A randomized prospective comparision of two methods of administering topical treatment in otitis externa

Ten patients with bilateral moderate or severe otitis externa were studied. Following aural toilet each patient was subjected to two different treatments: one ear had alternate day dressings containing a topical antibiotic/steroid mixture, while the external canal of the other was filled with the same topical preparation (sump filling). Improvement in the severity of the otitis externa was assessed after 1 week. 9 out of 10 ear canals improved in each group. An estimate of the relative cost of each treatment was made and sump filling was found to be less expensive. The results suggest that sump filling is a low cost alternative to standard treatment in moderate and severe otitis externa.     

Non-Cartesian data reconstruction using GRAPPA operator gridding (GROG).

A novel approach that uses the concepts of parallel imaging to grid data sampled along a non-Cartesian trajectory using GRAPPA operator gridding (GROG) is described. GROG shifts any acquired data point to its nearest Cartesian location, thereby converting non-Cartesian to Cartesian data. Unlike other parallel imaging methods, GROG synthesizes the net weight for a shift in any direction from a single basis set of weights along the logical k-space directions. Given the vastly reduced size of the basis set, GROG calibration and reconstruction requires fewer operations and less calibration data than other parallel imaging methods for gridding. Instead of calculating and applying a density compensation function (DCF), GROG requires only local averaging, as the reconstructed points fall upon the Cartesian grid. Simulations are performed to demonstrate that the root mean square error (RMSE) values of images gridded with GROG are similar to those for images gridded using the gold-standard convolution gridding. Finally, GROG is compared to the convolution gridding technique using data sampled along radial, spiral, rosette, and BLADE (a.k.a. periodically rotated overlapping parallel lines with enhanced reconstruction [PROPELLER]) trajectories.     

多层面CT重建诊断中央大气道良性病变

目的 :分析多层面CT三维重建诊断中央大气道良性病变的价值。材料和方法 :用多层面CT对 3 5例中央气道良性病变 (解剖性异常 5例 ,炎症性病变 18例及其它 12例 )扫描 ,并全部完成三维表面遮盖显示、容积显示和仿真内窥镜检查。所有病例第一次读片时仅有横断面图像 ,第二次读片时增加重建图像。结果 :三维重建帮助 4例横断面漏误诊的解剖性异常获得确诊 ,16例炎症性病变进一步详细显示 ,2例气管支气管裂伤明确范围和程度 ;虚拟内窥镜帮助 5例横断面上不能确诊的痰液获得确诊。结论 :CT三维重建可用于解剖性异常和痰液的诊断 ,对其它良性疾病主要是对病变的另一种形式的进一步显示。     

Canal wall reconstruction and mastoid obliteration with composite multi-fractured osteoperiosteal flap

We used inferior pedicled composite multi-fractured osteoperiosteal flap (CMOF), our original and new surgical approach, to obliterate the mastoid cavity and reconstruct the external auditory canal (EAC) to prevent the open cavity problems. CMOF was used to obliterate the mastoid cavity and reconstruct the EAC in 24 patients (13 women, 11 men; age span 12–51 years) who underwent radical mastoidectomy to treat the chronic otitis media between 1998 and 2004. Small meatoplasty was done in all 24 patients to relive their aesthetical concerns. Temporal bone CT scanning was done to observe the neo-osteogenesis in the mastoidectomy cavity and the CMOF, and the EAC volume was measured postoperatively. All our patients were followed-up for 2 years. The epithelization of the new EAC in our patients was complete at the end of the second month. Cholesteatoma, granulation, and recurrence of osteitis did not occur in any of the patients. We saw the new bone formation filling the mastoid cavity in the postoperative temporal bone CT scanning images. The mean volume of the new EAC on the 24th month was 1.83 ± 0.56 cm³. We had an almost natural EAC, which owed its existence to the neo-osteogenesis that grows behind the CMOF, which we use to obliterate the mastoid cavity and to reconstruct the EAC.This technique, composite multi-fractured osteoperiosteal flap, was presented in the symposium of Gulhane Military Medical Academy on otology and audiology, 15–18 September, 2005, Antalya, Turkey.     

A critical period for functional vestibular development in zebrafish.

