Síndrome pilórico en un body packer / Pyloric syndrome in a body packer

Introducción. El embalaje y transporte de estupefacientes dentro del organismo, o body packing, es una práctica frecuente en Centroamérica y el Caribe. Además del riesgo de muerte por la exposición a las sustancias tóxicas, existe el riesgo de complicaciones mecánicas con indicación de manejo quirúrgico. El Hospital de Engativá, por su cercanía al aeropuerto de Bogotá, D.C., Colombia, es el centro de referencia para el tratamiento de estos pacientes. Caso clínico. Un hombre de 65 años traído al hospital por un episodio emético con expulsión de cuatro cápsulas para el transporte de estupefacientes. Al examen físico se encontraron masas palpables en el hemiabdomen superior, sin abdomen agudo. La tomografía de abdomen informó un síndrome pilórico secundario a retención gástrica de cuerpos extraños. Fue llevado a laparotomía y gastrotomía logrando la extracción de 97 objetos cilíndricos de látex que contenían sustancias ilícitas. Discusión. En los body packer asintomáticos, la administración de soluciones laxantes es una estrategia terapéutica segura. Los casos reportados de obstrucción gastrointestinal son infrecuentes y se relacionan con la ingesta de un gran número de cápsulas, por lo que es necesario el tratamiento quirúrgico. Conclusión. El síndrome pilórico es una presentación infrecuente en un body packer. Se debe tener un alto índice de sospecha para garantizar un manejo oportuno

Introduction. Packaging and transportation of narcotic drugs inside a human body, or body packing, is a frequent practice in Central America and the Caribbean. In addition to the risk of death due to exposure to toxic substances, there is a risk of mechanical complications with an indication for surgical management. The Engativá Hospital, due to its proximity to the airport in Bogotá, D.C., Colombia, is the reference center for the treatment of these patients. Clinical case. A 65-year-old man brought to the hospital for an emetic episode with expulsion of four narcotic transport capsules. Physical examination revealed palpable masses in the upper abdomen, without an acute abdomen. Abdominal tomography revealed pyloric syndrome secondary to gastric retention of foreign bodies. He was taken to laparotomy and gastrotomy, achieving the extraction of 97 cylindrical latex objects that contained illicit substances. Discussion. In asymptomatic body packers, the administration of laxative solutions is a safe therapeutic strategy. Reported cases of gastrointestinal obstruction are infrequent and are related to the ingestion of a large number of capsules, for which surgical treatment is necessary. Conclusion. Pyloric syndrome is an uncommon presentation in body packers. A high index of suspicion is required to ensure timely management

Physical load and heart rate behavior in workers in the slaughterhouse and meat packing industries / Carga física e comportamento da frequência cardíaca em trabalhadores de frigorífico

Abstract High physical overload during the workday and some conditions present in the workplace can generate several losses in the worker's health. The use of tools capable of identifying physical load (PL), such as heart rate (HR) analysis, is essential. The aim of the study was to evaluate the physical load and heart rate behavior of workers in the slaughterhouse. The cardiovascular load reached by two individuals was 12% and 24%. In relation to the PL rating, they fit as moderately heavy to heavy work. The HR, was higher at the end of the work when compared to the beginning. Furthermore, it was pointed out that the temperature, noise, and body mass index were above normality values. The physical workload was classified as moderately heavy to heavy. The limit HR was reached in some moments of the work by one of the workers and two of them reached higher HR values at the end of the work.

Resumo A elevada sobrecarga física durante a jornada de trabalho e algumas condições presentes no ambiente de trabalho podem gerar diversos prejuízos na saúde do trabalhador. A utilização de ferramentas capazes de identificar a carga física (CF), como a análise da frequência cardíaca (FC), é fundamental. O objetivo do estudo foi avaliar o comportamento da carga física e da frequência cardíaca dos trabalhadores de frigorífico. A carga cardiovascular alcançada por dois indivíduos foi de 12% e 24%. Em relação à classificação da CF, enquadram-se como trabalhos moderadamente pesados ​​a pesados. A FC, foi maior no final do trabalho quando comparado ao início. Além disso, apontou-se que a temperatura, o ruído e o índice de massa corporal estavam acima dos valores da normalidade. A CF de trabalho foi classificada como moderadamente pesada a pesada. A FC limite foi atingida em alguns momentos do trabalho por um dos trabalhadores e dois deles atingiram valores maiores de FC ao final do trabalho.

