Mapping surgical coordinates of the sphenopalatine foramen : surgical navigation study

Aims to identify measurements that may help intra operative localisation of the sphenopalatine foramen. The study used three dimensional surgical navigation software to study radiological anatomy, in order to define the distances and angulations between identifiable bony landmarks and the sphenopalatine foramen. The distance from the anterior nasal spine to the sphenopalatine foramen was 59 mm (+4 mm; inter observer variation = 0.866; intra observer variation = 0.822). The distance from the piriform aperture to the sphenopalatine foramen was 48 mm (+4 mm; inter observer variation = 0.828; intra observer variation = 0.779). The angle of elevation from the nasal floor to the sphenopalatine foramen was 22 degrees (+3 degrees; inter observer variation = 0.441; intra observer variation = 0.499). The sphenopalatine foramen is consistently identifiable on three dimensional, reconstructed computed tomography scans. Repeatable measurements were obtained. The centre point of the foramen lies 59 mm from the anterior nasal spine at 22 degrees elevation above the plane of the hard palate and 48 mm from the piriform aperture. We discuss how these data could be used to facilitate intra operative location of the sphenopalatine foramen in difficult cases

Adenosine A1 Receptors Promote Vasa Vasorum Endothelial Cell Barrier Integrity via Gi_{i} and Akt-Dependent Actin Cytoskeleton Remodeling

Background: In a neonatal model of hypoxic pulmonary hypertension, a dramatic pulmonary artery adventitial thickening, accumulation of inflammatory cells in the adventitial compartment, and angiogenic expansion of the vasa vasorum microcirculatory network are observed. These pathophysiological responses suggest that rapidly proliferating vasa vasorum endothelial cells (VVEC) may exhibit increased permeability for circulating blood cells and macromolecules. However, the molecular mechanisms underlying these observations remain unexplored. Some reports implicated extracellular adenosine in the regulation of vascular permeability under hypoxic and inflammatory conditions. Thus, we aimed to determine the role of adenosine in barrier regulation of VVEC isolated from the pulmonary arteries of normoxic (VVEC-Co) or chronically hypoxic (VVEC-Hyp) neonatal calves. Principal Findings We demonstrate via a transendothelial electrical resistance measurement that exogenous adenosine significantly enhanced the barrier function in VVEC-Co and, to a lesser extent, in VVEC-Hyp. Our data from a quantitative reverse transcription polymerase chain reaction show that both VVEC-Co and VVEC-Hyp express all four adenosine receptors (A1, A2A, A2B, and A3), with the highest expression level of A1 receptors (A1Rs). However, A1R expression was significantly lower in VVEC-Hyp compared to VVEC-Co. By using an A1R-specific agonist/antagonist and siRNA, we demonstrate that A1Rs are mostly responsible for adenosine-induced enhancement in barrier function. Adenosine-induced barrier integrity enhancement was attenuated by pretreatment of VVEC with pertussis toxin and GSK690693 or LY294002, suggesting the involvement of G$_{i}$ proteins and the PI3K-Akt pathway. Moreover, we reveal a critical role of actin cytoskeleton in VVEC barrier regulation by using specific inhibitors of actin and microtubule polymerization. Further, we show that adenosine pretreatment blocked the tumor necrosis factor alpha (TNF-α)-induced permeability in VVEC-Co, validating its anti-inflammatory effects. Conclusions: We demonstrate for the first time that stimulation of A1Rs enhances the barrier function in VVEC by activation of the G$_{i}$/PI3K/Akt pathway and remodeling of actin microfilament

Etiological Profile and Treatment Outcome of Epistaxis at a Tertiary Care Hospital in Northwestern Tanzania: A Prospective Review of 104 Cases.

Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania. This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15. A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%. Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre

Sliding Mode Controller with Multisensor Data Fusion for Piezo Actuated Structure

The benefits of multisensor data fusion (MSDF) in controlling the piezo actuated beam structure using sliding mode controller (SMC) has been brought out. The first two vibrating modes of the smart cantilever beamare measured by two sensors namely, piezoelectric sensor and laser displacement sensor. The states are estimated from the sensors outputs using information filter, which were then fused and applied as input to the controller. The controller has been designed from the linear dynamic model of a piezo actuated beam, identified using linear recursive least square (RLS) method based on ARX model. A digital control system consisting of virtual instrumentation software LabVIEW, and USB data acquisition module NI 6008, was used for simulation and real-time control. Improved closed-loop performance was obtained when the controller designed used fused data, as compared to the closed-loop performance obtained with a single sensor. The beam structure considered in this work was a pilot model of the structures used in aerospace applications. Simulation and experimental results presented demonstrate the benefits of data fusion in controlling the vibration modes.Defence Science Journal, 2011, 61(4), pp.346-353, DOI:http://dx.doi.org/10.14429/dsj.61.111

The role of atopy in otitis media with effusion among primary school children: audiological investigation

