Standard Needle Magnetization for Ultrasound Needle Guidance: First Clinical Experiences in Fine‐Needle Aspiration Cytology of Thyroid Nodules

Fine‐needle aspiration cytology using a novel ultrasound needle guidance system on the basis of standard needle magnetization was consecutively performed in 30 (15 in‐plane and 15 out‐of‐plane) suspicious thyroid nodules. Nondedicated, commercially available needles were used. The technical effectiveness and safety of the system were satisfying; system failures were observed in 2 cases. The needle tip could be (at least occasionally) visualized inside the thyroid nodule in 96%, and the subjective procedure ratings were excellent in 57%. The out‐of‐plane technique was significantly superior in both respects (P = .021 and .027, respectively). Standard needle magnetization ultrasound needle guidance was easy to apply and cost‐effective and has the potential to improve fine‐needle aspiration cytology performance.     

Sentinel health events surveillance in diabetes. Deaths among persons under age 45 with diabetes

The pilot study for a sentinel health events surveillance system for deaths among persons under age 45 with diabetes was conducted in six states in 1984 and 1985. Two hundred and thirty-three events were identified. Information from death certificates, physicians, and families revealed that 22% died from acute complications of diabetes and 53% from chronic complications. Blood pressure measurement and urinalysis testing had been performed in the last year for almost all of the decedents, but other preventive practices were reported less frequently. Hypertension was present in 57% and of those, was not controlled in 73%. Forty-four percent were cigarette smokers at the time of death. Agreement between physicians and families was generally higher for clinical conditions than for care practices. This surveillance system appears to yield information about the health care of persons with diabetes not readily available from other sources, although modifications may be necessary before implementation.     

Hormone dependency and histological types of prostatic carcinoma

In comparative histological and cytological studies on 270 prostatic carcinoma patients highly and moderately differentiated tumors were found to be more frequent histologically than cytologically. An early and reliable sign of response to hormone therapy proved to be reticularization and vacuolization of the nuclear chromatin. Follow-up studies by means of multiple aspiration biopsies with cytologic examinations seem to be more reliable in prognostic terms than examination of the histological tumor structure.     

Bernardino Ramazzini (1633-1714). On the 275th anniversary of the death of the founder of occupational dermatology

Ramazzini is not only reputed to be the father of industrial hygiene, but must be thought to be the founder of occupational dermatology too. In his famous book about diseases of artists and craftsmen (De morbis artificium diatriba) he shows us numerous job-caused dermatoses, their occupational background, and makes proposals for their treatment and prophylaxis. The medical inspection of the work place and asking for the occupational history of the patient are tracing back to him too. His life is described.     

Human exposure to 3-carene by inhalation: toxicokinetics, effects on pulmonary function and occurrence of irritative and CNS symptoms

Terpenes, especially 3-carene, may irritate the skin and mucous membranes and prolonged exposure may result in allergic contact dermatitis or chronic lung function impairment. The toxicokinetics of 3-carene were studied in human volunteers exposed by inhalation (2 hr 50 W) in an exposure chamber on three occasions. The exposure concentrations were approximately 10, 225, and 450 mg/m3 3-carene. The relative pulmonary uptake was high, approximately 70% for the higher exposure levels. Total uptake increased linearly with increasing exposure. The blood clearance of 3-carene observed in this study, 0.9 liter.kg-1.hr-1, indicates that 3-carene is fairly readily metabolized. About 3% of the total uptake was eliminated unchanged via the lungs while less than 0.001% was eliminated in the urine after the end of exposure. A long half time in blood was observed in the terminal phase which indicates a high affinity to adipose tissues. A statistically significant divergence between ratings of irritation during the high exposure level and during the medium and control levels was observed. The difference in airway resistance after exposure to a high concentration of 3-carene compared to control level was not significant (P = 0.02).     

