin Drug Deliv 2024:1-19. [PMID: 38588553 DOI: 10.1080/17425247.2024.2340653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Endotracheal intubation is a common procedure to maintain an open airway with risks for traumatic injury. Pathological changes resulting from intubation can cause upper airway complications, including vocal fold scarring, laryngotracheal stenosis, and granulomas and present with symptoms such as dysphonia, dysphagia, and dyspnea. Current intubation-related laryngotracheal injury treatment approaches lack standardized guidelines, relying on individual clinician experience, and surgical and medical interventions have limitations and carry risks. AREAS COVERED The clinical and preclinical therapeutics for wound healing in the upper airway are described. This review discusses the current developments on local drug delivery systems in the upper airway utilizing particle-based delivery systems, including nanoparticles and microparticles, and bulk-based delivery systems, encompassing hydrogels and polymer-based approaches. EXPERT OPINION Complex laryngotracheal diseases pose challenges for effective treatment, struggling due to the intricate anatomy, limited access, and recurrence. Symptomatic management often requires invasive surgical procedures or medications that are unable to achieve lasting effects. Recent advances in nanotechnology and biocompatible materials provide potential solutions, enabling precise drug delivery, personalization, and extended treatment efficacy. Combining these technologies could lead to groundbreaking treatments for upper airways diseases, significantly improving patients' quality of life. Research and innovation in this field are crucial for further advancements.
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Affiliation(s)
- Denzel Ryan D Cruz
- Medical Scientist Training Program, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Biomedical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
| | - Avery Zheng
- Chemical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
| | - Tilahun Debele
- Chemical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
| | - Peter Larson
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Gregory R Dion
- Biomedical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Yoonjee C Park
- Biomedical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
- Chemical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
- Materials Science and Engineering Program, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
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Rommelaere S, Carboni A, Bada Juarez JF, Boquete JP, Abriata LA, Teixeira Pinto Meireles F, Rukes V, Vincent C, Kondo S, Dionne MS, Dal Peraro M, Cao C, Lemaitre B. A humoral stress response protects Drosophila tissues from antimicrobial peptides. Curr Biol 2024; 34:1426-1437.e6. [PMID: 38484734 DOI: 10.1016/j.cub.2024.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/18/2023] [Accepted: 02/21/2024] [Indexed: 04/11/2024]
Abstract
7An efficient immune system must provide protection against a broad range of pathogens without causing excessive collateral tissue damage. While immune effectors have been well characterized, we know less about the resilience mechanisms protecting the host from its own immune response. Antimicrobial peptides (AMPs) are small, cationic peptides that contribute to innate defenses by targeting negatively charged membranes of microbes. While protective against pathogens, AMPs can be cytotoxic to host cells. Here, we reveal that a family of stress-induced proteins, the Turandots, protect the Drosophila respiratory system from AMPs, increasing resilience to stress. Flies lacking Turandot genes are susceptible to environmental stresses due to AMP-induced tracheal apoptosis. Turandot proteins bind to host cell membranes and mask negatively charged phospholipids, protecting them from cationic pore-forming AMPs. Collectively, these data demonstrate that Turandot stress proteins mitigate AMP cytotoxicity to host tissues and therefore improve their efficacy.
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Affiliation(s)
- Samuel Rommelaere
- Global Health Institute, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
| | - Alexia Carboni
- Global Health Institute, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Juan F Bada Juarez
- Institute of Bioengineering, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Jean-Philippe Boquete
- Global Health Institute, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Luciano A Abriata
- Institute of Bioengineering, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Fernando Teixeira Pinto Meireles
- Institute of Bioengineering, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Verena Rukes
- Institute of Bioengineering, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Crystal Vincent
- Department of Biochemistry, School of Biological and Behavioural Sciences, Queen Mary University of London, E1 4NS London, UK
| | - Shu Kondo
- Department of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of Science, 162-8601 Tokyo, Japan
| | - Marc S Dionne
- Centre for Bacterial Resistance Biology and Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Matteo Dal Peraro
- Institute of Bioengineering, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Chan Cao
- Department of Inorganic and Analytical Chemistry, Chemistry and Biochemistry, University of Geneva, 1211 Geneva, Switzerland
| | - Bruno Lemaitre
- Global Health Institute, School of Life Science, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
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9
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Cui P, Zhao D, Liang L, Liu P, Li S. De-Epithelialized Viable Tracheal Allotransplantation Without Immunosuppressants: 5-Year Follow-Up. Ann Otol Rhinol Laryngol 2024; 133:384-389. [PMID: 38197389 DOI: 10.1177/00034894231221900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Tracheal transplantation could be a better option for patients with long segmental laryngotracheal stenosis or defects, but the need for immunosuppressants limits its widespread use due to the antigenicity of the tracheal epithelium. Chemically treated or cryopreserved nonviable tracheal allografts have no immunogenicity but lead to necrosis and stenosis in long-term outcomes. The present report describes the 5-year outcomes of de-epithelialized viable tracheal allotransplantation without immunosuppressants in a patient with severe laryngotracheal stenosis. METHODS The recipient was a 47-year-old female with relapsing polychondritis affecting the larynx and cervical trachea and producing a 5 cm long stenosis that could not be repaired using resection and anastomosis. A tracheal allograft was obtained from a 45-year-old male donor and treated with a combination of 3% sodium dodecyl sulfate (SDS) and organ preservation solution for 138 hours. The allograft was revascularized by heterotopical implantation in the infrahyoid muscles of the recipient for 3 months and then transplantation to the laryngotracheal defect with a split-thickness skin graft sutured to the lumen and a silicon T-tube. No immunosuppressants were used postoperatively. RESULTS The allograft was de-epithelialized, and most of the cartilage rings remained viable after the treatment. The allograft was revascularized, viable, and mechanically stable after 3 months of heterotopic implantation. No apparent signs of rejection or destruction were observed. The T-tube was removed, and the internal lining of the allograft was repopulated 4 months after orthotopic transplantation, despite the skin graft necrotizing at 2 weeks. Endoscopy and computed tomography showed a patent airway 5 years after orthotopic transplantation. The patient was able to resume her usual quality of life. CONCLUSION The present study demonstrates that transplantation of the de-epithelialized viable tracheal allograft without immunosuppressants is safe and promising for patients with long laryngotracheal stenosis or defects, especially for those with malignant tumor resections.
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Affiliation(s)
- Pengcheng Cui
- Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital and Laryngotracheal Reconstruction Center, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Daqing Zhao
- Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital and Laryngotracheal Reconstruction Center, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Leping Liang
- Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital and Laryngotracheal Reconstruction Center, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Pengfei Liu
- Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital and Laryngotracheal Reconstruction Center, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Shuqin Li
- Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital and Laryngotracheal Reconstruction Center, Air Force Medical University (Fourth Military Medical University), Xi'an, China
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10
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Celidonio J, Bahethi R, Malhotra R, Yan K. Acute myeloid leukemia: An unusual manifestation of the trachea. Laryngoscope Investig Otolaryngol 2024; 9:e1231. [PMID: 38525124 PMCID: PMC10960239 DOI: 10.1002/lio2.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 03/26/2024] Open
Abstract
Objectives Hematologic malignancy involving the trachea is rare. It is even less common for tracheal involvement to be the initial manifestation of this disease. We present a case report highlighting an unusual diagnosis of acute myeloid leukemia (AML) that first presented with prominent tracheal manifestations. There have been only three other published case reports of extramedullary AML with involvement of the trachea. Methods We discuss direct laryngoscopy and bronchoscopy findings, including pinkish-white irregular lesions, which were similar to findings described in the available literature for tracheal AML. Results Laboratory findings from our case are reported, including peripheral smear demonstrating 57% blasts and bone marrow biopsy confirming the diagnosis of AML, and the relevance of these findings is discussed. Conclusion In patients with unusual airway lesions, laboratory testing and a comprehensive airway evaluation including biopsy are necessary to narrow the differential diagnosis. Level of Evidence 5.
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Affiliation(s)
- Joseph Celidonio
- Department of Otolaryngology – Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Rohini Bahethi
- Department of Otolaryngology – Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Raj Malhotra
- Department of Otolaryngology – Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Kenneth Yan
- Department of Otolaryngology – Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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11
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Zhu J, Lu Y, Shan Y, Yuan L, Wu Q, Shen Z, Sun F, Shi H. Global Bibliometric and Visualized Analysis of Tracheal Tissue Engineering Research. Tissue Eng Part B Rev 2024; 30:198-216. [PMID: 37658839 DOI: 10.1089/ten.teb.2023.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The development of tracheal tissue engineering (TTE) has seen a rapid growth in recent years. The purpose of this study was to investigate the global status, trends, and hotspots of TTE research based on bibliometrics and visualization analysis. Publications related to TTE were retrieved and included in the Web of Science Core Collection. VOSviewer and CiteSpace were used to generate knowledge maps. Six hundred fifty-five publications were identified, and the quantity of the annual publications worldwide was on the increase. International collaboration is a widespread reality. The United States led the world in the field of trachea tissue engineering, whereas University College London was the institution with the greatest contribution. In addition, Biomaterials had a great influence in this field, attracting the largest number of papers. Moreover, the topics of TTE research largely concentrated on the biomechanical scaffold preparation, the vascularization and epithelialization of scaffold, the tracheal cartilage regeneration, and the tissue-engineered tracheal transplantation. And the research on the application of decellularization and 3D printing for the construction of a tissue-engineered trachea was likely to receive more widespread attention in the future. Impact statement In recent years, tracheal tissue engineering (TTE) has experienced rapid growth. In this study, we investigated the worldwide status and trends of TTE research, and revealed the countries, institutions, journals, and authors that had made significant contributions to the field of TTE. Moreover, the possible research hotspots in the future were predicted. According to our research, researchers can gain a better understanding of the trends in this field, and stay informed of the most current research by tracking key journals, institutions, and authors.