Body Packer y Body Stuffer: Serie de Casos. Revisión / Body Packer y Body Stuffer: serie de casos. Revision

"Body packing", "Body pushing" y "Body stuffing" son distintas formas de transportar sustancias ilegales dentro del cuerpo humano. Frente al ingreso en la unidad de emergencias de un "Body Packer", conocido como "tragador de paquetes" con fines de contrabando o un "Body Stuffer" llamados "tragadores rápidos", quienes ingieren en forma compulsiva paquetes manufacturados para la venta de sustancias ante la posibilidad de ser sorprendidos por agentes de la ley; se plantean una serie de desafíos en cuanto al tratamiento que al día de hoy permanecen en debate. Generalmente se prefiere mantener una conducta conservadora facilitando la expulsión de los paquetes. En aquellos casos en los que los pacientes presenten paquetes atascados o rotos o no mejoren con el tratamiento conservador, se recomienda el tratamiento quirúrgico.El presente trabajo tiene por objetivo reportar una serie de casos internados por ingesta de paquetes potencialmente peligrosos que se sometieron a una evacuación farmacológica y/o quirúrgica en 8 pacientes y una revisión bibliográfica sobre el tema.

"Body packing", "Body pushing", and "Body stuffing" are different ways to use the interior of the human body to transport illegal substances. In the face of a "Body Packer" or a "Body Stuffer" known as "fast swallowers", which are those cases in which they compulsively swallow manufactured packages for the sale of substances before the possibility of being surprised by law enforcement officers, a series of challenges present themselves regarding the treatment, which is currently up for debate. Generally, a conservative conduct is preferred, facilitating the expulsion of the packages. In those cases, in which patients have stuck or broken packages or do not improve with conservative treatment, surgical treatment is recommended.The present paper aims to report a series of cases in which the patients were admitted due to an intake of potentially dangerous packages and put through a pharmacological evacuation and/or surgical evacuation of 8 patients, and a bibliographical revision on the subject.

Body packing: tráfico de drogas y cirugía. Reporte de un caso / Body packing: drug traffic and surgery. Case report

Resumen Objetivo: Exponer el caso de un paciente con intoxicación aguda por cocaína en contexto de un body packing syndrome, considerando sus aspectos médico-quirúrgicos y legales. Materiales y Método: Se obtuvo la ficha clínica, con resguardo de anonimato, de un paciente que acude al servicio de urgencia (SU) y que es intervenido y evolucionando posteriormente en el Hospital el Pino de San Bernardo, Chile. Resultados: Paciente fue sometido a una gastrotomía, una enterotomía y una colotomía después de haber sido estabilizado por paro cardiorrespiratorio presentado en SU. Es trasladado a unidad de cuidados intensivos (UCI) donde evoluciona desfavorablemente. Discusión: El body packing syndrome es una entidad clínica infrecuente que, en la minoría de los casos, puede presentar complicaciones severas que requieren de un tratamiento médico-quirúrgico inmediato. Conclusión: Considerando que tanto el consumo como el tráfico de drogas se mantienen como un importante problema de salud pública y que sus consecuencias pueden ser devastadoras, es importante tener conocimiento sobre el tema.

Aim: To present the case of a patient with acute cocaine intoxication in the context of body packing syndrome, taking into consideration its medical-surgical and legal aspects. Materials and Method: A clinical record with anonymity protection was obtained, from a patient who was admitted to the emergency room and who was subsequently operated on and managed at Hospital El Pino in San Bernardo, Chile. Results: Patient underwent a gastrotomy, an enterotomy and a colotomy after being stabilized from a cardiorespiratory arrest in the emergency room. He was transferred to the Intensive Care Unit (ICU) where he evolved unfavorably. Discussion: Body packing is an infrequent clinical entity that, in a few cases, may develop severe complications that require immediate medical-surgical treatment, in addition to notification to authorities. Conclusion: Considering that both drug use and traffick remain as an important public health concern and that as its consequences may be devastating, it is important to have a knowledge on the subject.

Damage control surgery in lung trauma / Cirugía de control de daños del trauma pulmonar

Abstract Damage control techniques applied to the management of thoracic injuries have evolved over the last 15 years. Despite the limited number of publications, information is sufficient to scatter some fears and establish management principles. The severity of the anatomical injury justifies the procedure of damage control in only few selected cases. In most cases, the magnitude of the physiological derangement and the presence of other sources of bleeding within the thoracic cavity or in other body compartments constitutes the indication for the abbreviated procedure. The classification of lung injuries as peripheral, transfixing, and central or multiple, provides a guideline for the transient bleeding control and for the definitive management of the injury: pneumorraphy, wedge resection, tractotomy or anatomical resection, respectively. Identification of specific patterns such as the need for resuscitative thoracotomy, or aortic occlusion, the existence of massive hemothorax, a central lung injury, a tracheobronchial injury, a major vascular injury, multiple bleeding sites as well as the recognition of hypothermia, acidosis or coagulopathy, constitute the indication for a damage control thoracotomy. In these cases, the surgeon executes an abbreviated procedure with packing of the bleeding surfaces, primary management with packing of some selected peripheral or transfixing lung injuries, and the postponement of lung resection, clamping of the pulmonary hilum in the most selective way possible. The abbreviation of the thoracotomy closure is achieved by suturing the skin over the wound packed, or by installing a vacuum system. The management of the patient in the intensive care unit will allow identification of those who require urgent reintervention and the correction of the physiological derangement in the remaining patients for their scheduled reintervention and definitive management.

