Laryngospasm is an uncontrolled or involuntary muscular contraction (spasm) of the vocal folds. The condition typically lasts less than 60 seconds, but in some cases can last 20–30 minutes and causes a partial blocking of breathing in, while breathing out remains easier. It may be triggered when the vocal cords or the area of the trachea below the vocal folds detects the entry of water, mucus, blood, or other substance. It is characterized by stridor or retractions. Some people have frequent laryngospasms, whether awake or asleep. In an ear, nose, and throat practice, it is typically seen in people who have silent reflux disease. It is also a well known, infrequent, but serious perioperative complication.It is likely that more than 10% of drownings involve laryngospasm, but the evidence suggests that it is not usually effective at preventing water from entering the trachea. Signs and symptoms
The main symptom is choking and difficulty or inability to breathe or speak, a feeling of suffocation, which may be followed by hypoxia-induced loss of consciousness. As the airway reopens, breathing may cause a high-pitched sound called stridor. The episode seldom lasts over a couple of minutes before breathing is back to normal. Causes
Various stimuli including asthma, allergies, exercise, stress, and irritants such as smoke, dust, fumes, liquids, and food can trigger laryngospasm.
Cystitis glandularis is the transformation of mucosal cells lining the urinary bladder. They undergo glandular metaplasia, a process in which irritated tissues take on a different form, in this case that of a gland. The main importance is in the findings of test results, in this case histopathology. They must distinguish a benign metaplastic change from the cancerous condition urothelial cell carcinoma. It is a very common finding in bladder biopsies and cystectomies, and most often found in the trigone area. Cystitis glandularis lesions are usually present as small microscopic foci; however, occasionally it can form raised intramucosal or polypoid lesions. The cystitis glandularis lesions are within the submucosa. Types
There are two main types of cystitis glandularis, non-mucinous and mucinous (intestinal). The difference is in the cellular production of mucin, a normal feature of colonic and intestinal epithelial cells but not of urothelial cells. Another distinction is made between focal areas and diffuse involvement of the bladder. Whereas focal areas are more common, diffuse involvement is seen in chronically irritated bladders, such as in paraplegics or those with bladder stones or indwelling catheters. Individuals with diffuse intestinal-type cystitis glandularis are at increased risk for developing bladder cancer. Related lesions
Cystitis glandularis arises from and merges with Von Brunns nests, which are groups of urothelial cells (cells of urinary tract) within the lamina propria and submucosa, formed from budding from the surface mucosa. They are considered normal.