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1.
Life Sci ; 250: 117552, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32179074

RESUMO

AIMS: This study aimed to explore the possible mechanism of trauma-induced laryngotracheal stenosis and potential protective and therapeutic efficacy of quercetin on trauma-induced laryngotracheal stenosis. MAIN METHODS: The expression and activity of fibrotic factors [interleukin (IL)-6, IL-8, autophagy related 5 (ATG5), collagen (COL)-1, tumor growth factor (TGF)-ß COL-3, microtubule-associated proteins 1A/1B light chain 3A (LC3), and vascular endothelial growth factor (VEGF)] and fibrotic signaling mediators [mammalian target of rapamycin (mTOR) and phosphorylated AKT (pAKT)] were detected by real-time quantitative PCR (qRT-PCR), ELISA, Western blot, and immunohistochemical staining, respectively, in the lipopolysaccharide (LPS)-induced WI-38 (a human embryonic lung fibroblast cell line) cellular fibrotic model and a trauma-induced rabbit tracheal stenosis model, with and without quercetin treatment. KEY FINDINGS: Pre-treatment with quercetin significantly reversed the LPS-induced upregulation of pro-fibrotic factors (IL-6, IL-8, COL-1, COL-3, LC3) and fibrotic signaling mediators (mTOR and AKT), and it induced the downregulation of ATG5 in the WI-38 cells. Furthermore, the anti-fibrotic activity of quercetin was confirmed in the trauma-induced rabbit tracheal stenosis model. Thus, the nasogastric administration of quercetin attenuated the tracheal stenosis of the rabbit tracheal stenosis model, in addition to effectively reversing an increase in pro-fibrotic factors (VEGF, IL-6, TGF-ß, COL-1, and COL-3) and fibrotic signaling mediators (mTOR and AKT), as well as downregulating ATG5 of the rabbit tracheal stenosis model. SIGNIFICANCE: Quercetin exhibits anti-fibrotic activity by inhibiting pro-fibrotic factors and AKT/mTOR signaling pathway, in addition to activating autophagy activity. This study provided experimental evidence supporting the application of quercetin in tracheal stenosis, clinically.


Assuntos
Proteínas Proto-Oncogênicas c-akt/metabolismo , Quercetina/farmacologia , Serina-Treonina Quinases TOR/metabolismo , Traqueia/efeitos dos fármacos , Fator de Crescimento Transformador beta/metabolismo , Animais , Anti-Inflamatórios/farmacologia , Autofagia , Linhagem Celular , Sobrevivência Celular , Constrição Patológica/tratamento farmacológico , Regulação para Baixo , Feminino , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Humanos , Lipopolissacarídeos , Masculino , Coelhos , Transdução de Sinais , Traqueia/patologia
2.
BMC Infect Dis ; 20(1): 13, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31906888

RESUMO

BACKGROUND: The development of respiratory infections secondary to Aspergillus spp. spores found ubiquitously in the ambient environment is uncommon in immunocompetent patients. Previous reports of invasive upper airway aspergillosis in immunocompetent patients have generally demonstrated the efficacy of treatment regimens utilizing antifungal agents in combination with periodic endoscopic debridement, with symptoms typically resolving within months of initiating therapy. CASE PRESENTATION: A 43-year-old previously healthy female presented with worsening respiratory symptoms after failing to respond to long-term antibiotic treatment of bacterial sinusitis. Biopsy of her nasopharynx and trachea revealed extensive fungal infiltration and Aspergillus fumigatus was isolated on tissue culture. Several months of oral voriconazole monotherapy failed to resolve her symptoms and she underwent mechanical debridement for symptom control. Following transient improvement, her symptoms subsequently returned and failed to fully resolve in spite of increased voriconazole dosing and multiple additional tissue debridements over the course of many years. CONCLUSIONS: Invasive upper airway aspergillosis is exceedingly uncommon in immunocompetent patients. In the rare instances that such infections do occur, combinatorial voriconazole and endoscopic debridement is typically an efficacious treatment approach. However, some patients may continue to experience refractory symptoms. In such cases, continued aggressive treatment may potentially slow disease progression even if complete disease resolution cannot be achieved.