Resumen Las técnicas de control de daños aplicadas al manejo de lesiones torácicas han evolucionado en los últimos 15 años. A pesar de que el número de publicaciones es limitado, la información es suficiente para desvirtuar algunos temores y establecer los principios de manejo. La severidad del compromiso anatómico justifica el procedimiento de control de daños solamente en algunos casos. En la mayoría, la magnitud del deterioro fisiológico y la presencia de otras fuentes de sangrado dentro del tórax o en otros compartimientos corporales constituyen la indicación del procedimiento abreviado. La clasificación de la lesión pulmonar como periférica, transfixiante y central o múltiple, proporciona una pauta para el control transitorio del sangrado y para el manejo definitivo de la lesión: neumorrafía, resección en cuña, tractotomía o resecciones anatómicas, respectivamente. La identificación de ciertos patrones como la necesidad de toracotomía de reanimación o de oclusión aórtica, la existencia de un hemotórax masivo, de una lesión pulmonar central, una lesión traqueobronquial o una lesión vascular mayor, así como el reconocimiento de hipotermia, acidosis o coagulopatía, constituyen la indicación de una toracotomía de control de daños. En estos casos, el cirujano concluye de manera abreviada los procedimientos con empaquetamiento de las superficies sangrantes, el manejo primario con empaquetamiento de algunas lesiones pulmonares periféricas o transfixiante seleccionadas y el aplazamiento de la resección pulmonar, pinzando el hilio de la manera más selectiva posible. La abreviación del cierre de la toracotomía se logra con la sutura de la piel sobre el empaquetamiento de la herida, o mediante la instalación de un sistema de presión negativa. El manejo del paciente en cuidados intensivos permitirá identificar aquellos que requieren reintervención urgente y corregir la alteración fisiológica de los restantes para su reoperación programada y manejo definitivo.

Practice and thinking of Otorhinolaryngology Clinical Skill Competition / 中华医学教育探索杂志

This paper introduces the clinical skill competition organized by the faculty of Otolaryngology Department of Shanghai Jiao Tong University School of Medicine, and analyzes the main problems in implementing items of basic life support, single ear compression bandage, debridement and suturing, foreign body removal from pharynx and larynx area, nasal packing and hemostasis and comprehensive skills. According to contestants' performances, their abilities in clinical analysis and operating skills have been tested, and their professional humanities have been cultivated. Thus, the aim of "promoting learning through examination and substituting competition for practice" is achieved through the competition. Clinical skill competitions can be used widely as supplement form of medical education for its practicability, entertainment, innovation and interaction.

Evaluación de carga física en los procesos de empacado de fruta en empresas de la provincia de río negro en la patagonia, argentina

Introducción. Este estudio observacional de corte transversal describió el análisis realizado con una población de ocho operarios, para valorar la exposición a carga física de los trabajadores de la actividad de empaque de fruta en la provincia de Río Negro, Argentina. Métodos. El análisis que se efectuó con los métodos manuales RULA y Check List OCRA, favoreció la evaluación de la exposición a factores de riesgo que pueden ocasionar trastornos en miembros superiores. Resultados. La carga física en las actividades de selección y empaque de fruta alcanzan niveles críticos en movimientos y esfuerzos, están relacionados con más de 15 enfermedades de acuerdo con la OIT y la legislación argentina. Para disminuir el nivel de riesgo, se recomendaron tiempos de descanso, rotación de personal, apoyos corporales adecuados, entre otros. Conclusión. Se recomienda evaluar el proceso de manera sistémica para proponer una intervención integral que mejore el bienestar de los operarios.

Introduction. This cross-sectional observational study described the analysis carried out with a population of eight operators to assess the exposure of fruit packing workers to a physical load in the Rio Negro province, Argentina. Materials and methods. The analysis carried out with the RULA and OCRA Checklist manual methods favored assessing exposure to risk factors that can cause upper limb disorders. Results. According to the ILO and Argentine legislation, the physical load in the fruit selection and packing activities reaches critical levels in movements and efforts; they are related to more than 15 diseases. Breaks, staff rotation, adequate body support, among others, are recommended to reduce the level of risk. Conclusion. It is advisable to assess the process systemically to propose a comprehensive intervention that improves the operators' well-being.

Dilemas na implementação da Convenção-Quadro para o Controle do Tabaco da Organização Mundial da Saúde / Dilemas en la implementación del Convenio Marco para el Control del Tabaco de la Organización Mundial de la Salud / Dilemmas in the implementation of the World Health Organization Framework Convention on Tobacco Control

O artigo analisa alguns dilemas relacionados à implementação da Convenção-Quadro para o Controle do Tabaco, destacando as dificuldades dos Estados participantes para adotar políticas públicas, com custo-benefício comprovado, que visam à redução da oferta e demanda do tabaco. Especificamente, o artigo examina a recomendação para a adoção de políticas de padronização das embalagens de cigarro, presente nas diretrizes para a implementação dos Artigos 11 e 13 da Convenção. Por meio da análise de casos, identificamos fatores políticos e jurídicos que dificultam a implementação da Convenção, incluindo a inibição regulatória produzida pela abertura de litígios por parte da indústria do tabaco, que utiliza-se das cláusulas de arbitragem investidor-Estado existentes em acordos bilaterais de investimentos. Conclui-se que, apesar dos custos impostos aos Estados e dos atrasos na adoção dessas políticas, no médio ou longo prazo, as decisões proferidas pelos tribunais arbitrais e pelo Órgão de Solução de Controvérsias da Organização Mundial do Comércio podem consolidar o entendimento acerca da legalidade e efetividade de políticas que adotam o referido modelo.

