Extraction, Physicochemical Properties, and In Vitro Antioxidant Activities of Chondroitin Sulfate from Bovine Nose Cartilage.

Beef is an important high-nutrition livestock product, and several byproducts, such as bovine cartilage, are produced during slaughter. To effectively utilize these agricultural and pastoral byproducts, combined (trypsin-papain) enzymolysis and cetylpyridine chloride purification methods were used to obtain chondroitin sulfate (CS) from the nasal cartilage of Shaanxi Yellow cattle. The effects of pH, temperature, and time on the CS yield during enzymatic hydrolysis were investigated, and the CS extraction process was optimized using response surface methodology. The best yield of CS was 21.62% under the optimum conditions of pH 6.51, temperature of 64.53°C, and enzymolysis time of 19.86 h. The molecular weight of CS from Shaanxi cattle nasal cartilage was 89.21 kDa, glucuronic acid content was 31.76 ± 0.72%, protein content was 1.12 ± 0.03%, and sulfate group content was 23.34 ± 0.08%. The nasal cartilage CS of the Yellow cattle showed strong DPPH•, •OH, and ABTS+• radical scavenging abilities and ferrous reduction ability in the experimental concentration range. This study could contribute to "turn waste into treasure" and improve the comprehensive utilization of regional characteristic biological resources.

Using Compound Specific Isotope Analysis to decipher the 1,2,3-trichloropropane-to-Allyl chloride transformation by groundwater microbial communities.

1,2,3-trichloropropane (TCP), a refractory contaminant, can be reductive dehalogenated to allyl chloride (AC) by microorganisms, which has been shown a potential in situ bioremediation (ISB) strategy for TCP remediation in groundwater. In practice, however, it is hard to monitor the bioreduction extent because the TCP concentrations may also be decreased by non-biodegradation processes. Compound specific isotope analysis (CSIA) can be promising in determining the extent of degradation by quantifying the isotope enrichment factors (ε) of relevant degradation mechanisms. To date, no CSIA study has been reported on TCP degradation. In this study, a novel TCP-to-AC transformation enrichment culture (dominated by Azotobacter, Parabacteroides, Fusibacter, Hydrogenophaga, Trichococcus Desulfovibrio, etc) in the absence of the already identified TCP anaerobic reductive dechlorinating microorganisms (e.g., Dehalogenimonas) was derived from a chlorinated hydrocarbon-contaminated aquifer. A TCP degradation experiment was carried out by adding yeast extract to produce hydrogen as an electron donor. The TCP-to-AC transformation was found to conform to zero-order conversion kinetics with the rate constant 11 ± 0.34 µmol L-1 d-1 during the main biodegradation stage. The bulk carbon isotope enrichment factor (εbulk) of the TCP-to-AC transformation was firstly evaluated as -5.2 ± 0.1‰. This study for the first time characterized the carbon isotope fractionations during TCP biodegradation using a novel enrichment culture, which would provide a promising tool for the incorporation of ISB for TCP removal in the future.

Effect of Restricted Feeding on Metabolic Health and Sleep-Wake Rhythms in Aging Mice.

Aging, an irreversible and unavoidable physiological process in all organisms, is often accompanied by obesity, diabetes, cardiovascular diseases, sleep disorders, and fatigue. Thus, older adults are more likely to experience metabolic symptoms and sleep disturbances than are younger adults. Restricted feeding (RF) is a dietary regimen aimed at improving metabolic health and extending longevity, as well as reorganizing sleep-wake cycles. However, the potential of RF to improve metabolic health and sleep quality in older adults who are known to show a tendency toward increased weight gain and decreased sleep is unknown. To elucidate this issue, aged mice were assigned to an RF protocol during the active phase for 2 h per day for 2 weeks. Sleep-wake cycles were recorded during the RF regime in RF group and control mice. At the end of this period, body weight and blood biochemistry profiles, including blood glucose, cholesterol, and enzyme activity, in addition to dopamine concentrations in the brain, were measured in the RF group and age-matched controls. RF for 2 weeks improved the metabolic health of aged mice by reducing their body weights and blood glucose and cholesterol levels. At the beginning of the RF regime, sleep decreased in the dark period but not in the light period. After stable food entrainment was achieved (7 days post-RF commencement), the amount of time spent in wakefulness during the light period dramatically increased for 2 h before food availability, thereby increasing the mean duration of awake episodes and decreasing the number of wakefulness episodes. There was no significant difference in the sleep-wake time during the dark period in the RF group, with similar total amounts of wakefulness and sleep in a 24-h period to those of the controls. During the RF regime, dopamine levels in the midbrain increased in the RF group, pointing to its potential as the mechanism mediating metabolic symptoms and sleep-wake regulation during RF. In conclusion, our study suggested that RF during aging might prohibit or delay the onset of age-related diseases by improving metabolic health, without having a severe deleterious effect on sleep.