Assuntos
Antifúngicos/uso terapêutico , Desbridamento , Aspergilose Pulmonar Invasiva/terapia , Adulto , Antifúngicos/farmacologia , Aspergillus fumigatus/efeitos dos fármacos , Aspergillus fumigatus/isolamento & purificação , Terapia Combinada , Farmacorresistência Fúngica , Endoscopia , Feminino , Humanos , Aspergilose Pulmonar Invasiva/microbiologia , Nasofaringe/microbiologia , Nasofaringe/patologia , Nasofaringe/cirurgia , Traqueia/microbiologia , Traqueia/patologia , Traqueia/cirurgia , Resultado do Tratamento , Voriconazol/farmacologia , Voriconazol/uso terapêutico
3.
Cir. pediátr ; 33(1): 43-46, ene. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-186137

RESUMO

Introducción: Los quistes ductales subglóticos adquiridos (QDSA) son una causa rara de obstrucción de la vía aérea, sin consenso en la literatura en cuanto al tratamiento más eficaz. Presentamos nuestra experiencia en el tratamiento de los QDSA. Material y métodos: Estudio retrospectivo de los pacientes trata-dos en nuestro centro por QDSA en los últimos 5 años. Se recogieron los antecedentes de intubación, la clínica presentada, el tratamiento realizado, la evolución postquirúrgica, el seguimiento en consulta y los controles endoscópicos. Resultados: Se identificaron 4 pacientes, con unas medianas de edad y peso de 6,5 meses (6-8) y 5,9 kg (3,6-7), respectivamente. Todos presentaron antecedentes de intubación por intervenciones quirúrgicas, siendo prematuros 2 de ellos. La mediana entre la última intubación y el diagnóstico fue de 119,5 días (71-171). La clínica consistió en estridor bifásico con mejoría postural presentando una ocupación de la luz traqueal de más del 50% en la endoscopia diagnóstica. Se realizó escisión endoscópica (EE) al diagnóstico en 3 de los pacientes y como técnica de rescate en el cuarto por recidiva tras tratamiento con drenaje y dilatación con balón. La mediana de tiempo de intubación postquirúrgico fue de 13,5 horas (0-48) y la estancia hospitalaria de 7 días (6-9). Tras un seguimiento mediano de 17,5 meses (6-42) no se ha presentado ninguna recidiva. Conclusión: Los QDSA son una causa poco frecuente de estridor post-extubación. La EE permite un tratamiento eficaz con baja tasa de recidiva


Introduction: Subglottic cyst is a rare cause of airway obstruction, and there is a lack of evidence about the best treatment in the literature. This report describes our experience with endoscopic removal. Materials and methods: A retrospective study of all patients un-dergoing endoscopic removal of subglottic cyst at our healthcare facility between 2014 and 2019 was performed. Clinic and demographic data regarding gestational age, intubation, comorbidities, surgical procedures, first symptoms, endoscopic findings, treatment, and follow-up were collected. Results: Four patients were identified. Two out of four (50%) were preterm, and all patients were intubated during their neonatal period. Median age and weight at diagnosis were 6.5 months (6-8) and 5.9 kg (3.6-7). Median time between last intubation and diagnosis was 119.5 days (71-171). Biphasic stridor and progressive respiratory distress were the most common clinical symptoms. Airway obstruction of at least 50% was found during upper airway endoscopy in all patients. Endoscopic removal was performed as a first-line treatment in 3 patients, and as a second-line treatment in 1 patient. Median intubation time after treatment and hospital stay were 13.5 hours (0-48) and 7 days (6-9). All four pa-tients are free of disease, with a median follow-up of 17.5 months (6-42). Conclusion: Subglottic cyst is a rare cause of post-extubation stri-dor. Endoscopic removal seems to be a feasible and effective treatment with a low recurrence rate


Assuntos
Humanos , Masculino , Feminino , Lactente , Cistos/diagnóstico por imagem , Cistos/cirurgia , Glote/cirurgia , Endoscopia , Estudos Retrospectivos , Glote/diagnóstico por imagem , Cistos/patologia , Intubação , Tempo de Internação , Traqueia/patologia , Traqueia/cirurgia , Tomografia de Coerência Óptica
4.
Int J Vitam Nutr Res ; 90(1-2): 141-150, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30789805

