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1.
Artigo em Chinês | MEDLINE | ID: mdl-34628839

RESUMO

Objective:To investigate the application and efficacy of pedicled middle turbinate mucosal flap in transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. Methods:15 patients with cerebrospinal fluid rhinorrhea were retrospectively analyzed,including 13 patients with simple cerebrospinal fluid rhinorrhea (86.7%) and 2 patients with cerebrospinal fluid rhinorrhea with meningoencephalocele (13.3%). According to the location of the fistula, the pedicled middle turbinate mucosal flap under nasal endoscopy was used to repair cerebrospinal fluid rhinorrhea, in which 5 cases (33.3%) had leakage at the top of the sieve and 8 cases (53.3%) had leakage at the sieve plate. Two cases had leakage at the lateral racess of sphenoid sinus. Results:All cases of cerebrospinal fluid rhinorrhea were repaired successful and the mucosa epithelialized well in the operative area. There was no recurrence of cerebrospinal fluid rhinorrhea or other complications during the follow-up period of 4-24 months (average 13 months). Conclusion:The pedicled middle turbinate mucosal flap has a high success rate for repairing cerebrospinal fluid rhinorrhea, and the nasal cavity damage is small, which is worthy of clinical promotion.


Assuntos
Rinorreia , Conchas Nasais , Endoscopia , Humanos , Membrana Mucosa , Estudos Retrospectivos , Conchas Nasais/cirurgia
2.
Viruses ; 13(8)2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34452415

RESUMO

The emergence and ensuing dominance of COVID-19 on the world stage has emphasized the urgency of efficient animal models for the development of therapeutics for and assessment of immune responses to SARS-CoV-2 infection. Shortcomings of current animal models for SARS-CoV-2 include limited lower respiratory disease, divergence from clinical COVID-19 disease, and requirements for host genetic modifications to permit infection. In this study, n = 12 specific-pathogen-free domestic cats were infected intratracheally with SARS-CoV-2 to evaluate clinical disease, histopathologic lesions, and viral infection kinetics at 4 and 8 days post-inoculation; n = 6 sham-inoculated cats served as controls. Intratracheal inoculation of SARS-CoV-2 produced a significant degree of clinical disease (lethargy, fever, dyspnea, and dry cough) consistent with that observed in the early exudative phase of COVID-19. Pulmonary lesions such as diffuse alveolar damage, hyaline membrane formation, fibrin deposition, and proteinaceous exudates were also observed with SARS-CoV-2 infection, replicating lesions identified in people hospitalized with ARDS from COVID-19. A significant correlation was observed between the degree of clinical disease identified in infected cats and pulmonary lesions. Viral loads and ACE2 expression were also quantified in nasal turbinates, distal trachea, lungs, and other organs. Results of this study validate a feline model for SARS-CoV-2 infection that results in clinical disease and histopathologic lesions consistent with acute COVID-19 in humans, thus encouraging its use for future translational studies.


Assuntos
COVID-19 , Gatos , Modelos Animais de Doenças , SARS-CoV-2/fisiologia , Enzima de Conversão de Angiotensina 2/metabolismo , Animais , COVID-19/patologia , COVID-19/fisiopatologia , COVID-19/virologia , Feminino , Genoma Viral , Humanos , Pulmão/enzimologia , Pulmão/patologia , Pulmão/virologia , Linfonodos/virologia , Masculino , RNA Viral/análise , SARS-CoV-2/genética , Organismos Livres de Patógenos Específicos , Traqueia/enzimologia , Traqueia/virologia , Conchas Nasais/enzimologia , Conchas Nasais/virologia
3.
Viruses ; 13(8)2021 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-34452527

