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1.
Khirurgiia (Mosk) ; (9): 65-73, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36073585

RESUMO

Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging¼ type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive¼ type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3rd case was the most interesting. Initially, the foreign body was «underlying¼, but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.


Assuntos
Brônquios , Corpos Estranhos , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Broncoscopia/métodos , Corpos Estranhos/diagnóstico , Corpos Estranhos/etiologia , Corpos Estranhos/cirurgia , Humanos , Pulmão , Traqueia
2.
Respir Res ; 23(1): 227, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056356

RESUMO

BACKGROUND: Despite the well-known detrimental effects of cigarette smoke (CS), little is known about the complex gene expression dynamics in the early stages after exposure. This study aims to investigate early transcriptomic responses following CS exposure of airway epithelial cells in culture and compare these to those found in human CS exposure studies. METHODS: Primary bronchial epithelial cells (PBEC) were differentiated at the air-liquid interface (ALI) and exposed to whole CS. Bulk RNA-sequencing was performed at 1 h, 4 h, and 24 h hereafter, followed by differential gene expression analysis. Results were additionally compared to data retrieved from human CS studies. RESULTS: ALI-PBEC gene expression in response to CS was most significantly changed at 4 h after exposure. Early transcriptomic changes (1 h, 4 h post CS exposure) were related to oxidative stress, xenobiotic metabolism, higher expression of immediate early genes and pro-inflammatory pathways (i.e., Nrf2, AP-1, AhR). At 24 h, ferroptosis-associated genes were significantly increased, whereas PRKN, involved in removing dysfunctional mitochondria, was downregulated. Importantly, the transcriptome dynamics of the current study mirrored in-vivo human studies of acute CS exposure, chronic smokers, and inversely mirrored smoking cessation. CONCLUSION: These findings show that early after CS exposure xenobiotic metabolism and pro-inflammatory pathways were activated, followed by activation of the ferroptosis-related cell death pathway. Moreover, significant overlap between these transcriptomic responses in the in-vitro model and human in-vivo studies was found, with an early response of ciliated cells. These results provide validation for the use of ALI-PBEC cultures to study the human lung epithelial response to inhaled toxicants.


Assuntos
Fumar Cigarros , Xenobióticos , Brônquios/metabolismo , Fumar Cigarros/efeitos adversos , Fumar Cigarros/genética , Células Epiteliais/metabolismo , Humanos , Membrana Mucosa , Tabaco , Xenobióticos/metabolismo , Xenobióticos/farmacologia
3.
Ital J Pediatr ; 48(1): 159, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056440

RESUMO

BACKGROUND: Along with the wide spread application and technical development of the flexible and rigid bronchoscopy, the airway foreign body removing method cme to the specific technique for different foreign bodies from the single foreign body forceps. METHODS: Selected 633 children who were diagnosed as airway foreign bodies by the Department of Respiratory Intervention, Children's Hospital affiliated to Shandong University from January 1st, 2018 to December 31st, 2021, and the airway foreign bodies were diagnosed using bronchoscopy. After comprehensive assessment of the foreign body nature in the airway, the foreign bodies were removed by freezing, laser, electrocoagulation, balloon and other techniques, the success rate of the foreign body removed from the airway was observed, the percentage of the foreign body removed using different techniques, the operation time, and the incidence of post-adverse reactions during operation. RESULTS: The success rate using flexible bronchoscope alone to remove foreign bodies in the airway was 99.2%. After flexible bronchoscopy, 19 cases of foreign bodies were removed by vacuum suction alone, 513 cases were removed by foreign body forceps alone, 62 cases were combined with cryotherapy, 2 cases were electrocoagulation, 6 cases were mesh baskets, 3 cases were balloons, 5 cases were laser, and various 18 cases of foreign bodies were invloved by technical combination. 5 cases of flexible bronchoscope combined with rigid bronchoscope combined to remove foreign bodies. The operation time was from 5 min to 1 h, with an average of 20 min. There were 17 cases of hypoxemia (2.7%) during operation, 36 cases (5.7%) of bleeding caused by airway mucosa injury after treatment, and 70 cases (11.2%) of laryngeal edema. The total incidence of adverse reactions was 19.6%, there were no deaths due to foreign bodies and treatment. CONCLUSIONS: According to different properties of airway foreign bodies, it is safe and effective to select appropriate techniques to remove foreign bodies using the flexible bronchoscope, which can increase the removal rate of airway foreign bodies and reduce the occurrence of serious complications.


