Interinstitutional and intrainstitutional transmission of a strain of Acinetobacter baumannii detected by molecular analysis: comparison of pulsed-field gel electrophoresis and repetitive sequence-based polymerase chain reaction.

Pulsed-field gel electrophoresis and repetitive sequence-based polymerase chain reaction provided comparable strain discrimination with minor discordance in typing Acinetobacter baumannii clinical isolates from patients at our hospital and affiliated institutions. Typing revealed a cluster strain with intrainstitutional and interinstitutional spread during the study period. A long-term acute care facility may have been the reservoir.

Structural approach to endonasal rhinoplasty.

The marriage of endonasal rhinoplasty with structural grafting has resulted in more consistent rhinoplasty results. The nasal base can be stabilized by tongue-in-groove techniques, a columellar strut, or extended columellar strut. The middle vault can be addressed with spreader grafts or butterfly grafts.

Nuances in tip modification: specific applications of cartilage splitting in rhinoplasty.

Division of the lower lateral cartilages in rhinoplasty has long been maligned for producing unnatural results. However, recognition of medial, intermediate, or lateral crural discrepancies allows for their division and overlay. By identifying variant nasal anatomy and understanding the anticipated postsurgical dynamics, the rhinoplasty surgeon will be able to produce consistent, natural outcomes.

Aligning the bony nasal vault in rhinoplasty.

The bony nasal vault represents a complex three-dimensional structure, analogous to a truncated pyramid or pyramidal frustrum. By analyzing the nasal bones and determining the length and width of the nasal bones, appropriate surgical measures can be employed. In addition, a review of several different osteotomy techniques is performed.

Management of congenital bilateral subluxated cataract with Cionni ring.

Use of Cionni ring helped in the successful intraocular lens (IOL) implantation in a 30-year-old patient with bilateral congenital subluxated cataracts. The IOL was stable, well-centered without any iridodonesis or pseudophakodonesis.

Distal femoral allograft reconstruction for massive osteolytic bone loss in revision total knee arthroplasty.

Massive osteolytic bone loss in revision total knee arthroplasty has been an uncommon challenge. From 2001 to 2002, 11 knees in 10 patients underwent revision of failed modular PFC (Johnson and Johnson Orthopaedics, Raynham, Mass) total knee arthroplasties with distal femoral allografts and long-stemmed revision implants for massive osteolytic induced femoral bone loss. The mean follow-up was 42 months (range, 36-48 months).

Concentric and eccentric carved costal cartilage: a comparison of warping.

Objective: To determine if a systematic, concentric graft-carving technique results in less warping than eccentric carving.

Methods: Costal cartilage from ribs 3 through 9 were harvested from fresh human cadavers. Concentric dorsal grafts were carved from cartilage obtained from one side of the cadaver (n = 7) and eccentric grafts were carved from the opposite side (n = 11).

Double-blind, randomised, controlled trial assessing controller medications in asthma.

Background: The motive behind conducting this study was to determine if better control of asthma can be achieved by adding a second controller medication and to assess its use to reduce the dose of inhaled steroids.

Objectives: The study aimed to determine whether either oral sustained-release theophylline or montelukast added to inhaled steroids improved clinical symptoms and pulmonary function test parameters when compared to high-dose steroids alone.

Methods: Ninety patients with incompletely controlled asthma were allocated, in a randomised, double-blind fashion, to one of three treatment groups: group A: double dose of inhaled budesonide (400 microg b.

Inverse relation between in vivo amyloid imaging load and cerebrospinal fluid Abeta42 in humans.

Objectives: Amyloid-beta(42) (Abeta(42)) appears central to Alzheimer's disease (AD) pathogenesis and is a major component of amyloid plaques. Mean cerebrospinal fluid (CSF) Abeta(42) is decreased in dementia of the Alzheimer's type. This decrease may reflect plaques acting as an Abeta(42) "sink," hindering transport of soluble Abeta(42) between brain and CSF.

Improvement of the quality of whole wheat bread by supplementation of xylanase from Aspergillus foetidus.

The possible use of xylanase from Aspergillus foetidus MTCC 4898 as a bread improver was tested in whole wheat bread. The partially purified xylanase was used as an additive at 12 U/g during mixing of wheat flour. The effects of xylanase addition on the fermentation stage and the final bread quality were analyzed.

Absence of proximal neck dilatation and graft migration after endovascular aneurysm repair with balloon-expandable stent-based endografts.

Objective: Proximal neck dilatation (PND) and/or endograft migration with the subsequent development of type I endoleak is a significant cause of late endograft failure after endovascular abdominal aortic aneurysm repair (EVAR). Although there are numerous reports examining PND in patients receiving endografts that use self-expanding stents (SES) for proximal fixation, there are no such reports for patients treated with endografts that use balloon-expanding stents (BES). The purpose of this study was to investigate PND and endograft migration after EVAR with BES endografts.

Local anaesthetic flush reduces postoperative pain and haematoma formation after great saphenous vein stripping--a randomised controlled trial.

Objectives: To observe the effect of local anaesthetic flush through the great saphenous vein (GSV) tunnel on postoperative pain and haematoma formation following saphenous vein stripping operations.

Design: Prospective, double-blind, randomised, control trial.

Methods: One hundred patients were randomized to receive 20 ml of local anaesthetic (bupivacaine 0.

