scholarly journals THORACOSCOPIC POSTERIOR TRACHEOPEXIE IN A NEWBORN WITH TRACHEOMALACIA AND ESOPHAGEAL ATRESIA

2019 ◽  
Vol 8 (4) ◽  
pp. 66-72
Author(s):  
Yu. A. Kozlov ◽  
A. A. Rasputin ◽  
K. A. Kovalkov ◽  
P. J. Baradieva ◽  
Ch. B. Ochirov
Keyword(s):  
Esophageal Atresia ◽  
Pulmonary Ventilation ◽  
Treatment Method ◽  
Tracheal Lumen ◽  
Esophageal Anastomosis ◽  
Duration Of Surgery ◽  
New Treatment ◽  
Tracheal Collapse ◽  
Thoracoscopic Procedure ◽  
Complete Collapse

Introduction. Esophageal atresia is often accompanied by some form of tracheomalacia. Soon after birth, tracheal collapse can result in respiratory disturbances of various degrees – from mild to severe – requiring artifcial pulmonary ventilation. In this study, we describe the use of a new treatment method of tracheomalacia with posterior tracheopexie.Material and methods. A patient with tracheomalacia that developed against the background of esophageal atresia was presented in the study. A newborn boy of 2,720 g had a prenatally established diagnosis of esophageal atresia. The infant was born with the signs of respiratory disturbances. Following tracheoscopy, severe tracheomalacia was established with complete collapse of tracheal lumen. During the next thoracoscopic procedure, the trachea was fxed to the anterior longitudinal spinal ligament with several sutures.Results. Thoracoscopic posterior tracheopexie was performed prior to esophageal anastomosis. Overall duration of surgery was 85 minutes. Spontaneous breathing was restored at day 3 after the surgery. Tracheoscopy performed at day 10 after the surgery demonstrated a complete opening of the tracheal lumen.Conclusion. Promising results of the surgery prove that the procedure is effective for the treatment of tracheomalacia. Moreover, more complex (aortopexy) recurrent surgeries can be prevented using this approach as posterior tracheopexie can be performed during the primary thoracoscopic correction of esophageal atresia.

DOZ047.66: Thoracoscopic posterior tracheopexy during primary esophageal atresia repair

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S H A J Tytgat ◽  
D C van der Zee ◽  
J W Verweij ◽  
E S van Tuyll van Serooskerken ◽  
M Y A Lindeboom
Keyword(s):  
Esophageal Atresia ◽  
Respiratory Symptoms ◽  
Wide Spectrum ◽  
New Approach ◽  
Esophageal Anastomosis ◽  
Life Threatening ◽  
Syncytial Virus ◽  
The Right ◽  
Tracheal Collapse

Abstract Background Esophageal atresia (EA) is usually accompanied by some form of tracheomalacia. During the early phases in life, excessive dynamic collapse of the trachea can cause a wide spectrum of symptoms ranging from mild complaints to apparent life-threatening events (ALTE’s). Therapeutic strategies for severe tracheomalacia include aortopexy to lift the anterior weakened cartilaginous rings or posterior tracheopexy of the floppy membranous tracheal intrusion. Earlier we have introduced a new approach in which the posterior tracheopexy is performed directly during primary thoracoscopic correction of EA. Methods In the period 2017–2018, all consecutive EA patients (27) underwent a rigid tracheobronchoscopic evaluation during induction of anesthesia prior to the thoracoscopic EA repair. Tracheomalacia was diagnosed in 11 patients. During the subsequent thoracoscopic procedure, the posterior tracheal membrane was fixed to the anterior longitudinal spinal ligament with nonabsorbable sutures. The esophageal ends were then mobilized toward the right hemithorax and anastomosed. Results On preoperative RTB, six patients had a severe (66–99%) mid tracheal collapse and five patients had a moderate (33–66%) collapse. Thoracoscopic posterior tracheopexy with on to three sutures was possible in all 11 patients, prior to the formation of the esophageal anastomosis. Median time per suture was 6 minutes (range: 4–12 minutes). All operative procedures were uneventful. A median follow-up of 10 months (range: 2–22 months) revealed that eight patients recovered without any respiratory symptoms, one patient had respiratory symptoms caused by a suture granuloma that was removed by bronchoscopy, one patient had a respiratory syncytial virus bronchiolitis and one patient had a rhinovirus infection. None of the patients experienced any ALTE’s. Conclusion Eleven patients have been treated by thoracoscopic posterior tracheopexy during primary EA repair. This technique could prevent potentially deleterious sequelae of moderate to severe tracheomalacia that may complicate the lives of EA patients. Also, a second, sometimes complex surgical procedure can be prevented as the posterior tracheopexy is performed during the primary thoracoscopic EA correction.