RESUMO

Anti-inflammatory effect of Curcuma longa (C. longa) was shown previously. In the present study, the effect of the plant on tracheal responsiveness and lung pathological features in ovalbumin-sensitized rats was evaluated. Six groups of rats including control (C), ovalbumin (OVA)-sensitized (S), S groups treated with C. longa (CL; 0.75, 1.50, and 3.00 mg/ml equal to 150, 300 and 600 mg/kg/day) and dexamethasone (D; 1.25 µg/ml) were studied (n=8 in each group). The extract of C. longa and dexamethasone were administered with daily drinking water of animals during sensitization period (for 21 days). Following the treatment period, tracheal responsiveness to methacholine and ovalbumin and lung pathological features was investigated. Tracheal responsiveness to methacholine and OVA and lung pathological scores were increased in group S compared to controls (p<0.01 to p<0.001); however, these parameters in groups treated with dexamethasone and two higher concentrations of C. longa were significantly decreased compared to group S (p<0.05 to p<0.001). Tracheal responsiveness to methacholine was decreased from 50 to 400% due to the extract treatment. All concentrations of C. longa significantly decreased interstitial fibrosis compared to group S (p<0.05 to p<0.001). Treatment with the extract resulted to improvement of pathological changes from 20 to 70%. These results showed a preventive effect for C. longa extract on tracheal responsiveness and lung pathological insults in sensitized rats which were similar or even more than those of dexamethasone at used concentrations.


Assuntos
Curcuma , Pulmão/efeitos dos fármacos , Cloreto de Metacolina/farmacologia , Extratos Vegetais , Traqueia/efeitos dos fármacos , Animais , Pulmão/patologia , Cloreto de Metacolina/química , Ovalbumina , Extratos Vegetais/farmacologia , Ratos , Traqueia/patologia
6.
Medicine (Baltimore) ; 98(51): e18180, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860964

RESUMO

RATIONALE: Primary schwannoma is extremely rare in the trachea, and its optimal treatment has not yet been established. Previous literature have indicated that traditional resection by thoracotomy is an effective surgical procedure but with huge trauma, and endoscopic excision is a minimally invasive surgical method but with possibility of recurrence. Window resection was usually utilized for selected patients with trachea invasion by thyroid carcinoma, but video-assisted thoracoscopic window resection for trachea schwannoma has not been reported previously. PATIENT CONCERNS: A 23-year-old woman was admitted to hospital due to dyspnea, coughing and wheezing that had persisted for 2 months with aggravation for 1 week. DIAGNOSES: Chest computed tomography (CT) scan revealed a well-circumscribed soft-tissue mass located on the right lateral posterior wall of the trachea. Bronchofibroscopy (BFS) showed a whitish, smooth and round mass with a wide base in the trachea. Immunohistochemical staining demonstrated cells labeled with Vim (+), S-100 (+), SOX-10 (+), SMA (-), CK (-). Histopathological examinations showed that the mass was a schwannoma. INTERVENTIONS: The tumor was nearly completely excised via BFS, but relapsed 2 times at 12 days and 3 weeks after endoscopic resection. Finally, the patient underwent video-assisted thoracoscopic window resection of trachea. OUTCOMES: The patient recovered rapidly and no recurrence was observed over 6 months of follow-up. LESSONS: The treatment of tracheal schwannoma depends on the characteristics of tumor and the condition of patient. Surgical resection is a preferred alternative for sessile or transmural tumors and recurrence after endoscopic excision. Tracheal window resection by video-assisted thoracoscopy is beneficial for some appropriate patients with a small and sessile tumor.


Assuntos
Neurilemoma/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Neoplasias da Traqueia/cirurgia , Feminino , Humanos , Neurilemoma/diagnóstico , Neurilemoma/patologia , Tomografia Computadorizada por Raios X , Traqueia/patologia , Traqueia/cirurgia , Neoplasias da Traqueia/diagnóstico , Neoplasias da Traqueia/patologia , Adulto Jovem
7.
Cell Physiol Biochem ; 53(6): 1015-1028, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31854953

