bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiological characteristics of tetanus in Vojvodina
Authors: Petrovic Vladimir , Seguljev Zorica , Petrovic Mladen , Ilic Svetlana
Published: March 2007

Introduction. Vojvodina is an endemic area for tetanus. Material and Methods. Epidemiological characteristics of tetanus were analyzed based on registered cases of disease and death in the period 1960 - 2004, and epidemiological investigation of 50 registered cases during the last 10 years of this period. Epidemiological characteristics were analyzed chronologically, demographically and topographically. Results and Discussion. During the period of observation, the incidence rate of tetanus declined steadily. Due to immunization and extremely high coverage, tetanus has been practically eliminated in the age group of younger than 29 years. Neonatal tetanus and tetanus in the age group 30-59 years has been reduced to individual cases. Today, tetanus is a problem of the elderly population. Tetanus deaths occur statistically more often among persons older than 66 years. The average case fatality rate during the period of observation was 33.1%. The vaccination history in the majority of investigated cases was unknown (52%) or they have never been vaccinated (28%) because they were mainly elderly people born before introduction of mandatory immunization. Tetanus most often occurs after minor wounds, because of which patients do not seek medical attention. In the majority of cases tetanus occurred after limb injuries. Conclusion. Tetanus in Vojvodina is a problem among immunized elderly people. It mostly occurs after minor injuries or after contamination of chronic skin lesions. Mandatory vaccination of older age groups should contribute to further reduction in the incidence rate of tetanus. .
Hypertension, pre-eclampsia and eclampsia: Monitoring and outcome of pregnancy
Authors: Grujic Ilija , Milasinovic Ljubomir
Published: March 2007

Introduction. Pregnancy-induced hypertension, pre-eclampsia and eclampsia are parts of the hypertensive syndrome which is a life-threatening condition both for mother and fetus. Apart from being associated with unpredictable onset, it is incurable, except by ending the pregnancy. Its incidence is approximately between 6 - 10% of pregnant women. There is no unique definition and classification of the hypertensive syndrome in pregnancy, i.e. they differ from one expert group to another. Risks of pregnancy-induced hypertension. Pregnancy-induced hypertension syndrome can cause placental abruption, intracranial hemorrhage, liver lesions, acute renal disorders and disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), hypervolemia and inhalation of gastric content, due to deep sedation. Treatment of pregnancy-induced hypertension. Delivery is always appropriate therapy for the mother, but may not be a good solution for the fetus. Standard treatment of pre-eclampsia includes: anticonvulsive therapy, antihypertensive therapy, excessive fluid administration, and if necessary, management of oliguria, DIC, pulmonary edema and recovery of liver function. The outcome of pregnancy-induced hypertension (perinatal and maternal mortality). Maternal mortality due to pregnancy-induced hypertension is 15 - 33% out of the total number of maternal deaths. Newborn infants of mothers with pregnancy-induced hypertension present with intrauterine growth retardation, prematurity, dysmaturity and necrotizing enterocolitis. Pregnancy-induced hypertension is one of the major causes of maternal and fetal/neonatal morbidity and mortality. .
Forensic implications of rape
Authors: Novakovic Milan
Published: March 2007

Introduction. Rape is a sexual act of violence in which physical strength is used. Criminal law imposes strict punishments for such crimes as rape. Psycho-pathologically, rape is among the gravest of crimes, often associated with extremely deviated behavior. This article deals with the forensic aspects of sexual violence in Bosnia and Herzegovina in the period from 2000-2004. We report about sexual assaults, personality of delinquents, motives and consequences of rape. Material and Methods. Two groups of violent offenders were compared in the study: perpetrators of rape (N=90), and perpetrators of other criminal offences (N=90-recidivists). The control group included young males (N=90). Results. The results of the study show a high level of violence in Bosnia and Herzegovina. The rape rate equals the level of homicide in Bosnia and Herzegovina. Rape offenders are mostly people with personal disorders (70%), but they also present with other illnesses and behavior disorders. Conclusion. The significance of rape as a violent crime has not been sufficiently studied. High incidence of violence and rape in Bosnia and Herzegovina is extremely disturbing. The most disturbing aspect is the increase of violence and failure to take certain measures. The role of psychiatry is to provide penal education, treatment and programs for elimination of consequences of rape. .
An unusual cause of complete atrioventricular block: A case report
Authors: Krotin Mirjana , Milovanovic Branislav , Vukovic Dejana , Celeketic Dusica
Published: March 2007

Introduction. Complete atrioventricular block is a serious disorder, since patients may be asymptomatic. However, it is an important risk for sudden cardiac death. Case report. A 48-year old male patient was admitted to the coronary care unit, due to recurring substernal chest pain. It was followed by fatigue, weakness and confusion, it lasted more than half an hour and occurred twice. Loss of consciousness did not occur. The patient had a tick bite two months earlier. Physical examination was unremarkable, except for low heart rate (50/minute) electrocardiogram showed a complete atrioventricular block with narrow QRS complexes and good ventricular function. Elevation of ST segment was observed in the inferior ECG leads, with reciprocal ST depression in precordial leads; it was highly suspicious for acute myocardial infarction, but markers of myocardial necrosis (Troponin, Creatine kinase-MB) were normal. The chest pain recurred without evolutive changes in the electrocardiogram or increase in markers of myocardial necrosis. Tests for Lyme disease were negative, too. The cause of atrioventricular conduction disturbance was found by transthoracic echocardiography. A giant tumor was found in the right atrium and right ventricle. Further examinations excluded its secondary cause and the patient was sent to surgery. The tumor was inoperable and bled excessively. Although permanent pacing was performed, the patient died suddenly after dismisal. Conclusion. We can conclude that a giant primary tumor of the heart can be asymptomatic for a long time causing complete atrioventricular block, and in this case it clinically presented as acute myocardial infarction. Echocardiographic examination was the main diagnostic tool in our case. .
Initial evaluation of vertigo
Authors: Lemajic-Komazec Slobodanka , Komazec Zoran
Published: March 2007

