Radiological and Anatomical Evaluation of the Tracheal Morphology and Morphometry in Turkish Adults / Evaluación Radiológica y Anatómica de la Morfología y Morfometría Traqueal en Adultos Turcos

SUMMARY: The trachea is a tubular organ lying between larynx and lungs containing smooth muscle, membranes, and cartilage. This paper evaluated the dimessions of the trachea and main bronchi morphometry in healthy adults using Computed Tomography. This retrospective observational study was performed with 170 healthy adult subjects (89 females, 52.35 %; 81 males,47.65 %). The length of the trachea, the anteroposterior and transverse diameter of the trachea and the right and left main bronchi were measured. From these measurements, the trachea shape were calculated and four types of trachea were identified as circular, oval, horseshoe-shaped, and rectangular. All measurements were significantly higher in males than females (excluding tracheal bifurcation angle). According to the value obtained by dividing the anteroposterior by the width of the trachea, tracheal shapes are considered; the circular shape was seen 104 subjects (61.2 %), followed by oval type (34 subjects), horseshoe type (24 subjects) and rectangular type. (8 subjects). Also, the most frequently seen was circular type in both females and males. Hovewer, there was no significant difference between sex in terms of trachea shape. Additionally, a striking finding was that trachea morphometry and morphology showed the significance according to age dependent changes. Trachea measurements were affected several reasons such as used methods, age, sex, or race. This study has many clinical importance as it may reduce the risk of accidental damage to these area by clinicians such as cardiothoracic surgeons, anesthetist, or radiologist.

La tráquea es un órgano tubular que se encuentra entre la laringe y los pulmones y que contiene músculo liso, membranas y cartílago. Este trabajo evaluó las dimensiones de la tráquea y la morfometría de los bronquios principales en adultos sanos mediante Tomografía Computarizada. Este estudio observacional retrospectivo se realizó con 170 sujetos adultos sanos (89 mujeres, 52,35 %; 81 hombres, 47,65 %). Se midió la longitud de la tráquea, el diámetro anteroposterior y transversal de la tráquea y los bronquios principales derecho e izquierdo. A partir de estas mediciones, se calculó la forma de la tráquea y se identificaron cuatro tipos de tráquea: circular, ovalada, en forma de herradura y rectangular. Todas las mediciones fueron significativamente mayores en hombres que en mujeres (excluyendo el ángulo de bifurcación traqueal). Según el valor que se obtiene al dividir el anteroposterior por el ancho de la tráquea, se consideran las formas traqueales; la forma circular fue observada en 104 sujetos (61,2 %), seguida del tipo ovalado (34 sujetos), tipo herradura (24 sujetos) y tipo rectangular (8 sujetos). Además, el tipo más frecuente fue el circular tanto en mujeres como en hombres. Sin embargo, no hubo diferencias significativas entre sexos en términos de forma de la tráquea. Además, un hallazgo sorprendente fue que la morfometría y la morfología de la tráquea mostraron importancia según los cambios dependientes de la edad. Las mediciones morfométricas de la tráquea se vieron afectadas por varios motivos, como los métodos utilizados, la edad, el sexo o la raza. Este estudio tiene importancia clínica ya que puede reducir el riesgo de daño accidental por parte de médicos como cirujanos cardiotorácicos, anestesistas o radiólogos.

Descelularización y regeneración de tráquea porcina: un acercamiento a la ingeniería tisular / Decellularization and Regeneration of Porcine Trachea: an Approach to Tissue Engineering

Resumen Antecedentes: la ingeniería tisular permite obtener órganos como injertos a partir de tejidos descelularizados, regenerados con células autólogas. Objetivo: descelularizar y regenerar tráqueas porcinas. Material y métodos: se descelularizaron tráqueas porcinas colocándolas cada una en el epiplón de cuatro cerdos Yorkshire para su regeneración in vivo. Una tráquea desce-lularizada con tritón (DT), descelularizada con desoxicolato (DD), descelularizada con desoxicolato y reforzada con un polímero y células epiteliales (DDR), y una nativa crio-preservada (NC). Después de 8 días se obtuvieron la DD, NC y DDR; y al día 15, la DT. Se las evaluó mecánica e histológicamente, se realizó el análisis casuístico. Resultados: las tráqueas descelularizadas conservaron la integridad del cartílago, sin diferencias mecánicas, excepto la DDR con mayor rigidez. Las tráqueas regeneradas presentaron menor rigidez, excepto la DDR que además perdió el epitelio y la vascula-ridad. Las DT, DD mostraron epitelio no respiratorio, fibrosis y vasculogénesis con in-flamación. Conclusiones: las matrices conservaron sus características mecánicas. La regenera-ción in vivo ofrece ventajas como la esterilidad, interacción celular, nutrientes; es senci-llo, factible y económico, pero no hay control del crecimiento celular y vascularización, y los tejidos presentaron alteraciones mecánicas e histológicas. El polímero impidió la re-epitelialización y revascularización. Este estudio abre la posibilidad de mejorar las me-todologías de ingeniería tisular aplicadas al tejido traqueal.