Sinusitis in HIV: microbiology and therapy.

Rhinosinusitis in the HIV-infected population is an increasingly common finding as HIV infection has transitioned toward becoming a chronic medical condition. In this patient population, rhinosinusitis may be challenging to diagnose and treat effectively. However, adequate diagnostic tools are available, microbial identity can be reasonably anticipated based on the CD4 count, and effective management strategies can be implemented.

Role of matrix metalloproteinases in apoptosis after transient focal cerebral ischemia in rats and mice.

The involvement of matrix metalloproteinases (MMPs) in cerebral ischemia-induced apoptosis was investigated in a model of transient focal cerebral ischemia in rats treated intracerebroventricularly (i.c.v.

Multi-germ layer lineage central nervous system repair: nerve and vascular cell generation by embryonic stem cells transplanted in the injured brain.

Object: To restore proper function to a damaged central nervous system (CNS) through transplantation, it is necessary to replace both neural and nonneural elements that arise from different germ layers in the embryo. Mounting evidence indicates the importance of signals related to vasculogenesis in governing neural proliferation and differentiation in early CNS development. Here, the authors examined whether embryonic stem cell (ESC)-derived progenitors can selectively generate both neural and endothelial cells after transplantation in the damaged CNS.

Pitfalls of photography for facial resurfacing and rejuvenation procedures.

Photography's role in documenting changes after aesthetic surgical procedures is well established. Facial resurfacing procedures usually cause subtle changes in skin topography. Capturing these objective photographic differences necessitates an understanding of basic photographic principles pertinent to accurately documenting photographic changes.

Acute and chronic health effects due to green tobacco exposure in agricultural workers.

Background: An epidemiological study was undertaken in Gujarat, India to study the acute and chronic health effects of occupational exposure to green tobacco.

Methods: Non-Flue Cured Virginia (FCV) tobacco is the main crop in many districts of Central Gujarat. Three villages were selected from Anand district for the study and a random sample of 685 exposed workers were examined.

Sinusitis in HIV: Microbiology and Therapy.

Rhinosinusitis in the HIV-infected population is an increasingly common finding as HIV infection has transitioned toward becoming a chronic medical condition. In this patient population, rhinosinusitis may be challenging to diagnose and effectively treat. However, adequate diagnostic tools are available, microbial identity can be reasonably anticipated based on the CD4 count, and effective management strategies can be implemented.

The downstream financial effect of hepatology.

As a more consultative but less procedurally oriented specialty, Hepatology has been considered a financial liability in some academic centers. However, no actual data exist on the relative contribution of a Hepatology practice. The purpose of this study was to evaluate the direct and indirect (i.

Leukocyte-derived matrix metalloproteinase-9 mediates blood-brain barrier breakdown and is proinflammatory after transient focal cerebral ischemia.

Results of recent studies reveal vascular and neuroprotective effects of matrix metalloproteinase-9 (MMP-9) inhibition and MMP-9 gene deletion in experimental stroke. However, the cellular source of MMP-9 produced in the ischemic brain and the mechanistic basis of MMP-9-mediated brain injury require elucidation. In the present study, we used MMP-9-/- mice and chimeric knockouts lacking either MMP-9 in leukocytes or in resident brain cells to test the hypothesis that MMP-9 released from leukocytes recruited to the brain during postischemic reperfusion contributes to this injury phenotype.

Cementless bipolar hemiarthroplasty for displaced femoral neck fractures in the elderly.

Controversy exists regarding the use of cementless femoral fixation for hip arthroplasties in elderly patients. This study reviews the clinical and radiographic outcomes of cementless bipolar hemiarthroplasties in patients older than 65 years of age. From 1998 to 2000, 256 cementless bipolar hemiarthroplasties were performed in 248 patients with displaced femoral neck fractures who had a mean age of 77 years.

Corneal endothelial safety of intracameral preservative-free 1% xylocaine.

Purpose: To evaluate the effect of intracameral preservative-free 1% xylocaine on the corneal endothelium as an adjuvant to topical anaesthesia during phacoemulsification and Acrysof foldable IOL implantation.

Material & Methods: This is a prospective, controlled, randomised, double-masked study. 106 patients with soft to moderately dense (Grade 1-3) senile cataract and corneal endothelial cell density of >1500/mm2 were randomised to the xylocaine group (n=53) and control group(n=53).

Superficial skin resurfacing.

Options for both the cosmetic surgeon offering and patients seeking treatment for cutaneous aging have expanded greatly in recent years and continue to grow. Increasingly sophisticated aesthetic patients are seeking procedures to rejuvenate in record numbers,but many are unwilling to tolerate a large amount of downtime. In expert hands, ablative laser resurfacing has a long history of dramatic results for the treatment of cutaneous aging.

Frequency of reduced vancomycin susceptibility and heterogeneous subpopulation in persistent or recurrent methicillin-resistant Staphylococcus aureus bacteremia.

Vancomycin susceptibility was checked in isolates from initial and final blood samples obtained from 22 patients with persistent or recurrent methicillin-resistant Staphylococcus aureus bacteremia. The minimum inhibitory concentration of vancomycin was determined using Etest and found to have increased in 2 pairs of isolates, and results of screening in 4 mu g vancomycin and a modified population analysis profile suggested heteroresistance in 3 isolates (13.6%).