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Affiliation(s)
- Jianwei Zhu
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Yi Lu
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Yibo Shan
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Lei Yuan
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Qiang Wu
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhiming Shen
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Fei Sun
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Hongcan Shi
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
- The Second Xiangya Hospital, Central South University, Changsha, China
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12
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Mattioli F, Serafini E, Andreani A, Cappiello G, De Maria F, Marchioni D, Pinelli M, Marchioni A. Lipoaspirate Injection in Relapsing Idiopathic Subglottic Stenosis: Preliminary Results. Ann Otol Rhinol Laryngol 2024:34894241237021. [PMID: 38444374 DOI: 10.1177/00034894241237021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVES The management of idiopathic subglottic stenosis (iSGS) poses a clinical challenge due to high recurrence rates following both endoscopic and open approaches, often leading to tracheostomy. The activation of abnormal T-cells and cytokine pathways has been linked to iSGS pathogenesis. Autologous adipose tissue centrifugation yields lipoaspirate, offering optimal anti-inflammatory effects and biocompatibility widely utilized in various medical settings. This report presents the first 3 cases employing endoscopic dilation (ED) in combination with local lipoaspirate injection to address recurrent iSGS. METHODS A prospective observational study was conducted, involving multidisciplinary evaluation by the Tracheal Team at the University of Modena. Patients meeting specific criteria were directed to undergo ED + lipoaspirate injection. RESULTS Three patients fulfilled the inclusion criteria. The mean number of prior endoscopic procedures performed was 8. Endoscopic examination revealed 90% stenosis in patient A, 60% stenosis in patient B, and 60% stenosis in patient C. All patients presented inflammatory tissue or incipient granulations at the stenotic site, with an average time of 6 months between previous procedures. After 15 months, none of the patients required further procedures, and endoscopic examination revealed a significant reduction or disappearance of inflammatory tissue with a stable airway lumen. CONCLUSIONS The observed results are encouraging in terms of reducing local inflammation and halting stenosis progression, especially in cases of short-term relapsing iSGS.
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Affiliation(s)
- Francesco Mattioli
- Department of Otolaryngology Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Edoardo Serafini
- Department of Otolaryngology Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Alessandro Andreani
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Gaia Cappiello
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Federico De Maria
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Modena, Italy
| | - Daniele Marchioni
- Department of Otolaryngology Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Massimo Pinelli
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Modena, Italy
| | - Alessandro Marchioni
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
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Liu B, Yang Y, Fu Y, Zhao Y, Chen W, Wei S, Zuo X, Zhu Y, Ye H, Zhang M, Zhang P, Yang L, Wang W, Pan J. In-house ammonia induced lung impairment and oxidative stress of ducks. Poult Sci 2024; 103:103622. [PMID: 38513550 DOI: 10.1016/j.psj.2024.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Ammonia (NH3) is a toxic gas that in intensive poultry houses, damages the poultry health and induces various diseases. This study investigated the effects of NH3 exposure (0, 15, 30, and 45 ppm) on growth performance, serum biochemical indexes, antioxidative indicators, tracheal and lung impairments in Pekin ducks. A total of 288 one-day-old Pekin male ducks were randomly allocated to 4 groups with 6 replicates and slaughtered after the 21-d test period. Our results showed that 45 ppm NH3 significantly reduced the average daily feed intake (ADFI) of Pekin ducks. Ammonia exposure significantly reduced liver, lung, kidney, and heart indexes, and lowered the relative weight of the ileum. With the increasing of in-house NH3, serum NH3 and uric acid (UA) concentrations of ducks were significantly increased, as well as liver malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPX-Px) contents. High NH3 also induced trachea and lung injury, thereby increasing levels of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in the lung, and decreasing the mRNA expressions of zonula occludens 1 (ZO-1) and claudin 3 (CLDN3) in the lung. In conclusion, in-house NH3 decrease the growth performance in ducks, induce trachea and lung injuries and meanwhile increase the compensatory antioxidant activity for host protection.
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Affiliation(s)
- Bo Liu
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China; Changsha Sanwang Feed Co. Ltd, Changsha, China
| | - Yongjie Yang
- Key Laboratory of Animal Nutrition and Healthy Breeding, Ministry of Agriculture, Wen's Foodstuff Group Co. Ltd, Yunfu, China
| | - Yang Fu
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Yue Zhao
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Wenjing Chen
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Shi Wei
- Key Laboratory of Animal Nutrition and Healthy Breeding, Ministry of Agriculture, Wen's Foodstuff Group Co. Ltd, Yunfu, China
| | - Xin Zuo
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Yongwen Zhu
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Hui Ye
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Minhong Zhang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Pekin, China
| | - Peng Zhang
- Chimelong Group Co., Guangzhou 511430, China
| | - Lin Yang
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China
| | - Wence Wang
- State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University Guangzhou, China.
| | - Jie Pan
- Hunan Shihua Biotech Co. Ltd., Changsha, China
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Seo D, Kang K, Lim S, Namgoong B, Choe A, Uhm H, Hong H, Lee N, Kim I, Heo S, Kim MS. Radiographic and computed tomographic evaluation of tracheal diameter and length in kittens. J Am Vet Med Assoc 2024; 262:364-369. [PMID: 38134454 DOI: 10.2460/javma.23.09.0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/08/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To measure the tracheal diameter and length in kittens using radiography and CT and to evaluate the concordance between measurements obtained with these 2 modalities. ANIMALS 15 kittens with an estimated age of 12 weeks and mean body weight of 1.49 kg. METHODS Radiographic and CT images were retrospectively evaluated to measure tracheal lengths and diameters. Tracheal diameters were measured at 5 different sites (A [at the level of the C2-3 intervertebral disk space], B [at the level of the C4-5 intervertebral disk space], C [at the cranial end of the manubrium sterni], D [at the level of the second rib], and E [1 cm cranial to the carina]) along the trachea. The cross-sectional area and transverse and vertical diameter ratios were calculated for each measurement site. RESULTS The cross-sectional area was largest at site A and decreased from site C to site E. Based on the vertical diameter ratio, the tracheal shape was most circular at sites A and E, whereas from sites B to D, it was elliptical. The vertical diameters of the trachea on radiography and CT did not differ statistically significantly. However, the tracheal length measured on radiography was approximately 6 mm longer than that measured on CT (P < .05). CLINICAL RELEVANCE Using the first rib as an anatomical reference, the placement of a cuffed endotracheal tube is recommended in kittens. In emergency situations, regression equations based on body weight may be helpful in predicting tracheal diameters.
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Affiliation(s)
- Daeyun Seo
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Kyuyong Kang
- 2Eum Animal Medical Center, Gyeonggi-do, South Korea
| | - Seongsoo Lim
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Beomkwan Namgoong
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Ahreum Choe
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Heesung Uhm
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Hyeajeong Hong
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Nanju Lee
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Isong Kim
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Seunghun Heo
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
| | - Min-Su Kim
- 1Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Gwanak-gu, Seoul, South Korea
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15
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Fitzsimons LA, Tasouri E, Willaredt MA, Stetson D, Gojak C, Kirsch J, Gardner HAR, Gorgas K, Tucker KL. Primary cilia are critical for tracheoesophageal septation. Dev Dyn 2024; 253:312-332. [PMID: 37776236 PMCID: PMC10922539 DOI: 10.1002/dvdy.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/14/2023] [Accepted: 09/09/2023] [Indexed: 10/02/2023] Open
Abstract
INTRODUCTION Primary cilia play pivotal roles in the patterning and morphogenesis of a wide variety of organs during mammalian development. Here we examined murine foregut septation in the cobblestone mutant, a hypomorphic allele of the gene encoding the intraflagellar transport protein IFT88, a protein essential for normal cilia function. RESULTS We reveal a crucial role for primary cilia in foregut division, since their dramatic decrease in cilia in both the foregut endoderm and mesenchyme of mutant embryos resulted in a proximal tracheoesophageal septation defects and in the formation of distal tracheo(broncho)esophageal fistulae similar to the most common congenital tracheoesophageal malformations in humans. Interestingly, the dorsoventral patterning determining the dorsal digestive and the ventral respiratory endoderm remained intact, whereas Hedgehog signaling was aberrantly activated. CONCLUSIONS Our results demonstrate the cobblestone mutant to represent one of the very few mouse models that display both correct endodermal dorsoventral specification but defective compartmentalization of the proximal foregut. It stands exemplary for a tracheoesophageal ciliopathy, offering the possibility to elucidate the molecular mechanisms how primary cilia orchestrate the septation process. The plethora of malformations observed in the cobblestone embryo allow for a deeper insight into a putative link between primary cilia and human VATER/VACTERL syndromes.
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Affiliation(s)
- Lindsey Avery Fitzsimons
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, Maine, U.S.A
- Dept. of Biomedical Sciences, Center for Excellence in the Neurosciences, College of Osteopathic Medicine, University of New England, Biddeford, Maine 04005, U.S.A
| | - Evangelia Tasouri
- Interdisciplinary Center for Neurosciences, University of Heidelberg, 69120 Heidelberg, Germany
- Institute of Anatomy and Cell Biology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Marc August Willaredt
- Interdisciplinary Center for Neurosciences, University of Heidelberg, 69120 Heidelberg, Germany
- Institute of Anatomy and Cell Biology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Daniel Stetson
- AstraZeneca Pharmaceuticals LP, 35 Gatehouse Drive, Waltham, Massachusetts 02451, U.S.A
| | - Christian Gojak
- Interdisciplinary Center for Neurosciences, University of Heidelberg, 69120 Heidelberg, Germany
- Institute of Anatomy and Cell Biology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Joachim Kirsch
- Institute of Anatomy and Cell Biology, University of Heidelberg, 69120 Heidelberg, Germany
| | | | - Karin Gorgas
- Institute of Anatomy and Cell Biology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Kerry L. Tucker
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, Maine, U.S.A
- Dept. of Biomedical Sciences, Center for Excellence in the Neurosciences, College of Osteopathic Medicine, University of New England, Biddeford, Maine 04005, U.S.A
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16
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Lee JA, Patel KR, Smith AJ, Thompson DM. Management of Tracheobronchial Stenosis in Chondrodysplasia Punctata. Laryngoscope 2024; 134:1464-1468. [PMID: 37522476 DOI: 10.1002/lary.30920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
Chondrodysplasia punctata (CDP) is a rare congenital syndrome characterized by aberrant, punctate deposition of calcium during endochondral bone formation, resulting in the characteristic finding of epiphyseal stippling on radiographs. While otolaryngologic manifestations such as nasomaxillary hypoplasia and mixed hearing loss are common, tracheobronchial calcification occurs rarely in neonates with CDP. The management of CDP-related airway stenosis is complex and there is limited literature pertaining to outcomes of airway interventions. Herein, we describe the clinical course and outcome of tracheal dilation for a newborn patient with CDP. Laryngoscope, 134:1464-1468, 2024.
