The Feasibility of the Retrofacial Approach to the Pediatric Sinus Tympani

OBJECTIVE: To investigate the feasibility of the retrofacial approach to the pediatric sinus tympani (ST).

STUDY DESIGN AND SETTING: Five pediatric cholesteatoma cases, 10 pediatric and 24 adult normal specimens were studied retrospectively using high-resolution CT measurements in our university hospital. The normal pediatric and adult specimens also underwent temporal bone dissections. CT measurements included the depth (d-ST) and the width (w-ST) of ST, the distance (F-PSC) from the facial canal to the posterior semicircular canal, and the distance (P-ST) from the depth of ST on a line perpendicular to the F-PSC line.

RESULTS: There were no significant differences in any measurements between pediatric and adult normal specimens and between pediatric diseased and normal specimens ( P > 0.05). The retrofacial approach performed in pediatric specimens was no more complex than in adult specimens. F-PSC>3.0 mm and P-ST<2.0 mm provided an accessible approach to the pediatric ST.

CONCLUSION: The retrofacial approach can be used in selected pediatric cases.

SIGNIFICANCE: This approach plays its individual role to eradicate cholesteatoma in a difficult-to-reach pediatric ST.

Reactivity of patients with maintenance hemodialysis to erythropoietin in the treatment of renal anemia

To explore the reactivity of patients with renal anemia (MHD) to erythropoietin (EPO) in maintenance hemodialysis (HD), 31 patients were enrolled in this study. According to the level of serum ferritin (SF), they were divided into two groups; one group received treatment using recombinant human erythropoietin (rHuEPO) and the other group was given iron sucrose. Taking terminal EPO dosage, terminal erythropoietin resistance index (ERI) and rate of change of ERI (ΔERII) as target indexes, the influence of SF level on dosage of EPO was evaluated after usage conditions of relevant substances in a 3-month period. The results revealed that differences of dialysis age, albumin (ALB), blood calcium, initial and terminal SF, variable quantity of hemoglobin (Hb), terminal EPO and ERI between two groups had statistical significance. Furthermore, SF level and terminal EPO (r = -0.37, P < 0. 05) as well as SF level and terminal ERI (r = - 0.39, P <0.05) were negatively correlated. Difference of terminal ERI between the two groups had statistical significance. It can therefore be summarized that supplementing an iron agent intravenously to maintain SF level between 500 ng/ml and 1200 ng/ml may improve reactivity of patients with MHD to EPO. In addition, rHuEPO therapy in treating anemia of patients with MHD has the same effect with intravenous drug delivery, less side effects and is easy to administer.

Effects of sodium ferrous chlorophyll treatment on anemia of hemodialysis patients and relevant biochemical parameters

This study explores the effects of sodium ferrous chlorophyll treatment on the anemia of maintenance hemodialysis (MHD) patients, as well as the relevant biochemical parameters. We selected 72 patients who had received regular MHD treatment two or three times a week for more than 3 months in the Hospital of Traditional Chinese Medicine of Zhengzhou City of Henan Province from March 2014 to March 2016. They were equally divided into a treatment group and a control group. Haemoglobin (HB) and hematocrit (HCT) of the treatment group increased significantly after treatment (p < 0.01), but less in the control group (p < 0.05); Also serum ferritin (SF) and transferrin saturation (TAST) of the treatment group increased significantly after treatment (p < 0.01); SF of the control group also increased significantly (p < 0.01) and TAST of the control group increased (p < 0.05) but less than in the treatment group. No obvious changes of serum creatinine (SCR), blood urea nitrogen (BUN), C-reactive protein (CRP) and superoxide dismutase (SOD) were found in either groups after treatment (p>0.05). Albumin (ALB) dosage of the treatment group increased after treatment (p < 0.05) while hemopoietin (EPO) decreased significantly (p < 0.01). ALB and EPO of the control group had no obvious changes after treatment (p>0.05). ALB level of the treatment group increased more significantly than in the control group (p < 0.05), while EPO dosage decreased more significantly than in the control group (p <0.05). Therefore, the combination of conventional western medicine and sodium ferrous chlorophyll can effectively improve anemia conditions of MHD patients and their quality of life.