Dizziness is one of the most common reasons patients visit their physicians. Balance control depends on receiving afferent sensory information from several sensory systems: vestibular, optical and proprioceptive. Bioelectric signals, generated by body movements in the semicircular canals and in the otolithic apparatus, are transported via the vestibular nerve to the vestibular nucleus. All four vestibular nuclei, located bilaterally in medial longitudinal fasciculus, are linked with central nervous system structures. These central nervous system structures are involved in maintaining visual stability, spatial orientation and balance control. Nystagmus is a result of afferent signals balance disorders. Nystagmus due to peripheral lesions is conjugate nystagmus, because there is a bilateral central connection. Lesions above the vestibular nuclei induce deficits in synchronization and conjugation of eye movements, thus the nystagmus is dissociated. This paper shows that in peripheral vestibular disorders spontaneous nystagmus is rhythmic, associated, horizontal-rotatory or horizontal, with subjective sensation of dizziness which decreases with time and harmonic signs whose direction coincides with the slow phase of nystagmus and it is associated with mild disorders during pendular stimulation with statistically significant vestibular hypofunction. Spontaneous nystagmus in central vestibular lesions is severe, dissociated, horizontal, rotatory or vertical, without changes related to optical suppression; if vestibular symptoms are present, they are non-harmonic. In central disorders, findings after thermal stimulation are either normal or pathological, with dysrhythmias and inhibition in pendular stimulation. This paper deals with differential diagnosis of vertigo based on anamnesis and clinical examination, as well as objective diagnostic tests. .
Changes in mandible due to osteoporosis
Authors: Postic Srdjan
Published: March 2007

Introduction: Osteoporosis may occur in bone tissue as a result of ageing. Aim: The aim of this study was to investigate remodeling of old human edentulous mandibular bone due to osteoporosis. Materials and Methods: Osseous surfaces of one edentulous and one dentate mandible were extracted from a cadaver. This study included 5 methods of analysis of bone structures in experimental and control bony samples of human mandibular bones. Absolute densities of samples were determined. SEM analysis and X-ray diffraction analysis of spectra were used to assess bony layers. Results: Minimum density 1.9658 g/cm3 of edentulous ridge site was detected. SEM micrographs indicated reductions of trabecular and lamellar width. Significant differences (p<0.01) in cancellous site width were recorded in experimental basal specimens. Noticeable increase of porosity was observed in 6.35% of edentulous ridge site and 14.06% of experimental basal site. There was a significant correlation between oxygen presence (p=0.046) eroded and defect bone surfaces (p<0.001). Complexes of hydroxyapatite, calcium-phosphate, tetracalcium-pyrophosphate and amorphous calcium-phosphate were inorganic constituents considerable mineral modifications of edentulous ridge site. Conclusion. Based on the results of the present study, various levels of degradation of cortical matrix and cancellous layers of edentulous mandible may be observed as a result of osteoporosis. .
Evaluation of antibacterial effect of endodontic materials
Authors: Matovic Ivan , Teodorovic Nevenka
Published: March 2007

Introduction. Due to the inability to sterilize infected root canals during cleaning and shaping, contemporary endodontic materials are expected to possess certain antibacterial effect. Aim. The aim of this study was to evaluate antibacterial effect of four contemporary endodontic materials: Acroseal, AH-Plus, Gutta Flow and Mineral Trioxide Aggregate (MTA) in vitro. Materials and Methods. Antibacterial effect of tested materials was evaluated against bacterial species Enterococcus faecalis ATCC 29212 using the agar diffusion test. Results. Based on the obtained results, it can be concluded that freshly mixed Acroseal and AH-Plus exhibited significant antibacterial effect while Gutta Flow and MTA did not present any antimicrobial potential in this study. Conclusion. Endodontic sealers tested in this study, freshly mixed Acroseal and AH-Plus, possess certain antibacterial effect whereas in solid state this effect is not present. .
The impact of demographic factors on the possibility of cleft lip and palate occurrence
Authors: Radojicic Julija , Tanic Tatjana
Published: March 2007

Introduction: Lip and palate clefts (cheilognathopal atoschisis) are very severe congenital anomalies. Aim: To examine the impact of demographic factors in the first pregnancy trimester on the occurrence of lip and palate cleft. Subjects and Methods: Children born in the period between March 1999 to December 2003, as well as their parents were included in the study. The study group consisted of 96 children with cleft lip and palate treated at the Gynecology - Obstetrics clinics of the Clinical Center in Nis (Neonatology ward), VMA (Military Medical Academy) Belgrade (Institute for plastic surgery), Mother and Child Institute - Novi Beograd and University children's Clinic, Belgrade. The control group comprised 142 healthy children. The examination was carried out using two questionnaires. One was for mothers and consisted of 41 questions related to the first pregnancy trimester. The other questionnaire was filled in by fathers and had 16 questions also related to the period of the first trimester of their wives' pregnancies. Results: The results showed that unilateral lip and palate cleft occurred in the same percentage in boys and girls (53.1%). Isolated palate cleft was more frequently found in boys, and unilateral lip cleft in girls. Statistically higher possibility for lip and palate cleft was found in the third child. The age of mothers in the time of conception does not represent risk factor for the cleft occurrence. Mothers who gave birth to children with clefts were younger (26.4 years old) than mothers in control group (28.4 years old). Conclusion: There is a need for constant education of women on risk factors that they can be exposed to during pregnancy. .
Progressive hemifacial atrophy Parry Romberg syndrome characteristics of craniofacial morphology
Authors: Nikodijevic-Latinovic Angelina
Published: March 2007