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Affiliation(s)
- Joshua A Lee
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago College of Medicine, Chicago, Illinois, U.S.A
| | - Krupa R Patel
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Alyssa J Smith
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Dana M Thompson
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
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17
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Lau CH, Rouhani MJ, Maughan EF, Orr JC, Kolluri KK, Pearce DR, Haughey EK, Sutton L, Flatau S, Balboa PL, Bageta ML, O'Callaghan C, Smith CM, Janes SM, Hewitt R, Petrof G, Martinez AE, McGrath JA, Butler CR, Hynds RE. Lentiviral expression of wild-type LAMA3A restores cell adhesion in airway basal cells from children with epidermolysis bullosa. Mol Ther 2024:S1525-0016(24)00101-1. [PMID: 38429928 DOI: 10.1016/j.ymthe.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
The hallmark of epidermolysis bullosa (EB) is fragile attachment of epithelia due to genetic variants in cell adhesion genes. We describe 16 EB patients treated in the ear, nose, and throat department of a tertiary pediatric hospital linked to the United Kingdom's national EB unit between 1992 and 2023. Patients suffered a high degree of morbidity and mortality from laryngotracheal stenosis. Variants in laminin subunit alpha-3 (LAMA3) were found in 10/15 patients where genotype was available. LAMA3 encodes a subunit of the laminin-332 heterotrimeric extracellular matrix protein complex and is expressed by airway epithelial basal stem cells. We investigated the benefit of restoring wild-type LAMA3 expression in primary EB patient-derived basal cell cultures. EB basal cells demonstrated weak adhesion to cell culture substrates, but could otherwise be expanded similarly to non-EB basal cells. In vitro lentiviral overexpression of LAMA3A in EB basal cells enabled them to differentiate in air-liquid interface cultures, producing cilia with normal ciliary beat frequency. Moreover, transduction restored cell adhesion to levels comparable to a non-EB donor culture. These data provide proof of concept for a combined cell and gene therapy approach to treat airway disease in LAMA3-affected EB.
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Affiliation(s)
- Chun Hang Lau
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK
| | - Maral J Rouhani
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Elizabeth F Maughan
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Jessica C Orr
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Krishna K Kolluri
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - David R Pearce
- UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK
| | - Elizabeth K Haughey
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Liam Sutton
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Sam Flatau
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Pablo Lopez Balboa
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Maria Laura Bageta
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Christopher O'Callaghan
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Claire M Smith
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Richard Hewitt
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Gabriela Petrof
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Anna E Martinez
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
| | - Colin R Butler
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK.
| | - Robert E Hynds
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK.
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18
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Mammana M, Bonis A, Verzeletti V, Dell'Amore A, Rea F. Tracheal Tissue Engineering: Principles and State of the Art. Bioengineering (Basel) 2024; 11:198. [PMID: 38391684 PMCID: PMC10886658 DOI: 10.3390/bioengineering11020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
Patients affected by long-segment tracheal defects or stenoses represent an unsolved surgical issue, since they cannot be treated with the conventional surgery of tracheal resection and consequent anastomosis. Hence, different strategies for tracheal replacement have been proposed (synthetic materials, aortic allografts, transplantation, autologous tissue composites, and tissue engineering), each with advantages and drawbacks. Tracheal tissue engineering, on the other hand, aims at recreating a fully functional tracheal substitute, without the need for the patient to receive lifelong immunosuppression or endotracheal stents. Tissue engineering approaches involve the use of a scaffold, stem cells, and humoral signals. This paper reviews the main aspects of tracheal TE, starting from the choice of the scaffold to the type of stem cells that can be used to seed the scaffold, the methods for their culture and expansion, the issue of graft revascularization at the moment of in vivo implantation, and experimental models of tracheal research. Moreover, a critical insight on the state of the art of tracheal tissue engineering is also presented.
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Affiliation(s)
- Marco Mammana
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Alessandro Bonis
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Vincenzo Verzeletti
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Andrea Dell'Amore
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Federico Rea
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
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Lorandi LL, Ceccon FP, Callegari FM, Bacchi CE, Haddad L. Benign cervical schwannoma with tracheal invasion. Einstein (Sao Paulo) 2024; 22:eRC0528. [PMID: 38324847 PMCID: PMC10948098 DOI: 10.31744/einstein_journal/2024rc0528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/21/2023] [Indexed: 02/09/2024] Open
Abstract
Schwannomas commonly develop in the cervical region, 25% - 45% of cases are diagnosed in this anatomical region. Tracheal neurogenic tumors are exceedingly rare and can be misdiagnosed as invasive thyroid carcinomas or other infiltrating malignancies when present at the level of the thyroid gland. Here, we present a case of synchronous benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma in a patient who was initially hospitalized for COVID-19. The patient presented with dyspnea that was later found to be caused by tracheal extension of a cervical tumor. Surgical excision was performed, and the surgical team proceeded with segmental tracheal resection, removal of the cervical mass, and total thyroidectomy. The specimen was sent for pathological analysis, which revealed synchronous findings of a benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma. The literature on this subject, together with the present case report, suggests that neurogenic tumors should be included in the differential diagnosis of obstructing tracheal cervical masses. Surgical excision is the first-line of treatment for benign cervical schwannomas.
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Affiliation(s)
- Leonardo Lima Lorandi
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Israelita Albert EinsteinSão PauloSPBrazil Faculdade Israelita de Ciências da Saúde Albert Einstein , Hospital Israelita Albert Einstein , São Paulo , SP , Brazil .
| | - Fabio Pupo Ceccon
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein , São Paulo , SP , Brazil .
| | - Fabiano Mesquita Callegari
- Pathology DepartmentUniversidade Federal de São PauloSão PauloSPBrazil Pathology Department , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Carlos Eduardo Bacchi
- Laboratorio de Patologia Bacchi LtdaBotucatuSPBrazil Laboratorio de Patologia Bacchi Ltda , Botucatu , SP , Brazil .
| | - Leonardo Haddad
- Department of Otorhinolaryngology and Head and Neck SurgeryEscola Paulista de MedicinaUniversidade Federal de São PauloSão PauloSPBrazil Department of Otorhinolaryngology and Head and Neck Surgery , Escola Paulista de Medicina , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
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20
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Yoon JU, Byeon GJ, Kim HY, Kim HJ, Yoo YM, Bae J, Lee J. Concordance of esophageal and tracheal temperatures in patients using breathing circuit with heated wire humidifier: A prospective observational study. Medicine (Baltimore) 2024; 103:e37166. [PMID: 38306513 PMCID: PMC10843427 DOI: 10.1097/md.0000000000037166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
RESULTS After excluding 4 patients with an anesthesia duration of < 2 hours, data from 34 patients (1163 sets of tracheal and esophageal temperatures) were analyzed. Concordance correlation coefficient was 0.78. The overall mean bias (95% limits of agreement) between the tracheal and esophageal temperatures was -0.16°C (-0.65°C to 0.34°C). The percentage of temperature differences within ± 0.25°C was 73.5% ± 32.3, with a median of 89.4% [0,100]. The linear mixed-effects model revealed that the estimated intercept was 0.17°C with a 95% confidence interval (CI) of 0.13°C to 0.22°C. The duration of anesthesia and the number of temperature measurements were associated with higher concordance between the tracheal and esophageal temperatures in univariate analysis.
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Affiliation(s)
- Ji-Uk Yoon
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Gyeong-Jo Byeon
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hee Young Kim
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hye-Jin Kim
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Yeong Min Yoo
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jaesang Bae
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jimin Lee
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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21
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Güneş K, Sever F, Özmert S. Determining optimal cuff volume for cuffed endo tracheal tubes commonly used in pediatric patients: A prospective observational study. Saudi Med J 2024; 45:147-153. [PMID: 38309733 DOI: 10.15537/smj.2024.45.2.20230578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/11/2023] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To determine an optimal cuff inflation volume to achieve safe cuff pressure (20-25 cmH2O) in cuffed endotracheal tubes (ETTs) with an inner diameter of 4.5, 5.0, and 5.5 mm, which are commonly used in pediatric anaesthesia clinical practice and to create a formula to determine the optimal cuff volume. METHODS This study was carried out between February and June 2021 in Ankara City Hospital, Ankara, Turkey. A total of 127 pediatric patients who were intubated with 4.5, 5.0 and 5.5 numbered cuffed ETTs were included in this study. The same brand of cuffed ETT was used for each patient. The diameter of the subglottic transverse airway was measured by ultrasound for selecting the appropriate tube. Cuff pressure was measured with a cuff manometer to ensure optimum cuff pressure (20-25 cmH2O). RESULTS We found out that the mean ideal cuff volume inflated for 4.5 size tube was 1.7±0.3 ml, 1.9±0.3 ml for 5.0 size tube, and 2.1±0.3 ml for 5.5 size tube. Additionally we developed the "endotracheal cuff volume (ml) = 1,027 x height (m) + 0,104 x subglottic transverse diameter (mm) - 0,0191" formula to predict the most suitable inflation volume for ETT cuffs. CONCLUSION In this study, we suggested the optimal cuff volume to inflate the cuffs of ETTs 4.5, 5.0, and 5.5, which are frequently used in pediatric anaesthesia practice, in the appropriate cuff pressure range.ClinicalTrials.gov ref. no.: NCT04948359.
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Affiliation(s)
- Kahir Güneş
- From the Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Feyza Sever
- From the Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Sengül Özmert
- From the Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
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22
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Feng M, Watson W, Arom G, Damazo B, Krishna P. More Than 1 Way to Put in A T-Tube: A Review of Different Techniques Used in Insertion of Montgomery T-Tubes. Ann Otol Rhinol Laryngol 2024; 133:205-213. [PMID: 37706490 DOI: 10.1177/00034894231198756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE The Montgomery T-tube is a commonly used device initially designed as a temporary airway stent, but also used as a long-term airway solution for stenosis. For patients undergoing either endoscopic or open airway procedures, proper techniques for inserting these tubes are well documented. This review compiles the techniques used for insertion of the Montgomery T-tube stent. METHODS The NCBI Pubmed database was queried using the keywords: "stent," "Montgomery," "T-tube," "stenosis," "technique." A total of 33 papers were reviewed with 12 papers selected for the study. Papers were selected based on inclusion criteria of English language and whether the paper described a technique for insertion of a Montgomery T-tube into the airway. Papers were excluded if they did not describe the technique of insertion of Montgomery T-tubes or dealt with another aspect of T-tube management. RESULTS The 12 selected papers each described a different technique for insertion of a Montgomery T-tube stent. Though nearly all the selected studies described using a modified Seldinger technique for insertion of the T-tube, there were discrepancies and a wide array of different instruments used. The instrument and/or technique that was selected was often determined by the individual need of the patient. Several studies addressed the challenge of interrupting ventilation while inserting or exchanging a T-tube in the operating room. These studies described attaching the T-tube to the endotracheal tube to pass the T-tube into the airway while allowing for continuous ventilation. Yet other studies used optical forceps or rigid bronchoscopes to allow placement of the T-tube with direct visualization. CONCLUSION There are many techniques used for the insertion of a Montgomery T-tube. Nearly all studies described using a modified Seldinger technique and all the studies agreed on the necessity of a team approach for placement of the Montgomery T-tube.