Assuntos
Broncoscópios , Corpos Estranhos , Brônquios/cirurgia , Broncoscopia/métodos , Criança , Corpos Estranhos/cirurgia , Humanos , Estudos Retrospectivos , Traqueia/cirurgia
4.
Vet Res ; 53(1): 67, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056449

RESUMO

Middle East respiratory syndrome coronavirus (MERS-CoV) poses a serious threat to public health. Here, we established an ex vivo alpaca tracheal explant (ATE) model using an air-liquid interface culture system to gain insights into MERS-CoV infection in the camelid lower respiratory tract. ATE can be infected by MERS-CoV, being 103 TCID50/mL the minimum viral dosage required to establish a productive infection. IFNs and antiviral ISGs were not induced in ATE cultures in response to MERS-CoV infection, strongly suggesting that ISGs expression observed in vivo is rather a consequence of the IFN induction occurring in the nasal mucosa of camelids.


Assuntos
Camelídeos Americanos , Infecções por Coronavirus , Coronavírus da Síndrome Respiratória do Oriente Médio , Animais , Antivirais , Brônquios , Infecções por Coronavirus/veterinária , Coronavírus da Síndrome Respiratória do Oriente Médio/fisiologia
5.
Kyobu Geka ; 75(10): 841-845, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36155580

RESUMO

Tracheobronchial injurie( TBI) is rare but potentially life threatening. Blunt trauma of the chest and post-intubation injury are the most common cause of TBI. Clinical findings of TBI are subcutaneous emphysema, pneumomediastinum, and pneumothorax. Chest computed tomography (CT) and bronchoscopy are important examination for TBI to evaluate of injured site and condition. Most traumatic or iatrogenic TBIs occurred within 2.5 cm of the carina and/or main bronchus. Early diagnosis and early treatment are important to improve the long-term results of TBI. In principle, blunt traumatic TBI excluded membranous minor laceration should be operated immediately, if possible. Surgical procedures are usually selected single closure or end to end anastomosis with or without débridement. Right thoracotomy is often suitable for repair of carina or main bronchus in closed trauma. Recently transcervical repair of iatrogenic distal membranous tracheal laceration is reported. Conservative treatment of iatrogenic TBI cause by single lumen tube may be a save option in patients with stable spontaneous breathing, no other injury( such as esophagus), and small to moderate rupture. Left main bronchial rupture caused by double lumen tube during right thoracic surgery is critical situation. Throughout the operation expert cooperation between surgeon and anesthetist is important.


Assuntos
Lacerações , Ferimentos não Penetrantes , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Broncoscopia , Humanos , Doença Iatrogênica , Ruptura , Traqueia/diagnóstico por imagem , Traqueia/lesões , Traqueia/cirurgia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/cirurgia
6.
Kyobu Geka ; 75(10): 851-858, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36155582

RESUMO

Foreign body aspiration is most common in infants of <3 years of age and the elderly. Peanuts and plant seeds account for approximately 70~80% of airway foreign bodies in children, while dental materials( e.g., dentures and crowns) are common in adults. Tracheobronchial foreign bodies are diagnosed by detailed history taking, careful auscultation, chest radiography, and computed tomography (CT). Chest radiography should be performed in frontal and lateral views. CT is useful for assessing the presence of a foreign body, the site of involvement, and secondary changes (e.g., pneumonia or atelectasis). In urgent cases with severe dyspnea, life-saving measures, including endotracheal intubation, administration of oxygen, and securing an intravenous line should be performed first, followed by immediate removal. Removal is often performed with a rigid bronchoscope in children, and a flexible bronchoscope under local anesthesia in adults. When removal by flexible bronchoscope is difficult, a rigid bronchoscope is used. Surgical removal is considered when bronchoscopic removal is difficult or associated with a high risk of complications( e.g., major bleeding or bronchial perforation). After removal, pneumonia is likely to occur, so antibiotic agents should be administered. For airway foreign bodies, appropriate and immediate treatment is required from the diagnosis to removal and post-removal management.


Assuntos
Corpos Estranhos , Traqueia , Adulto , Idoso , Antibacterianos , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Broncoscopia/métodos , Criança , Materiais Dentários , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Lactente , Oxigênio , Estudos Retrospectivos , Traqueia/diagnóstico por imagem , Traqueia/cirurgia
7.
Eur J Cardiothorac Surg ; 62(4)2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36083021

RESUMO

Vascular clips are currently acknowledged as a safe and efficient tool for vessel ligation in every surgical field. Here, we describe a case of massive haemoptysis due to perforation of both the aorta and bronchus, caused by a titanium clip that was placed between them 3 years ago. The present case highlights the rare but life-threatening complications that clips can cause in the mediastinum, especially when placed between a fixed structure and a large blood vessel or respiratory tract.


