An alternative technique for fabricating an interim nasal profile dressing using computer-aided design, spectrophotometry, and a color formulation software program.

A total rhinectomy may be part of the treatment of nasal malignancy and can cause severe facial disfigurement and unwanted psychological repercussions. A technique is described for fabricating a skin-colored interim nasal profile dressing for immediate fitting after surgery without the need for either preoperative or postoperative impressions. The technique avoids patient discomfort, and the initial emotional trauma of facial disfigurement may be avoided. The fabrication process includes the use of a preoperative computerized tomography scan, a computer-aided design software program, 3-dimensional printing, and spectrophotometry.

The 'Own Children' fertility estimation procedure: a reappraisal.

The Full Birth History has become the dominant source of estimates of fertility levels and trends for countries lacking complete birth registration. An alternative, the 'Own Children' method, derives fertility estimates from household age distributions, but is now rarely used, partly because of concerns about its accuracy. We compared the estimates from these two procedures by applying them to 56 recent Demographic and Health Surveys. On average, 'Own Children' estimates of recent total fertility rates are 3 per cent lower than birth-history estimates. Much of this difference stems from selection bias in the collection of birth histories: women with more children are more likely to be interviewed. We conclude that full birth histories overestimate total fertility, and that the 'Own Children' method gives estimates of total fertility that may better reflect overall national fertility. We recommend the routine application of the 'Own Children' method to census and household survey data to estimate fertility levels and trends.

Investigations of the interactions between synthetic antimicrobial polymers and substrate-supported lipid bilayers using sum frequency generation vibrational spectroscopy.

Sum frequency generation (SFG) vibrational spectroscopy was used to analyze interactions between solid-supported lipid bilayers acting as models for cellular membranes and several membrane-active random copolymers with different lipophilic side chains, named 0R (no group), 33Me (methyl group), 11Bz (benzyl group), and 33Bu (butyl group), according to both the identity and percentage of the side chains within the polymer. Biological tests of the minimum inhibitory concentration (MIC) and hemolytic concentration were performed. The inherent surface sensitivity of SFG allowed for independent monitoring of isotopically labeled lipid bilayer leaflets as a function of concentration to study polymer-bilayer interaction mechanisms. Concentrations at which each bilayer leaflet was disrupted were quantitatively determined for each copolymer. Spectroscopic evidence of interaction with the bilayer below the critical concentrations was observed for the 11Bz polymer. The lipophilic butyl side chain of the 33Bu polymer was found to be oriented parallel to the surface normal. This research shows that SFG is a useful analytical technique which provides unique details regarding the interaction mechanisms of these membrane-active copolymers and lipid bilayers.

Immobilization of amphiphilic polycations by catechol functionality for antimicrobial coatings.

A new strategy for preparing antimicrobial surfaces by a simple dip-coating procedure is reported. Amphiphilic polycations with different mole ratios of monomers containing dodecyl quaternary ammonium, methoxyethyl, and catechol groups were synthesized by free-radical polymerization. The polymer coatings were prepared by immersing glass slides into a polymer solution and subsequent drying and heating. The quaternary ammonium side chains endow the coatings with potent antibacterial activity, the methoxyethyl side chains enable tuning the hydrophobic/hydrophilic balance, and the catachol groups promote immobilization of the polymers into films. The polymer-coated surfaces displayed bactericidal activity against Escherichia coli and Staphylococcus aureus in a dynamic contact assay and prevented the accumulation of viable E. coli, S. aureus, and Acinetobacter baumannii for up to 96 h. Atomic force microscopy (AFM) images of coating surfaces indicated that the surfaces exhibit virtually the same smoothness for all polymers except the most hydrophobic. The hydrophobic polymer without methoxyethyl side chains showed clear structuring into polymer domains, causing high surface roughness. Sum-frequency generation (SFG) vibrational spectroscopy characterization of the surface structures demonstrated that the dodecyl chains are predominantly localized at the surface-air interface of the coatings. SFG also showed that the phenyl groups of the catechols are oriented on the substrate surface. These results support our hypothesis that the adhesive or cross-linking functionality of catechol groups discourages polymer leaching, allowing the tuning of the amphiphilic balance by incorporating hydrophilic components into the polymer chains to gain potent biocidal activity.

