Otoplasty: a modified Chong-Chet technique with positive long-term results

Background:In the last few decades, many techniques have been developed to correct prominent ear deformities. Modified Chong-Chet otoplasty represents a new and improved classical Chong-Chet procedure for prominent ear surgery. This study evaluates and compares the long-term results of standard Chong-Chet otoplasty with the modified technique.Methods:A retrospective study was conducted on patients undergoing otoplasty at the Special Hospital S-tetik Banja Luka between January 17, 2017, and February 5, 2019. The total number of patients undergoing the procedure was 129. The first group (48 patients) underwent otoplasty using the Chong-Chet technique, while the second group (81 patients) underwent a modified Chong-Chet procedure. All patients were randomly selected on the condition that the antihelix was absent.The data were processed and analyzed using the Statistical Package for the Social Sciences version 24 using nonparametric tests (χ² test, Mann–Whitney U test and Kruskal–Wallis test).Results:Every second patient was satisfied (19 patients were partially satisfied and five patients were completely satisfied) with the results of the classical Chong-Chet technique. Seven patients were neither satisfied nor dissatisfied, while 17 patients were dissatisfied (11 patients were completely dissatisfied and 6 patients were mostly dissatisfied). As for the modified method, on average, nine out of 10 patients (73 or 90.1%) were satisfied, of which 49 patients (60.5%) were completely satisfied and 24 patients (29.6%) were mostly satisfied.The statistical significance was P < .05.Research results point to the modified Chong-Chet technique being a significant improvement to the classical method.Conclusion:Modified Chong-Chet technique increases the number of positive long-term results and significantly improves the standard method.     

A 3D LTCC-Based Ceramic Microfluidic System with RF Dielectric Heating of Liquids

The design, fabrication and functional evaluation of the radio-frequency dielectric heating of liquids in an LTCC-based ceramic microfluidic system are described and discussed. The device, which relies on the dielectric heating of liquids, was fabricated using a low temperature co-fired ceramic (LTCC) technology. A multilayered ceramic structure with integrated electrodes, buried channels and cavities in micro and millimetre scales was fabricated. The structure with the dimensions of 35 mm × 22 mm × 2.4 mm includes a buried cavity with a diameter of 17.3 mm and a volume of 0.3 mL. The top and bottom faces of the cavity consist of silver/palladium electrodes protected with 100 μm thick layers of LTCC. The power, used to heat a polar liquid (water) in the cavity with the volume of 0.3 mL, ranges from 5 to 40 W. This novel application of RF dielectric heating could enable the miniaturization of microfluidic systems in many applications. The working principle of such a device and its efficiency are demonstrated using water as the heated medium.     

Metformin exacerbates and simvastatin attenuates myelin damage in high fat diet‐fed C57BL/6 J mice

Diabetic neuropathy is one of the most deleterious complications of diabetes mellitus in humans. High fat diet (HFD)‐fed C57BL/6 J mice are a widely used animal model for type 2 diabetes mellitus and metabolic syndrome. We investigated the effects of metformin and simvastatin on the ultrastructural characteristics of sciatic nerve fibers in these mice. Metformin treatment increased the number of structural defects of the myelin sheet surrounding these fibers in already affected nerves of HFD fed mice, and simvastatin treatment reduced these numbers to the levels seen in control mice. These results warrant further research on the effects of metformin and statins in patients developing diabetic neuropathy and advise caution when deciding about optimal treatment modalities in these patients.     

Neural gain control measured through cortical gamma oscillations is associated with sensory sensitivity

Gamma oscillations facilitate information processing by shaping the excitatory input/output of neuronal populations. Recent studies in humans and nonhuman primates have shown that strong excitatory drive to the visual cortex leads to suppression of induced gamma oscillations, which may reflect inhibitory‐based gain control of network excitation. The efficiency of the gain control measured through gamma oscillations may in turn affect sensory sensitivity in everyday life. To test this prediction, we assessed the link between self‐reported sensitivity and changes in magneto‐encephalographic gamma oscillations as a function of motion velocity of high‐contrast visual gratings. The induced gamma oscillations increased in frequency and decreased in power with increasing stimulation intensity. As expected, weaker suppression of the gamma response correlated with sensory hypersensitivity. Robustness of this result was confirmed by its replication in the two samples: neurotypical subjects and people with autism, who had generally elevated sensory sensitivity. We conclude that intensity‐related suppression of gamma response is a promising biomarker of homeostatic control of the excitation–inhibition balance in the visual cortex.     

