Anisotropic elastic behavior of a hydrogel-coated electrospun polyurethane: Suitability for heart valve leaflets.

Although xenograft biomaterials have been used for decades in replacement heart valves, they continue to face multiple limitations, including limited durability, mineralization, and restricted design space due to their biological origins. These issues necessitate the need for novel replacement heart valve biomaterials that are durable, non-thrombogenic, and compatible with transcatheter aortic valve replacement devices. In this study, we explored the suitability of an electrospun poly(carbonate urethane) (ES-PCU) mesh coated with a poly(ethylene glycol) diacrylate (PEGDA) hydrogel as a synthetic biomaterial for replacement heart valve leaflets.

Note: Detector collimators for the nanoscale ordered materials diffractometer instrument at the Spallation Neutron Source.

Five neutron collimator designs were constructed and tested at the nanoscale ordered materials diffractometer (NOMAD) instrument. Collimators were made from High Density PolyEthylene (HDPE) or 5% borated HDPE. In all cases, collimators improved the signal to background ratio and reduced detection of secondary scattering.

The prevalence of latex allergy in patients with rhinitis.

Natural rubber latex hypersensitivity to the constituent proteins of natural rubber latex is now an international health problem. This study investigates the prevalence of latex allergy in patients presenting with rhinitis. Fifty-nine consecutive patients, who presented to a general Otolaryngology out-patient clinic with symptoms suggestive of rhinitis, completed a questionnaire and underwent skin prick testing.

Improving the endoscopic view of the hypopharynx with anterior neck traction during the trumpet manoeuvre.

The postcricoid subsite is difficult to visualize on flexible laryngopharyngoscopy. The view can be improved with either auto-insufflation manoeuvres or anterior neck skin traction. In this study, the view of the hypopharynx was graded whilst anterior neck skin traction was applied during the trumpet manoeuvre; the latter involves the patient blowing on his finger as if blowing up a balloon.

Otitis media with effusion and size at birth.

To investigate whether recurrent or persistent otitis media with effusion (OME) was associated with particular patterns of fetal growth, we conducted a case control study of 129 children admitted for insertion of grommets and 150 controls. The risk of OME was not statistically significantly related to gestational age or individual measures of size at birth, but the ratio of head circumference to total length and the ponderal index at birth were statistically significantly lower in children with OME, both before and after adjustment for the potentially confounding effects of sex, age at current operation, and maternal gravidity. Mothers of cases were 2.

Clinical applications of photodynamic therapy.

Photodynamic therapy is a modality for the treatment of malignant disease in which a photosensitive drug is selectively absorbed or retained by malignant tissues, after intravenous injection and is then photoactivated by light of an appropriate wavelength, often produced by a laser. Over the past two decades, the combination of haematoporphyrin derivative (HPD) and then its active component dihaematoprophyrin ether (DHE), now marketed as Photofrin, plus red light at 630 nm have been used in clinical practice for the treatment of a range of tumours; some very promising results have been obtained. Several countries have approved this drug/light combination for clinical use for a number of tumours.

Treatment of hereditary haemorrhagic telangiectasia by the pulsed dye laser.

Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome, Osler's disease) is an inherited abnormality of the vasculature characterized by abnormal subepithelial vessels. Treatment has included repeated intranasal cautery, intra-arterial embolization and arterial ligation. Historically, the operation of septodermoplasty and the use of systemic/topical oestrogens have been the most effective and lasting treatments, but over time the telangiectasias recur.

Long-term use of hearing aids in patients with presbyacusis.

The aim of this study was to determine how the use of a hearing aid in presbyacusis varied with the passage of time. A questionnaire survey of patients with presbyacusis who had been fitted with a monaural behind the ear NHS hearing aid for the first time was undertaken. The patients were divided into six groups ranging from 6 months to 5 years after fitting.

Idiopathic tracheal stenoses.

The case histories are presented of three patients with circumferential subglottic stenoses who presented, over a six-month period, to a teaching hospital's Otolaryngology department. No recognisable cause for their subglottic stenoses was found. Traumatic, iatrogenic, infectious and specific inflammatory processes were excluded.

Low adrenal androgen output in patients with abnormal laryngeal epithelium.

We present 16 new patients who had abnormal vocal cord biopsies. Each had a serum sex hormone profile performed on the morning of the procedure. The striking abnormality was that 12 (75%) had low dehydroepiandrosterone sulphate (DHEAS), the main adrenal androgen, and four of these had prepubertal levels.

Matrix-specific effect of endothelial control of smooth muscle cell migration.

Purpose: Smooth muscle cell (SMC) migration is a critical element in the development of intimal hyperplasia. The effect of endothelial cells (ECs) on SMC migration and the modulation of this cell-to-cell interaction by extracellular matrix is not well understood.

Methods: To examine this relationship SMCs and ECs were cocultured on opposite sides of a semipermeable membrane and were compared with SMCs cultured alone.

Diet-modified sex hormone metabolism: is this the way forward in recurrent respiratory papillomatosis and squamous carcinoma prophylaxis?

We report two cases of recurrent laryngeal papillomatosis in women who subsequently developed squamous cell carcinoma as they approached the climacteric. The role of human papilloma virus (HPV) and oestrogen metabolism is outlined. The use of indoles from cruciferous vegetables is also discussed.

Laryngeal papillomatosis with subsequent development of papillomata in the paranasal sinuses--is it seeding by intubation?

Concern has been expressed regarding the seeding of viral DNA, in laryngeal papillomatosis, to other sites in the respiratory tract during treatment. Controversy exists regarding the concept of seeding by the laser plume. However, instrumentation and anaesthetic intubation are also strongly implicated in seeding DNA to the proximal respiratory tract.

Tubeless anesthetic technique for optimal carbon dioxide laser surgery of the larynx.

Purpose: To evaluate the operative conditions and safety of a tubeless technique of anesthesia for carbon dioxide laser surgery of the larynx.

Materials And Methods: This prospective study evaluated 78 consecutive procedures in 72 adult patients undergoing carbon dioxide laser microlaryngeal surgery. Anesthesia was maintained by an intravenous infusion of Propofol (ICI Pharmaceuticals, Cheshire, UK) while the patient breathed spontaneously without endotracheal intubation.

Orbital infection secondary to sinusitis in children: diagnosis and management.

A series of 18 children with orbital infection secondary to sinusitis is described. The presenting symptoms were headache and periorbital swelling but it was found to be impossible to determine the stage of the orbital infection on clinical grounds. CT scanning can accurately identify the presence of a sub-periosteal abscess but both axial and coronal sections may be needed to diagnose abscesses in the superomedial portion of the orbit.

Necrotizing fasciitis of the face without significant trauma.

Necrotizing fasciitis is a rare but well recognized clinical entity which most often occurs on the trunk, perineum or legs following surgery or trauma. The condition is much less common in the head and neck and it is particularly uncommon in the midface/periorbital region. In almost all the cases occurring in the neck the condition follows obvious dental or oropharyngeal sepsis and in all the cases of the scalp there is a history of previous surgery or trauma.

Management of the parotid pleomorphic adenoma, the problem of exposing tumour tissue at operation. The logical pursuit of treatment policies.

The objective of treatment of a parotid pleomorphic adenoma is to remove all tumour cells with minimal short- and long-term morbidity and minimal recurrence rates. If an enucleation is carried out, the facial nerve may be put at risk and tumour fragments will inevitably be left in the wound. Most surgeons suggest that after enucleation, radiotherapy must be given to reduce the recurrence rate to an acceptable level.