El artículo analiza algunos dilemas relacionados con la implementación del Convenio Marco para el Control del Tabaco, destacando las dificultades de los Estados participantes para adoptar políticas públicas, con coste-beneficio comprobado, que tienen como objetivo la reducción de la oferta y demanda del tabaco. Específicamente, el artículo examina la recomendación para la adopción de políticas de estandarización de los paquetes de cigarrillos, presente en las directrices para la implementación de los Artículos 11 y 13 del Convenio. Mediante el análisis de casos, identificamos factores políticos y jurídicos que dificultan la implementación del Convenio, incluyendo la inhibición regulatoria, producida por la apertura de litigios por parte de la industria del tabaco, que recurre a cláusulas de arbitraje inversor-Estado, existentes en acuerdos bilaterales de inversión. Se concluye que, a pesar de los costes impuestos a los Estados, y de los atrasos en la adopción de esas políticas, en el medio o largo plazo, las decisiones proferidas por los tribunales arbitrales y por el Órgano de Solución de Diferencias de la Organización Mundial del Comercio pueden consolidar el entendimiento acerca de la legalidad y efectividad de políticas que adoptan el referido modelo.

The article analyzes some dilemmas related to the implementation of the Framework Convention on Tobacco Control, underscoring the States parties' difficulties in adopting public policies with proven cost-benefit and aimed at reducing tobacco's supply and demand. Specifically, the article examines the recommendation to adopt policies for plain cigarette packaging, as provided in the guidelines for implementation of the Convention's Articles 11 and 13. Based on case analysis, we identified political and legal factors that hinder the Convention's implementation, including the regulatory chill produced by legal claims filed by the tobacco industry, which uses investor-State arbitration clauses from bilateral investment agreements. The article concludes that despite the costs imposed on States and the delays in the adoption of such policies, in the medium and long term the rulings handed down by the arbitration courts and the World Trade Organization's Dispute Settlement Body can consolidate the understanding of the legality and effectiveness of policies that adopt the model.

Study of Cranial Capacity & Its Sexual Dimorphism in Adult Human Skulls

Background: Like other body dimensions, Cranial capacity of skull are affected by geographical, racial, gender and age factor. Intention of this study is to know the gender variations of cranial capacities in available human skulls of north Indian region. Aims and objectives: To measure the cranial capacities and its sexual dimorphism in the available skulls which may be helpful to establish the sex of a person from remains of skeletal?. Methods: 200 dry human skulls (110 male & 90 female) were obtained from the anthropology museum of the Dept. of Anatomy, GSVM Medical College, Kanpur (U.P) & SGRR institute of medical &Health Sciences, Dehradun (U.K). Cranial capacity was measured by filling and packing method in which mustard seeds were used to avoid the error as their smaller size clay was used as a packing material to avoid the spillage of seeds from any aperture or foramina. Intact & undamaged Adult skulls were included while those which were having ambiguity of sex, broken or damaged were excluded. Results: The mean cranial capacity of male skulls was observed to be 1280.28 ± 68.20 cc (range 1200-1410 cc) and those of female skulls were observed to be 1167.32± 42.18 cc (range 1150-1380cc). Conclusion: The mean cranial capacity of males is higher than that of the females. Filling and packing method is one of the most reliable Cranio-metric methods to be used for measuring the cranial capacity of skull and determination of sex.

Tratamiento médico del "body packer" entre los años 2014 y 2016 en un hospital universitario del caribe colombiano / Medical management of the "body packer" at a university hospital in the colombian caribbean in the period 2014-2016

Introducción. El término "body packer" hace referencia a sujetos portadores de objetos intraabdominales extraños, que contienen drogas ilícitas con fines de contrabando. La mayoría son pacientes asintomáticos, en quienes se instaura conducta expectante, observación clínica estrecha y administración de medicamentos para la evacuación de los paquetes, con miras a prevenir posibles complicaciones, como obstrucción intestinal o intoxicación, asociadas a su transporte intraabdominal. Materiales y método. Se llevó a cabo un estudio transversal de linealidad retrospectiva en pacientes admitidos en la E.S.E Hospital Universitario del Caribe entre los años 2014 y 2016,bajo la sospecha diagnóstica de "body packer". Luego de una revisión de las bases de datos institucionales se analizaron variables demográficas y clínicas de los sujetos incluidos en el estudio. Resultados. Se incluyeron 4 pacientes de género masculino, entre los 22 y 66 años de edad. La cantidad de cápsulas transportadas en promedio fue de 43, para una máxima de 74. La cocaína fue la sustancia que más se identificó. Para la evacuación de los paquetes se empleó irrigación intestinal con polietilenglicol. El tiempo de evacuación máximo fue de 48 horas y no hubo complicaciones asociadas al manejo proporcionado. Discusión. Estudios respecto al tema, como este, confirman la seguridad del manejo conservador del paciente asintomático y apoyan el uso de polietilenglicol dada su efectividad para lograruna limpieza intestinal completa y por su bajo riesgo de complicaciones asociado a su uso en comparación con otros métodos, así como la menor necesidad de intervenciones quirúrgicas. Se requieren estudios prospectivos aleatorizados controlados a partir de los cuales se determinen, con base en mayor evidencia, las mejores prácticas a seguir