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Affiliation(s)
- Max Feng
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - WayAnne Watson
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Gabriel Arom
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Benjamin Damazo
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Priya Krishna
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
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Selvaraj S, Gn Y, Wong TG, Ali Khan S. Anaesthesia Management for Neurosurgery in a Patient With Congenital Lung Agenesis. Cureus 2024; 16:e54522. [PMID: 38380108 PMCID: PMC10877663 DOI: 10.7759/cureus.54522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 02/22/2024] Open
Abstract
Congenital lung agenesis is a rare congenital abnormality associated with an absence or under-development of either one or both lungs, and its presentation in adulthood is even rarer. We describe a 40-year-old female patient with a history of congenital agenesis of the right lung and a high-grade glioma in the frontal region of the brain presenting for craniotomy and excision of the tumor in an MRI suite. Lung protective strategies of ventilation were utilized intraoperatively. The remote location of the MRI suite made access to extra manpower support challenging. The patient was managed uneventfully and discharged stable to the high-dependency unit. Our case describes how congenital lung agenesis poses a unique set of challenges for anaesthetic management, particularly in neurosurgical patients, and provides guidance to a multidisciplinary team approach.
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Affiliation(s)
| | - Yingmao Gn
- Anaesthesiology, Singapore General Hospital, Singapore, SGP
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24
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Faldynova M, Prikrylova H, Sebkova A, Volf J, Karasova D, Crhanova M, Babak V, Rychlik I. Contact with adult hens affects the composition of skin and respiratory tract microbiota in newly hatched chicks. Poult Sci 2024; 103:103302. [PMID: 38052128 PMCID: PMC10746563 DOI: 10.1016/j.psj.2023.103302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/04/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023] Open
Abstract
Chickens in commercial production are hatched in hatcheries without any contact with their parents and colonization of their skin and respiratory tract is therefore dependent on environmental sources only. However, since chickens evolved to be hatched in nests, in this study we evaluated the importance of contact between hens and chicks for the development of chicken skin and tracheal microbiota. Sequencing of PCR amplified V3/V4 variable regions of the 16S rRNA gene showed that contact with adult hens decreased the abundance of E. coli, Proteus mirabilis and Clostridium perfringens both in skin and the trachea, and Acinetobacter johnsonii and Cutibacterium acnes in skin microbiota only. These species were replaced by Lactobacillus gallinarum, Lactobacillus aviarius, Limosilactobacillus reuteri, and Streptococcus pasterianus in the skin and tracheal microbiota of contact chicks. Lactobacilli can be therefore investigated for their probiotic effect in respiratory tract in the future. Skin and respiratory microbiota of contact chickens was also enriched for Phascolarctobacterium, Succinatimonas, Flavonifractor, Blautia, and [Ruminococcus] torque though, since these are strict anaerobes from the intestinal tract, it is likely that only DNA from nonviable cells was detected for these taxa.
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Affiliation(s)
- Marcela Faldynova
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | - Hana Prikrylova
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | - Alena Sebkova
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | - Jiri Volf
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | - Daniela Karasova
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | | | - Vladimir Babak
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic
| | - Ivan Rychlik
- Veterinary Research Institute, Hudcova 70, 62100, Brno, Czech Republic.
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25
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Kaur A, Biswas G. Internal mammary artery perforator flap in the management of tracheoesophageal fistulae. J Laryngol Otol 2024:1-4. [PMID: 38185828 DOI: 10.1017/s0022215123002360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND A pathological communication between the trachea and oesophagus - a tracheoesophageal fistula - may be congenital or acquired, benign or malignant, necessitating a multidisciplinary approach. Conservative attempts at closure of this abnormal connection are ineffective; the interposition of healthy vascular tissue offers the least chance of recurrence. METHODS Outcomes of an islanded fasciocutaneous internal mammary artery perforator flap applied for tracheoesophageal fistula management were assessed in four radiated patients with laryngeal carcinoma using retrospective records. RESULTS Four male patients, with an average age of 60.75 years, underwent tracheoesophageal fistula closure between September 2017 and February 2021. A left-sided second internal mammary artery perforator flap was used in all cases, with an average dimension of 10.5 × 4.5 cm. There were no complications of tracheoesophageal leak, flap issues or donor site morbidity on follow up. CONCLUSION Recent advances in angiosomal territory mapping and microvascular dissection techniques, combined with an understanding of tracheoesophageal fistula pathology, have changed management perspectives in these difficult-to-treat patients.
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Affiliation(s)
- Amrita Kaur
- Department of Plastic Surgery, Tata Medical Centre, Kolkata, India
| | - Gautam Biswas
- Department of Plastic Surgery, Tata Medical Centre, Kolkata, India
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26
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Suzuki T, Saito M, Takahashi H, Suzuki H, Makino K, Ueda K, Mochizuki K, Mochizuki Z, Nemoto H, Sano N, Onishi H. Evaluation of a New Method for CyberKnife Treatment for Central Lung and Mediastinal Tumors by Tracheobronchial Tracking. Technol Cancer Res Treat 2024; 23:15330338241232557. [PMID: 38378006 PMCID: PMC10880520 DOI: 10.1177/15330338241232557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/27/2023] [Accepted: 01/24/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND CyberKnife treatment for central lung tumors and mediastinal tumors can be difficult to perform with marker less. PURPOSE We aimed to evaluate a novel tracheobronchial-based method (ie, tracheobronchial tracking) for the purpose of minimally invasive CyberKnife treatment for central lung and mediastinal tumors. METHODS Five verification plans were created using an in-house phantom. Each plan included five irradiation sessions. The reference plan irradiated and tracked the simulated tumor (using the target tracking volume, TTV). Trachea plans tracked the simulated tracheo-bronchus and irradiated the simulated tumor and included two types of subplans: correlated plans in which the displacement of the simulated tracheobronchial and the simulated tumor were correlated, and non-correlated plans in which these factors were not correlated. Moreover, 15 mm and 25 mm TTVs were evaluated for each plan. The sin waveform and the patient's respiratory waveform were prepared as the respiratory model. Evaluations were performed by calculating the dose difference between the radiophotoluminescent glass dosimeter (RPLD)-generated mean dose values (generated by the treatment planning system, TPS) and the actual absorbed RPLD dose. Statistical analyses were performed to evaluate findings for each plan. Correlation and prediction errors were calculated for each axis of each plan using log files to evaluate tracking accuracy. RESULTS Dose differences were statistically significant only in comparisons with the non-correlated plan. When evaluated using the sin waveform, the mean values for correlation and prediction errors in each axis and for all plans were less than 0.6 mm and 0.1 mm, respectively. In the same manner, they were less than 1.1 mm and 0.2 mm when evaluated using the patient's respiratory waveform. CONCLUSION Our newly-developed tracheobronchial tracking method would be useful in facilitating minimally invasive CyberKnife treatment in certain cases of central lung and mediastinal tumors.
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Affiliation(s)
- Toshihiro Suzuki
- CyberKnife Center, Kasugai General Rehabilitation Hospital, Yamanashi, Japan
| | - Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Takahashi
- CyberKnife Center, Kasugai General Rehabilitation Hospital, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Makino
- Department of Mechatronics, Faculty of Engineering, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Mochizuki
- CyberKnife Center, Kasugai General Rehabilitation Hospital, Yamanashi, Japan
| | - Zennosuke Mochizuki
- CyberKnife Center, Kasugai General Rehabilitation Hospital, Yamanashi, Japan
| | - Hikaru Nemoto
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
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27
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Sissoko C, Walker V, Dion GR. Biomechanical Evaluation of Tracheal Needle Puncture Forces: Comparative Analysis of Annular Ligaments and Tracheal Cartilage. J Biomech Eng 2024; 146:011008. [PMID: 37851532 DOI: 10.1115/1.4063821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023]
Abstract
Percutaneous tracheotomies (PCT) are commonly performed minimally invasive procedures involving the creation of an airway opening through an incision or puncture of the tracheal wall. While the medical intervention is crucial for critical care and the management of acute respiratory failure, tracheostomy complications can lead to severe clinical symptoms due to the alterations of the airways biomechanical properties/structures. The causes and mechanisms underlaying the development of these post-tracheotomy complications remain largely unknown. In this study, we aimed to investigate the needle puncture process and its biomechanical characteristics by using a well establish porcine ex vivo trachea to simulate the forces involved in accessing airways during PCT at varying angular approaches. Given that many procedures involve inserting a needle into the trachea without direct visualization of the tracheal wall, concerns have been raised over the needle punctures through the cartilaginous rings as compared to the space between them may result in fractured cartilage and post-tracheostomy airway complications. We report a difference in puncture force between piercing the cartilage and the annular ligaments and observe that the angle of puncture does not significantly alter the puncture forces. The data collected in this study can guide the design of relevant biomechanical feedback system during airway access procedures and ultimately help refine and optimize PCT.
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Affiliation(s)
- Cheick Sissoko
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
| | - Victoria Walker
- University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
| | - Gregory R Dion
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
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28
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Pradeep S, Alexander A, Ganesan S, Srinivasan DG, Kushwaha A, Gopalakrishnan A, Penubarthi LK, Raja K, Saxena SK. Site of Tracheostomy and Its Influence on The Surgical Outcome and Quality of Life After Tracheal Resection and Anastomosis in Patients with Tracheal Stenosis. Int Arch Otorhinolaryngol 2024; 28:e22-e29. [PMID: 38322442 PMCID: PMC10843922 DOI: 10.1055/s-0043-1776702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 12/25/2022] [Indexed: 02/08/2024] Open
Abstract
Introduction With the advances in critical care, the incidence of post intubation tracheal stenosis is increasing. Tracheal resection and anastomosis have been the gold standard for the management of grades III and IV stenosis. Scientific evidence from the literature on the determining factors and outcomes of surgery is not well described. Objective This study was aimed at determining the influence of tracheostoma site on the surgical outcomes and postoperative quality of life of patients undergoing tracheal resection anastomosis. Methods Thirteen patients who underwent tracheal resection and anastomosis during a period of 3 years were followed up prospectively for 3 months to determine the degree of improvement in their quality of life postsurgery by comparing the pre and postoperative validated Tamil/vernacular version of RAND SF-36 scores and Medical Research Council (MRC) dyspnea score. Results As per preoperative computed tomography (CT), the mean length of stenosis was found to be 1.5 cm while the mean length of trachea resected was 4.75 cm. We achieved a decannulation rate of 61.53%. There was an estimated loss of 3.20 +/- 1.90 cm of normal trachea from the lower border of the stenosis until the lower border of the stoma that was lost during resection. Analysis of SF-36 and MRC dyspnea scores revealed significant improvement in the domains of physical function postoperatively in comparison with the preoperative scores ( p < 0.05). Conclusion Diligent placement of tracheostomy in an emergency setting with respect to the stenotic segment plays a pivotal role in minimizing the length of the resected segment of normal trachea.
