Surgical management of extensive gnathophyma

Rhinophyma is an uncommon disease of the nose characterized by irregular skin thickening and nodular deformation. The extensive growth causing 'whisky nose' is due to hyperplasia of the sebaceous glands and the surrounding connective tissue. Other facial regions may concomitantly be affected. We present a case of extensive gnathophyma accompanying minor lesions of the nose. Surgical treatment led to an excellent cosmetic result.     

Is growth hormone a radioprotective agent?

There is currently substantial clinical interest in growth hormone (GH) as a protective agent against radiation-related normal tissue injury. To further assess the potential radiation injury-preventive effects of GH, these effects were studied in rats by using a radiation-induced skin injury model. Group 1 received neither GH nor irradiation (control group). Group 2 received 30 Gy of gamma irradiation as a single dose to the right hind legs of the rats (radiation group). Group 3 and 4 received the same irradiation plus either 0.01 U/kg/day GH (RT + 0.01 GH group) or 0.02 U/kg/day GH (RT + 0.02 GH group) subcutaneously. Clinically and histopathologically, acute skin reactions were assessed by two independent experts in radiation oncology and pathology, respectively. Irradiation increased dermatitis in rats when compared with the control group. The severity of radiodermatitis in the rats in the RT + 0.01 GH and RT + 0.02 GH groups was significantly lower than that in the RT group; radiodermatitis developed earlier in the RT group than in the other groups. GH was efficacious in preventing epidermal atrophy, dermal degeneration such as oedema and collagen fibre loss, and hair follicle atrophy, but not better than in the control group. These results are preliminary to studies that will be performed with higher doses of GH in radiation-treated cancer patients, with the aim of reducing radiation-induced toxicity.     

NCB-02(standardized Curcumin preparation)protects dinitrochlorobenzene-induced colitis through down-regulation of NFκ-B and iNOS

AIM:To evaluate the efficacy and mechanism of action of NCB-02,a standardized Curcumin preparation,against 2,4-dinitrochlorobenzene(DNCB)-induced ulcerative colitis in rats.METHODS:Ulcerative colitis was induced in male rats by sensitizing with topical application of DNCB in acetone for 14 d and intra-colonol challenge with DNCB on day 15.A separate group of animals with vehicle treatment in similar fashion served as control group.Colitis rats were divided into different groups and treated with NCB-02 at doses of 25,50 and 100 mg/kg b.wt p.o.for 10 d.Sulfasalazine at a dose of 100 mg/kg b.wt for 10 d served as a reference group.On day 10 after respective assigned treatment,all the animals were euthanized and the length of the colon,weight of entire colon and distal 8 cm of the colon were recorded.The distal part of the colon was immediately observed under a stereomicroscope and the degree of damage was scored.Further distal 8 cm of the colon was subject to the determination of colonic myeloperoxidase(MPO),lipid peroxidation(LPO)and alkaline phosphatase (ALP)activities.A small piece of the sample from distal colon of each animal was fixed in 10% neutral buffered formalin and embedded in paraffin wax and sectioned for immunohistochemical examination of NFκ-B and iNOS expression.RESULTS:NCB-02 showed a dose dependent protection against DNCB-induced alteration in colon length and weight.NCB-02 treatment also showed a dose dependent protection against the elevated levels of MPO,LPO and ALP,induced by DNCB.NCB-02 demonstrated a significant effect at a dose of 100 mg/kg b.wt.,which was almost equipotent to 100 mg/kg b.wt.of sulfasalazine.Treatment with sulfasalazine and curcumin at a dose of 100 mg/kg b.wt.inhibited the DNCB-induced overexpression of NFκ-B and iNOS in the colon.CONCLUSION:Curcumin treatment ameliorates colonic damage in DNCB-induced colitic rats,an effect associated with an improvement in intestinal oxidative stress and downregulation of colonic NFκ-B and iNOS expression.     

Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

Background

Hospitals have a critically important role in the management of mass causality incidents (MCI), yet there is little information to assist emergency planners. A significantly limiting factor of a hospital''s capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations.

Methods

The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission.

Results

From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%), pelvic injuries (11.5%), thoracic injuries (5.0%) and major amputations (3.1%). The mean cut to suture time was 130 min (IQR 65-165 min). Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00), ISS ≥ 35 (OR 2,94), hemoglobin level ≤ 8 mg/dL (OR 1,40), pulse rate on hospital admission < 40 or > 120/min (OR 1,39), blood pressure on hospital admission < 90 mmHg (OR 1,35), prehospital infusion volume ≥ 2000 ml (OR 1,34), GCS ≤ 8 (OR 1,32) and anisocoria (OR 1,28) on-scene.

Conclusions

The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.     

经腹腔镜开窗减压术治疗巨大非寄生虫性脾囊肿是有效的保脾术式

原发性脾囊肿是一种罕见的疾病,目前尚缺乏对该疾病的理想治疗方法的相关研究.大多数原发性脾囊肿是上皮性囊肿.近几年,腹腔镜脾脏外科手术普及率不断提高.该研究报告了关于经腹腔镜保脾手术治疗脾囊肿的相关经验.1996年至2006年间,作者治疗了11例有症状的非寄生虫性脾脏巨大囊肿病人.病人均诉左上腹涨满症状,触诊可扪及腹部包块.术前腹部超声及CT均已明确诊断.病人接受经腹腔镜脾脏囊肿部分切除术或脾脏囊肿开窗减压术.结果发现,7例病人为脾脏间皮囊肿,2例为脾脏表皮样囊肿,2例为脾脏假性囊肿,没有发现囊肿癌变.手术操作时间为62～85 min,无中转开腹.     

Dental caries experience in young Australian Army recruits 2008

Background: Recent studies have shown a substantial decline in caries experience in Australian Army recruits between 1996 and 2002–2003, and in Australian adults between 1987–1988 and 2004–2006. However, studies in children have reported an increasing trend in caries experience between 1998 and 2002. The aim of this study was to investigate caries experience in Australian Army recruits in 2008. Methods: A cross‐sectional study involving 1084 Australian Army recruits was conducted from January to May 2008. Data were obtained from a clinical dental examination with bitewing radiographs, and a questionnaire elicited socio‐demographic data and history on lifetime exposure to fluoridated drinking water. Results: Mean DMFT scores were 3.16, 4.08, 5.16 and 7.11 for recruits aged 17–20, 21–25, 26–30 and 31–35 years, respectively. Recruits with a lifetime exposure to fluoridated drinking water had a mean DMFT of 3.02, while recruits with no exposure had a mean DMFT of 3.87. Conclusions: Caries experience in Australian Army recruits aged 17–25 years increased between 2002–2003 and 2008. Recruits with lifetime exposure to fluoridated drinking water had 25 per cent less caries experience compared with recruits who had no exposure to fluoridated drinking water after adjusting for the effects of age, gender, education and socio‐economic status.