RESUMO

BACKGROUND/AIMS: Pulmonary infections with Pseudomonas aeruginosa (P. aeruginosa) or Staphylococcus aureus (S. aureus) are of utmost clinical relevance in patients with cystic fibrosis, chronic obstructive pulmonary disease, after trauma and burn, upon ventilation or in immuno-compromised patients. Many P. aeruginosa and S. aureus strains are resistant to many known antibiotics and it is very difficult or often impossible to eradicate the pathogens in patient´s lungs. We have recently shown that the sphingoid base sphingosine very efficiently kills many pathogens, including for instance P. aeruginosa, S. aureus or Acinetobacter baumannii, in vitro. In vivo experiments of our group on cystic fibrosis mice indicated that inhalation of sphingosine prevents or eliminates existing acute or chronic pneumonia with P. aeruginosa or S. aureus in these mice. We also demonstrated that sphingosine is safe to use for inhalation up to high doses, at least in mice. To facilitate development of sphingosine to an anti-bactericidal drug that can be used in humans for inhalation, safety data on non-rodents, larger animals are absolutely required. METHODS: Here, we inhaled mini pigs with increasing doses of sphingosine for 10 days and analyzed the uptake of sphingosine into epithelial cells of bronchi as well as into the trachea and lung and the systemic circulation. Moreover, we measured the generation of ceramide and sphingosine 1-phosphate that potentially mediate inflammation, the influx of leukocytes, epithelial cell death and disruption of the epithelial cell barrier. RESULTS: We demonstrate that inhalation of sphingosine results in increased levels of sphingosine in the luminal membrane of bronchi and the trachea, but not in systemic accumulation. Inhaled sphingosine had no side effects up to very high doses. CONCLUSION: In summary, we demonstrate that inhalation of sphingosine results in an increase of sphingosine concentrations in the luminal plasma membrane of tracheal and bronchial epithelial cells. The inhalation has no systemic or local side effects.


Assuntos
Antibacterianos/metabolismo , Esfingosina/metabolismo , Administração por Inalação , Animais , Antibacterianos/farmacologia , Brônquios/metabolismo , Brônquios/patologia , Ceramidas/análise , Humanos , Pulmão/patologia , Lisofosfolipídeos/análise , Espectrometria de Massas , Pseudomonas aeruginosa/efeitos dos fármacos , Esfingosina/análogos & derivados , Esfingosina/análise , Esfingosina/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Suínos , Porco Miniatura , Traqueia/metabolismo , Traqueia/patologia
8.
Khirurgiia (Mosk) ; (11): 5-12, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714523

RESUMO

OBJECTIVE: To analyze early and delayed results of various variants of circular tracheal resection (CTR) with anastomosis, to determine the safest approach, dates and conditions of correction, features of postoperative period in patients after previous tracheal surgery. MATERIAL AND METHODS: There were 831 patients with cicatricial tracheal stenosis. CTR was made in 330 (39.7%) patients. Most patients had previous prolonged ICU-stay. The patients were divided into 4 groups. Group 1 consisted of 61 (18.5%) patients after previous prolonged tracheal stenting. Group 2 included 45 (13.6%) patients who underwent circular tracheal resection with a functioning tracheostomy. Tracheostomy tube served as a stent in these patients. Group 3 enrolled 32 (9.7%) patients with previous staged reconstructive plastic surgeries on cranial segment of the respiratory tract. Tracheostomy or stent were absent in 192 (58.2%) patients who underwent circular tracheal resection at the first hospitalization. These patients were enrolled into the fourth (control) group. Favorable outcomes (without complications and mortality) were achieved in 85.5% (n=282) of patients. Postoperative complications occurred in 48 (14.5%) patients. Mortality rate was 0.6% (n=2). The greatest number of complications including anastomositis and restenosis was noted in patients after CTR and previous tracheoplasty with T-tube (n=8, 25%). The most common complication in patients after tracheal resection and previous stenting was anastomositis (14.7%). Long-term results depended on postoperative complications and methods of their correction. Recurrent stenosis occurred in 5 (1.5%) patients within the period of 3 months - 8 years. CTR after previous tracheoplasty with T-tube was carried out in 4 of these patients. CONCLUSION: Tracheal resection after preliminary stenting or tracheostomy is quite safe and technically feasible. Stenting allows postponing radical surgery for correction of concomitant diseases and closure of tracheostomy as a focus of infection within the surgical approach and further tracheal anastomosis. Tracheal resection with simultaneous closure of tracheostomy results a higher rate of postoperative complications compared with preliminary stenting.