RESUMO

CONTEXT: The Global Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic has resulted in explosive patterns of transmission in most countries. Nasopharyngeal swabs were the specimen's collection tools recommended for the diagnosis of SARS-CoV-2 infection, and for monitoring infection outbreaks in communities. Our objective was to report the quality and efficacy of unsupervised self-collected mid turbinate "dry FLOQSwabs" (MT FLOQSwabs) (56380CS01, Copan). There were 111 specimens collected for the study: 36 by health care personnel, from themselves, to verify the quality and efficacy of mid-turbinate swabs; 75 to compare and assess the diagnostic performance, among health care personnel, of nasopharyngeal swabs and self-collected mid-turbinate FLOQSwabs. A collection of 51 specimens was enrolled to define the efficacy of the Testami program (validation). Our analyses demonstrate that self-collected mid-turbinate dry swabs ensure an accuracy of 97.3%, as compared to the standard nasopharyngeal swabs collected by health care workers. Furthermore, the mid-turbinate FLOQSwabs can be stored without medium for six days at room temperature without affecting the molecular diagnosis of the SARS-CoV-2 virus infection. Self-collection of diagnostic specimens at home could offer an avenue to increase testing availability for SARS-CoV-2 infection without asking people to travel to a clinic or a laboratory, thus reducing people's exposure to infection. Our findings demonstrate that unsupervised self-collection swabs, transported dry, are sensitive, practical and easy-to-use tools and should be considered for diagnosis of SARS-COV-2 and coronavirus disease 2019 (COVID-19) surveillance.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , Manejo de Espécimes , Conchas Nasais/virologia , Humanos , Nasofaringe/virologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Manejo de Espécimes/instrumentação , Manejo de Espécimes/métodos
4.
A A Pract ; 15(8): e01502, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34403375

RESUMO

Adenotonsillectomies are one of the most common otolaryngologic surgeries performed to alleviate obstructive sleep-disordered breathing and apnea in children. The pain management following adenotonsillectomy continues to be a challenge for both pediatric anesthesiologists and otolaryngologists due to the mortality that stems from the use of opioid pain medications in children who have an increased baseline risk airway obstruction and apnea that is exacerbated by any exposure to opioids. We present a case utilizing bilateral suprazygomatic maxillary nerve (SZMN) blocks or, more accurately, suprazygomatic infratemporal-pterygopalatine fossa injections to achieve opioid-free perioperative analgesia for pediatric adenotonsillectomy with nasal turbinate reduction.


Assuntos
Analgésicos Opioides , Tonsilectomia , Analgésicos Opioides/uso terapêutico , Criança , Humanos , Dor Pós-Operatória/tratamento farmacológico , Fossa Pterigopalatina , Conchas Nasais
7.
J Virol ; 95(19): e0101921, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34287044

RESUMO

Based on our previous studies, we show that the M gene is critical for the replication and pathogenicity of the chimeric H17 bat influenza virus (Bat09:mH1mN1) by replacing the bat M gene with those from human and swine influenza A viruses. However, the key amino acids of the M1 and/or M2 proteins that are responsible for virus replication and pathogenicity remain unknown. In this study, replacement of the PR8 M gene with the Eurasian avian-like M gene from the A/California/04/2009 pandemic H1N1 virus significantly decreased viral replication in both mammalian and avian cells in the background of the chimeric H17 bat influenza virus. Further studies revealed that M1 was more crucial for viral growth and pathogenicity than M2 and that the amino acid residues M1-41V and M2-27A were responsible for these characteristics in cells and in mice. These key residues of the M1 and M2 proteins identified in this study might be important for influenza virus surveillance and could be used to produce live attenuated vaccines in the future. IMPORTANCE The M1 and M2 proteins influence the morphology, replication, virulence, and transmissibility of influenza viruses. Although a few key residues in the M1 and M2 proteins have been identified, whether other residues of the M1 and M2 proteins are involved in viral replication and pathogenicity remains to be discovered. In the background of the chimeric H17 bat influenza virus, the Eurasian avian-like M gene from the A/California/04/2009 virus significantly decreased viral growth in mammalian and avian cells. Further study showed that M1 was implicated more than M2 in viral growth and pathogenicity in vitro and in vivo and that the key amino acid residues M1-41V and M2-27A were responsible for these characteristics in cells and in mice. These key residues of the M1 and M2 proteins could be used for influenza virus surveillance and live attenuated vaccine applications in the future. These findings provide important contributions to knowledge of the genetic basis of the virulence of influenza viruses.