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Affiliation(s)
- Soorya Pradeep
- Department of ENT, Christian Medical College (CMC), Vellore, India
| | - Arun Alexander
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Sivaraman Ganesan
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | | | - Akshat Kushwaha
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Aparna Gopalakrishnan
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Lokesh Kumar Penubarthi
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Kalaiarasi Raja
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Sunil Kumar Saxena
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
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29
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Russell NX, Burra K, Shah RM, Bottasso-Arias N, Mohanakrishnan M, Snowball J, Ediga HH, Madala SK, Sinner D. Wnt signaling regulates ion channel expression to promote smooth muscle and cartilage formation in developing mouse trachea. Am J Physiol Lung Cell Mol Physiol 2023; 325:L788-L802. [PMID: 37873566 DOI: 10.1152/ajplung.00024.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/28/2023] [Accepted: 10/15/2023] [Indexed: 10/25/2023] Open
Abstract
Ion channels play critical roles in the physiology and function of the nervous system and contractile tissue; however, their role in noncontractile tissue and embryonic development has yet to be understood. Tracheobronchomalacia (TBM) and complete tracheal rings (CTR) are disorders affecting the muscle and cartilage of the trachea and bronchi, whose etiology remains poorly understood. We demonstrated that trachealis muscle organization and polarity are disrupted after epithelial ablation of Wntless (Wls), a cargo receptor critical for the Wnt signaling pathway, in developing trachea. The phenotype resembles the anomalous trachealis muscle observed after deletion of ion channel encoding genes in developing mouse trachea. We sought to investigate whether and how the deletion of Wls affects ion channels during tracheal development. We hypothesize that Wnt signaling influences the expression of ion channels to promote trachealis muscle cell assembly and patterning. Deleting Wls in developing trachea causes differential regulation of genes mediating actin binding, cytoskeleton organization, and potassium ion channel activity. Wnt signaling regulates the expression of Kcnj13, Kcnd3, Kcnj8, and Abcc9 as demonstrated by in vitro studies and in vivo analysis in Wnt5a and β-catenin-deficient tracheas. Pharmacological inhibition of potassium ion channels and Wnt signaling impaired contractility of developing trachealis smooth muscle and formation of cartilaginous mesenchymal condensation. Thus, in mice, epithelial-induced Wnt/β-catenin signaling mediates trachealis muscle and cartilage development via modulation of ion channel expression, promoting trachealis muscle architecture, contractility, and cartilaginous extracellular matrix. In turn, ion channel activity may influence tracheal morphogenesis underlying TBM and CTR.NEW & NOTEWORTHY Ion channels play critical roles in the physiology and function of the nervous system and contractile tissue; however, their role in noncontractile tissue and embryonic development has yet to be understood. In this study, we focused on the role of ion channels in the differentiation and patterning of the large airways of the developing respiratory tract. We identify a mechanism by which Wnt-beta-catenin signaling controls levels of ion channel-encoding genes to promote tracheal differentiation.
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Affiliation(s)
- Nicholas X Russell
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati Honors Program, Cincinnati, Ohio, United States
| | - Kaulini Burra
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
| | - Ronak M Shah
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati Honors Program, Cincinnati, Ohio, United States
| | - Natalia Bottasso-Arias
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
| | - Megha Mohanakrishnan
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati Honors Program, Cincinnati, Ohio, United States
| | - John Snowball
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
| | - Harshavardhana H Ediga
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Satish K Madala
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Debora Sinner
- Neonatology and Pulmonary Biology Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, Ohio, United States
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Sen M, Gunalp M, Oguz AB, Coruh AG, Genc S, Koca A, Polat O. Role of ultrasonography in upper airway assessment: A comparison with computerized tomography measurements. Am J Emerg Med 2023; 74:21-26. [PMID: 37738893 DOI: 10.1016/j.ajem.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/04/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION This study aimed to compare ultrasonography (US) measurements of the upper airway to computerized tomography (CT) measurements. Our study's primary outcome is to research the accuracy of US measurements in the evaluation of upper airway diameters when CT is taken as the gold standard; the secondary outcome is to determine the time required to obtain US measurements. METHODS This prospective study included patients ≥18 years old that had undergone thoracic or neck CT due to current clinical necessity. The US measurement for each patient was performed by two researchers with different levels of experience, both of whom were blinded to each other and the CT measurements. Measurements were obtained from the vocal cords and subglottic region. The duration of the US performance was also recorded. RESULTS The US and CT measurements were obtained from 94 patients. Concordance between US and CT measurements was found in the Bland-Altman analysis, with a mean -0.05 mm difference for vocal cord diameter and -1.2 mm for subglottic diameter. The intra-class correlation coefficients (ICC) between the CT and US measurements were 0.993, and 0.609 for vocal cord and subglottic diameter measurements, respectively. The ICC between US performers was 0.992 for vocal cord diameter and 0.959 for subglottic diameter. The US's mean time for vocal cord diameter measurement was 38 ± 23 s, and the mean time for subglottic diameter measurement was 49 ± 30 s. CONCLUSION The concordance between US and CT measurements is high and the measurements of different practitioners with different experience levels are compatible with each other.
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Affiliation(s)
- Muhammedcan Sen
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Muge Gunalp
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Ahmet Burak Oguz
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey.
| | | | - Sinan Genc
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Ayca Koca
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Onur Polat
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
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Rafieian S, Ershadi R, Amini H, Samimiat A, Gholinataj Jelodar M, Vahedi M. Primary benign intra tracheal schwannoma: A case report and review of the literature. Respirol Case Rep 2023; 11:e01241. [PMID: 37915369 PMCID: PMC10616687 DOI: 10.1002/rcr2.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/19/2023] [Indexed: 11/03/2023] Open
Abstract
Shwannomas are rare benign tumours especially in tracheal. A 16-year-old male presented with a chronic cough, and a thoracic CT scan revealed a pedunculated tumour measuring approximately 11 × 13 mm in size, located 22 mm away from the main carina. Tissue sample was obtained via rigid bronchoscopy and cryobiopsy, and the pathological analysis confirmed the diagnosis of a benign nerve sheath tumour consistent with schwannoma. The patient subsequently underwent resection of the tumour and tracheal anastomosis. Schwannomas are uncommon pulmonary tumours that typically occur in adults, with a higher incidence among females. The presenting symptoms vary depending on the size and location of the tumour. Treatment options include therapeutic bronchoscopy or surgical resection, with the choice of approach based on tumour characteristics (pedunculated or sessile), preoperative surgical risk, and risk of recurrence. The prognosis is generally favourable, with a low risk of recurrence and excellent outcomes.
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Affiliation(s)
- Shahab Rafieian
- Department of Thoracic Surgery, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Reza Ershadi
- Department of Thoracic Surgery, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hesam Amini
- Department of Thoracic Surgery, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Alireza Samimiat
- Department of Surgery, Sina HospitalTehran University of Medical SciencesTehranIran
| | | | - Matin Vahedi
- Department of Surgery, Sina HospitalTehran University of Medical SciencesTehranIran
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Piazza C, Lancini D, Zigliani G, Del Bon F, Tomasoni M, Montenegro C, Rampinelli V, Mattavelli D. Hemicricoidectomy with modified rotational thyro-crico- tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques. Acta Otorhinolaryngol Ital 2023; 43:382-389. [PMID: 37814978 PMCID: PMC10773548 DOI: 10.14639/0392-100x-n2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 10/11/2023]
Abstract
Objective The aim of the present study is to describe our novel surgical technique of hemicricoidectomy and reconstruction with modified rotational thyro-crico-tracheal anastomosis for the treatment of non-squamous cell subglottic tumours. The procedure has been defined as Type E crico-tracheal resection and anastomosis (CTRA) following the University of Brescia (C)TRA classification introduced elsewhere. Methods A detailed anatomical step-by-step dissection was reproduced and illustrated on a cadaveric laryngo-tracheal specimen. Moreover, oncological and functional outcomes of the first 5 patients who underwent Type E CTRA at our Institution between October 2016 and September 2022 are described. Results Three patients underwent Type E CTRA for cricoid chondrosarcoma (CS) and 2 patients for subglottic adenoid cystic carcinoma (ACC). No post-operative complication was reported. All patients maintained intact oral intake and an intelligible voice at discharge. All but one patient with obstructive sleep apnoea hypopnea syndrome and lung comorbidity were successfully decannulated before discharge. At the last follow-up (April 2023), one patient experienced local recurrence of CS that was still amenable to conservative treatment by transoral debulking, while the remaining patients were free of disease. Conclusions With the proper indications, Type E CTRA is a feasible and effective conservative surgical technique for selected non-squamous cell subglottic tumours.
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Affiliation(s)
- Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gabriele Zigliani
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Francesca Del Bon
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Montenegro
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
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Montenegro C, Mattavelli D, Lancini D, Paderno A, Marazzi E, Rampinelli V, Tomasoni M, Piazza C. Treatment and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review. Acta Otorhinolaryngol Ital 2023; 43:365-374. [PMID: 37814980 PMCID: PMC10773543 DOI: 10.14639/0392-100x-n2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/10/2023] [Indexed: 10/11/2023]
Abstract
Objectives Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities. Methods Full text English manuscripts published from January 1st 2000 to December 14th 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed. Results Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%). Conclusions In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.
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Affiliation(s)
- Claudia Montenegro
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Marazzi
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
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Klabukov I, Atiakshin D, Kogan E, Ignatyuk M, Krasheninnikov M, Zharkov N, Yakimova A, Grinevich V, Pryanikov P, Parshin V, Sosin D, Kostin AA, Shegay P, Kaprin AD, Baranovskii D. Post-Implantation Inflammatory Responses to Xenogeneic Tissue-Engineered Cartilage Implanted in Rabbit Trachea: The Role of Cultured Chondrocytes in the Modification of Inflammation. Int J Mol Sci 2023; 24:16783. [PMID: 38069106 PMCID: PMC10706106 DOI: 10.3390/ijms242316783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Immune responses to tissue-engineered grafts made of xenogeneic materials remain poorly studied. The scope of current investigations is limited by the lack of information on orthotopically implanted grafts. A deeper understanding of these processes is of great importance since innovative surgical approaches include the implantation of xenogeneic decellularized scaffolds seeded by cells. The purpose of our work is to study the immunological features of tracheal repair during the implantation of tissue-engineered constructs based on human xenogeneic scaffolds modified via laser radiation in rabbits. The samples were stained with hematoxylin and Safranin O, and they were immunostained with antibodies against tryptase, collagen II, vimentin, and CD34. Immunological and inflammatory responses were studied by counting immune cells and evaluating blood vessels and collagen. Leukocyte-based inflammation prevailed during the implantation of decellularized unseeded scaffolds; meanwhile, plasma cells were significantly more abundant in tissue-engineered constructs. Mast cells were insignificantly more abundant in tissue-engineered construct samples. Conclusions: The seeding of decellularized xenogeneic cartilage with chondrocytes resulted in a change in immunological reactions upon implantation, and it was associated with plasma cell infiltration. Tissue-engineered grafts widely differed in design, including the type of used cells. The question of immunological response depending on the tissue-engineered graft composition requires further investigation.
