Dražen Shejbal

Thermography-measured effect of capsaicin, methylprednisolone and mitomycin on the survival of random skin flaps in rats

Aims: This study was designed to determine if steroids, capsaicin and mytomicin improved skin flap survival in rats, and it has confirmed that thermography is an effective method to measured skin flap vitality.

Posttraumatic Stress Disorder and Orofacial Pain.

Chronic orofacial pain occurs frequently in patients with posttraumatic stress disorder (PTSD) and at the same time any pathological process involving orofacial area can be reflected in emotional interpretation of pain and can trigger a series of reactions associated with the PTSD group of symptoms in patients with PTSD. Painful stimuli caused in this way may occur after the primary cause ceased, and because of convergence can cause referred pain outside of the anatomical site where the primary injury occurred. Chronic orofacial pain and PTSD are diagnosed on the basis of subjective testimony and this regularly occurs in the context of social interaction between patients, doctors, medical staff or researchers making it difficult to standardize the results and introduces many cultural phenomena.

Cystic Shape Cemento-Ossifying Fibroma of Ethmoid Sinus

Cemento-ossifying fibromas are a group of rarely occurring benign tumours, developing from the periodontal membrane and varying considerably in appearance and in the progress of the disease. Their common feature is higher or lower production of cemental tissue. In most cases the tumours are small because their cementoma mature quickly and become inactive, which causes the tumour to stop growing. They develop most frequently in the mandible and also in the maxilla. Other sites, such as paranasal cavities, soft tissues and bones of the head, are extremely rare. The case of a cemento-fibrosing tumour with psammoma infiltrations, developing from the ethmoid sinus in a nine-year-old girl is reported. Due to frontal headaches and sight defects as well as impaired vision on the right side, NMR was done, which showed a mucocele of the front and rear ethmoid with destruction of the orbital wall and a breakthrough into the orbit. The right maxillary sinus showed a visible retention and a thickened mucous membrane. A rhinoscopy revealed a ball-shaped spherical mass in the medial nasal meatus, which was defined as concha bullosa. An endoscopic examination showed that the tumour protruded in front of the medium nasal concha into the right nasal cavity, softened the ethmoid roof, penetrated toward the base of the skull, adhered and pushed the orbit. It was removed by FESS technique, and PHD revealed subsequently that it was not a mucocele but a cemento-ossifying fibroma.

Impact of posttraumatic stress disorder on sinonasal symptoms and quality of life in patients with chronic rhinosinusitis.

Background Severity of chronic rhinosinusitis (CRS), measured by disease-specific health-related quality-of-life questionnaires, is expected to increase in patients who also suffer from posttraumatic stress disorder (PTSD). Altered pain perception, sleep disorders, and fatigue may be associated with this comorbidity. Methods Severity of CRS was compared between a group of 28 patients with CRS and a group of 28 patients with CRS and concomitant PTSD using different disease-specific and generic instruments, such as visual analog scale (VAS), Short Form-36 test (SF-36), and Sino-Nasal Outcome Test-22 (SNOT 22). Results SNOT-22 test showed significantly higher CRS severity in patients with CRS and PTSD, compared to patients with CRS without PTSD. Conclusion Patients with less severe CRS, measured by objective outcome measures, due to the impact of comorbid PTSP, are classified as having severe rhinosinusitis, and are exposed to the risk of unnecessary diagnostic and therapeutic procedures. In patients with difficult-to-treat rhinosinusitis, diagnosis should be revised, and one item that should be evaluated is whether they suffer from PTSD.

Evaluation of cutaneous flap survival by IR thermography

There are plenty of recent studies showing the influence of different drugs on the survival of the cutaneous flap. The effects of a topically applied capsaicin, methylprednisolon, mitomycin and gastric pentadecapeptide BPC-157 in improving skin vitality and preventing distal flap necrosis were tested in a random-pattern dorsal skin flap model. Wistar rats were randomized into five groups, four experimental groups and a control group. A standardized full thickness dorsal random-pattern skin flap was raised on each rat and sutured back into place. A gelatin sponge was placed before suturing between the flap and its recipient bed, with 0.9% saline in the control group and with capsaicin, methylprednisolon, mitomycin and pentadecapeptide BPC157 in the experimental groups. The flap survival was judged one