Tracheoscopic Findings and Their Impact on Respiratory Symptoms in Children with Esophageal Atresia

2019 ◽  
Vol 30 (04) ◽  
pp. 371-377
Author(s):  
Johannes Balleisen ◽  
Josef Holzki ◽  
Grigore Cernaianu ◽  
Miguel Alejandre Alcàzar ◽  
Martin Dübbers ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Respiratory Symptoms ◽  
Surgical Repair ◽  
Clinical Symptoms ◽  
Tracheal Lumen ◽  
Obstructive Apnea ◽  
Airway Symptoms ◽  
Before And After ◽  
Life Threatening ◽  
Tracheal Collapse

Introduction Esophageal atresia (EA) is often accompanied by tracheobronchial malformations leading to stridor, recurrent bronchitis, and occasionally to life-threatening obstructive apnea after surgical repair. The aim of this study was to identify the presence of tracheomalacia in patients with EA and tracheoesophageal fistula (TEF) pre- and postoperatively and to find endoscopic correlates leading to clinical airway symptoms. Methods In a cohort of 362 patients with EA-TEF who underwent 595 tracheoscopies at the Children's Hospital of Cologne between January 1983 and December 2002, impaired tracheal lumen, localization of TEF, tracheal pulsations, and corresponding clinical symptoms were retrospectively analyzed. Results The incidence of tracheomalacia was higher in patients with EA and TEF (Gross B–D) compared with patients with EA alone (Gross A) and average tracheal collapse does not significantly change before and after surgical repair of the esophagus in all types. Patients with cyanosis while eating and obstructive apnea presented with an average tracheal collapse of 89%. The presence of respiratory symptoms such as cough, stridor, or bronchitis was not associated with a higher grade of tracheal collapse compared with patients without any airway symptoms (average tracheal collapse of 37% in symptomatic patients vs. 33% in nonsymptomatic patients). Conclusion Tracheomalacia tends to be present independently of surgical procedure. Tracheomalacia should be measured by tracheoscopy (in % of tracheal collapse). Patients with a tracheal collapse of >80%, a ventral pulsation, and obstructive apnea or cyanosis in combination, are at risk for life-threatening situations and further surgical treatment should be considered.

scholarly journals Pulp Revascularization of Immature Permanent Teeth: A Review of the Literature and a Proposal of a New Clinical Protocol

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mélanie Namour ◽  
Stephanie Theys
Keyword(s):  
Treatment Method ◽  
Permanent Teeth ◽  
Clinical Protocol ◽  
Therapeutic Success ◽  
Immature Teeth ◽  
Triple Antibiotic Paste ◽  
New Treatment ◽  
Near Future ◽  
Pulp Revascularization ◽  
Stimulation Of

Tissue engineering is a growing field. In the near future, it will probably be possible to generate a complete vital tooth from a single stem cell. Pulp revascularization is dependent on the ability of residual pulp and apical and periodontal stem cells to differentiate. These cells have the ability to generate a highly vascularized and a conjunctive rich living tissue. This one is able to colonize the available pulp space. Revascularization is a new treatment method for immature necrotic permanent teeth. Up to now, apexification procedures were applied for these teeth, using calcium dihydroxide or MTA to produce an artificial apical barrier. However, the pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth. Two pulp revascularization techniques are used in the literature, one using calcium dihydroxide and the second using a triple antibiotic paste. Based on these two different pulp revascularization protocols, which obtain the desired therapeutic success, the literature will be reviewed and analyzed according to the relevance of their choice of materials. Based on the literature, we propose a new relevant protocol and a new mixture of antibiotics.

scholarly journals Gold Extraction from Cyanidation Tailing Using Microwave Chlorination Roasting Method

Metals ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. 1025 ◽  
Author(s):  
Fei Zhu ◽  
Libo Zhang ◽  
Haoyu Li ◽  
Shaohua Yin ◽  
Sivasankar Koppala ◽  
...  
Keyword(s):  
Microwave Field ◽  
High Efficiency ◽  
Chloride Concentration ◽  
Treatment Method ◽  
Gold Extraction ◽  
Microwave Roasting ◽  
Gold Mines ◽  
Chlorination Roasting ◽  
New Treatment ◽  
Gold Industry