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Affiliation(s)
- Ilya Klabukov
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, 249031 Obninsk, Russia
| | - Dmitri Atiakshin
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Evgenia Kogan
- Strukov Department of Pathological Anatomy, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Michael Ignatyuk
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Mikhail Krasheninnikov
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Nickolay Zharkov
- Strukov Department of Pathological Anatomy, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Yakimova
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Vyacheslav Grinevich
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Pavel Pryanikov
- Russian Child Clinical Hospital, Pirogov Russian National Research Medical University, 119571 Moscow, Russia
| | - Vladimir Parshin
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia
| | - Dmitry Sosin
- Centre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical Biological Agency, 119121 Moscow, Russia
| | - Andrey A. Kostin
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Peter Shegay
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Andrey D. Kaprin
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Denis Baranovskii
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Department of Biomedicine, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
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Laitman BM, Cruz-Encarnacion P, Gordon RE, Genden EM. Case Report: Human Tracheal Transplantation Undergoes Progressive Reepithelialization Over Time. Laryngoscope 2023. [PMID: 37975487 DOI: 10.1002/lary.31170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/29/2023] [Accepted: 07/18/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Tracheal transplantation is an ideal option for the reconstruction of long-segment circumferential tracheal defects. Our group performed the first successful vascularized single-staged tracheal transplantation in January 2021. Although a rigid biocompatible structure is necessary for a functioning tracheal replacement, the importance of ciliated epithelium, which allows for critical mucociliary clearance, is now being appreciated. Here, we examined the histological changes of the first single-staged human tracheal transplant from serial endoscopic biopsies. METHODS Biopsies of the tracheal mucosa were serially obtained since the time of the tracheal transplantation. Samples were examined via hematoxylin and eosin, electron microscopy, and immunohistochemistry. RESULTS One week after transplantation, there is loss of ciliated epithelium and seromucinous cells, with only a basal layer of epithelium remaining. By 2 weeks, however, the epithelium begins to recover, albeit differently depending on the location of the biopsy. Near the site of tracheal anastomosis, there is epithelial proliferation, with the appearance of early ciliated cells. However, in the midgraft, there appears to be evidence of squamous metaplasia. Over time, however, normal ciliated epithelium and mucous cells appear without signs of chronic inflammation. CONCLUSIONS Critically, the tracheal allograft regained normal appearing respiratory epithelium after initial ischemic injury. The histologic differences at the midgraft versus anastomosis may suggest unique mechanisms of reepithelialization. At the recipient-donor interface, there may be a faster direct migration of recipient-derived epithelial cells, in line with preclinical studies. The midgraft, in contrast, responds with epithelial proliferation from the donor basal cells or dedifferentiated mucous cells. LEVEL OF EVIDENCE N/A Laryngoscope, 2023.
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Affiliation(s)
- Benjamin M Laitman
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Pamela Cruz-Encarnacion
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Ronald E Gordon
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Eric M Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Lorenz RR. The Evolution and Outcomes of the "Maddern Procedure" for the Treatment of Subglottic Stenosis. Laryngoscope 2023; 133:3100-3108. [PMID: 37194674 DOI: 10.1002/lary.30752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION A novel technique to treat subglottic stenosis, the "Maddern Procedure", has been gaining acceptance in academic centers. This study describes the technique in detail, as well as its evolution over the first 28 patients performed at an academic center. METHODS A prospective case-series, with descriptive technique modifications cataloged throughout the 6 years needed to accumulate the patient cohort with a minimum of 2 years of follow-up (11/2015-11/2021). Main outcomes examined included changes to surgical indications, complications, and post-operative outcomes as measured by validated measures of voice and breathing. RESULTS Complete resection of subglottic scaring was performed, at first transcervically (2 pts), then transorally (26 pts). Successful performance of the procedure occurred in all patients without complications, with either successful decannulation of previously existing tracheotomies, or removal of perioperative tracheotomies. Buccal grafts (8/26) replaced skin graft as the graft of choice. Although high subglottic disease was first thought to be a contraindication, superior results became evident in cases of high stenosis rather than disease that included the upper trachea, with 4/26 patients requiring subsequent tracheal resection or tracheal dilation. Of the 22 remaining patients, 19/22 had successful arresting of restenosis, with 2/22 undergoing subsequent cricotracheal resection, and 1/22 pts requiring subglottic dilation. Overall, 19/26 Maddern pts (73%) had objectively favorable outcomes, with 24/26 (92%) reporting that they would have undergone the procedure again. CONCLUSION Full-thickness mucosal resection and relining of the subglottis is a developing technique that is a safe, yet technically challenging procedure which addresses the recurrent nature of the disease. LEVEL OF EVIDENCE Level 4 (Case-series) Laryngoscope, 133:3100-3108, 2023.
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Affiliation(s)
- Robert R Lorenz
- Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio, USA
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Pino-Jiménez B, Giannios P, Casanova J. Polyploidy-associated autophagy promotes larval tracheal histolysis at Drosophila metamorphosis. Autophagy 2023; 19:2972-2981. [PMID: 37424089 PMCID: PMC10549192 DOI: 10.1080/15548627.2023.2231828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
Polyploidy is an extended phenomenon in biology. However, its physiological significance and whether it defines specific cell behaviors is not well understood. Here we study its connection to macroautophagy/autophagy, using the larval respiratory system of Drosophila as a model. This system comprises cells with the same function yet with notably different ploidy status, namely diploid progenitors and their polyploid larval counterparts, the latter destined to die during metamorphosis. We identified an association between polyploidy and autophagy and found that higher endoreplication status correlates with elevated autophagy. Finally, we report that tissue histolysis in the trachea during Drosophila metamorphosis is mediated by autophagy, which triggers the apoptosis of polyploid cells.Abbreviations: APF: after pupa formation; Atg: autophagy related; btl: breathless; CycE: Cyclin E; DT: dorsal trunk; fzr: fizzy-related; L3: larval stage 3; PBS: phosphate-buffered saline; RI: RNAi; Tr: tracheal metamere; yki: yorkie.
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Affiliation(s)
- Beatriz Pino-Jiménez
- Department of Cell and Tissues, Institut de Biologia Molecular de Barcelona (CSIC), Barcelona, Catalonia, Spain
- Institut de Recerca Biomèdica de Barcelona, (IRB Barcelona), The Barcelona Institute of Science and Technology (BIST), Barcelona, Catalonia, Spain
| | - Panagiotis Giannios
- Department of Cell and Tissues, Institut de Biologia Molecular de Barcelona (CSIC), Barcelona, Catalonia, Spain
- Institut de Recerca Biomèdica de Barcelona, (IRB Barcelona), The Barcelona Institute of Science and Technology (BIST), Barcelona, Catalonia, Spain
| | - Jordi Casanova
- Department of Cell and Tissues, Institut de Biologia Molecular de Barcelona (CSIC), Barcelona, Catalonia, Spain
- Institut de Recerca Biomèdica de Barcelona, (IRB Barcelona), The Barcelona Institute of Science and Technology (BIST), Barcelona, Catalonia, Spain
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Kennedy MM, Abdel-Aty Y, Butterfield R, Zhang N, Lott DG. Is Continued Perioperative Antithrombotic Therapy Safe When Performing Open Tracheostomy? Ann Otol Rhinol Laryngol 2023; 132:1285-1292. [PMID: 36647237 DOI: 10.1177/00034894221147807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To date, there are no specific guidelines on antithrombotic therapy (ATT) management, which includes both anticoagulation and antiplatelet medications, for open tracheostomy. The objective of this study was to evaluate whether the use of perioperative antithrombotic medication during open tracheostomy influences the incidence of perioperative or postoperative complications. METHODS A retrospective review was conducted of all patients who underwent open tracheostomies at a tertiary care medical center from January 2015 to December 2019. Charts were reviewed for demographics, comorbidities, indication for tracheostomy, ATT use, operative details, and complications. RESULTS A total of 217 tracheostomies were evaluated for this study, of which 148 (68.2%) were not on ATT and 69 (31.8%) were on ATT during surgery. No significant difference was observed based on ATT status in perioperative bleeding (P = .983), postoperative bleeding (P = .24), or median days to decannulation (P = .5986). ATT patients were 2.67 times more likely to experience 30-day mortality than those non-ATT patients (P = .035). There was only one death due to hemorrhage in the ATT group. This was unrelated to the tracheostomy. This compares to 2 hemorrhage-related deaths in those not on ATT. CONCLUSION There was no significant difference in perioperative or postoperative bleeding based on ATT use. Patients on ATT were significantly more likely to experience 30-day mortality, however only one death was due to hemorrhage in the ATT group and was unrelated to tracheostomy. Therefore, continued perioperative ATT use appears to be safe when performing open tracheostomy. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Maeve M Kennedy
- Head and Neck Regenerative Medicine Laboratory, Center for Regenerative Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Yassmeen Abdel-Aty
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, University of South Florida Health
| | - Richard Butterfield
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic Arizona, Scottsdale, USA
| | - Nan Zhang
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic Arizona, Scottsdale, USA
| | - David G Lott
- Head and Neck Regenerative Medicine Laboratory, Center for Regenerative Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
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Lloyd F, Robertson J, Murison PJ. Retrospective computed tomography analysis of endo tracheal tube constriction and mispositioning in cats and dogs. Vet Anaesth Analg 2023; 50:467-476. [PMID: 37735027 DOI: 10.1016/j.vaa.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/31/2023] [Accepted: 07/13/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To discover the prevalence of endotracheal tube (ETT) constriction and rostral and caudal mispositioning in anaesthetized cats and dogs, and to identify associated risk factors. STUDY DESIGN Retrospective analysis. ANIMALS A total of 146 cats and 670 dogs. METHODS Computed tomography images of the head/neck/thorax from orotracheally intubated cats and dogs were visually assessed for constriction or mispositioning of the ETT. If constriction was present, measurements of the cross-sectional area (CSA) of the ETT lumen at constricted and un-constricted locations were compared. Location and cause of constriction were noted and the expected increase in resistance to gas flow was calculated. Animal information was collected from clinical records. Normality of continuous variables was assessed via the Shapiro-Wilk test. Chi-square tests examined associations between variables. Kendall's tau-b test was performed between measured ETT size and degree of constriction. RESULTS The ETT extended rostrally beyond incisors in 52% of cases; the connector was within the oral cavity in 19% of cases. The ETT extended beyond the first rib in 25.5% of cases. The prevalence of ETT constriction was 22.7%. Median reduction in CSA was 7.68% (0.14-64.19%). Median increase in resistance assuming laminar and turbulent flow was 16.5% (0.3-680%) and 21% (0.3-1200%), respectively. The most common cause of constriction was the presence of a radiotherapy mouth gag. Significant associations existed between presence of constriction and rostral mispositioning, and caudal mispositioning and extreme brachycephaly. Increased severity of constriction was more likely in smaller ETT. CONCLUSIONS AND CLINICAL RELEVANCE Constriction and mispositioning of ETT occurred very commonly in this population. Checking the ETT within the oral cavity for constriction and mispositioning is recommended. Radiotherapy mouth gags increase the risk of ETT compression. Smaller ETT are at greater risk of severe constriction. Brachycephalic dogs are at particular risk of caudal mispositioning.
