Extraluminal laryngotracheal fixation with absorbable miniplates.

OBJECTIVE: To determine if miniplates made of polydioxanone can be used successfully for extraluminal laryngotracheal fixation. DESIGN: Twelve rabbits underwent anterior and posterior laryngotracheofissure with extraluminal fixation of the divided segments with polydioxanone miniplates. Three control animals did not undergo plating. Animals were killed after 2, 4, and 12 weeks. Larynges were removed and examined to determine the intraluminal area and histologic status of the repair site. RESULTS: The intraluminal area of the animals in the experimental group was 1.6 times that of those in the control group. The trachea was relined with respiratory mucosa by 2 weeks. Little inflammatory reaction was evident. Plate resorption was almost complete at 12 weeks. CONCLUSION: Polydioxanone plating is a feasible and well-tolerated method of extraluminal laryngotracheal fixation. It may be useful in the treatment of grade 2 or 3 subglottic stenosis.

Temporal pattern of nerve growth factor (NGF) binding in vivo and the in vitro effects of NGF on cultures of developing auditory and vestibular neurons.

NGF binding patterns reflect the presence of receptors for this growth factor. High specific binding of 125I 2.5 S-NGF was observed for the 11 gestation day (gd) statoacoustic ganglion (SAG) with lower levels recorded for both 14 gd acoustic ganglion (AG) and vestibular ganglion (VG) samples. Fourteen day AG cells were more than twice as active for binding NGF when compared to VG samples of the same gestational age. Both whole ganglion explants and dissociated cell cultures were grown in chemically defined medium for short term culture to assay changes in neurite outgrowth and survival of neurons in response to the addition of exogenous 2.5 S-NGF. The most vigorous neurite outgrowth and neuronal survival responses were produced by 11 gd SAG samples treated with NGF. Acoustic ganglion specimens of both 11 gd and 14 gd embryos were much more responsive to the neurotrophic effects of NGF when compared to the responses of their VG counterparts. There was a correlation between NGF binding ability and in vitro responsiveness to exogenous NGF. We hypothesize based on the results of this study that NGF (and/or a member of the NGF family of growth factors) is involved in the control of developmentally regulated neuronal cell death of SAG neurons and may play a role in the innervation of developing inner ear sensory structures.

From puppy to service dog: raising service dogs for the rehabilitation team.

Service dogs, also known as assistance dogs, are seen increasingly in public places, including healthcare settings. Whereas an earlier article reviewed literature relevant to the human-animal bond in general, this article recounts my personal and professional experiences as a volunteer for Canine Companions for Independence (CCI). Rehabilitation professionals are advocates for their clients, and this article provides important information about the issues, benefits, and challenges in obtaining, training, and living with a service dog. For additional information, sources available through the Internet and a bibliography are provided.

Acute pulmonary haemorrhage in an infant during induction of general anaesthesia.

Pulmonary haemorrhage is a rare, life-threatening complication of anaesthesia. This report describes the anaesthetic management of an infant who developed laryngospasm and pulmonary haemorrhage during general anaesthesia. The infant was subsequently found to have prior exposure to a fungus, Stachybotrys chartarum, which produces mycotoxins that may have produced capillary fragility in the infant's rapidly growing lungs.