Biobrane dressing for paediatric burns in Singapore: a retrospective review

<p><b>INTRODUCTION</b>The ideal burn dressing for children should aim to alleviate pain, decrease length of hospital stay and minimise complications such as conversion and infection. The current literature is still inconclusive with regard to the gold standard burn dressing for the paediatric population.</p><p><b>METHODS</b>We retrospectively reviewed children with superficial partial thickness burns admitted to our paediatric burns unit from January 2014 to April 2015. A total of 30 patients were included in our study, of whom 13 had Biobrane dressing. The remaining 17 patients were treated with conventional silver foam dressing (i.e. Biatain Ag) and served as matched controls. Long-term follow-up scar evaluation was carried out at an average interval of two years after injury.</p><p><b>RESULTS</b>In the Biobrane group, the length of hospital stay was significantly shorter (Biobrane vs. silver foam: 4.76 ± 2.64 days vs. 8.88 ± 5.09 days; p = 0.01) and the infection rate was significantly lower (Biobrane vs. silver foam: 0% vs. 35.3%; p = 0.02). The Biobrane group had no hypergranulation or wound infection and did not require skin grafting. Long-term follow-up scar evaluation did not reveal any statistical difference between the patient groups at the two-year interval.</p><p><b>CONCLUSION</b>Paediatric patients with partial thickness burns treated with Biobrane dressing had shorter hospital stay and lower incidence of infection compared to those treated with conventional silver foam dressing. Biobrane and silver foam dressings did not demonstrate any significant difference in terms of long-term scar outcomes over an average follow-up duration of two years.</p>

The Rolling Earlobe Flap for Dilated Ear Holes Following Ear Gauging: A Novel Approach to Aesthetically Preserving Earlobe Soft Tissue Volume

Patients are increasingly seeking repair of their earlobes following ear gauging. Research has shown that current repair techniques either excessively reduce the lobular volume or leave an obvious scar along the free edge of the earlobe. In our case series, we describe the use of a novel technique for repairing earlobes following ear gauging using a rolling earlobe flap that preserves the lobular volume and avoids leaving a scar on the free edge of the lobule. The procedure was performed on 3 patients (6 earlobes) who had defects from ear gauging that ranged from 3.0 to 6.5 cm. There were no postoperative complications of infection, wound dehiscence, flap necrosis, hypertrophic scars, or keloids, and all patients were highly satisfied with the postoperative results. This versatile technique allows for an aesthetically pleasing reconstruction of the lobule with the advantages of: the absence of a surgical scar on the free edge of the lobule, preserving the lobule volume, and presenting a highly customizable technique that allows lobules to be created with various shapes and volumes.

The Rolling Earlobe Flap for Dilated Ear Holes Following Ear Gauging: A Novel Approach to Aesthetically Preserving Earlobe Soft Tissue Volume

Patients are increasingly seeking repair of their earlobes following ear gauging. Research has shown that current repair techniques either excessively reduce the lobular volume or leave an obvious scar along the free edge of the earlobe. In our case series, we describe the use of a novel technique for repairing earlobes following ear gauging using a rolling earlobe flap that preserves the lobular volume and avoids leaving a scar on the free edge of the lobule. The procedure was performed on 3 patients (6 earlobes) who had defects from ear gauging that ranged from 3.0 to 6.5 cm. There were no postoperative complications of infection, wound dehiscence, flap necrosis, hypertrophic scars, or keloids, and all patients were highly satisfied with the postoperative results. This versatile technique allows for an aesthetically pleasing reconstruction of the lobule with the advantages of: the absence of a surgical scar on the free edge of the lobule, preserving the lobule volume, and presenting a highly customizable technique that allows lobules to be created with various shapes and volumes.

