Unusual Cause of Upper Gastrointestinal Hemorrhage: Spontaneous Dissection of the Celiac Trunk

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One-year follow-up results of combined use of CO<Subscript>2</Subscript> laser and cold instrumentation for Reinke’s edema surgery in professional voice users

The purpose of this study was to present our experience with combined use of CO₂ laser and cold instrumentation for Reinke’s edema surgery and to evaluate 1-year follow-up results of the technique in a series of professional voice users. Fifteen patients with Reinke’s edema who underwent microlaryngoscopic surgery were included. Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year follow-up, no recurrence of Reinke’s edema was encountered. Significant postoperative improvement was obtained in the quality of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological examinations. Combined use of CO₂ laser and cold instrumentation provides a reliable and safe method for Reinke’s edema surgery, and cessation of smoking, voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke’s edema and provides better quality of voice. However, it does not imply that our method is superior to others’, but this procedure constitutes an effective treatment of choice for Reinke’s edema patients, including professional voice users.     

The treatment of ruptures of multiple extensor tendons at wrist level by a free tendon graft in the rheumatoid patient

We report the results of the treatment of multiple ruptures of extensor tendons to the fingers at wrist level in the rheumatoid patient by free tendon grafts. Twenty-three patients averaged 65 degrees of active motion at the metacarpophalangeal joints when seen at an average follow-up of 43 months.     

Temporary antibiotic loaded acrylic hip replacement: a novel method for management of the infected THA

Postoperative infection after hip joint replacement is an uncommon but potentially devastating complication in contemporary orthopaedics. Management in two stages is the more favored approach in North America. This introduces difficulty with patient management in the interval between stages, delays rehabilitation, and introduces technical difficulty during the second stage. A method has been developed whereby a temporary antibiotic-loaded facsimile of the hip is introduced at the first stage, designed to maintain stability of the joint, length of the limb, and mobility of the patient. It has been used in a total of 86 cases to date. The results in 46 cases with a minimum follow-up of 2 years are reviewed in this article. The infection was controlled in 93.5% of cases.     

Importance of pre-operative embolization in the surgery of nasopharyngeal angiofibroma

Juvenile Nasopharyngeal Angiofibroma are rare vasoformative¹ neoplasms of the Nasopharynx. Due to innocuous nature of their presenting symptoms, the tumour frequently has extranasopharyngeal extensions at the time of initial diagnosis. The advances in radiographic CT techniques² and pre-operative embolization³ have reduced the mortality and morbidity to a great extent. We analysed nine cases of angiofibroma with and without embolization and concluded that preoperative embolization reduces intraoperative blood loss considerably giving excellent surgical clearance of the tumour mass with minimal risk of recurrence.     

Preparation and characterization of Antheraea assama silk fibroin based novel non‐woven scaffold for tissue engineering applications

The quest for novel materials as scaffolds with suitable micro‐architecture for supporting tissue neogenesis in tissue engineering and regenerative medicine (TERM) is continuing. In this paper we report an Antheraea assama silk‐based non‐woven fibroin scaffold for applications in TERM. The novel three‐dimensional scaffold is highly interconnected and porous, with a pore size of 150 µm, porosity of 90% and water uptake capacity of 85%. FTIR revealed a typical β‐sheet structure of fibroin. The scaffold has thermal and mechanical properties superior to those of Bombyx mori, as revealed by DSC, TGA and tensile tests. The scaffold exhibited satisfactory blood compatibility, as determined by thrombogenicity, haemolysis, platelet/leukocyte count, platelet adhesion and protein adsorption studies. The scaffold was found to be cytocompatible with human cell lines A549, KB, HepG2 and HeLa for a period of up to 4 weeks. SEM analysis revealed excellent attachment, spreading and migration of cells in the scaffold. MTT assay was performed to estimate the viability and growth of cells in the matrix. Quantification of collagen in cell–scaffold constructs was done by picro‐Sirius red assay. Ex ovo chorioallantoic membrane assay and nitric oxide estimations in spent culture medium showed the scaffold's ability to promote angiogenesis. Finally, the biodegradability of the scaffold was determined by the weight loss observed upon treatment with trypsin over a period of 4 weeks. The results reveal that the fibroin from A. assama is a promising candidate as a biocompatible, biomimetic and biodegradable biomaterial of natural origin for applications in TERM. Copyright © 2009 John Wiley & Sons, Ltd.     

Adipocyte signals in energy balance and digestive diseases]

For the regulation of energy balance in various internal organs including gut, pancreas and liver, visceral adipose tissue and brain perform important sensing and signaling roles via neural and endocrine pathway. Among these, adipose tissue has been known as a simple energy-storing organ, which stores excess energy in triglyceride. However, it became apparent that adipocytes have various receptors related to energy homeostasis, and secrete adipocytokines by endocrine, paracrine and autocrine mechanisms. In this review, basic roles of adipocytes in energy homeostasis and the correlation between adipocyte signals and digestive diseases are discussed.