Introduction. The term "body packer" refers to subjects carrying intraabdominal foreign objects that contain illicit drugs for contraband purposes. The majority of patients are asymptomatic, in whom expectant management is established, with close clinical observation and administration of medications for evacuation of the packages, with prevention of possible complications such as intestinal obstruction or intoxication associated with intraabdominal transport. Materials and method. A retrospective linearity cross sectional study was carried out in patients admitted to the Hospital Universitario del Caribe, Cartagena, Colombia, under the diagnostic suspicion of "body packer" in the period 2014 and 2016. After a review of the institutional databases, demographic and clinical variables of the study subjects were analyzed. Results. Four patients were included, male, ages 22 to 66 years. The average number of capsules transported was 43, with maximum of 74. Cocaine was the substance mainly identified. Intestinal irrigation with polyethylene glycol was used for intestinal evacuation. The maximum evacuation time was 48 hours and there were no complication associated with the given management. Discussion. The existing studies on the subject, as well as this one, confirm the safety of the conservative management in the asymptomatic patient and support the effectiveness of polyethyleneglycol in achieving complete intestinal cleansing and the low risk of complications associated with its use with respect to other methods, together with diminished need for surgical intervention. Controlled randomized prospective studies are required to provide greater evidence in order to determine the best practice to be followed

Audit of various otorhinolaryngological diseases in Shangla valley

Objective: To assess the prevalence of various ear, nose and throat diseases in Shangla valley. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Study was carried out in shangla. Duration of study was 3 months, from Jun 2014 to Aug 2014

Material and Methods: All the patients of any age group and both genders who reported with any ENT disorder and emergency were included in this study. Frequency and percentage of various ENT diseases among patients and emergency procedures performed were found

Results: A total of 2725 patients were included. The most common ENT disorder encountered was rhinosinusitis which was seen in 14.2% cases, followed by ear wax [impacted cerumen] in 13.4% and pharyngitis in 12.5% cases. Allergic rhinitis was seen in 10.4% cases, epistaxis in 7.4% and chronic suppurative otitis media in 6.4% cases. Among the emergency ENT procedures performed, anterior nasal packing was the commonest [done in 55 cases] followed by stitching of lacerations and foreign body removal from ear and nose

Conclusion: Ear, nose and throat diseases are very common in Shangla and their spectrum range from rhinosinusitis, impacted cerumen [ear wax] and pharyngitis to less common but potentially dangerous conditions like foreign body impaction in ear and nose

Fabrication and verification of three-dimensional prototyped models of nasal cavities and paranasal sinuses / 中华耳鼻咽喉头颈外科杂志

Objective@#To make three-dimensional prototyped models of nasal cavities and paranasal sinuses for endoscopic skills training and teaching and to verify and evaluate the fidelity of the models.@*Methods@#Imaging data of a patient with nasal septum deviation was selected for prototyping the nasal cavities model, and the imaging data of a patient with chronic rhinosinusitis who underwent the endoscopic sinus surgery 4 months ago was selected for the paranasal sinuses model. Both patients came from the Department of Rhinology, the First Affiliated Hospital of Zhengzhou University. The models were printed by the desktop-level printer based on the fused deposition modeling (FDM). The evaluations of anatomical structures and prespecified tasks on the simulators were completed by 5 residents and 5 experts of Rhinology.The models were evaluated by survey ratings based on a 5-point Likert scale. The average time to complete each task was calculated.Mann-Whitney nonparametric test was used to assess the differences between experts and residents groups. The statistical significance level was set at P<0.05.@*Results@#All the components of the two models were prototyped in 24 h. For the nasal cavities model, the scores of each anatomical structure were more than 4.0. As to the paranasal sinuses model, except for the frontal sinus (3.6), the scores of each anatomical structure were more than 4.0. All the participants who performed the prespecified tasks evaluated the models well (>4.0). With the nasal cavity simulator, the experts completed the tasks (nasal cavity and nasopharyngeal endoscopy, removal of nasal foreign body, nasal packing, pledget insertion), and the other tasks (the nasal cavity and nasopharyngeal endoscopy, identification of ostiums of paranasal sinuses, maxillary sinus debridement with 70° nasal endoscopy) were completed with paranasal sinus model. The average time to complete each task by experts group and residents group (M (P25, P75)) were 10.3 (10.0, 10.7) s vs 17.1 (14.6, 20.7) s, 2.1 (2.0, 2.2) s vs 3.4 (2.6, 4.7) s, 30.1 (27.8, 32.8) s vs 59.2 (52.0, 65.4) s, 54.8 (50.1, 63.2) s vs 92.2 (79.3, 106.9) s, 9.3 (8.7, 9.9) s vs 14.5 (13.3, 14.9) s, 20.1 (19.3, 21.2) s vs 41.9 (35.5, 45.1) s, 31.1 (28.8, 35.2) s vs 52.8 (47.7, 56.3) s, respectively, and the average time to complete each task was shorter for the experts group than for the residents (U value was 0, 1.000, 0, 0, 0, 0, 0, respectively, all P<0.05).@*Conclusion@#The models of nasal cavities and paranasal sinuses made by our desktop-level FDM 3D-printer are useful for endoscopic training skills.