The aim of this case report was to analyze clinical finding in a patient with rare, Parry Romberg syndrome. The patient was diagnosed with progressive facial hemiatrophy that affected skin, subcutaneous tissue and underlying bony structures. Analysis of study models and cephalometric radiographs confirmed there was insufficient development of the facial right side: asymmetric narrow upper jaw, shorter mandibular ramus and corpus, upper frontal teeth asymmetry, crowding of the upper dental arch on the right side. An orthodontic treatment plan was proposed within the entire rehabilitation program that included collaboration with a maxillofacial and plastic surgeon.
Spatiotemporal Trends and Age-Period-Cohort Modeling of the Incidence of Type 1 Diabetes Among Children Aged <15 Years in Norway 1973–1982 and 1989–2003
Authors: Aamodt Geir , Stene Lars C. , Njølstad Pål R. , Søvik Oddmund , Joner Geir ,   for the The Norwegian Childhood Diabetes Study Group
Published: March 2007

OBJECTIVE—We have investigated age-period-cohort effects and spatial and temporal trends for the incidence of type 1 diabetes among 0- to 14-year-old children in Norway.

RESEARCH DESIGN AND METHODS—We included children with the diagnosis of type 1 diabetes in Norway during 1973–1982 and 1989–2003. We studied age, calendar period, and birth cohort effects using Poisson regression, including Holford's method of parameterization, to model the dependencies between age, period, and cohort effects. To study spatiotemporal clustering of cases, we used spatial scan statistics.

RESULTS—The overall incidence rate for the study population <15 years of age was 22.7 cases per 100,000 (95% CI 22.1–23.4), showing an average annual increase of 1.2% (95% CI 0.7–1.5%) during the study period. One specific area with 30% increased incidence rates was identified in the southern part of Norway during 1976–1980 (P = 0.001). Also, children born during 1964–1966 in a specific region in the southern part of Norway as well as children born during 1987–1989 in a region in northern Norway showed 2.0 and 2.6 times, respectively, higher incidence rates compared with the rest of the country (both P = 0.001).

CONCLUSIONS—The incidence of type 1 diabetes among children increased during the study period. Birth cohort effects were identified using the spatiotemporal scan statistic but not using age, period, and birth cohort modeling. Such effects, within the relatively homogenous Norwegian population, suggest the influence of nongenetic etiological factors.
High Titer of Autoantibodies to GAD Identifies a Specific Phenotype of Adult-Onset Autoimmune Diabetes
Authors: Buzzetti Raffaella , Di Pietro Sergio , Giaccari Andrea , Petrone Antonio , Locatelli Mattia , Suraci Concetta , Capizzi Marco , Arpi Maria Luisa , Bazzigaluppi Elena , Dotta Francesco , Bosi Emanuele ,   for the Non Insulin Requiring Autoimmune Diabetes (NIRAD) Study Group
Published: March 2007

OBJECTIVE—The aim of the present study was to define heterogeneity of adult-onset autoimmune diabetes based on characterization of GAD antibodies (GADAs).

RESEARCH DESIGN AND METHODS—Patients enrolled in a nationwide survey, the Non Insulin Requiring Autoimmune Diabetes (NIRAD) Study, have been screened for GADAs and IA-2 antibodies (IA-2As) and further characterized for GADA titer, antibodies to thyroid peroxidase (TPO), and HLA DRB1-DQB1 polymorphisms.

RESULTS—Of 4,250 consecutive type 2 diabetic patients, 4.5% had either GADAs and/or IA-2As. Patients with autoimmune diabetes showed a clinical phenotype significantly different from that of type 2 diabetes, including higher fasting glucose and A1C, lower BMI and uric acid, lower prevalence of metabolic syndrome and its components, and higher frequency of TPO antibodies. More interestingly, analysis of GADA titers showed a bimodal distribution that identified two subgroups of patients with high (>32 GADA arbitrary units) and low (≤32 GADA arbitrary units) GADA titers. Compared with those with low GADA titers, patients with high GADA titers had more prominent traits of insulin deficiency and a profile of more severe autoimmunity resulting in higher A1C, lower BMI, a lower prevalence of metabolic syndrome and its components (P < 0.02 for all), a higher prevalence of IA-2As, TPO antibodies (P < 0.003 for both), and DRB1*03-DQB1*0201 (50 vs. 26.8%, P = 0.001), and a decreasing frequency of DQB1*0602 and DRB1*0403 (from type 2 to low and to high GADA titer autoimmune diabetes; P < 0.001 for trend for both comparisons).