Correlation Study between hMOF Expression and Prognosis in Patients with Non-small Cell Lung Cancer after Radiotherapy / 中国医科大学学报

Objective To investigate the hMOF protein expression in non?small cell lung cancer and explore the relationship between its expres?sion and radiotherapy prognosis. Methods Immunohistochemical staining was used to detect the hMOF expression in 59 cases of non?small cell lung cancer after radiotherapy. The relationship between hMOF expression with clinicopathological and radiation prognosis was analyzed. Results Among the 59 cases of non?small cell lung cancer tissues,there were 30 cases found to be high expression with hMOF. The rate of positive expression of hMOF in non?small cell lung cancer were 50.85%. Clinical stage and hMOF expression were independent predictors for non?small cell lung can?cer. Conclusion The expression of hMOF had a positive correlation with the radiation prognosis in non?small cell lung cancer,which could be used as a prognostic indicator of radiotherapy.

Extensive Necrotizing Fasciitis after Fat Grafting for Bilateral Breast Augmentation: Recommended Approach and Management

No abstract available.

Metformin ameliorates insulin resistance in L6 rat skeletal muscle cells through upregulation of SIRT3 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>SIRT3 is an important regulator in cell metabolism, and recent studies have shown that it may be involved in the pharmacological effects of metformin. However, the molecular mechanisms underlying this process are unclear.</p><p><b>METHODS</b>The effects of SIRT3 on the regulation of oxidative stress and insulin resistance in skeletal muscle were evaluated in vitro. Differentiated L6 skeletal muscle cells were treated with 750 µmol/L palmitic acid to induce insulin resistance. SIRT3 was knocked down and overexpressed in L6 cells. SIRT3, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65, c-Jun N-terminal kinase 1 (JNK1), and superoxide dismutase 2 (SOD2) were evaluated by Western blotting.</p><p><b>RESULTS</b>Over expression of SIRT3 increased glucose uptake and decreased ROS production in L6-IR cells as well as in L6 cells. Knock-down of SIRT3 induced increased production of ROS while decreased glucose uptake in both L6 and L6-IR cells, and these effects were reversed by N-acetyl-L-cysteine (NAC). Metformin increased the expression of SIRT3 (1.5-fold) and SOD2 (2-fold) while down regulating NF-κB p65 (1.5-fold) and JNK1 (1.5-fold). Knockdown of SIRT3 (P < 0.05) reversed the metformin-induced decreases in NF-κB p65 and JNK1 and the metformin-induced increase in SOD2 (P < 0.05).</p><p><b>CONCLUSIONS</b>Upregulated SIRT3 is involved in the pharmacological mechanism by which metformin promotes glucose uptake. Additionally, SIRT3 may function as an important regulator of oxidative stress and a new alternative approach for targeting insulin resistance-related diseases.</p>

Neurogenic heterotopic ossification after a stroke: diagnostic and radiological challenges

Heterotopic ossification (HO) is the aberrant formation of ectopic bone within the soft tissues, of which the aetiology is usually either traumatic or neurogenic. Neurogenic HO is a known but uncommon complication that occurs after a cerebral or spinal insult. The condition may present with a spectrum of symptoms and is often difficult to diagnose clinically. Although different imaging modalities have been used to diagnose HO, clinicians and radiologists may occasionally encounter radiological features of HO that may mimic other disease conditions. We herein report a rare case of neurogenic HO occurring in the non-paretic limb of a patient, and the diagnostic and radiological challenges encountered.

Rescue of the recombinant infectious bronchitis virus with the ectodomain region of H120 spike glycoprotein / 病毒学报

To explore the expression potential of heterogeneous genes using the backbone of infectious bronchitis virus (IBV) Beaudette strain, the ectodomain region of the Spike gene (1,302 bp) of IBV H120 strain was amplified by RT-PCR and replaced into the corresponding location of the IBV Beaudette strain full-length cDNA. This recombinant was designated as BeauR-H120(S1). BeauR-H120(S1) was directly used as the DNA template for the transcription of viral genomic RNA in vitro. Then, the transcription product was transfected into Vero cells by electroporation. At 48 h post-transfection, the transfected Vero cells were harvested, and passaging continued. A syncytium was not observed until the recombinant virus had passed through four passages. The presence of rBeau-H120(S1) was verified by the detection of the replaced ectodomain region of the H120 Spike gene using RT-PCR. Western blot analysis of rBeau-H120 (S1)-infected Vero cell lysates demonstrated that the nucleocapsid (N) protein was expressed, which implied that rBeau-H120(S1) could propagate in Vero cells. The TCIDs0 and EIDs0 data demonstrated that the titer levels of rBeau-H120(S1) reached 10(590+/-0.22)TCID50/mL and 10(6.13+/-0.23)EID50/mL in Vero cells and 9-day-old SPF chicken embryos, respectively. Protection studies showed that the percentage of antibody-positive chickens, which were vaccinated with rBeau-H120(S1) at 7 days after hatching, rose to 90% at 21 days post-inoculation. Inoculation provided an 85% rate of immune protection against a challenge of the virulent IBV M41 strain (103EID50/chicken). This recombinant virus constructed using reverse genetic techniques could be further developed as a novel genetic engineering vaccine against infectious bronchitis.

