sinuses

鼻窦
  • 文章类型: Journal Article
    为了评估肿瘤的影像学特征,强调它的位置,并确定嗅觉神经母细胞瘤(ONB)的典型和非典型位置的频率。
    我们回顾性回顾了2000年4月至2023年4月之间经病理证实为ONB的患者的计算机断层扫描和磁共振成像发现。人口统计信息,首席投诉,肿瘤位置,并提取肿瘤延伸。
    在58名患者中,50(86.2%)的肿块中心位于鼻腔上部,而8例患者(13.8%)在其他非典型位置有震中:7例患者(12.1%)在鼻腔中部,1例患者(1.7%)在两个蝶窦内。
    ONB并不总是存在于鼻腔的上部或顶部,并且偶尔在鼻腔的其余部分和其他非典型位置发现大量的ONB。
    UNASSIGNED: To evaluate the imaging characteristics of the tumor, emphasizing its location, and to determine the frequency of typical and atypical locations of olfactory neuroblastoma (ONB).
    UNASSIGNED: We retrospectively reviewed the computed tomography and magnetic resonance imaging findings of patients with pathologically proven ONB between April 2000 and April 2023. Demographic information, chief complaints, tumor location, and tumor extension were extracted.
    UNASSIGNED: Of the 58 patients, 50 (86.2%) had the epicenter of the mass at the superior part of the nasal cavity, while eight patients (13.8%) had the epicenter at other atypical locations: seven patients (12.1%) at the middle part of the nasal cavity and one patient (1.7%) within both sphenoid sinuses.
    UNASSIGNED: ONB is not always present in the upper part or the roof of the nasal cavity, and a significant number of ONBs are occasionally found in the rest of the nasal cavity and other atypical locations.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    目的:粘膜黑色素瘤(MM)是一种罕见的,头部和颈部区域的侵袭性肿瘤,主要影响鼻腔和上颌窦。本研究探讨了PRAMEIHC染色与鼻窦MM临床病理因素和生存结局的相关性。
    方法:回顾性队列包括2011年1月至2022年5月诊断为黑色素瘤的患者。组织病理学重新评估确认MM亚型(上皮样或纺锤体)。IHC检测涉及S100,MelanA,HMB45,SOX10,PRAME,BRAFV600E,和泛TRK。Kaplan-Meier和Cox比例风险分析探讨了生存概率和结果。
    结果:该队列包括30名患者(17名女性,13名男性),平均年龄65岁(标准差13)。5年生存率约为32%。Cox分析显示,在≥70%的细胞中,男性和PRAMEIHC染色与较低的生存概率相关。
    结论:在鼻窦MM中,≥70%细胞的PRAMEIHC染色与显着较低的生存概率相关。男性,pN1级,肿瘤在鼻窦的位置也预示着较差的生存结果.这些发现强调了MM中PRAME表达和其他临床病理因素的潜在预后意义。需要进一步的研究来验证和扩展这些观察结果。
    OBJECTIVE: Mucosal melanoma (MM) is a rare, aggressive neoplasm in the head and neck region, primarily affecting the nasal cavity and maxillary sinus. This study investigates the correlation of PRAME IHC staining with clinicopathological factors and survival outcomes in sinonasal MM.
    METHODS: The retrospective cohort included patients diagnosed with melanoma from January 2011 to May 2022. Histopathological reassessment confirmed MM subtype (epithelioid or spindle). IHC testing involved S100, MelanA, HMB45, SOX10, PRAME, BRAF V600E, and pan-TRK. Kaplan-Meier and Cox proportional hazards analyses explored survival probabilities and outcomes.
    RESULTS: The cohort comprised 30 patients (17 females, 13 males) with a mean age of 65 years (standard deviation 13). The 5-year survival probability was approximately 32%. Cox analysis revealed male sex and PRAME IHC staining in ≥70% of cells as associated with lower survival probability.
    CONCLUSIONS: In sinonasal MM, PRAME IHC staining in ≥70% of cells is associated with significantly lower survival probability. Male sex, pN1 stage, and tumor location in the sinus are also predictive of poorer survival outcomes. These findings highlight the potential prognostic significance of PRAME expression and other clinicopathological factors in MM. Further studies are warranted to validate and expand upon these observations.
