RESUMEN
A fungal ball consists of a dense conglomerate of fungal hyphae growing at the surface of the sinus mucosa without tissue infiltration. The maxillary sinus is by far the most commonly involved paranasal sinus cavity followed by the sphenoid sinus. The present study is a retrospective study of 25 consecutive cases treated during the last 10 years in the two hospitals be- longing to the Catholic University of Louvain (CHU Mont-Godinne and UCL Saint Luc). We report the symptomatology, the imaging and discuss the different surgical managements. We conclude that the clinician must have a high index of suspicion when dealing with a unilateral rhinosinusitis persisting despite a maximal and well conducted medical treatment. This is particularly so in elderly women when associated with facial pain and post nasal drip, particularly when the computed tomography shows an unilateral opacity of the sphenoid sinus with or without a sclerosis or an erosion of the bony walls, a polyp in the sphenoethmoidal recess or a hyperdensity mimicking a foreign body. An endonasal endoscopic sphenoidotomy is the treatment of choice in most cases, allowing good ventilation of the sinus and radical removal of all the fungal concretion. A biopsy of the sinus mucosa adjacent to fungal elements is of upmost important to confirm the non- invasiveness of the fungi within the tissue. Antifungal medication is not required in uncomplicated forms. All host factors producing some degree of immunosuppression must be corrected when present and must alert the clinician to rule out any forms of invasive disease.
Asunto(s)
Micosis/diagnóstico , Micosis/cirugía , Seno Esfenoidal/microbiología , Sinusitis del Esfenoides/diagnóstico , Sinusitis del Esfenoides/microbiología , Sinusitis del Esfenoides/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
The capability to image real time cell/material interactions in a three-dimensional (3D) culture environment will aid in the advancement of tissue engineering. This paper describes a perfusion flow bioreactor designed to hold tissue engineering scaffolds and allow for in situ imaging using an upright microscope. The bioreactor can hold a scaffold of desirable thickness for implantation (>2 mm). Coupling 3D culture and perfusion flow leads to the creation of a more biomimetic environment. We examined the ability of the bioreactor to maintain cell viability outside of an incubator environment (temperature and pH stability), investigated the flow features of the system (flow induced shear stress), and determined the image quality in order to perform time-lapsed imaging of two-dimensional (2D) and 3D cell culture. In situ imaging was performed on 2D and 3D, culture samples and cell viability was measured under perfusion flow (2.5 mL/min, 0.016 Pa). The visualization of cell response to their environment, in real time, will help to further elucidate the influences of biomaterial surface features, scaffold architectures, and the influence of flow induced shear on cell response and growth of new tissue.
Asunto(s)
Materiales Biocompatibles/metabolismo , Reactores Biológicos , Imagenología Tridimensional , Osteoblastos/metabolismo , Ingeniería de Tejidos/métodos , Animales , Técnicas de Cultivo de Célula , Línea Celular , Supervivencia Celular , Células Clonales , Medios de Cultivo , Ratones , Perfusión , Poliésteres/metabolismo , Especificidad por Sustrato , Ingeniería de Tejidos/instrumentaciónRESUMEN
BACKGROUND: The most powerful predictor of survival for patients with melanoma is the status of the regional lymph nodes. Sentinel lymph node biopsy may provide improved staging accuracy without the morbidity of elective lymph node dissection (ELND). METHODS: Sixty-eight patients with intermediate thickness melanoma underwent gamma probe guided sentinel node biopsy without ELND and were followed up over a mean of 22 months. RESULTS: A sentinel node was found in all patients. Six patients (9%) had positive sentinel nodes; all underwent complete lymphadenectomy. Two patients (3%) with negative sentinel nodes developed nodal recurrence; 1 of these patients was found to have microscopic disease on reexamination of the sentinel node. Two patients (3%) developed systemic disease. CONCLUSION: Gamma probe guided sentinel node biopsy can be performed with a high rate of technical success. It provides accurate pathological staging with a low incidence of nodal basin failure.
Asunto(s)
Biopsia con Aguja/métodos , Ganglios Linfáticos/patología , Melanoma/patología , Neoplasias Cutáneas/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Escisión del Ganglio Linfático , Masculino , Melanoma/diagnóstico por imagen , Persona de Mediana Edad , Estadificación de Neoplasias/métodos , Valor Predictivo de las Pruebas , Pronóstico , Cintigrafía/métodos , Neoplasias Cutáneas/diagnóstico por imagenRESUMEN
True commitment and top executive performance can best be achieved through a combination of making the right hiring decision, providing appropriate authority, developing a trusting relationship, and providing appropriate compensation.
Asunto(s)
Planes para Motivación del Personal , Práctica de Grupo/organización & administración , Administración de Personal , Ejecutivos Médicos , Humanos , Salarios y Beneficios , Estados UnidosRESUMEN
Results of three extensive plant field tests using both area and personal sampling and involving 51 sets of comparison samples show the Du Pont Pro-Tek Formaldehyde Badge to have excellent correlation with three commonly used formaldehyde monitoring methods. In addition, comprehensive laboratory validation tests are reported which confirm an overall accuracy of +/- 9.6 to +/- 11.6% for the badge over an exposure range of 0.12-6.8 ppm. Laboratory test data are also included showing that the badge: (1) meets NIOSH and OSHA accuracy requirements of less than or equal to +/- 25% down to 1.6 ppm-hours (200 ppb) for an 8-hour TWA exposure; (2) is capable of accurately sampling for 15-minute exposures; and (3) is not affected by pressure or relative humidity variations.
Asunto(s)
Contaminantes Ocupacionales del Aire/análisis , Formaldehído/análisis , Colorimetría , Estudios de Evaluación como Asunto , HumanosRESUMEN
A rapid stability-indicating high-performance liquid chromatographic assay for noxythiolin has been developed and its application to the determination of the shelf-life of solid and solution forms is illustrated. Kinetic models which describe the degradation profile have been evaluated and concentrated solutions are modelled by a A B + C system whereas more dilute solutions approximate to the A B or limiting first-order case.