Dependence of antimicrobial selectivity and potency on oligomer structure investigated using substrate supported lipid bilayers and sum frequency generation vibrational spectroscopy.

Sum frequency generation (SFG) vibrational spectroscopy was used to study interactions between solid-supported lipid bilayers mimicking microbial and erythrocyte cellular membranes and synthetic antimicrobial arylamide oligomers named 2, 3, and 4, designed with the facial amphiphilicity common to naturally occurring antimicrobial peptides. The three compounds have the same backbone structure but varied side chains. The inherent interfacial sensitivity of SFG allowed for simultaneous monitoring of lipid ordering in the individual bilayer leaflets and orientation of 2, 3, and 4 upon interaction with the bilayer. Critical concentrations at which the inner leaflet is disrupted were determined for each oligomer. Spectral evidence of the oligomers' interaction with the bilayer below the critical concentrations was also found. Oligomers 2 and 3 tilted toward the bilayer surface normal, in agreement with previous experimental and simulation results. These oligomers selectively interact with microbial membrane models over erythrocyte membrane models, correlating well to previously published SFG studies on antimicrobial oligomer 1. It was shown that the oligomers interact with the lipid bilayers differently, indicating their different activity and selectivity. This research further shows that SFG is a particularly useful technique for the investigation of interaction mechanisms between cell membranes and membrane-active molecules. Additionally, SFG provides details of the specific interactions between these novel antimicrobials and lipid bilayers.

Tongue necrosis: a rare complication of prolonged oral intubation.

This is a case report of necrosis of more than two-third of the dorsal tongue in a 74-year-old male following prolonged oral intubation for vascular surgery. This necrosis progressed from the left tongue to involve much of the dorsal tongue bilaterally. A diagnosis of rhabdomyolysis was made evident by compartment syndrome of the legs with an elevated creatine kinase level of 89 789 u/l (units per litre). The literature also reveals that vasopressin has been linked with reported cases of tongue necrosis. Other possible aetiological factors were discussed in this finding.

Actinomycosis of tongue: Rare presentation mimicking malignancy with literature review and imaging features.

Actinomycosis of the tongue is rare. It may be difficult to differentiate this infection clinically and radiologically from other tongue pathology especially neoplasia. We report a substantial tongue lesion which mimicked malignancy at presentation. The patient was treated successfully with 4 weeks of oral antibiotic therapy. It is also important that clinicians are aware of the radiological differential diagnosis of lingual actinomycosis.

Protection of the patient's hair with a standard swimming cap during major maxillofacial operations.

During maxillofacial operations there is inevitably a lot of blood shed, which soils the patients hair. The cleaning of blood stained hair is a laborious and time-consuming task, particularly after a long operation. To prevent this we advocate using a standard swimming cap to protect the hair.

Hairy intraoral flap--an unusual indication for laser epilation: a series of 5 cases and review of the literature.

A variety of the flaps used to reconstruct defects of the head and neck region following surgery for malignant disease contain hair follicles that may result in unwanted hair growth. This can cause significant distress to the patients in a variety of ways. We report 5 cases of significant intraoral hair growth of which 4 cases were successfully managed with long-pulsed alexandrite laser. One patient was not treated due to technical difficulties. We review the literature on the management of hair growth on intraoral flaps.

A novel method of managing persistent parotid sialocele.

Sialocele formation is a recognised complication of parotid surgery. The initial management is usually conservative and often effective. We present a novel method that utilises an intra-oral approach and pig-tail catheter for safely and rapidly draining a large persistent sialocele. It is particularly appropriate when other methods have failed and the skin is at risk of breakdown.