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  • 文章类型: Case Reports
    pop窝的皮肤放线菌病很不寻常,由一组在口腔定植的厌氧或微氧革兰氏阳性丝状细菌引起的慢性肉芽肿病,结肠,和泌尿生殖道。pop窝放线菌病是临床罕见的疾病;因此,对该实体的认识需要高度怀疑,因为该生物体是特定的内部居民;四肢的主要参与很少。
    本病例报告介绍了一例罕见的40岁男性患者的pop窝放线菌病(左侧)。患者抱怨在pop窝上有多个脓液渗出的肿块。腿部X光显示有异物。病变活检的组织病理学检查证实了皮肤放线菌病的诊断。
    皮肤放线菌病是一种诊断挑战很大的疾病,需要高度怀疑早期诊断,避免不必要的手术,降低发病率和死亡率。
    UNASSIGNED: Cutaneous actinomycosis of popliteal fossa is quite unusual, chronic granulomatous disease caused by a group of anaerobic or microaerophilic Gram positive filamentous bacteria that colonize the mouth, colon, and urogenital tract. Actinomycosis of popliteal fossa is rare clinical condition; therefore, recognition of this entity needs high degree of suspicion as the organism is specific internal habitant; primary involvement of extremities is rare.
    UNASSIGNED: This case report presents a rare case of actinomycosis of popliteal fossa (left side) in a 40-year-old male patient. The patient complained of presence of a mass with multiple pus oozing sinuses over popliteal fossa. The X-ray of leg revealed presence of foreign body. Histopathological examination of the biopsy from the lesions confirmed diagnosis of cutaneous actinomycosis.
    UNASSIGNED: Cutaneous actinomycosis is a disease with great diagnostic challenge and requires high degree of suspicion for the early diagnosis which avoids unnecessary surgery and decreased morbidity and mortality.
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  • 文章类型: Journal Article
    背景:额窦支架已被引入以减少手术后额窦再狭窄并改善预后。
    方法:本研究是对19例经额窦入路并插入软窦支架的鼻内镜鼻窦手术患者的回顾性分析。
    结果:78.9%的患者额隐窝有专利,21.1%的患者有狭窄;未观察到完全闭合的隐窝。平均随访时间为20.7个月,支架置入时间平均为9.8个月;47.4%的患者出现并发症,术后鼻窦感染是最常见的。
    结论:在作者的经验中,额窦支架置入的适应症包括多功能性鼻内镜鼻窦手术后顽固性慢性鼻-鼻窦炎(尤其是伴鼻息肉的慢性鼻-鼻窦炎),有重要颅面手术史或外伤史的患者,和复发性黏液囊肿。支架总体耐受性良好,因为仅观察到轻微的并发症。密切的临床随访是强制性的。
    BACKGROUND: Frontal sinus stents have been introduced to reduce frontal sinus re-stenosis after surgery and to improve outcomes.
    METHODS: This study was a retrospective analysis of 19 patients who had endoscopic sinus surgery with approach to the frontal sinus and insertion of a soft sinus stent.
    RESULTS: The frontal recess was patent in 78.9 per cent and stenosed in 21.1 per cent of patients; no completely closed recesses were observed. Mean follow up was 20.7 months, and time period of stenting was 9.8 months on average; complications were observed in 47.4 per cent of the patients, with post-operative sinonasal infection being the most common.
    CONCLUSIONS: In the authors\' experience, indications for frontal sinus stenting include recalcitrant chronic rhinosinusitis after multiple functional endoscopic sinus surgeries (especially in chronic rhinosinusitis with nasal polyps), patients with history of important craniofacial surgery or trauma, and recurrent mucoceles. The stent was overall well tolerated as only minor complications were observed. Close clinical follow up is mandatory.