Effect of metformin on expression of SIRT3 in skeletal muscle of rats with type 2 diabetes / 中华内分泌代谢杂志

[Summary] Type 2 diabetic rat model accompanied by insulin resistance was established by high fat/high glucose diet and streptozotocin.Following metformin treatment for 4 weeks,realtime PCR and Western blot were used to detect the expressions of SIRT3 mRNA and protein in skeletal muscle tissue,respectively.The results showed that insulin sensitivity,superoxide dismutase (SOD),and glutathione (GSH) levels were significantly reduced in diabetic group compared with the control group (P＜0.05),while methane dicarboxylic aldehyde (MDA) level was increased (P＜0.05),along with the decreased expressions of SIRT3 mRNA and protein in skeletal muscles (P＜0.01).After metformin treatment,the insulin sensitivity,SOD,GSH,and SIRT3 mRNA and protein levels were significantly increased (P＜ 0.05 or P＜ 0.01),while MDA level was decreased (P ＜ 0.05),suggesting that metformin may ameliorate insulin resistance via upregulating SIRT3 expression in skeletal muscles of diabetic rats.

A mark-release-recapture experiment with Anopheles sinensis in the northern part of Gyeonggi-do, Korea

In order to study the range of flight and feeding activity of Anopheles sinensis, the dispersal experiment was conducted in Paju city, located in the northern part of Gyeonggi-do, Republic of Korea, during the period of 7th to 28th September 1998. Unfed females An. sinensis were collected in cowshed and released after being marked with fluorescent dye at 23:00 hours on the same day. Released female mosquitoes were recaptured everyday during 21 days using light traps, which were set at 10 sites in the cowsheds located 1, 3, 6, 9 and 12 km north-northwest and north-northeast and at 3 sites located 1, 6 and 9 km toward south-west from the release point. In addition, to study the longest flight distance in one night, we set the light traps at 16 and 20 km toward north-northeast from the release site. All the collected mosquitoes were placed on filter papers and observed on UV transilluminator after treatment with one drop of 100% ethanol. Out of 12,773 females of An. sinensis released, 194 marked females mosquitoes were recaptured, giving 1.52% recapture rate. Of 194, 72 mosquitoes (37.1%) were recaptured in light traps from three places set at 1 km from the release point, 57 mosquitoes (29.4%) from two places at 1-3 km, 41 mosquitoes (21.1%) from three places at 3-6 km, 20 mosquitoes (10.3%) from three places at 6-9 km, and 4 mosquitoes (2.1%) from two places at 9-12 km. Since 170 female mosquitoes (87.6%) out of 194 marked mosquitoes were captured within 6 km from the release point, this flight radius represents the main activity area. An sinensis was found to be able to fly at least 12 km during one night.

