Filtración de anastomosis colorrectal tratada con E-VAC con espuma de polivinilo podría reducir el tiempo de tratamiento / Colorectal anastomotic leak treated with E-VAC with polyvinyl sponge could reduce treatment time

RESUMEN Las filtraciones de anastomosis colorrectales tienen una incidencia de 5 a 15% y su manejo depende de las manifestaciones clínicas, la distancia desde el margen anal y su ubicación intra o extra peritoneal. En algunos casos seleccionados el manejo endoscópico ha demostrado ser un tratamiento efectivo. En el presente reporte de caso se utilizó el sistema de drenaje rectal transanal asistido por vacío descrito por Weidenhagen et al., para el tratamiento de una fuga anastomótica pero se utilizó una espuma de polivinilo en vez la espuma tradicionalmente usada de poliuretano con el fin de disminuir el número de cambios de la espuma y el tiempo de tratamiento.

ABSTRACT Colorectal anastomosis leaks have an incidence of 5 to 15% and their management depends on the clinical manifestations, the distance to the anal verge and the intra or extra peritoneal location. In some selected cases, endoscopic management has proven to be an effective treatment. In this case report, the vacuum-assisted transanal rectal drainage system described by Weidenhagen et al. was used for the treatment of an anastomotic leak. We used a polyvinyl sponge instead of the polyurethane sponge traditionally used with the intention to reduce sponge changes and treatment time.

Effect of stem cells combined with a polymer/ceramic membrane on osteoporotic bone repair

Abstract Cell therapy associated with guided bone regeneration (GBR) can be used to treat bone defects under challenging conditions such as osteoporosis. This study aimed to evaluate the effect of mesenchymal stem cells (MSCs) in combination with a poly(vinylidene-trifluoroethylene)/barium titanate (PVDF-TrFE/BT) membrane on bone repair in osteoporotic rats. Osteoporosis was induced in female rats by bilateral removal of the ovaries (OVX) or sham surgery (SHAM), and the osteoporotic condition was characterized after 5 months by microtomographic and morphometric analyses. Calvarial defects were created in osteoporotic rats that immediately received the PVDF-TrFE/BT membrane. After 2 weeks, bone marrow-derived MSCs from healthy rats, characterized by the expression of surface markers using flow cytometry, or phosphate-buffered saline (PBS) (Control) were injected into the defects and bone formation was evaluated 4 weeks post-injection by microtomographic, morphometric, and histological analyses. A reduction in the amount of bone tissue in the femurs of OVX compared with SHAM rats confirmed the osteoporotic condition of the experimental model. More bone formation was observed when the defects were injected with MSCs compared to that with PBS. The modification that we are proposing in this study for the classical GBR approach where cells are locally injected after a membrane implantation may be a promising therapeutic strategy to increase bone formation under osteoporotic condition.

Three-dimensional comparison of 2 digital models obtained from cone-beam computed tomographic scans of polyvinyl siloxane impressions and plaster models

PURPOSE: This study was performed to evaluate the dimensional accuracy of digital dental models constructed from cone-beam computed tomographic (CBCT) scans of polyvinyl siloxane (PVS) impressions and cast scan models.MATERIALS AND METHODS: A pair of PVS impressions was obtained from 20 subjects and scanned using CBCT (resolution, 0.1 mm). A cast scan model was constructed by scanning the gypsum model using a model scanner. After reconstruction of the digital models, the mesio-distal width of each tooth, inter-canine width, and inter-molar width were measured, and the Bolton ratios were calculated and compared. The 2 models were superimposed and the difference between the models was measured using 3-dimensional analysis.RESULTS: The range of mean error between the cast scan model and the CBCT scan model was −0.15 mm to 0.13 mm in the mesio-distal width of the teeth and 0.03 mm to 0.42 mm in the width analysis. The differences in the Bolton ratios between the cast scan models and CBCT scan models were 0.87 (anterior ratio) and 0.72 (overall ratio), with no significant difference (P>0.05). The mean maxillary and mandibular difference when the cast scan model and the CBCT scan model were superimposed was 53 µm.CONCLUSION: There was no statistically significant difference in most of the measurements. The maximum tooth size difference was 0.15 mm, and the average difference in model overlap was 53 µm. Digital models produced by scanning impressions at a high resolution using CBCT can be used in clinical practice.