Noise-induced damage to ribbon synapses without permanent threshold shifts in neonatal mice

Recently, ribbon synapses to the hair cells (HCs) in the cochlea have become a novel site of interest in the investigation of noise-induced cochlear lesions in adult rodents (Kujawa and Liberman, 2009; Lin et al., 2011; Liu et al., 2012; Shi et al., 2013). Permanent noise-induced damage to this type of synapse can result in subsequent degeneration of spiral ganglion neurons (SGNs) in the absence of permanent changes to hearing sensitivity. To verify whether noise exposure during an early developmental period produces a similar impact on ribbon synapses, the present study examined the damaging effects of noise exposure in neonatal Kunming mice. The animals received exposure to broadband noise at 105-decibel (dB) sound pressure level (SPL) for 2h on either postnatal day 10 (P10d) or postnatal day 14 (P14d), and then hearing function (based on the auditory brainstem response (ABR)) and cochlear morphology were evaluated during either postnatal weeks 3-4 (P4w) or postnatal weeks 7-8 (P8w). There were no significant differences in the hearing threshold between noise-exposed and control animals, which suggests that noise did not cause permanent loss of hearing sensitivity. However, noise exposure did produce a significant loss of ribbon synapses, particularly in P14d mice, which continued to increase from P4w to P8w. Additionally, a corresponding reduction in the amplitude of compound action potential (CAP) was observed in the noise-exposed groups at P4w and P8w, and the CAP latency was elongated, indicating a change in synaptic function.

Therapeutic effects of tibial support braces on posterior stability after posterior cruciate ligament reconstruction with autogenous hamstring tendon graft

BACKGROUND

In the patients who have to be in supine position for most of the time after posterior cruciate ligament (PCL) reconstruction, the tibia tends to shift backwards due to the gravity of the lower leg and the tensed hamstring muscle.

AIM

To observe the effects of tibial support braces on rehabilitation after PCL reconstruction.

DESIGN

Retrospective study.

SETTING

Inpatients.

POPULATION

Thirty-nine patients were divided into regular brace (N.=18) and tibial support brace (N.=21) groups according to using different types of braces after PCL reconstruction.

METHODS

The follow-up time was more than 2 years in all patients. The function of the affected knee joint was evaluated with International Knee Documentation Committee (IKDC) score, Lysholm knee score, Tegner activity rating, range of motion (ROM) and kneelax arthrometer before and after PCL reconstruction, respectively.

RESULTS

The function of the affected knee joint was significantly improved in both groups after PCL reconstruction. Compared with regular brace group, postoperative Lysholm and IKDC scores were significantly increased in tibial support brace group (P<0.05). However, there were no statistical differences in Tegner activity rating and ROM between regular brace group and tibial support brace group (P<0.05).

CONCLUSION

Tibial support brace can obtain better therapeutic effects for PCL reconstruction.

CLINICAL REHABILITATION IMPACT

This study suggests that compared with regular brace, tibial support brace can significantly improve the mechanical stability and functional outcomes of the affected knee after PCL reconstruction.

Electroacupuncture decreases the urinary bladder pressure in patients with acute gastrointestinal injury

The present study investigates the effects of electroacupuncture (EA) on urinary bladder pressure (UBP) in patients with acute gastrointestinal injury (AGI). Twenty patients with AGI admitted to the First Hospital of Jiaxing intensive care unit from December 2011 to June 2013 were evaluated. Conventional group patients (n = 10) were administered moderate enteral nutritional support, and electroacupuncture group patients (n = 10) were administered enteral nutritional support followed by EA at bilateral Zusanli (ST-36), Shangjuxu (ST-37), Hegu (LI-4), and QuChi (LI-11) acupoints. UBP was then measured every 6 h and the serum creatinine once daily for 7 days. There were no statistically significant patient demographic differences in the study groups (P > 0.05). The initial UBP of both patient groups was ≥12 mmHg. On days 6 and 7, the UBP significantly decreased in the EA group compared to the conventional group (P < 0.05). The serum creatinine concentration on day 7 was significantly lower in the EA group than in the conventional group (P < 0.05). Based on these results, electroacupuncture contributed to gastrointestinal motility recovery in patients with AGI. This procedure may reduce UBP and provide organ-protective effects in AGI patients.

