Clinical performance of cuffed versus uncuffed preformed endotracheal tube in pediatric patients undergoing cleft palate surgery.

BACKGROUND: Uncuffed endotracheal tubes are commonly used in children but due to several decade preferred in paediatric oral surgery. Due to lack of conclusive evidences in this regard, we have conducted this study to compare post-operative morbidity following use of cuffed and uncuffed endotracheal tubes in paediatric patients undergoing cleft lip-palate surgery. METHODS: This randomised controlled trial was conducted on children aged 2 to 12 years.110 patients were allocated in two parallel groups using computer generated list of random numbers. Post operative extubation stridor, sore throat, time to first oral intake and regaining of normal voice were compared between two groups. RESULTS: The incidence of sore throat was significantly more (P value > 0.005) in patients of uncuffed group compared to cuffed group. The time to first oral intake and time to regain normal voice were significantly earlier in cuffed group compared to the other. CONCLUSION: With standard care, preformed cuffed ET tube has shown reduced incidence of post operative sore throat. Cuffed group has earlier oral intake and normal voice regain compared to uncuffed group.

Association of serum electrolytes and smoking with salivary gland stone formation.

To further define potential factors that may contribute to stone formation in salivary glands (sialolithiasis), a retrospective chart review was performed of patients diagnosed with sialolithiasis between March 1, 1998 and February 29, 2012. Information on salivary gland stone number, location and size, medical history, medications, and serum electrolyte levels were collected. Associations between electrolyte levels and stone characteristics (such as stone number and size) were examined. Fifty-nine patients were identified; their median age was 58 years (range 25-89 years) and most were male (95%). Salivary stones were most commonly located in the submandibular glands (83%). Thirty-five patients (59%) had a smoking history, with 16 (27%) reported as current smokers. There was a significant association between current smoker status and stone size (mean largest stone size 12.4±8.8mm vs. 7.5±4.8mm in current smokers vs. non-smokers; P=0.03). Serum sodium levels (r=0.32, P=0.014) and serum potassium levels (r=0.31, P=0.017) showed significant positive correlations with stone size. While the aetiology of sialolithiasis remains unclear, smoking (which can contribute to reduced saliva flow) and higher serum sodium levels (which can reflect volume depletion) are associated with larger salivary stones.

Vibrational spectroscopy and theory of the protonated benzene dimer and trimer.

Protonated benzene cluster ions, H(C(6)H(6))(2)(+) and H(C(6)H(6))(3)(+), are produced in a pulsed electrical discharge source coupled to a supersonic expansion. Mass-selected complexes are investigated with infrared photodissociation spectroscopy in the 1000-3200 cm(-1) region using the method of argon tagging. The IR spectra of H(C(6)H(6))(2)(+)-Ar and H(C(6)H(6))(3)(+)-Ar contain broad bands in the high frequency region resulting from CH-π hydrogen bonds. Sharp peaks are observed in the fingerprint region arising from the ring modes of both the C(6)H(7)(+) and C(6)H(6) moieties. M06-2X calculations have been performed to investigate the structures and vibrational spectra of energetically low-lying configurations of these complexes. H(C(6)H(6))(2)(+) is predicted to have three nearly isoenergetic conformers: the parallel displaced (PD), T-shaped (TS), and canted (C) structures [Jaeger, H. M.; Schaefer, H. F.; Hohenstein, E. G.; Sherrill, C. D. Comput. Theor. Chem. 2011, 973, 47-52]. A comparison of the experimental dimer spectrum with those predicted for the three isomers suggests an average structure between the TS and PD conformers, which is consistent with the low energy barrier predicted to separate these two structures. No evidence is found for the C dimer even though it lies only 1.2 kcal/mol above the PD dimer. Although the trimer is also computed to have many low lying isomers, the IR spectrum limits the possible species present.

Primary culture of polarized human salivary epithelial cells for use in developing an artificial salivary gland.

Therapeutic irradiation for head and neck cancer, and the autoimmune disease Sjogren's syndrome, lead to loss of salivary parenchyma. They are the two main causes of irreversible salivary gland hypofunction. Such patients cannot produce adequate levels of saliva, leading to considerable morbidity. We are working to develop an artificial salivary gland for such patients. A major problem in this endeavor has been the difficulty in obtaining a suitable autologous cellular component. This article describes a method of culturing and expanding primary salivary cells obtained from human submandibular glands (huSMGs) that is serum free and yields cells that are epithelial in nature. These include morphological (light and transmission electron microscopy [TEM]), protein expression (immunologically positive for ZO-1, claudin-1, and E-cadherin), and functional evidence. Under confocal microscopy, huSMG cells show polarization and appropriately localize tight junction proteins. TEM micrographs show an absence of dense core granules, but confirm the presence of tight and intermediate junctions and desmosomes between the cells. Functional assays showed that huSMG cells have high transepithelial electrical resistance and low rates of paracellular fluid movement. Additionally, huSMG cells show a normal karyotype without any morphological or numerical abnormalities, and most closely resemble striated and excretory duct cells in appearance. We conclude that this culture method for obtaining autologous human salivary cells should be useful in developing an artificial salivary gland.