Assuntos
Constrição Patológica/cirurgia , Stents/efeitos adversos , Estenose Traqueal/cirurgia , Traqueostomia/efeitos adversos , Constrição Patológica/etiologia , Humanos , Estudos Retrospectivos , Traqueia/patologia , Traqueia/cirurgia , Estenose Traqueal/etiologia
9.
Yonsei Med J ; 60(12): 1181-1186, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31769249

RESUMO

PURPOSE: To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients. MATERIALS AND METHODS: We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. The raters applied the Penetration-Aspiration Scale (PAS) for tracheal aspiration and pixel-based circumscribed area ratio and Yale Pharyngeal Residue Severity for post-swallow residue in VFSS and FEES, respectively. Anatomy-physiologic findings during FEES associated with tracheal aspiration were also analyzed. RESULTS: A total of 178 participants were enrolled in our study. In correlation analysis, PAS (r=0.74), vallecula retention (r=0.76), and pyriform sinus retention (r=0.78) showed strong positive correlations between FEES and VFSS. Intra-rater agreement between VFSS and FEES was good for PAS (κ=0.65) and vallecula (κ=0.65) and pyriform sinus retention (κ=0.69). Among 72 patients who showed subglottic shelf residue, a suspected finding of aspiration, in FEES, 68 had concomitant tracheal aspiration during VFSS. Both vocal fold hypomobility and glottic gap during phonation were significantly associated with findings suggestive of tracheal aspiration during FEES (p<0.05). CONCLUSION: Quantitative and reliable aspiration and post swallow residue rating scales showed strong positive correlations and good agreement between VFSS and FEES.


Assuntos
Endoscopia , Fluoroscopia , Fibras Ópticas , Faringe/diagnóstico por imagem , Faringe/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Reprodutibilidade dos Testes , Sucção , Traqueia/patologia , Prega Vocal/patologia
10.
Infect Immun ; 88(1)2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31591166

RESUMO

The avian pathogen Mycoplasma gallisepticum, the etiological agent of chronic respiratory disease in chickens, exhibits enhanced pathogenesis in the presence of a copathogen such as low-pathogenic avian influenza virus (LPAIV). To further investigate the intricacies of this copathogenesis, chickens were monoinfected or coinfected with either virulent M. gallisepticum strain Rlow or LPAIV H3N8 (A/duck/Ukraine/1963), with assessment of tracheal histopathology, pathogen load, and transcriptomic host responses to infection by RNA sequencing. Chickens coinfected with M. gallisepticum Rlow followed by LPAIV H3N8 exhibited significantly more severe tracheal lesions and mucosal thickening than chickens infected with LPAIV H3N8 alone and greater viral loads than chickens infected first with H3N8 and subsequently with M. gallisepticum Rlow Recovery of live M. gallisepticum was significantly higher in chickens infected first with LPAIV H3N8 and then with M. gallisepticum Rlow, compared to chickens given a mock infection followed by M. gallisepticum Rlow The transcriptional responses to monoinfection and coinfection with M. gallisepticum and LPAIV highlighted the involvement of differential expression of genes such as Toll-like receptor 15, Toll-like receptor 21, and matrix metallopeptidase 1. Pathway and gene ontology analyses of these differentially expressed genes suggest that coinfection with virulent M. gallisepticum and LPAIV induces decreases in the expression of genes related to ciliary activity in vivo and alters multiple immune-related signaling cascades. These data aid in the understanding of the relationship between M. gallisepticum and LPAIV during copathogenesis in the natural host and may contribute to further understanding of copathogen infections of humans and other animals.


Assuntos
Coinfecção/patologia , Influenza Aviária/patologia , Infecções por Mycoplasma/patologia , Doenças das Aves Domésticas/patologia , Traqueia/patologia , Animais , Carga Bacteriana , Galinhas , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Histocitoquímica , Interações Hospedeiro-Patógeno , Vírus da Influenza A/crescimento & desenvolvimento , Influenza Aviária/complicações , Infecções por Mycoplasma/complicações , Mycoplasma gallisepticum/crescimento & desenvolvimento , Carga Viral
12.
Adv Respir Med ; 87(4): 254, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476016

RESUMO

Foreign-body aspiration is often a serious medical condition demanding timely recognition and prompt action. Flexible and rigid bronchoscopy have become the cornerstone of both the diagnosis and treatment of patients with suspected airway foreign bodies, which are most commonly seen in patients with foreign body aspiration. We describe a case of a 58-year-old man with a huge fishhook in the right main bronchus.