Abstract Introduction: tissue engineering makes it possible to obtain organs as grafts from de-cellularized tissues, regenerated with autologous cells.Objective: decellularize and regenerate porcine tracheas.ARTÍCULO ORIGINAL | Respirar, 2023; 15(3): 188-199 | ISSN 2953-3414 | https://doi.org/10.55720/respirar.15.3.5RECIBIDO: 9 agosto 2023ACEP TADO: 31 agosto 2023 Elisa Barrera-Ramírezhttps://orcid.org/0000-0002-2778-0882Rubén Efraín Garrido-Cardonahttps://orcid.org/0000-0001-6083-5403Alejandro Martínez-Martínezhttps://orcid.org/0000-0003-3448-910XLuis Fernando Plenge-Tellecheahttps://orcid.org/0000-0002-1619-5004Edna Rico-Escobarhttps://orcid.org/0000-0002-0933-0220Esta revista está bajo una licencia de Creative Commons Reconocimiento 4.0 Internacional. Respirar 2023; 15 (3): 189ARTÍCULO ORIGINAL / E. Barrera-Ramírez, R.E. Garrido-Cardona, A. Martínez-Martínez, L.F. Plenge-Tellechea, E. Rico-EscobarDescelularización y regeneración de tráqueaISSN 2953-3414Materials and Methods: Porcine tracheas were decellularized by placing each one in the omentum of four Yorkshire pigs for regeneration in vivo. A trachea decellularized with triton (DT), decellularized with deoxycholate (DD), decellularized with deoxycho-late and reinforced with a polymer, and epithelial cells (DDR), and a cryopreserved na-tive (NC). After 8 days, the DD, NC and DDR were obtained; and on day 15, the DT. The evaluation was mechanically and histologically, performing the case analysis.Results: the decellularized tracheas preserved the integrity of the cartilage, with no me-chanical differences, except for the DDR with greater rigidity. The regenerated trache-as presented less rigidity, except the DDR, which also lost the epithelium and vascular-ity. The DT, DD showed non-respiratory epithelium, fibrosis and vasculogenesis with inflammation.Conclusions: the matrices retained their mechanical characteristics, in vivo regenera-tion offers advantages such as sterility, cell interaction, nutrients; it is simple, feasible and economical, but there is no control of cell growth and vascularization, and the tis-sues presented mechanical and histological alterations. The polymer prevented re-epi-thelialization and revascularization. This study opens the possibility of improving tissue engineering methodologies applied to tracheal tissue.

Evaluation of angles of the tracheobronchial tree with the 3-dimensional reconstruction method: a morphometric and radiologic study / Evaluación de los ángulos del árbol traqueobronquial con el método de reconstrucción tridimensional: un estudio morfométrico y radiológico

SUMMARY: The objective of the current research is to assess the branching angles of the tracheobronchial tree and the correlation between these angles and the lung volume using the 3-dimensional reconstruction method. Thorax CT (computed tomography) images of 150 individuals, who were over 18 years of age and did not have any pathology on CT, were obtained retrospectively. A 3-dimensional reconstruction of the trachea, bronchi, and lungs was carried out. External and internal angles between the trachea and main bronchi, between the main bronchi and lobar bronchi, and between the lobar bronchi were measured. The volume measurement of the right and left lungs was performed. The individuals included in the study were grouped by sex and age (20-40 years, 41-61 years, and 62-87 years). The left subcarinal angle (LSA), total subcarinal angle (TSA), and left interbronchial angle (LIA) were found to be greater in the 62-87 age group. Both the external angle (LULB-LMBE) and the internal angle (LULB- LMBI) between the left upper lobar bronchus and the left main bronchus were observed to be greater in males. In males, a statistically significant negative moderate correlation was identified between the right lung volume and the right subcarinal angle (RSA). In females, a statistically significant positive moderate correlation was revealed between the external (RULB-IBE) and internal angles (RULB-IBI) between the right upper lobar bronchus and the intermediate bronchus, and the right lung volume. In the literature review we performed, we did not find any studies investigating the correlation between the branching angles of the tracheobronchial tree and the lung volume using the 3-dimensional reconstruction method. Therefore, we are of the opinion that our study will contribute to the literature.

El objetivo de la investigación fue evaluar los ángulos de ramificación del árbol traqueobronquial y la correlación entre estos ángulos y el volumen pulmonar utilizando el método de reconstrucción tridimensional. Se obtuvieron retrospectivamente imágenes de tomografía computarizada de tórax de 150 individuos mayores de 18 años sin patología. Se realizó una reconstrucción tridimensional de la tráquea, los bronquios y los pulmones. Se midieron los ángulos externo e interno entre la tráquea y los bronquios principales, entre los bronquios principales y los bronquios lobares, y entre los bronquios lobares. Se realizó la medición del volumen de los pulmones derecho e izquierdo. Los individuos incluidos en el estudio fueron agrupados por sexo y edad (20-40 años, 41-61 años y 62-87 años). Se encontró que el ángulo subcarinal izquierdo, el ángulo subcarinal total y el ángulo interbronquial izquierdo eran mayores en el grupo de edad de 62 a 87 años. Tanto el ángulo externo (LULB-LMBE) como el ángulo interno (LULB-LMBI) entre el bronquio lobular superior izquierdo y el bronquio principal izquierdo era mayor en los hombres. En los hombres, se identificó una correlación moderada negativa estadísticamente significativa entre el volumen pulmonar derecho y el ángulo subcarinal derecho. En mujeres, se reveló una correlación positiva moderada estadísticamente significativa entre los ángulos externos (RULB-IBE) e internos (RULB-IBI) entre el bronquio lobar superior derecho y el bronquio intermedio, y el volumen pulmonar derecho. En la revisión bibliográfica que realizamos, no encontramos ningún estudio que analizara la correlación entre los ángulos de ramificación del árbol traqueobronquial y el volumen pulmonar utilizando el método de reconstrucción tridimensional. Por lo tanto, consideramos que nuestro estudio contribuirá a la literatura especializada del tema.

comparative histological study of submucosal gland hypertrophy in trachea of mice exposed to cigarette and shisha smoke

Objective: To observe the effects of Shisha smoke on submucosal glands of trachea of mice; and compare it with tracheal glands of mice exposed to cigarette smoke

Study Design: Randomised controlled trial

Place and Duration of Study: Department of Anatomy, Islamic International Medical College, Rawalpindi, in collaboration with National Institute of Health [NIH], Islamabad from October 2013 till April 2014

Methodology: Sample comprised of 40 adult male mice of strain BALB/c. They were randomly divided into three groups. Control group was labelled as Group 'C'. The mice in this group were kept in a whole body smoke exposure chamber and were exposed to fresh air. Shisha group was labelled as Group 'SS', and the mice in this group were exposed to Shisha smoke. Mice in the third group labelled as Group CS were exposed to cigarette smoke. All the mice were dissected after an exposure period of eight weeks. Tracheal tissue was stained and examined microscopically for submucosal gland hypertrophy and compared with the control group, using Reid's Index. An Index of more than 0.4 is termed as hypertrophy