CONCLUSIONS—GADA titers identify two subgroups of patients with adult-onset autoimmune diabetes having distinct clinical, autoimmune, and genetic features.
Treatment of Osteoporotic Fractures of the Spine
Authors: Buljat Gojko , Perović Darko
Published: March 2007

Mogućnosti Liječenja Osteoporotskih Prijeloma Kralježnice

Osteoporotski prijelomi kralježnice dva do tri puta su učetaliji nego prijelomi kuka, posebice u žena. Vertebralni osteoporotski kompresijski prijelomi tipično uključuju srednju i donju torakalnu kralježnicu i torakolumbalni prijelaz. Klinička slika očituje se u akutnom stanju u obliku nagle boli u leđima nakon minimalne ozljede a često i kad ozljede nema. U dijagnostici je osnovno uzeti dobru anamnezu te provesti klinički pregled pacijenta. Temelj radiološke dijagnostike je standardni RTG. Ako postoji klinička indikacija (diferencijalna dijagnostika tumora ili spondilitisa, neurološka slabost) radi se i CT i/ili MR. Pristup liječenju osteoporotskih prijeloma kralježnice je individualan i temelji se na povijesti bolesti, lokalizaciji simptoma, te korelaciji kliničkog pregleda i radiološkog nalaza. Česte su posljedice prijeloma dugotrajni bolovi, gubitak visine i deformacije kralježnice, koje znatno koreliraju sa smetnjama hoda i pokretljivosti, smanjenjem funkcije pluća, gubitkom teka i na kraju povećanom smrtnošću. Otvorena repozicija, dekompresija i fiksacija indicirana je u pacijenata s posttraumatskom stenozom i neurološkom slabošću. Moderne kirurške tehnike liječenja su vertebroplastika i kifoplastika koje znatno smanjuju bol i poboljšavaju pokretljivost pacijenata, a time i kvalitetu života.
Tumor Necrosis Factor-α Stimulates the Expression of C-C Chemokine Ligand 2 Gene in Fibroblasts from the Human Nasal Polyp through the Pathways of Mitogen-Activated Protein Kinase
Authors: Lin Sze-Kwan , Kok Sang-Heng , Shun Chia-Tung , Hong Chi-Yuan , Wang Chih-Chiang , Hsu Ming-Che , Liu Chia-Ming
Published: March 2007

Background

Recruitment of macrophages is crucial to the pathogenesis of the nasal polyp (NP) because this disease is believed to be inflammation related. Information regarding the expression of C-C chemokine ligand 2 (CCL2), an essential modulator of monocyte chemotaxis in nasal polyp fibroblasts (NPFs), remains unavailable. In this study, the effects of tumor necrosis factor (TNF)-α on CCL2 expression in NPFs and the signaling pathway involved were investigated.

Methods

Primary cultures of NPFs were established from NPs. The expressions of CCL2, c-Fos, and c-Jun mRNAs in NPF after TNF-α stimulation were detected by Northern blot. Western blot was used to examine the activation of mitogen-activated protein kinase (MAPK) signaling pathways. Activator protein (AP) 1/DNA interactions were evaluated by electrophoretic mobility shift assay (EMSA).

Results

Northern blot showed that TNF-α stimulated CCL2 gene expression in NPFs. Significant increase of B-Raf, phosphorated MAPK including mitogen-activated ERK-activate kinase (MEK)1/2, extracellular signal-related kinase 1/2, and p38 were detected by Western blot. c-Fos and c-Jun mRNAs were induced by TNF-α, and PD98059 (MEK inhibitor) and SB203580 (p38 inhibitor) abolished the up-regulation of c-Fos. EMSA revealed that TNF-α increased AP-1/DNA binding, and PD98059 and SB203580 attenuated this reaction, possibly via reducing c-Fos synthesis. PD98059 and curcumin (AP-1 inhibitor) markedly suppressed the TNF-α–induced CCL2 expression, whereas the effect of SB203580 was less noted.

Conclusion

TNF-α induces CCL2 transcription in NPFs. B-Raf/MEK/ERK signaling cascade and to a less extent the p38 pathway are responsible for c-Fos activation and the subsequent AP-1/DNA interaction leading to CCL2 expression.
Deposition of Aerosolized Particles in the Maxillary Sinuses before and after Endoscopic Sinus Surgery
Authors: St. Martin Michele B. , Hitzman Cory J. , Wiedmann Timothy S. , Rimell Frank L.
Published: March 2007

Background

Recent studies suggest that topical therapy is beneficial in many conditions underlying chronic sinusitis. Current literature has documented low aerosolized particle deposition efficiency into the paranasal sinuses. Mathematical modeling suggests that three factors influence the deposition efficiency: particle size, pressure gradient, and size of the sinus ostium. Ostium size is the most dominant factor. Therefore, we sought to determine if maxillary antrostomy and ethmoidectomy would increase the deposition efficiency.

Methods

Five cadavers underwent pre- and postoperative scintigraphy after administration of aerosolized Tc-99M. Images were obtained with a γ-camera and regions of interest (ROIs) were drawn around the maxillary sinuses. Counts per minute in the pre- and postoperative ROIs were then compared using the paired t-test.

Results

Results indicated a significant increase in deposition of radioactivity in the maxillary sinuses in the postoperative state (p < 0.01).

Conclusion

Topical therapy for chronic sinusitis may be more feasible in the postoperative population.
Cigarette Smoke Extract Induces Cytotoxicity on Human Nasal Epithelial Cells
Authors: Lan Ming-Ying , Ho Ching-Yin , Lee Te-Chang , Yang An-Hang
Published: March 2007

Background

The nasal mucosa is the first area to be exposed to a variety of inhaled toxins. Among various inhaled toxins, cigarette smoke is the most common one and is associated with several nasal and sinus disorders.

Methods

To evaluate the cytotoxic effects of cigarette smoke, primary human nasal epithelial cells were cultured in various concentrations of cigarette smoke extract (CSE) for various times. Cell viability was evaluated by WST-1 (4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate) assay. Morphological findings were observed under the light microscope and the electron microscope. Annexin-V stain was used for the detection of apoptosis.