Assuntos
Brônquios/diagnóstico por imagem , Broncoscopia/métodos , Corpos Estranhos/diagnóstico por imagem , Traqueia/diagnóstico por imagem , Brônquios/patologia , Brônquios/cirurgia , Corpos Estranhos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Traqueia/patologia , Traqueia/cirurgia
13.
World J Pediatr Congenit Heart Surg ; 10(5): 558-564, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31496414

RESUMO

PURPOSE: Children with congenital heart disease may present with severe airway compression prior to any surgical procedure or may develop airway compression following their surgical procedure. This combination of congenital heart defect and airway compression poses a significant management challenge. The purpose of this study was to review our experience with the Lecompte procedure for relief of severe airway compression. METHODS: This was a retrospective review of ten patients who underwent a Lecompte procedure for relief of severe airway compression over the past nine years (2010-2018). Three patients with absent pulmonary valve syndrome presented with severe symptoms prior to any surgical procedure. Seven patients presented with symptoms of airway compression following repair of their congenital heart defects (one with absent pulmonary valve syndrome, three patients had repair of pulmonary atresia with ventricular septal defect, and three patients had undergone aortic arch surgery). The median age at presentation was two years (range: one day to seven years). RESULTS: The ten patients underwent a Lecompte procedure without any significant complications or operative mortality. The median interval between the surgical procedure and extubation was 9.5 days. No patients have required any further interventions for relief of airway obstruction. CONCLUSIONS: The Lecompte procedure is a surgical option for young children who present with severe airway compression. The patients in this series responded well to the Lecompte procedure as evidenced by clinical relief of airway compression.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiopatias Congênitas/cirurgia , Comunicação Interventricular/cirurgia , Atresia Pulmonar/cirurgia , Obstrução das Vias Respiratórias , Aorta Torácica/anormalidades , Aorta Torácica/cirurgia , Brônquios/patologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Período Pós-Operatório , Artéria Pulmonar/anormalidades , Atelectasia Pulmonar/patologia , Valva Pulmonar/cirurgia , Estudos Retrospectivos , Síndrome , Traqueia/patologia , Resultado do Tratamento
14.
Pathol Res Pract ; 215(10): 152614, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31500927

RESUMO

BACKGROUND: Smoking cessation may help in the reversal of inflammation and damage caused by smoking. The endogenous annexin A1 (AnxA1) protein has anti-inflammatory effects which instigates the understanding of its role in the attenuation of inflammatory processes caused by smoking. MATERIAL AND METHODS: Wistar rats were exposed to cigarette smoke for 8 weeks. After the exposure period, one of the groups remained other 8 weeks in the absence of smoke. Animals not exposed to smoke were used as control. Blood, trachea and lungs were obtained for histopathological, immunohistochemical and biochemical analyses. RESULTS: Loss of cilia of the tracheal lining epithelium was found by smoke exposure, but smoking cessation led to recovery of the tracheal epithelium. Similarly, chronically exposed-to-smoke animals showed increased lymphocytes and macrophages in bronchoalveolar lavage and higher levels of glucose and gamma-GT in their blood. Reduction of lymphocytes, glucose and gamma-GT occurred after smoking cessation. In addition, IL-1ß, IL-6, IL-10, TNF-α and MCP-1 levels were elevated by smoke exposure. Smoking cessation significantly reduced the levels of IL-1ß, IL-6 and MCP-1 but increased the IL-10 concentration. Numerous mast cells and macrophages were observed in the lung of chronically exposed-to-smoke animals with reduction by smoking cigarette abstinence. AnxA1 increased expression and concomitant NF-κB reduction were found in the smoking cessation group. CONCLUSION: Our results showed that cigarette abstinence promoted partial recovery of the inflammatory process. The attenuation of the inflammatory profile may be associated with the overexpression of AnxA1 protein.


Assuntos
Anexina A1/metabolismo , Pulmão/metabolismo , Abandono do Hábito de Fumar , Fumar/metabolismo , Traqueia/metabolismo , Animais , Citocinas/metabolismo , Modelos Animais de Doenças , Inflamação/metabolismo , Inflamação/patologia , Pulmão/patologia , Linfócitos/metabolismo , Macrófagos/metabolismo , Ratos , Ratos Wistar , Fumaça , Fumar/patologia , Traqueia/patologia
16.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414746

