Operative strategy for recurrent laryngeal cleft: a case report and review of the literature

A case is reported of recurrent laryngotracheoesophageal cleft following two attempted repairs. The anterior approach to the larynx and trachea provided excellent exposure for defining the extent of the recurrent cleft, and allowed precise anatomic repair. Neurovascular structures were easily avoided by this operative method. Of 170 clefts reported in the literature, 19 recurred necessitating reoperation. The anterior approach to the larynx and trachea is appropriate in recurrent clefts and may be preferable at the initial repair.     

Topically active carbonic anhydrase inhibitors. 1. O-acyl derivatives of 6-hydroxybenzothiazole-2-sulfonamide

A series of O-acyl derivatives of 6-hydroxybenzothiazole-2-sulfonamide (4, L-643,799) was prepared and the potential utility of each series member as a topically active inhibitor of ocular carbonic anhydrase was determined. In vitro studies showed these esters to be substrates for ocular esterases which liberate 4 during corneal translocation. The most interesting series member, 2-sulfamoyl-6-benzothiazolyl 2,2-dimethylpropionate (22, L-645,151), acting as a prodrug form of 4, was found to enhance delivery through the isolated albino rabbit cornea by 40-fold when compared to the parent phenol 4. Studies in rabbits revealed that 22 is a potent topically active ocular hypotensive carbonic anhydrase inhibitor.     

Meniscal abnormalities: prospective correlation of double-contrast arthrography and arthroscopy

In a prospective study conducted over a 12-month period, 30 patients underwent double-contrast arthrography of the knee followed by arthroscopic study. An 80% correlation rate was found between results. Arthrography had a higher rate of accuracy (93%) than arthroscopy (84%) and had a 7% false-positive and 0% false-negative rate. A commonly overlooked arthrographic sign--the triple-S or stuck sail sign--was 91% accurate in the prediction of meniscal tears. The complementary nature of the two examinations is discussed.     

Immobilization and characterization of beta-galactosidase in thermally reversible hydrogel beads

Beta-Galactosidase has been immobilized within thermally reversible hydrogel beads and has been studied in batch and packed bed reactor systems. The enzyme was entrapped in a copolymer hydrogel of N-isopropylacrylamide (NIPAAm) and acrylamide (AAm) as beads were formed in an inverse suspension polymerization. A reversible deswelling and reswelling of the hydrogel matrix was induced by first warming and then cooling through 37-40 degrees C, which is the lower critical solution temperature, LCST, of the backbone copolymer. The optimum temperature for maximum activity of the immobilized enzyme-gel bead system was found to be 30-35 degrees C in a batch mode and 40 degrees C in a packed bed reactor, which were both below the 50 degrees C optimum for the free enzyme. These differences are understandable, since the mass transfer rates of substrate and product within the pores of the gel matrix are controlled mainly by the temperature, so therefore it is the temperature which governs the overall activity of the immobilized enzyme system. It was also found that when the operational temperature in the packed bed reactor was cycled between temperatures below (35 degrees C) and above (45 degrees C) the copolymer gel LCST, the activity of the immobilized enzyme almost fully recovered after each cycle. In fact, the enzyme-gel system exhibited a complete "shut-off" in activity at 50 degrees C which was the temperature where the free enzyme showed its maximum activity. The thermal cycling operation of LCST enzyme-gel beads can be used to enhance overall activity and productivity of a packed bed reactor, when compared to isothermal operation of this reactor. This is due to the thermally induced "pumping" which enhances mass transfer rates of substrate in and product out of the gel beads.     

Present and emerging applications of polymeric biomaterials

An important trend in biomaterials research and development is the synthesis of polymers, which combine capabilities of biologic recognition ('biomimetic') with special physicochemical properties of the synthetic polymer system. For example, an antibody may be conjugated to the backbone of a polymer which precipitates upon small changes in pH, temperature, or ionic strength. Crosslinked gels may also be synthesized from such polymers, and a biomolecule such as an enzyme may be chemically or physically entrapped in these gels. Such gels will shrink and swell in response to small changes in environmental stimuli. Another approach is to 'engineer', perhaps via computer-aided molecular design, new artificial biomimetic systems by exact placement of functional groups on rigid polymer backbones, crosslinked structures, or macromolecular assemblies. In this way, biocatalytic functioning or biorecognition similar to enzymes and antibodies can be achieved without the inherent instability often encountered with the native biomolecules or assemblies. In addition to these synthetic approaches, new and exciting analytical tools, such as the scanning tunnelling microscope and the atomic force microscope, are permitting visualization of individual and small clusters of proteins and other biomolecules on surfaces. Cell attachments and spreading may also be visualized at various depths within the cell using the confocal laser microscope. Such analytical techniques can lead to important new knowledge about biologic interactions with biomaterials, and, therefore, to development of even more biocompatible implants and devices. This paper overviews the field of polymeric biomaterials and highlights the important emerging trends in synthesis and analysis of these materials.     

Pollution prevention as a market-enhancing strategy: a storehouse of economical and environmental opportunities

EPA's (Environmental Protection Agency) Green Lights Program for energy-efficient lighting illustrates the economic benefits and the market-transforming value of a pollution prevention philosophy. Using technologies available today, and assuming current prices, this program is expected to reduce air pollution 5%, while saving the nation's businesses up to 20 billion in electric bills every year. However, these pollution prevention and savings estimates may be low. As Green Lights transforms the market for lighting services by creating a higher demand for better technologies at lower costs, the program will likely achieve even larger pollution reductions and electricity savings.     

Sister chromatid exchanges in Chinese hamster ovary cells exposed to high intensity pulsed ultrasound: inability to confirm previous positive results

This study was undertaken in an attempt to determine a physical mechanism of action for a recently published report of a small but statistically significant increase in sister chromatid exchanges (SCEs) in Chinese hamster ovary cells exposed to high-intensity pulsed ultrasound. The "positive" report's protocol involved a sizeable chance of ultrasound beam impingement on the side wall of the cell exposure chamber. Ten experiments per regimen were conducted; the regimens included exposures of (a) chamber center, (b) chamber wall, (c) nine grid sites, 0.5 mm between sites, and (d) nine grid sites, 1.5 mm between sites. The last was an exact replication of the conditions previously reported to induce the small SCE effect. The results did not support the postulate of an increase in SCEs with the ultrasound exposures.     

Some epidemiological and scanning electron microscopic features of crazing of the dental enamel of Polynesians

The prevalence of enamel crazing was determined from the maxillary incisors and canines of 1,109 Tongan residents aged 5-20 years, 1,417 Cook Island residents aged 6-20 years, 520 French Polynesian residents aged 10-15 years, and 92 New Zealand-born and -resident Polynesians aged 11-18 years. Crazing occurred in 22 percent of Tongans, 7 percent of Cook Islanders, but not in French Polynesians or New Zealand-born Polynesians. Cracks become clinically apparent at about 8 years of age; were more common in males than females; and became more common with increasing age. The central incisors were the most commonly affected of the maxillary anterior teeth. Cross-sections of teeth with crazing viewed by light and scanning electron microscopy appeared similar to other stained cracks. The indications are that crazing is a post-eruptive change caused by trauma from local environmental factors resulting in stress fractures. The significance of crazing on enamel structure and strength is unknown, but it is probably minor without long-term disadvantages. The prevalence of crazing may prove useful in anthropology as an indicator of the use of teeth as tools and in assessing the "modernisation" of a population.