Assuntos
Instrumentos Cirúrgicos , Titânio , Aorta/diagnóstico por imagem , Aorta/cirurgia , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Humanos , Ligadura , Instrumentos Cirúrgicos/efeitos adversos
8.
Respir Res ; 23(1): 244, 2022 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100847

RESUMO

BACKGROUND: Epithelial-mesenchymal transition (EMT) is one of the mechanisms of airway remodeling in chronic asthma. Interleukin (IL)-24 has been implicated in the promotion of tissue fibrosis, and increased IL-24 levels have been observed in the nasal secretions and sputum of asthmatic patients. However, the role of IL-24 in asthmatic airway remodeling, especially in EMT, remains largely unknown. We aimed to explore the effect and mechanism of IL-24 on EMT and to verify whether IL-37 could alleviate IL-24-induced EMT in chronic asthma. METHODS: BEAS-2B cells were exposed to IL-24, and cell migration was assessed by wound healing and Transwell assays. The expression of EMT-related biomarkers (E-cadherin, vimentin, and α-SMA) was evaluated after the cells were stimulated with IL-24 with or without IL-37. A murine asthma model was established by intranasal administration of house dust mite (HDM) extracts for 5 weeks, and the effects of IL-24 and IL-37 on EMT and airway remodeling were investigated by intranasal administration of si-IL-24 and rhIL-37. RESULTS: We observed that IL-24 significantly enhanced the migration of BEAS-2B cells in vitro. IL-24 promoted the expression of the EMT biomarkers vimentin and α-SMA via the STAT3 and ERK1/2 pathways. In addition, we found that IL-37 partially reversed IL-24-induced EMT in BEAS-2B cells by blocking the ERK1/2 and STAT3 pathways. Similarly, the in vivo results showed that IL-24 was overexpressed in the airway epithelium of an HDM-induced chronic asthma model, and IL-24 silencing or IL-37 treatment could reverse EMT biomarker expression. CONCLUSIONS: Overall, these findings indicated that IL-37 mitigated HDM-induced airway remodeling by inhibiting IL-24-mediated EMT via the ERK1/2 and STAT3 pathways, thereby providing experimental evidence for IL-24 as a novel therapeutic target and IL-37 as a promising agent for treating severe asthma.


Assuntos
Remodelação das Vias Aéreas , Asma , Interleucina-1/farmacologia , Animais , Asma/metabolismo , Asma/prevenção & controle , Brônquios/metabolismo , Transição Epitelial-Mesenquimal , Humanos , Interleucinas/metabolismo , Interleucinas/farmacologia , Camundongos , Pyroglyphidae/metabolismo , Transdução de Sinais , Vimentina/metabolismo
10.
Neoreviews ; 23(9): e613-e624, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36047759

RESUMO

Respiratory distress in the neonate is one of the most common reasons for referral to a tertiary NICU, accounting for more than 20% of admissions. (1) The cause of respiratory distress can range from parenchymal lung disease to anomalies of any portion of the neonatal airway including the nose, pharynx, larynx, trachea, or bronchi. This review will focus on airway anomalies at or immediately below the level of the larynx. Although rare, those with such congenital or acquired laryngotracheal anomalies often require urgent evaluation and surgical intervention. This review describes 1) the pathophysiology associated with congenital and acquired laryngotracheal deformities in the neonate, 2) the clinical presentation and diagnostic evaluation of these anomalies, and 3) the current medical and surgical strategies available in the NICU and after discharge.


Assuntos
Doenças do Recém-Nascido , Laringe , Síndrome do Desconforto Respiratório , Brônquios , Humanos , Recém-Nascido , Laringe/anormalidades , Laringe/cirurgia , Traqueia
11.
Bull Exp Biol Med ; 173(4): 486-489, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36058975

RESUMO

We studied contractile responses of isolated airway smooth muscle segments from rats with metabolic syndrome. Metabolic syndrome was induced in rats by high-fat and high-carbohydrate diet. It was shown that metabolic syndrome was associated with an increase of bronchoconstrictor action of cholinergic receptor activator carbacholine (0.1-100 µM) and a decrease of the dilatory effect of ß2-adrenoreceptor activator salbutamol (0.1-100 µM). The observed effects of agonists are epithelium-dependent. Disorders in contractile activity in the airway smooth muscles were accompanied by bronchial epithelium destruction, immune inflammation in the bronchial wall, muscular and peribronchial adipose tissue hypertrophy.