At present, gold mines are increasingly scarce in the world. The yield of cyanidation tailing (CT) of refractory gold ores with a grade of 10 g/T is huge; however, the effective capitalization of the cyanidation tailing is a significant problem in the gold industry. In this work, a new treatment method, a microwave-roasting process developed. The effect of roasting temperature, calcium chloride concentration, holding time and mineral size on the recovery of Au researched under conventional and microwave conditions. It found that, under the same processing conditions, the Au recovery in the microwave field is much higher than that of conventional conditions. The preliminary reinforcing role of the microwave discussed in the recovery of gold. This might be because of the microwave absorption ability of CaCl2 is much better, heated quickly and the reactions intensified among CaCl2, O2, and H2O. As a result, the extraction of gold in CT drastically increased in the microwave field, and the microwave roasting technology shows the characteristics of environmental protection in terms of low energy consumption and high efficiency.

scholarly journals Development of an Immune-Related Gene Signature for Prognosis in Melanoma

2021 ◽  
Vol 10 ◽  
Author(s):  
Jia-An Zhang ◽  
Xu-Yue Zhou ◽  
Dan Huang ◽  
Chao Luan ◽  
Heng Gu ◽  
...  
Keyword(s):  
T Cells ◽  
Immune Cell ◽  
Treatment Method ◽  
Gene Signature ◽  
Cell Infiltration ◽  
Venn Diagram ◽  
Immune Cell Infiltration ◽  
Tumor Purity ◽  
New Treatment ◽  
Immune Related Genes

Melanoma remains a potentially deadly malignant tumor. The incidence of melanoma continues to rise. Immunotherapy has become a new treatment method and is widely used in a variety of tumors. Original melanoma data were downloaded from TCGA. ssGSEA was performed to classify them. GSVA software and the "hclust" package were used to analyze the data. The ESTIMATE algorithm screened DEGs. The edgeR package and Venn diagram identified valid immune-related genes. Univariate, LASSO and multivariate analyses were used to explore the hub genes. The "rms" package established the nomogram and calibrated the curve. Immune infiltration data were obtained from the TIMER database. Compared with that of samples in the high immune cell infiltration cluster, we found that the tumor purity of samples in the low immune cell infiltration cluster was higher. The immune score, ESTIMATE score and stromal score in the low immune cell infiltration cluster were lower. In the high immune cell infiltration cluster, the immune components were more abundant, while the tumor purity was lower. The expression levels of TIGIT, PDCD1, LAG3, HAVCR2, CTLA4 and the HLA family were also higher in the high immune cell infiltration cluster. Survival analysis showed that patients in the high immune cell infiltration cluster had shorter OS than patients in the low immune cell infiltration cluster. IGHV1-18, CXCL11, LTF, and HLA-DQB1 were identified as immune cell infiltration-related DEGs. The prognosis of melanoma was significantly negatively correlated with the infiltration of CD4+ T cells, CD8+ T cells, dendritic cells, neutrophils and macrophages. In this study, we identified immune-related melanoma core genes and relevant immune cell subtypes, which may be used in targeted therapy and immunotherapy of melanoma.

scholarly journals The Effects of Mycophenolate on the Formation of Granulation Tissue Post-operatively in Canine Tracheal Stent Patients (2014–2020)

2021 ◽  
Vol 8 ◽  
Author(s):  
Kevin F. Barber ◽  
Catherine A. Loughin ◽  
Dominic J. Marino ◽  
Martin Lesser
Keyword(s):  
Mycophenolate Mofetil ◽  
Granulation Tissue ◽  
Control Group ◽  
Tracheal Lumen ◽  
Loss To Follow Up ◽  
Treatment Groups ◽  
Tracheal Stent ◽  
Significant Difference ◽  
Tracheal Collapse

Objectives: To determine if mycophenolate mofetil reduces the incidence and severity of granulation tissue in-growth in canine tracheal stent patients.Study design: Randomized clinical trial.Animals: 111 dogs from the hospital population.Methods: Client-owned dogs that received an endoluminal self-expanding tracheal stent for canine tracheal collapse between 2014 and 2020 were randomly assigned into one of two treatment groups. Control group medication protocol consisted of prednisone 0.5 mg/kg PO BID/SID/EOD × 30 days, hydrocodone 0.25 mg/kg PO TID × 30 days, and cefovecin 8 mg/kg SQ post-placement. Mycophenolate group medication protocol was identical to the control group medication protocol with the addition of mycophenolate mofetil 10 mg/kg PO BID × 30 days, SID for life. Recheck tracheoscopy was performed at 1, 3, and 6 months post-stent placement. Presence and severity of granulation tissue were determined by tracheoscopy and were recorded as a percentage of tracheal lumen obstruction by blinded evaluators (none present, <25%, >25–50%, and >50%).Results: At none of the three time points was there a statistically significant difference in grade between controls and those receiving mycophenolate (p = 0.467, p = 0.330, and p = 0.410).Conclusions and Clinical Significance: Our results suggest that mycophenolate can be safely given to these patients but do not support that its administration will reduce the incidence and severity of granulation tissue. Although a difference was observed in the severity of granulation tissue between the two groups, loss to follow-up may have influenced conclusions. A larger study would be warranted to further evaluate the effect of mycophenolate on the development of granulation tissue.