Assuntos
Vírus da Influenza A Subtipo H1N1/genética , Infecções por Orthomyxoviridae/virologia , Orthomyxoviridae/crescimento & desenvolvimento , Orthomyxoviridae/patogenicidade , Proteínas da Matriz Viral/metabolismo , Aminoácidos/metabolismo , Animais , Linhagem Celular , Quirópteros , Genes Virais , Humanos , Pulmão/virologia , Camundongos , Orthomyxoviridae/genética , Vírus Reordenados/genética , Vírus Reordenados/crescimento & desenvolvimento , Vírus Reordenados/patogenicidade , Conchas Nasais/virologia , Proteínas da Matriz Viral/química , Proteínas da Matriz Viral/genética , Virulência , Replicação Viral
8.
Diagn Microbiol Infect Dis ; 101(2): 115469, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34280773

RESUMO

Alternatives to nasopharyngeal sampling are needed to increase capacity for SARS-CoV-2 testing. Among 275 participants, we piloted the collection of nasal mid-turbinate swabs amenable to self-testing, including polyester flocked swabs as well as 3D-printed plastic lattice swabs, placed into viral transport media or an RNA stabilization agent. Flocked nasal swabs identified 104/121 individuals who were PCR-positive for SARS-CoV-2 by nasopharyngeal sampling (sensitivity 87%, 95% CI 79-92%), missing those with low viral load (<106 viral copies/mL). 3D-printed nasal swabs showed similar sensitivity. When nasal swabs were placed directly into RNA preservative, the mean 1.4 log decrease in viral copies/uL compared to nasopharyngeal samples was reduced to <1 log, even when samples were left at room temperature for up to 7 days. We also evaluated pooling strategies that involved pooling specimens in the lab versus pooling swabs at the point of collection, finding both successfully detected samples with >105 viral copies/mL.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , Recursos em Saúde/provisão & distribuição , Humanos , Limite de Detecção , Nasofaringe/virologia , RNA Viral/genética , SARS-CoV-2/genética , Autoteste , Manejo de Espécimes/instrumentação , Manejo de Espécimes/métodos , Conchas Nasais/virologia , Carga Viral
9.
Vestn Otorinolaringol ; 86(3): 66-71, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34269027

RESUMO

After septoplasty procedure and removing of nasal packing, numerous symptoms usually appear that result from inflammation. OBJECTIVE: To evaluate the effect of nasal spray Polydexa with phenylephrine on the postoperative period and bacterial contamination in the nasal cavity after septoplasty and inferior turbinectomy. MATERIAL AND METHODS: There were 40 people observed, who underwent septoplasty and inferior turbinectomy followed by nasal packing. RESULTS: After removing the tampons from the nasal cavity, the growth of coagulase-negative staphylococci was most often observed in 50%, Enterococcus faecalis - 22.5%, Staphylococcus aureus - 20.0%. In patients who received intranasally Polydexa with phenylephrine drug in the postoperative period, we observed decrease in inflammation in the nasal cavity, an improvement in the quality of life, as well as a significant (p<0.05) decrease in bacterial growth (both in the presence of flora and in intensity growth of microorganisms). The absence of intranasal antibacterial drugs in the scheme of postoperative management of patients contributes to the growth of pathogenic flora, in particular S. aureus.


