Lugansk State Medical University

Cervical esophageal stenosis is a rare but serious complication following thyroidectomy. It presents with dysphagia and odynophagia, which can mimic common postoperative symptoms, leading to delayed diagnosis. Early recognition is crucial for timely intervention and improving patient outcomes.

A 64-year-old female with papillary thyroid carcinoma (PTC) underwent total thyroidectomy. Intraoperatively, an iatrogenic esophageal injury was sutured. Postoperatively, she developed dysphagia, dyspnea, and neck swelling. Imaging revealed cervical esophageal stenosis, and despite initial management with a nasogastric tube and gastrostomy tube, her dysphagia persisted. A corrective partial cervical esophagectomy was performed, and the patient recovered uneventfully, resuming oral intake after 6 days.

Cervical esophageal stenosis can result from surgical trauma or inflammation during thyroidectomy, particularly in patients with PTC. Early imaging and clinical assessment are key for diagnosis. Severe stenosis may require surgical correction, such as esophagectomy, when endoscopic dilation is not sufficient.

Cervical esophageal stenosis should be considered in patients with post-thyroidectomy dysphagia. Prompt diagnosis and intervention, including surgery when necessary, can prevent long-term complications and improve quality of life.

The purpose of this study was to use bioinformatics techniques to investigate the genetic basis and evaluate medication for individuals with Post-Tuberculosis Tracheobronchial Stenosis (PTTS). Text mining was done to find 63 gene sets that are related to tuberculosis, granulation tissue proliferation, cicatrization, and hypertrophic scars. Using the DAVID and STRING tool to study the functional classification of these genes, revealed that these genes are associated with significant ways for instance the 'MAPK' signaling cascade, 'JAK-STAT' signaling pathway, and the 'VEGF' signaling pathway. The relevance of the genes was suggested by real-time quantitative PCR, which verified that MAPK14, STAT3, and VEGFA expression was elevated in PTTS tissues. The 14 hub genes were used to search the DGI database for drugs associated with these genes and the corresponding diseases. Out of the identified compounds, 34 of them were found to be possible drug candidates that could target PTTS's underlying pathophysiology. Such drugs include those targeting protein kinase, a cytokine with anti-inflammatory properties, angiogenesis inhibitors, and those targeting fibrosis. By applying this bioinformatics workflow, it was possible to use very little time in identifying genes and drugs that are involved in the main disease processes of PTTS. Future work should then be directed to conducting more experimental validation on these genes and possible drug candidates for future therapeutic application.

Myopia, or nearsightedness, is one of the most common eye conditions worldwide. However, a comparison of the effectiveness of different laser-assisted interventions is lacking. Thus, we aimed to compare the efficacy and safety of LASIK and IntraLASIK in addressing myopia.

The study was conducted in two ophthalmology clinics in Beijing, China, in 2022. A total of 84 patients (152 eyes) with different degrees of myopia were examined and underwent LASIK (n=46, 80 eyes) or IntraLASIK (n=38, 72 eyes). Keratometry, corneal topography, pachymetry, visual acuity evaluation, and corneal biomechanical analysis were performed before and after the intervention.

IntraLASIK produced more precise flaps than LASIK, with deviations of <8 mm and 0.1 mm from the intended thickness and diameter, respectively. LASIK resulted in nonuniform flaps, with thickness deviations of 5-86 mm. IntraLASIK demonstrated a superior efficacy for patients with severe myopia and thin corneas, with a mean spherical equivalent of 0.9 D at 6 months compared to the 1.4 D for LASIK. Approximately 91% and 83% of the patients with mild to moderate and severe myopia, respectively, achieved results within ± 0.49 D from the refractive target with IntraLASIK.

Corneal hysteresis and corneal resistance factor decreased with an increase in laser intensity, and they decreased faster with thinner corneas. Thus, IntraLASIK is more useful than LASIK in patients with thin corneas and severe myopia.