1 case of relapsed leprosy accompanied by multiple cranial nerve palsies / 나학회지

It is well known that M. leprae involves peripheral nerves, but it is a few known that M. leprae involves craninal nerves. I experienced one case of relapsed leprosy accompanied by multiple cranial nerve palsies. Revealed symptoms are to involve trigeminal nerve (V). facial nerve (VII), vestibular nerve (VIII), glossopharyngeal nerve (IX), vagus nerve (X). It is not effect to treat with corticosteroid, but is good effect to treat with MDT(multiple drug therapy)

Anlysis of the resalts of the Anti-PGL-1 ELISA Test / 나학회지

We had given the Anti-PGL-1 ELISA test to the 235 leprosy patients in our Hospital from July 1999 to Aug 2000. There are 48 patients(20.4%) who are over 200 PGL-1 Ab score and 11 patients(4.7%) who are over 500. The patients who are over 500 of PGL-1 Ab score are all lepromatous leprosy and they have been treated from 5 to 49 years. Two patients among them are positive patients and 9 patients are to be observed only I think that they need to be followed up and if the score of Ab has incresed. We suspect that those patients will become active.

An Epidemiologic Study on the Health Hazards of Inhabitants chronically exposed to Glass Fiber / 한국역학회지

Fiberglass, as a substitute of asbestos, is used for more than 60 years as a insulator material. Health hazards including irritation of skin, mucosa and respiratory system associated with use of fiberglass is reported. Many studies on the fibrogenicity and carcinogenicity of fiberglass was conducted but evidence is not sufficient to confirm the carcinogenicity or fibrogenicity. Authors studied the health hazards among 152 inhabitants(71 men and 81 women) from 32 households living around the fiberglass factory which produced the fiberglass insulators and glasswool panels for 20 years. Questionnaire survey on household and persons, examination of underground water, pathologic examination of subcutaneous tumors and examination of fiberglass in tumor tissues were done. The results are as follows; 1. Fiberglass concentration of underground water sampled from 33 households in the study area was 13. 7-95. 9 fiber/cc with the diameter to length ratio more than 1:20. 2. Prevalence of dermatosis among study subjects was 23.0 % (35 cases). Prevalence was not associated with the distance from the factory nor duration of exposure. 3. There were 15 cases of subcutaneous tumor with prevalence of 9. 9 %. Age of subcutaneous tumor cases was all above 30 year-old except one cases, who was 5 year old child, who lived in the surveyed area since he was born. Prevalence of subcutaneous tumor was significantly high in area A(42.9 %) than area B(4.6 %, p<0.01). Prevalence of subcutaneous tumor was higher in long-term exposed inhabitants, but was not statistically significant. 4. Pathologic examination exhibits partly encapsulated fat tissue masses and cut surfaces were pale yellow with gritty sensation. The masses consist of mature fat cells showing variation in size and shape. On polarizing microscope, the peripheries of tumors include small irregular threads of doubly refractile material probably represent glass fibers in fibrocollagenous tissue. Concentration of fiberglass in tissue was 5.1-10.2 fiber/rag wet tissue in case 1, 25.8-184.9 fiber/mg wet tissue in case 2 and 40.8-126.5 fiber/mg wet tissue in case 3. Length of fiberglass was shorter than that in underground water. 5. Cases of malignant tumor among inhabitants since last 10 years were 4, 3 of whom was developed in a same household just near the factory. Diagnoses of malignancy cases were stomach cancer, stomach and esophageal cancer, oral cavity cancer, and stomach cancer with liver metastasis. On review examination of tissues of endoscopic biopsy specimen from a case of stomach cancer, there was adenocarcinoma with no evidence of fiberglass materials. Authors concluded there is evidences that fiberglass was strongly associated with the development of the health hazards including dermatosis and benign subcutaneous tumor. However, the association of fiberglass exposure with the development of malignant tumor was not clear, although strongly suggested. For the prevention of development of further health hazards, it is recommended that under ground water source should be closed and further experimental study to confirm the mechanism of the tumorigenesis and follow up survey on the inhabitants should be conducted.

Signs and symptoms of nicotine withdrawal and adverse effects of nicotine patch

No abstract available.

Signs and symptoms of nicotine withdrawal and adverse effects of nicotine patch

No abstract available.

Cardiac Arrest During Pediatric Anesthesia / 대한마취과학회지

It is a well known that cardiac arrest can occur during general anesthesia. We had experienced of a cardiac arrest during anesthsia in a child with halothane just after the use of a thiopental sodium and vecuronium bromide. When the cardiac asystole was noted by E.C.G., immediate treatment was performed. In this case, We think that Cardiac arrest being related to several factors, anxiety about operation, rough sugical maniplation, light anesthesia and drugs.

