Thermal coagulation caused by different power settings of CO2 laser surgery.

The aim of this clinical research project was to evaluate histopathologically the zone of thermal effects along the cut margin of tissue specimens with the use of CO2 laser surgery regarding laser artifacts and diagnostic biopsy.     

Aspergillus fumigatus infection of the maxillary sinus. A case report

The diagnosis and radiological findings in a 48-year-old woman with paranasal sinus Aspergillus fumigatus infection is described. The patient had had chronic post-nasal discharge and sinusitis for 7 years. She was treated by total removal of all infected material.     

Effect of age on the pharmacokinetics of solifenacin in men and women

OBJECTIVE: The pharmacokinetics of solifenacin succinate (YM905; Vesicare), a new, bladder-selective, muscarinic receptor antagonist for the treatment of overactive bladder in young/middle-aged and elderly subjects were compared. MATERIAL: Solifenacin. METHODS: 47 healthy adults (24 young/middle-aged: mean age 35; and 23 elderly: mean age 68; 12 males in each age group) were enrolled in a single-center, multi-dose, open-label, crossover trial. Solifenacin, 5 or 10 mg, was administered once daily during two 14-day study periods separated by a washout period. Subjects were randomized to one dose in the first period and the other dose in the second period. Primary outcome variables were maximum plasma concentration (C(max)) and area under the curve from time 0 - 24 hours (AUC(0-24)). Secondary parameters included terminal elimination half-life (t1/2), time to C(max) (t(max)), fraction unbound, renal clearance, amount/percent of dose excreted in urine as solifenacin and its metabolites, and trough plasma metabolite concentrations. Adverse events and other safety parameters were also evaluated. RESULTS: Mean C(max) and AUC(0-24) were 16% (90% confidence interval 0.973 - 1.373) and 20% (1.003 - 1.435) higher, respectively, in elderly subjects. Mean t(max) and t1/2 were higher in elderly subjects. In both elderly and younger subjects, increasing the dose from 5 to 10 mg dose proportionally increased C(max), AUC(0- 24), and the amount excreted in urine. As expected, t(max) and t1/2 were not affected. Plasma concentrations and amounts of metabolites excreted in urine also increased dose proportionally. Solifenacin was highly bound to plasma proteins (fraction of the drug unbound in plasma was approximately 0.02), but there was no clear effect of gender or age. Solifenacin 5 or 10 mg once daily for 14 days was well tolerated by all subjects. CONCLUSION: Although C(max) and AUC(0-24) were higher in elderly subjects than in younger subjects and there was a tendency toward longer t(max) and t1/2, these differences were small and not considered clinically relevant. In this study, no consistent safety/tolerability issues were associated with these pharmacokinetic differences and the administration of solifenacin 5 or 10 mg once daily was well tolerated. The number of adverse events in elderly subjects was similar to that in younger subjects, indicating that no age-related dose adjustments are needed with this agent.     

Biomechanical events of swallowing are determined more by bolus consistency than by age or gender

The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue pressure (ATP), and the rise and release slopes of ATP were measured while participants (39 female and 39 male participants, age 5-65 years) swallowed saliva, 5 mL water (reference), 5 mL thick liquid, and 5 mL solid food. Mean outcome parameters varied with the consistency of the liquid or food swallowed, with the exception of the rise slope of ATP. Moreover, outcome variables were not substantially affected by age with children of 5 years and older showing similar biomechanical events to those of adults. It is important to gain insight into the biomechanics of swallowing saliva and substances of different consistencies in order to understand the underlying mechanisms of dysphagia children and adults.     

T cell responses to respiratory syncytial virus fusion and attachment proteins in human peripheral blood mononuclear cells

The cellular immune response to respiratory syncytial virus (RSV) is considered important in both protection and immunopathogenesis. We have studied the HLA class I- and class II-restricted T cell responses to RSV fusion (F) and attachment (G) proteins in peripheral blood mononuclear cells (PBMCs) obtained from healthy young adults. PBMCs were stimulated with autologous cells infected with recombinant modified vaccinia virus Ankara (rMVA) expressing RSV F (rMVA-F) or G (rMVA-G). In rMVA-F-stimulated bulk cultures F-specific CD4(+) and CD8(+) T cell responses were demonstrated, whereas in rMVA-G-stimulated cultures only G-specific CD4(+) T cell responses were detected. Using a set of overlapping peptides spanning the F protein, a number of the F-specific T cell responses could be mapped to different antigenic regions, whereas for the G protein only CD4(+) T cell responses recognizing the central conserved domain could be detected. These results suggest that the RSV glycoprotein-specific T cell response is directed to a number of different epitopes. Further studies must be performed to confirm the apparent inability of the RSV G protein to induce CD8(+) T cell responses. The rMVA-based in vitro stimulation protocol will be useful to define protein-specific T cell responses in different viral systems.