Results: There was significant submucosal gland hypertrophy in groups CS and SS as compared to group C. There was also significant difference in the frequency of mucosal hypertrophy between SS [93.7%] and CS groups [53.3%], which was found statistically significant [p<0.001]

Conclusion: Shisha smoking was significantly associated with mucosal hypertrophy when compared with cigarette smoking and controls. Shisha smoke contains higher level of toxicants as compared to cigarette smoke, and it causes more oxidative damage of tissues

Morfologia da traqueia e lobação pulmonar de Leopardus pardalis (jaguatirica) / Morphology of the trachea and lung lobation of Leopardus pardalis (ocelot)

A espécie Leopardus pardalis, conhecida popularmente como jaguatirica, é um felino de médio porte com ampla distribuição em território nacional e está incluída na lista de espécies da fauna brasileira ameaçadas de extinção. Este estudo teve como objetivo caracterizar os aspectos macroscópicos e microscópico da traqueia e lobos pulmonares em L. pardalis. As análises foram feitas utilizando cinco exemplares de jaguatirica, sendo dois machos e três fêmeas, adultos, três desses exemplares foram a óbito por atropelamento em rodovias próximas ao município de Alta Floresta, e dois doados após a morte pelo IBAMA ao o Laboratório de Zoologia e Morfologia Animal. Nos espécimes a traqueia era um tubo flexível formado por pares de arcos cartilaginosos, apresentando epitélio pseudo-estratificado não ciliado no seu revestimento interno, e outros estruturas básicas deste órgão. O pulmão se mostrou como um órgão constituído por lobos separados por fissuras com um parênquima usual aos demais mamíferos descritos. No que diz respeito às caraterísticas anatômicas da traqueia e pulmão se mostraram semelhantes à de outros mamíferos, já nos aspectos microscópicos da traqueia apresentou certas peculiaridades diferindo dos demais trabalhos encontrados. No que tange o aspecto do parênquima pulmonar as características histológicas não variaram com as que estão descritas.(AU)

The species Leopardus pardalis, popularly known as ocelot, is a medium sized cat with wide distribution in the national territory and is included in the list of species of Brazilian fauna threatened with extinction. This study aimed to characterize the macroscopic and microscopic aspects of the trachea and lung lobes in L. pardalis. Analyses were performed using five copies of ocelot, two males and three females, adults, three of these specimens died from being run over on highways nearby the municipality of Alta Floresta, and two donated after death by IBAMA to the Laboratory of Zoology and Animal Morphology. In the trachea specimens was a flexible tube formed by pairs of cartilaginous arches, with pseudo-stratified epithelium ciliated not in its inner lining, and other basic structures of this body. Lung proved as a body made up of lobes separated by cracks with a usual parenchyma to the other described mammals. With respect to the anatomic features of the trachea and lung were similar to other mammals, as in the microscopic aspects of the trachea showed certain peculiarities found differing from the other jobs. Regarding the appearance of the lung parenchyma histological characteristics did not differ with those described.(AU)

Histological description of Cerdocyon thous (Linnaeus, 1766) respiratory system / Descrição histológica do sistema respiratório de Cerdocyon thous (Linnaeus, 1766)

The massive agricultural expansion converted the Cerdocyon thous, a South American native predator, in vulnerable specie. Basic data, such as histological description, are important to raise awareness on animal species, helping on preservation strategies. Considering the difficult in obtain samples, as the euthanasia of wild animals for this purpose is not allowed, data on histology are very scarce or inexistent. The objective of this paper was to provide a detailed histological description of the trachea and bronchial tree of the crab-eating fox Cerdocyon thous (Linnaeus, 1766). The specimens (one adult male and one adult female) used were provided by the Federal University of Pelotas (Pelotas, RS, Brazil) Rehabilitation Center of Wild Fauna (NURFS). Tissue samples were fixed in 10% formalin and included in paraffin. After slicing, samples were stained with HE (hematoxylin and eosin), PAS (periodic acid-Schiff) and resorcin fuchsin. Trachea had an average diameter of 7.87mm, and approximately 57% of the mucosa ciliated pseudo-stratified columnar epithelium was composed of goblet cells, mostly in the dorsal region. Bronchia and bronchioles had a mucosal fold with higher number of goblet cells. Using all these techniques there is no great remarkable differences from C. thous trachea and lung, when compared with the previous described structures for carnivores and most mammals, except for the goblet cells "regionalization". Described results are important to understand the animal physiological and behavioral habits, allowing the development of preservation and protection strategies.(AU)

A expansão agrícola maciça tornou o Cerdocyon thous, um predador nativo sul-americano, vulnerável. Dados básicos, tais como descrição histológica, são importantes para aumentar o conhecimento sobre as espécies, ajudando nas estratégias de preservação. A eutanásia de animais selvagens para a coleta de amostras não é permitida, por isso os dados sobre a histologia são muito escassos ou inexistentes. O objetivo deste trabalho foi de fornecer uma descrição histológica detalhada da traqueia e árvore brônquica do cachorro do mato Cerdocyon thous (Linnaeus 1766). Os espécimes (um macho e uma fêmea adultos) utilizados foram fornecidos pela Universidade Federal de Pelotas (Pelotas, RS, Brasil), Centro de Reabilitação da Fauna (NURFS). As amostras de tecido foram fixadas em formalina a 10% e incluídas em parafina. Após o corte, as amostras foram coradas com HE (hematoxilina e eosina), PAS (ácido periódico de Schiff) e resorcina fucsina. A traqueia tinha um diâmetro médio de 7,87 milímetros e aproximadamente 57% do diâmetro do epitélio colunar pseudo-estratificado ciliado da mucosa composto por células caliciformes, principalmente na região dorsal do órgão. Os brônquios e bronquíolos apresentaram cararísticas similares aos outros animais, contudo aparenta ter maior número de células caliciformes. Usando distintas técnicas de coloração, observou-se que não há diferenças notáveis da traqueia e do pulmão de C. thous quando comparados com os dados para carnívoros e para a maioria dos mamíferos, exceto a regionalização de células caliciformes. Os resultados descritos são importantes para compreender a fisiologia dos animais e hábitos comportamentais, permitindo o desenvolvimento de estratégias de preservação e proteção.(AU)