A Case of Maxillary Sinus Spindle Cell Sarcoma: Alert to Polyurethane Associated Malignancy / 대한이비인후과학회지

There has been no literature that reports a case of sino-nasal malignancy associated with polyurethane implants. However, several previous in vitro and animal model studies revealed that polyurethane implants may cause malignancy in body tissue. In this report, we describe a case of maxillary sinus spindle cell sarcoma diagnosed in a 59-year-old man who had undergone polyurethane nasal packing in the nasal cavity following endoscopic sinus surgery two years ago. Complete removal of the packing material was not confirmed as the patient has not returned for postoperative care. Although there are no direct evidence of association between this spindle cell sarcoma case and polyurethane nasal packing, surgeons should be alert to the complete removal of polyurethane nasal packing after sino-nasal surgery.

Difficult endotracheal intubation secondary to tracheal deviation and stenosis in a patient with severe kyphoscoliosis: a case report / 대한마취과학회지

We report on a case of difficult endotracheal intubation in a patient with marked tracheal deviation at an angle of 90 degrees combined with stenosis due to kyphoscoliosis with vertebral body fusion. After induction of general anesthesia, a proper laryngeal view was easily obtained using a videolaryngoscope. But a tracheal tube could not be advanced more than 3 cm beyond the vocal cords due to resistance, despite various attempts, including the use of small size tubes, full rotation of the tube tip, and fiberoptic bronchoscopy. Ultimately, the airway was successfully secured by placing a tube tip above the area of resistance and by additionally packing saline-soaked gauzes around the tracheal inlet to minimize gas leakage and to fasten the tube in the trachea.

Complex Anterior Skullbase Fracture Caused by a Bottle Cap: A Case Report and Review of the Literature

We report a case of foreign body presence in the ethmoid sinus cavity with anterior skull base fracture and visual loss. A 42-year-old male had an uncertain history of trauma and a penetrating wound near the left medial canthus. Computed tomography imaging showed a 3.0-cm bottle cap penetrating into the anterior skull base. He underwent foreign body removal, canalicular repair, ethmoidectomy, and cerebrospinal fluid leakage repair using packing material. Six months after the initial surgery, a second-stage operation for blow-out fracture repair was performed. At the 18-month postoperative follow-up from the initial surgery, the patient had no complaints except anosmia. This is a very rare case of a large, blunt, foreign body penetrating into the anterior skull base without long-term complications after successful removal and skull base repair. Simultaneous repair of cerebrospinal fluid leakage, management of canaliculi injury, and traumatic optic nerve neuropathy should be considered in such cases.

APPLICATION OF HPLC METHOD FOR A RAPID DETERMINATION OF / Монголын эм зүй, эм судлал