Assuntos
Broncoconstritores , Síndrome Metabólica , Albuterol/farmacologia , Animais , Brônquios , Broncoconstritores/metabolismo , Broncoconstritores/farmacologia , Carbacol/metabolismo , Carbacol/farmacologia , Carboidratos/farmacologia , Síndrome Metabólica/metabolismo , Contração Muscular , Músculo Liso , Ratos , Receptores Colinérgicos/metabolismo
12.
Tuberk Toraks ; 70(3): 293-297, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36164954

RESUMO

Accessory cardiac bronchus (ACB) is a rare congenital anomaly mainly located in the medial wall of the intermediate bronchus. This anomaly can present with dyspnea, recurrent infections, and hemoptysis. It usually has a blind ending, which may have an impact on airflow patterns and lobar distribution regardless of its diameter and depth. There have been very few cases with ACB. However, the airflow pattern and lobar distribution have not been well studied. In our case with ACB, the proportion of airflow in the right lung was higher than in the model without ACB, while mean airflow velocities were similar in both models. In this regard, quantitative lung ventilation scintigraphy could be better than the anatomical formula in predicting postoperative forced expiratory volume 1 in patients with accessory cardiac bronchus who will undergo lung resection.


Assuntos
Brônquios , Traqueia , Brônquios/diagnóstico por imagem , Humanos , Pulmão/diagnóstico por imagem , Traqueia/diagnóstico por imagem
13.
Eur J Radiol ; 154: 110448, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35917756

RESUMO

PURPOSE: To evaluate the outcome of dual-vessel intervention (DVI), including bronchial or pulmonary arterial embolization (B/PAE), in managing massive hemoptysis caused by cavitary lung lesions (with or without aspergilloma) and identify cavitary angiographic features influencing DVI procedures. METHOD: A retrospective analysis of the medical records and angiograms of 15 patients who underwent DVI for massive hemoptysis was performed. RESULTS: The most frequent causes of cavitary lung lesions were tuberculosis (TB) (8/15, 53%) and bronchiectasis (6/15, 40%). Eight patients were diagnosed with aspergilloma (8/15, 53%). In all, 24 systemic arteries, including the orthotopic and ectopic bronchial arteries and 1 pulmonary artery branch, were embolized in 16 procedures. Clinical success and immediate cessation of hemoptysis were achieved in 12 patients (80%). Hemoptysis was controlled in 10 patients (67%) and recurred in 2 patients (17%), while 1 patient (7%) required repeat embolization. The bronchopulmonary fistula (shunting) rate was 73.3% (11/15). The average fistula emergence time was 1.28 ± 1.27 s (M ± SD), and the average vessel diameter was 3.974 ± 1.57 mm. There were no significant differences in angiographic features, clinical success, or recurrence of cavitary lesions with or without aspergilloma. The complication rates were low, with only transient chest pain and ventricular arrhythmia reported. CONCLUSIONS: BAE is an effective and safe procedure for most cavitary lesions causing massive hemoptysis, and DVI is needed under certain circumstances. High bronchopulmonary fistula rates and early fistula emergence times were observed for cavitary lesions. The DVI strategy depends on the culprit vessel diameter, fistula type, and fistula emergence time.


Assuntos
Embolização Terapêutica , Hemoptise , Brônquios , Artérias Brônquicas/diagnóstico por imagem , Embolização Terapêutica/métodos , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
14.
Afr J Paediatr Surg ; 19(4): 274-276, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36018215

RESUMO

Introduction: We report the first case of complex supracardiac middle mediastinal foregut duplication lesion compressing and adherent to the heart, managed successfully thoracoscopically in an infant, in an innovative way. Materials and Surgical Technique: A 1-year-old girl was diagnosed as having supracardiac middle mediastinal foregut duplication lesion. It was completely overlying and adherent to her heart giving transmitted pulsations to the lesion, causing indentation over the left atrium and surrounded by all vital structures such as aorta, pulmonary artery, bronchi and phrenic nerve. After proper counselling of parents and relatives, the patient was posted for surgery. After proper positioning, thoracoscopic access was gained, difficulty here was neither bulge nor surface marking of the lesion was seen in thoracic cavity anywhere, considering the anatomical relations. The mediastinal pleura was opened, through a very narrow window for accessing the lesion, which was surrounded by vital structures in the middle mediastinum. A gentle dissection of the lesion was done to relieve it from adjacent adhered thoracic vitals structures successfully. Histopathological examination confirmed it as a bronchogenic cyst. Discussion: Foregut duplication cyst, especially bronchogenic cysts, have been reported at various locations, however, supracardiac middle mediastinal bronchogenic cyst completely sitting on the heart, adherent to it causing compression of the left atrium and left bronchus and surrounded completely by the aorta, pulmonary artery and bronchus, has not been reported till date. Also, successful thoracoscopic excision of such rarely located lesion moving with heart, in a 1-year-old girl, has not been reported yet.


