Transnasal endoscopic management of angiofibroma extending to pterygopalatine and infratemporal fossae.

INTRODUCTION: Surgical approaches to the pterygopalatine and infratemporal fossae are complex and cause significant morbidity. The commonest benign tumour to extend to the pterygopalatine and infratemporal fossae is angiofibroma. PATIENTS AND METHODS: This prospective study included 15 male patients aged 12-27 years with recurrent, severe epistaxis. After computed tomography and magnetic resonance imaging, a modified Wormald and Robinson's two-surgeon approach was used. Follow up, with endoscopy and magnetic resonance imaging, ranged from two to five years. RESULTS: Twelve patients were cured (endoscopically and radiologically). Three patients suffered recurrence, one each in the lateral sphenoid wall, pterygoid canal and infratemporal fossa. Revision surgery was performed, but one patient suffered another recurrence (lateral sphenoid wall with cavernous sinus infiltration) and was referred for gamma knife surgery. CONCLUSION: This endoscopic two-surgeon technique is an excellent approach for managing angiofibroma extending to the pterygopalatine and infratemporal fossae. Our modification markedly decreased morbidity by avoiding septum opening and sublabial incision, and by enabling better haemostasis (via maxillary artery control). Recurrence may be minimised by careful examination of the lateral sphenoid wall, pterygoid canal and infratemporal fossa pterygoid muscles.

Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction.

OBJECTIVE: This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the detection of fungi in sinus aspirate by culture and by polymerase chain reaction assay, and to relate the presence of fungi in the nasal sinuses to the type of fungal allergen causing disease. METHODS: Sixty-eight cases of allergic fungal rhinosinusitis underwent fungal culture and polymerase chain reaction assay for universal fungal, aspergillus and bipolaris DNA. Aspergillus-specific immunoglobulin E levels were measured in sinus aspirate, and total serum immunoglobulin E levels were calculated. A control group of 10 cases was included in the study. RESULTS: Of the 68 allergic fungal rhinosinusitis cases, only 42 (61.7 per cent) had positive fungal cultures; of the 10 controls, only three (30 per cent) had positive cultures. Species from the dematiaceous family were most commonly grown, being isolated in 30 cases (71.4 per cent). Bipolaris was the most commonly isolated species (18 cases) followed by curvularia (11 cases) and alternaria (one case). Polymerase chain reaction assay detected fungal DNA in all the allergic fungal rhinosinusitis cases and also in four controls (40 per cent). Ten patients (of 68; 14.7 per cent) were positive for Aspergillus fumigatus specific immunoglobulin E. The mean concentration of this immunoglobulin was 11.32 +/- 4.12 IU/ml in patients and 0 IU/ml in controls, a statistically significant difference. CONCLUSION: Detection of fungal DNA in nasal aspirate by polymerase chain reaction was superior to fungal cultures as a method of detecting fungal growth. In allergic fungal rhinosinusitis, fungal growth is not always accompanied by an allergic reaction.

Surface and biocidal activity of some synthesized metallo azobenzene isothiouronium salts.

A novel series of azobenzene isothiouronium salts of different alkyl chains (propyl, hexyl and dodecyl) were synthesized by reaction of 4-((4-methylphenyl)azo)phenol with 1,3-dibromopropane, 1,6-dibromohexane and 1,12-dibromododecane, respectively. These salts were reacted with copper (II) halide to give their corresponding metallo complexes. The surface tension measurements for the synthesized compounds show that the metallo complexes have adsorption and micellization better than that of the parent azobenzene isothiouronium salts. The pathogenic Gram-negative bacteria, Gram-positive bacteria, fungi and yeast were used to determine the biocidal activity of these compounds using gradient plate technique. The results indicate that the copper complexes of the synthesized azobenzene isothiouronium salts have a relatively better biocidal activity than the parent salts.

Removal of copper(II) from some environmental samples by sorptive-flotation using powdered marble wastes as sorbents and oleic acid as surfactant.

A simple and economic experimental sorptive -flotation procedure is presented for the removal of copper(II) species from aqueous solutions. It is based on using powdered marble wastes (PMW), which are widespread and inexpensive and may represent an environmental problem, as the effective inorganic sorbent and oleic (HOL) as the surfactant. The main parameters (i.e. initial solution pH, sorbent, surfactant and copper concentrations, stirring times, ionic strength, temperature and the presence of foreign ions) influencing the flotation of PMW and /or Cu(II) were examined. Nearly, 100% of PMW and Cu(II) were removed from aqueous solutions at pH7 after stirring for 10 min and at room temperature, (approximately 25 degrees C). The procedure was successfully applied to recover Cu(II) spiked to some natural water samples. A mechanism for sorption and flotation is suggested.