Comparison of the Efficacy of Nonsteroidal Anti-Inflammatory Drugs and Opioids in the Treatment of Acute Renal Colic: A Systematic Review and Meta-Analysis.

Background: Although multiple randomized controlled trials (RCTs) and systematic review and meta-analysis were performed to investigate the efficiency and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids in the treatment of acute renal colic, the therapeutic regimen of renal colic is still controversial. Therefore, the aim of this study was to derive a more concise comparison of the effectiveness and safety between NSAIDs and opioids in the treatment for patients with acute renal colic by a systematic review and meta-analysis. Design: We searched PubMed, Embase, and Cochrane Central Register of controlled trials for seeking eligible studies. The pooled mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI) was calculated using the random effects model. The primary outcome was assessed according to the Grading of Recommendations Assessment, Development and Evaluation. Results: A total of 18 studies involving 3,121 participants were included in the systematic review and meta-analysis. No significant difference between the NSAID and opioid groups was observed, with changes in the visual analog scale (VAS) at 0-30 min (MD = 0.79, 95% CI: -0.51, 2.10). NSAIDs in the form of intravenous administration (IV) had no better effect on the changes in the VAS at 0-30 min, when compared to opioids (MD = 1.25, 95% Cl: -4.81, 7.3). The NSAIDs group in the form of IV had no better outcome compared to the opioids group, as well as the VAS at 30 min (MD = -1.18, 95% Cl: -3.82, 1.45; MD = -2.3, 95% Cl: -5.02, 0.42, respectively). Moreover, similar results of this outcome were also seen with the VAS at 45 min (MD = -1.36, 95% Cl: -5.24, 2.52). Besides, there was a statistical difference in the incidence of later rescue (RR = 0.76, 95% CI: 0.66, 0.89), drug-related adverse events (RR = 0.44, 95% CI: 0.27, 0.71), and vomiting (RR = 0.68, 95% CI: 0.49, 0.96). Conclusion: There is no significant difference between the NSAIDs and opioids in the treatment of renal colic in many outcomes (e.g., the VAS over different periods using different injection methods at 30 and 60 min), which has been focused on in this study. However, the patients who were treated using NSAIDs by clinicians can benefit from fewer side effects.

Bleaching of photodarkening in Tm-doped silica fiber with deuterium loading.

We demonstrate the rapid photodarkening (PD) phenomenon in Tm-doped fiber (TDF) core pumped by a laser at 1080 nm and the bleaching effect of deuterium (${{\rm D}_2}$D2) on PD TDF. By ${{\rm D}_2}$D2 loading for seven days, the PD-induced excess loss (PIEL) in the visible (VIS) and near-infrared (NIR) region have been largely eliminated, and no degradation was observed within 30 days. PD resistance of the ${{\rm D}_2}$D2 pretreated TDF has been investigated as well. The formation of color centers based on defects and precursors in the silica matrix and the mechanism of ${{\rm D}_2}$D2 bleaching are discussed.

[Spatial distribution patterns and associations of typical tree species in different regions.] / ä¸åŒåŒºåŸŸå ¸åž‹æ ‘æœ¨çš„ç©ºé—´åˆ†å¸ƒæ ¼å±€åŠå ³è”æ€§.

