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To investigate the possible clinical relationship between gastroesophageal reflux disease and the type one tympanoplasty surgical outcomes of adults with chronic otitis media, by using a simple, cost-effective, reliable questionnaire and physical findings.
Fifty-two of 147 patients undergoing type one tympanoplasty were studied. Gastroesophageal reflux disease symptoms were evaluated using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease questionnaire. Laryngoscopic physical findings of laryngopharyngeal reflux were evaluated using the Reflux Finding Score. A successful outcome was defined as an intact tympanic membrane. Correlations between the two assessment tool results and the patient's surgical success were calculated.
The gastroesophageal reflux disease questionnaire score was significantly higher in patients with unsuccessful tympanic membrane closure (group one) than in patients with successful closure (group two) (p < 0.05). The Reflux Finding Score was also significantly higher in group one than group two (p < 0.05). There was a significant positive relationship between the gastroesophageal reflux disease questionnaire score and the Reflux Finding Score (p < 0.01).
Gastroesophageal reflux disease may be a significant prognostic factor for tympanoplasty failure. Therefore, reflux investigation may be important during the treatment of chronic otitis media, and positive cases may need reflux treatment as well as ear disease treatment.
This study sought to evaluate the incidence, aetiology, clinical features and treatment modalities for laryngocoele formation after supracricoid partial laryngectomy.
The medical charts of 62 patients who had undergone supracricoid partial laryngectomy were reviewed.
Three patients developed laryngocoele, giving an incidence of 4.8 per cent. Two of these patients presented with a cervical mass, dyspnoea and fever. The mobility of the arytenoids was disturbed on the involved side. The third patient was admitted complaining only of a compressible cervical mass. In all patients, diagnosis was made by computed tomography scan. The transcervical surgical approach was preferred for resection.
Laryngocoele can occur as a late complication of supracricoid partial laryngectomy. Remnants of the laryngeal ventricle may be the cause of laryngocoele formation. The integrity of the laryngeal ventricle in the resected specimen should be routinely checked in order to avoid this rare complication. Clinicians should be aware that, following supracricoid partial laryngectomy, a cervical mass presenting with dyspnoea and disturbance of arytenoid mobility does not always indicate tumour recurrence.
Most patients with nasolacrimal duct obstruction have dry, crusty nasal mucosa. Mucociliary clearance is modulated by the amount and biochemical composition of nasal mucus. Nasolacrimal duct obstruction disturbs the drainage of tears into the nasal cavity.
We examined the effect of nasolacrimal duct obstruction on the mucociliary transport of nasal mucosa, by comparing saccharine test results for epiphora patients versus healthy volunteers.
Prospective, randomised, clinical trial.
Eight patients with bilateral epiphora and 10 patients with unilateral epiphora were included in the study group. Complete nasolacrimal duct obstruction was demonstrated by studying irrigation of the nasolacrimal system, and by fluorescein dye study. The control group comprised 20 healthy volunteers. Mucociliary transport was assessed by the saccharine test in both the study and control groups. The saccharine transit times of 26 impaired nasal cavities were compared with those of 20 healthy nasal cavities of controls. Also, the saccharine transit times of the healthy nasal cavities of the 10 patients with unilateral epiphora were compared with those of their diseased sides, and also with those of healthy volunteers.
The saccharine transit times of the epiphora patients were statistically significantly greater than those of the control group. Also, there was a statistically significant difference in saccharine transit times, comparing the healthy and impaired nasal cavities of patients with unilateral epiphora.
Nasolacrimal duct obstruction has a negative effect on nasal mucociliary clearance. This may be related to changes in the amount and biochemical composition of nasal mucus.
The haemodynamic responses during extubation can cause complications after
open-heart surgery. In this study, we aimed to examine the effect of esmolol
and magnesium before extubation on these haemodynamic responses.
