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Objective/hypothesis: Various professional societies, clinical practices, hospitals, and health care-related Web sites provide Internet-based patient education material (IPEMs) to the general public. However, this information may be written above the 6th-grade reading level recommended by the US Department of Health and Human Services. The purpose of this study is to assess the readability of facial fracture (FF)-related IPEMs and compare readability levels of IPEMs provided by four sources: professional societies, clinical practices, hospitals, and miscellaneous sources., Study Design: Analysis of IPEMs on FFs available on Google.com., Methods: The readability of 41 FF-related IPEMs was assessed with four readability indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). Averages were evaluated against national recommendations and between each source using analysis of variance and t tests., Results: Only 4.9% of IPEMs were written at or below the 6th-grade reading level, based on FKGL. The mean readability scores were: FRES 54.10, FKGL 9.89, SMOG 12.73, and Gunning FOG 12.98, translating into FF-related IPEMs being written at a "difficult" writing level, which is above the level of reading understanding of the average American adult., Conclusions: IPEMs related to FFs are written above the recommended 6th-grade reading level. Consequently, this information would be difficult to understand by the average US patient., (Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.)

Objectives/hypothesis: Numerous professional societies, clinical practices, and hospitals provide Internet-based patient education materials (PEMs) to the general public, but not all of this information is written at a reading level appropriate for the average patient. The National Institutes of Health and the US Department of Health and Human Services recommend that PEMs be written at or below the sixth-grade level. Our purpose was to assess the readability of endoscopic sinus surgery (ESS)-related PEMs available on the Internet and compare readability levels of PEMs provided by three sources: professional societies, clinical practices, and hospitals., Study Design: A descriptive and correlational design was used for this study., Methods: The readability of 31 ESS-related PEMs was assessed with four different readability indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). Averages were evaluated against national recommendations and between each source using analysis of variance and t tests., Results: The majority of PEMs (96.8%) were written above the recommended sixth-grade reading level, based on FKGL (P < .001). Only one article (3.2%) had an FKGL at or below the sixth-grade level. The mean readability values were: FRES 47.1 ± 13.4, FKGL 10.7 ± 2.4, SMOG 13.7 ± 1.6, and Gunning FOG 12.4 ± 2.7., Conclusions: Current Internet-based PEMs related to ESS, regardless of source type, were written well above the recommended sixth-grade level. Materials from the hospitals/university-affiliated websites had lower readability scores, but were still above recommended levels. Web-based PEMs pertaining to ESS should be written with the average patient in mind., (Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.)

PURPOSE. Use of nomograms based on the "heparin correlation value" (HCV)-a value that corresponds to measured activated partial thromboplastin time (aPTT) and that removes the need to revise nomograms in response to a change in the aPTT reagent or coagulometer used-was evaluated as an alternative to traditional aPTT-based anticoagulation nomograms. SUMMARY. Data were collected on patients receiving heparin therapy for selected indications (thrombotic disorders, cardiac conditions, and acute coronary syndromes) during four-month periods before (n = 59) and after (n = 60) implementation of the HCV-based nomograms. The primary endpoints were the rate at which coagulation laboratory measurements were obtained at the appropriate time and the rate of appropriate dosage adjustment in response to reported laboratory values; secondary endpoints included the time to attainment of the first target anticoagulation value. After implementation of HCV-based nomograms, coagulation laboratory measurements were obtained at the appropriate time in (mean ± S.D.) 92.9% ± 12.8% of patients, compared with 80.1% ± 15.5% of patients who received aPTT-based monitoring (p < 0.0001). After implementation of HCV-based monitoring, the rate of correct heparin dosage adjustments was improved (mean ± S.D. 94.7% ± 7.8% versus 89.3% ± 14.0%, p = 0.01), and the time to attainment of the first target anticoagulation value was shorter (mean ± S.D. 16.4 ± 10.6 hours versus 21.5 ± 14.8 hours, p = 0.03). CONCLUSION. The HCV, which relates measured aPTT values to corresponding antifactor Xa concentrations, was substituted for aPTT in heparin nomograms and appeared to be a viable alternative to the aPTT.