Assuntos
Rinoplastia , Staphylococcus aureus , Humanos , Septo Nasal/cirurgia , Qualidade de Vida , Rinoplastia/efeitos adversos , Conchas Nasais/cirurgia
10.
Vestn Otorinolaringol ; 86(3): 78-83, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34269029

RESUMO

OBJECTIVE: To determine the impact of various types of unilateral nasal septum deviation (NSD), concha bullosa (CB) and hypertrophic inferior turbinate (HIT) on the development of sinusitis. MATERIAL AND METHODS: This study was conducted in the Irkutsk State Medical University and the Irkutsk City Clinical Hospital No. 1 from October 2017 to November 2018. By continuous sampling retrospective analysis of 1300 protocols of paranasal sinuses MSCT of adult patients was performed. We used MSCT scanners Somatom Emotion 16 Siemens and GE BrightSpeed 16. The studies were carried out on the patients lying on the back with the subsequent reconstruction on a graphical station in the coronal and axial projections using the slices around 1 mm in the thickness. Inclusion criteria: unilateral or absence NSD. Exclusion criteria: bilateral NSD, chronic polyposis or allergic rhinitis. We have analyzed 272 protocols: 70 without NSD and 172 with unilateral NSD, on the right side - 89 (52%) and on the left - 83 (48%). 108 (44.6%) patients were male and 134 (55.4%) were female with average age 38.5±12 years. All patients were divided into 4 groups by R. Mladina' classification (1987): with NSD types 1, 2, 3, and 5. The results were evaluated using the Yates corrected chi-square and the Fisher's exact test by Statistica 10.0. RESULTS: There were 34 patients with NSD type 1: 12 with sinusitis; 9 had CB: 6 with sinusitis, 3 without it; HIT was in 27 cases: 33% with sinusitis, 67% without it. There were 69 patients with NSD type 2: 12 had sinusitis; 22 had CB: 5 with sinusitis, 17 without it; HIT was in 42 cases: 26% with sinusitis, 74% without it. There were 43 patients with NSD type 3: 26 had sinusitis; 15 had CB: 6 with sinusitis, 9 without it; 30 had HIT: 57% with sinusitis, 43% without it. There were 26 patients with NSD type 5: 11 had sinusitis; 9 had CB: 3 with sinusitis, 6 without it; 24 had HIT: 42% with sinusitis, 58% without it. NSD type 2 was statistically significant prevailed in patients without sinusitis (p=0.000005); NSD type 3 (p=0.03) and the combination of NSD type 1 with contralateral CB (p=0.04) prevailed in patients with sinusitis. CONCLUSION: NSD type 3 (by R. Mladina), as well as the combination of type 1 with contralateral CB are have influence to the development of sinusitis. CB and HIT are statistically significant prevailed on the contralateral side to unilateral NSD, but do not affect to development of sinusitis.


Assuntos
Sinusite , Conchas Nasais , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/diagnóstico por imagem , Estudos Retrospectivos , Sinusite/diagnóstico , Sinusite/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Conchas Nasais/diagnóstico por imagem
11.
Sci Rep ; 11(1): 14903, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34290378

RESUMO

The impact of repeated sample collection on COVID-19 test performance is unknown. The FDA and CDC currently recommend the primary collection of diagnostic samples to minimize the perceived risk of false-negative findings. We therefore evaluated the association between repeated sample collection and test performance among 325 symptomatic patients undergoing COVID-19 testing in Atlanta, GA. High concordance was found between consecutively collected mid-turbinate samples with both molecular (n = 74, 100% concordance) and antigen-based (n = 147, 97% concordance, kappa = 0.95, CI = 0.88-1.00) diagnostic assays. Repeated sample collection does not decrease COVID-19 test performance, demonstrating that multiple samples can be collected for assay validation and clinical diagnosis.