Based on the monitoring data from the plots of Changbai Mountains in the temperate zone (CBS), Guandi Mountain in the warm temperate zone (GDS), Heishiding Mountain in the subtropical zone (HSD), we analyzed the spatial distribution of tree species from three families (Pinaceae, Fagaceae, Rosaceae) and their correlation using paired correlation function g(r). The results showed that the individual number and size class structural characteristics of the trees from the three families varied among different regions. Pinaceae had high population density and a bimodal size-class structure in GDS plot but a small number and skewed normal size-class structure in CBS and HSD plots. Fagaceae had low abundance and a bimodal, skewed normal size-class structure respectively in CBS and GDS plots but a large number and an inverted J-type diameter distribution in HSD plot. Rosaceae had high abundance and a L-type size structure in GDS plot but relatively low abundance and a L-inverted and J-type size class distribution respectively in HSD and CBS plots. The trees from those three families showed different spatial distribution patterns in three different forest plots. The large size class individuals of Pinaceae were regularly distributed at small scale in CBS and GDS plots but aggregated in HSD plot, the middle and small size class ones were consis-tently aggregated in three plots. Fagaceae trees were mainly characterized by large size class and approximately distributed at random in CBS plot, but mainly characterized by middle or small size class and aggregated in GDS and HSD plots. The trees of Rosaceae were aggregated in three plots. The aggregation degree of trees from three families decreased with the increases of spatial scales. The large size class individuals of Fagaceae were negatively associated at small scale or uncorrelated with Pinaceae trees in CBS and HSD plots. The middle or small size class individuals of Fagaceae were negatively associated with Pinaceae ones in CBS and GDS plots but positively associated with Pinaceae ones in HSD plot. Trees from Pinaceae were negatively correlated with trees from Rosaceae in three plots. The middle or small size class individuals of Fagaceae were positively correlated with individuals of Rosaceae in CBS and GDS plots but negatively correlated with trees of Rosaceae in HSD plot. In conclusion, the spatial distribution patterns and associations of the trees from three families changed with the size class, research scale and had different patterns among three plots.

[Species composition, structure and spatial distribution of secondary cold-temperate Picea forest in Guandi Mountain, China]. / å ³å¸å±±å¯’æ¸©æ€§äº‘æ‰æ¬¡ç”Ÿæž—æ ·åœ°æ ‘ç§ç»„æˆã€ç»“æž„å’Œç©ºé—´åˆ†å¸ƒ.

The secondary Picea forest is one of the dominant vegetation types in Guandi Mountain. It's also the representative type of evergreen cold-temperate coniferous forests in subalpine region of north China. A 4 hm2 fixed monitoring Picea forest plot was established in Pangquangou Nature Reserve, Guandi Mountain (GDS plot) to better understand the basic characteristics such as species composition, community structure and its potential ecological process and mechanisms. We analyzed species composition, structure and spatial distribution of sample forest based on the first background survey data in this paper. The results showed that a total of 30 woody plant species existed in the sample area, which belonged to 11 families, 22 genera. The total individual number (including branches) was 26218 (independent individual number was 10266). Floristic composition in the region was defined as north temperate elements. Big differences of individual number, average diameter at breast height (DBH) and basal area among different species caused significant community layering effect, and the dominant species in each layer was obvious. Size-class structure of species showed bimodal skewed normal distribution at the canopy layer, approximate normal distribution at the subtree layer, and 'L' type distribution at the shrub layer. Spatial distribution of the dominant tree species such as Picea wilsonii and Larix principis-rupprechtii showed different pattern features with the changing size class, whether in individual number or in aggregation degree. Compared with the above two species with the same size class, a large number of L. principis-rupprechtii with DBH≥30 cm aggregated in the center of sample plot, but few P. wilsonii individuals with DBH≥30 cm occurred in the plot and had no clustering distribution. Only a few L. principis-rupprechtii with DBH≤10 cm occurred in the plot with a scattering distribution, and a large number of P. wilsonii with DBH≤10 cm aggregated in the center of the plot. There were also many P. wilsonii individuals with DBH≤10 cm distributed in the northwest area of the plot, but Betula albo-sinensis individuals with DBH≤10 cm mostly distributed in the southeast area of the plot. Shrub species such as Cotoneaster acutifolius, Spiraea pubescens and Lonicera szechuanica also showed heterogeneous spatial distribution. Species distribution pattern was affected by habitat conditions, and related to its own development, regeneration traits and ecological habits.

A receptor like kinase gene with expressional responsiveness on Xanthomonas oryzae pv. oryzae is essential for Xa21-mediated disease resistance.