Results

Using the WST-1 assay, CSE reduced cell viability in a time- and concentration-dependant manner. CSE-treated cells showed initial membrane blebbing followed by vesicle formation without apoptotic body formation or cell membrane rupture. Cells were stained with annexin-V but without propidium iodide under a fluorescence microscope. TUNEL (terminal deoxynucleotidyltransferase-mediated dUPT nick end labeling) stain was positive in CSE-treated cells.

Conclusion

CSE induces cytotoxicity on primary human nasal epithelial cells and the morphological findings closely mimic partition apoptosis.
Microarray cDNA to Identify Inflammatory Genes in Nasal Polyposis
Authors: Figueiredo Claudia R. , Santos Rodrigo P. , Silva Ismael D.C.G. , Weckx Luc L.M.
Published: March 2007

Background

The objective of this study was to investigate the spectrum of inflammatory gene expression in patients with nasal polyposis.

Methods

The cDNA microarray technique was used to identify gene expression in tissue samples from nasal polyps and adjacent inflammatory nasal mucosa of 21 patients with nonallergic nasal polyposis. To validate the microarray analysis, we compared the expression of five genes by reverse transcription-polymerase chain reaction (RT-PCR): tumor necrosis factor, IL-5, IL-9, fibroblast growth factor, and transforming growth factor (TGF)-β1.

Results

We tested 96 different inflammatory genes in our samples. Thirty-six genes exhibited differences in expression between the two tissue types. In all 36 genes the level of expression was greater in the inflammatory mucosa than the polyps. The RT-PCR confirmed the cDNA results.

Conclusion

We believe that the high expression of TGF-β1 in inflammatory mucosa compared with the low expression in polyps may reflect an important role in the inhibitory mechanisms of nasal polyposis.
Use of a Sprayed Fibrin Hemostatic Sealant after Laser Therapy for Hereditary Hemorrhagic Telangiectasia Epistaxis
Authors: Richmon Jeremy D. , Tian Ying , Husseman Jacob , Davidson Terence M.
Published: March 2007

Background

Hereditary hemorrhagic telangiectasia (HHT) is a relatively common autosomal dominant condition. Epistaxis is a frequent manifestation, often occurring daily and requiring iron and blood transfusions. Surgery often is bloody and difficult. The aim of this study was to evaluate the effectiveness of a sprayed fibrin, hemostatic sealant in preventing postoperative epistaxis after laser treatment of nasal mucosa in HHT. Fibrin sealant was compared with nasal packing for likelihood of postoperative epistaxis and financial impact including material costs and hospitalization fees.

Methods

Retrospective review was performed of 64 individual laser treatments for epistaxis in HHT patients at the University of California, San Diego, Medical Center between 2002 and 2005. Nasal packing was used in 30 procedures and fibrin sealant was used in 34 procedures.

Results

Six of 30 (20%) procedures using postoperative nasal packing required admission with an average hospital expense of $5914. One of 34 patients (3%) in the fibrin sealant group required hospitalization (p = 0.04).

Conclusion

Aerosolized fibrin sealant prevents postoperative epistaxis after nasal laser treatment in HHT patients. Compared with traditional nasal packing we found improved patient comfort and recovery with substantial cost savings.
Innate Responses to Aspergillus: Role of C1q and Pentraxin 3 in Nasal Polyposis
Authors: Baruah Paramita , Trimarchi Matteo , Dumitriu Ingrid E. , Dell'Antonio Giacomo , Doglioni Claudio , Rovere-Querini Patrizia , Bussi Mario , Manfredi Angelo A.
Published: March 2007

Background

Pentraxin 3 (PTX3) and complement component C1q are humoral factors of innate immunity, produced at sites of inflammation, and are essential in immune defense against several microbes such as Aspergillus, which is commonly implicated in nasal polyposis.

Methods

PTX3 and C1q were measured in nasal polyp tissue, normal nasal mucosa, and serum of patients and healthy subjects. Immunohistochemistry for the two proteins was done on normal nasal mucosa and nasal polyps. In addition, PTX3 and C1q production from mononuclear cells from patients and healthy subjects was assessed.

Results

Normal nasal mucosa was found to have 100-fold higher levels of PTX3 compared with serum. No measurable local increase of PTX3 was observed in polyps compared with normal mucosa. Immunohistochemistry revealed PTX3 expression in the lining of blood vessels both within normal mucosa and nasal polyps. PTX3 also was present in mononuclear cells infiltrating nasal polyps. C1q levels were higher in polyps than in normal nasal mucosa.

Conclusion

High levels of PTX3 are present in normal nasal mucosa, suggesting a role in the maintenance of tissue homeostasis. Elevated C1q levels in nasal polyps might be indicative of an ongoing inflammatory response in the nasal mucosa in these patients.
Comparison of Techniques for Transsphenoidal Pituitary Surgery
Authors: Neal Jeffrey G. , Patel Sunil J. , Kulbersh John S. , Osguthorpe J. David , Schlosser Rodney J.
Published: March 2007

Background

The aim of this study was to compare three different techniques for transsphenoidal pituitary surgery: (1) sublabial transseptal approach with microscopic resection, (2) transnasal transseptal approach with endoscopic resection, and (3) endoscopic approach with endoscopic resection.

Methods

We performed a retrospective review of 50 pituitary surgeries performed by the same neurosurgeon. Demographic, radiographic, and clinical data were collected.

