Anatomical variation of the nasal septum: Correlation among septal components

The nasal septum consists of multiple components with various developmental origins and is considered a mosaic structure. Few studies have focused on anatomical relationships among the components of the nasal septum, even though they are essential for clinical assessments of morphological abnormalities in the nasal septum. This study was performed to evaluate anatomical correlations among components of the nasal septum using computed tomography (CT) of the paranasal sinus. We studied images from CT scans of 168 paranasal sinuses collected at a secondary referral hospital between July 2008 and February 2009. The area of each component of the nasal septum was measured using median sagittal images of CT scans after three‐dimensional reconstruction using computer software. The area of the cartilaginous septum decreased with age, whereas the area of the total nasal septum remained constant. The area of the perpendicular plate of ethmoid increased with age at the expense of the area of the septal cartilage. Clin. Anat. 23:945–949, 2010. © 2010 Wiley‐Liss, Inc.     

自我效能教育对膀胱癌腹壁造口患者生活质量的影响

目的探讨自我效能教育对膀胱癌腹壁造口患者生活质量的影响。方法选择膀胱全切加腹壁造口术的膀胱癌患者64例,随机分为干预组和对照组各32例,干预组采用增强自我效能健康教育方式,对照组采用常规健康教育方式,比较两组干预6个月后生活质量、并发症发生率和1、3、6个月自我效能评分。结果干预组患者躯体功能、角色功能、认知功能、情绪功能、社会功能等功能领域评分,疲劳、疼痛、恶心或呕吐等症状领域,失眠、食欲丧失、便秘、腹泻等单一条目,总体健康状态均显著优于对照组(P<0.05),干预组生活质量明显优于对照组。干预组干预1、3、6个月自我效能评分均显著高于对照组(P<0.05),对照组则呈明显的下降趋势,各时间点间比较,差异有统计学意义(P<0.05)。干预组造口狭窄、造口周围皮肤感染、造口回缩发生率和总发生率均显著低于对照组(P<0.05)。结论自我效能健康教育可有效改善膀胱癌腹壁造口患者生活质量,提高其自我护理、疾病管理的自我效能,减少并发症的发生。     

PCT与CRP及白细胞计数对细菌感染性疾病诊断价值

目的探讨降钙素原(PCT)、C反应蛋白(CRP)与白细胞计数(WBC)在细菌感染性疾病诊断中的价值。方法对86例细菌感染者、63例病毒感染者和75例健康体检者,分别采用电化学发光法定量检测PCT,免疫散射比浊法定量检测CRP,核酸荧光染色技术和激光流式细胞技术双方法检测WBC,比较各组PCT、CRP与WBC水平及阳性率,并分析PCT、CRP与WBC诊断细菌感染的灵敏度及特异度。结果细菌感染组的PCT、CRP及WBC水平及阳性率均显著高于病毒感染组和正常对照组(χ2=4.395~5.627,P<0.05)。PCT诊断细菌感染的灵敏度(90.7%)略低于CRP(93.0%),差异无显著性(P>0.05),PCT诊断细菌感染的特异度(87.0%)显著高于CRP及WBC(χ2=4.362、3.249,P<0.05)。结论 PCT、CRP及WBC均可用于细菌感染性疾病的诊断及鉴别诊断,PCT诊断的特异度高于CRP及WBC,为细菌感染性疾病的诊断提供了更有利的证据。     

Efficacy of Fractional Flow Reserve Measurements at Side Branch Vessels Treated With the Crush Stenting Technique in True Coronary Bifurcation Lesions

Background

Measurement of fractional flow reserve (FFR) has been frequently used to optimize the results of coronary stenting in patients with significant narrowing of coronary arteries.

Hypothesis

There has been a consensus that an FFR value > 0.90 after stenting is a useful surrogate for favorable long‐term clinical outcome. We evaluated the efficacy of FFR measurement at side branch vessels of true coronary bifurcation lesions that were treated with the crush stenting technique.

Methods

This study included 12 patients with significant narrowing in both a main coronary vessel and side branch vessel who underwent the crush stenting procedure.