Auricular Acupressure as a Treatment for Anxiety in Prehospital Transport Settings

Background: Auricular acupuncture at the relaxation point has been previously shown to be an effective treatment for anxiety in the preoperative setting. The purpose of this prospective, randomized, blinded study was to determine whether auricular acupressure can reduce stress and anxiety during ambulance transport.

Methods: Patients who required ambulance transport secondary to medical conditions were randomized to receive auricular acupressure at the relaxation point (n = 17) or at a sham point (n = 19). A visual analog scale was used to assess state anxiety as well as patient anticipation of hospital medical treatment (estimated waiting period for treatment, anticipated pain during treatment, attitude toward the physicians, and treatment outcomes). These variables were assessed at baseline and on arrival to the hospital.

Results: Patients in the relaxation group reported significantly less anxiety than patients in the sham group on arrival to the hospital (visual analog scale mean +/- SD: 37.6 +/- 20.6 to 12.4 +/- 7.8 mm vs. 42.5 +/- 29.9 to 46.7 +/- 25.9 mm, respectively;P = 0.002). Similarly, patient perception of pain during treatment (mean visual analog scale +/- SD: 32.7 +/- 27.7 to 14.5 +/- 8.1 mm vs. 17.2 +/- 26.1 to 28.8 +/- 21.9 mm, respectively;P = 0.006) and treatment outcomes of their illnesses (mean visual analog scale +/- SD: 46.7 +/- 29.4 to 19.1 +/- 10.4 mm vs. 35.0 +/- 25.7 to 31.5 +/- 20.5 mm, respectively;P = 0.014) were significantly more positive in the relaxation group than in the sham group. No differences were found in the other variables assessed.     

Characterisation of surface-modified solid lipid nanoparticles (SLN): influence of lecithin and nonionic emulsifier.

Solid lipid nanoparticles (SLN), an alternative colloidal drug delivery system to polymer nanoparticles, emulsions and liposomes, are generally produced by high pressure melt-emulsification. However, the harsh production process is not applicable for formulations containing shear and temperature sensitive compounds. For that reason, subsequent adsorptive SLN loading might be a promising alternative. The aim of the present study was the development and characterisation of surface-modified SLN for adsorptive protein loading by variation of both the lipid matrix and the emulsifier concentration in the continuous phase. Variations in SLN composition resulted in particle sizes between 674 and 61 nm corresponding to specific surfaces of 4.5 m(2)/g and 48.9 m(2)/g and zeta potentials between -23.4 mV and -0.9 mV. In dependence of SLN surface properties, albumin payload ranged from 2.5 to 15%. Thermoanalysis, X-ray diffraction and electron microscopy revealed anisometrical and crystalline particles. In vitro cytotoxicity was low in terms of both haemolysis, which was between 1 and 2%, and neutral red test (NRT) showing a half lethal dose between 1.1 and 4.6%.     

Complications of orthodontic-orthognathic surgery treatment in mentally handicapped patients.

AIM: The aim of this study was to analyse possible intra- and postoperative complications and long-term results in combined orthodontic-orthognathic treatment of mentally handicapped patients compared with a control group of patients without handicap. PATIENTS AND METHODS: A group of 20 mentally handicapped patients (male = 7, female = 13) and of 102 non-handicapped patients (male = 36, female = 66) were evaluated retrospectively. The results of the two point-discrimination sensory test and the cephalometric findings of both groups were assessed. Complications during and after the operation, the results of nerve function tests and relapse rates were reported. The statistical analysis was carried out using binary logistical regression analysis with adjustment according to the diagnosis and the type of operation (p < 0.05) RESULTS: No significant differences could be found between the mentally handicapped and the non-handicapped patients. Only the nerve function test immediately postoperatively revealed differences between the two patient groups. The relapse rate in mentally handicapped patients was similar to non-handicapped patients. Forty-seven months after the operation, relapse (change in the ANB angle of more than 0.5 degrees ) was observed in four patients only (handicapped patients). CONCLUSION: Orthognathic surgical procedures in mentally handicapped patients can be carried out with a similarly high success rate as in mentally healthy patients.