Bronchial Glands: Age, Regional and Individual Structural Features

The aim was to study the quantitative indicators and structure of the distribution of the glands in human main bronchi in the age aspect.Material and methods. The object of the study was the glands in the walls of the main bronchi, obtained as a single complex together with the lower part of the trachea, including the area of bifurcation. Samples were taken from 110 corpses of people in the age range from the neonatal period to 87 years (10 observations in each age group), who died from causes not related to the pathology of the respiratory system and did not have pathological changes in the respiratory system at autopsy. For micro-macroscopy using an MBS-9 binocular microscope, the glands in the walls of the main bronchi were selectively stained with methylene blue according to R.D. Sinelnikov, followed by fixation in a saturated solution of ammonium picric acid. The following characteristics were analyzed: the shape of the glands, their total number on the total preparation, the density of their location (the number of the mouths of the excretory ducts per 1 cm2), the width of their initial section. Due to the normal distribution of the data, the methods of parametric statistics based on the Statistica 6.0 program were used for statistical data processing. Statistical data processing included the calculation of the arithmetic mean indicators, their errors, the analysis of the amplitude of the variation series of each indicator was carried out.Results. The performed macro-microscopic examination revealed an asymmetry in the distribution of glands – the number and density of distribution of glands was 1.50–2.10 times higher (p <0.05) for the left bronchus than for the right and 1.56–2.91 (p <0.05) times more in the cartilaginous than in the membranous part. At the same time, the width of the orifice of the gland showed opposite patterns. In terms of age, there was an increase in the number of glands and their size with a maximum by the age of 21–35 and a subsequent decrease by senil age. The distribution density decreased throughout the entire period of life.Conclusion. The revealed age, regional and individual features of the structure of the glandular apparatus of the main human bronchi may be of interest both in scientific research and in clinical practice, forming a basic description of the structural norm.

New species of the pirate spider genus Mimetus Hentz, 1832 from China with a cladistic hypothesis on their phylogenetic placement (Araneae, Mimetidae)

Five new species of mimetid spiders from China are described: Mimetus subulatus n. sp., M. clavatus n. sp., M. dentatus n. sp., M. niveosignatus n. sp. and M. uncatus n. sp. The phylogenetic placement of these new species is inferred based on a cladistic analysis of an expanded version of the morphological dataset of Benavides and Hormiga (2020). The new species form a clade that can be distinguished from other Mimetus species by the presence of a subtegular apophysis between paracymbium and subtegulum, pilose cuticular projections on the membranous part of the conductor in the male palp and by a bicameral structure of the spermathecae in females. The new species are part of a clade that includes Mimetus syllepsicus Hentz, 1832, the type species of the genus. The genus Mimetus as currently circumscribed is not monophyletic, as the clade that includes all the Mimetus species also includes the genera Australomimetus Heimer, 1986 and Anansi Benavides and Hormiga, 2017, corroborating the results of Benavides and Hormiga (2020).

Revisiting the type of Cespitularia stolonifera Gohar, 1938 leads to the description of a new genus and a species of the family Xeniidae (Octocorallia, Alcyonacea)

Because of the problematical identity and status of the type of the xeniid soft coral genus Cespitularia Milne-Edwards & Haime, 1850, the species C. stolonifera Gohar, 1938 is revised. Examination of the type colonies has led to the establishment of the new genus Unomia gen. n. which is described and depicted. This genus features a stalk, commonly divided into branches featuring a diffuse polypiferous part consisting of distal clustered polyps and proximal individual ones on the stalk or the basal membranous part of the colonies. The sclerites are ellipsoid platelets composed of dendritic calcite rods whose tips are distinct on the surface of the platelets. Freshly collected material from Venezuelan reefs where the species is invasive was subjected to molecular phylogenetic analysis, the results of which substantiate the taxonomic assignment of the new genus under U. stolonifera comb. n. A new species, U. complanatis, from Japan and Green Island (Taiwan) is described and further illustrates the extent of the interspecific morphological variation within the genus. The results reveal that the biogeographic distribution of Unomia gen. n. includes Pacific Ocean reefs in addition to the previously reported invaded Caribbean reefs.