Fluoride content of tank water in Australia

BACKGROUND

The aims of this study were to: (1) analyse the fluoride content of tank water; (2) determine whether the method of water collection or storage influenced fluoride content; and (3) survey participant attitudes towards water fluoridation.

METHODS

Plastic tubes and a questionnaire were distributed through dentists to households with water tanks in Victoria. A midstream tank water sample was collected and fluoride analysed in triplicate using ion chromatography

RESULTS

All samples (n = 123) contained negligible amounts of fluoride, with a mean fluoride concentration of <0.01 ppm (range: <0.01-0.18 ppm). No statistically significant association was found between fluoride content and variables investigated such as tank material, tank age, roof material and gutter material. Most people did not know whether their tank water contained fluoride and 40.8% preferred to have access to fluoridated water. The majority thought fluoride was safe and more than half of the respondents supported fluoridation. Fluoride content of tank water was well below the optimal levels for caries prevention.

CONCLUSIONS

People who rely solely on tank water for drinking may require additional exposure to fluoride for optimal caries prevention.

Serum and tissue level of YKL-40 in endometrial cancer

OBJECTIVE

Serum YKL-40 level is elevated in patients with several malignancies. This study was designed to assess the correlation between serum YKL-40 and the corresponding tissue expression in endometrial cancer (EC).

MATERIALS AND METHODS

Preoperative serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA) from 41 patients with EC, 27 patients with uterine myoma, and 30 healthy women. YKL-40 protein expression in tissue was determined by immunohistochemistry for patients with EC and patients with uterine myoma.

RESULTS

Median preoperative serum YKL-40 level was 157.2 microg/l (range 76.0 - 301.2) in EC compared with 86.6 microg/l (range 69.3 - 191.1) in uterine myoma, and 86.2 microg/l (range 52.1 - 201.1) in healthy women (p < 0.05). Of 41 patients with EC, 26 patients with elevated serum YKL-40 level statistically differed from the remaining 15 patients with normal serum YKL-40 level with respect to FIGO Stage, tumor grade, washing cytology, and serum CA125 (p < 0.05). In multivariate analysis, elevated serum YKL-40 significantly correlated with FIGO stage (p < 0.05) and tumor grade (p < 0.01). The percentage of positive YKL-40 tissue staining was higher in EC patients (34.1%, 14/41) than in uterine myoma patients (11.1%, 3/27) (p < 0.05) and was lower than that of elevated serum levels in EC (26/41, 63.4%) (p < 0.05).

CONCLUSIONS

The elevated preoperative serum YKL-40 is related to stage and histologic grade of EC. The discordance between serum and tissue level of YKL-40 in EC indicates intrauterine tumor may not be the only source of serum YKL-40.

TiCx–Ti2C nanocrystals and epitaxial graphene-based lamellae by pulsed laser ablation of bulk TiC in vacuum

Faceted δ-TiC_x and δ′′-Ti₂C nanocondensates co-existing with ribbon-like graphene-based lamellae with a 2-D turbostratic structure.

Consensus guidelines from The American Society of Peritoneal Surface Malignancies on standardizing the delivery of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients in the United States

BACKGROUND

The American Society of Peritoneal Surface Malignancies (ASPSM) is a consortium of cancer centers performing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). This is a position paper from the ASPSM on the standardization of the delivery of HIPEC.

METHODS

A survey was conducted of all cancer centers performing HIPEC in the United States. We attempted to obtain consensus by the modified method of Delphi on seven key HIPEC parameters: (1) method, (2) inflow temperature, (3) perfusate volume, (4) drug, (5) dosage, (6) timing of drug delivery, and (7) total perfusion time. Statistical analysis was performed using nonparametric tests.

RESULTS

Response rates for ASPSM members (n = 45) and non-ASPSM members (n = 24) were 89 and 33 %, respectively. Of the responders from ASPSM members, 95 % agreed with implementing the proposal. Majority of the surgical oncologists favored the closed method of delivery with a standardized dual dose of mitomycin for a 90-min chemoperfusion for patients undergoing cytoreductive surgery for peritoneal carcinomatosis of colorectal origin.

CONCLUSIONS

This recommendation on a standardized delivery of HIPEC in patients with colorectal cancer represents an important first step in enhancing research in this field. Studies directed at maximizing the efficacy of each of the seven key elements will need to follow.