The efficacy of cotton ball packing after endoscopic sinus surgery: A prospective, randomized, controlled trial.

OBJECTIVE: The blocking of airflow into sinonasal cavity may decrease postoperative crusting and the development of adhesions. The purpose of this study was to investigate the efficacy of cotton ball packing in patients following endoscopic sinus surgery (ESS). METHODS: Thirty nine patients with chronic rhinosinusitis requiring the same extent of ESS were included. As a part of postoperative care, the patients were instructed to perform a nasal saline irrigation and apply a nasal spray in each nostril, and then informed to put a cotton ball in a one side of nostril, and the other side was kept to be empty as a control. Patients' subjective symptoms, patients' pain while receiving sinonasal cavity debridement, time required to perform debridement, and postoperative wound healing were evaluated. RESULTS: Although cotton ball packing resulted in less discomfort for postnasal drip, rhinorrhea, headache, and facial pain than no packing, there were no statistically significant differences between the groups. The cotton ball packing was associated with significantly less pain on while performing postoperative debridement, therefore less time was needed to perform debridement. The cotton ball packing appears to improve wound healing within the sinus cavities up to 1 month postoperatively. CONCLUSION: The use of the cotton ball packing after ESS results in significantly less formation of crusts and adhesions, leading to decreasing pain and time during postoperative debridement and promoting faster wound healing.

Ethanol Extract of the Flower Chrysanthemum morifolium Augments Pentobarbital-Induced Sleep Behaviors: Involvement of Cl Channel Activation.

Dried Chrysanthemum morifolium flowers have traditionally been used in Korea for the treatment of insomnia. This study was performed to investigate whether the ethanol extract of Chrysanthemum morifolium flowers (EFC) enhances pentobarbital-induced sleep behaviors. EFC prolonged sleep time induced by pentobarbital similar to muscimol, a GABA(A) receptors agonist. EFC also increased sleep rate and sleep time when administrated with pentobarbital at a subhypnotic dosage. Both EFC and pentobarbital increased chloride (Cl(-)) influx in primary cultured cerebellar granule cells. EFC increased glutamic acid decarboxylase (GAD) expression levels, but had no effect on the expression of α1-, ß2-, and γ2-subunits of the GABA(A) receptor in the hippocampus of a mouse brain. This is in contrast to treatment with pentobarbital, which showed decreased α1-subunit expression and no change in GAD expression. In conclusion, EFC augments pentobarbital-induced sleep behaviors; these effects may result from Cl(-) channel activation.

Comparative proteomic analysis of advanced serous epithelial ovarian carcinoma: possible predictors of chemoresistant disease.

To identify specific proteins associated with chemotherapeutic responses, we analyzed protein expression patterns in stage IIIc primary serous epithelial ovarian cancer tissues displaying differential responses to first-line postoperative adjuvant chemotherapy. The expression profiles of five chemoresistant tissues [progression-free survival (PFS) ≤12 months] and five chemosensitive tissues (PFS ≥48 months) were analyzed with 2D electrophoresis, and the spot intensities of differentially expressed proteins were quantified. To validate these proteins as markers for chemoresistant disease, we analyzed tissues from an additional 17 patients. All the patients were allocated to the over- or underexpressing group according to protein spot intensity, and survival analysis was performed. In chemoresistant tissues, four proteins (thioredoxin domain containing four, similar to RIKEN cDNA 1700016G05, tubulin α 1A chain, and the pyruvate dehydrogenase E1-ß subunit precursor) were overexpressed, and seven proteins [keratin 1, vitamin D-binding protein, creatine kinase B, annexin V, SH3-containing guanine nucleotide exchange factor (SGEF), tryptophan-aspartate repeat protein-1 (WDR 1), and WDR 1 isoform 1] were underexpressed. The underexpression of keratin 1, creatine kinase B, annexin V, SGEF, WDR1, and WDR1 isoform 1 were significantly correlated with poor overall survival. A combination of keratin 1 and SGEF showed the highest sensitivity of 0.800, specificity of 0.917, PPV of 0.800, and NPV of 0.917 in predicting chemoresistant disease. These proteins may be useful as predictive markers of chemoresistant disease. However, further analyses in large-scale should be performed before they can be considered reliable predictive markers of chemoresistant disease.

Green tea extract increases cyclophosphamide-induced teratogenesis by modulating the expression of cytochrome P-450 mRNA.

The effects of green tea extract (GTE) on the fetal development and external, visceral and skeletal abnormalities induced by cyclophosphamide were investigated in rats. Pregnant rats were daily administered GTE (100mg/kg) by gavage for 7 d, from the 6th to 12th day of gestation, and intraperitoneally administered with cyclophosphamide (11mg/kg) 1h after the final treatment. On the 20th day of gestation, maternal and fetal abnormalities were determined by Cesarian section. Cyclophosphamide was found to reduce fetal and placental weights without increasing resorption or death. In addition, it induced malformations in live fetuses; 94.6%, 41.5% and 100% of the external (skull and limb defects), visceral (cleft palate and ureteric dilatation) and skeletal (acrania, vertebral/costal malformations and delayed ossification) abnormalities. When pre-treated with GTE, cyclophosphamide-induced body weight loss and abnormalities of fetuses were remarkably aggravated. Moreover, repeated treatment with GTE greatly increased mRNA expression and activity of hepatic cytochrome P-450 (CYP) 2B, which metabolizes cyclophosphamide into teratogenic acrolein and cytotoxic phosphoramide mustard, while reducing CYP3A expression (a detoxifying enzyme). The results suggest that repeated intake of GTE may aggravate cyclophosphamide-induced body weight loss and malformations of fetuses by modulating CYP2B and CYP3A.