Results

After crush stenting, FFR measurement was performed at the side branch vessel prior to and after kissing balloon angioplasty (KBA). FFR values increased significantly, from 0.94 ± 0.04 pre‐KBA to 0.97 ± 0.03 post‐KBA (P = 0.011). FFR values after crush stenting but prior to KBA already measured > 0.90 in 9 of the 12 patients (75%). FFR values for the remaining 3 patients were 0.88, 0.88, and 0.90, respectively.

Conclusions

FFR measurement at side branch vessels of coronary bifurcation lesions treated with crush stenting may not contribute to adequate decision‐making for improvement of long‐term clinical outcomes. KBA should be strongly considered for patients with bifurcation lesions treated with crush stenting. Copyright © 2010 Wiley Periodicals, Inc. This study was partly supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (Nos. A085012 and A000385); a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (No. A085136); and the Cardiovascular Research Center, Seoul, Republic of Korea. The authors have no other funding, financial relationships, or conflicts of interest to disclose. Byoung Kwon Lee, MD and Hyun Hee Choi, MD contributed equally to this article.     

Trend analysis of diabetic prevalence and incidence in a rural area of South Korea between 2003–2008

Aims/Introduction: This study determined the change in prevalence of diabetes and prediabetes over a period of 5 years in South Korea. The incidence of diabetes and prediabetes and risk factors associated with the development of diabetes were also investigated. Materials and Methods: The Dalseong population‐based cohort survey recruited 1806 subjects who were over 20‐years‐old in 2003. Five years later, 1287 of the original subjects were re‐evaluated and 187 new subjects were added to the study. All participants completed a questionnaire, were given a physical examination, and provided blood samples for analysis including 2 h oral glucose tolerances. Results: Age‐adjusted prevalence of diabetes rose from 6.7% in 2003 to 9.1% in 2008. The prevalence of prediabetes also increased from 18.5% in 2003 to 28.4% in 2008. The incidence rates of diabetes and prediabetes were 18.3 per 1000 person‐years and 55.4 per 1000 person‐years, respectively. The development of diabetes was associated with impaired fasting glucose (IFG) (odds ratio [OR] 5.661), impaired glucose tolerance (IGT) (OR: 6.013), age (OR 1.013), and waist‐to‐hip ratio (OR 1.513). After excluding the IFG and IGT, systolic blood pressure (OR 1.023), high‐sensitivity C‐reactive protein (hsCRP; OR 1.097), triglyceride (OR 1.002) and waist‐to‐hip ratio (OR 1.696) were statistically significant risk factors in a multivariate logistic regression analysis. Conclusions: A significant rise in the prevalence of diabetes and prediabetes was observed between 2003 and 2008. In addition, this study newly demonstrated that waist‐to‐hip ratio and hsCRP were associated with the development of diabetes after adjusting for several confounding factors. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00045.x, 2010)     

膀胱癌全切尿流改道腹壁造口术后患者的延续护理干预

目的 探讨延伸护理干预对膀胱癌全切尿流改道腹壁造口术后患者自我护理能力和生活质量的影响.方法 选取膀胱癌全切尿流改道术腹壁造口的患者共70例,随机分为干预组和对照组各35例:针对35例干预组患者进行延伸护理干预,而对照组患者仅仅给予健康宣教及电话随访,采用造口相关知识调查问卷及生活质量综合评定问卷(QOL)对患者的腹壁造口相关知识掌握情况以及生活质量指数进行评价.结果 干预组患者的腹壁造口相关知识掌握情况较前显著提高,SF36各维度评分明显高于对照组(P＜0.01).结论 对膀胱全切尿流改道术腹壁造口的患者进行有针对性的延伸护理干预,能够大大加强患者自我护理意识,提高自我护理能力水平以及改善患者的生活质量.     