Background In the present work, a reverse – phase high –performance liquid chromatographic procedure has been developed for the determination of vitamin E in cereals. The sample treatment was done by Sohhlet extraction procedure with a water bath. Afterwards, vitamin E was analyzed by HPLC on a Discovery C 18 (250 x 4.6 mm, 5 mm) analytical column, using a solution of methanol: water (95:5, v/v) as mobile phase. The UV-Vis detection of vitamin was made at 210 nm for all samples and fl ow rate was adjusted at 0.8 ml.min-1. Among grain-cereal products, average content of vitamin E were determined in kamut, špaldove kernotto and špalda loupana, namely 1.19, 1.19 and 1.30 mg.100g-1. Keywords: vitamin E, HPLC, cereal INTRODUCTION Vitamin E is a fat soluble vitamin, being well presented in vegetables, fruits, seeds, nuts (Bramley et al., 2000). Cereals are one of the important sources of lipids as well as a good source of vitamin E. Several studies have been investigated that presences of numerous antioxidant compounds in two specifi c food groups, the carotenoids and the vitamin E contributes signifi cantly in disease prevention ( Palozza & Krinsky, 1992, Halliwell et al.,1995, Andlauer & Fürst, 1998 ). Biological activities of vitamin E vitamers generally believed to its antioxidant action by tocopherols. Specially, α-tocopherol has been labeled as most effi cient antioxidant for lipid peroxidation in biological membranes (Traber & Atkinson, 2007). Vitamin E is not synthesized within a human body, and must be supplied in the diet. More data on vitamin E contents in cereals and other foodstuffs are needed, however, since they have been investigated with modern, reliable analytical methods in a few studies (Panfi li, 2003, Sundl et al., 2007). Due to the reason many researche have been performed to develop a simple and sensitive determination method for vitamin E and other fat soluble vitamins in foods. Several HPLC methods for determination of vitamin E are described in the literature, as well as methods its vitamers simultaneous determination (Lang et al., 1992, Luque-Garcia, 2001, Escriva´ et al., 2002). The aim of this study was to develop a normal phase HPLC method for a fast and reliable determination of vitamin E of cereals. Therefore, it was to investigate the precision of calculatedvitamin E content of cereals. MATERIAL AND METHODS Chemicals. D, L-α-tocoferol and - were from Fluka (Sigma-Aldrich Co, Germany). Methanol (purity: 99.8%) was obtained from Sigma-Aldrich (Germany). All other reagents were analytical grade and were purchased from Petr Lukes (Uhersky Brod, Czech Republic). Samples. For this analysis were chosen following cereals grown in organic farming: Kamut, Špaldove kernotto, Grünkern and Špalda loupaná. Individual samples were delivered directly by the manufacturer PRO-BIO, Ltd., (Staré Město Sněžníkem, Czech Republic). Cereals products stored in the original container in a dark place at room temperature and not more than 4 months after packing.

Análisis funcional de oligómeros de alfa-sinucleína en la permeabilidad de membranas / Functional analysis of oligomeric alpha-synuclein in membrane permeabilization / Análise funcional dos oligômeros de alfa-sinucleína na permeabilidade das membranas

La enfermedad de Parkinson es un desorden neurodegenerativo común originado por la muerte celular dentro de la substancia nigra pars compacta. Se caracteriza por la presencia de agregados intracelulares proteicos compuestos principalmente por la alfa-sinucleína. Aunque los mecanismos moleculares por los cuales esta proteína contribuye a la toxicidad neuronal todavía se desconocen, se ha sugerido que los intermediarios oligoméricos son citotóxicos y permeabilizan las membranas celulares posiblemente a través de complejos que forman un poro en la bicapa; sin embargo, este mecanismo es altamente controversial. Así pues es necesario identificar el mecanismo por el cual ocurre la permeabilización de membranas para entender la interacción entre oligómeros y lípidos y poder estimar la relevancia biológica de este proceso.En este trabajo se evaluó por espectroscopía de fluorescencia la liberación de contenidos acuosos originados por oligómeros de alfa-sinucleína desde vesículas fosfolipídicas de distinta composición mediante el método ANTS/DPX. Los resultados muestran que la disrupción de membranas solo ocurre en presencia de lípidos aniónicos y también por parámetros de empaquetamiento lipídico, lo que sugiere que la accesibilidad a la región hidrofóbica de las vesículas modula la interacción lípido-oligómero.

Parkinson's disease is a common neurodegenerative disorder marked by increased cell death within the substantia nigra pars compacta. It is characterized by the presence of intracellular aggregates composed primarily of the protein alpha-synuclein. How the aggregation of a-synuclein is related to neuronal degeneration is an important unresolved question. Oligomeric intermediates have been found to be more toxic to cells than monomeric or fibrillar forms of the protein. A possible mechanism by which oligomers could be toxic is through the disruption and permeabilization of cellular membranes. The proposed disruption mechanism is the formation of pore-like structures within the lipid bilayer although this mechanism is still highly controversial. To identify the mechanism through which membrane permeabilization is facilitated and to estimate the biological relevance of this process, it is crucial to have a greater knowledge of the lipid-oligomer interaction. The membrane disruptive effect of Alpha-synuclein oligomers on lipid vesicles of different headgroup composition using the ANTS/DPX assay was evaluated in this work. It was shown that membrane permeabilization is mainly determined by the presence of negatively charged lipids and also by lipid packing parameters, suggesting that the accessibility to the bilayer hydrocarbon core modulates oligomer-membrane interaction.

pars compacta. é caracterizada pela presença de agregados intracelulares protéicos compostos especialmente pela alfa-sinucleína.Mesmo que se desconheça os mecanismos moleculares por onde essa proteína contribui para toxicidade neuronal, existe uma possibilidade de que os intermediários oligoméricos sejam citotóxicos, e permeabilizam as membranas celulares possivelmente através de complexos que formam um poro na capa dupla, entretanto, este mecanismo gera muita controvérsia. Sendo assim, é necessário identificar o mecanismo responsável pela permeabilidade das membranas para entender a interação entre os oligômeros e os lipídios, e para ter uma estimativa da relevância biológica deste processo. Neste trabalho, analisamos através de espectroscopia de fluorescência, a liberação dos conteúdos aquoso originados por oligômeros de alfa-sinucleína a partir das vesículas fosfolídicas de composição diferente através do método ANTS/DPX. Os resultados mostraram que a ruptura de membranas ocorrerá somente diante da presença de lipídios aniônicos, e também pelos parâmetros de empacotamento lipídico, e isso sugere que a acessibilidade à região hidrofóbica das vesículas faz a modulação da interação lípidio-oligômero.

