Proposal for the existence of a nasogastric reflex in humans, as a potential cause of upper gastrointestinal symptoms

The nose is a gateway of air from the environment to the body and with its rich innervation from the olfactory and trigeminal nerves plays a critical role as a sensor in both human beings and primitive animals. Irritation of the nasal or paranasal mucosa may initiate a severe bradycardia, apnea, and vasoconstriction and increase the pulmonary airflow resistance. However, the interaction between nasal mucosa and the upper gastrointestinal tract is more often than not neglected in the clinical literature. We propose that a nasogastric reflex might exist with its afferent and efferent loops being the trigeminal and vagus nerves, respectively. The central connection of these loops is located at the pontomedullary level. The sensory inputs from the nasal mucosa to the general somatic afferent component of the brainstem including the pontine and medullary trigeminal nucleuses may induce the neighboring nucleus of the solitary tract and dorsal motor nucleus of the vagus. This initiates, via the efferent fibers of the vagus nerve, the manifestations of the vagal stimulation. The presence of a nasogastric reflex may warrant considerations as diseases of nose and paranasal sinuses may be the cause upper gastrointestinal symptmatology.     

Synthesis and antihypertensive activity of 1-(2-thiazolyl)-3, 5-disubstituted -2-pyrazolines

Several substituted 3-aryl-1-(4-aryl-2-thiazolyl)-5-(3-pyridyl)-2-pyrazolines were synthesized by reacting substituted 3-aryl-5-(3-pyridyl)-1-thiocarbamoyl-2-pyrazolines with phenacyl bromide in ethanol. The structures of all compounds were confirmed by IR, (1)H-NMR, mass spectral data and elemental analyses. The antihypertensive activity of compounds was examined by the tail-cuff method and compared with clonidine. Compounds 24-28 showed significant antihypertensive activity.     

Surfing prognostic factors in head and neck cancer at the millennium

The ability to reliably predict cancer outcome could tailor therapy to the aggressiveness of the tumour to achieve the best results in terms of loco-regional control, overall survival and quality of life. Retrospective and prospective clinical trials involving large series of patients have validated some predictive clinical and pathological factors, whereas the utility of many other prognostic factors has not been established. This has led to some confusion in clinical practice. In order to clarify the significance, role and cost of these prognostic factors we carried out a Medline search of all papers published between 1993 and 1998 concerning the reliability and cost of markers with prognostic significance, in head and neck squamous cell carcinoma, and assessed the results according to a number of criteria relating to reliability and cost. Regarding reliability we classified prognostic factors into: (1) those with a proven significance based on the fact that they were unanimously reported as having an independent statistical correlation with outcome and prognosis; and (2) those for which results were not unanimous, and which significance is still controversial. Cost analysis showed a substantial difference between validated tests which are of low cost and experimental tests which are expensive. Based on these data regarding both the reliability and cost of each prognostic factor, we propose guidelines for their use in clinical practice in the year 2000.     

Compartmental tongue surgery: Long term oncologic results in the treatment of tongue cancer

Compartmental tongue surgery (CTS) is a surgical technique that removes the compartments (anatomo-functional units) containing the primary tumor, eliminating the disease and potential muscular, vascular, glandular and lymphatic pathways of spread and recurrence. Compartment boundaries are defined as each hemi-tongue bounded by the lingual septum, the stylohyoid ligament and muscle, and the mylohyoid muscle. In this non-randomized retrospective study we evaluated the oncologic efficacy of CTS in patients with squamous cell carcinoma (SCCA) of the tongue treated from 1995 to 2008. We evaluated 193 patients with primary, previously untreated cT2-4a, cN0, cN+, M0 SCCA with no contraindication to anesthesia and able to give informed consent. Fifty patients treated between October 1995 and July 1999 received standard surgery (resection margin >1cm); 143 patients treated between July 1999 and January 2008 received CTS. Study endpoints were: 5-year local disease-free, locoregional disease-free and overall survival. After 5years, local disease control was achieved in 88.4% of CTS patients (16.8% improvement on standard surgery); locoregional disease control in 83.5% (24.4% improvement) and overall survival was 70.7% (27.3% improvement). The markedly improved outcomes in CTS patients, compared to those treated by standard surgery, suggest CTS as an important new approach in the surgical management of tongue cancer.     

Biomechanical stability of different suture fixation techniques for tibial eminence fractures

Purpose

Displaced tibial eminence fractures require surgical fixation in order to obtain a stable knee joint. Suture fixation with FiberWire^® seems to be the most favorable therapeutic option. Biomechanical studies show failure of this technique most commonly due to a suture cutout with subsequent fracture of the tibial eminence fragment. The goal of this study is to compare the biomechanical properties of three different techniques of suture fixation using FiberWire^®.

Methods

Bone mineral density was evaluated in 18 human knee specimens by pqCT, and three similar groups were formed. A standardized anterior tibial eminence fracture was created, and suture fixation was performed using one of three different techniques in 6 specimens each. Cyclic and destructive testing was conducted.

Results

Significant differences between the three techniques could be shown neither in the cycles needed to achieve a steady state nor in a failure load or initial stiffness. Almost all specimens failed by suture cutout.

Conclusion

The presented modification of the existing technique for suture fixation of tibial eminence fractures did not lead to an increased initial stability nor did it lower the rate of suture cutout. All tested suture techniques showed comparable initial stiffness and failure load.     

Angle stable locking nails versus conventionally locked intramedullary nails in proximal tibial shaft fractures: a biomechanical study

Introduction  

A tibial nail with fixed-angle locking screws intends to combine the advantages of angular stability and intramedullary stabilization in extraarticular proximal tibial fractures. The goal of this study is to analyze if the angle stable tibial nail (ASN) is biomechanically more stable than an established conventional standard nail (CN).     

Assessment and Investigation on the Fate of Organochlorine Pesticides in Water and Sediments of International Amir-kalaye Wetland in North of Iran

A total of 48 water samples and 24 sediment samples were collected at four sampling stations along the wetland during four seasons from 2009 to 2010 and analyzed by gas chromatograph–electron capture detector (GC–ECD). In water the total concentration of OCPs was 0.33, 0.01, 0.1 and 0.07 mg/L in summer, autumn, winter and spring, respectively. The most frequent OCP compounds detected were endrin and chlordane (0.08 and 0.07 mg/L), heaxachlorobenzene and chlordane (0.06, 0.02 mg/L), and chlordane (0.07 mg/L) in summer, winter and spring, respectively. The maximum concentration of ΣOCPs was found in samples collected from station 1 in summer (0.26 mg/L). In sediments the total concentrations of OCPs were 15.84 and 2.62 mg/g-dry weight (dw) in summer and winter, respectively. Chlordane was the most frequently found OCP compound, followed by lindane, 9.92 and 2.47 mg/g-dry weight (dw), respectively, in summer. While, lindane (2.52 mg/g-dw) and endosulfan I (0.1 mg/g-dw) were the highest OCP compounds detected in winter. The results obtained in this study show that there still exist a variety of organochlorine pesticide residues in the water and sediments from the Amir-kalaye wetland in Iran.