The Impact of Septoplasty on Cardiopulmonary Functions in Patients With Nasal Septal Deviation: A Prospective Comprehensive Analysis of Echocardiographic Outcome and Serum N-Terminal Pro BNP Levels.

ABSTRACT: This study was designed to evaluate the impact of septoplasty on cardiopulmonary functions in patients with nasal septal deviation (NSD). A total of 30 consecutive adult patients (mean [standard deviation] age: 33.7 [10.9] years, 56.7% were males) who underwent septoplasty due NSD were included. Visual analog scale scores, nose obstruction symptom evaluation scale scores, serum N-terminal Pro BNP levels, and cardiologic examination findings on electrocardiogram, transthoracic echocardiography, and exercise treadmill testing were evaluated both 7 days before and 3-months after septoplasty operation. A significant decrease was noted in mean (standard deviation) visual analog scale scores (8.27 [0.83] versus 1.87 [0.73], P < 0.001), and nose obstruction symptom evaluation scores (83.7 [4.9] versus 12.7 [(5.4], P < 0.001) from preoperative to postoperative period, while maximum effort capacity was improved significantly (11.8 [1.9] versus 13.1 [2.1], P = 0.010) after septoplasty. Echocardiography findings at 3rd postoperative month revealed significant decrease in pulmonary artery systolic pressure (22.2 [3.2] versus 19.0 [3.6], P = 0.001), whereas significant increase in trans-mitral early diastolic rapid filling (E wave, 0.82 [0.14] versus 0.87 [0.13], P = 0.011), peak systolic velocity (S, 0.11 [0.02] versus 0.12 [0.02], P = 0.002), tricuspid annular plane systolic excursion (22.6 [3.2] versus 24.9 [2.9], P = 0.002), and right ventricle stroke volume (0.14 [(0.02] versus 0.15 [0.02], P = 0.013). In conclusion, our findings indicate favorable outcome of septoplasty in NSD patients not only in terms of improved nasal airflow but also cardiopulmonary functions, particularly the exercise capacity, pulmonary artery pressure, and right ventricular systolic functions. In this regard, our findings emphasize the important role of treating NSD patients without delay, given the likelihood of septoplasty to reverse the changes in the pulmonary artery system and to prevent onset of permanent cardiopulmonary dysfunction via amelioration of chronic obstruction of the upper respiratory tract.

Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: is it common or rare?

Globus pallidus involvement is a well-known magnetic resonance (MR) imaging finding of acute kernicterus. However, it is not clear how early the involvement of globus pallidus occurs and whether or not it is seen in every case. Therefore, we aimed to investigate the globus pallidus involvement in 13 neonates with acute kernicterus by MR imaging. Thirteen neonates who were admitted with jaundice, encephalopathy and indirect hyperbilirubinemia (mean, 37.0 mg/dl) were prospectively evaluated with cranial MR imaging. Pathological signal changes were noted concerning the globus pallidus. Eight of the 13 patients demonstrated bilateral, symmetric increased signal intensity in the globus pallidus on T1-weighted MR imaging. These lesions were not apparent on T2-weighted images. Multiple parenchymal punctuate T1 hyperintense lesions were detected in one patient without globus pallidus involvement. This appearance was consistent with hemorrhage. The MR imaging findings of the other four patients showed no evidence of abnormality. The symmetric involvement of globus pallidus seen as hyperintense on T1-weighted MR imaging is a common and characteristic finding of acute kernicterus.

Generation of anti-idiotypic antibodies that mimic HBsAg and vaccination against hepatitis B virus.

The advent of hybridoma technology has opened up a new avenue in vaccine development, and antigen-mimicking properties of anti-idiotypic antibodies have provided promising alternatives in the generation of experimental anti-idiotypic vaccines. In the present study, mice were immunized with anti-hepatitis B virus (HBV) mouse monoclonal and anti-HBV goat polyclonal antibody to produce anti-idiotypic antibodies. Two mouse monoclonal antibodies (6C9, 6H9) were obtained from the fusions, and the immunogenic properties and specificity of antibodies were analyzed. BALB/c mice were immunized with varying concentrations of anti-idiotypic antibodies (25, 50, 75, and 100 micrograms of anti-Id), and it was shown that anti-idiotypic antibodies generated hepatitis B surface antigen (HBsAg), as well as a BSA-specific antibody response. A simple method for the purification of monoclonal antibodies by dialyzing antibody against water has also been reported.