Many forms of management of the Paradoxical Vocal Fold Movement (PVFM) disorder have been presented in past literature, but it is vital to recognize the complexity of the disorder and the necessity for proper diagnosis to allow for appropriate management. A review of the literature suggests that this disorder predominantly occurs in the young female, and presents with a history of associated medical conditions. A single case study of an unusual presentation of PVFM in a young eleven year old boy with PVFM is discussed in this paper. The PVFM was observed and diagnosed by the Otorhinolaryngologist at the University Malaya Medical Center (UMMC), Kuala Lumpur. Nasendoscopy revealed otherwise normal vocal fold movement in quiet breathing and during an episodic attack. The young boy was subsequently referred for speech therapy; management of the PVFM was solely with speech rehabilitation. The management of the disorder in this young boy is discussed up to the time of discharge from therapy.

Sepsis causes significant mortality in neonatal foals; however, there is little data describing the cellular and molecular pathways of lung inflammation in septic foals. This study was conducted to characterize lung inflammation in septic foals. Lung tissue sections from control (n = 6) and septic (n = 17) foals were compared using histology and immunohistology. Blinded pathologic scoring of hematoxylin and eosin stained samples revealed increased features of lung inflammation such as thickened alveolar septa and sequestered inflammatory cells in septic foals. Septic foal lungs showed increased expression of von Willebrand factor in blood vessels, demonstrating vascular inflammation. Use of MAC387 antibody to detect calprotectin as a reflection of mononuclear cell infiltration revealed a significant increase in their numbers in alveolar septa of lungs from septic foals compared to those from control foals. The mononuclear cells appeared to be mature macrophages and were located in the septal capillaries, suggesting they were pulmonary intravascular macrophages (PIMs). Finally, lungs from septic foals showed increased expression of Toll-like receptor 4 and 9 in mononuclear cells relative to the control. Taken together, this study is the first to show the expression of inflammatory molecules and an increase in PIMs in lungs from foals that died from sepsis.
Blood Vessels ; Capillaries ; Eosine Yellowish-(YS) ; Hematoxylin ; Horses ; Immunohistochemistry ; Inflammation ; Leukocyte L1 Antigen Complex ; Lung* ; Macrophages* ; Mortality ; Pneumonia ; Sepsis ; Toll-Like Receptor 4 ; Toll-Like Receptors* ; von Willebrand Factor*