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  • 文章类型: Journal Article
    呼吸道是分隔和异质的环境。上气道的鼻咽和鼻窦具有与肺不同的特性,这些差异可能会影响细菌的适应和进化。上呼吸道生态位作为呼吸道细菌病原体的早期定植部位,包括那些,比如铜绿假单胞菌,这可能会导致囊性纤维化(CF)患者的肺部慢性感染。尽管上气道环境在促进早期适应宿主环境方面很重要,目前可用于CF呼吸道感染研究的体外模型仅集中在肺部。此外,动物模型,广泛用于弥合体外系统和临床方案之间的差距,不允许单独研究上下气道。我们开发了一套培养基,再现了上下呼吸道的关键特征,用于研究细菌在不同呼吸环境中的适应和进化。对于上气道和下气道模拟介质,我们开发了反映健康气道状况和反映CF呼吸道环境改变的制剂。这里,我们描述了这些培养基的开发和验证,以及它们在健康和CF中上气道或下气道条件下生长过程中铜绿假单胞菌的遗传和表型适应研究中的应用。
    The respiratory tract is a compartmentalised and heterogenous environment. The nasopharynx and sinuses of the upper airways have distinct properties from the lungs and these differences may shape bacterial adaptation and evolution. Upper airway niches act as early colonisation sites for respiratory bacterial pathogens, including those, such as Pseudomonas aeruginosa, that can go on to establish chronic infection of the lungs in people with cystic fibrosis (CF). Despite the importance of upper airway environments in facilitating early adaptation to host environments, currently available in vitro models for study of respiratory infection in CF focus exclusively on the lungs. Furthermore, animal models, widely used to bridge the gap between in vitro systems and the clinical scenario, do not allow the upper and lower airways to be studied in isolation. We have developed a suite of culture media reproducing key features of the upper and lower airways, for the study of bacterial adaptation and evolution in different respiratory environments. For both upper and lower airway-mimicking media, we have developed formulations that reflect airway conditions in health and those that reflect the altered environment of the CF respiratory tract. Here, we describe the development and validation of these media and their use for study of genetic and phenotypic adaptations in P. aeruginosa during growth under upper or lower airway conditions in health and in CF.
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  • 文章类型: Journal Article
    单细胞技术最近允许识别包膜下的多个淋巴内皮细胞(LEC)亚群,杂种,髓质,以及小鼠和人类的其他淋巴结(LN)窦系统。新的分析表明,LEC在免疫应答期间在LN基质中发挥关键的免疫功能。我们讨论了不同LEC类型在引导白细胞和癌细胞进出LN薄壁组织中的作用,在捕获微生物时,在运输中,介绍,并在不同类型的淋巴窦中储存淋巴携带的抗原。我们强调了人类LEC的特定适应,并提出了有关LEC在人类疾病中的功能的悬而未决的问题。尽管我们对人类淋巴管的了解有限-阻碍了炎症和转移的临床翻译-我们支持LNLEC作为增强/抑制免疫反应性的推定靶标的潜力。
    Single-cell technologies have recently allowed the identification of multiple lymphatic endothelial cell (LEC) subsets in subcapsular, paracortical, medullary, and other lymph node (LN) sinus systems in mice and humans. New analyses show that LECs serve key immunological functions in the LN stroma during immune responses. We discuss the roles of different LEC types in guiding leukocyte and cancer cell trafficking to and from the LN parenchyma, in capturing microbes, and in transporting, presenting, and storing lymph-borne antigens in distinct types of lymphatic sinuses. We underscore specific adaptations of human LECs and raise unanswered questions concerning LEC functions in human disease. Despite our limited understanding of human lymphatics - hampering clinical translation in inflammation and metastasis - we support the potential of LN LECs as putative targets for boosting/inhibiting immunoreactivity.
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  • 文章类型: Controlled Clinical Trial
    背景:嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉(eCRSwNP)的常规治疗通常是有限的;因此,复发经常发生,准确的局部给药是目前主要关注的研究领域。
    方法:基于术后鼻窦计算机断层扫描(CT)图像,3D打印技术用于设计和制造精确的轨道引导鼻窦给药装置。对照组按常规方法应用糖皮质激素鼻喷雾剂治疗1年,而实验组使用3D打印的轨道引导式精确鼻窦给药装置接受局部鼻腔糖皮质激素治疗1年。1个月时复查时的Sino-N鼻结果测试(SNOT-22)量表和Lund-Kennedy鼻内窥镜量表的得分,3个月,6个月,术后1年作为评价依据。
    结果:内窥镜鼻窦手术(ESS)后的随访时间为12个月或更长时间。两组在3个月时的SNOT-22评分和鼻息肉Lund-Kennedy分差异有统计学意义,6个月,1年(p<0.001),6个月和1年时血浆皮质醇无差异(p>0.05)。
    结论:在控制eCRS复发方面,使用我们的3D打印精密鼻窦给药装置的局部给药优于常规鼻腔给药。
    Conventional treatment for eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) is usually limited; consequently, relapses occur frequently, accurate local drug delivery is currently a research area of major interest.