A clinical case of successful treatment of complete abruption of the trachea from the larynx

Tracheobronchial injuries as a consequence of chest blunt trauma are rare. Blunt traumas of the cervical part of the trachea are a rarer pathology presenting a serious diagnostic problem for a clinician. Traumas of the larynx and the trachea account for 40 to 80% of lethality. The tracheas cervical part is vulnerable despite that it is covered with the neck muscles, spine, clavicles, and mandible. In cut/stab wounds, the tracheas cervical part is often damaged together with the adjacent structures. In blunt trauma, under a direct action of a traumatizing agent, the mobile trachea displaces toward the spine, accompanied by damage to the tracheal cartilages, its membranous part, and the soft surrounding tissues with preservation of the integrity of the skin. Tracheal ruptures along the distance up to 1 cm from the cricoid cartilage account for not more than 4% of all tracheal ruptures. A complete tracheal rupture and its abruption from the larynx are extremely rare pathology. Because of severe respiratory disorders, most victims die at the site where their injury occurred. This article presents a clinical case of the successful treatment of patient Z., 41 years of age, with complete tracheal abruption from the larynx. The cause of tracheal damage was blunt neck trauma in a traffic accident. A peculiarity of this clinical case was that the victim arrived at a specialized thoracic surgery unit with a functioning tracheostomy two days after the trauma. Conclusion. Tracheal trauma is a potentially fatal condition. Therefore, early diagnosis of tracheobronchial damage is essential since it permits timely surgical intervention and diminished risk of lethal outcome. When dealing with patients with trauma of the head, neck, and chest with non-corresponding clinical data and the absence of effective recommended standard therapeutic measures, a clinician should become alert and exclude the tracheal and bronchial damage. X-ray computed tomography and fibrotracheobronchoscopy are strongly recommended as reliable methods to diagnose tracheobronchial damages. In a surgical intervention, it is necessary to perform the primary suture on the trachea, avoid preventive tracheostomy, and delay interventions associated with poorer prognosis and a high complication rate.

Surgical anatomy of the upper esophagus related to robot-assisted cervical esophagectomy

Robot-assisted cervical esophagectomy (RACE) enables radical surgery for tumors of the middle and upper esophagus, avoiding a transthoracic approach. However, the cervical access, narrow working space, and complex topographic anatomy make this procedure particularly demanding. Our study offers a stepwise description of appropriate dissection planes and anatomical landmarks to facilitate RACE. Macroscopic dissections were performed on formaldehyde-fixed body donors (three females, three males), according to the surgical steps during RACE. The topographic anatomy and surgically relevant structures related to the cervical access route to the esophagus were described and illustrated, along with the complete mobilization of the cervical and upper thoracic segment. The carotid sheath, intercarotid fascia, and visceral fascia were identified as helpful landmarks, used as optimal dissection planes to approach the cervical esophagus and preserve the structures at risk (trachea, recurrent laryngeal nerves, thoracic duct, sympathetic trunk). While ventral dissection involved detachment of the esophagus from the tracheal cartilage and membranous part, the dorsal dissection plane comprised the prevertebral compartment harboring the thoracic duct and right intercosto-bronchial artery. On the left side, the esophagus was attached to the aortic arch by the aorto-esophageal ligament; on the right side, the esophagus was bordered by the azygos vein, right vagus nerve, and cardiac nerves. The stepwise, illustrated topographic anatomy addressed specific surgical demands and perspectives related to the left cervical approach and dissection of the esophagus, providing an anatomical basis to facilitate and safely implement the RACE procedure.

A rare association of blepharophimosis–ptosis–epicanthus inversus case with congenital nasolacrimal duct obstruction

Purpose: The aim of reporting this case is to describe a rare combination of blepharophimosis–ptosis–epicanthus inversus syndrome with congenital nasolacrimal duct obstruction. A variety of lacrimal anomalies have been seen in blepharophimosis–ptosis–epicanthus inversus syndrome but the occurrence of nasolacrimal duct obstruction is rare. Method: The blepharophimosis–ptosis–epicanthus inversus syndrome is an autosomal dominant rare genetic defect with clinical manifestation of dysplasia of the eyelids, palpebral fissures, flat nasal bridge, and ptosis. A 20-month-old boy was referred with the complaints of watering and discharge from his right eyes since birth. On examination, the child had all the features of blepharophimosis–ptosis–epicanthus inversus syndrome with right congenital nasolacrimal duct obstruction in line with the published reports. Result: On endoscopic probing and irrigation, the probe could not be visualized into the inferior meatus. On dacryoendoscopy, the membranous part of the nasolacrimal duct was found to be completely obliterated with no light transmission into the nose indicating a malformed nasolacrimal duct. The child was managed by endoscopic dacryocystorhinostomy. We could find only one case report published so far on the combination of congenital nasolacrimal duct obstruction with blepharophimosis–ptosis–epicanthus inversus syndrome. This study adds one more case of blepharophimosis–ptosis–epicanthus inversus syndrome with congenital nasolacrimal duct obstruction and adjuvant use of dacryoendoscopy.