scholarly journals Implantation and Retrieval of Magnetic Nanobots for Treatment of Endodontic Re-Infection in Human Dentine

2021 ◽  
Author(s):  
Debayan Dasgupta ◽  
Shanmukh Srinivas Peddi ◽  
Deepak K. Saini ◽  
Ambarish Ghosh
Keyword(s):  
Root Canal ◽  
Treatment Method ◽  
Therapeutic Modality ◽  
Clinical Practices ◽  
Human Teeth ◽  
Dentinal Tubules ◽  
Current State ◽  
Human Dentine ◽  
New Treatment ◽  
Magnetic Drive

<div> <div> <div> <p>More than 10% of root canal treatments undergo failure worldwide due to remnant bacteria deep in the dentinal tubules located within the dentine tissue of human teeth. Owing to the complex and narrow geometry of the tubules, current techniques relying on passive diffusion of anti-bacterial agents are inadequate. Here, we present a new treatment method using actively maneuvered nanobots, which can be incorporated during standard root canal procedure. Our technique will enable dentists to execute procedures inside the dentine not yet possible by current state of the art. We demonstrate that magnetically driven nanobots can reach the depths of the tubules up to hundred times faster than current clinical practices. Subtle modifications of the magnetic drive allowed deep implantation of the nanobots isotopically distributed throughout the dentine, along with spatially controlled retrieval from selected areas. Finally, we demonstrate the integration of bactericidal therapeutic modality with the nanobots, thereby validating the tremendous potential of nanobots in dentistry, and nanomedicine in general. </p> </div> </div> </div>

Metody leczenia endodontycznego zębów stałych z niezakończonym rozwojem wierzchołków korzenia – rewaskularyzacja, 12-miesięczna obserwacja. Część II

2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Renata Pazera ◽  
Magdalena Piechota-Urbańska ◽  
Patrycja Proc ◽  
Joanna Szczepańska
Keyword(s):  
Root Length ◽  
Treatment Method ◽  
Modern Method ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
Control Group ◽  
Tissue Healing ◽  
New Treatment ◽  
Radiological Image ◽  
Irreversible Pulpitis

Introduction. Apexogenesis is the process of shaping the root for 3 years after the appearance of the crown in the oral cavity. The condition for continuing this process is to preserve the vitality of the tooth. Injury, caries or disorders of the anatomical structure may cause necrosis or irreversible pulpitis. The assumption of endodontic treatment of immature permanent teeth is to create a mineralized barrier closing the lumen of the canal (apexification) or continuing the development of the root (revascularization). Regeneration of the pulpo-dentinal complex allows for the increase of root length, thickening of its walls and narrowing of the apical hole. This can be achieved by a new treatment method – revascularization. The advantage of this therapeutic method is to avoid all the defects arising after endodontic treatment with the use of apexification, i.e. tooth brittleness, susceptibility to root fracture, discoloration of the tooth tissue. Aim. The aim of the study was to evaluate the modern method of treatment of necrosis or irreversible pulpitis in immature permanent teeth by revascularization in the aspect of tissue healing, regeneration of the pulp-dentinal complex, thickness growth and the length of the root walls. Material and methods. The study was conducted among 7 children aged 7-12, including 3 girls and 2 boys. Revascularization was performed in 7 teeth. The study involved 6 central incisors and 1 premolars. During the treatment, polyurethane paste and MTA were used. The control group consisted of patients who were tested using MTA due to the inability to perform revascularization. 23 patients aged 7-13 were qualified to the control group. Control tests were carried out after 3, 6, 12 months after treatment. The clinical condition of the tooth and the radiological image were evaluated. Results. Radiological examination was crucial in assessing the effectiveness of the revascularization procedure. It confirmed the decrease of periapical lesions, increase in root length, root wall thickness and closing of the apical hole. During the clinical examination, the subjective feelings of the patient, discoloration of the tooth's tissues, reaction to tapping, tooth mobility, depth of the gingival pocket, tenderness of the appendage and tightness of the final filling were controlled. The obtained results were compared with the control group. Conclusions. Revascularization is a promising treatment for immature permanent teeth due to the increase in the length of the root and the thickness of its walls. As a result, the teeth after treatment are more durable and are better for long-term maintenance in the mouth. The procedure of revascularization has some limitations at the stage of patient’s qualification for the procedure. If it is not possible to perform this procedure, the alternative is to apexify using MTA.

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