Objective of this study is to value the role of atopy in otitis media with effusion (OME) in children attending primary school in Western Sicily focusing on the audiological characteristics among atopic and non atopic subjects suffering from OME. 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests. The parameters considered were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months; presence of B or C tympanogram; absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz through 4 kHz. 56 children (18.06%) resulted atopics while 254 were non atopics. OME was identified in 24 atopic children and in 16 non atopic children for a total number of 40 children; the overall prevalence rate was 12.9% (42.85% for G1 and 6.30% for G2). OME was bilateral in 28 children (70%), with a significative difference between G1 (79.17%) and G2 (56.25%). The prevalence of B tympanogram was 70.59%, corresponding to 79.07% for G1 and 56% for G2. The mean air conduction pure tone was respectively 31.97 dB for G1 and 29.8 dB for G2. The prevalence value of OME in atopics children, also supported by the higher predominance of bilaterality, B tympanogram and hearing loss among this group, could suggest the important role of allergy in the pathogenesis of OME

Bats in the Ghats: Agricultural intensification reduces functional diversity and increases trait filtering in a biodiversity hotspot in India

The responses of bats to land-use change have been extensively studied in temperate zones and the neotropics, but little is known from the palaeotropics. Effective conservation in heavily-populated palaeotropical hotspots requires a better understanding of which bats can and cannot survive in human-modified landscapes. We used catching and acoustic transects to examine bat assemblages in the Western Ghats of India, and identify the species most sensitive to agricultural change. We quantified functional diversity and trait filtering of assemblages in forest fragments, tea and coffee plantations, and along rivers in tea plantations with and without forested corridors, compared to protected forests. Functional diversity in forest fragments and shade-grown coffee was similar to that in protected forests, but was far lower in tea plantations. Trait filtering was also strongest in tea plantations. Forested river corridors in tea plantations mitigated much of the loss of functional diversity and the trait filtering seen on rivers in tea plantations without forested corridors. The bats most vulnerable to intensive agriculture were frugivorous, large, had short broad wings, or made constant frequency echolocation calls. The last three features are characteristic of forest animal-eating species that typically take large prey, often by gleaning. Ongoing conservation work to restore forest fragments and retain native trees in coffee plantations should be highly beneficial for bats in this landscape. The maintenance of a mosaic landscape with sufficient patches of forest, shade-grown coffee and riparian corridors will help to maintain landscape wide functional diversity in an area dominated by tea plantations

Reduced cortical thickness in patients with acute-on-chronic liver failure due to non-alcoholic etiology

Background: Acute-on-chronic liver failure (ACLF) is a form of liver disease with high short-term mortality. ACLF offers considerable potential to affect the cortical areas by significant tissue injury due to loss of neurons and other supporting cells. We measured changes in cortical thickness and metabolites profile in ACLF patients following treatment, and compared it with those of age matched healthy volunteers. Methods: For the cortical thickness analysis we performed whole brain high resolution T1-weighted magnetic resonance imaging (MRI) on 15 ACLF and 10 healthy volunteers at 3T clinical MR scanner. Proton MR Spectroscopy (1H MRS) was also performed to measure level of altered metabolites. Out of 15 ACLF patients 10 survived and underwent follow-up study after clinical recovery at 3 weeks. FreeSurfer program was used to quantify cortical thickness and LC- Model software was used to quantify absolute metabolites concentrations. Neuropsychological (NP) test was performed to assess the cognitive performance in follow-up ACLF patients compared to controls. Results: Significantly reduced cortical thicknesses in multiple brain sites, and significantly decreased N-acetyl aspartate (NAA), myo-inositol (mI) and significantly increased glutamate/glutamine (glx) metabolites were observed in ACLF compared to those of controls at baseline study. Follow-up patients showed significant recovery in cortical thickness and Glx level, while NAA and mI were partially recovered compared to baseline study. When compared to controls, follow-up patients still showed reduced cortical thickness and altered metabolites level. Follow-up patients had abnormal neuropsychological (NP) scores compared to controls. Conclusions: Neuronal loss as suggested by the reduced NAA, decreased cellular density due to increased cerebral hyperammonemia as supported by the increased glx level, and increased proinflammatory cytokines and free radicals may account for the reduced cortical thickness in ACLF patients. Presence of reduced cortical thickness, altered metabolites and abnormal NP test scores in post recovery subjects as compared to those of controls is associated with incomplete clinical recovery. The current imaging protocol can be easily implemented in clinical settings to evaluate and monitor brain tissue changes in patients with ACLF during the course of treatment

High energy X-γ ray spectrometer on the Chandrayaan-1 mission to the Moon

The Chandrayaan-1 mission to the Moon scheduled for launch in late 2007 will include a high energy X-ray spectrometer (HEX) for detection of naturally occurring emissions from the lunar surface due to radioactive decay of the 238U and 232Th series nuclides in the energy region 20-250 keV. The primary science objective is to study the transport of volatiles on the lunar surface by detection of the 46.5 keV line from radioactive 210Pb, a decay product of the gaseous 222Rn, both of which are members of the 238U decay series. Mapping of U and Th concentration over the lunar surface, particularly in the polar and U-Th rich regions will also be attempted through detection of prominent lines from the U and Th decay series in the above energy range. The low signal strengths of these emissions require a detector with high sensitivity and good energy resolution. Pixelated Cadmium-Zinc-Telluride (CZT) array detectors having these characteristics will be used in this experiment. Here we describe the science considerations that led to this experiment, anticipated flux and background (lunar continuum), the choice of detectors, the proposed payload configuration and plans for its realizatio