Repair of Nasal Septal Perforation with Porcine Small Intestinal Submucosa Xenograft

Background: Numerous techniques have been described for nasal septal perforation repair, with various degrees of success in achieving closure. Evidence supports the use of bilateral mucoperichondrial advancement flaps with interpositional grafting for greatest success. Many surgeons use autografts such as fascia, cartilage, bone, and pericranium, however, extracellular matrices have also become popular. Objective: We analyze factors determining the success of nasal septal perforations repaired using using an acellular, freeze-dried interpositional xenograft derived from Porcine Small Intestinal Submucosa (PSIS). Methods: Patients with septal perforation repaired by the senior author from 1998 to 2006 were examined in a retrospective chart review with regard to perforation size, etiology, pre- and postoperative symptoms, follow-up, outcomes and complications. Results: Forty-seven PSIS repairs were performed on 46 patients. Two procedures were planned staged procedures. Of the total 47 procedures, 41 (87.2%) continued to be closed at the site of repair during the follow up period. Follow up ranged from 6 months to 4.9 years with a mean of 18.3 months. Two patients (4.3%) were found to have perforations at the site of closure in the immediate post-operative period. One patient (2.1%) perforated at the site of closure after the immediate post-operative period. Subjective symptom scores demonstrated improvement in crusting, epistaxis and obstruction postoperatively. Larger perforations correlated with poorer outcomes. Conclusions: The authors conclude that closure of nasal septal perforation with an interpositional xenograft derived from PSIS compares favorably to published results for autografts with advantages including absence of donor site morbidity, easy graft modification and manipulation, and shorter operative time

A Preliminary Report of Percutaneous Craniofacial Osteoplasty in a Rat Calvarium

Objective: To evaluate the potential for injectable, permanent bone augmentation by assessing the biocompatibility and bioactivity of subperiosteal hydroxylapatite (Radiesse) deposition in a rat model. Methods: Fourteen adult Sprague Dawley rats were injected in the parietal skull with hydroxylapatite (n=10) or a carrier gel control (n=4), using a subperiosteal injection technique on the right and a subcutaneous injection technique on the left. At 1, 3, and 6 months, 3 rats (1 negative control, 2 variables) were sacrificed. At 12 months, the remaining 5 rats were sacrificed. After each harvest, the calvaria were examined under both light and polarized microscopy. Results: The inflammatory response was limited in all specimens. Injectables were still present 12 months after the injection. New bone formation was only seen when the injection was located deep to a disrupted periosteum The odd of new bone formation was 48.949 times higher (95% CI (2.637, 3759.961), p = 0.002) with subperiosteal hydroxylapatite injections compared to all other combinations of injection plane and injectable. Conclusion: This preliminary report of subperiosteal hydroxylapatite (Radiesse) injection in a rat model has verified the biocompatibility of injectable hydroxylapatite at the bony interface and suggests the potential for new bone formation

Metrics for Transparency

Transparency is a novel non-functional requirement for software systems. It is acclaimed to improve the quality of service since it gives users access to information concerning the system's processes, clarifying who is responsible if something goes wrong. Thus, it is believed to support people's right to a secure and private processing of their personal data. We define eight quality metrics for transparency and we demonstrate the usage and the effectiveness of the metrics by assessing transparency on the Microsoft HealthVault, an on-line platform for users to collect, store, and share medical records

An assessment of the policy and legal framework necessary for the extension of water supply to informal settlements in Freetown

Accessing water in Freetown’s informal settlement faces various challenges. This study conducted an assessment of the existing legal and policy framework that governs water supply to informal settlements in Freetown. Through the Literature review and analysis from the expert interviews and focus group discussions, the research found that there are areas within the legal, policy and strategy documents that must be addressed, to create the necessary framework for increasing access to water supply in these communities. Key recommendations from the findings includes: the Ministry of Water Resources in consultations with key stakeholders must develop a comprehensive water law; roles and responsibilities must be clarified, coordination and collaboration among sector stakeholders must be regularised for better planning and the Central and Local Government together with the Utility Company must improve on community engagement with these communities

Differences and Similarities in the Discourse of Equality in Cross Cultural Academic Dialogues Europe-China.

In her paper "Differences and Similarities in the Discourse of Equality in Cross Cultural Academic Dialogues Europe-China" Xiana Sotelo provides an overall summary of the historical, political and socioeconomic context of Chinese women and their understanding of equality. The paper also embraces commonalities and nodal points between Chinese and European gender academics. In particular, it highlights the realization that cross-cultural misunderstandings are not triggered by essential differences among us, but by the ignorance of our particularities and specific contexts. The willingness to be open to the diversity of each other´s realities, and to reject hegemonic discourses of sameness, paves the way to recognize that women´s equality and liberation cannot be cross-culturally imposed. Retaining differences and interacting peacefully is the first step towards achieving intercultural cooperation and respect.post-print358 K