BACKGROUND: Leucine-rich repeat receptor-like kinases (LRR-RLKs) represent a large class of proteins in regulating plant development and immunity. The LRR-RLK XA21 confers resistance to the bacterial disease caused by the pathogen of Xanthomonas oryzae pv. oryzae (Xoo). Several XA21 binding proteins have been characterized, however the early events governing XA21 signaling have not been fully elucidated. RESULTS: Here we report the identification of one LRR-RLK gene (XIK1) whose expression is induced rapidly upon the infection with the pathogen of Xoo. Expression pattern analysis reveals that XIK1 is preferentially expressed in reproductive leaves and panicles, and that expression is associated with plant development. By using RNA interference (RNAi), we silenced the expression of XIK1 in rice with Xa21 and found that reduced expression of XIK1 compromised disease resistance mediated by XA21. In addition, we found that the expression of the downstream marker genes of pathogen associated molecular pattern (PAMP) triggered immunity (PTI) in rice was compromised in Xa21 plants silenced for XIK1. CONCLUSION: Our study reveals that the LRR-RLK gene XIK1 is Xoo-responsive and positively regulates Xa21-mediated disease resistance.

[Aerosol optical properties during different air-pollution episodes over Beijing].

Based on the 2005-2011 data from Aerosol Robotic Network (AERONET), this study conducted analysis on aerosol optical properties over Beijing during different air-pollution episodes (biomass burning, CNY firework, dust storm). The aerosol optical depth (AOD) showed notable increases in the air-pollution episodes while the AOD (at 440 nm) during dust storm was 4. 91, 4. 07 and 2.65 times higher as background, biomass burning and firework aerosols. AOD along with Angstrom exponent (alpha) can be used to determine the aerosol types. The dust aerosol had the highest AOD and the lowest alpha. The alpha value of firework (1.09) was smaller than biomass burning (1.21) and background (1.27), indicating that coarse particles were dominant in the former type. Higher AOD of burnings (than background) can be attributed to the optical extinction capability of black carbon aerosol. The single scattering albedo (SSA) was insensitive to wavelength. The SSA value of dust (0.934) was higher than background (0.878), biomass burning (0.921) and firework (0.905). Additionally, the extremely large SSA of burnings here maybe was caused by the aging smoke, hygroscopic growth and so on. The peak radius of aerosol volume size distributions were 0.1-0.2 microm and 2.24 -3.85 microm in clear and polluted conditions. The value of volume concentration ratio between coarse and fine particles was in the order of clear background (1.04), biomass burning (1.10), CNY firework (1.91) and dust storm (4.96) episode.

Lipid peroxidation dysregulation in ischemic stroke: plasma 4-HNE as a potential biomarker?

4-hydroxynonenal (4-HNE) is a major aldehyde produced during the lipid peroxidation of ω-6 polyunsaturated fatty acids. Recently, 4-HNE has been reported to contribute to the pathogenesis of neuronal diseases such as Alzheimer's disease. However, the role of 4-HNE in ischemic stroke is unclear yet. In this study, we found that plasma 4-HNE concentrations were higher in the genetic stroke-prone rats (stroke-prone spontaneously hypertensive rats) and experimental stroke rats with middle cerebral artery occlusion (MCAO). Moreover, administration of 4-HNE via intravenous injection before MCAO surgery not only enlarged cerebral ischemia-induced infarct area, but also increased oxidative stress in brain tissue, which was evidenced by the enhanced ROS/MPA levels, and the reduced GSH/GSSG ratio and MnSOD levels. Overexpression of aldehyde dehydrogenasesbcl-2 (ALDH2), an enzyme catalyses 4-HNE, rescued neuronal survival against 4-HNE treatment in PC12 cells. The plasma 4-HNE concentrations in patients with ischemic stroke were higher than those in control subjects. In a small sample population (N=60), the plasma 4-HNE concentration was positively correlated with the plasma homocysteine concentration, a risk factor for ischemic stroke. Taken together, our study suggests that the plasma 4-HNE level is a potential biomarker for ischemic stroke.

Endovascular treatment of complicated ruptured anterior communicating artery aneurysms based on the anatomical features of the anterior communicating artery complex.