Accuracy of casts produced from conventional and digital workflows: A qualitative and quantitative analyses

PURPOSE: Comparing the accuracy of casts produced from digital workflow to that of casts produced from conventional techniques. MATERIALS AND METHODS: Whole arch alginate (ALG) and polyvinyl siloxane (PVS) impressions were taken with stock trays and custom trays, respectively. The ALG impressions were poured with type III dental stone, while the PVS impressions were poured with type IV dental stone. For the digital workflow, IOS impressions were taken and physical casts were produced by 3D printing. In addition, 3D printed casts were produced from images obtained from a laboratory scanner (LS). For each technique, a total of 10 casts were produced. The accuracies of the whole arch and separated teeth were virtually quantified. RESULTS: Whole arch cast accuracy was more superior for PVS followed by LS, ALG, and IOS. The PVS and ALG groups were inferior in the areas more susceptible to impression material distortion, such as fossae and undercut regions. The LS casts appeared to have generalized errors of minor magnitude influencing primarily the posterior teeth. The IOS casts were considerably more affected at the posterior region. On the contrary, the IOS and LS casts were more superior for single tooth accuracy followed by PVS and ALG. CONCLUSION: For whole arch accuracy, casts produced from IOS were inferior to those produced from PVS and ALG. The inferior outcome of IOS appears to be related to the span of scanning. For single tooth accuracy, IOS showed superior accuracy compared to conventional impressions.

Comparison of displacement of polyvinyl chloride and silicone left-sided double-lumen tubes during lateral positioning / 대한마취과학회지

BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906). CONCLUSION: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.

Effectiveness of Polyvinyl Acetate Sheeted with Carboxymethyl Cellulose as a Packing Material after Septoplasty

BACKGROUND AND OBJECTIVES: Although polyvinyl acetate (Merocel®) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet (Rhinocel®) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. SUBJECTS AND METHOD: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with Rhinocel® and the other one with Merocel®. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. RESULTS: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, Rhinocel® was significantly more comfortable while in situ and less painful on removal than Merocel®, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. CONCLUSIONS: The use of Rhinocel® after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to Merocel® packing. Therefore, Rhinocel® may be a useful packing material after septoplasty.

Comparison of Intubation Efficiency by Suction Device in a Hemorrhagic Airway Manikin Model: Yankauer Suction Tip vs. Polyvinyl Chloride Catheter Suction Tip

PURPOSE: Tracheal intubation in a hemorrhagic airway is a difficult procedure because the visibility can be obscured by blood or vomitus. Several devices and methods have been developed to overcome such obstacles, but they are not available at all practical sites. Therefore, this study was conducted to assess the time and success rate of tracheal intubation according to the type of suction tip used in a hemorrhagic airway manikin model. METHODS: This study was a randomized crossover manikin simulation study. We recruited 18 emergency physicians to perform intubation with suction using a Yankauer suction tip and a polyvinyl chloride (PVC) catheter suction tip in a hemorrhagic airway manikin model. We then measured the time and success rate of intubation for each suction tip. RESULTS: The mean intubation time using the Yankauer suction tip was 42.3 seconds, and the mean intubation time using the PVC catheter suction tip was 91.1 seconds (p < 0.001). Two cases of esophageal intubation occurred when the PVC catheter suction tip was used (success rate, 88.9%). In contrast, there was no esophageal intubation when the Yankauer suction tip was used (success rate, 100%) (p=0.217). CONCLUSION: Intubation of a hemorrhagic airway manikin model can be performed in a shorter time when a Yankauer suction tip is used than when a PVC catheter suction tip is used.