Tracheal length in adult human: the results of 100 autopsies / Longitud de la tráquea en humanos adultos: los resultados de 100 autopsias

The purpose of this study was to investigate the average tracheal length and number of the tracheal cartilages in Turkish people, with emphasis on the relationships to body height and sex. A hundred fresh human cadaver tracheas were harvested from 75 males and 25 females. Age, sex and body height of cadavers were recorded. All the neck and intrathoracic structures were removed. The tracheal length was measured between the subcricoid level to the carina in resting and maximally stretched positions. Average tracheal length and number of the tracheal cartilages were compared in different body height groups in both sexes. We found that average body height was 160±6.4 cm and average tracheal length in resting position was 8.5±1 cm (range 6.5­11 cm) in females and average body height was 168.6±5.6 cm, average tracheal length was 8.7±1.1 cm (range 7­11.6 cm) in males, average number of tracheal cartilages was 13.6±1.7 (range 10­16) in females and 13.3±1.6 (range 10­19) in males and average number of the tracheal cartilages per centimeter was 1.6±0.2 in female and 1.5± 0.2 in male cadavers in resting position. Average tracheal length in male group was found to be significantly different in cadavers with body height equal or taller than 170 cm in comparison to cadavers with body height shorter than 170 cm (p <0.05). This study revealed that the average tracheal length in Turkish people is shorter than the reported length in literature. It is worth commenting that there is a considerable difference between the different races with regard to tracheal length. Tracheal length may vary with body height.

El objetivo de este estudio fue investigar la longitud traqueal promedio y el número de los cartílagos traqueales en pueblo turco, con énfasis en las relaciones a la altura del cuerpo y el sexo. Cien tráqueas frescas de cadáveres humanos fueron extraidas de 75 hombres y 25 mujeres. Se registraron la edad, sexo y altura del cuerpo en cada caso. Se disecaron el cuello y las estructuras intratorácicas. La longitud de la tráquea fue medida entre el nivel subcricoides y la carina en reposo, y en posición de máximo estiramineto. Se comparó la longitud promedio traqueal y el número de los cartílagos traqueales ente grupos con diferente de la altura del cuerpo en ambos sexos. En las mujeres, la altura del cuerpo promedio fue 160±6,4 cm y la longitud traqueal promedio en posición de reposo 8,5±1 cm (rango 6,5­11 cm). En hombres, la altura del cuerpo promedio fue 168,6±5,6 cm y la longitud traqueal promedio 8,7±1,1 cm (rango 7­11,6 cm). El número promedio de cartílagos traqueales fue 13,6±1,7 (rango 10­16) en las mujeres y 13,3±1,6 (rango 10­19) en los hombres, y el número promedio de cartílagos traqueales por centímetro fue 1,6±0,2 en mujeres y 1,5±0,2 en los hombres, en posición de reposo. La longitud traqueal promedio en el grupo de hombres fue significativamente diferente en cadáveres con una altura del cuerpo igual o mayor que 170 cm, en comparación con cadáveres con la altura del cuerpo menor a 170 cm (p<0,05). Este estudio reveló que la longitud traqueal promedio en pueblo turco es menor que la longitud reportada en la literatura. Por otra parte, existe una diferencia considerable entre las diferentes razas con respecto a la longitud traqueal. La longitud traqueal puede variar con la altura del cuerpo.

Morfologia e morfometria da traqueia da preguiça (bradypus variegatus): conhecimentos para procedimentos de emergência / Morphological and morphometric trachea sloth (bradypus variegatus): knowledge for emergency procedures

Por ser uma espécie pouco estudada, principalmente do ponto de vista morfológico, objetivou-se conhecer a anatomia da traqueia da preguiça (Bradypus variegatus) a fim de fornecer informações para facilitar a eleição de tubo endotraqueal adequado, máscara laríngea ou cânula de traqueostomia para anestesia e procedimentos de emergência, uma vez que a mesma revelou-se possuidora de uma morfologia especial. Foram investigados 11animais jovens de idades diferentes, sendo quatro machos e sete fêmeas, provenientes do Museu Emilio Goeldi e doados a UFRA. Os exemplares foram perfundidos via intramuscular com solução aquosa de formol a 10% para fins de conservação e posteriormente foram dissecados em nível cervico-torácico, por meio de mesoscopia, expondo-se desde a laringe até os brônquios principais direito e esquerdo ao nível do hilo pulmonar. As traqueias foram divididas em cinco regiões (região cervical, região da primeira flexura, região da segunda flexura, região da terceira flexura e região da carina) as quais foram mensuradas altura e largura, assim como o comprimento traqueal total e parte do material foi submetido à técnicas de rotina histológica. Macroscopicamente, destacou-se a presença de sinuosidades acentuadas em porção médio caudal, contemplando a carina. O comprimento médio traqueal foi de 14,6cm. Microscopicamente, a traqueia era constituída por placas separadas de cartilagem hialina constituindo cada anel, sendo revestido por epitélio estratificado ciliado. Apesar da traqueia da preguiça comum apresentar revestimento padrão encontrado na traqueia de outros animais, na literatura não há registros de outras espécies que tenham morfologia macroscópica nas condições descritas, o que nos leva a sugerir, quando necessário acesso para ventilação de emergência, a prática da IOT e não a de traqueostomia.