BACKGROUND: Endovascular therapy of complicated ruptured anterior communicating artery (ACoA) aneurysms is difficult due to their small size and unfavorable shape. AIM: Based on the anatomical features of the ACoA complex, we investigated the feasibility and efficacy of different coil embolism strategies for complicated ACoA aneurysms. MATERIALS AND METHODS: Sixteen patients with complicated ruptured ACoA aneurysms received endovascular treatment. Aneurysm sac plus ACoA embolism or ACoA coil embolism were performed if the bilateral A1 segment was normally developed or unilateral A1 segment dysplasia (≥1/2 normal contralateral diameter) was present. Where unilateral A1 segment dysplasia (<1/2 normal contralateral diameter) or aplasia was present, sac embolism alone was performed. Follow-up angiography was performed, and clinical follow-up data were categorized as fully recovered, improved, unchanged or worsened. RESULTS: Aneurysm sac plus ACoA (n=5) or ACoA alone (n=2) coil embolism was performed in seven patients with normal bilateral A1 segments (n=5) or dysplasia (n=2). Sac coil embolism was performed in nine patients with unilateral A1 segment dysplasia (n=1) or aplasia (n=8). Immediate angiography indicated total/near-total occlusion was achieved in 14 patients. Final angiographic (mean 11.9 ± 5.1 months) and clinical (mean 17.7 ± 5.9 months) follow-up confirmed total/near-total occlusion in 12 patients, one partial occlusion, two enlarged residual sacs and one reopened aneurysm. Clinical symptoms fully recovered in 10 patients, improved in four, were unchanged in one and worsened in one patient. CONCLUSION: This small middle-term follow-up study demonstrates coil embolism endovascular treatment of complicated ruptured ACoA aneurysms, based on the anatomical features of the ACoA complex, is feasible and effective.

Lymph node ratio and preoperative CA 19-9 levels predict overall survival and recurrence-free survival in patients with resected pancreatic adenocarcinoma.

AIM: Clinicopathologic factors predicting overall survival (OS) would help identify a subset to benefit from adjuvant therapy. METHODS: One hundred and sixty-nine patients patients from 1984 to 2009 with curative resections for pancreatic adenocarcinoma were included. Tumors were staged by American Joint Committee on Cancer 7th edition criteria. Univariate and multivariable analyses were performed using Kaplan-Meier methodology or Cox proportional hazard models. Log-rank tests were performed. Statistical inferences were assessed by two-sided 5% significance level. RESULTS: Median age was 67.1 (57.2-73.0) years with equal gender distribution. Tumors were in the head (89.3%) or body/tail (10.7%). On univariate analysis, adjuvant therapy, lymph node (LN) ratio, histologic grade, negative margin status, absence of peripancreatic extension, and T stage were associated with improved OS. Adjuvant therapy, LN ratio, histologic grade, number of nodes examined, negative LN status, and absence of peripancreatic extension were associated with improved recurrence-free survival (RFS). On multivariable analysis, LN ratio and carbohydrate antigen (CA) 19-9 levels were associated with OS. LN ratio was associated with RFS. CONCLUSION: The LN ratio and CA 19-9 levels are independent prognostic factors following curative resections of pancreatic cancer.

Notch signaling alters sensory or neuronal cell fate specification of inner ear stem cells.

Multipotent progenitor cells in the otic placode give rise to the specialized cell types of the inner ear, including neurons, supporting cells, and hair cells. The mechanisms governing acquisition of specific fates by the cells that form the cochleovestibular organs remain poorly characterized. Here we show that whereas blocking Notch signaling with a γ-secretase inhibitor increased the conversion of inner ear stem cells to hair cells by a mechanism that involved the upregulation of bHLH transcription factor, Math1 (mouse Atoh1), differentiation to a neuronal lineage was increased by expression of the Notch intracellular domain. The shift to a neuronal lineage could be attributed in part to continued cell proliferation in cells that did not undergo sensory cell differentiation due to the high Notch signaling, but also involved upregulation of Ngn1. The Notch intracellular domain influenced Ngn1 indirectly by upregulation of Sox2, a transcription factor expressed in many neural progenitor cells, and directly by an interaction with an RBP-J binding site in the Ngn1 promoter/enhancer. The induction of Ngn1 was blocked partially by mutation of the RBP-J site and nearly completely when the mutation was combined with inhibition of Sox2 expression. Thus, Notch signaling had a significant role in the fate specification of neurons and hair cells from inner ear stem cells, and decisions about cell fate were mediated in part by a differential effect of combinatorial signaling by Notch and Sox2 on the expression of bHLH transcription factors.

A novel frameshift mutation in the EYA1 gene in a Korean family with branchio-oto-renal syndrome.

