The purpose of this study was to determine whether topical mitomycin C could be used to prolong the patency of a myringotomy site in the absence of a ventilation tube. Mitomycin C is an antineoplastic agent used to maintain a patent trabeculectomy site in patients with glaucoma. The KTP laser was used to create bilateral myringotomies 0. 4 mm in diameter in 28 chicks (Gallus domesticus). Mitomycin C was applied to the right myringotomy site, and sterile water, used as a control, was applied to the left myringotomy site. The animals were divided into 2 groups with group A treated with freshly prepared mitomycin C and group B treated with 2-week-old mitomycin C. The patency rates of the experimental ears of groups A and B were 80% and 70%, respectively, 15 days after surgery and 33% and 7.7%, respectively, at 30 days. All myringotomy sites in the control ears were healed within 5 days. Using a logistic regression model for repeated measures, we determined the odds ratio between the experimental and control myringotomies of the combined groups to be 149.1 (P = 0.0001). We conclude that mitomycin C had a significant effect in prolonging the patency of myringotomies in chick tympanic membranes.

ObjectivesThis study's aim was to describe a hospital‐wide system to deliver rapid door‐to‐balloon time across the entire spectrum of emergency percutaneous intervention.BackgroundMany patients needing emergency PCI are excluded from door‐to‐balloon public reporting metric; these groups do not achieve door‐to‐balloon times ≤90 min and have increased mortality rates. Methods: We prospectively implemented a protocol for patients with STEMI or other emergency indication for catheterization mandating (1) emergency department physician or cardiologist activation of the catheterization lab and (2) immediate patient transfer to an immediately available catheterization lab by an in‐house nursing transfer team.ResultsFrom September 1, 2005 to December 31, 2008, 526 consecutive patients underwent emergency PCI. Median door‐to‐balloon time was 68 min with 85.7% ≤90 min overall. Important subgroups included primary emergency department (62.5 min), cardiorespiratory arrest (71 min), cardiogenic shock (68 min), need for temporary pacemaker or balloon pump (67 min), initial ECG without ST‐elevation (66.5 min), transfer from another ED (84 min), in‐hospital (70 min), and activation indications other than STEMI (68 min). Patients presenting to primary ED and in transfer were compared to historical controls. Treatment ≤90 min increased (28%–85%, P < 0.0001). Mean infarct size decreased, as did hospital length‐of‐stay and admission total hospital costs. Acute myocardial infarction all‐cause 30‐day unadjusted mortality and risk‐standardized mortality ratios were substantially lower than national averages.ConclusionA hospital‐wide systems approach applied across the entire spectrum of emergency PCI leads to rapid door‐to‐balloon time, reduced infarct size and hospitals costs, and low myocardial infarction 30‐day all‐cause mortality. © 2015 Wiley Periodicals, Inc.