Assuntos
Cisto Broncogênico , Cisto Mediastínico , Brônquios , Feminino , Humanos , Lactente , Mediastino , Traqueia
15.
BMC Anesthesiol ; 22(1): 260, 2022 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-35971080

RESUMO

BACKGROUND: The mainstream facilitation of one-lung ventilation is using double-lumen endobronchial tubes. However, it is more difficult to be positioned properly and more likely to cause airway injuries. How to place double-lumen endobronchial tubes rapidly and correctly is important for thoracic anesthesiologists. METHODS: One hundred eight patients with an American Society of Anesthesiologists physical status of I to III were 20 years of age or over, and required one-lung ventilation for thoracic surgery. They were randomly assigned to the conventional technique group (n = 36), the flexible fiberoptic bronchoscopy group (n = 36), or the Trachway® flexible stylet group (n = 36). The primary endpoint was the time needed for intubation. T1, the time from the tip of the blade passing between the patient's lips to identification of the vocal cords; and T2, the time from identification of the vocal cords to the bronchial lumen was in the correct position. RESULTS: T1 had no significant difference between groups, but T2 was significantly shorter in the Trachway® flexible stylet group (p < 0.0001) and longer in the conventional technique group (p < 0.0001). CONCLUSIONS: Using Trachway® flexible stylet for correct placement of double-lumen endobronchial tubes not only significantly shortened the intubation time, but also reduced incidence of carinal injuries. It is an alternative, and a choice with good safety. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02364622, 18/02/2015, Retrospectively registered.


Assuntos
Intubação Intratraqueal , Ventilação Monopulmonar , Brônquios , Broncoscopia/métodos , Humanos , Intubação Intratraqueal/métodos , Estudos Prospectivos
16.
BMC Anesthesiol ; 22(1): 264, 2022 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-35982403

RESUMO

BACKGROUND: The variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube. METHODS: In this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube. RESULTS: The distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3 mm, 25.4 ± 3.7 mm and 28.5 ± 3.1 mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05). CONCLUSIONS: The length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube. TRIALS REGISTRATION: Clinical Trials. gov. no. NCT04127903. Registered at https://register. CLINICALTRIALS: gov on 16/10/2019.


Assuntos
Intubação Intratraqueal , Traqueia , Adulto , Brônquios/diagnóstico por imagem , Broncoscopia , Humanos , Intubação Intratraqueal/métodos , Tomografia Computadorizada por Raios X
17.
Int J Immunopathol Pharmacol ; 36: 3946320221120962, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35968643

RESUMO

The present study reports the clinical data of a patient with small cell lung cancer who developed relapsing polychondritis. We report a case of a 57-year-old female presented with cough, expectoration, and fever. A Computed Tomography (CT) scan performed at the hospital revealed diffuse thickening of bronchial walls in both lungs. Bronchoscopy revealed that the tracheal mucosa was thickened, narrowed, and collapsed, and the bronchoscope could pass through. The bronchial mucosa on both sides was thickened and edematous, the surface was rough, each bronchus was narrow, and the intervertebral ridges were widened. Needle biopsy: considering small cell carcinoma in combination with immunohistochemical results. Her symptom was not improved after anti-infective therapy. The left auricle was red and swollen, the auricle collapsed, and the left eye had subconjunctival hemorrhage during her hospitalization without obvious cause. After multidisciplinary consultation, pulmonary small cell lung cancer cT0N2Mx rumen lymph node metastasis and RP were considered. Treatment: Prednisone, orally for RP. Chemotherapy combined with radiotherapy was given for small cell lung cancer. The chemotherapy regimen was carboplatin combined with etoposide. The patient has already been followed for 1 year after receiving chemoradiotherapy; the condition of the patient is stable at present. Based on the case of our patient, for cases of RP with symptoms such as auricle chondritis, ocular inflammatory disease, and nasal chondritis, we should pay great attention to whether the case is caused by lung cancer with relapsing polychondritis. Because of the rarity of the disease, the clinician should improve the recognition of the disease in order to strive for early diagnosis and therapy.