As the sloth (Bradypus variegatus) is a little studied species, especially from a morphological point of view, this research aimed to define the anatomy of its trachea. The information would facilitate the selection of a proper endotracheal tube, laryngeal mask or tracheostomy tube for anesthesia and emergency procedures, since it appeared to have a special morphology. Eleven young animals of different ages were investigated, four males and seven females, obtained from the Emilio Goeldi Museum and donated to UFRA. The specimens were infused intramuscularly with 10% aqueous formaldehyde for preservation and were later dissected at the cervico-thoracic level, by mesoscopia, exposing the area from the larynx to the right and left primary bronchi at the hilum. The tracheae were divided into five regions (cervical, first flexure, second flexure, third flexure, and carina) for which length and width were measured, as well as the total tracheal length. Sharp windings were seen in the middle caudal portion, including the carina. The average tracheal length was 14.6 cm. Microscopically, the trachea was made up of separate plates of hyaline cartilage forming each ring, lined with ciliated epithelium. Despite the trachea of the common sloth displaying the same lining pattern found in other animals, there are no reports in the literature of other species having a macroscopic morphology as described here, which leads us to suggest, where appropriate access to emergency ventilation, the practice of IOT and not tracheostomy.

Descripción histológica de los diferentes segmentos del aparato respiratorio de avestruz (Struthio camelus var. Domesticus) / Histologic description of the different segments from the ostrich respiratory system (Struthio camelus var. Domesticus)

Debido al creciente interés actual en la industria del avestruz (Struthio camelus var. domesticus) y al escaso material bibliográfico referente a la morfología del aparato respiratorio, se ha propuesto analizar comparativamente el segmento laringo traqueo siringeo pulmonar de esta especie, con el objeto de contribuir en esta área. El estudio se realizó con seis avestruces clínicamente sanos, de los cuales se obtuvieron muestras representativas del segmento laringo traqueo siringeo pulmonar. Las muestras fueron procesadas de acuerdo a las técnicas histológicas de rutina para luego realizar un análisis morfológico comparativo con la gallina (Gallus gallus). En el avestruz el cartílago aritenoides es par y está situado en posición dorsal y craneal a la laringe. El cartílago cricoides es único, situado en posición ventral y caudal a la laringe. Al igual que en la gallina, presenta un cartílago procricoides. La tráquea presenta un número mayor de anillos que el observado en la gallina. A nivel de la siringe, el pessulus está constituido por un doble pliegue dorsoventral de la membrana mucosa, con una lámina propia de tejido conectivo denso sobre una gruesa capa de tejido adiposo. A diferencia de la gallina, el pessulus del avestruz no presenta tejido cartilaginoso ni óseo. La mucosa situada desde la laringe hasta los bronquios secundarios, posee un epitelio seudoestratificado prismático ciliado con células caliciformes, con criptas y glándulas túbulo-alveolares simples de secreción mucosa. En el caso de los bronquios primarios extrapulmonares esta característica histológica se observa sólo en la región medial, donde se encuentran los extremos de los semianillos de cartílago hialino. La mucosa restante de éstos, sólo posee un epitelio seudoestratificado prismático ciliado con células caliciformes. Los sacos aéreos presentan esta característica histológica en algunos sectores.

Due to the growing interest of the ostrich industry (Struthio camelus var. domesticus) and the scarce bibliographic material related to morphology of the respiratory system of the ostrich, we carried out a comparative analysis of the laryngotracheal pulmonary segment of this bird. The research was conducted in six clinically healthy ostriches from which representative samples of the laryngotracheal pulmonary segment were obtained. Samples were processed using standard histological technique and a comparative morphological analysis between ostriches and chicken (Gallus gallus) was performed. In the ostrich, the arytenoid cartilage is double and placed in a dorsal and cranial position in relation to the larynx while the cricoid cartilage is single and situated in a ventral and caudal position. Like the chicken, the procricoid cartilage is also present. The trachea exhibits a greater number of rings compared to the chicken. At the syrinx level, the pessulus is made up of a dorso-ventral double-fold of mucous membrane with a lamina propria of dense connective tissue over a thick adipose layer. Unlike the chicken the ostrich pessulus does not contain any ossified or cartilaginous tissues. The mucosa between the larynx and secondary bronchi has a pseudostratified prismatic ciliated epithelium with mucous goblet cells with crypts and simple tubuloalveolar mucosal glands for mucous secretion. In the extrapulmonary primary bronchi this histological feature is observed only in the medial aspect where the ends of the cartilaginous rings are found. The remaining mucosa of these bronchi has a pseudostratified prismatic ciliated epithelium with mucous goblet cells. Aerial sacs show this histological feature in some sectors.

Arabian oryx (oryx leucoryx) trachea: a descriptive and morphometric analysis / Tráquea del órix de arabia (oryx leucoryx): un análisis descriptivo y morfométrico

The objective of this study was to report the distinctive anatomical and histological features of the trachea of the Arabian Oryx (Oryx leucoryx). The number of tracheal rings and tracheal length were measured. The diameter, thickness and cross sectional area of tracheal ring were determined at four tracheal regions (cranial cervical (CCR), middle cervical, thoracic inlets and intra thoracic). Tracheal rings were also collected for histological analysis. The mean length of the trachea was 54.1cm +/- 0.73, while the number of tracheal rings varied from 50-51. Tracheal ring measurements (diameter, thickness and cross sectional area) were smallest at the thoracic inlet region. The ratio of the outer transverse to outer vertical and inner transverse to inner vertical diameter ranged between 0.75 and 0.98. The histological analysis revealed that the wall of the trachea consists from four histological layers: a mucosa made of pseudostratified epithelium and lamina propria, submucosa made of dense irregular connective tissue, a hyaline cartilage and a tunica adventitia made of loose connective tissue.

El objetivo fue describir las características anatómicas e histológicas distintivas de la tráquea del Orix de Arabia (Oryx leucoryx). Fueron medidos el número de anillos traqueales y la longitud traqueal. El diámetro, grosor y área de la sección transversal (AST) del anillo traqueal fueron determinados en cuatro regiones (cervical craneal (CCR), medio cervical (MC), entradas torácicas (ET) e intratorácica (EIT)). También se realizó en los anillos traqueales el análisis histológico. La longitud media de la tráquea fue de 54,1+/-0,73 cm, mientras que el número de anillos traqueales varió desde 50 hasta 51. Las mediciones del anillo traqueal (diámetro, grosor y AST) fueron menores en la región de la entrada torácica. La relación de los diámetros transversal exterior a vertical exterior y transversal interno a vertical interno osciló entre 0,75 y 0,98. El análisis histológico reveló que la pared de la tráquea se compone de cuatro capas: mucosa de epitelio pseudoestratificado y lámina propia, submuscosa de tejido conectivo denso irregular, cartílago hialino y túnica adventicia de tejido conectivo laxo.

