Charging Behavior and Stability of the Novel Amino Group Containing Cellulose Ester Cellulose‐4‐[N‐methylamino]butyrate Hydrochloride

The charging behavior of water‐soluble cellulose‐4‐[N‐methylamino]butyrate hydrochloride (CMABH) with different degree of substitution (DS) is investigated by polyelectrolyte titration at different pH values. Samples of high DS (0.92) and low DS (0.31) exhibit a decrease in positively charged groups from pH 2 (3.9 and 1.9 mmol g^?1) to pH 9 (0.81 and 0.65 mmol g^?1) due to the deprotonation of the ammonium groups. The stability of the ester linkage of CMABH is examined as a function of pH value and storage time (up to 28 d). A hydrolysis of the ester moiety is evident after 2 h at pH 8, which is also proved by ATR‐FTIR‐ and Raman spectroscopy.     

Cholinergic Syndrome: a Case Report of Acute Organophosphate and Carbamate Poisoning

Cholinergic syndrome is a common topic at western medical universities yet rarely observed in clinical practice. The treatment involves muscarinic antagonists, acetylcholinesterase reactivation, seizure control, and supportive measures. Here we report a case of a 52-year old Caucasian male who attempted suicide by ingesting a purple crystal powder that turned out to be a mixture of carbofuran and chlormephos. At clinical examination, the patient presented with salivation, perspiration, diarrhoea, bradypnoea, loss of consciousness, and epileptic seizures. Laboratory tests showed low plasma cholinesterase, and we started obidoxime along with supportive intensive care treatment. He was later transferred to the psychiatry department for further diagnostics and treatment.     

Patient satisfaction in the long-term effects of Eustachian tube balloon dilation is encouraging

Object: To investigate the long-term effects of balloon Eustachian tuboplasty (BET) from patient’s perspective and to discover which symptoms of Eustachian tube dysfunction (ETD) benefit the most from BET.

Method: We designed a retrospective postal questionnaire based on the seven-item ETD questionnaire (ETDQ-7). Our questionnaire covered the severity of present ETD symptoms in comparison with the preoperative situation, the severity of current overall ear symptoms, and possible surgical interventions after BET. Forty-six patients treated in our institution between 2011 and 2013 fulfilled the inclusion criteria and 74% (34 patients; total 52 ears treated with BET) returned the questionnaire with a mean follow-up time of 3.1 years (range 1.8-4.6 years).

Results: Pain in the ears, feeling of pressure in the ears, and feeling that ears are clogged had reduced in 75% of the ears that suffered from these symptoms preoperatively. Seventy-seven percent of all the responders felt that their overall ear symptoms were reduced. Altogether, 82% of all the patients stated that they would undergo BET again if their ear symptoms returned to the preoperative level.

Conclusion: Patient satisfaction in the long-term effects of BET is encouraging. These results may help clinicians in preoperative patient selection and counselling.     

Subpopulations of human lymphocytes differing in receptors to mouse and sheep red blood cells

A segregation procedure of human lymphocytes by successive rosetting with mouse and sheep red blood cells, and separation of rosettes by Ficoll Hypaque gradient centrifugation, is described. This method yields four lymphocyte subpopulations: lymphocytes with mouse and sheep receptors (M+E+), with mouse receptor only (M+E-), with sheep receptor only (M-E+), and without any receptors (M-E-). Presence of surface membrane receptors: E, C3, Fc, and DR on the cells in the subpopulations have indicated that M-E+ and M+E+ cells are T cells, M+E- cells are B cells and M-E- cells are nonhomogeneous, consisting of B cells, T cells, monocytes, and granulocytes.     

Posttraumatic Vernet syndrome without fracture: A case report and short literature review

Rationale:The aim of this case is to emphasize the need to include nerve traction in the differential diagnosis of nerve deficits associated with Vernet syndrome. This mechanism of injury has been described only once, but must not be overlooked and should be considered and included as a possible cause in diagnostic algorithms.Patient concerns:A patient presenting with dysphagia, extreme hoarseness, and limited shoulder movement after head injury was admitted to the emergency department.Diagnoses:Multidisciplinary evaluation was performed, and nerve traction-induced Vernet syndrome was established as a running diagnosis.Interventions:Intensive swallowing and speech exercises, assisted by a specialist, were performed.Outcomes:Swallowing and speech exercises significantly and objectively improved the patient''s swallowing and voice, with mild hoarseness of voice remaining as the main symptom. Spectral acoustic analysis went from a voice pitch of 163.77 Hz to normal (187.77 Hz), jitter improved from 17.87% to 0.86% and shimmer values decreased from 39.86% to 19.60%. Breathiness during phonation measuring 2.91% was reduced to 1.08% and appropriate average intensity of voice (63.95 dB) was achieved. Initial dysphagia and fluid retention in the right piriform sinus, along with tracheal aspiration, were not observed in control fiberoptic endoscopic evaluation of swallowing.Lessons:According to our knowledge and literature data, this is the second reported case of posttraumatic Vernet syndrome without radiologically confirmed jugular foramen fracture, induced by nerve traction. Such patients need a prompt multidisciplinary approach in diagnosis and timely posttraumatic rehabilitation therapy for favorable clinical evolution and retrieval of nerve function.