Results

Fifteen patients underwent sublabial approach with microscopic tumor resection, 21 patients underwent the transnasal approach with endoscopic resection, and 14 patients underwent the completely endoscopic technique. There were a total of 20 complications in the sublabial group, 13 transnasal complications, and 6 endoscopic complications. Cerebrospinal fluid leak incidence was 53% in the sublabial approaches, 47% transnasal, and 28% in the endoscopic patients. Diabetes insipidus was encountered in 33% of sublabial approaches, 5% of transnasal approaches, and 7% of endoscopic approaches. Lumbar drains were required in 40% of sublabial approaches, 38% of transnasal approaches, and 7% of endoscopic approaches. Nasal packing was used in 100% of sublabial and transnasal approaches and 0% of endoscopic approaches. Mean recurrence rate and follow-up was sublabial in 6.6% (50 months), transnasal in 9.5% (11 months), and endoscopic in 0% (7 months). Average hospital stay for sublabial approaches, transnasal approaches, and endoscopic approaches was 8.3, 6.2, and 3.4 days, respectively (p < 0.05).

Conclusion

Transsphenoidal pituitary surgery has evolved over the past several decades, because advances in technology have been the catalyst for minimally invasive surgeries. Less invasive approaches, such as the transnasal approach with endoscopic resection of tumor and the completely endoscopic technique have less morbidity and a shorter hospital stay than traditional sublabial approaches. Continued follow-up is needed to confirm long-term benefits and similar recurrence rates.
Activity of Nasal Amphotericin B Irrigation against Fungal Organisms in Vitro
Authors: Shirazi Mobeen A. , Stankiewicz James A. , Kammeyer Pat
Published: March 2007

Background

The role of fungi in chronic rhinosinusitis has been described in recent reports. Controversy exists on the use of topical amphotericin B therapy as a treatment modality for this condition. The effect of various concentrations of amphotericin B nasal irrigation on actively growing fungi was studied in vitro.

Methods

Ten species of fungi commonly found in the nasal cavity were grown on growth media plates. Each fungi was exposed to 20 mL of amphotericin B nasal irrigation at concentrations of either 100, 200, or 300 μg/mL or sterile water two times daily for 6 weeks. Each plate was subcultured on a weekly basis to examine for any viable fungi.

Results

Fungi growth was not arrested in the 100-μg/mL amphotericin B and sterile water groups at the end of 6 weeks. Use of the 300-and 200-μg/mL amphotericin B solutions showed failure of the subcultured fungi to grow at 5 and 6 weeks, respectively.

Conclusion

Nasal amphotericin B irrigation is ineffective in killing fungi in vitro at a concentration of 100 μg/mL over a 6-week period. Concentrations of 200 and 300 μg/mL successfully prevented fungi growth at the conclusion of the study. The current concentration of commercially available topical amphotericin B (100 μg/mL) seems ineffective in eradicating fungi in vitro.
Relationship between Toxocara Seropositivity and Allergic Rhinitis
Authors: Yariktas Murat , Demirci Mustafa , Aynali Giray , Kaya Selcuk , Doner Fehmi
Published: March 2007

Background

Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. The purpose of this study was to investigate the association between Toxocara seropositivity and allergic rhinitis.

Methods

Sixty-four consecutive patients with allergic rhinitis and 61 healthy volunteers in the control group were included in this study. The diagnosis of allergic rhinitis was defined by positive epicutaneous prick test. The diagnosis of toxocariasis was established by IgG and specific IgE antibodies against Toxocara by ELISA method. All cases were examined for intestinal parasites also. The seropositive cases with Toxocara were reevaluated for symptoms and signs of toxocariasis.

Results

Higher toxocariasis seropositivity (ELISA IgG; 28.1%) rate was determined in the patients with allergic rhinitis and compared with the control groups (11.5%; p < 0.05). Specific IgE seropositivity (17.2%) was high for the patients with allergic rhinitis compared with the control group (3.3%; p < 0.05).

Conclusion

Our results show that there was a possible causal relationship between Toxocara infection and allergic rhinitis. Patients with allergic rhinitis from a region with high prevalence for this parasitic infection should be evaluated for Toxocara infection.
Patient Satisfaction Survey of Outpatient-Based Topical Local Anesthetic KTP Laser Inferior Turbinectomy: A Prospective Study
Authors: Orabi Ahmad A. , Sen Aloke , Timms Michael S. , Morar Pradeep
Published: March 2007

Background

The aim of this study was to determine patient satisfaction and feasibility of performing KTP laser inferior turbinectomy under topical anesthetic/decongestant spray. A prospective survey study was performed in the Outpatients’ Department of a District General Hospital.

Methods

Thirty-nine consecutive patients suffering from allergic or nonallergic vasomotor rhinitis were prospectively entered into the study. Preoperative details were gathered including current nasal obstruction score as indicated on a visual analog score (VAS). Lidocaine hydrochloride 5% w/v and phenylephrine hydrochloride 0.5% w/v was applied via topical spray to anesthetize and decongest the nose. The inferior turbinates (ITs) were reduced by parallel mucosal cuts using the KTP laser. Intraoperative details were recorded included pain experienced and bleeding. We studied the subjective clinical effectiveness and patient satisfaction.

Results

All patients were followed up at standard intervals by telephone over a 6-month period. At each interval, current nasal obstruction, pain, bleeding, and crusting on VAS were collected. Morbidity was determined in terms of return to work, return to hospital, or recurrence of symptoms. At the end of 6 months all patients were asked if they would have the procedure repeated again and/or recommend it to a friend. Reduction of ITs under topical anesthesia was acceptable to 83% of all patients. Eighty-seven percent of all patients felt they would recommend the procedure and mode of anesthesia to a friend. Our patients obtained the maximum subjective benefit at 6 weeks postoperatively. A significant improvement in nasal obstruction was achieved. There was subjective improvement in associated symptoms including hyposmia/anosmia, rhinorrhea, and sneezing. Only 28% of all patients required medication again to aid symptom control. Postoperative bleeding was insignificant. The return to a ward or clinic was minimal and 82% of all employed patients were back at work within a week.