Observación del diámetro y morfología de la laringe y tráquea en niños menores de 3 años / Observation the diameter and morphology of the larynx and trachea in children under 3 years

Introducción: tradicionalmente se sabe que la vía aérea en niños y bebés es diferente a la de los adultos. Esto se basa en estudios que demostraban que la zona más estrecha de la misma en los niños es el área subglótica. Con la aparición de nuevas técnicas de diagnóstico por imágenes (TAC, RMN) comenzaron a reevaluarse los clásicos conceptos. Objetivo: medir los diámetros laríngeo y traqueal y la morfología de esta parte de la vía aérea en niños de hasta tres años, para observar si la zona más estrecha se halla a nivel subglótico o glótico. Diseño: investigación clínica observacional descriptiva exploratoria. Población: niños de hasta tres años sin alteraciones craneofaciales sometidos a resonancias magnéticas en SAMIC “Prof. Dr. Juan P. Garrahan” Hospital Pediátrico entre enero de 2011 y abril de 2012. Métodos: todos los pacientes incluidos fueron anestesiados con sevoflorano menos de 1 CAM, con ventilación espontánea con mascarilla; las imágenes fueron tomadas y analizadas por tres personas diferentes. Las mediciones de los diámetros por diferentes operadores permitió evaluar la confiabilidad de las mismas evaluando variabilidad inter-observador. Para analizar la concordancia entre los diferentes observadores se utilizó la correlación intraclase. Para analizar las diferencias entre las medidas de la glotis con las de la subglotis y cricoides se utilizó el test no paramétrico del signo. Resultados: no se encuentran diferencias significativas a favor de los diámetros subglóticos, como se consideraba tradicionalmente, excepto en la medida que compara los diámetros glótico y cricoideo en el plano axial anteroposterior.

Evaluation of histological changes after tracheal occlusion at different gestational ages in a fetal rat model

OBJECTIVES: To evaluate the histological changes of tracheal cartilage and epithelium caused by tracheal occlusion at different gestational ages in a fetal rat model. METHODS: Rat fetuses were divided into two groups: a) External control, composed of non-operated rats, and b) Interventional group, composed of rats operated upon on gestational day 18.5 (term = 22 days), divided into triads: 1) Tracheal occlusion, 2) Internal control and 3) Sham (manipulated but not operated). Morphological data for body weight, total lung weight and total lung weight/body weight ratio were collected and measured on gestational days 19.5, 20.5 and 21.5. Tracheal samples were histologically processed, and epithelial, chondral and total tracheal thicknesses were measured on each gestational day. RESULTS: The tracheal occlusion group exhibited an increase in total lung weight/body weight ratio (p<0.001). Histologically, this group had a thicker epithelial thickness (p<0.05) and thinner chondral (p<0.05) and total tracheal thicknesses (p<0.001). These differences were more prominent on gestational days 20.5 and 21.5. CONCLUSION: Tracheal occlusion changed tracheal morphology, increased epithelial thickness and considerably decreased total tracheal thickness. These changes in the tracheal wall could explain the development of tracheomegaly, recently reported in some human fetuses subjected to tracheal occlusion.

Entrenador virtual de fibrobroncoscopia de bajo costo para enseñanza / Development of a virtual model of fibro-bronchoscopy

A virtual model of fibro-bronchoscopy is reported. The virtual model represents in 3D the trachea and the bronchi creating a virtual world of the bronchial tree. The bronchoscope is modeled to look over the bronchial tree imitating the displacement and rotation of the real bronchoscope. The parameters of the virtual model were gradually adjusted according to expert opinion and allowed the training of specialists with a virtual bronchoscope of great realism. The virtual bronchial tree provides clues of reality regarding the movement of the bronchoscope, creating the illusion that the virtual instrument is behaving as the real one with all the benefits in costs that this means.

Modelo para o aprendizado experimental em cirurgia e microcirurgia vascular: esôfago e traquéia de frango / Experimental model for learning in vascular surgery and microsurgery: esophagus and trachea of chicken

PURPOSE: This paper proposes a model of training surgical skills using vascular anastomosis in an animal model that simulates the size, consistency and resistance arteries and veins, to use it to chicken trachea and esophagus, respectively. METHODS: We used chicken necks where the esophagus and trachea were dissected and after preparation were followed every step of the procedure of vascular anastomosis. The flow of the anastomosis was confirmed by direct observation and testing of filling (empty-and-refill test) immediately after the anastomosis. RESULTS: All samples proved to be viable by the criteria described above. CONCLUSION: For the first time presents an interesting experimental model used to train vascular sutures, because it is endowed with all the necessary requirements for the learning of experimental vascular surgery.

OBJETIVO: O presente trabalho propõe um modelo de treinamento de habilidades cirúrgicas em anastomoses vasculares utilizando um modelo que simula o calibre, a consistência e a resistência arterial e venosa, utilizando-se para isto a traquéia e esôfago de frango, respectivamente. MÉTODOS: Foram utilizados pescoços de frango, onde foram dissecados esôfago e traquéia e após preparo foram seguidos todos os passos do procedimento da anastomose vascular. O fluxo das anastomoses foi comprovado por observação direta e teste de enchimento imediatamente após as anastomoses. RESULTADOS: Todas as amostras mostraram-se viáveis pelos critérios acima descritos. CONCLUSÃO: Pela primeira vez apresenta-se um modelo experimental interessante que serve para treinar suturas vasculares, pois é dotado de todos os requisitos necessários para o aprendizado da cirurgia vascular experimental.