    Based on postoperative nasal sinus computed tomography (CT) images, the 3D printing technique was used to design and fabricate a precise track-guided sinus drug delivery device. The control group was treated with glucocorticoids by nasal spray for 1 year according to the conventional method, while the experimental group received topical nasal glucocorticoids using the 3D-printed track-guided precise sinus drug delivery device for 1 year. Scores on the Sino-Nasal Outcome Test (SNOT-22) scale and the Lund-Kennedy nasal endoscopic scale during reexamination at 1 month, 3 months, 6 months, and 1 year after the operation were used as the basis for evaluation.
    The follow-up duration was 12 months or more following endoscopic sinus surgery (ESS) with neosinus cavity formation. The two groups showed significant differences in SNOT-22 scores and nasal polyp Lund-Kennedy subscores at 3 months, 6 months, and 1 year (p < 0.001) and no differences in plasma cortisol at 6 months and 1 year (p > 0.05).
    Local drug administration using our 3D-printed precise sinus drug delivery device is superior to conventional nasal cavity administration in controlling eCRS recurrence.
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  • 文章类型: Journal Article
    结核病是一个全球性的健康问题。肺外结核仍然是诊断和治疗的挑战。结核性中耳炎由于其表现多样而不常见,早期诊断和治疗仍然是一个挑战。这项研究的目的是提出各种不同的和不寻常的表现以及组织病理学确认的重要性以及新的诊断工具,例如CBNAAT(基于药筒的核酸扩增测试),这些工具有助于确认并开始抗结核治疗(ATT)。该研究包括在两年内的5例结核性中耳炎病例。在这5例病例中,有3例表现为排出鼻窦,一个患有乳突脓肿,一个患有肺源性结核性中耳炎。所有5例均通过适当的组织病理学检查得到确认,2例经CBNAAT(基于盒的核酸扩增测试)确认。开始抗结核治疗(ATT),患者无病。结核性中耳炎仍然是慢性化脓性中耳炎的罕见并发症,在治疗慢性化脓性中耳炎时必须牢记。结核性中耳炎的经典表现如今尚未见,疾病扩展到乳突是最初表现的变化趋势。确认该疾病的适当怀疑仍然是诊断和抗结核治疗的金标准。
    Tuberculosis is a global health problem. Extrapulmonary tuberculosis remains to be a challenge in the diagnosis and treatment. Tuberculous otitis media being not so commonly diagnosed due to its varied presentation, early diagnosis and treatment remains to be a challenge. The aim of this study is to present the varied and unusual presentations and the importance of histopathological confirmation and new diagnostic tools like CBNAAT (cartridge based nucleic acid amplification test) which aids in the confirmation and to start anti-tubercular treatment (ATT). Five cases of tuberculous otitis media within a period of two years were included in the study. Among the five cases three cases presented with discharging sinuses, one with mastoid abscess and one with tuberculous otitis media with pulmonary origin. All five cases were confirmed with proper histopathological examination and two cases with CBNAAT (cartridge based nucleic acid amplification test) confirmation. Anti-tubercular treatment (ATT) was started and the patients were disease free. Tuberculous otitis media remains to be a rare complication of chronic suppurative otitis media and it has to be kept in mind while treating chronic suppurative otitis media. Classical presentations of tuberculous otitis media are not seen nowadays and the disease extending to the mastoid is the changing trend as the initial presentation. A proper suspicion with confirmation of the disease remains to be the gold standard for diagnosis and for treatment with anti-tubercular therapy.
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  • 文章类型: Journal Article
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