Uncommon Sites for Body Stuffing: A Literature Review.

Introduction: ‘‘Body stuffing’ refers to concealment of illegal drugs within the human body to avoid arrest. Emergency physicians and law enforcement authorities should be aware of uncommon sites of concealment used to avoid detection. Methods: A literature search of Medline (Pubmed), Science Direct and the Cochrane databases was done, for articles relating to body packing or body stuffing of illegal drugs and sites of concealment. Results: A total of 55 full text articles and one abstract were reviewed after removing duplicates and non relevant titles. Seventeen articles were included in the results. Cocaine was the most common drug. Body stuffing is more common among males in the 3rd to 4th decade of life. The majority of cases, 99% (1144 cases), involved concealment in the oral cavity or ingestion. Unusual sites for body stuffing reported were the external auditory canal (5 cases), the rectum (3 cases), the superior oropharynx and glans penis (one case each). Complications reported are fatal toxicity, aspiration and oesophageal obstruction. Conclusion: Although uncommon, ear, nose and throat orifices have been used in body stuffing. Authorities and attending physicians should be aware that these orifices can be used to conceal drugs and proceed to a full otorhinolaryngologic examination if warranted.

Efficacy of infusing cold fluid through the bile duct in cooling the liver / 第二军医大学学报

Objective: To evaluate the liver cooling effect of infusing cold fluid through the bile duct in liver injury models. Methods: A total of 14 BA-MA mini-pigs were randomized into two groups: control group (n=7) and hypothermia group (n = 7). All the animals underwent tracheal intubation under general anaesthesia and liver injury was created after opening the abdomen. The liver bleeding was allowed for 15 min, and then initial treatment was given by packing the liver injury and infusing fluid for 1 hour before suturing the wound. Then the cold fluid (4'C lactated Ringer's solution) was infused through the bile duct in the hypothermia group, with no further treatment given to the control group. The body and local liver temperature and hemodynamic variations were recorded. Blood samples were collected from the front vena cava to perform liver function tests. The liver specimens of animals were subjected to histopathological evaluation at the end of the experiment. Results: The primary bleeding volume, heart rate and mean artery pressure at different time points were not significantly different between the two groups. After 2 hours intervention, the liver temperature dropped by(1. 36 ±0. 80) C in the control group and by (2. 72±1. 01)'C in the hypothermia group, with significant difference found between the two groups(P=0. 020); at the same time point, thebody temperaturedropped by (0. 89 ± 0. 76) C and (0. 97 ± 0. 97) C, respectively; showing no significant ditference between the two groups (P = 0. 87). Liver function examination showed that at the end of infusion aspartate transaminase (AST) in the hypothermia group was significantly lower than that in the control group (P<0. 05). The inflammatory cell infiltration of liver tissues in the hypothermia group was slighter than that in the control group. Conclusion: Infusion with cold 4C lactated Ringer's solution has a protective effect on liver trauma by inducing liver hypothermia to promote the recovery of liver function and alleviate liver inflammation reaction.

Reinforcing effect of calcium sulfate cement bovine bone morphogenetic protein on vertebral in the rabbit model of osteoporosis

OBJECTIVE@#To observe reinforcing effect of calcium sulfate cement (CSC) bovine bone morphogenetic protein (bBMP) on vertebral in the rabbit model of osteoporosis.@*METHODS@#A total of 48 New Zealand white rabbits were randomly divided into group I (blank control group), group II (CSC injection group), group III (CSC/bBMP injection group) and control group. White rabbit osteoporosis model was established rapidly by using castration method+methylprednisolone candidate. After modeling, groups II, III were given corresponding vertebral body injection material, and 4 animals were sacrificed respectively at 24 h, 6 weeks, 12 weeks after vertebral plasty. Tissue pathological status, vertebral mineral density and vertebral body bone mechanical strength were observed.@*RESULTS@#Vertebral body structure form was normal in the groups II and III. Trabecular bone coarsens, connection and repair were observed in micro fracture and bone defects, bone trabecular connectivity was superior to group I significantly; vertebral body compression strength in the group I was on the decline, vertebral compression strength in the groups II and III was on the rise, the largest vertebra. Postoperative BMC and BMD in groups II and III were increased, and significantly higher than group I after 6 weeks (P<0.05), BMC and BMD in group III after 12 weeks were higher than the other three groups.@*CONCLUSION@#Compound bBMP CSC has good bone induction. It can improve the three-dimensional construction effect for osteoporosis vertebral trabecula, and can significantly improve the vertebral strength, as a vertebral packing material with good application prospect.