PubMed · 11676433
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A Scammell. 2001. Evolving practice.. https://doi.org/10.1136/adc.85.5.442b
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The aim of this prospective anatomical study was to determine the place of the thyroid alar cartilage graft (TAC) in the laryngotracheoplasty in a population of premature and newborn babies. Ninety-eight fresh larynges, collected from autopsies, were included in the study. After measurement of cartilage dimensions and thickness, the potential dimensions of TAC and its widening capacity were calculated for each specimen. The results showed that TAC thickness was similar to the anterior cricoid arch but was significantly less than the posterior cricoid arch. The maximal degree of stenosis which could be normalized by TAC ranged between 47.8 and 74.3%. The height of the TAC allowed a widening, from the level of the glottis to the inferior part of the second tracheal ring in 100% of cases and to the inferior part of the third tracheal ring in more than 70% of cases. In conclusion, the TAC could be used for anterior grafting in laryngotracheoplasty. Its indications should be limited to grade II and a few grade III of the Myer subglottic stenosis classification without glottic or tracheal extension. Moreover, variability of TAC dimensions leads to peroperatively reassess its indication.
BACKGROUND: Maspin, a novel serine protease inhibitor, has been shown to inhibit prostate tumor cell motility and invasion in vitro and to inhibit prostate tumor growth and metastasis in vivo. Maspin expression in high-grade prostate carcinoma (PC) is reduced compared with that in low-grade PC. Interestingly, however, compared with low-grade PC, benign secretory prostate epithelial cells express significantly less maspin. This observation appears paradoxical to a putative tumor suppressive role of maspin in prostate carcinogenesis, and this finding issue needs to be clarified. METHODS: We examined maspin expression simultaneously in benign basal cells, benign secretory cells, high-grade prostate intraepithelial neoplasia (HGPIN), low-grade PC, and high-grade PC in 46 radical prostatectomy specimens plus 51 autopsy prostate glands by a combination of immunohistochemistry and in situ hybridization. RESULTS: Benign basal cells consistently expressed maspin at a high level. In PC, the loss of basolateral maspin expression coincides with loss of the basal cell layer. Maspin expression in secretory cells, on the other hand, appears to undergo a biphasic differential regulation, i.e., essentially absent in benign secretory cells, dramatically up-regulated in HGPIN, then progressively down-regulated through low-grade PC to high-grade PC. Maspin expression in PC is inversely correlated with tumor grade. Furthermore, maspin expression in HGPIN is inversely correlated with the Gleason's grade of the adjacent PC. CONCLUSIONS: An up-regulation of maspin expression precedes, rather than occurs at, the critical transition from premalignant prostate lesion of HGPIN to PC. Our data suggest maspin may mark an important transitional phase and play an important role in the premalignancy of the prostate gland.
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