Following in the footsteps of smallpox: can we achieve the global eradication of measles?

Background  

Although an effective measles vaccine has been available for almost 40 years, in 2000 there were about 30 million measles infections worldwide and 777,000 measles-related deaths. The history of smallpox suggests that achieving measles eradication depends on several factors; the biological characteristics of the organism; vaccine technology; surveillance and laboratory identification; effective delivery of vaccination programmes and international commitment to eradication.     

Comparison of fluconazole and nystatin oral suspensions for treatment of oral candidiasis in infants

Oral thrush is a common condition in young infants. Nystatin treatment is associated with frequent recurrences and difficulty in administration. Fluconazole was compared with nystatin for the treatment of oral candidiasis in infants. Thirty-four infants were randomized to either nystatin oral suspension four times a day for 10 days or fluconazole suspension 3 mg/kg in a single daily dose for 7 days. Clinical cures for nystatin were 6 of 19 (32%), and those for fluconazole were 15 of 15 (100%), P < 0.0001. In this small pilot study fluconazole was shown to be superior to nystatin suspension for the treatment of oral thrush in otherwise healthy infants.     

Protective effect of HSV-mediated gene transfer of nerve growth factor in pyridoxine neuropathy demonstrates functional activity of trkA receptors in large sensory neurons of adult animals

The distinct distribution of trkA receptors on small neurons and trkC receptors on large neurons in the dorsal root ganglion correlates with the dependence of these two classes of neurons on nerve growth factor and neurotrophin-3, respectively, for survival during development. In adult animals, the distribution of high affinity neurotrophin (trk) is complex and overlapping; neurotrophins are not required for cell survival, but may influence cell phenotype and the response to injury. In order to test the functional activity of trkA receptors in the sensory ganglia of adult animals in vivo, we examined the ability of a nerve growth factor-expressing recombinant replication-defective herpes simplex virus-based vector to prevent the selective degeneration of large sensory fibres caused by intoxication with pyridoxine. Transduction of dorsal root ganglion neurons in vivo by subcutaneous inoculation of the nerve growth factor-expressing vector prevented the development of pyridoxine-induced neuropathy measured by electrophysiological, morphological and behavioural measures. These results demonstrate a functional activity of trkA receptors expressed on large neurons in the dorsal root ganglion in mature animals; this observation has important implications for the choice of neurotrophic factors for treatment of peripheral nerve disease.     

Systemic corticosteroid use in orbital lymphangioma

PURPOSE: To describe the clinical results of systemic corticosteroid use in a series of patients with orbital lymphangioma. METHODS: Four patients (two adults and two children) were treated with corticosteroids using intravenous, oral, or both routes for 2 days to a month. Corticosteroids were used with and without other therapies for symptomatic exacerbations. RESULTS: The adults showed more improvement with pain than with swelling, whereas the children had improvement with both the signs and symptoms. There were no complications in any patient. CONCLUSIONS: Systemic corticosteroids are a useful therapeutic option for patients with orbital lymphangioma and can be used as an adjuvant treatment to surgery and other modalities. Resolution of symptoms with corticosteroids was expedited compared with the natural history of the disease in the patients studied.     

Gene therapy applications for the treatment of neuropathic pain

Neuropathic pain is notoriously difficult to treat; currently available pharmaceutical drugs result in moderate analgesia in approximately a third of patients. As our understanding of the biological processes involved in the establishment and maintenance of neuropathic pain increases, so does the development of novel treatment options. Significant advancements have been made in the past few years in gene transfer, a very powerful potential therapy that can be used to directly target affected areas of the neuraxis or body tissues involved in neuropathic pain. Candidate gene products include directly analgesic proteins as well as proteins that interfere with pain-associated biochemical changes in nerve or other tissues underlying the disease process.     

Methods of early detection： would clinical breastexamination and breast ultrasonography be a good alternative to mammography？

Breast cancer is one of the leading causes of cancer deaths among women[1].In the past 40 years,breast cancer incidence has doubled or even tripled in developed countries such as South Korea and Japan; whereas it is about 20% to 30% in China and India in the past decade[2-4]. An increasing incidence rate of 3%     

Posttonsillectomy taste distortion: a significant complication

OBJECTIVE/HYPOTHESIS: Tonsillectomy is among the most commonly performed procedures. As with any surgery, head and neck surgeons must be aware of possible complications and their potential affects. At our smell and taste center, we have been referred several patients in a 6-month period with the complaint of taste distortion after tonsillectomy. We report in this article a patient that complains of taste distortion after a right tonsillectomy for unilateral tonsillar hypertrophy. STUDY DESIGN: A prospective study documenting taste distortion after tonsillectomy using clinical, subjective, and objective evaluation. METHODS: The clinical course of a patient with taste distortion after a tonsillectomy is described. The gustatory function was investigated by conducting electrogustometry and spatial taste testing. Threshold measurements were determined at three left- and three right-side tongue regions: 1) the tongue tip region (innervated by the chorda tympani branch of the facial nerve), 2) the lateral margin of the tongue (anterior to the foliate papillae), and 3) the posterior tongue region (innervated by the lingual branch of the glossopharyngeal nerve). RESULTS: After a complete clinical evaluation and taste testing, it was found that the patient suffered an injury to the right lingual branch of the glossopharyngeal nerve. The close anatomic relationship between the palatine tonsil and lingual branch of the glossopharyngeal nerve makes the nerve vulnerable during tonsillectomy. This injury has caused the patient to suffer ageusia to the right posterior one third of the tongue, compensated by a contralateral phantogeusia (phantom taste) with clinical dysgeusia. The phantogeusia was abolished by application of anesthetic to the area where the phantom was perceived. We propose that the phantogeusia is the result of release-of-inhibition in the contralateral glossopharyngeal nerve. CONCLUSION: Taste distortion (including, phantogeusia and dysgeusia) after tonsillectomy is rarely reported as a complication but has a significant impact on quality of life. This article examines the taste distortion presence as a complication after tonsillectomy to make head and neck surgeons aware of this serious complication and the pathophysiology of taste distortion.