Study of Foreign-Body Extraction from the Upper Third of the Esophagus in Children

Background

Throat-operating forceps are an auxiliary tool used for tracheal intubation during general anesthesia as well as for artificial respiration and during airway emergency when tracheal intubation is necessary. These forceps are a commonly used tool particularly for introducing the distal end of the endotracheal catheter into the airway at the epiglottis during difficult airway intubation and nasotracheal intubation. Throat-operating forceps have a required radian for operation at the intraoral epiglottis and have different types (large, medium, and small) that are suitable for patients of different ages. These tools have flexible forceps clamps and target-like, smooth distal ends that do not injure mucous membranes. Given these advantages, throat-operating forceps are used for pediatric endoesophageal foreign-body removal.

Case Presentation

Pediatric patients were anesthetized using different methods according to their age. A total of 15 patients five years to nine years of age were recruited. Foreign bodies were successfully removed without any complications.

Conclusion

Tracheal intubation forceps successfully removes esophageal foreign bodies in children because of the distinct shape of the forceps. The method is simple, feasible, and safe.     

Effect of osteoporosis and intervertebral disc degeneration on endplate cartilage injury in rats

Objective:To investigate the effect of osteoporosis and intervertebral disc degeneration on the endplate cartilage injury in rats.Methods:A total of 48 female Sprague Dawley rats(3 months)were randomly divided into Groups A,B,C and D with 12 rats in each group.Osteoporosis and intervertebral disc degeneration composite model,simple degeneration model and simple osteoporosis model were prepared in Groups A,B and C respectively.After modeling,four rats of each group at 12th.18th and 24th week were sacrificed,Intervertebral height of cervical vertebra C6/C7 was measured.Micro-CT was used to image the endplate of cephalic and caudal cartilage at C6/C7 intervertebral disc.Abraded area rate of C6 caudal and C7 cephalic cartilage endplate was calculated,and then C6/C7 intervertebral disc was routinely embedded and sectioned.stained with safranin O to observe histological changes microscopically.Results:At 12,18 and24 weeks,intervertebral disc height of C6/C7 were(0.58±0.09)mm,(0.53±0.04)mm and(0.04±0.06)mm in Group A rats,(0.55±0.05)mm,(0.52±0.07)mm and(0.07±0.05)mm in Group B rats.At 24th week.intervertebral disc height of Group A rats was significantly lower than that of Group B rats(P0.05);intervertebral disc height of Groups A and B rats at each time point were significantly lower than that of Groups C and D(P0.05).There was no significantly statistical difference of intervertebral disc height between Groups C and D(P0.05).At 12 and 18 weeks,the abraded rate of C6 caudal and C7 cephalic cartilage endplate in Group A rats were significantly higher than that in Groups B.C and D rats(P0.05);the abraded rate in Group B was significantly higher than that in Groups C and D(P0.05).Microscopic observation of CT showed that ventral defects in C6caudal or C7 cephalic cartilage endplate in Groups A and B appeared after 12 weeks of modeling;obvious cracks were found in front of the C6 and C7 vertebral body,and cartilage defect shown the trend of"repairing"at 18 and 24 weeks after modeling.Conclusions:Intervertebral disc degeneration and osteoporosis can cause damage to the cartilage endplate.Co-existence of these two factors can induce more serious damage to the endplate.which has possitive correlation with intervertebral disc degeneration.Osteoporosis plays a certain role in intervertebral disc degeneration process,and accelerates the degeneration of intervertebral disc in a specific time window.     

口腔颌面部异物36例临床分析

目的:探讨口腔颌面部异物伤的诊断与治疗及影像学诊断的重要性。方法 :选择2003-01—2010-12期间收治的,影像和病历资料完善的口腔颌面部异物存留伤36例。分析异物类型,并对临床疗效进行评估。结果:36例异物存留伤患者中,金属异物12例,非金属异物24例。择期异物取出26例;需要急诊清创者10例,而清创术可一期取出异物者6例,4例延期取出。30例经常规X线片检查后,需经CT或三维CT检查进一步定位,评估手术取出的可行性及风险。其中26例经手术取出,4例保留并观察。结论:三维CT在非金属异物存留伤诊疗中起到重要的作用;必须根据异物大小、部位及与周围大血管的毗邻关系,患者全身情况等综合因素判定是否手术及手术时机。     

The diagnostic utility of cerebrospinal fluid alpha-synuclein analysis in dementia with Lewy bodies – A systematic review and meta-analysis

BackgroundDementia with Lewy Bodies (DLB) can be difficult to distinguish clinically from other dementias.ObjectiveTo investigate the diagnostic utility of CSF alpha-synuclein in differentiating between DLB and other dementias.MethodsElectronic databases were systematically searched for studies investigating reproducible alpha synuclein quantification methods. Random effects model was used to calculate weighted mean difference (WMD) and 95% confidence intervals between DLB and other groups.ResultsA total of 13 studies, comprising 2728 patients were included. Mean CSF alpha-synuclein concentration was significantly lower in DLB patients compared to those with Alzheimers disease (AD) [WMD ?0.24; 95% CI, ?0.45, ?0.03; p = 0.02]. No significant difference was found between patients with DLB compared to Parkinsons disease [WMD 0.05; 95% CI, ?0.17, 0.28; p = 0.65] or other neurodegenerative conditions.ConclusionCSF alpha synuclein may be of diagnostic use in differentiating between DLB and AD. We propose several recommendations to guide better design of future studies.     