Is age-induced decline in immune response associated with hypothalamic glutamate receptor density and dietary protein?

Manipulation of dietary protein has been found to be the most useful dictator in the age-associated decline of neuroimmune activity in mammals. In the present study, we sought to clarify the effect of dietary protein on age-induced alterations of hypothalamic glutamatergic activity and immune response. The hypothalamic glutamatergic activity and immune response were found to increase and decrease, respectively, with the increase in age of rats from young (3 months) to old (18 months) maintained with normal (20%) protein diet. Intake of low (5%) protein diet (LPD) and high (40%) protein diet (HPD) under short-term period (7 days) failed to alter the age-associated loss of immune response and increase in hypothalamic glutamatergic activity. However, long-term (30 days) supplementation of LPD retarded the age-induced decline in immune response and increase in hypothalamic glutamatergic activity, whereas, HPD consumption under similar condition potentiated the age-related immunosuppression and increase in hypothalamic glutamatergic activity. These results suggest that (a) the age-associated immunosuppression may be inversely related to the hypothalamic glutamatergic activity and (b) consumption of diets having variable quantity of protein without variation of calorie content modulates immune response and hypothalamic glutamatergic activity depending upon age and duration of dietary supplementation.

Dietary protein alters age-induced change in hypothalamic GABA and immune response.

The effect of dietary protein on hypothalamic GABAergic activity and immune response of rats in relation to age was studied. The age-induced (due to increase of age from three to 18 months) decrease in hypothalamic GABAergic activity and immune response were potentiated with the supplementation of protein rich diet under both short- and long-term conditions. Long-term consumption of protein-poor diet, in contrast, produced activation of hypothalamic GABAergic activity with an immunopotentiation with the increase of age from three to 18 months; whereas, short-term supplementation of low protein diet did not show any effect. The results of the present study may indicate that the activation or inhibition of hypothalamic GABAergic activity by immunopotentiation or immunosuppression during aging depends on the variation of the amount of dietary protein as well as the duration of its supplementation.

2-5A antisense directed against telomerase RNA produces apoptosis in ovarian cancer cells.

OBJECTIVE: RNase L is converted to an active form upon binding short 2',5'-oligoadenylates (2-5A). To direct RNase L to an RNA target, 2-5A is attached to an antisense oligonucleotide (2-5A antisense). This chimera can be directed against telomerase-an RNA-protein complex that elongates telomeric DNA and is involved in cellular immortalization. Our objective is to investigate the effect of 2-5A antisense by targeting telomerase RNA (hTR) in the ovarian cancer cell line, HEY-1B. METHODS: Baseline RNase L levels and telomerase activities were measured in both HEY-1B and normal ovarian epithelial cells (NOE). Cells were treated daily with chimeric oligonuclotides (ODN) directed against four different hTR sites, or control ODNs including nonchimeric antisense, 2-5A fused to a mismatched sequence, or inactive 2-5A fused to antisense. At 48 h, apoptosis was evaluated using the TUNEL assay. After six daily ODN administrations, telomerase activity was redetermined, and at 7 days viability counts were obtained. RESULTS: Both cell lines expressed similar levels of RNase L. Hey-1B displayed telomerase activity while NOE did not. After 7 days of transfection, 2-5A antisense ODNs caused profound cell death in the HEY-1B cells, but not in the NOE cells. This effect was seen regardless of hTR target site, and ODN controls showed no significant decrease in cell viability in either cell line. HEY1B cells treated with 2-5A antisense against hTR showed a decrease in telomerase activity and a profound induction of programmed cell death. CONCLUSIONS: The results suggest that 2-5A antisense directed against telomerase RNA results in apoptotic cell death in ovarian cancer cells, but not normal ovarian epithelial cells. The 2-5A antisense strategy may hold a considerable advantage over the conventional antisense approach in targeting cancer-causing genes.

Theophylline-induced changes in mammalian adenosine deaminase activity and corticosterone status: possible relation to immune response.

Theophylline at low doses (10 mg/kg/day p.o.) under long-term conditions (for 16 consecutive days) increased the adenosine deaminase (ADA) activity in spleen and thymus of adult male albino rats without changing its hepatic ADA activity. Treatment with high doses (20 mg/kg/day p.o.) under similar conditions, on the other hand, decreased the splenic and hepatic ADA activity and increased the thymic ADA activity. This induction of thymic ADA activity, however, was significantly less than that observed with low doses of theophylline. The plasma corticosterone level was increased without changing its adrenal level under similar conditions. This study, thus, indicates that long-term theophylline treatment may potentiate or suppress the immune response, depending on the dose, through the tissue (liver/spleen/thymus)-specific modulation of ADA activity and plasma corticosterone status.

Caffeine-induced increase of adenosine deaminase activity in mammalian lymphoid organs.

Adenosine deaminase (ADA) activity was increased in spleen and thymus of rat with single and multiple caffeine treatments (10 and 20 mg/kg/day). The stimulation was greater at the higher dose. ADA activity of liver was not affected under these conditions. This study indicates that caffeine may potentiate immunity with the modulation of adenosinergic system through increasing splenic and thymic ADA activity.