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BACKGROUND AND OBJECTIVES: The purpose of this research was to evaluate physiological significances of expression of immediate early gene proteins in the vestibular nuclear complex by change of arterial pressure (AP) in adult Sprague-Dawley rats. MATERIALS AND METHOD: Record AP and inject either sodium nitroprusside (SNP) or phenylnephrine to change AP. Either fast or slow removal of blood from the femoral artery was made to induce different rapidity in reduction of AP. Blood supply to the inner ear was temporally blocked by clamping anterior inferior cerebellar artery (AICA). Immunohistochemical staining and image analysis for cFos, FosB, Krox, and JunB proteins were performed 2, 6, 12 hours after change of AP. RESULTS: The selective expression of cFos protein was observed in the medial vestibular nucleus (MVN) following reduction of AP. The number of cFos positive neurons peaked at 2 hours and then rapidly reduced, returning to the normal value 24 hours after SNP injection. And cFos protein expression was also well correlated with that of AP reduction at 2 hours of SNP injection. The rapid falling of AP caused a significant expression of cFos protein but slow withdrawal of blood did a minimal change of cFos protein expression. In addition, there was a significant expression of cFos protein following the increase of AP by single injection of phenylnephrine. Unilateral occlusion of AICA resulted in the significant expression of cFos protein in bilateral MVN. Furthermore, bilateral ablation of vestibular endorgans resulted in significant reduction of cFos expression by AICA occlusion in MVN. CONCLUSION: These results suggest that cFos protein is a marker for neuronal excitation in vestibular complex in response to rapid changes in the arterial blood pressure and that medial vestibular nuclei plays an important role in signaling the process of cardiovascular information coming from the peripheral vestibular apparatus.
Assuntos
Adulto , Animais , Humanos , Ratos , Pressão Arterial , Artérias , Pressão Sanguínea , Constrição , Orelha Interna , Artéria Femoral , Neurônios , Nitroprussiato , Proteínas , Ratos Sprague-Dawley , Valores de Referência , Núcleos Vestibulares , Vestíbulo do LabirintoRESUMO
BACKGROUND AND OBJECTIVES: The combined Laryngotracheal stenosis produces cripling complications of respiratory and phonation difficulty. The area between cricoid cartilage and first tracheal ring is the most common site of stenosis and is the most difficult area to manage, therefore, appropriate selection of surgical method is the important factor determining the success of treatment. The authors treated laryngotracheal stenosis with thyrotracheal anastomosis and here we report the results and problems of thyrotracheal anastomosis to provide aid in the management of laryngotracheal stenosis. MATERIALS AND METHODS: Authors retrospectively studied 11 cases of laryngotracheal resection with thyrotracheal anastomosis patients for clinical characteristics, site and degree of stenosis, operation technique such as granulation tissue removal under bronchoscopy, CO2 laser excision, insertion of T-tube, insertion of laryngeal stent, and its results. RESULTS: 1) Decannulation was possible in seven cases (63.6%). 2) The success rates of patients under the ages of 20years was 80%, patients with normal vocal cord movement was 85.7%. 3) The patients with residual neurologic symptom, or with decreased coughing reflex failed in decannulation. CONCLUSION: Treatment of combined laryngotracheal stenosis is very difficult and our study showed a success rate of 63.6%. Laryngotracheal resection and end to end thyrotracheal anastomosis showed to be the most effective treatment method and in general the patients under the ages of 20 years, or with normal vocal cord movement showed better prognosis. Therefore, a radical treatment planning with efforts to reduce complication at this group may produce satisfactory results in the management of laryngotracheal stenosis.
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Humanos , Broncoscopia , Constrição Patológica , Tosse , Cartilagem Cricoide , Tecido de Granulação , Lasers de Gás , Manifestações Neurológicas , Fonação , Prognóstico , Reflexo , Estudos Retrospectivos , Stents , Prega VocalRESUMO
BACKGROUND AND OBJECTIVES: The Warthin's tumor is characterized by its frequent occurrence in the parotid tail and multifocal presentation. Superficial or total parotidectomy was advocated by many surgeons due to its multifocal nature. Recently, with the advancement of various radiologic diagnostic methods, more conservative surgical management with low morbidities can be considered since an accurate pattern and site of the tumor can be determined. MATERIALS AND METHODS: Authors retrospectively studied 20 cases of pathologically diagnosed Warthin's tumor for clinical pattern, tumor site in parotid gland, recurrence and complication rate according to different surgical methods. Patients were divided into two groups: Group II received enucleation and Group II received either superficial parotidectomy or total parotidectomy. RESULTS: Post operative complication rate was low in enucleation group, compared with parotidectomy. There was no difference in the recurrence between the two groups. CONCLUSION: Enucleation is an effective method in treatment of solitary or multifocal Warthin's tumors.