Spinal Anesthesia with 0.25 % Hyperbaric Bupivacaine : Effect of Different Dosage / 대한마취과학회지

Authors selected 54 patients in ASA class I, II, aged from 20 to 60 years old undergoiag operations of lower limbs and lower abdomen. In the different dosage of 0.25% hyperbaric bupivacaine, these were divided into 3 groups ; group A(22 patients) using l0 mg(4 ml), group B(17 patients) using 15 mg(6 ml), group C(15 patients) using 20 mg(8ml), which were injected into subarachnoid space. The following results were obtained. I) Maimum level of sensory loss was significantly increased with increase dosage, and the time of onset was significantly faster with decrease dosage. 2) Duratioan of sensory loss was significantly longer with increase dosage. 3) Onset time of motor block was signficantly faster in the group C of Bromages scale degree l, Duration of motor block was signficantly longer with increase dosage. 4) Systolic and diastolic blood pressure were little decreased with increase dosage. No signficant changes were noted in the pulse rate. 5) Post spinal headache developed in 5 patients out of 54 patients(9.3%). In the study of the group C, urinary retention developed in 4 patients out of 15 patients. From above results, we conclude that 0.25% hyperbaric bupivacaine can be used for operations lasting than 1~2 hours of lower limbs and lower abdomen because cardiovascular system is little affected with increase dosage.

Effect of Hyperbaric 0.25 % Bupivacaine for Spinal Anesthesia / 대한마취과학회지

In our department we selected 52 patients in ASA Class I, aged from 20 to 60 years old undergoing operation of lower limbs and lower abdomen, lasting 1 to 2 hours of duration. They were divided into 2 groups, group A (30 patients) using 0.5% hyperbaric Tcaine 13 mg (2.6 ml), group B (22 patiens) using 0.25% hyperbaric bupivacaine 10 mg (4 ml), which were injected into intrathecal space. Sensory loss level was significantly higher in group A than in group B. The time taken for the block to reach maximum level was significantly faster in group B. Analgesic duration was significantly shorter in group B. In group B, onset of motor blockade was significantly slower and also, the total duration was significantly shorter. In group A, significant decrease of diastolic and systolic blood presssure were noted. Hyperbaric 0.25% bupivacaine can be used for short timed operation of lower limbs and lower abdomen without changes of cardiovascular system.

Comparative Study of Spinal Anesthesia with 0.5 % Isobaric Bupivacaine and Hyperbaric T-caine / 대한마취과학회지

In our hospital we studied the effects of spinal anesthesia with 0.5% isobarie bupivacaine and hyperbaric T-caine in 60 patients undergoing operation of lower abdomen or lower limbs. The following results were obtained. 1) Maximum level of sensory loss were similar in both groups, the time taken to it was significantly faster in the T-caine group but the duration was significantly longer in the bupivacaine group. 2) Onset time of motor blockade was significantly faster in the T-caine group but the duration was significantly longer in the bupivacaine. 3) The fall in blood pressure appeared faster in the T-caine group but no significant value of difference between the two groups. No significant changes were noted in the pulse rates. 4) Post spinal headache developed in 5 patients out of 60 patients (8.3%). With the results, we can assume that 0.5% isobaric bupivacaine is a good local anesthetic agent for spinal anesthesia in operations of the lower abdomen and lower limbs.

A Case of Lipodystrophia Centrifugalis Abdominalis Juvenilis / 대한피부과학회지

We report a case who has been diagnosed as lipodytrophia centrifugalis abdomialis juvenilis. The patient was a 9 year-old girl. At the age of 4 years, these well-defined, depressed lesions appeared in both ing-uinal areas and gradually spread to the labia major, the abdomen and both flank areas and, by 9 years, had reached lower portion of the chest. Biopsy specimen from the depressed lesion showed absence of the subcutsneous fat. The epidermal appendage were well preserved. There were lympho-histiocytic infiltrations around the blood vessels in the upper dermis.