Following the approval of local Ethics Committee, 120 patients having
coronary artery bypass grafting with extubation in the intensive care unit
were included in the study. Patients were allocated to receive esmolol 1 mg
kg−1 (group I, n = 40), magnesium 30 mg kg−1 (Group II,
n = 40) or normal saline (Group III,
n = 40). Study medication was
administered as a 20-min infusion in a volume of 20 mL. Patients were
extubated just after termination of the infusion. Heart rate, blood pressure
and central venous pressure were recorded prior to drug administration,
before extubation, during extubation and 1 min after extubation.
Heart rate was lower in Group I than in Groups II (P < 0.05) and III (P < 0.001) and lower in
Group II than in Group III (P < 0.05) during extubation. It was
also lower in Group I than in Group III (P < 0.05) after
extubation. Systolic blood pressure was lower in Group I than in Groups II
and III (P < 0.001) during extubation. Diastolic blood pressure
was higher in Group III than in Groups I and II during extubation (P
< 0.001) and after extubation (P < 0.05). Mean
arterial pressure was lower in Group I than in Groups II and III (P
< 0.001) during extubation, lower in Group II than in Group III
(P < 0.05) during extubation and lower in Group I than in Group
III (P < 0.05) after extubation.
We found that using esmolol before extubation following coronary artery
bypass graft surgery prevents undesirable haemodynamic responses while
magnesium reduces undesirable haemodynamic responses but does not prevent
Numerical simulations of thermal stresses in copper interconnect and low-κ
dielectric systems are carried out. The analyses include two- and
three-dimensional finite element modeling of the interconnect structure.
Various combinations of metal, oxide and polymer-based low-κ dielectric
schemes are considered in the simulation. The evolution of stresses and
deformation pattern in copper, barrier layers, and the dielectrics are
This study focuses on the atomistics of interface-mediated plasticity in thin metallic films. Molecular statics simulations are carried out to model the tensile stress-strain response of the free-standing and substrate-bonded films. In the free-standing film dislocation glide readily occurs, inducing slip steps at both surfaces of the film. The existence of an interface with the substrate constrains the dislocation motion in the film and restricts the slip steps to only the free surface. The propensity of film plasticity is dictated by the capability of atoms to slide along the interface. The flow stress of the film can be correlated with the dislocation activities obtained from the simulation. The propensity of spreading of relatively energetic atoms associated with the dislocation near the interface is also discussed.
Atomistic simulations using molecular statics are carried out to study dislocation plasticity in thin metal films attached to stiff substrates. The analysis utilizes a sample two-dimensional crystal, with an embedded initial point defect used for triggering dislocation activities in a controlled manner. The existence of an interface between the film and the substrate is shown to delay plastic yielding and lead to film strengthening. The capability of atoms to slide along the interface plays a crucial role in determining the macroscopic stress-strain response and the microscopic dislocation activities. Within the modeling framework we examine the quantitative interfacial sliding behavior and the resulting dislocation-interface interactions and their consequences.
A combined numerical and experimental study was undertaken to investigate the effect of microstructural heterogeneity on indentation response. Finite element analyses were carried out to simulate the stress-strain behavior and the indentation response of two model heterogeneous systems: one with hard particles embedded within a soft matrix and the other with a pore-containing ductile material. For the particle-containing system, the indentation response consistently overestimates the overall strength of the composite. This is largely due to the localized increase in particle concentration directly underneath the indent. For the porous system, the indentation response consistently underestimates the overall strength due to the pore-crushing effect. Experiments on metal-ceramic composites confirmed the non-correspondence between the indentation and stress-strain responses, even when the indent size is much greater than the microstructural feature size. Implications of the present findings in utilizing indentation to quantify surface mechanical properties are discussed.
Iron-enriched basalt (IEB) has been investigated as a containment medium for defense transuranic (TRU) and defense high-level wastes (HLW). IEB samples have been fabricated incorporating simulated and actual defense TRU wastes generated at the Rocky Flats Plant (RFP), and simulated defense high-level wastes. These samples were tested for leaching resistance and fracture toughness. Cesium and strontium volatility from an IEB melt was also assessed, using radioactively spiked samples.
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