Comparison of Three-Dimensional Accuracy between Digital Models Obtained from Impression Scan and Model Scan / 대한치과재료학회지

The purpose of the study is to compare and analyze the accuracy of digital images obtained from impression and stone model with model scanner and to find out clinical effectiveness. A mandibular left first molar composite resin tooth was made for abutment. Digital models were obtained with a same model scanner(Ceramill Map 400, Amann Girrbach, Austria); (1) Fabricated resin model was scanned(Group C). (2) 10 impressions were taken with putty and polyvinyl siloxane, then were scanned (Group I). (3) Type IV stone was poured in each impressions made in step(2) and 10 stone models were scanned(Group S). 3 dimensional super-impositional program (Geomagic control X, 3D Systems, USA) was used to analyze the STL files. Stone model scan(Group S) showed lower deviation than impression scan(Group I) compared to the control group(P < 0.001). Both Group I and Group S showed signs of expansion in the occlusion surface and margin surface while showing contraction in the axial surface. The deviations were smaller in order of occlusal plane, horizontal plane of margin and axial plane. Within the limited boundary of this study, the digital model obtained from stone model scan showed smaller deviation than the digital model obtained from impression scan.

Determination of the effective anticandidal concentration of denture cleanser tablets on some denture base resins

Abstract Objective Although the effectiveness of chemical cleansing against Candida albicans biofilm has been shown, the effective concentration of denture cleanser tablets has not been studied. The aim of this study was to assess the effect of three denture materials against Candida albicans biofilm and to determine effective concentrations of denture cleanser tablets. Material and methods The surface-roughness of Acron-hi™, QC-20™ and Deflex™ (n=45 per resin) resins was standardized by using a profilometer and their contact angle or surface free energy was calculated. C. albicans biofilm was formed on all three resins and were treated with Polident 3 min™, Corega™ and Fittydent™ cleanser solutions at various concentrations and both resin-biofilm and cleanser-biofilm interest were determined by using a MTT protocol according to the European Committee on Antimicrobial Susceptibility Testing's antifungal susceptibility testing (AFST-EUCAST). Scanning electron microscopy was used to compare the efficacy of different resin materials against C. albicans biofilm. Anticandidal activity and surface free energy statistical parameters were calculated by using 3-way and 1-way ANOVA, respectively (p<0.05). Results Polident 3 min™ and Corega™ tablets significantly inhibited (p<0.05) the proliferation of C. albicans against all denture resins at 27-37 mg/mL. Scanning electron microscopy results indicated that there was no significant difference among resin specimens regarding biofilm formation on dentures. We failed to find a significant relationship between surface free energy and the anticandidal effect of resin types. However, the polarity value of the resins was statistically associated with their anticandidal activity. Conclusions The polarity of the resins, the concentrations of tablets and the chemical content of the cleanser may directly affect C. albicans biofilm formations. Polident 3 min™ and Corega™ tablets should be suggested for patients who use any denture resin types, whereas the Fittydent™ tablet should only be proposed for those who use Deflex™, when two tablets are dropped into 150 mL water.

Comparison of MPure-12 Automatic Nucleic Acid Purification and Chelex-100 Method / 法医学杂志

<p><b>OBJECTIVES</b>To explore the forensic application value of MPure-12 automatic nucleic acid purification （MPure-12 Method） for DNA extraction by extracting and typing DNA from bloodstains and various kinds of biological samples with different DNA contents.</p><p><b>METHODS</b>Nine types of biological samples, such as bloodstains, semen stains, and saliva were collected. DNA were extracted using MPure-12 method and Chelex-100 method, followed by PCR amplification and electrophoresis for obtaining STR-profiles.</p><p><b>RESULTS</b>The samples such as hair root, chutty, butt, muscular tissue, saliva stain, bloodstain and semen stain were typed successfully by MPure-12 method. Partial alleles were lacked in the samples of saliva, and the genotyping of contact swabs was unsatisfactory. Additional, all of the bloodstains （20 μL, 15 μL, 10 μL, 5 μL, 1 μL） showed good typing results using Chelex-100 method. But the loss of alleles occurred in 1 μL blood volume by MPure-12 method.</p><p><b>CONCLUSIONS</b>MPure-12 method is suitable for DNA extraction of a certain concentration blood samples．Chelex-100 method may be better for the extraction of trace blood samples．This instrument used in nucleic acid extraction has the advantages of simplicity of operator, rapidity, high extraction efficiency, high rate of reportable STR-profiles and lower man-made pollution.</p>