Background and Objectives: To compare shoulder function with respect to pain and disability in patients who have undergone nerve sparing neck dissection i.e. selective neck dissection (levels I, II, III) and functional neck dissection as a part of their treatment modality for carcinoma tongue on a follow up of minimum six months., Material and Methods: A total of 100 patients were selected for this study. 50 patients who had undergone selective neck dissection (levels I, II, III) and 50 who underwent functional neck dissection as a part of their treatment modality for squamous cell carcinoma of the tongue from January 2005 to January 2007 were asked to participate in this study. A standardized questionnaire was used to assess pain and disability. Pain and disability scores were then compared between the two nerve sparing dissections., Results: 100% of the patients in Selective Neck Dissection (SND) (levels I, II, III) group and in Functional Neck Dissection (FND) groups complained of pain. Though there is pain present in both the treatment groups, no significant difference in the pain values was found between FND and SND (levels I, II, III) in any of the pain parameters. Disability was present in both the treatment groups. However patients who have undergone FND had significantly higher severity of disability when compared to SND (levels I, II, III) especially during activities which involve shoulder abduction like dressing, doing heavy household work, hair wash and washing clothes/dishes (5.18, 5.22, 5.5, 4.88 in FND and 2.26, 4.08, 4.58, 2.2 in SND (levels I, II, III) respectively. Disability perceived during other activities like doing heavy household and facial care was 2.08 and 1.84 in both the treatment groups respectively., Interpretation and Conclusion: Degree of shoulder morbidity is much higher in patients who have undergone FND as compared to SND (levels I, II, III) as a treatment modality for carcinoma tongue, even though both the treatment options are nerve preserving.

Many kinds of materials have been tried in the Laboratory and to some extent clinically prior to introduction of acrylic resin. With the introduction of acrylic resin as denture base material, continuous attempts have been made to evaluate its physical properties. To observe the changes in vertical measurements of acrylic resin dentures due to water sorption and to assess variations of vertical movements of individual teeth within dentures due to water sorption; present study was carried out on 25 maxillary acrylic dentures. From results, the maximum water sorption appears to take place within 24 hours and after 28 day of water sorption; there is no change in vertical dimension if the denture is placed for further more time. With the introduction of acrylic resin as denture base material continued attempts have been made to evaluate physical properties so as to determine its suitability as an ideal nonmetalic denture base materials. Several investigations have been carried out on physical properties of this material such as compressive strength, tensile strength, solubility and colour stability. These have proved their superiority over other nonmetalic denture base materials used so far. Also several studies have been carried out to assess dimensional changes that occur in acrylic resin during processing, but very few studies have been carried out about the water sorption changes in the acrylic resin and still few about the vertical dimensional changes in acrylic resin due to water sorption. While fabricating the denture base from the acrylic resin, it comes in contact with water during polishing as well as cleaning, consequently during the use of denture it is constantly wetted by oral fluids. It is the hypothesis that water sorption by denture base acrylic may effect the retention and stability of the denture. It has been shown that water molecules act according to the laws of diffusion. The diffusion presumably occurs between the macromolecules which are forced slightly apart. This separation renders the molecules mobile and the inherent stresses created during heat curing of the acrylic resin can be relieved with consequent intermolecular relaxation and possible changes in the shape of the denture. Exposure time also plays a significant role in water sorption. The present investigation was therefore, carried out by keeping the following objectives: (1) The primary objective was to observe the changes in vertical measurements of acrylic resin dentures due to water sorption. (2) To assess the variations of vertical movement of individual teeth within the dentures due to water sorption.

Sixteen patients with echocardiographic and cinefluoroscopic evidence of Björk-Shiley prosthetic valve obstruction (13 mitral valves and 3 aortic valves) were treated with intravenous streptokinase. Streptokinase was administered as an initial bolus of 250,000 units for 30 minutes, followed by an infusion of 100,000 units/hr. Serial cinefluoroscopy and echocardiography (M-mode, two-dimensional, and Doppler) were performed at 0, 24, 48, and 72 hours of treatment. The end point of treatment was defined as near normalization of clinical, echocardiographic, and fluoroscopic parameters. Successful thrombolysis was achieved in all patients. The average duration of streptokinase therapy was 43 hours (range 2 to 72 hours). Two of 16 patients had minor systemic embolism during therapy. Short-term follow-up has shown sustained benefit in 14 of 16 patients. Two patients have had rethrombosis of the mitral prosthetic valves and have undergone thrombectomy. Our study demonstrates the feasibility, safety, and efficacy of thrombolytic therapy in the treatment of prosthetic valve thrombosis. It also emphasizes the role of serial Doppler echocardiography in guiding the duration of therapy and assessing its efficacy.