RESUMO

BACKGROUND: Foreign body aspiration is a rare entity in adults. We presented an adult case with recurrent pulmonary infection firstly misdiagnosed as tuberculosis, which proved as foreign body aspiration in the left main stem bronchus by bronchoscopy. METHODS: Appropriate laboratory tests are carried out. The chest CT scan and bronchoscopy were performed for diagnosis. RESULTS: Serum sedimentation was increased and tuberculosis antibody was positive. The chest CT scan showed left lung consolidation and small pleural exudate on the left side. Significant calcification can be seen near the left main bronchus. The bronchoscopy demonstrated plenty of yellow sputum in left main bronchus and a peanut shell completely obstructed the left main bronchus and peripheral granulation tissue hyperplasia. The peanut shell was removed and the left main trachea was unobstructed. CONCLUSIONS: When a patient has recurrent pulmonary infection, especially at the same site, physicians should pay attention to airway obstruction caused by foreign body, cancer and other causes of airway stenosis. Bronchoscopy is crucial for the ultimate diagnosis.


Assuntos
Sedimentação Sanguínea , Erros de Diagnóstico , Corpos Estranhos/diagnóstico , Pulmão/diagnóstico por imagem , Mycobacterium tuberculosis/imunologia , Tuberculose/diagnóstico , Idoso , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Brônquios/microbiologia , Brônquios/patologia , Broncoscopia , Humanos , Pulmão/microbiologia , Masculino , Mycobacterium tuberculosis/fisiologia , Tomografia Computadorizada por Raios X , Traqueia/microbiologia , Traqueia/patologia , Tuberculose/sangue , Tuberculose/microbiologia
17.
Panminerva Med ; 61(3): 298-325, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31364332

RESUMO

We describe the current knowledge and skills for the main techniques of operative bronchoscopy and their applications in the treatment of malignant and benign central airway disorders. Rigid bronchoscopy has a history of over 100 years. The use of rigid bronchoscopy was abandoned upon the introduction of the fiberoptic bronchoscope but has made a reappearance with the development of interventional pulmonology in the late nineteenth and early twentieth century. The advantages of rigid bronchoscopy include allowing simultaneous procedures, such as ablation, debulking and suctioning, without limiting ventilation but at the moment there are no standard approaches to perform the procedure. Rigid bronchoscopy also plays a vital role in stent placement, repositioning, maintenance and removal. An interventional pulmonology practice should only be developed when there is a locoregional unmet medical need and when a dedicated interventional pulmonology unit can be guaranteed. These departments should be available 7 days a week and should provide a fast and appropriate response to referrals in emergency cases. There is a clear need to define a competency-based training program for rigid bronchoscopy, including stent placement. An optimal, multimodality training program for bronchoscopy should include didactic lectures, web-based learning, case-based reviews and hands-on training.


Assuntos
Broncoscopia/educação , Broncoscopia/métodos , Competência Clínica , Pneumopatias/diagnóstico por imagem , Pneumologia/educação , Pneumologia/métodos , Broncoscópios , Constrição Patológica/diagnóstico , Tecnologia de Fibra Óptica , Humanos , Pulmão/patologia , Pulmão/cirurgia , Pneumopatias/cirurgia , Stents , Traqueia/patologia
18.
World J Gastroenterol ; 25(30): 4213-4221, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31435174

RESUMO

BACKGROUND: Clinically, tracheoesophageal fistula (TEF) is lack of effective surgical strategies. One reason is due to the lack of appropriate animal models of acquired TEF, which is usually complex and difficult. Recently, the magnetic compression technique has been applied for digestive tract anastomosis or vascular anastomosis in animals. In this study, an animal model of TEF in dogs was developed by using the magnetic compression technique, hoping to provide a new method for mimicking TEF. AIM: To establish a TEF model in dogs by using the magnetic compression technique. METHODS: Six male beagles were used as models with two Nd-Fe-B permanent magnets for TEF. The parent magnet and the daughter magnet were placed in the cervical esophagus and trachea, respectively. The anterior wall of the esophagus and the posterior wall of the trachea were compressed when the two magnets coupled. After 4-6 d, the necrotic tissue between the two magnets fell off and the parent and daughter magnets disengaged from the target location, leaving a fistula. Gastroscopy/bronchoscopy, upper gastrointestinal contrast study, and histological analysis were performed. RESULTS: The establishment of the TEF model in all six beagles was successful. The average time of magnet placement was 4.33 ± 1.11 min (range, 3-7 min). Mean time for the magnets to disengage from the target location was 4.67 ± 0.75 d (range, 4-6 d). TEFs were observed by gastroscopy/bronchoscopy and esophageal angiography. The gross anatomical structure of the esophagus and the trachea was in good condition. There was no esophageal mucosa or pseudostratified ciliated columnar epithelium at the site of the fistula according to histological analysis. CONCLUSION: It is simple, feasible, and minimally invasive to use the magnetic compression technique for the establishment of the TEF model in dogs.