Abdomen abierto y contenido: sistema "no comercial - hand made" en pacientes traumatizados. Alternativa terapéutica en situaciones con bajos recursos. ¿Es una opción segura y eficiente? / Open abdomen and content in "non commercial hand made system" in trauma patients Therapeutic alternative in situations with low resources. Is it a safe and efficient option?

Introducción: En la década del '80 se iniciaron los conceptos de laparotomía y relaparotomías. La hipertensión intraabdominal, la cirugía del control del daño, la necesidad de reexploración por packing hemostáticos o las colecciones abdominales son las indicaciones para considerar un abdomen abierto y contenido. A lo largo de los años distintos sistemas de contención del abdomen fueron comercializados, reduciendo la mortalidad a 7 %. Objetivos: El problema es la disponibilidad del recurso dado su alto costo en instituciones con bajo presupuesto. El objetivo es analizar la efectividad y seguridad del método propuesto para aplicar en medios donde el recurso no está disponible en su forma comercial. Material y Método: Realizado entre el 01 de enero 2015 y Julio de 2016, 10 pacientes fueron tratados con abdomen abierto y contenido "no comercial ­hand made". Consiste en la aplicación de un film de polivinilo, multifenestrado, ubicado en la cavidad abdominal por debajo del peritoneo. Sobre ésta, una cubierta de poliuretano y gasas que envuelve una sonda tipo K9. Un film adhesivo cubre toda la incisión, aplicándose una presión negativa de 100 a 150 cm de agua. En un solo caso se utilizó el Wittmann Patch. Resultados: En 7 pacientes se hallaron lesiones combinadas. Lesión hepática: 7; 2 presentaban hipertensión intraabdominal con dificultad para el afrontamiento abdominal. Packing pancreático duodenal: 1. Contaminación de la cavidad: 1. La cantidad de exploraciones fue de 9 y de 3 lavados en promedio. Conclusiones: El sistema "no comercial ­hand made" es un método seguro, de bajo costo y con baja de tasa de complicaciones

Introduction: In the decade of the'80 the concept of laparotomy and relaparotomies began. Intra-abdominal hypertension, damage control surgery, need for re ­examination by hemostatic packing or abdominal collections are indications to consider perfoming the open and contained abdomen. Throughout the years different systems of containment of the abdomen were commercialized. reducing mortality to 7%. Objectives: To analyze the effectiveness and safety of the method proposed to be applied where the resource is not available in its commercial way Material and Methods: In the period between January 1, 2015 and July 2016, 10 patients were treated with open abdomen and "non-commercial -hand made" contents. Consists in the application of a multilayer polyvinyl film of 80 microns, located in the abdominal cavity below the peritoneum, surpassing it inwards by 5 cm. A layer of polyurethane and gauze is placed over this layer, which envelops a polyvinyl probe type K9, until it reaches the edge of the wound. An adhesive film covers the whole incision and passes it by 15 cm, while applying a negative pressure of 100 to 150 cm of water. In only one case the technique described by Dietmar Witmann, the Wittmann Patch was used. Results: Combined lesions were found in 7 patients. Liver injury: 7; 2 also presented HIA with difficulty for abdominal coping. Packing Pancreatic duodenal 1. Cavity contamination: 1. The number of scans was 9 and 3 washes on average. Conclusions: The "non -commercial -hand made" system is a safe, low -cost and low complication rate.