The parthenogenetic activation of canine oocytes with Ca-EDTA by various culture periods and concentrations.

In the present study, canine oocytes were exposed to various concentrations of and durations of exposure to EDTA saturated with Ca(2+) (Ca-EDTA), a cell membrane-impermeable metal ion chelator, to determine if parthenogenetic activation could be induced. When oocytes were cultured for 48 or 72 h in parthenogenetic activation medium (PAM) without Ca-EDTA (control) or PAM supplemented with 1 or 5mM Ca-EDTA, the highest rate of pronuclear formation (PN) was obtained in oocytes cultured in 1mM Ca-EDTA for 48 h (8.0%; P<0.05). There was no pronuclear formation in the control group (PAM without Ca-EDTA). Oocytes treated with 5mM Ca-EDTA for 48 h or 1mM Ca-EDTA for 72 h formed a parthenogenetic pronucleus (3.1 and 4.5, respectively). However, there was no pronuclear formation in oocytes treated with 5mM Ca-EDTA for 72 h. In summary, exposure to Ca-EDTA can induce pronuclear formation in canine oocytes.

Extracorporeal pelvic floor magnetic stimulation in children with voiding dysfunction.

OBJECTIVE: To determine the effect of extracorporeal pelvic floor magnetic stimulation in children with an overactive bladder, as although such stimulation is an effective treatment for voiding dysfunction such as urge incontinence (UI) and urgency-frequency syndrome, experience in children is scarce. PATIENTS AND METHODS: This prospective study included 42 children diagnosed with an overactive bladder, based on urodynamic or video-urodynamic study; a complete follow-up was available in 34. The children were grouped into those with UI only, not monosymptomatic nocturnal enuresis (nMNE), or MNE, according to their symptoms. Clinical variables were assessed by recording a voiding and nocturnal enuresis diary before and after magnetic stimulation, the latter being administered twice a week for 4 weeks using a size-adjusted magnetic chair (each session took 20 min). RESULTS: The UI only and nMNE group had a significant decrease in voiding frequency and frequency of UI (P < 0.05); the MNE group also had a significant decrease in voiding frequency (P < 0.05). There was a significant increase in functional bladder capacity in all groups (P < 0.05) but no significant decrease in the mean volume and frequency of NE in the nMNE and MNE groups (P > 0.05). CONCLUSIONS: Extracorporeal pelvic floor magnetic stimulation has an acute effect on voiding dysfunction such as urge syndrome in children. However, controlled studies with a sham-stimulation group and various durations of stimulation are necessary for its application as a primary treatment for voiding dysfunction in children.

Intravesical electrical stimulation improves neurogenic bowel dysfunction in children with spina bifida.

PURPOSE: We observed concomitant improvement in fecal incontinence in children with myelomeningocele undergoing intravesical electrical stimulation (IVES) to decrease uninhibited bladder contractions and increase bladder capacity and/or bladder sensation. We retrospectively reviewed the effect of intravesical electrical stimulation on neurogenic bowel dysfunction in these children. MATERIALS AND METHODS: A total of 9 boys and 15 girls 3.9 to 13.2 years old (mean age 8.1) completed a mean of 30.3 daily sessions (range 10 to 69) of IVES. Evaluation forms were used to record frequency of fecal incontinence, daily bowel movement and diaper use before and after IVES. RESULTS: The mean number of overall fecal incontinence episodes decreased significantly from 7.36 to 4.8 a week after IVES (p <0.05). Greater than 50% decrease in the episodes of fecal incontinence was observed in 75% of the patients. However, there was no significant change in the number of daily bowel movements before (1.8 daily) and after (1.55 daily) IVES. CONCLUSIONS: These results demonstrate the therapeutic effect of IVES in children with neurogenic bowel dysfunction and spina bifida. We believe that IVES is another viable option for controlling fecal incontinence in these children.

Changes in lipid peroxidation and antioxidant trace elements in serum of women with cervical intraepithelial neoplasia and invasive cancer.

This study investigated serum lipid peroxidation, antioxidant capacity, and trace element levels in Korean women as related to uterine cervical neoplasia. Twenty-eight subjects had cervical intraepithelial neoplasia (CIN), 36 had invasive cervical cancer, as determined by a colposcopically directed biopsy, and controls included 44 subjects with normal colposcopic findings. Significantly lower selenium (Se) and zinc (Zn) levels and higher copper/Zn ratios were found in both CIN and cancer patients compared with the controls. Serum malondialdehyde levels decreased significantly in the order CIN>cancer>control, implying the involvement of reactive oxygen species at the precancerous stage, that is, prior to progression into invasive cervical cancer. Serum glutathione peroxidase activity was significantly lower in patients with CIN or cancer than controls, and total antioxidant ability decreased from controls to CIN to cancer (P < 0.0001). This study demonstrated the involvement of lipid peroxidation, decreased Se and Zn levels, and an impaired serum antioxidant system in the pathogenesis of cervical dysplasia. Further research is needed to examine the possibility of an effective chemopreventive treatment in cervical cancer based on enhancing the endogenous antioxidant system.