Unusual Contiguous Soft Tissue Spread of Advanced Malignant Mesothelioma Detected by FDG PET/CT

Malignant pleural mesothelioma (MPM) is a tumor of mesodermal origin that arises from the serosa of the pleura, peritoneum, pericardium or tunica vaginalis. MPM is well known to have a poor prognosis with a median survival time of 12 months. Accurate diagnosis, staging and restaging of MPM are crucial with [18F] flurodeoxy-D-glucose positron emission tomography (FDG PET/CT) playing an increasingly important role. Here we report a case of MPM with unusual contiguous soft tissue spread of the tumor along the dermal and fascial planes characterized by PET/CT. Given that the loco-regional tumor in the thorax was under control on PET/CT, the death of the patient was most likely associated with physiologic or metabolic causes associated with an extra-thoracic tumor.     

Smoking,alcohol and family history of cancer as risk factors for small intestinal neuroendocrine tumors: a systematic review and meta-analysis

Objectives: Risk factors for small intestinal neuroendocrine tumors (SI-NETs) are not well understood. The aim of this systematic literature review was to identify risk factors for SI-NET and to further assess these by meta-analysis.

Material and methods: PubMed and abstracts from the ENETS and NANETS were searched for studies published until May 2015. Eligible studies were selected according to the PRISMA statement.

Results: Seven studies evaluating six individual populations were included (study accrual period 1980–2012) in the meta-analysis, involving 765 (range 17–325) cases and 502,282 (range 52–498,376) controls. All studies were case–control by design. The following risk factors were reported in ≥2 studies: family history of any cancer, family history of colorectal cancer, ever alcohol use and ever smoking. The pooled OR was 1.34 (95% CI: 1.12–1.60; p?<?.01; I²?=?0.0%) for family history of any cancer, 1.43 (95% CI: 1.15–1.79; p?<?.01; I²?=?0.0%) for family history of colorectal cancer, 1.04 (95% CI: 0.63–1.72; p?=?.87; I²?=?65.0%) for ever alcohol use and 1.40 (95% CI: 1.06–1.86; p?<?.05; I²?=?49.3%) for ever smoking.

Conclusions: Family history of any cancer, family history of colorectal cancer and history of ever smoking were associated with an increased risk of SI-NET by meta-analysis. Alcohol consumption was not a significant risk factor for SI-NET. However, the studies reporting smoking and alcohol had a high degree of heterogeneity. Therefore, further studies are needed for clarification of smoking and alcohol as risk factors for the occurrence of SI-NET.     

Crystal structure and physicochemical properties of crystalline form of 2'-O-{3-[(7-chloro-4-quinolinyl)amino]propyl}-9-deoxo-9a-methyl-9a-aza-9a-homoerythromycin A

The intent of the study was to prepare and characterize crystalline form of 2'-O-{3-[(7-chloro-4-quinolinyl)amino]propyl}-9-deoxo-9a-methyl-9a-aza-9a-homoerythromycin A (1), a novel 15-membered azalide derivative with antimalarial activity. The crystalline material was prepared by crystallization from acetonitrile reproducible in high yield and purity. Single crystal X-ray studies, X-ray powder diffractometry, differential scanning calorimetry, thermogravimetric analysis, moisture adsorption, Karl Fischer titration, gas chromatography, scanning electron microscopy, optical microscopy, solubility, and solid-state and solution stability were conducted to investigate physicochemical properties of the existing crystalline form. Crystalline 1 is not hygroscopic, does not contain solvents, is physicochemically stable in solid state for up to 4 weeks, and is highly soluble at pH values below 6 and in biorelevant media (simulated gastric fluid, fed simulated intestinal fluid, and fasted simulated intestinal fluid). Solution stability studies (buffers and biorelevant media) indicated that this compound is stable in solutions at pH values 5-6, and that stability is influenced by pH and temperature.     

Bile stone ileus with cholecystoduodenal fistula--Bouveret's syndrome

This is a case report of a 71-year-old man, who presented to emergency department with elevated temperature, vomiting and epigastric pain. Computed tomography of the abdomen revealed a large fistulous tract extending from the gallbladder to the duodenal bulb, as well as a large calculus obstructing the second part of the duodenum. The patient subsequently underwent successful surgical therapy.