Assuntos
Teste para COVID-19/métodos , COVID-19/diagnóstico , COVID-19/virologia , SARS-CoV-2/isolamento & purificação , Manejo de Espécimes/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Conchas Nasais/virologia
12.
Stem Cell Res Ther ; 12(1): 402, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256823

RESUMO

BACKGROUND: Stem cell transplantation is a fascinating therapeutic approach for the treatment of many neurodegenerative disorders; however, clinical trials using stem cells have not been as effective as expected based on preclinical studies. The aim of this study is to validate the hypothesis that human neural crest-derived nasal turbinate stem cells (hNTSCs) are a clinically promising therapeutic source of adult stem cells for the treatment of Alzheimer's disease (AD). METHODS: hNTSCs were evaluated in comparison with human bone marrow-derived mesenchymal stem cells (hBM-MSCs) according to the effect of transplantation on AD pathology, including PET/CT neuroimaging, immune status indicated by microglial numbers and autophagic capacity, neuronal survival, and cognition, in a 5 × FAD transgenic mouse model of AD. RESULTS: We demonstrated that hNTSCs showed a high proliferative capacity and great neurogenic properties in vitro. Compared with hBM-MSC transplantation, hNTSC transplantation markedly reduced Aß42 levels and plaque formation in the brains of the 5 × FAD transgenic AD mice on neuroimaging, concomitant with increased survival of hippocampal and cortex neurons. Moreover, hNTSCs strongly modulated immune status by reducing the number of microglia and the expression of the inflammatory cytokine IL-6 and upregulating autophagic capacity at 7 weeks after transplantation in AD models. Notably, compared with transplantation of hBM-MSCs, transplantation of hNTSCs significantly enhanced performance on the Morris water maze, with an increased level of TIMP2, which is necessary for spatial memory in young mice and neurons; this difference could be explained by the high engraftment of hNTSCs after transplantation. CONCLUSION: The reliable evidence provided by these findings reveals a promising therapeutic effect of hNTSCs and indicates a step forward the clinical application of hNTSCs in patients with AD.


Assuntos
Doença de Alzheimer , Transplante de Células-Tronco Mesenquimais , Adulto , Doença de Alzheimer/terapia , Animais , Cognição , Modelos Animais de Doenças , Humanos , Camundongos , Camundongos Transgênicos , Crista Neural , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Células-Tronco , Conchas Nasais
13.
J Pediatric Infect Dis Soc ; 10(8): 872-879, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34173660

RESUMO

BACKGROUND: Nasopharyngeal (NP) specimen testing by reverse transcriptase polymerase chain reaction (RT-PCR) is the standard of care for detecting SARS-CoV-2. Data comparing the sensitivity and specificity of the NP specimen to the less invasive, mid-turbinate (MT) nasal specimen in children are limited. METHODS: Paired clinical NP and research MT specimens were collected from children <18 years with respiratory symptoms and tested by molecular assays to detect SARS-CoV-2 RNA. Sensitivity, specificity, and agreement (Cohen's kappa [κ]) were calculated for research MT specimens compared to the clinical NP specimens. RESULTS: Out of 907 children, 569 (62.7%) had parental consent and child assent when appropriate to participate and provided paired MT and NP specimens a median of 4 days after symptom onset (range 1-14 days). 16.5% (n = 94) of MT specimens were positive for SARS-CoV-2 compared with 20.0% (n = 114) of NP specimens. The sensitivity of research MT compared to clinical NP specimens was 82.5% (95% CI: 74.2%, 88.9%), specificity was 100.0% (95% CI: 99.2%, 100.0%), and overall agreement was 96.1% (κ = 0.87). The sensitivity of MT specimens decreased with time from 100% (95% CI: 59.0%, 100.0%) on day 1 of illness to 82.1% (95% CI: 73.8%, 88.7%) within 14 days of illness onset; sensitivity was generally >90% when specimens were collected within the first week of illness. CONCLUSION: MT specimens, particularly those collected within the first week of illness, have moderately reduced sensitivity and equivalent specificity to less-tolerated NP specimens in pediatric outpatients. MT specimen use in children may represent a viable alternative to NP specimen collection.