Conclusion

Our study showed that KTP laser inferior turbinectomy is suitable to be performed in the outpatient department under topical anesthetic/decongestant spray and provides excellent relief for nasal obstruction and high patient compliance and satisfaction.
Impact of Age on Presentation of Chronic Rhinosinusitis and Outcomes of Endoscopic Sinus Surgery
Authors: Reh Douglas D. , Mace Jess , Robinson Jamie L. , Smith Timothy L.
Published: March 2007

Background

As the population ages, the mean age of patients with chronic rhinosinusitis (CRS) likely will increase as will the frequency of endoscopic sinus surgery (ESS) in the older population. The purpose of this study was to compare symptom presentation, CT scores, endoscopy scores, and quality of life (QOL) measures in patients <60 years of age as compared with younger patients.

Methods

A prospective cohort of 18 patients >60 years and 121 patients ≤60 years undergoing ESS for CRS were studied. Patient factors, symptom severity, and CT scores were examined preoperatively. Endoscopy and QOL scores were compared pre- and postoperatively between the two groups.

Results

The prevalence of allergies, polyps, asthma, aspirin sensitivity, and revision surgery was similar in each age group. There was no statistically significant difference in the visual analog scale scores of symptom severity in each age group. Older patients had scores that were similar to younger patients with regard to CT (13.11 versus 11.63; p = 0.419), preoperative endoscopy (8.22 versus 7.96; p = 0.828), postoperative endoscopy (3.06 versus 4.82; p = 0.100), and change in endoscopy (−5.17 versus −3.15; p = 0.083). Older patients had similar preoperative, postoperative, and change scores when compared with younger patients on the Rhinosinusitis Disability Index (−15.33 versus −20.63; p = 0.318) and Chronic Sinusitis Survey (14.35 versus 23.11; p = 0.126).

Conclusion

Older patients with CRS present with symptoms and patient factors that are comparable with younger patients and have a similar degree of improvement on endoscopy scores and QOL measures after ESS.
Clinical Predictors of Chronic Rhinosinusitis
Authors: Pynnonen Melissa , Fowler Karen , Terrell Jeffrey E.
Published: March 2007

Background

Chronic rhinosinusitis (CRS) is diagnosed by the presence of signs and symptoms of CRS in conjunction with physical evidence of mucosal inflammation. We sought to identify symptoms that predict CRS.

Methods

We performed a retrospective review of patients referred to a tertiary care rhinology clinic for evaluation of CRS. Symptom survey data and diagnoses were reviewed.

Results

Of 187 patients who met inclusion criteria, 112 (60%) were diagnosed with CRS and 75 (40%) were not. Chronic purulent rhinorrhea (odds ratio [OR], 2.2) and hyposmia (OR, 2.3) individually and in combination (OR, 3.8) were significant predictors of CRS. The major criteria of the 1997 Task Force in Rhinology (TFR) also predicted CRS (OR, 1.9) but the minor criteria did not (OR, 0.3).

Conclusion

In this preliminary study, purulent rhinorrhea and hyposmia are strong predictors of CRS. The major criteria of the TFR also predict CRS but the minor criteria do not.
Effectiveness of Topical Antibiotics on Staphylococcus Aureus Biofilm in Vitro
Authors: Desrosiers Martin , Bendouah Zohra , Barbeau Jean
Published: March 2007

Background

In vitro biofilm-producing capacity in isolates of Staphylococcus aureus and Pseudomonas aeruginosa collected from the sinus cavities after endoscopic sinus surgery (ESS) are associated with a poor outcome in patients with chronic rhinosinusitis (CRS). However, conventional oral antibiotic therapy is frequently ineffective in eradicating bacteria in the biofilm form. Increasing the concentration of antibiotics may offer a means of countering this resistance. The aim of this study was to determine the in vitro activity of moxifloxacin (MOXI) against S. aureus in biofilm form (recovered from patients with CRS at least 1 year post-ESS).

Method

This study was performed in a research microbiology laboratory, where five isolates of S. aureus with known biofilm-forming capacity were cultured in Tryptic Soy Broth 0.5% glucose in 96-well plates at 37°C for 24 hours. After visual confirmation of biofilm formation, plates were incubated in phosphate-buffered saline (PBS) or with MOXI at concentrations of 0.1×, 1×, 100×, and 1000× minimal inhibitory concentration (MIC) for an additional 24 hours. Biofilm from 3 wells of each concentration were collected and sonicated and the number of viable bacteria was determined by serial dilution and plating.

Results

After incubation, the number of viable bacteria was similar for nontreated and MOXI-treated biofilms at MIC and sub-MIC levels. However, MOXI at 1000X (0.1–0.2 mg/mL) gave a 2 to 2.5 log reduction in number of viable bacteria.

Conclusion

In vitro results show that increased concentrations of antibiotics, easily attainable in topical solutions, are effective in killing bacteria in bacterial biofilms. This suggests a role for topical antibiotic therapies in the treatment of biofilm infections.
Randomized, Controlled, Study of Absorbable Nasal Packing on Outcomes of Surgical Treatment of Rhinosinusitis with Polyposis
Authors: Franklin Jason H. , Wright Erin D.
Published: March 2007

Background

The aim of this study was to establish the effect of absorbable dressing on postoperative discomfort and mucosal healing after sinus surgery. A prospective, randomized, controlled, blinded study was performed.