Branchio-oto-renal (BOR) syndrome is an autosomal dominant disorder characterized by branchial cleft fistulae or cysts, preauricular pits, ear malformations, hearing loss, and renal anomalies. Mutations in the human homologue of the Drosophilia eyes absent gene (EYA1) are the most common cause of BOR syndrome. In this study, we found a Korean family showing clinical features of the disease. Mutation analysis of the EYA1 gene revealed a novel one-base-pair deletion resulting in truncated protein (c.321delT; p.Ala107fs). This is the first report of BOR syndrome caused by deletion mutation of the EYA1 gene in Korea.

A comparison of postoperative pain and complications in tonsillectomy using BiClamp forceps and electrocautery tonsillectomy.

OBJECTIVES: To compare the efficacy and safety of BiClamp forceps tonsillectomy (BT) with standard electrocautery tonsillectomy (ET) in terms of postoperative pain and complication rates. STUDY DESIGN: Prospective randomized study. SUBJECTS AND METHODS: The following variables were examined: postoperative complications, intraoperative blood loss, operating time, postoperative pain and diet scores using visual analog scales, and time until return to normal activity. RESULTS: The mean operating time and the grade of intraoperative blood loss were significantly lower in the BT group than in the ET group for both pediatric and adult patients. For adult patients, the overall complication rates were significantly lower in the BT group. In addition, a significant early decrease in the pain score and significant improvement in dietary intake until postoperative day 14 were observed in the BT group for both pediatric and adult patients. CONCLUSIONS: The use of BiClamp forceps in tonsillectomy reduces the intraoperative blood loss and postoperative pain score, and facilitates an early return to normal diet and activity.

Bilateral pneumothorax and pneumomediastinum following total thyroidectomy with central neck dissection.

We describe a 60-year-old woman who developed extensive emphysema, bilateral pneumothorax, and pneumomediastinum after total thyroidectomy and central neck dissection with sacrifice of a recurrent laryngeal nerve. In this report, we discuss the possisle etiology of those rare complications.

Prediction of hypothyroidism after hemithyroidectomy: a biochemical and pathological analysis.

The possibility of postsurgical hypothyroidism after hemithyroidectomy is no longer a new subject. Although many previous studies have mentioned posthemithyroidectomy hypothyroidism, the incidence and contributing factors for hypothyroidism remain uncertain. We intended to evaluate the incidence and the time of development of hypothyroidism after hemithyroidectomy and to analyze the relationship of posthemithyroidectomy hypothyroidism with preoperative biochemical parameters and postoperative histopathological findings. From February 2001 through December 2004, 287 consecutive cases of hemithyroidectomized patients were retrospectively analyzed; 136 of these patients were included in this study after the exclusion criteria were applied. The relationship between posthemithyroidectomy hypothyroidism and several parameters such as sex, age, preoperative free T4, TSH, microsomal antibody (Ab), thyroglobulin antibody (Ab) levels and lymphocytic infiltration of the resected gland was statistically analyzed. Postoperative hypothyroidism developed in 58 patients (42.6%). In hypothyroid group, 11 patients (19%) showed overt hypothyroidism and 47 patients (81%) showed subclinical hypothyroidism. Preoperative TSH value was significantly higher in the hypothyroid group (2.15+/-1.30 microU/ml) compared to the euthyroid group (1.29+/-0.9 microU/ml). Positive ratio of preoperative microsomal Ab and thyroglobulin Ab were significantly higher in hypothyroid group (38.9 and 41.9%) compared to euthyroid group (3.6 and 19.3%) (P <0.05). In addition, patients with a higher grade of lymphocytic infiltration were found to have a higher probability of developing hypothyroidism. About 85% of postoperative hypothyroidism was detected between 1 and 6 months postoperatively. We might predict the possibility of developing the posthemithyroidectomy hypothyroidism especially in case of preoperatively positive microsomal antibody, thyroglobulin antibody and high-grade lymphocytic infiltration of the resected gland. In addition, our findings support the recommendation for regular serum TSH follow-up at least for 12 months after hemithyroidectomy.

Voice outcomes of polyacrylamide hydrogel injection laryngoplasty.