Structure and concentration of elastic system fibers in the trachea of the rat / Estructura y concentración del sistema de fibras elásticas en la tráquea de la rata

The extracellular matrix is a key element in the tracheal morphology and physiology, both in normal and pathological states, yet little is known regarding its composition and organization. Herein we carried out a detailed study of the morphological organization and volumetric density of elastic system fibers in the trachea of Wistar rats. Six Wistar rats at the age of 45 days were used. The trachea was excised following anesthesia with Thiopental and perfusion through the left ventricle with buffered saline followed by formalin solution. Samples were fixed in formaline, embedded in paraffin, and histologically processed. The elastic system fibers were evaluated at light microscopy by using Weigert's resorcin-fuchsin technique after oxidation with oxone. Morphometric studies were performed by the point-counting method. Quantities were expressed ( percent, mean) as volumetric densities and were determined on 25 random fields for each animal. Elastic system fibers were identified beneath the tracheal mucosa showing mainly a longitudinal profile. There were also some bundles of oblique fibers in this region, forming an irregular network of elastic tissue. Close to the inner surface of the cartilaginous ring, a well defined circular layer is present. The volumetric density of the elastic system fibers in the trachea of Wistar rats is 2.46 +/- 0.99 percent. The data in the present study provides original information regarding the elastic system fibers of the rat trachea, which might be used as a model for studying human major airway morphology. The results reported herein provide the basis for continuous investigations on tracheal extracellular matrix by stereology.

La matriz extracelular es un elemento clave en la morfología y fisiología de la tráquea, tanto en estados normales como patológicos. Sin embargo, poco se sabe acerca de su composición y organización. Se llevó a cabo un estudio detallado de la organización morfológica y la densidad volumétrica de fibras del sistema elástico en la tráquea de ratas Wistar. Se utilizaron seis ratas Wistar edad de 45 días de vida. La tráquea fue extraída después de anestesia con tiopental y la perfusión a través del ventrículo izquierdo con solución salina tamponada seguido de solución de formalina. Las muestras fueron fijadas en formalina e incluidas en parafina y se procesaron histológicamente. Las fibras del sistema elástico fueron evaluadas en microscopía de luz utilizando la técnica de Weigert, resorcina-fucsina después de la oxidación con Oxone. Los estudios morfométricos fueron realizados por el método de conteo de puntos. Las cantidades se expresaron ( por ciento, media) como la densidad volumétrica y se determinaron en 25 campos al azar para cada animal. Las fibras elásticas del sistema fueron identificadas por bajo la mucosa traqueal que muestra principalmente un perfil longitudinal. También se encontraron algunos haces de fibras oblicuas en esta región, formando una red irregular de tejido elástico. Cerca de la superficie interna del anillo cartilaginoso, una capa bien definida circular está presente. La densidad volumétrica de las fibras del sistema elástico en la tráquea de ratas Wistar fue de 2,46 +/- 0,99 por ciento. Los datos del presente estudio proporcionan información inicial sobre las fibras del sistema elástico de la tráquea de rata, que puede ser utilizado como un modelo para el estudio de la morfología de las vías respiratorias humanas. Los resultados reportados en este documento constituyen la base de investigaciones continuas en la tráquea de la matriz extracelular por estereología.

Microscopic anatomy of the lower respiratory system of the African giant pouched rat (Cricetomys gambianus, Waterhouse 1840) / Anatomía microscópica del sistema respiratorio inferior de la rata gigante Africana (Cricetomys gambianus, Waterhouse 1840)

A qualitative and quantitative study, by light microscopy, was undertaken on the lower respiratory system of the African Giant pouched rat. Specifically, the trachea, bronchi and lungs were stained with Haematoxylin and eosin, Alcian blue at a pH of 2.5 and Periodic Acid-Schiff stains. Three cell types were identified in saggital sections of the trachea: the ciliated cells, basal cells and mucous cells. Fibers of the trachealis muscles in the laminar propria separated the underlying cartilages from the basal cells. Mucous cells were visible only in the membranous portion of the trachea and they were predominant in the rostral and caudal portion of the trachea. Lobar bronchi consisted of cuboidal epithelium and a layer of one or two smooth muscle cells and opened into segmental bronchi and respiratory bronchiole. Some tracheal cartilaginous rims stained blue with AB while most glandular cells stained red with PAS. The diameter of respiratory bronchiole, alveoli duct and alveoli were 24.93 µm (+/- 1.27), 21.14 um (+/- 0.66) and 12.95 um (+/- 0.21), respectively. These and other findings were compared with similar report in other rodents.

Se realizó un estudio cualitativo y cuantitativo, mediante microscopía de luz, en el sistema respiratorio inferior de la rata gigante Africana. La tráquea, los bronquios y los pulmones fueron teñidos con hematoxilina y eosina, azul Alcián a pH de 2,5 y ácido periódico de Schiff. Tres tipos de células fueron identificadas en las secciones sagitales de la tráquea: células ciliadas, basales y mucosas. Las fibras del músculo traqueal en la propia laminar separados los cartílagos subyacente de las células basales. las células mucosas son visibles sólo en la porción membranosa de la tráquea y predominan en la parte rostral de la porción caudal de la tráquea. Los bronquios lobares consistían en epitelio cúbico y una capa de una o dos células de músculo liso y abierto en los bronquios y bronquiolos segmentarios respiratorias. Algunos bordes azules cartilaginoso traqueal manchada con AB, mientras que la mayoría de las células glandulares teñido de rojo con PAS. El diámetro de los bronquiolos respiratorios, conductos alveolares y los alvéolos fueron 24,93 m (+/- 1,27), 21,14 m (+/- 0,66) y 12,95 m (+/- 0,21), respectivamente. Estos y otros resultados se compararon con el informe similar en otros roedores.