We have determined a critical period for vestibular development in zebrafish by using a bioreactor designed by NASA to simulate microgravity for cells in culture. A critical period is defined as the briefest period of time during development when stimulus deprivation results in long lasting or permanent sensory deficits. Zebrafish eggs were collected within 3 hours of being laid and fertilized. In experiment 1, eggs were placed in the bioreactor at 3, 24, 30, 36, 48, or 72 hours postfertilization (hPF) and maintained in the bioreactor until 96 hPF. In experiment 2, eggs were placed in the bioreactor immediately after they were collected and maintained in the bioreactor until 24, 36, 48, 60, 66, 72, or 96 hPF. Beginning at 96 hPF, all larvae had their vestibulo-ocular reflexes (VOR) evaluated once each day for 5 days. Only larvae that hatched from eggs that were placed in the bioreactor before 30 hPF in experiment 1 or removed from the bioreactor later than 66 hPF in experiment 2 had VOR deficits that persisted for at least 5 days. These data suggest a critical period for vestibular development in the zebrafish that begins before 30 hPF and ends after 66 hPF. To confirm this, zebrafish eggs were placed in the bioreactor at 24 hPF and removed at 72 hPF. VORs were evaluated in these larvae once each day for 5 days beginning at 96 hPF. These larvae had VOR deficits that persisted for at least 5 days. In addition, larvae that had been maintained in the bioreactor from 24 to 66 hPF or from 30 to 72 hPF, had only temporary VOR deficits. In a final experiment, zebrafish eggs were placed in the bioreactor at 3 hPF and removed at 96 hPF but the bioreactor was turned off from 24 hPF to 72 hPF. These larvae had normal VORs when they were removed from the bioreactor at 96 hPF. Taken as a whole, these data support the idea that there is a critical period for functional maturation of the zebrafish vestibular system. The developmental period identified includes the timeframe during which the vestibular primary afferent neurons are born, innervate their central and peripheral targets, and remodel their central projections.     

An effective pharyngoesophageal reconstruction with free radial forearm flaps

Summary Treatment of cancer of the cervical aerodigestive tract is challenging due in part to the difficulty in reestablishment of pharyngoesophageal continuity after resection of the involved tract. From May 1989 to August 1990, six patients underwent immediate reconstruction utilizing microvascular transfer of free radial forearm flaps following resection of pharyngoesophageal neoplasms. A small island flap connected to the radial vascular pedicle by fasciocutaneous branch was used to monitor the vascular condition of the hidden fabricated free forearm flap. Stricture is the most troublesome complication of esophageal reconstruction using a conventional free forearm flap. Two small triangular flaps were designed and inserted bilaterally in the distal anastomosis of both lateral esophageal walls to prevent circular contracture. The outer layer sutures were anchored to surrounding rigid structures to withstand shrinkage and circular contraction. The problem of stricture was solved by these procedures. This one-stage, easily monitored operation for pharyngoesophageal reconstruction is considered to be as useful as a free jejunal transfer.     

环丙沙星滴耳液对内耳影响的研究

豚鼠中耳（听泡）内滴入０．５％、１％、２％环丙沙星与庆大霉素滴耳液７天或２１天，借助光镜和扫描电镜观察内耳的显微和超微结构变化。结果证明环丙沙星对内耳没有明显的毒性作用。庆大霉素则使耳蜗明显受损，以底回为重，Ｃｏｒｔｉ’ｓ器外毛细胞坏死较多，内毛细胞及支持细胞病变较轻。位觉斑耳石脱落，毛细胞纤毛粘连、脱落。壶腹嵴中央区纤毛也缺失。本实验对客观评价环丙沙星对内耳的作用及临床使用提供了形态学资料。     

TOTAL LARYNGECTOMY WITH PRIMARY VOICE RESTORATION

Forty-three patients were prospectively studied following tracheo-oesophageal puncture at the time of laryngectomy (primary voice restoration). Blom-Singer voice prostheses were used. The surgery was regarded as successful if a patient continued to use the voice prosthesis as the major means of communication with clear intelligibility 4 months after the operation. Using this criterion, the success in this series was 70%. No attempt was made to assess the quality of speech. Complications and causes of failure are discussed.     

间置空肠贲门再造术在抗返流性食管炎上的应用

作者对１５例贲门癌患者行根治术同时，采用食管残胃间插入带蒂空肠并附加贲门再造术，通过ＳＰＥＣＴ胃食管返流指数测定、食管下端ｐＨ检测及返流症状评定方法，并与单纯食管胃套叠吻合术进行随机对比分析，证明该术式具有单向住屏障作用，能有效地预防返流性食管炎的发生。