Endonasal removal of a large ethmoidal cementoblastoma

Cementoblastoma is a benign tumour, which pertains to the family of fibro osseous lesions of the jaws. A small number of clinical reports of cementum containing tumours locating in the paranasal sinuses have been published during the last three decades. Ethmoidal cementomas often attain a large size; they can destroy surrounding bone, invade the orbit and the skull base and usually require radical surgery for complete excision. We present a new case of a large cementoblastoma located in the left posterior ethmoid in the close vicinity of the optic nerve canal. In the 40-year old woman, endoscopic endonasal computer-assisted surgery allowed for complete tumour removal. No intraoperative damage to the orbit and the optic nerve occurred. No residual tumour was found at the follow-up visit three years after the surgery.     

The effect of preapplication of corticosteroids on skin irritation and performance of the GlucoWatch G2 Biographer

Skin irritation due to iontophoresis may limit the frequency of use of devices for drug delivery or transdermal extraction of analytes of clinical interest. This study examined whether preapplication of corticosteroid preparations could reduce skin irritation from iontophoresis used by the GlucoWatch G2 Biographer (Cygnus, Inc., Redwood City, CA) in monitoring interstitial glucose levels frequently and automatically. Numerous corticosteroid preparations were screened to identify formulations that did not interfere with adhesion of the Biographer to the skin or glucose sensing. Kenalog (Westwood-Squibb Pharmaceuticals, Inc., Buffalo, NY) (triamcinolone acetonide) and Cortizone-10 Quick Shot (Pfizer, Inc., New York, NY) (hydrocortisone) sprays were selected and, in a double-masked, randomized, controlled trial, were applied to the forearms of 66 subjects with diabetes and allowed to dry. Biographers were applied and worn for 15 h, and home blood glucose measurements were taken every 30 min to assess accuracy. Irritation was assessed periodically by trained observers and study subjects. Skin irritation was reduced by both corticosteroid sprays, with the fraction of subjects who experienced moderate irritation reduced by 57% and 43% for the Kenalog and Cortizone-10 Quick Shot sprays, respectively. The treatment effect persisted at the 1-week assessment. Preapplication of these preparations did not affect the clinical utility of interstitial glucose readings. Preapplication of Kenalog or Cortizone-10 Quick Shot sprays significantly reduced skin irritation due to iontophoresis, and did not interfere with glucose measurements. This approach may enable the minority of users who experience moderate to severe skin irritation to use the Biographer more frequently for diabetes management.     

Endoscopic diagnosis and treatment of nasal rhinorrhea

43 patients with nasal liquorrhea (NL) were admitted to and operated on using endonasal endoscopic technique in N. N. Burdenko Research Institute of Neurosurgery from 1999 to 2002. The diagnostic examination included nasal cavity endoscopy, biochemistry of glucose in nasal discharge. CT and MRT-cysternography, plain CT and MRT of the brain. By etiology, liquor fistulas were divided into spontaneous (n = 21), posttraumatic (n = 6) and iatrogenic (n = 16). The source of liquorrhea located in the sphenoidal sinus (n = 20), roof of the ethmoidal labyrinth (n = 10), cribriform plate (n = 12). A total of 47 operations and 4 reoperations were made with application of the biological fibrin-thrombin glue tissucol. The maximal size of the defect in the base of the skull in this series reached 15 mm. Lumbar drainage, removed on postoperative day 5, on the average, was established during endoscopic endonasal plastic repair of the liquor fistula in 34 patients. In maximal follow-up of 3.5 years, a complete recovery was observed in 38 (88.4%) operated on patients. The main causes of unsatisfactory effectiveness of endonasal operations were the following: impossible visualization of the fistula in a deep lateral pocket of the sphenoidal sinus, compound pathology (nasal liquorrhea and tumor of the base of the skull), extensive multiple traumas of the bone structures of the base of the skull.     

Retrograde transurethral balloon dilation of prostate: Innovative management of abacterial chronic prostatitis and prostatodynia

Retrograde transurethral balloon dilatation (RTBD) of the prostate recently has been suggested as alternative therapy for patients with benign prostatic hyperplasia (BPH). Seven patients with documented functional urinary outlet obstruction at the level of the bladder neck or prostatic urethra underwent RTBD of prostate. Each patient had a classic diagnosis of abacterial chronic prostatitis or prostatodynia based on history, physical examination, and localization cultures. Prior to RTBD of prostate, patients underwent cystoscopy, voiding cystourethrogram, urodynamic and uroflow studies. RTBD of prostate was done as an outpatient procedure requiring intravenous sedation or general anesthesia. Dilation was performed with a 25-mm urethroplasty balloon catheter inflated at 3.5 atm of pressure for twenty minutes. Improvement in voiding symptomatology was noted in all patients and graded numerically (0-10 scale), with ten indicating normal voiding. Follow-up to date ranges from one to five months. This technique may have promise as a treatment option in patients with abacterial chronic prostatitis and prostatodynia.     

Avidity and titer of immunoglobulin G subclasses to Porphymmonas gingivalis in adult periodontitis patients

The relative avidity and titer of antibodies representing the 4 immunoglobulin G (IgG) subclasses (IgG1-4) reactive with Porphyromonas gingivalis, P. gingivalis-lipopolysaccharide (-LPS), streptokinase (SK) and tetanus toxoid (TT) in the sera of patients having adult periodontitis and of healthy controls were measured. Patient antibody titers to P. gingivalis and P. gingivalis-LPS were found to be significantly elevated for IgG, IgG1 (no P. gingivalis-LPS antibodies) and IgG2. The predominant antibody response to P. gingivalis and P. gingivalis-LPS occurred in the IgG2 subclass. When the relative avidity of the antibodies to P. gingivalis and P. gingivalis-LPS were examined, no significant differences between control and patient sera could be identified. However, anti-P. gingivalis and P. gingivalis-LPS antibodies were found to possess significantly lower relative avidity than either SK or TT antibodies. The IgG1 subclass antibodies to P. gingivalis, SK and TT all appeared to be of high relative avidity. In contrast, anti-P. gingivalis and P. gingivalis-LPS of the IgG2 subclass were of significantly lower relative avidity. Since the predominant humoral response to P. gingivalis occurs in the IgG2 subclass, the low relative avidity of these antibodies predominates in measurements of whole serum activity.     

Effect of sodium oxybutyrate on metabolic indices in ischemic hypoxia of muscle tissue

It has been demonstrated in experiments on rats with an ischemized hind limb that sodium hydroxybutyrate promoted activation of glucose-6-phosphate dehydrogenase of the pentosophosphate cycle, prevented the changes in the content of lactic acid and activity of lactate dehydrogenase in the ischemized muscle, interfered with the development of metabolic acidosis during devascularization of the ischemized limb.