Surgical treatment of a female patient with tracheomalacia and expiratory tracheal stenosis

Abnormal mobility of the posterior membranous wall of the trachea and large bronchi is seen in many bronchopulmonary chronic inflammatory diseases. Currently, clear explanation of a mechanism of the expiratory tracheal stenosis (ETS) is absent. The advanced ETS is associated with severe ventilation abnormalities including asphyxia and syncope. The latter conditions are considered as indications for surgical treatment. Results of the surgical treatment are controversial and are not fully acceptable. For this reason, the surgical treatment for ETS is not routinely used and any successive case of such treatment is of great interest. Strict indications, such as life-threatening conditions or failure of optimal medical treatment, are required for surgical treatment of patients with tracheomalacia and ETS. Surgical treatment for tracheomalacia and ETS is contraindicated in the case of lobar bronchial lesion impeding stabilization the membranous part of the tracheobronchial tree.

MODERN METHODS OF TREATING DISEASES OF THE BULBO-MEMBRANOUS PART OF URETHRA

Strictures of the bulbous-membranous urethra are a common cause of obstructive urination disorder. Modern trends in the development of medicine lead to a wider application of endoscopic method, a more frequent cause of iatrogenic injury of the urethra. At present, conservative, endourologic and reconstructive methods of care are used to treat urethral strictures. There are several conservative, endourological and reconstructive methods for treating patients with urethral stricture. Conservative methods include interventions that do not involve the destruction of urethral stricture or its reconstruction, such as stenting, blind dilatation, and recanalization of the urethra. Performing blind dilatation strictures of the bulbo-membranous urethra is not recommended because of the high risk of false path formation and low efficiency. Endourological operations refer to surgical methods of care and suggest the natural restoration of urethral tissues after the destruction of stricture. Because of the low effectiveness of correction of strictures of the posterior urethra (more than 90 % of relapses in five years), this method is a variant of temporary or palliative care. Currently, two approaches to the reconstruction of the bulbo-membranous urethra are used: anastomotic and replacement operations. Anastomotic surgery involves excision of the affected area and juxtaposition of healthy urethral tissues without tension. Replacement plastic allows to restore patency of the urethra by increasing the diameter of the lumen due to the implantation of various grafts. The article shows that, based on international clinical studies, the most effective method of reconstructing the bulbomembranous urethra is reconstructive surgical methods.

Revision of Pygoda Amyot & Serville, 1843 stat. rest. (Heteroptera: Pentatomidae: Edessinae) with description of four new species

Edessa is the largest genus of Edessinae and comprises five subgenera: Edessa, Aceratodes, Dorypleura, Hypoxys and Pygoda. Systematics of Edessa is very confusing due to several factors, among them, large number of species and vague diagnosis to the subgenera. In this work we continue revising Edessa elevating Pygoda to genus level based in morphological characters: pronotal angles short and acute. Abdominal segment VII developed posteriorly and at least 1.5 longer than wide at the base. Males with pygophore large in relation to body size when compared with other edessines. Phallus large, constricted distally and showing a remarkable ventral development. Females with capsula seminalis large in comparison with other edessines. Distal part of the ductus receptaculi sclerotized. Pars intermedialis with sclerotized part bigger than membranous part. This genus comprises nine species: the type species Pygoda polyta, four species originally described in Edessa—E. irrorata, E. thoracica, E. expolita and E. civilis, and four new species—P. amianta, P. variegata, P. poecila and P. ramosa. Diagnosis, illustration of the internal genitalia from males and females, photographs of the external genitalia from both sexes, body in dorsal and ventral view, and distribution map are provided. A key to the species of Pygoda is also provided. The lectotypes of Edessa irrorata, Pentatoma polyta, Edessa nervosa, Edessa civilis and Edessa thoracica are here designated.