Assuntos
Neoplasias Pulmonares , Policondrite Recidivante , Carcinoma de Pequenas Células do Pulmão , Brônquios , Feminino , Humanos , Pulmão , Neoplasias Pulmonares/terapia , Pessoa de Meia-Idade , Policondrite Recidivante/complicações , Policondrite Recidivante/diagnóstico , Policondrite Recidivante/terapia , Carcinoma de Pequenas Células do Pulmão/complicações , Carcinoma de Pequenas Células do Pulmão/terapia
18.
Int J Pediatr Otorhinolaryngol ; 161: 111266, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35964494

RESUMO

Tracheobronchomegaly is a rare condition characterized by diffuse dilation of the trachea and main bronchi. In ventilator-dependent neonates with tracheobronchomegaly, a tracheostomy may be hazardous due to the lack of an appropriate tracheostomy tube size that can fit the enlarged trachea. Here, we describe a modification of the laryngotracheal separation procedure to permit ventilation in a child with tracheobronchomegaly and severe bronchopulmonary dysplasia.


Assuntos
Traqueobroncomegalia , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Criança , Humanos , Recém-Nascido , Traqueia/cirurgia , Traqueostomia , Traqueotomia
19.
Sci Rep ; 12(1): 14255, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35995803

RESUMO

Cystic fibrosis is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) that can lead to terminal respiratory failure. Ultrafine carbonaceous particles, which are ubiquitous in ambient urban and indoor air, are increasingly considered as major contributors to the global health burden of air pollution. However, their effects on the expression of CFTR and associated genes in lung epithelial cells have not yet been investigated. We therefore evaluated the effects of carbon nanoparticles (CNP), generated by spark-ablation, on the human bronchial epithelial cell line 16HBE14o- at air-liquid interface (ALI) culture conditions. The ALI-cultured cells exhibited epithelial barrier integrity and increased CFTR expression. Following a 4-h exposure to CNP, the cells exhibited a decreased barrier integrity, as well as decreased expression of CFTR transcript and protein levels. Furthermore, transcriptomic analysis revealed that the CNP-exposed cells showed signs of oxidative stress, apoptosis and DNA damage. In conclusion, this study describes spark-ablated carbon nanoparticles in a realistic exposure of aerosols to decrease CFTR expression accompanied by transcriptomic signs of oxidative stress, apoptosis and DNA damage.


Assuntos
Fibrose Cística , Nanopartículas , Brônquios/metabolismo , Carbono/metabolismo , Fibrose Cística/metabolismo , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Regulador de Condutância Transmembrana em Fibrose Cística/metabolismo , Células Epiteliais/metabolismo , Humanos , Nanopartículas/toxicidade , Material Particulado/metabolismo
20.
Can Respir J ; 2022: 9595184, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35979256

RESUMO

Background: The study aimed to explore risk factors for bronchial mucus plugs (BMP) formation in children with adenovirus (AdV) pneumonia. Methods: A retrospective study was conducted on children with AdV pneumonia who underwent bronchoscopy from January 2019 to December 2019. Children were divided into the BMP group and the control group, depending on whether BMP was formed or not. The clinical information and treatment proposals of the two groups of children were counted and analyzed via multiple logistic regression analysis, ROC curve analysis, and correlation analysis. Results: Among 453 patients with AdV pneumonia, 185 (40.84%) were in the BMP group. Among all the cases, there were 188 patients with a single AdV infection, including 64 (34.04%) in the BMP group and 124 (65.96%) in the control group. The incidence of dyspnea, poor spirits, mixed infections, and other symptoms in the BMP group was higher than in the control group. Children in the BMP group had a longer heat range. C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), and AdV load levels were higher in the MBP group. AdV load, Mycoplasma coinfection, DD, heat range, and LDH were independent risk factors for BMP, among which AdV load was the most significant (AUC = 0.819). AdV load was positively correlated with other risk factors, respectively. AdV load and heat range were independent risk factors for BMP patients with a single AdV infection. Conclusion: AdV load might have important clinical value in predicting BMP development in AdV pneumonia.


Assuntos
Coinfecção , Pneumonia Viral , Adenoviridae , Brônquios , Criança , Humanos , L-Lactato Desidrogenase , Muco , Pneumonia Viral/terapia , Estudos Retrospectivos
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