Assuntos
COVID-19 , SARS-CoV-2 , Criança , Humanos , Pacientes Ambulatoriais , RNA Viral , Conchas Nasais
14.
Front Immunol ; 12: 683902, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34163482

RESUMO

Respiratory syncytial virus (RSV) is a public health concern that causes acute lower respiratory tract infection. So far, no vaccine candidate under development has reached the market and the only licensed product to prevent RSV infection in at-risk infants and young children is a monoclonal antibody (Synagis®). Polyclonal human anti-RSV hyper-immune immunoglobulins (Igs) have also been used but were superseded by Synagis® owing to their low titer and large infused volume. Here we report a new drug class of immunoglobulins, derived from human non hyper-immune plasma that was generated by an innovative bioprocess, called Ig cracking, combining expertises in plasma-derived products and affinity chromatography. By using the RSV fusion protein (F protein) as ligand, the Ig cracking process provided a purified and concentrated product, designated hyper-enriched anti-RSV IgG, composed of at least 15-20% target-specific-antibodies from normal plasma. These anti-RSV Ig displayed a strong in vitro neutralization effect on RSV replication. Moreover, we described a novel prophylactic strategy based on local nasal administration of this unique hyper-enriched anti-RSV IgG solution using a mouse model of infection with bioluminescent RSV. Our results demonstrated that very low doses of hyper-enriched anti-RSV IgG can be administered locally to ensure rapid and efficient inhibition of virus infection. Thus, the general hyper-enriched Ig concept appeared a promising approach and might provide solutions to prevent and treat other infectious diseases. Importance: Respiratory Syncytial Virus (RSV) is the major cause of acute lower respiratory infections in children, and is also recognized as a cause of morbidity in the elderly. There are still no vaccines and no efficient antiviral therapy against this virus. Here, we described an approach of passive immunization with a new class of hyper-enriched anti-RSV immunoglobulins (Ig) manufactured from human normal plasma. This new class of immunoglobulin plasma derived product is generated by an innovative bioprocess, called Ig cracking, which requires a combination of expertise in both plasma derived products and affinity chromatography. The strong efficacy in a small volume of these hyper-enriched anti-RSV IgG to inhibit the viral infection was demonstrated using a mouse model. This new class of immunoglobulin plasma-derived products could be applied to other pathogens to address specific therapeutic needs in the field of infectious diseases or even pandemics, such as COVID-19.


Assuntos
Anticorpos Antivirais/administração & dosagem , Imunização Passiva , Imunoglobulina G/administração & dosagem , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Vírus Sincicial Respiratório Humano/imunologia , Administração Intranasal , Animais , Anticorpos Antivirais/imunologia , Anticorpos Antivirais/isolamento & purificação , Modelos Animais de Doenças , Humanos , Imunoglobulina G/imunologia , Imunoglobulina G/isolamento & purificação , Pulmão/efeitos dos fármacos , Pulmão/virologia , Testes de Neutralização , Infecções por Vírus Respiratório Sincicial/virologia , Conchas Nasais/efeitos dos fármacos , Conchas Nasais/virologia , Proteínas Virais de Fusão/imunologia , Replicação Viral/efeitos dos fármacos
17.
Acta Chir Plast ; 63(1): 6-13, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34034490

