The assessment of airbag deployment and seatbelt use in preventing facial injuries.

This study aimed to determine the effectiveness of airbags and seatbelts in the prevention of facial fractures and slight facial injuries in relation to the speed and kinetic energy experienced in frontal collisions. All cases of vehicle occupants who had been in frontal collisions and had subsequently been examined in the Institute for Emergency Medical Assistance and the Clinical Center of Montenegro in 2017 were analyzed. There were 29 cases of facial fractures (Group 1), 35 cases of slight facial injuries (including nondisplaced nasal fractures) (Group 2), and 26 cases of occupants who had suffered no facial injuries (control Group 3). In all assessed cases all of the subjects had been wearing a seatbelt and the airbag had deployed at the time of impact. A frontal collision is defined as a collision in which the principal force acts within a range of 90° from the longitudinal axis of the vehicle. Using the mass and the speed of the vehicles, the total kinetic energy (KE) of all frontal collisions being analyzed was calculated. The cut-off value of total KE in frontal collisions that were associated with either facial fractures or slight facial injury was estimated using a receiver operating characteristic (ROC) curve. The cut-off amounts of KE were then used to calculate the barrier equivalent velocity (BEV). The BEV for a vehicle of average mass was estimated to be 55.7 km/h (34.6 mph) in Group 1, and 49.2 km/h (30.6 mph) in Group 2. Airbags and seatbelts are effective in preventing facial injuries in vehicles of average mass that are traveling at speeds under 49.2 km/h (30.6 mph) at the point of impact, but they do not protect from facial fractures when the vehicle speed exceeds 55.7 km/h (34.6 mph).

Immunoregulatory cytokines and chronic tonsillitis.

The purposes of the present study were to determine the distribution of cells producing cytokines: tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in different morphological sections of tonsils in patients with tonsillar hypertrophy (TH) and recurrent tonsillitis (RT), to analyze the level of production of these cytokines in TH and RT and evaluate the potential of peripheral blood lymphocytes for production of interferon-γ (IFN-γ) and interleukin 4 (IL-4). Analyzed materials consisted of the tonsils after tonsillectomy and blood taken from patients right before tonsillectomy (study group) and blood taken from healthy donors (control group).We used histological and immunohistochemical method, morphometric methods for the quantification of TNF-α and IL- 6 producing cells and immunological methods for determining the concentration of IFN-γ and IL-4. Most of TNF-α producing cells are settled in the subepithelial region (55%). Numerical density of TNF-α producing cells in the crypt epithelium, subepithelial and interfollicular region was significantly higher in RT compared with TH. The concentration of IFN-γ is three times higher in RT then in TH. After the stimulation of peripheral blood lymphocytes in culture there was no significant increase in concentrations of IL- 4. The index of stimulation of IFN-γ was the highest in the RT, and of IL- 4 in TH. The production of Th1-type cytokines (TNF-α and IFN-γ) is higher in RT compared with TH. In both forms of tonsillitis, production of Th1-type cytokines is higher in relation to the production of Th2-type cytokines (IL-6 and IL-4).

Investigation of oxidative stress in patients with chronic tonsillitis.

OBJECTIVES: Oxidative stress has been implicated in numerous pathological conditions including chronic tonsillitis. The aim of this study was to assess levels of lipid peroxidation, evidenced by formation of thiobarbituric acid reactive substance (TBARS), level of total sulfhydryl groups (TSH), and carbonyl content in patients with tonsillar hypertrophy (TH) and recurrent tonsillitis (RT), before and after tonsillectomy. METHODS: In this study the serum and tonsillar tissue levels of TBARS, TSH and carbonyl content were investigated in 35 patients with TH and RT, before and 1 month after the operation, compared to 30 age-matched controls. RESULTS: In both TH and RT groups, a significantly higher serum TBARS levels were observed before and 4 weeks after tonsillectomy in comparison with healthy subjects. The serum level in TH patients after operation was even higher compared to the levels before. There was statistically significant difference in serum TSH levels between patients with RT before operation compared to the control group. After tonsillectomy the serum levels of TSH were higher compared to control groups and TH and RT patients before operation. Carbonyl content was attenuated only in TH patients after tonsillectomy. In tonsillar tissue, significantly lower level of glutathione content (GSH) has been observed in RT related to TH patients. CONCLUSIONS: Oxidative stress, in patients with tonsillar hypertrophy and recurrent tonsillitis, is still present 1 month after the removal of tonsillar tissue. Antioxidant therapy, during the recovery period after tonsillectomy, could be optional treatment.

Distribution of dipeptidyl peptidase IV in patients with chronic tonsillitis.

In the pathogeneses of recurrent tonsillitis (RT) and tonsillar hypertrophy (TH), different immunological mechanisms are involved. Dipeptidyl peptidase IV (DPP IV) and aminopeptidase N (APN) participate in the regulation of the immune response during inflammation. In this study, the localization of DPP IV and the enzymatic activities of DPP IV and APN in 32 patients, 13 with RT and 19 with TH, who underwent tonsillectomy were investigated. The localization of DPP IV in tonsils was studied using histochemical and immunohistochemical methods. The enzymatic activities of DPP IV and APN in tonsillar lymphocytes and the patients' sera were determined kinetically at 37 degrees C using Gly-Pro-p-nitroanilide (for DPP IV) and Ala-p-nitroanilide (for APN) as chromogenic substrates. In samples from both RT and TH patients, DPP IV was found to localize mainly in extrafollicular areas of tonsillar tissue in a pattern corresponding to the T-cell distribution. Significantly higher (P < 0.001) levels of DPP IV and APN activities in sera from patients with TH than in sera from patients with RT were found. A correlation of DPP IV activities in sera and tonsillar lymphocytes from patients with TH was also found (r = 0.518; P < 0.05). Moreover, the results show that DPP IV and APN activities in sera decreased significantly with age. Tonsillar lymphocytes demonstrated a wide range of DPP IV and APN activities, without significant differences between the investigated groups. The results of this study show that the localization of DPP IV does not depend on the type of tonsillitis, whereas the variety in levels of DPP IV and APN activities in sera of patients with TH and RT suggests different patterns of participation of antigen-stimulated tonsils in the immune system.