Methods

Patients 18–80 years old undergoing sinus surgery were enrolled in the study. Each patient's ethmoid cavities were randomized to receive either absorbable dressing or the standard nonabsorbable sinus packs. Therefore, patients served as their own control. Preoperative CT scan and intraoperative endoscopic photographs were used for staging within the Lund-Mackay system. The procedure was performed as indicated by extent of disease. The remaining absorbable dressing was removed at 2 weeks by endoscopic suctioning in the clinic. Patients completed questionnaires regarding sinus symptoms and discomfort. Postoperative endoscopic appearance was graded by a single rhinologist. Length of follow-up was 6 months.

Results

Thirty-five patients were randomized. There were no significant adverse events in either group. Patients’ symptom scores improved at 2 weeks and at 1 and 3 months when compared with preoperation. Both groups had similar preoperative grade of disease and extent of surgery. Endoscopic appearance of the absorbable cavity showed a trend toward improvement at 2 weeks (p < 0.05). Endoscopic appearance showed a similar trend toward improvement at 1, 3, and 6 months in the absorbable group (NS). Twenty-seven patients had a strong preference for a particular nasal packing of which 16 of 27 (59.3%) patients preferred the absorbable dressing.

Conclusion

The absorbable dressing showed a trend toward positive effect on early wound healing and in late results. Strong patient preference was indicated for the absorbable dressing over standard sponges.
Device Operation of Conjugated Polymer/Zinc Oxide Bulk Heterojunction Solar Cells
Authors: Koster L. J. A. , van Strien W. J. , Beek W. J. E. , Blom P. W. M.
Published: March 2007

Solar cells based on a poly(p‐phenylene vinylene) (PPV) derivative and zinc oxide nanoparticles can reach a power conversion efficiency of 1.6 %. The transport of electrons and holes in these promising devices is characterized and it is found that the electron mobility is equal to 2.8 × 10–9 m2 V–1 s–1, whereas the hole mobility amounts to 5.5 × 10–10 m2 V–1 s–1. By modeling the current–voltage characteristics under illumination it is found that the performance of PPV/zinc oxide solar cells is limited by the charge‐carrier mobilities. Subsequently, how to further improve the efficiency is discussed.
A Facile Synthesis and Characterization of Monodisperse Spherical Pigment Particles with a Core/Shell Structure
Authors: Lin C. , Li Y. , Yu M. , Yang P. , Lin J.
Published: March 2007

In this paper, a facile sol–gel process for producing monodisperse, spherical, and nonaggregated pigment particles with a core/shell structure is reported. Spherical silica particles (245 and 385 nm in diameter) and Cr2O3, α‐Fe2O3, ZnCo2O4, CuFeCrO4, MgFe2O4, and CoAl2O4 pigments are selected as cores and shells, respectively. The obtained core/shell‐structured pigment samples, denoted as SiO2@Cr2O3 (green), SiO2@α‐Fe2O3 (red), SiO2@MgFe2O4 (brown), SiO2@ZnCo2O4 (dark green), SiO2@CoAl2O4 (blue), and SiO2@CuFeCrO4 (black), are well characterized by using X‐ray diffraction (XRD), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), and UV‐vis diffuse reflection, as well as by investigating the magnetic properties. The results of XRD and high‐resolution TEM (HRTEM) demonstrate that the pigment shells crystallize well on the surface of SiO2 particles. The thickness of the pigment shell can be tuned by the number of coatings, to some extent. These pigment particles can be well dispersed in some solvents (such as glycol) to form relatively more stable suspensions than the commercial products. Apart from the color characteristics, some of pigments like SiO2@Cr2O3, SiO2@MgFe2O4, and SiO2@CuFeCrO4 also show magnetic properties with coercivities of 1098 Oe (5 K), 648 Oe (5 K), and 91 Oe (298 K), respectively.
Environmental Optical Sensitivity of Gold Nanodecahedra
Authors: Pastoriza–Santos I. , Sánchez–Iglesias A. , García de Abajo F. J. , Liz–Marzán L. M.
Published: March 2007

The sensitivity of localized surface plasmon resonances with respect to changes in the refractive index of the surrounding medium is measured for small (< 60 nm side length) and large (ca. 150 nm side length) regular gold nanodecahedra (pentagonal bipyramids), and compared to rigorous solutions of Maxwell's equations for bicones based upon the boundary element method (BEM). Small particles are prepared through ultrasound‐induced reduction of HAuCl4 by N,N‐dimethylformamide (DMF) on presynthesized penta‐twinned Au seeds, whereas large decahedra are grown using smaller ones as seeds. Excellent agreement between experimental and calculated spectra is found for dispersions and monolayers of particles in different solvents, as well as for the effect of uniform silica layers of various thicknesses grown on them. These results are expected to be useful for the development of novel biosensors.
Inclination effects on circumferential film flow distribution in annular gas/liquid flows
Authors: Geraci G. , Azzopardi B. J. , van Maanen H.R.E.
Published: March 2007

Measurements of the circumferentially resolved axial liquid film flow rate have been obtained for a 38 mm internal dia. pipe at inclinations of 0°, 20°, 45°, 70 and 85° from the horizontal. The method employed is based on that used by Butterworth, and consists of a film extraction technique which utilizes a unit with a wall that is porous over a sector of the pipe. Liquid entrained fraction was determined from the total film flow rate. Results show that the local liquid film flow rate is not symmetrical. Flow rates are higher on the lower part of the pipe. As the inclination angle deviates from horizontal, the film flow rate becomes systematically less asymmetric. There is not a strong dependence of the entrained fraction on pipe inclination. For the case when the pipe is horizontal, the circumferential variation of film flow rate is well predicted by a horizontal annular flow model. © 2007 American Institute of Chemical Engineers AIChE J, 2007