ABSTRACT
Since homocysteine (Hcy) is considered a risk factor to cerebral diseases and adenine nucleotides are important molecules to brain normal function, in the present study we investigated the effect of chronic mild hyperhomocysteinemia on ectonucleotidase activities and expression in rat cerebral cortex. The levels of ATP, ADP, AMP and adenosine (Ado) in cerebrospinal fluid (CSF) of adult rats also were evaluated by high-performance liquid chromatography. For the chronic chemically induced mild hyperhomocysteinemia, Hcy (0.03 µmol/g of body weight) was administered subcutaneously from the 30th to the 60th day of life. Control rats received saline solution in the same volumes. Results showed that Hcy significantly decreased nucleotide hydrolysis in the synaptosomal fraction and increased E-NTPDase1 and ecto-5'-nucleotidase transcripts in rat cerebral cortex. ATP levels were significantly increased, while Ado decreased in CSF of Hcy-treated rats. These findings suggest that the unbalance in ATP and Ado levels may be, at last in part, involved in the cerebral toxicity of mild hyperhomocysteinemia.
Subject(s)
Adenine/metabolism , Brain/pathology , Extracellular Fluid/metabolism , Hyperhomocysteinemia/pathology , 5'-Nucleotidase/genetics , 5'-Nucleotidase/metabolism , Adenosine Diphosphate/metabolism , Adenosine Triphosphatases/genetics , Adenosine Triphosphatases/metabolism , Adenosine Triphosphate/metabolism , Animals , Brain/metabolism , Brain/ultrastructure , Disease Models, Animal , GPI-Linked Proteins/genetics , GPI-Linked Proteins/metabolism , Gene Expression Regulation, Enzymologic , Hyperhomocysteinemia/metabolism , Purines/cerebrospinal fluid , RNA, Messenger , Rats , Rats, Wistar , Subcellular Fractions/metabolism , Subcellular Fractions/pathology , Synaptosomes/metabolismABSTRACT
OBJECTIVE: To assess the rate of tracheocutaneous fistula requiring surgical repair and the complications and outcomes following it in the ENT department of a tertiary referral university paediatric hospital. METHODS: A retrospective review of all children requiring airway support with a tracheostomy between 1995 and 2009 and subsequently requiring closure of tracheocutaneous fistula. RESULTS: One hundred and ninety-three children underwent 196 tracheostomies. Seventy-three children were successfully decannulated until now. Twenty-three children (11.9%) required subsequent surgical closure of their tracheocutaneous fistula. In all these children the age at tracheostomy was less than 1 year old, and the median age at decannulation was 4 years old, (range 2-9 yo). Surgical repair was undertaken 6-12 months after decannulation. There were 4 minor complications in the postoperative period (wound infection, haemorrhage and early recurrence) and no major complications. None of the patients have experienced any degree of significant airway stenosis and there was no need for a repeat tracheotomy in any of the tracheocutaneous fistula closure patients. The cosmetic results were deemed to be good. CONCLUSIONS: Our rate of tracheocutaneous fistula compares well with the reported rates in the literature (13-43%). There appears to be a significant relation to age at tracheostomy and duration of tracheostomy.
Subject(s)
Cutaneous Fistula/epidemiology , Cutaneous Fistula/surgery , Hospitals, Pediatric/statistics & numerical data , Postoperative Complications , Respiratory Tract Fistula/etiology , Tracheal Diseases/etiology , Tracheostomy/methods , Child , Female , Humans , Male , Respiratory Tract Fistula/epidemiology , Respiratory Tract Fistula/surgery , Trachea , Tracheal Diseases/epidemiology , Tracheal Diseases/surgeryABSTRACT
A 29-year-old man fractured his thyroid cartilage while playing rugby. It was treated successfully with an Inion biodegradable plating system. Biodegradable plates are recommended for laryngeal reconstruction.
