[Laryngotracheal reconstruction in children with subglottic stenosis].

OBJECTIVE: To study the effect of laryngotracheal reconstruction (LTR) in children with subglottic stenosis (SGS), and to discuss the indications and the risks of intraoperative and postoperative treatment of LTR. METHODS: From September 2008 to February 2010, 5 children (4 girls and 1 boy, aged 4 to 6 years) were treated by LTR. Among the 5 children, there were 2 congenital SGS and 3 acquired SGS. One had mild grade III SGS, 3 had severe grade III SGS, and one had grade IV SGS. One child with mild III SGS was treated by single-stage LTR, and the rest four children were treated by double-stage LTR. The surgical technique consisted of cricoid lamina midline vertical incision, rib cartilage graft interposition and endotracheal tube (ETT) stenting for 2 to 3 weeks. RESULTS: Four children with grade III SGS were de-cannulated 3 months after operation, and the child with grade IV SGS got de-cannulated 6 months after operation. Of all children, rib cartilage graft grower well, and the size of subglottis were amplified by grade III SGS to grade I SGS, and grade IV SGS to grade II SGS. All children obtained stable airway. One child with grade IV SGS who had hoarseness got effective phonation during follow-up 2 years after operation. CONCLUSIONS: LTR is a safe and effective treatment for pediatric subglottic stenosis. The important factors of successful operation are correct assessment and evaluation of the severity and overall medical status and selection of suitable surgical techniques.

Lingual thyroglossal duct cyst with recurrence after cystectomy or marsupialization under endoscopy: diagnosis and modified Sistrunk surgery.

OBJECTIVE: To explore the radiologic characteristics of lingual thyroglossal duct cyst relevant to diagnosis. In addition, to probe the feasibility of modified Sistrunk surgery for patients who experience recurrence after cystectomy or marsupialization under endoscopy. STUDY DESIGN: Retrospective. METHODS: Seven patients, three male and four female, who had been diagnosed with lingual thyroglossal duct cysts, had received cystectomy or marsupialization under endoscopy between one and eight times with cyst recurrence soon after every operation. All of these cases were evaluated by CT before proceeding with the latest modified Sistrunk surgery. During surgery, we routinely used methylene blue to trace the cysts, and then we used an enlarged Sistrunk procedure for such cases. RESULTS: The CT images demonstrated that there were cysts located posteriorly to the tongue that had a close relationship with the hyoid bone and the foramen cecum. In addition, the results of the pathological examinations were consistent with thyroglossal duct cysts. During the postoperative follow up of 18 to 31 months, the patients did not show any symptoms or signs of recurrence. The results of their most recent examinations, two by laryngoscopy and five by CT scan, did not reveal any abnormality in their pars laryngea pharyngis. CONCLUSIONS: CT could differentiate lingual thyroglossal duct cysts from the other cysts occurring at the lingual root. For those patients with lingual thyroglossal duct cysts that recur after cystectomy or marsupialization under endoscopy, the modified Sistrunk operation could be a suitable treatment option.

Endoscopic carbon dioxide laser procedure for an endogenous thyroglossal duct cyst.

From 1940 to September 2008, 21 cases with TDCs extending into respiratory tract have been reported, often with misdiagnosis. There were only 10 cases by the end of 2006, but the number increased rapidly recently. To evaluate endoscopic carbon dioxide (CO(2)) laser procedure for thyroglossal duct cyst (TDC) extending into respiratory tract, we reported an unusual case and performed a retrospective correlate review. A 3-year-old female patient with a TDC extending into respiratory tract, without any neck lumps, was previously misdiagnosed as an epiglottic cyst. An asymptomatic follow-up visit had been for 10 months after she had received endoscopic CO(2) laser procedure. To our best knowledge, endoscopic CO(2) laser procedure was administered for the first time for TDCs, though it had been a valid management of other benign lesions in respiratory tract. The endoscopic CO(2) laser procedure might be for TDC extending into respiratory tract. In order to increase awareness of this situation, we recommend that the novel concept of endogenous type should be considered to unify these TDCs extending into respiratory tract without projecting neck masses.

[Expression and purification of recombinant human interleukin 4 in Escherichia coli].

Human interleukin 4 (IL-4) cDNA was optimized and synthesized according to E. coli preferred codon. A recombinant expression plasmid pET-30a (+)/rhIL-4 was constructed with the target cDNA inserted between Nde I and EcoR I sites, which can translate the mature IL-4 protein with an extra methionine residue at N-terminal. The expression vector was transformed into E. coli BL21 (DE3). The rhIL-4 protein was expressed in the inclusion body. By using the optimized fermentation conditions, the high expression level was achieved with the expression level as high as 35% of total protein obtained. A purification strategy has been designed which includes Q-Sepharose and SP-Sepharose ion-exchange chromatography and dialysis renaturation. The rhIL-4 was purified with the purity more than 98% and the yield of 40 mg per liter fermentation culture achieved. Western blot proved that the purified protein is IL-4. Amino acid sequencing revealed that N-terminal 16 residue sequence is identical to the theoretical sequence. Biological activity assay on TF-1 cells demonstrated that the rhIL-4 is active with an activity of 2.5 x 10(6) AU/mg. This study promises large scale production of rhIL-4.

[An experimental study(II) on the inhibition of prostatic hyperplasia by extract of seeds of Brassica alba].

OBJECTIVE: To study the active components and their functionary mechanism of the extract of Brassica alba seeds, which inhibits experimental mice prostatic hyperplasia. METHOD: Prostatic hyperplasia of castrated male mice induced by testosterone propionate, the penetrability of capillary vessel of mice skin induced by histamine and the endermic flesh bud of rat induced by filter paper were used as experimental models. Sinalbin and beta-sitosterol separated from seeds of Brassica alba were used to test the activities. RESULT: Sinalbin and beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly inhibit mice prostatic hyperplasia induced by testosterone propionate and activity of serum acid phosphatase(P < 0.01 or P < 0.05), Sinalbin(16.0 mg.kg-1.d-1)could significantly inhibit the hyperplasia of endermic flesh bud in rat induced by filter paper(P < 0.05), beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly decrease the penetrability of capillary vessel of mice skin induced by histamine. CONCLUSION: Sinalbin and beta-sitosterol have anti-androgen and anti-inflammation activities.

[An experimental study(I) on the inhibition of prostatic hyperplasia with extract of seeds of Brassica alba].

OBJECTIVE: To study the effective fraction of the extract of seeds of Brassica alba, which inhibits experimental mice prostatic hyperplasia. METHOD: An experimental model of prostatic hyperplasia of castrated male mice induced by testosterone propionate was made. Fractions I, II and III were prepared by extracting the seeds of Brassica alba successively with ether, ethanol and water under reflux. Total extract was prepared by extracting the seeds of Brassica alba with 60% ethanol under reflux. The total extract and the three fractions were used to test the activities. RESULT: Total extract, fractions I and II could not only significantly inhibit mice prostatic hyperplasia induced by testosterone propionate and activity of serum acid phosphatase, but also decrease wet weight of preputial glands, while fraction III is inactive. CONCLUSION: Extract from seeds of Brassica alba can significantly inhibit mice prostatic hyperplasia induced by exterior hormone, possessing an activity of anti-androgen. Fractions I and II show an equivalent activity of total extract, which indicate that these fractions contain active components of seeds of Brassica alba which can inhibit prostatic hyperplasia.