Antidiabetes and antiobesity effect of cryptotanshinone via activation of AMP-activated protein kinase

Metabolic disorders, including type 2 diabetes and obesity, represent major health risks in industrialized countries. AMP-activated protein kinase (AMPK) has become the focus of a great deal of attention as a novel therapeutic target for the treatment of metabolic syndromes, because AMPK has been demonstrated to mediate, at least in part, the effects of a number of physiological and pharmacological factors that exert beneficial effects on these disorders. Thus, the identification of a compound that activates the AMPK pathway would contribute significantly to the treatment and management of such syndromes. In service of this goal, we have screened a variety of naturally occurring compounds and have identified one compound, cryptotanshinone, as a novel AMPK pathway activator. Cryptotanshinone was originally isolated from the dried roots of Salvia militorrhiza, an herb that is used extensively in Asian medicine and that is known to exert beneficial effects on the circulatory system. For the first time, in the present study, we have described the potent antidiabetic and antiobesity effects of cryptotanshinone, both in vitro and in vivo. Our findings suggest that the activation of the AMPK pathway might contribute to the development of novel therapeutic approaches for the treatment of metabolic disorders such as type 2 diabetes and obesity.     

Lead-contaminated soil induced oxidative stress,defense response and its indicative biomarkers in roots of <Emphasis Type="Italic">Vicia faba</Emphasis> seedlings

Seeds of Vicia faba. L were grown in increasing concentrations of lead (Pb)-added soils (0–2,000 mg/kg). After germination of 25 days, roots were harvested to investigate oxidative stress, defense response and indicative biomarkers based upon chemical analyses and biological measurements. The results showed that higher concentrations of Pb-polluted soils led to seedling growth inhibition, indicative of phytotoxicity. O₂^•− and lipid peroxidation were increased with the increase of available Pb in soils and Pb contents in roots, displaying a “J”-shaped dose response curve, whereas H₂O₂ showed a biphasic dose response curve (a consecutive “J”-shaped and inverted “U”-shaped curve). Superoxide dismutase (SOD), guaiacol peroxidase (POD) and ascorbate peroxidase (APX) enzymes were activated by soil Pb, displaying biphasic curves. The upregulated POD and APX enzymes might be major scavengers of excessive H₂O₂ when CAT activities were drastically reduced with the increasing soil Pb. The enhanced glutathione (GSH) and APX activities suggested that GSH-ascorbate cycle also participated in eliminating H₂O₂. Moreover, obvious changes were observed in SOD, CAT and POD isoenzyme patterns, but not in APX except increasing intensities of bands. HSP70 synthesis was significantly induced by extraneous Pb from 125 to 1,000 mg/kg and showed a biphasic curve in this experiment. Comparatively, HSP70 and lipid peroxidation might be more sensitive than other parameters in response to Pb stress, suggesting that these two parameters in the roots might be potential biomarkers for early bioassay of Pb-contaminated soils.     

EGFR mutations and human papillomavirus in squamous cell carcinoma of tongue and tonsil

This study was performed to determine the clinical significance of mutations in the EGFR (epidermal growth factor receptor) along with their association with human papillomavirus (HPV) infections in patients with squamous cell carcinoma of the head and neck (HNSCC). Exons 18-21 of the EGFR tyrosine kinase domain were sequenced and HPV typing was carried out using the HPV DNA chip in tissues obtained from patients with tongue and tonsil cancer. Univariate and multivariate analyses were used to identify the significant factors. One hundred and eight patients were enrolled. Ten patients (9%) were HPV positive and 17 (16%) had EGFR mutations. None of the patients with EGFR mutations were HPV positive. Gender, age (<60 years versus 60 years), and smoking history were not associated with EGFR mutations. A higher percentage of patients with tonsillar cancer were HPV positive than those with tongue cancer (26% and 0%, respectively; P<0.001). EGFR mutations were not a significant prognostic factor (P=0.746). HPV-positive patients had prolonged survival (P=0.025). Multivariate analysis revealed a longer overall survival in HPV-positive patients (P=0.007). EGFR mutations are not associated with the HPV-positive status, which may confer a better survival outcome. Clinical features of lung cancer patients with EGFR mutations were not observed in HNSCC. A further study will be needed to confirm these results.