Subject(s)
Absorbable Implants , Fracture Fixation, Internal/instrumentation , Fractures, Cartilage/surgery , Thyroid Cartilage/injuries , Adult , Deglutition Disorders/etiology , Football/injuries , Fractures, Cartilage/complications , Humans , Internal Fixators , Male , Voice Disorders/etiologyABSTRACT
Recurrent respiratory papillomatosis (RRP) is a benign, often multi-focal neoplasm. A potentially fatal manifestation of human papilloma virus infection, the condition is characterised by multiple warty excrescences on the mucosal surface of the respiratory tract. RRP is rare--incidence is estimated at 3.5 per million person-years, with a prevalence of 4 in 100,000 children. Affected children usually require multiple interventions; the impact on patients, their families, and the healthcare system is considerable. Treatment of RRP accounts for an estimated dollar 109 million annual expenditure in the USA.
Subject(s)
Neoplasm Recurrence, Local , Papilloma , Papillomavirus Infections , Respiratory Tract Neoplasms , Antiviral Agents/therapeutic use , Child , Early Diagnosis , Humans , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/therapy , Papilloma/diagnosis , Papilloma/therapy , Papillomavirus Infections/diagnosis , Papillomavirus Infections/therapy , Respiratory Tract Neoplasms/diagnosis , Respiratory Tract Neoplasms/therapy , Tracheotomy/methodsABSTRACT
Silver nitrate is used extensively in rhinological practice for the treatment of recurrent epistaxis. There are currently no recommendations in the literature regarding the optimum application time of this chemical for effective treatment. We assessed the histological effects of silver nitrate on mucosal tissue at varying contact times and made recommendations based on our findings. Silver nitrate was applied at predetermined contact times to tonsillar mucosa, immediately before tonsillectomy in subjects undergoing routine surgery. The cauterized areas were subsequently analysed histologically. The depth of tissue penetration by the silver nitrate was measured. The means for 5, 10 and 20 s were 0.44, 0.30 and 0.38, respectively, P = 0.3. Overall, there was no deeper penetration of the tissues with contact times over 5 s. We conclude that it is not necessary to apply silver nitrate for greater than 5 s to achieve maximal tissue penetration.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Epistaxis/therapy , Palatine Tonsil , Silver Nitrate/administration & dosage , Cautery/methods , Humans , Statistics, Nonparametric , TonsillectomyABSTRACT
Eosinophils play a key role in the pathophysiology of sinonasal polyposis; their role in chronic rhinosinusitis without polyposis is less clear. To investigate this further, we biopsied diseased sinonasal tissue from 116 patients undergoing endoscopic sinus surgery and normal nasal mucosa from 24 controls. The patients were grouped, according to the nasal endoscopic appearance of their disease, into four clinical groups: chronic rhinosinusitis with no polyps, grade 1 polyps, grade 2 polyps, and grade 3 polyps. We also measured the peripheral blood eosinophil count. Histological analysis of the inflammatory cell content of the biopsies was carried out. The percentage of eosinophils in tissue from each of the clinical groups was significantly higher than that from the controls. There was no significant difference between the percentage of eosinophils in any of the clinical groups, but a trend. Peripheral eosinophil count increased with increasing severity of nasal disease.
Subject(s)
Endoscopy/methods , Eosinophilia/complications , Eosinophilia/physiopathology , Nasal Polyps/complications , Nasal Polyps/physiopathology , Sinusitis , Adult , Chronic Disease , Eosinophilia/blood , Female , Humans , Male , Middle Aged , Severity of Illness Index , Sinusitis/complications , Sinusitis/physiopathology , Sinusitis/surgeryABSTRACT
In this paper we present a case of a 6-year-old child who presented with Ludwig's angina caused by an infected tongue base lymphangioma. We provide a literature review of tongue lymphangioma and Ludwig's angina in the paediatric population. Both Ludwig's angina and tongue base lymphangioma are rare conditions in their own right and a combination of the two has not previously been described in the literature.