Descripción anatómica del esqueleto de los tractos respiratorios superiores del periquito australiano (Melopsittacus undulatus) / Anatomical description of upper respiratory tracts skeleton of budgerigar (Melopsittacus undulatus)

Se describe detalladamente los elementos esqueléticos de los tractos respiratorios superiores de 10 periquitos australianos (Melopsittacus undulatus), dicha descripción permitió encontrar claras diferencias en su anatomía no referidas con anterioridad, debido posiblemente al interés por estudiar la siringe y no los tractos respiratorios completos, el objetivo principal fue describir la morfología y osificación de los tractos respiratorios superiores del periquito australiano, a través de la técnica de transparentación con doble tinción (rojo de alizarina "S" y azul de alciano), que permite observar la osificación de los tractos respiratorios; obteniendo como resultado dos diferencias óseas importantes: (1) la lengua exhibe dos pequeños huesos paraglosales asociados con la movilidad de la misma y (2) una importante osificación desde la lengua hasta los elementos "A" siringeales. En cuanto al patrón del esqueleto traqueal y siríngeo, no se observan grandes diferencias con respecto a otros psittaciformes. Se propone el estudio del esqueleto lingual para determinar su importancia en el establecimiento de relaciones de parentesco y su valor taxonómico, y de esta forma, abrir una puerta para nuevos estudios de morfología comparativa.

In this work describes in detail skeletical elements of upper respiratory tracts of 10 budgerigars (Melopsittacus undulatus), the description obtains evident differences in its anatomy doesn't relate before, this should to be possible at interest to study syrinx and not full respiratory tracts the objective was to describer morphology and ossification of full upper respiratory tracts of budgerigar, this obtained utilizing clearing technique's with stain double (alizarin red "S" and alcian blue) it allows to observe ossification of respiratory tracts, it obtained like result two principal evident differences: (1) the lingual shows two small paragloss bones associates with its mobility and (2) a important ossification from the lingual to "A" syrinx elements. Respectful at patron tracheal and syrinx skeletical doesn't show evident differences in comparation with other psittacidae. It proposes a study of lingual skeletical to determination of importance for to establish relationship and its taxonomic value and this form meets a door for new studies of comparative morphology.

Sleep disordered breathing in children.

Sleep disordered breathing (SDB) is increasingly being recognised as a cause of morbidity even in young children. With an estimated prevalence of 1 to 4 per cent, SDB results from having a structurally narrow airway combined with reduced neuromuscular tone and increased airway collapsibility. SDB in children differs from adults in a number of ways, including presenting symptoms and treatment. Presentation may differ according to the age of the child. Children have a more varied presentation from snoring and frequent arousals to enuresis to hyperactivity. Those with Down syndrome, midface hypoplasia or neuromuscular disorders are at higher risk for developing SDB. First line definitive treatment in children involves tonsillectomy and adenoidectomy. Rapid maxillary expansion, allergy treatment and continuous positive airway pressure (CPAP) are other options. As untreated SDB results in complications as learning difficulties, memory loss and a long term increase in risk of hypertension, depression and poor growth, it is important to diagnose SDB.

Evaluation of the upper airway in obstructive sleep apnoea.

The evaluation of the upper airway (UA) includes the physical examination of pharyngeal structures and a number of imaging techniques that vary from the mostly used lateral cephalometry and computed tomography to more sophisticated methods such as tri-dimensional magnetic resonance image (MRI). Other complex techniques addressing UA collapsibility assessed by measurement of pharyngeal critical pressure and negative expiratory pressure however are not routinely performed. These methods provide information about anatomic abnormalities and the level of pharyngeal narrowing or collapse while the patient is awake or asleep. Data suggest that individual patients have different patterns of UA narrowing. So, the best method for evaluating obstruction during obstructive events remains controversial. In general, in clinical practice physical examination including a systematic evaluation of facial morphology, mouth, nasal cavity and the pharynx as well as simple imaging techniques such as nasopharyngoscopy and cephalometry have been more routinely utilized. Findings associated with obstructive sleep apnoea (OSA) are UA narrowing by the lateral pharyngeal walls and enlargements of tonsils, uvula and tongue. Additionally cephalometry identifies the most significant craniofacial characteristics associated with this disease. MRI studies demonstrated that lateral narrowing of UA in OSA is due to parapharyngeal muscle hypertrophy and/or enlargement of non adipose soft tissues. The upper airway evaluation has indubitably contributed to understand the pathophysiology and the diagnosis of OSA and snoring. Additionally, it also helps to identify the subjects with increased OSA risk as well as to select the more appropriate modality of treatment, especially for surgical procedures.

Quantitative anatomy of the trachea of the giraffe (Giraffa camelopardalis rothschildi) / Anatomía cuantitativa de la tráquea de la jirafa (Giraffa camelopardalis rothschildi)

We described the macroscopic and quantitative anatomy of the trachea of the Giraffe (Giraffa camelopardalis rothschildi). The trachea of one juvenile male giraffe (25 months of age) weighing 754 kg was used in this study. The length of the neck was 125 cm. The trachea had 107 cm in length on its cervical part and 18 cm on its thoracic part. The total number of cartilage was 87.74 at the neck and 13 at the thorax. The general shape of the duct was mostly circular. The separation of the dorsal ends of the tracheal cartilages was pronounced in the first half of the cervical trachea, reducing caudally and overlapping in the thoracic trachea. In the caudal part the trachea had a tracheal bronchus for the cranial lobe of the right lung and the end of the trachea was divided into two main bronchi, where the left was larger in diameter.

Describimos la anatomía macroscópica y cuantitativa de la tráquea de la jirafa (Giraffa camelopardalis rothschildi). La tráquea de una jirafa macho joven (25 meses de edad), con un peso 754 kg fue utilizada en este estudio. La longitud del cuello era de 125 cm. La tráquea tuvo 107 cm de longitud en su parte cervical y 18 cm en su parte torácica. El número total de cartílagos fue de 87,74 en el cuello y 13 en el tórax. La forma general de la vía fue principalmente circular. La separación de los extremos dorsales de los cartílagos traqueales se pronunció en la primera mitad de la tráquea cervical, reduciéndose caudalmente y superponiéndose en la tráquea torácica. En la parte caudal la tráquea tenía un bronquio traqueal para el lobo craneal del pulmón derecho y el final de la tráquea se dividió en dos bronquios principales, donde el izquierdo fue de mayor diámetro.