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Affiliation(s)
- Ffion Lloyd
- Small Animal Hospital, University of Glasgow, School of Biodiversity, One Health and Veterinary Medicine, Glasgow, UK.
| | - Josephine Robertson
- Small Animal Hospital, University of Glasgow, School of Biodiversity, One Health and Veterinary Medicine, Glasgow, UK
| | - Pamela J Murison
- Small Animal Hospital, University of Glasgow, School of Biodiversity, One Health and Veterinary Medicine, Glasgow, UK
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Sun L, Liu K, Li M, Sun Y, Zhu X, Chang C. Tracheobronchial Amyloidosis Accompanied with Asthma: A Case Report and a Mini-Review. J Asthma Allergy 2023; 16:1187-1193. [PMID: 37920270 PMCID: PMC10619460 DOI: 10.2147/jaa.s433639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
Tracheobronchial amyloidosis is a rare disease characterized by amyloid deposits on the tracheal and bronchial tissue. Patients with tracheobronchial amyloidosis are asymptomatic or exhibit symptoms, such as chronic wheezing, dyspnea, and cough, that are common manifestations of other disorders, including asthma. A bronchoscopic tissue biopsy using Congo red staining is the key standard for diagnosing tracheobronchial amyloidosis. Treatment strategies vary depending on the degree of airway obstruction. If the obstruction is significant and the patient is symptomatic, repeated bronchoscopic treatment, including local resection, laser therapy, stent placement, and radiation therapy, is considered a safer and better option. It is often misdiagnosed as asthma, but cases of tracheobronchial amyloidosis accompanied with asthma have not been reported. We report a case of intermittent wheezing, cough for 33 years, and shortness of breath on exertion for 7 years, which had aggravated in the previous 22 days. A pulmonary examination revealed diffuse wheezing. Pulmonary function testing revealed an obstructive ventilation dysfunction. Computerized tomography (CT) imaging revealed circumferential and irregular thickening of the tracheobronchial wall tissue with calcification and atelectasis of the right middle and lower lobe of the lung. Bronchoscopy revealed diffuse thickening of the mucosa of the trachea and bilateral main bronchi, with multiple nodular protuberances and relatively narrow lumens. The bronchial biopsies revealed massive amyloid deposits under the bronchial mucosa. The deposits exhibited a green birefringence under crossed polarized light after Congo red positive staining. The patient received standard treatment for asthma, and remains in good general condition without wheezing. It is not difficult to distinguish tracheobronchial amyloidosis through chest CT examination for patients with wheezing as long as this disease was considered. It was interesting that we present a rarer case of patient with tracheobronchial amyloidosis accompanied with asthma which both can cause symptoms such as wheezing.
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Affiliation(s)
- Lina Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Kexin Liu
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Meijiao Li
- Department of Radiology, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Xiang Zhu
- Department of Pathology, Peking University Third Hospital, Beijing, People’s Republic of China
- Department of Pathology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Chun Chang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
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Drees L, Schneider S, Riedel D, Schuh R, Behr M. The proteolysis of ZP proteins is essential to control cell membrane structure and integrity of developing tracheal tubes in Drosophila. eLife 2023; 12:e91079. [PMID: 37872795 PMCID: PMC10597583 DOI: 10.7554/elife.91079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Membrane expansion integrates multiple forces to mediate precise tube growth and network formation. Defects lead to deformations, as found in diseases such as polycystic kidney diseases, aortic aneurysms, stenosis, and tortuosity. We identified a mechanism of sensing and responding to the membrane-driven expansion of tracheal tubes. The apical membrane is anchored to the apical extracellular matrix (aECM) and causes expansion forces that elongate the tracheal tubes. The aECM provides a mechanical tension that balances the resulting expansion forces, with Dumpy being an elastic molecule that modulates the mechanical stress on the matrix during tracheal tube expansion. We show in Drosophila that the zona pellucida (ZP) domain protein Piopio interacts and cooperates with the ZP protein Dumpy at tracheal cells. To resist shear stresses which arise during tube expansion, Piopio undergoes ectodomain shedding by the Matriptase homolog Notopleural, which releases Piopio-Dumpy-mediated linkages between membranes and extracellular matrix. Failure of this process leads to deformations of the apical membrane, tears the apical matrix, and impairs tubular network function. We also show conserved ectodomain shedding of the human TGFβ type III receptor by Notopleural and the human Matriptase, providing novel findings for in-depth analysis of diseases caused by cell and tube shape changes.
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Affiliation(s)
- Leonard Drees
- Research Group Molecular Organogenesis, Department of Molecular Developmental Biology, Max Planck Institute for Multidisciplinary SciencesGöttingenGermany
| | - Susi Schneider
- Cell biology, Institute for Biology, Leipzig UniversityLeipzigGermany
| | - Dietmar Riedel
- Facility for electron microscopy, Max Planck Institute for Multidisciplinary SciencesGöttingenGermany
| | - Reinhard Schuh
- Research Group Molecular Organogenesis, Department of Molecular Developmental Biology, Max Planck Institute for Multidisciplinary SciencesGöttingenGermany
| | - Matthias Behr
- Cell biology, Institute for Biology, Leipzig UniversityLeipzigGermany
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42
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Sumerags D, Jain N, Pilmane M, Sumeraga G. Assessment of professional singers using laryngeal, respiratory, and airflow measurements. LOGOP PHONIATR VOCO 2023:1-9. [PMID: 37846032 DOI: 10.1080/14015439.2023.2270592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE In the pedagogy of classical vocal singing, it can be difficult to determine the human voice fach, especially for the voice of aspiring vocalists. Hence, an objective metric-based system for the determination of the human voice is needed. In the present study, we investigated the anthropological and aerodynamic parameters for 60 professional singers with a professionally confirmed singing range. METHODS Amongst the 60 included professional singers, there were ten participants each for sopranos, mezzo-sopranos, altos (female vocal fach), and tenors, baritones, basses (male vocal fach). Airflow measurements were recorded using spirometry whilst anthropological measurements were taken using CT scans. Appropriate statistical analyses were done using the Mann-Whitney U test and Kruskal Wallis H test with post-hoc tests and Bonferroni correction. p < 0.05 was considered statistically significant. RESULTS Soprano singers, who have the highest pitch, were found to be the shortest and least heavy, whilst basses, who have the lowest pitch, were found to be tallest and heaviest amongst the study participants. Furthermore, sopranos had the smallest lung volumes while the basses had the largest lung volumes (raw spirometry measures). However, when normalized ratios were considered, no differences were observed. Finally, laryngeal size showed sexual dimorphism due to developmental changes. CONCLUSIONS A mix of anthropological and aerodynamic measurements may be useful to assist singers and vocal pedagogues to assess and determine voice types before the beginning of their vocal studies.
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Affiliation(s)
- Dins Sumerags
- Department of Otorhinolaryngology, Cesu Klinika Hospital, Cesis, Latvia
| | - Nityanand Jain
- Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradiņš University, Riga, Latvia
| | - Mara Pilmane
- Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradiņš University, Riga, Latvia
| | - Gunta Sumeraga
- Department of Otorhinolaryngology, Riga Stradiņš University, Riga, Latvia
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43
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Chou YL, Wang YT, Cheng LH, Liu SC, Wang HW. Efficacy of levocetirizine in isolated rat tracheal smooth muscle. Int J Med Sci 2023; 20:1671-1678. [PMID: 37928871 PMCID: PMC10620866 DOI: 10.7150/ijms.86769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023] Open
Abstract
Histamine receptor-1 (H1) antagonists like levocetirizine are frequently used nowadays to treat rhinitis patients who experience rhinorrhea and sneezing. The trachea may be affected by the H1 antagonist when it is used to treat nasal symptoms, either orally or through inhalation. The purpose of this study was to ascertain in vitro effects of levocetirizine on isolated tracheal smooth muscle. As a parasympathetic mimetic, methacholine (10-6 M) causes contractions in tracheal smooth muscle, which is how we tested effectiveness of levocetirizine on isolated rat tracheal smooth muscle. We also tested the drug's impact on electrically induced tracheal smooth muscle contractions. The impact of menthol (either before or after) on the contraction brought on by 10-6 M methacholine was also investigated. According to the results, the addition of levocetirizine at concentrations of 10-5 M or more caused a slight relaxation in response to methacholine's 10-6 M contraction. Levocetirizine could prevent spike contraction brought on by electrical field stimulation (EFS). As the concentration rose, it alone had a neglect effect on the trachea's basal tension. Before menthol was applied, levocetirizine might have also inhibited the function of the cold receptor. According to this study, levocetirizine might potentially impede the parasympathetic function of the trachea. If levocetirizine was used prior to menthol addition, it also reduced the function of cold receptors.
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Affiliation(s)
- Ying-Liang Chou
- Department of Otolaryngology-Head and Neck Surgery, Taichung Armed Forces General Hospital, Taichung, Taiwan, Republic of China
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of Radical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan, Republic of China
| | - Yueh-Ting Wang
- Bioinformatics Program, Boston University, Boston, MA, USA
| | - Li-Hsiang Cheng
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Shao-Cheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hsing-Won Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- The Graduate Institute of Clinical Medicine and Department of Otolaryngology, College of Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, Republic of China
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44
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Bell PT, Anderson J, Coulter C, Dettrick AJ, Burke A, Baird T. A mariner's tale: Invasive endo tracheal Mycobacterium marinum infection. Respirol Case Rep 2023; 11:e01211. [PMID: 37664419 PMCID: PMC10471489 DOI: 10.1002/rcr2.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023] Open
Abstract
Mycobacterium marinum is a ubiquitous water-borne non-tuberculous mycobacterial (NTM) pathogen. In humans, M. marinum infections are acquired through direct inoculation of skin wounds and are almost exclusively localized to skin and soft tissues. Pulmonary infection with M. marinum is extremely rare, and to our knowledge, invasive endobronchial disease has not been reported. Here, we present a case of a 71-year-old immunocompetent male surfer with invasive endotracheal M. marinum granulomatous disease. The patient was successfully cured with a regimen of azithromycin 250 mg daily, ethambutol 900 mg (15 mg/kg) daily and rifampicin 600 mg daily for 12 months following culture conversion. This case highlights several important concepts: Firstly, M. marinum infection, including invasive endobronchial infection, should be considered a rare cause of NTM pulmonary disease. Secondly, endotracheal infection can be successfully eradicated with this selected therapeutic regimen. Finally, the absence of M. marinum skin or soft-tissue infection in this patient, raises the possibility that human disease might also be acquired via inhalation of M. marinum contaminated water in rare circumstances.