Glaucoma secundário a fístula carótido-cavernosa / Secondary glaucoma following carotid cavernous fistula

RESUMO As fístulas carótido-cavernosas são uma causa rara, porém grave, de glaucoma secundário por aumento da pressão venosa episcleral. Apresenta-se um caso de uma mulher de 72 anos, negra, atendida no Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (HC-UFTM) com dor, sensação de pulsação, proptose, engurgitamento episcleral e quemose em olho direito, com aumento da pressão intraocular (PIO) apesar do uso de mediação anti-glaucomatosa. Na arteriografia foi evidenciada fístula dural para o seio cavernoso à direita, com refluxo para as veias orbitárias ipsilaterais. Realizou-se tratamento com agente líquido de embolização e, após o tratamento cirúrgico, apresentou melhora completa da proptose e congestão dos vasos episclerais, porém manteve PIO aumentada e desenvolvimento de glaucoma de ângulo fechado pela presença de goniossinéquias em 270º, com controle satisfatório com medicação.

ABSTRACT Carotid-cavernous fistulas are a major cause of secondary glaucoma due to increased episcleral venous pressure. We present the case of a 72-year-old female patient, treated at the Hospital de Clínicas at the Universidade Federal do Triângulo Mineiro (HC-UFTM), with pain, proptosis, episcleral engorgement, chemosis and pulsation in the right eye, with increased intraocular pressure (IOP) on anti-glaucomatous medication.Arteriography showed dural fistula to the right cavernous sinus, with reflux to orbital veins.Treatment with liquid embolization agent was performed, following full recovery of proptosis and congestion of the episcleral vessels. However, the patient maintained increased IOP because of narrow-angle glaucoma development due to the presence of goniosynechiae in 270º, which was controlled satisfactorily with medication.

Onyx embolization for treatment of dural arteriovenous fistula: comparison of long- distance versus routine injection method / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the efficacy, clinical characteristics, safety, injection time and radiation exposure of Onyx embolization using a long-distance injection method and routine injection method for management of dural arteriovenous fistula (DAVF).</p><p><b>METHODS</b>The clinical data were retrospectively analyzed in 59 patients with DAVF treated with Onyx embolization using long-distance injection method (28 patients) and routine injection method (31 patients). The efficacy, safety, injection time and radiation exposure during Onyx embolization were compared between the two injections methods.</p><p><b>RESULTS</b>The average radiation dose exposure to the surgeon per procedure was significantly lower in the long-distance injection group than in the routine group. The injection time (P=0.53), injection volume (P=0.78), number of supply arteries (P=0.80), Cognard types (P=0.67), and effect of embolization (P=0.88) were all similar between the two groups.</p><p><b>CONCLUSION</b>Endovaseular treatment of intracranial DAVF with Onyx embolization using the long-distance injection method is feasible, safe and effective and can reduce the radiation exposure to the surgeon.</p>

Rescuing axons from degeneration does not affect retinal ganglion cell death

After a traumatic injury to the central nervous system, the distal stumps of axons undergo Wallerian degeneration (WD), an event that comprises cytoskeleton and myelin breakdown, astrocytic gliosis, and overexpression of proteins that inhibit axonal regrowth. By contrast, injured neuronal cell bodies show features characteristic of attempts to initiate the regenerative process of elongating their axons. The main molecular event that leads to WD is an increase in the intracellular calcium concentration, which activates calpains, calcium-dependent proteases that degrade cytoskeleton proteins. The aim of our study was to investigate whether preventing axonal degeneration would impact the survival of retinal ganglion cells (RGCs) after crushing the optic nerve. We observed that male Wistar rats (weighing 200-400 g; n=18) treated with an exogenous calpain inhibitor (20 mM) administered via direct application of the inhibitor embedded within the copolymer resin Evlax immediately following optic nerve crush showed a delay in the onset of WD. This delayed onset was characterized by a decrease in the number of degenerated fibers (P<0.05) and an increase in the number of preserved fibers (P<0.05) 4 days after injury. Additionally, most preserved fibers showed a normal G-ratio. These results indicated that calpain inhibition prevented the degeneration of optic nerve fibers, rescuing axons from the process of axonal degeneration. However, analysis of retinal ganglion cell survival demonstrated no difference between the calpain inhibitor- and vehicle-treated groups, suggesting that although the calpain inhibitor prevented axonal degeneration, it had no effect on RGC survival after optic nerve damage.