The response of macrophages to titanium particles is determined by macrophage polarization

Aseptic loosening of total joint replacements is driven by the reaction of macrophages to foreign body particles released from the implant. It was hypothesized that the macrophages’ response to these particles is dependent, in addition to particle characteristics and contaminating biomolecules, on the state of macrophage polarization as determined by the local cytokine microenvironment. To test this hypothesis we differentiated M1 and M2 macrophages from human peripheral blood monocytes and compared their responses to titanium particles using genome-wide microarray analysis and a multiplex cytokine assay. In comparison to non-activated M0 macrophages, the overall chemotactic and inflammatory responses to titanium particles were greatly enhanced in M1 macrophages and effectively suppressed in M2 macrophages. In addition, the genome-wide approach revealed several novel, potentially osteolytic, particle-induced mediators, and signaling pathway analysis suggested the involvement of toll-like and nod-like receptor signaling in particle recognition. It is concluded that the magnitude of foreign body reaction caused by titanium particles is dependent on the state of macrophage polarization. Thus, by limiting the action of M1 polarizing factors, e.g. bacterial biofilm formation, in peri-implant tissues and promoting M2 macrophage polarization by biomaterial solutions or pharmacologically, it might be possible to restrict wear-particle-induced inflammation and osteolysis.     

“Cannonballs” and psammoma bodies: Unusual cytologic features of metastatic pulmonary small‐cell carcinoma in a pleural effusion

Large three‐dimensional cell aggregates and psammoma bodies are usually encountered in benign serous effusions (mesothelial hyperplasia and endosalpingiosis), mesotheliomas, and metastatic papillary carcinomas. We report a case of pulmonary small‐cell carcinoma occurring in an 88‐year‐old woman that initially presented with a malignant pleural effusion characterized cytologically by a predominance of large three‐dimensional neoplastic cell aggregates (“cannonballs”), associated with rare psammoma bodies. Although the crowded three‐dimensional tumor‐cell aggregates did not allow detailed cytologic examination, the diagnosis of metastatic small‐cell carcinoma could be established noting the characteristic chromatin features of the occasional single neoplastic cells and the characteristic “cell‐in‐cell” and “stack‐of‐coins” arrangements of rare small clusters of neoplastic cells. Immunoperoxidase stains showing positivity of the tumor cells for CD56, synaptophysin, and TTF1 further supported this diagnosis. Endobronchial ultrasound‐guided fine‐needle aspiration of a mediastinal lymph node subsequently confirmed the diagnosis of pulmonary small‐cell carcinoma. Metastatic pulmonary small‐cell carcinoma should be considered in the differential diagnosis of serous effusions showing large three‐dimensional neoplastic cell aggregates and psammoma bodies to prevent a potential diagnostic pitfall. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc.     

Case series of undetected intranasal impression material in patients with clefts

We report the cases of two female patients in their twenties who had had corrective surgery for bilateral cleft lip and palate as babies. They had both had residual palatal fistulas and had had further treatment that required repeated dental impressions. Several years later both had complained of persistent nasal discomfort and discharge, and routine clinical examination and investigations had failed to identify the cause. Full examination of the whole nasal cavity under general anaesthesia, in both cases, showed the presence of displaced dental impression material in the nasal floor. Removal resulted in complete resolution of symptoms.     

Foreign Bodies in Facial Trauma-Report of 3 Cases

Background

Foreign bodies embedded deep in facial tissues presents a challenge to maxillofacial surgeons. Approximately one third of all foreign bodies are missed during initial examination. After facial trauma foreign bodies like grit particles, wooden pieces, thorns, pebbles, glass particles may get embedded into deeper facial tissues which are detected only accidently either with the help of radiographs or at a later stage when patient presents with some signs & symptoms like pain, pus discharge, sinus formation etc. Trauma to maxillofacial region especially after road traffic accidents is one of major cause of embedment of foreign body, but many of these cases go unnoticed. This article contains 3 cases of foreign bodies embedded in facial tissues.

Conclusion

Proper initial examination of facial lacerations with thorough debridement is very essential for finding embedded foreign bodies. Foreign bodies embedded in deeper tissues are missed by surgeon eyes, so whenever in doubt radiographs must be advised to rule out presence of foreign bodies.     

锥形束CT诊断颌面部异物1例

<正>张口受限为颌面外科的常见疾患,但颌面部异物引起张口受限多为个案报道[1-3]。准确定位异物位置及其形状大小,是外科手术取出异物,保证手术成功的关键。锥形束CT(cone beam computed tomography,CBCT)因其独特的三维成像特点,可以精确定位,更好地引导外科手术的顺利进行[4-6]。现对我院收治的1例颌面部异物引起的张口受限患者的临床资料进行报道,并结合文献回顾对CBCT在颌面异物诊断中的应用价值进行讨论。