Background and objectives: Recurrent herpes simplex keratitis (HSK) is the most common cause of corneal blindness in the developed world. A relationship between host gene polymorphisms and the recurrence of herpes simplex virus (HSV) infection has previously been proposed. Thus, the aim of this study was to investigate a potential association between the IL28B host genotype and recurrent HSK. Materials and Methods: Eighty patients older than 18 years of age of both genders with a history of recurrent herpes simplex labialis (HSL) were considered for inclusion. Seventy-five of these patients were found to be seropositive for HSV-1 and were subsequently enrolled in the study. Twenty-four of the enrolled patients also had a history of recurrent HSK associated with severe corneal scarring and visual acuity deterioration. Total DNA was isolated from whole blood samples. A single-nucleotide polymorphism (SNP) rs12979860 near the IL28B gene on chromosome 19 was genotyped. Results: A significant association was observed between recurrent HSK and two SNPs of the IL28B genotype (CCrs12979860 and CTrs12979860, p < 0.01). The variation CCrs12979860 showed a significantly greater association with HSK (16 out of 26 patients) compared with CTrs12979860 (8 out of 34 patients). Conclusion: Seropositive individuals with a history of recurrent HSK are likely to have the CC IL28B genotype. This genotype may be related to incomplete control of the infection and more frequent periodical viral shedding along the first nerve branch of the trigeminal ganglion, which clinically manifests as recurrent herpes keratitis. The clinical manifestation of recurrent HSV-1 infection seems to be influenced by polymorphism of the IL28B genotype.
Abstract. In the trauma of craniofacial junction, frontal sinus wall fractures take up 5-15% of all facial bone fractures. The most common mechanism of their occurrence comes as a result of the action of high-energy impact force on the frontal area. Treatment of the injuries in frontal-orbital-ethmoidal regions largely depends on the responsible experts (otolaryngologist, maxillofacial surgeon or neurosurgeon) in all cases, because of the implementation of diverse surgical technics in order to achieve the best possible outcome for the patient. Bearing in mind the complex anatomical features of this region, it is clear that these procedures are often accompanied by series of possible complications, all of which are certainly neurosurgical. These can be expressed as early or late complications, and could be characterized by diverse clinical manifestations. Mucocele is formed, either due to partial obstruction of the sinus mucosa or due to the obstruction of the frontal sinus. The long term existence of mucocele and its progressive growth will result in strongpressure on the adjacent bones, and lead to their destruction followed by the process-propagation into surrounding tissues and spaces. In the further development if a bacterial contamination is detected, it will lead to the purulent inflammatory process and clinical picture of mucopyocele. In most clinical cases with complications proptosis and diplopia are dominant ophthalmic manifestations. In this paper we will present our experience in the treatment of proptosis and diplopia, as well as the ways of diagnostic evaluation in order to achieve timely diagnosis and assure swift healing of patients.
The period of bone healing after trauma goes through certain physiological processes. In situations where a bone fracture occurs, our intention is to surgically position in an appropriate morpho-anatomical position. For osteosynthesis we used vipla wire and micro plates with corresponding screws. The aim of our research was to evaluate the optimal time for the removal of the osteosynthetic material, fracture site biomechanical stability, and measurement of the callus thickness. For this research ten 4 months old rabbits with right leg femur fracture were used. Osteosynthesis was done with titanium micro plates, corresponding screws and vipla wire. Experimental animals were observed through the post-operative period at the first and seventh postoperative day and there on at 2, 4, 6, 9, 12 weeks. Further additional fixation was needed in one of the rabbits in the second week. The postoperative period provided us information about the optimal moment for the removal of titanium micro plates. It showed that over a period of six weeks, the bone had almost all normal biomechanical properties. Significantly greater strength and rigidity of the recovered femur were obtained after 12 weeks. Micro plates that were removed after 4, 6 or 9 weeks, did not need furhter fixation and therefore fixation was not applied, compared to those placed during the 12 weeks. X Ray evaluation provided us with follow up results of fracture healing. The results suggest that it is acceptable to remove titanium micro plates after a period of healing, that is, after the formation of the callus and bridging of the fracture gap and diastasis with newly formed bone.
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