The influence of the viscosity of the internal and external phases and the interfacial tension between the two phases, in the emulsion type of microencapsulation system was investigated. The viscosity of mineral oil (external phase) was measured by a capillary viscometer and the viscosity of cellulose acetate trimellitate solution (internal phase) was measured by a Brookfield viscometer. The viscosity of the two phases were measured prior to mixing and at 5 and 60 min after mixing the phases. It was observed that the viscosity of the mineral oil phase prior to mixing had little effect on the average diameter of the microspheres, until a high concentration of light mineral oil was used. A graph of viscosity ratio of the internal phase to the external phase shows that a minimum viscosity ratio may be required before particle size increases. Results are discussed with respect to viscosity effects of mineral oil and polymer solution, as influenced by the solvent uptake by the mineral oil. The interfacial tension between the two phases was measured by pendant drop method. Interfacial tension was measured at 5 and 60 min after the two phases came in contact. The interfacial tension between the mineral oil and polymer solution ranged up to 7 dyne/cm and the particle size was not affected appreciably by the interfacial tension. Particle size and morphological analysis of the microspheres were determined using microscopy and scanning electron microscope.

A 60-year-old man presented with features of superior vena cava (SVC) obstruction. On evaluation, he was diagnosed as having angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). SVC obstruction due to AILD, to our knowledge, has not been described.

Phase diagrams were prepared to indicate the region of microcapsule formation for the following system: cellulose acetate trimellitate, light mineral oil, and the solvent mixture (acetone:ethanol), using chloroform as the hardening agent. The effect of sorbitan monoleate, sorbitan monolaurate, and sorbitan trioleate on the region of the phase diagram for the formation of microcapsules was investigated. The results indicate that microcapsules are readily formed when the polymer concentration is in the 0.5-1.5% range and the solvent concentration is in the 5-10% range. Aggregation of microcapsules was minimized by using lower solvent concentration. Low concentrations of sorbitan monooleate in mineral oil (less than or equal to 1%) gave products that had smoother coats and more uniform particle size. Surfactants with low hydrophile:lipophile balance produced larger regions on the phase diagram for microencapsulation compared with a surfactant with higher hydrophile:lipophile balance. A mechanism for microencapsulation is described. Tartrazine microcapsules produced using different concentrations of surfactant were tested for dissolution characteristics in both acidic and neutral conditions. Tartrazine-containing microcapsules prepared by using 3% sorbitan monooleate had the lowest release in acidic conditions. The effect of surfactant and formulation concentration on microcapsule size was studied by analyzing the particle size distribution for both blank and tartrazine-containing microcapsules. The smallest microcapsule size was obtained when the sorbitan monooleate concentration was 3%. It appears that there is an upper limit for the surfactant concentration that could be used to achieve successful microencapsulation.

Quantitative electromyographic (QEMG) data from 3 muscles recorded with a 50-micronV threshold for the turns and amplitude measurements are presented. Using turns per unit amplitude as the index, consistent and comparable readings were recorded from abductor digiti minimi, biceps brachii and vastus medialis in normal subjects, namely 1.132 +/- 0.08 (31 subjects), 1.059 +/- 0.122 (31 subjects) and 1.007 +/- 0.088 (11 subjects), respectively. It is shown here that the diagnostic yield increases when all 3 values, namely, turns/s, average amplitude and turns/unit amplitude are considered in conjunction rather than considering the first 2 alone.

Quantitative electromyographic (QEMG) data recorded with two levels of threshold for the apparatus are compared. Using a fixed fraction of a subject's maximum effort the data are shown to be independent of sex, age and the strength of the muscles. The diagnostic yield of such a method is shown to be better with 50 muV threshold for analysis than with 100 muV, in cases of muscle disorders such as Duchenne muscular dystrophy and polymyositis. However, in cases of neurogenic lesions due to anterior horn cell disease the diagnostic yield remains the same with both thresholds.

Data were collected from 150 men and women complete-denture patients. Their jaw records were evaluated with a specially designed instruments. The extent of deviation of the maxillary and the mandibular ridges in the horizontal plane was calculated at various interridge distances, at a constant interalveolar crest-line angle of 80 degrees. It was found that: 1. Most patients of both sexes revealed a normal horizontal ridge relationship. 2. Next to the normal ridge relationship, there was a tendency for a unilateral cross-bite ridge relationship on the left sides of those patients who had recent extractions (up to 6 months previously). 3. True bilateral cross-bite ridge relationships were found only in those patients who gave a history of prolonged edentulousness. 4. The decision to arrange the posterior teeth in normal or cross-bite ridge relationship should take into consideration the deviations in the ridge relationship as well as the interridge distance. A method of evaluating interridge deviations in the horizontal plane in the posterior region of articulated jaw records of edentulous patients was developed.

A rare case of linear scleroderma with plaques of morphea in hemicorporeal distribution and subclinical systemic involvement is presented. Its possibility of progression into systemic sclerosis, which has not been reported earlier, is discussed.