OBJECTIVES: Polyacrylamide hydrogel (PAAG, Aquamid) is widely used as permanent facial tissue filler during facial plastic surgery. In this study, we examined the long-term effects and safety aspects of PAAG as a vocal fold augmentation material for patients with permanent unilateral vocal cord paralysis. STUDY DESIGN: Prospective clinical trials. METHODS: PAAG injection laryngoplasty was performed in 34 consecutive patients with permanent unilateral vocal cord paralysis. Percutaneous injection was performed under local anesthesia into the vocalis muscle using disposable 25 gauge long needles. Of the 34 patients, 16 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 6 and 12 months after the injection. RESULTS: Acoustic and perceptual parameters (GRBAS [Overall grade of dysphonia, Roughness, Breathiness, Aesthenia, Strain], Maximal phonation time [MPT], jitter, and shimmer) were significantly improved (P < .05) after injection and remained stable over 12 months. The grades of mucosal waves and glottic closure were also significantly improved (P < .01). The voice handicap index (VHI), as well as the visual analogue scale (VAS) of hoarseness and aspiration significantly improved over 12 months. No adverse effects were observed except for a decrease in the mucosal wave of one patient, after injection into a superficial area of the vocal fold. CONCLUSION: Based on the preliminary results of this trial, PAAG appears to be a long-lasting and safe injection material that is suitable for the treatment of glottal insufficiency caused by permanent unilateral vocal cord paralysis.

Is lack of placement of drains after thyroidectomy with central neck dissection safe? A prospective, randomized study.

OBJECTIVE: Selective use of drains after thyroidectomy has been suggested in the literature. Although the safety of thyroidectomy without drains has been reviewed, there is little specific data available to identify the safety of thyroidectomy combined with central neck dissection (CND) without drains. This study aims to determine the feasibility and safety of thyroidectomy without drains, especially in cases of combined CND. STUDY DESIGN: Prospective, randomized study. MATERIALS AND METHODS: One hundred ninety-eight consecutive thyroidectomized patients were enrolled in this study. Drain group (n = 101) consisted of 41 hemithyroidectomies (HT), 28 total thyroidectomies (TT), and 32 total TT with CND. No-drain group (n = 97) consisted of 42 HT, 18 TT, and 37 TT with CND. The following variables were examined: perioperative complications (hemorrhage, hematoma, seroma), intraoperative bleeding, operation time, volume of resected thyroid gland, time of hospital discharge after operation, duration of drain placement, and total amount of drainage (drain group). RESULTS: There were no significant differences in age, sex, volume of resected thyroid gland, types of operation, operation time, and histopathlologic diagnosis between two groups. In the drain group, overall perioperative complications occurred in seven (7/101, 6.9%) patients. In the no-drain group, overall perioperative complications occurred in nine (10/97, 10.3%) patients. There was no significant difference in overall perioperative complications between the drain and no-drain groups, even in cases of performing CND. Time of hospital discharge after operation was significantly shorter in the no-drain group than the drain group (P < .05). CONCLUSIONS: We conclude that thyroidectomy without drains is safe and effective even in combination with CND and appears to confer several advantages over the routine drainage method. In addition, we achieved significant reduction of hospital stay, which led to a reduction in costs for the patients.

Usefulness of autologous cartilage and fibrin glue for the prevention of septal perforation during septal surgery: a preliminary report.

OBJECTIVES: Septal surgery is one of the most common causes of nasal septal perforation. In cases in which a septal mucosal defect at the corresponding area has occurred, autologous cartilage is usually inserted between the injured mucosal flaps. In addition, we applied fibrin glue to the margins of injured mucosal surface to fix the inserted cartilage and to promote mucosal regeneration. The aim of this study was to evaluate the efficacy of this method in the prevention of nasal septal perforation. STUDY DESIGN: Retrospective analysis of medical records. METHODS: A total of 463 septal surgeries were performed between March 2003 and August 2005. Septal mucosal defect at the corresponding area occurred in 34 patients. In group 1 (23 patients), septal or auricular cartilage was inserted between the injured mucosal flaps. In group 2 (11 patients), septal or auricular cartilage was inserted, and fibrin glue was applied on the mucosal margins of cartilage insertion site. We compared the perforation rate between the two groups. RESULTS: In group 1, nasal septal perforation occurred 8 of 23 (34.8%) patients, and in group 2, 1 of 11 (9.1%) patients experienced perforation. Although the occurrence rate of perforation was significantly lower in group 2, statistical significance between the two groups could not be established because of the small number of patients who experienced septal perforation. CONCLUSION: The application of fibrin glue at the bilaterally injured mucosal surface after cartilage insertion is thought to be very useful as a preventive measure of nasal septal perforation. We report these results as preliminary data for further study to determine the usefulness of fibrin glue in the prevention of nasal septal perforation.