Management of nasopharyngeal and oropharyngeal stenosis in children

Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We present a series of eight children with varying degrees of stenosis and associated symptoms. Choice of treatment varied with the severity of disease. In our series, successful interventions included triamcinolone acetonide injection, lysis of adhesions, rotational and advancement mucosal flaps, and jejunal free flap. Preoperative evaluation and individualized surgical repair are essential for successful treatment.     

Treatment with alendronate prevents fractures in women at highest risk: results from the Fracture Intervention Trial

BACKGROUND: The efficacy of antiresorptive therapy in preventing fractures in women at highest fracture risk, such as very elderly women or those with severe osteoporosis, is uncertain. PARTICIPANTS AND METHODS: Using data from a double-blind, randomized, placebo-controlled clinical trial that enrolled 2027 postmenopausal women aged 55 to 81 years with low femoral neck bone mineral density (BMD) and existing vertebral fractures, we examined the consistency of the effect of treatment with alendronate sodium in preventing fractures within a priori-specified risk subgroups defined at baseline by age, bone density, number of preexisting vertebral fractures, and history of postmenopausal fracture. The women were randomized to oral administration of alendronate or placebo and followed up for an average of 2.9 years. The initial dose of alendronate sodium was 5 mg/d; the dosage was increased from 5 to 10 mg/d at 24 months. New vertebral fractures, the primary end point of this arm of the trial, were defined by morphometry as a decrease of 20% and at least 4 mm in any vertebral height between baseline and a follow-up radiograph at 36 months. Incident clinical fractures, the secondary end point, included nonspine and clinical (symptomatic) vertebral fractures. All clinical fractures were confirmed with x-ray film reports or, in the case of clinical vertebral fractures, x-ray films. RESULTS: Overall, there was a 47% significant reduction in risk of new vertebral fractures in the alendronate group compared with the placebo group. The reduction in risk of new vertebral fracture was consistent across fracture risk categories including age (relative risk [RR], 0.49 in women < 75 years compared with 0.62 in those > or = 75 years), BMD (RR, 0.54 in women with a femoral neck BMD < 0.59 g/cm2 [median] compared with 0.53 in those with a BMD > or = 0.59 g/cm2), and number of preexisting vertebral fractures (RR, 0.58 in women with 1 vertebral fracture compared with 0.52 in those with > or = 2). The overall significant 28% reduction in risk of incident clinical fractures in the alendronate group compared with the placebo group was also observed within these subgroups. Compared with the number of lower-risk women, a similar or smaller number of high-risk women needed to be treated to prevent 1 fracture. For example, 8 women aged 75 years or older compared with 9 women younger than 75 years, or 4 women with 2 or more existing vertebral fractures compared with 16 women with 1 existing vertebral fracture, needed to be treated with alendronate for 5 years to prevent 1 new vertebral fracture. CONCLUSIONS: Alendronate effectively reduces fracture risk in postmenopausal women with vertebral fractures and low BMD, including those women at highest risk because of advanced age or severe osteoporosis. Since the risk reductions observed with alendronate treatment were consistent within fracture risk categories, more fractures were prevented by treating women at highest risk.     

地域通信网的干扰技术研究

本文在分析地域通信网结构及组成的基础上,研究了对地域通信网实施的节点破坏、末端信息封锁、局部阻塞瘫痪等对抗方法,并使用干扰地域通信网的程度、节点干扰率、末端节点封锁率和传递信息误差率等指标对干扰效果进行评估。     

Aging, expertise, and narrative processing.

In a study of how aviation expertise influences age differences in narrative processing, young and older pilots and nonpilots read and recalled aviation and general narratives. They chose referents for sentences referring to a protagonist or minor character mentioned 1 sentence (recent character) or 3 sentences (distant character) before this target sentence. All groups chose referents less accurately for sentences about distant and minor characters than about recent and protagonist characters, perhaps because these referents were less likely to be in working memory. Young readers and pilots were more accurate for distant and minor character target sentences in aviation narratives and recalled aviation narratives more accurately. Expertise did not reduce age differences. Expertise differences may reflect decreased demands on working memory capacity, and age declines may reflect reduced capacity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of the aortic root by MRI: insights from patients with homozygous familial hypercholesterolemia

Hepatitis C chronically infects approximately 1.5% of Americans and is the most common clinical problem facing hepatologists. Since the virus was initially described in 1989, development of an effective therapy has been challenging. Although several different therapeutic agents have been used, no therapy has been shown to reliably eradicate the virus. Interferon-alpha, a cytokine with immunostimulatory and anti-viral properties, has become the therapy of choice for patients with chronic hepatitis C infection. Trials assessing the efficacy of interferon-alpha have characterized host and viral factors predictive of responses to treatment. A thorough understanding of these predictive factors is requisite to providing cost-effective therapeutic decisions for the patient with chronic hepatitis C infection.     

Transient Current Behaviour for Iron in 3.5%NaCl and 3.5%NaCl+ 1%NaNO_2 Solutions during Corrosion Fatigue

The transient current behaviour for Iron in 3.5%NaCl and 3.5%NaCl +1%NaNO2 solutions during corrosion fatigue (CF) process has been investigated at different given strain amplitudes and strain rates. The results show that elastic strain has little contribution to material dissolution. The elastic tension strain results in the decrease in the transient current, while the elastic compression strain increases the transient current. Compared to the elastic deformation, plastic deformation affects material dissolution evidently For iron in 3.5%NaCl solution, the strain amplitude plays a dominant role in the dissolution process accelerated by the plastic strain, while in 3.5%NaCl+1%NaNO2 solution, both the strain amplitude and strain rate play an important role in this process. In this paper, the effect of the elastic deformation on the material dissolution and the relation between the tension and compression current peak values under the plastic cycle deformation are discussed