RESUMO

Nasal basal cell carcinomas are the most common malignant tumors of the facial skin, which predilectively affect areas exposed to sunlight, including the nasal area. After their radical removal, there is a variable complex defect of the affected area (defect of all 3 layers of the nose) or even a composite defect (it also occupies the adjacent soft tissues around the nose), which are usually used to reconstruct this area. A 73-year-old female patient with recurrent infiltrative basal cell carcinoma of the left nasal ala underwent four re-excisions before histologically verified free margins without the presence of the tumor. The result was a composite defect that occupied the top of the dome of the right nostril, the entire left half of the soft nose, including the base of the wing, part of the upper lip, and a defect of the adjacent face area of 9 × 5cm. In the first phase, the left cheek and upper lip were reconstructed by advancement French plasty and coverage of the two residual skin defects with full-thickness skin graft. One month later, during the second phase of reconstruction, the flap was re-elevated, shifted and rotated, and a three-stage nasal reconstruction was started using a composite septal pivotal flap and left turbinate flap for inner lining reconstruction, and the nasal skeleton was reconstructed with a cartilaginous L-graft from the 6th rib, septal and conchal cartilages. The skin cover of the nose was reconstructed with the left paramedian forehead flap, which was thinned during the second stage with the simultaneous widening of the bottom of the left nostril by the transposition flap, during the third stage the flap pedicle was removed. In the reconstruction of a complex defect of the nose and its surroundings, it is first necessary to create a stable platform on which the reconstruction of the nose itself will be performed. To achieve an excellent functional and aesthetic result of nose reconstruction, it is appropriate to use a three-stage forehead flap. In this paper, we describe a unique method of nasal reconstruction - a combination of a septal pivotal flap with a turbinate flap to reconstruct the inner lining in conjunction with an L-graft to ensure a stable nasal skeleton and forehead flap to reconstruct the skin cover.


Assuntos
Neoplasias Nasais , Rinoplastia , Neoplasias Cutâneas , Idoso , Feminino , Testa/cirurgia , Humanos , Neoplasias Nasais/cirurgia , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos , Conchas Nasais
19.
BMC Oral Health ; 21(1): 206, 2021 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-33894757

RESUMO

BACKGROUND: In individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT). METHODS: The CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined. RESULTS: A significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD. CONCLUSION: The results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.


Assuntos
Tomografia Computadorizada por Raios X , Conchas Nasais , Tomografia Computadorizada de Feixe Cônico , Humanos , Cavidade Nasal , Septo Nasal/diagnóstico por imagem , Conchas Nasais/diagnóstico por imagem
20.
Biochem Biophys Res Commun ; 554: 173-178, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-33798944

RESUMO

Neural crest-derived cells (NCDCs), a class of adult stem cells not restricted to embryonic tissues, are attractive tissue regenerative therapy candidates because of their ease of isolation, self-renewing properties, and multipotency. Although adult NCDCs can undergo osteogenic differentiation in vitro, whether they induce bone formation in vivo remains unclear. Previously, our group reported findings showing high amounts of NCDCs scattered throughout nasal concha tissues of adult mice. In the present study, NCDCs in nasal conchae labeled with enhanced green fluorescent protein (EGFP) were collected from adult P0-Cre/CAG-CAT-EGFP double transgenic mice, then cultured in serum-free medium to increase the number. Subsequently, NCDCs were harvested and suspended in type I atelocollagen gel, then an atelocollagen sponge was used as a scaffold for the cell suspension. Atelocollagen scaffolds with NCDCs were placed on bone defects created in a mouse calvarial bone defect model. Over the ensuing 12 weeks, micro-CT and histological analysis findings showed that mice with scaffolds containing NCDCs had slightly greater bone formation as compared to those with a scaffold alone. Furthermore, Raman spectroscopy revealed spectral properties of bone in mice that received scaffolds with NCDCs similar to those of native calvarial bone. Bone regeneration is important not only for gaining bone mass but also chemical properties. These results are the first to show the validity of biomolecule-free adult nasal concha-derived NCDCs for bone regeneration, including the chemical properties of regenerated bone tissue.


Assuntos
Células-Tronco Adultas/citologia , Regeneração Óssea/fisiologia , Crista Neural/citologia , Transplante de Células-Tronco/métodos , Conchas Nasais/citologia , Células-Tronco Adultas/metabolismo , Animais , Diferenciação Celular , Células Cultivadas , Modelos Animais de Doenças , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Camundongos , Camundongos Endogâmicos ICR , Camundongos Transgênicos , Crista Neural/metabolismo , Conchas Nasais/metabolismo
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