Assuntos
Modelos Animais de Doenças , Esôfago/patologia , Traqueia/patologia , Fístula Traqueoesofágica/patologia , Animais , Cães , Esôfago/cirurgia , Humanos , Imãs , Masculino , Pressão/efeitos adversos , Traqueia/cirurgia , Fístula Traqueoesofágica/etiologia , Fístula Traqueoesofágica/cirurgia , Resultado do Tratamento
19.
Cytogenet Genome Res ; 158(3): 121-125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31315107

RESUMO

VACTERL association is defined by the occurrence of congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula with esophageal atresia, radial and renal dysplasia, and limb defects. No genetic alterations have been discovered except for some sporadic chromosomal rearrangements and gene mutations. We report a boy with VACTERL association and shawl scrotum with bifid scrotum who presented with a de novo Yq11.223q11.23 microdeletion identified by array CGH. The deletion spans 3.1 Mb and encompasses several genes in the AZFc region, frequently deleted in infertile men with severe oligozoospermia or azoospermia. Herein, we discuss the possible explanation for this unusual genotype-phenotype correlation. We suggest that the deletion of the BPY2 (previously VCY2) gene, located in the AZFc region and involved in spermatogenesis, contributed to the genesis of the phenotype. In fact, BPY2 interacts with a ubiquitin-protein ligase, involved in the SHH pathway which is known to be implicated in the genesis of VACTERL association.


Assuntos
Canal Anal/anormalidades , Deleção Cromossômica , Cromossomos Humanos Y/genética , Esôfago/anormalidades , Cardiopatias Congênitas/genética , Cardiopatias Congênitas/patologia , Rim/anormalidades , Deformidades Congênitas dos Membros/genética , Deformidades Congênitas dos Membros/patologia , Proteínas/genética , Escroto/patologia , Coluna Vertebral/anormalidades , Traqueia/anormalidades , Canal Anal/patologia , Hibridização Genômica Comparativa , Esôfago/patologia , Estudos de Associação Genética , Humanos , Lactente , Rim/patologia , Masculino , Coluna Vertebral/patologia , Traqueia/patologia , Ubiquitina-Proteína Ligases/metabolismo , Incerteza
20.
Cancer Sci ; 110(8): 2485-2492, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31265162

RESUMO

Multi-walled carbon nanotube-7 (MWCNT-7) fibers are biopersistent and have a structure similar to asbestos. MWCNT-7 has been shown to induce malignant mesothelioma when administered by intrascrotal or intraperitoneal injection in rats and mice, and an inhalation study demonstrated that rats exposed to respirable MWCNT-7 developed lung tumors. MWCNT-N, which is similar to MWCNT-7, was shown to induce both lung tumors and malignant mesothelioma in rats when administered by trans-tracheal intrapulmonary spraying (TIPS). The present study was performed to investigate the carcinogenicity of MWCNT-7 when administered by the TIPS method. Ten-week-old male F344/Crj rats were divided into 3 groups and administered 0.5 mL vehicle, 0.250 µg/mL MWCNT-7 or 0.250 µg/mL crocidolite once a week for 12 weeks (total doses of 1.5 mg/rat) and then observed for up to 104 weeks. Rats in the MWCNT-7 group began to die from pathologies associated with the development of malignant mesothelioma 35 weeks after the final TIPS administration. Overall, the incidence of malignant mesothelioma in the MWCNT-7 group was significantly higher than in the vehicle or crocidolite groups.


Assuntos
Neoplasias Pulmonares/induzido quimicamente , Pulmão/efeitos dos fármacos , Mesotelioma/induzido quimicamente , Nanotubos de Carbono/efeitos adversos , Neoplasias Pleurais/induzido quimicamente , Animais , Asbesto Crocidolita/efeitos adversos , Injeções Intraperitoneais/métodos , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/patologia , Neoplasias Pleurais/patologia , Ratos , Ratos Endogâmicos F344 , Traqueia/efeitos dos fármacos , Traqueia/patologia
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