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Affiliation(s)
- Peter T. Bell
- Department of Respiratory MedicineSunshine Coast University HospitalBirtinyaQueenslandAustralia
- Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - James Anderson
- Department of Respiratory MedicineSunshine Coast University HospitalBirtinyaQueenslandAustralia
| | - Christopher Coulter
- Queensland Mycobacterial Reference Laboratory, Pathology QueenslandRoyal Brisbane Women's Hospital CampusBrisbaneQueenslandAustralia
| | - Andrew J. Dettrick
- School of HealthUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
- Pathology QueenslandSunshine Coast University HospitalBirtinyaQueenslandAustralia
| | - Andrew Burke
- Department of Thoracic MedicineThe Prince Charles HospitalBrisbaneQueenslandAustralia
- University of Queensland Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Timothy Baird
- Department of Respiratory MedicineSunshine Coast University HospitalBirtinyaQueenslandAustralia
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Kinoshita T, Ishii H, Sakazaki Y, Azuma K, Sasaki J, Tokito T, Tominaga M, Ogou E, Kawayama T, Hoshino T. Proton Beam Therapy as a Curative Treatment for a Young Case of Unresectable Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2877-2881. [PMID: 36792199 PMCID: PMC10602834 DOI: 10.2169/internalmedicine.0574-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/28/2022] [Indexed: 02/16/2023] Open
Abstract
Primary tracheal adenoid cystic carcinoma (TACC) is a rare malignancy without an established treatment. Central airway obstruction due to TACC often decreases the quality of life and has life-threatening consequences. A 19-year-old man with unresectable TACC and central airway obstruction suffered from progressive cough and dyspnea after exercise. Proton beam therapy (PBT) was selected as the preferred treatment over systemic anti-cancer chemotherapy for TACC. PBT led to complete remission of TACC and the almost complete disappearance of the respiratory symptoms without adverse events. PBT is a useful and safe treatment for unresectable primary TACC.
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Affiliation(s)
- Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Yuki Sakazaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Jun Sasaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Masaki Tominaga
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Etsuyo Ogou
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
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46
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Saetti R, Ronzani G, Meneghesso S, Silvestrini M. Operative technique: Tracheal resection and anastomosis in a revision surgery. Head Neck 2023; 45:2730-2734. [PMID: 37477351 DOI: 10.1002/hed.27468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023] Open
Abstract
Tracheal stenosis is an uncommon pathological condition in which the lumen of the trachea is reduced. Within its management an adequate preoperative workup is crucial to determine the most appropriate procedure for each patient. In this scenario tracheal resection and anastomosis is a viable approach, as a procedure in which part of the trachea is removed and then restored with a tension-free anastomosis. It is usually indicated for extensive and high-grade lesions or when previous endoscopic procedures had failed. The patient here presented had already undergone a balloon dilatation twice and a tracheal resection and referred to our clinic with a residual tracheal stenosis graded Myer-Cotton 3 involving three tracheal rings. We here illustrate step-by-step the surgical procedure and highlight a peculiar way to perform the anastomosis, especially in a revision surgery.
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Affiliation(s)
- Roberto Saetti
- Department of Otolaryngology, Ospedale San Bortolo, Vicenza, Italy
| | - Guglielmo Ronzani
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Verona, University of Verona, Verona, Italy
| | - Stefano Meneghesso
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Verona, University of Verona, Verona, Italy
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覃 时, 魏 东, 徐 晨, 苏 同, 雷 大. [A case of pediatric tracheal inflammatory myofibroblastic tumor]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:840-842. [PMID: 37828892 PMCID: PMC10803238 DOI: 10.13201/j.issn.2096-7993.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Indexed: 10/14/2023]
Abstract
Inflammatory myofibroblastic tumor is a rare tumor of mesenchymal origin. A case of intratracheal inflammatory myofibroblastic tumor in a male child was reported. The clinical characteristics, diagnosis, treatment and prognosis of the disease were reviewed based on the literature, and a differential diagnosis between inflammatory myofibroblastic tumor and hamartoma was performed to ultimately confirm the nature of the tumor in the child.
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Affiliation(s)
- 时超 覃
- 山东大学齐鲁医院耳鼻咽喉科 国家卫生健康委员会耳鼻喉科学重点实验室(山东大学)(济南,250012)Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology[Shandong University], Ji'nan, 250012, China
| | - 东敏 魏
- 山东大学齐鲁医院耳鼻咽喉科 国家卫生健康委员会耳鼻喉科学重点实验室(山东大学)(济南,250012)Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology[Shandong University], Ji'nan, 250012, China
| | - 晨阳 徐
- 山东大学齐鲁医院耳鼻咽喉科 国家卫生健康委员会耳鼻喉科学重点实验室(山东大学)(济南,250012)Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology[Shandong University], Ji'nan, 250012, China
| | - 同东 苏
- 山东大学齐鲁医院耳鼻咽喉科 国家卫生健康委员会耳鼻喉科学重点实验室(山东大学)(济南,250012)Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology[Shandong University], Ji'nan, 250012, China
| | - 大鹏 雷
- 山东大学齐鲁医院耳鼻咽喉科 国家卫生健康委员会耳鼻喉科学重点实验室(山东大学)(济南,250012)Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology[Shandong University], Ji'nan, 250012, China
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48
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Nicholas GE, Dahl JP, Otjen JP, Richardson CM. Tracheal Mirror Image Artifact in Patients With Normal and Pathologic Tracheas. Otolaryngol Head Neck Surg 2023; 169:1080-1082. [PMID: 36883989 PMCID: PMC10485171 DOI: 10.1002/ohn.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 03/09/2023]
Abstract
Ultrasonography is gaining popularity as a diagnostic imaging modality for airway pathology. Tracheal ultrasound (US) has several nuances that are important for clinicians, including imaging artifacts, which can be mistaken for pathology. Tracheal mirror image artifacts (TMIAs) occur when the US beam is reflected back to the transducer in a nonliner direction or with multiple timesteps. It has previously been believed that the convexity of the tracheal cartilage prevents mirror image artifacts, but in reality, the air column acts as an acoustic mirror and causes TMIA. We describe a cohort of patients with both normal and pathologic tracheas, all of whom have TMIA on the tracheal US. These artifacts are important to recognize, especially as the airway US becomes more commonplace.
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Affiliation(s)
- Grace E Nicholas
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - John P Dahl
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Jeffrey P Otjen
- Department of Pediatric Radiology, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Clare M Richardson
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Phoenix Children's Hospital, Phoenix, Arizona, USA
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49
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Mikami E, Nakamichi S, Nagano A, Misawa K, Hayashi A, Tozuka T, Takano N, Noro R, Maebayashi K, Kubokura H, Terasaki Y, Kubota K, Seike M. Successful Treatment with Definitive Concurrent Chemoradiotherapy Followed by Durvalumab Maintenance Therapy in a Patient with Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2731-2735. [PMID: 36642523 PMCID: PMC10569923 DOI: 10.2169/internalmedicine.1142-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/04/2022] [Indexed: 01/15/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare type of malignant tracheal tumor originating from the secretory glands. Complete surgical resection is the current standard of care for tracheal ACC. However, there have been few case reports of chemoradiotherapy for unresectable tracheal ACC. We herein report a 28-year-old man with unresectable tracheal ACC who received concurrent chemoradiotherapy (CCRT) followed by maintenance therapy with durvalumab. CCRT was completed with a good response and safety, and the patient is currently receiving durvalumab as maintenance therapy. Durvalumab after CCRT can be a treatment option for patients with unresectable tracheal ACC.
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Affiliation(s)
- Erika Mikami
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Atsuhiro Nagano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Kazuhito Misawa
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Anna Hayashi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Takehiro Tozuka
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Natsuki Takano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Rintaro Noro
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Katsuya Maebayashi
- Department of Radiology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Hirotoshi Kubokura
- Department of Thoracic Surgery, Graduate School of Medicine, Nippon Medical School Musashikosugi Hospital, Japan
| | - Yasuhiro Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
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Daboussi S, Saidane A, Mhamdi S, boubaker N, Mariem C, Aichaouia C, Hela G, Msadek F, Zied M. Case Report: Tracheal infiltration with wheezing revealing Hodgkin's disease. F1000Res 2023; 12:404. [PMID: 37767019 PMCID: PMC10521064 DOI: 10.12688/f1000research.130928.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Hodgkin's disease with an initial tracheobronchial involvement is not common. The symptoms might be misleading, resulting in a diagnosis delay. We report the case of a 38-year-old woman with a one-month history of wheezing associated with a dry cough. The physical examination revealed a good general state of health, bilateral wheezing and supra-clavicular lymphadenopathy. The adenopathy biopsy's histopathology revealed Hodgkin lymphoma. The whole body FDG-PET scan was an important tool to assess the diagnosis as well as for the staging. The patient was treated with chemotherapy. Another unusual aspect is the tracheobronchial metastasis confirmed by a bronchial biopsy. Thus, our patient was put on a second-line chemotherapy. She died one year after the initial diagnosis. To conclude, it is an atypical clinical presentation of an Hodgkin lymphoma with a tracheobronchial relapse. It should be considered in the differential diagnosis of asthma or a tracheal tumor.
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Affiliation(s)
- Selsabil Daboussi
- University of Tunis El Manar, Tunis, Tunisia
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Asma Saidane
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Samira Mhamdi
- University of Tunis El Manar, Tunis, Tunisia
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Nouha boubaker
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Chaabane Mariem
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Chiraz Aichaouia
- University of Tunis El Manar, Tunis, Tunisia
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
| | - Ghedira Hela
- University of Tunis El Manar, Tunis, Tunisia
- Hematology Department, Military hospital of Tunis,, Tunis, 10008, Tunisia
| | - Fehmi Msadek
- University of Tunis El Manar, Tunis, Tunisia
- Hematology Department, Military hospital of Tunis,, Tunis, 10008, Tunisia
| | - Moetemri Zied
- University of Tunis El Manar, Tunis, Tunisia
- Pneumology Department, Military Hospital of Tunis, Tunisia, 1008, Tunisia
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