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Humanos , Glândula Parótida , Recidiva , Estudos RetrospectivosRESUMO
Tracheal stenosis can be caused by various etiologies, such as infectious disease, trauma from previous prolonged incubation, airway surgery, or external blunt trauma, and neoplasm. Recently, the development of emergency and intensive care units leads to the primary cause of airway stenosis using airway devices. The stenotic lesions can be produced at any level between the vocal cord and the site of the tip of the tube. Laryngotracheal stenosis may be due to prolonged endotrachel intubation, especially with large tube, large tracheostomy stoma, too highly placed oacheostomy, erosion by local infection, the prying action of heavyweight equipment that connects the tracheostomy to the ventilator, excessive cuff pressure, or erosion by the tip of the tube. Prevention of tracheal stenosis is of key importance by understanding and attending to these causes. We experienced three cases of tracheal stenosis occurred after use of airway devices. In first and second cases, We performed end-to-end anastomosis artier resection of stenotic segment of the trachea in a 22-year-ol4 female and a 25-year-old male. They ha6 been treated with prolonged endotracheal incubation and emergency tracheostomy, respectively, for a ventilatory support for the respiratory failure after falling down from a height. The stenotic lesions occurred at the cuff site in the first case and at the stomal level in the second case. In third case, We performed one-stage laryngotracheoplastic procedure for subglottic stenosis in a 23-year-old male. He had been treated with emergence tracheostomy which had been placed too high for a ventilators support for the respiratory failure after traffic accident. The stenotic lesion occurred at the stomal level. The postoperative courses were uneventful.
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Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Acidentes de Trânsito , Doenças Transmissíveis , Constrição Patológica , Emergências , Unidades de Terapia Intensiva , Intubação , Insuficiência Respiratória , Traqueia , Estenose Traqueal , Traqueostomia , Ventiladores Mecânicos , Prega VocalRESUMO
BACKGROUND AND OBJECTIVES: Substernal goiter, defined as any thyroid enlargement that has greater mass inferior to the thoracic inlet, is a relatively rare disease with a potential for malignancy and the risk of postoperative airway obstruction secondary to tracheomalacia. We investigated clinical characteristics of substernal goiters and analyzed the results of the treatment to establish modalities of the surgical management. MATERIALS AND METHODS: We examined, retrospectively, ten cases of substernal goiters and reviewed their clinical features, radiological findings, histopathologic findings, operative findings and postoperative complications. RESULTS: We found tracheal deviations in six patients, tracheomalacia in three patients and calcification in two patients. We performed partial thyroidectomy for 9 cases and total thyroidectomy and superior mediastinal dissection were done for a case which revealed to be follicular carcinoma. The main histopathologic findings were multinodular goiter in five cases, followed by follicular adenoma, and follicular carcinoma in one case. Endotracheal intubation was removed after 24 hours postoperatively for six cases who showed severe tracheal compression and tracheal deviation and the tracheopexy (tracheal suspension) to the sternum was performed for one case among them. CONCLUSION: Because of the possibilities of malignancy and the acute airway obstruction, the surgical treatment and careful postoperative airway management should be emphasized for substernal goiter.
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Humanos , Adenoma , Manuseio das Vias Aéreas , Obstrução das Vias Respiratórias , Baías , Bócio , Bócio Subesternal , Intubação Intratraqueal , Complicações Pós-Operatórias , Doenças Raras , Estudos Retrospectivos , Esterno , Glândula Tireoide , Tireoidectomia , TraqueomaláciaRESUMO
No abstract available.
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Processo Mastoide , Otite Média com Derrame , Otite Média , OtiteRESUMO
No abstract available.
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No abstract available.
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No abstract available.
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Processo Mastoide , Otite Média com Derrame , Otite Média , OtiteRESUMO
No abstract available.