Marginal and internal fit of zirconia copings obtained using different digital scanning methods

Abstract The objective of this study was to evaluate the marginal and internal fit of zirconia copings obtained with different digital scanning methods. A human mandibular first molar was set in a typodont with its adjacent and antagonist teeth and prepared for an all-ceramic crown. Digital impressions were made using an intraoral scanner (3Shape). Polyvinyl siloxane impressions and Type IV gypsum models were also obtained and scanned with a benchtop laboratory scanner (3Shape D700). Ten zirconia copings were fabricated for each group using CAD-CAM technology. The marginal and internal fit of the zirconia copings was assessed by the silicone replica technique. Four sections of each replica were obtained, and each section was evaluated at four points: marginal gap (MG), axial wall (AW), axio-occlusal edge (AO) and centro-occlusal wall (CO), using an image analyzing software. The data were submitted to one-way ANOVA and Tukey's test (α = 0.05). They showed statistically significant differences for MG, AO and CO. Regarding MG, intraoral scanning showed lower gap values, whereas gypsum model scanning showed higher gap values. Regarding AO and CO, intraoral digital scanning showed lower gap values. Polyvinyl siloxane impression scanning and gypsum model scanning showed higher gap values and were statistically similar. It can be concluded that intraoral digital scanning provided a lower mean gap value, in comparison with conventional impressions and gypsum casts scanned with a standard benchtop laboratory scanner.

Influence of different fillers on the properties of an experimental vinyl polysiloxane

Abstract The aim of the study was to evaluate the effect of the incorporation of different fillers on an experimental vinyl polysiloxane (VPS) at two different concentrations, 20% and 40%. Different fillers were added to an experimental VPS. The study was developed in two stages: (i) incorporation of fillers in different concentrations: (a) 20 wt% fillers, and (b) 40 wt%. The fillers were added to experimental VPS and mixed with a speed mixer; (ii) characterization of experimental VPS; after the base paste and catalyst paste were mixed, the experimental VPS was used to make specimens specifically for each test, which were stored at 23°C for 24 hours. The tests were designed according to the specific standardization for the analysis of tensile strength, detail reproduction, Shore A hardness, and elastic recovery. For analysis of filler size pattern, scanning electron microscopy at 1500× magnification was used. The aerosil OX-50 40% (AE), and pure aluminum hydroxide 40% (PAH) groups presented the highest tensile strength and Shore A hardness values. However, those were the only groups that did not present continuous detail reproduction of an intersection of 20 μm line. The elastic recovery was not statistically significant. The undesirable characteristics of VPS (lowest Shore A hardness and tensile strength) were observed when it was added to the composition of acrylic polymer (AP) and fiberglass (FG) in both concentrations, 20% and 40%. In groups AE and PAH, agglomerates of nanofillers were shown in SEM micrography, while the other groups presented different shapes and fillers sizes.

Refractory Spontaneous Chronic Subdural Hematoma: A Rare Presentation of an Intracranial Arteriovenous Fistula

The author has encountered a 67-year-old man with dural arteriovenous fistula (AVF) presenting as a non-traumatic chronic subdural hematoma (CSDH). This previously healthy patient was hospitalized due to progressive headache with subacute onset. He underwent burr-hole surgery twice for evacuating the left CSDH that was thickest at the posterior temporal area. The operative procedure and finding was not extraordinary, but subdural hematoma slowly progressed for days following the revision surgery. After investigation by super-selective external carotid angiography, a dural AVF found near the transverse-sigmoid sinus was diagnosed. Dural AVF was completely occluded with trans-arterial injecting polyvinyl alchol particles into the petrosquamosal branch of the middle meningeal artery. The patient showed a good neurological outcome with no additional intervention. Brain surgeons have to consider the possibility of dural AVF and perform cerebral angiogram if necessary when they manage the cases that have a spontaneously occurred and repeatedly recurring CSDH.

Oral Bio Dissolving Films in Dentistry: A New Perspective in Treatment Modality.

The environment of oral cavity provides a large surface area for the delivery of drugs bypassing the first pass metabolism in the liver. Hence, the oral cavity is being targeted for providing quicker delivery of drugs for immediate action. However, oral delivery system in the form of tablets/ capsules needs modifications in elderly, children, and unconscious patients because of the fear of choking and aspiration. To overcome these problems much research is being undertaken to develop oral bio dissolving films as an alternative to tablets. The objective of the article was to provide an overview of the composition, advantages and disadvantages, and uses of bio dissolving films in the field of medicine and dentistry.

Preparation and characterization of celecoxib dispersions in soluplus[R]: comparison of spray drying and conventional methods

The present study deals with characterization of dispersions of a poorly water-soluble drug, celecoxib [CLX] in polyvinyl caprolactame-polyvinyl acetate-polyethylene glycol graft copolymer [Soluplus[R] [SOL]] prepared by different techniques. Dispersions of CLX in SOL at different ratios [2:1, 1:1, 1:2, 1:4 and 1:6] were prepared by spray drying, conventional solvent evaporation and melting methods. The solid states of samples were characterized using particle size measurements, optical and scanning electron microscopy, XRPD, DSC and FT-IR. The Gordon-Taylor equation was used to predict the T[g] of samples and the possibility of interaction between CLX and SOL. The solubility and dissolution rate of all samples were determined. Stability of samples was studied at ambient conditions for a period of 12 months. DSC and XRPD analyses confirmed amorphous state of drug in samples. Surprisingly dispersions of CLX:SOL with the ratio of 2:1 and 1:1 showed slower dissolution rate than CLX while other samples showed higher dissolution rate. At 1:2 ratio the spray dried samples exhibited higher dissolution rate than corresponding samples prepared by other methods. However at higher SOL content [1:4 and 1:6], samples prepared by different methods showed similar dissolution profiles. The stability studies showed that there were no remarkable changes in the dissolution profiles and solid state of the drug after 12 months storage at ambient conditions. It was concluded that SOL was a proper carrier to enhance the dissolution rate of CLX. At high SOL ratios the method of preparation of dispersed samples had no effect on dissolution rate, whilst at low SOL content spray drying was more efficient method

Size-dependent toxicity of silver nanoparticles to Glyptotendipes tokunagai

OBJECTIVES: This study aims to evaluate the size-dependent toxicity of spherical silver nanoparticles (Ag NPs) to an endemic benthic organism, Glyptotendipes tokunagai. METHODS: Ag nanoparticles of three nominal sizes (50, 100, and 150 nm) capped with polyvinyl pyrrolidone (PVP-Ag NPs) were used. Their physicochemical properties, acute toxicity (48 hours), and bioaccumulation were measured using third instar larvae of G. tokunagai. RESULTS: The aggregation and dissolution of PVP-Ag NPs increased with exposure time and concentration, respectively, particularly for 50 nm PVP-Ag NPs. However, the dissolved concentration of Ag ions was not significant compared with the median lethal concentration value for AgNO3 (3.51 mg/L). The acute toxicity of PVP-Ag NPs was highest for the smallest particles (50 nm), whereas bioaccumulation was greatest for the largest particles (150 nm). However, larger PVP-Ag NPs were absorbed and excreted rapidly, resulting in shorter stays in G. tokunagai than the smaller ones. CONCLUSIONS: The size of PVP-Ag NPs significantly affects their acute toxicity to G. tokunagai. In particular, smaller PVP-Ag NPs have a higher solubility and stay longer in the body of G. tokunagai, resulting in higher toxicity than larger PVP-Ag NPs.