Problem-based learning(PBL) is defined as a process of acquiring understanding, knowledge, skills and attitudes in the context of an unfamiliar situation, and applying such learning to that situation. PBL is a way of enabling students thinking more efficiently than they can do in the traditional methods of largely rote learning. Because mordern medical knowledge is growing at an enormous rate, PBL is though as a mean to cope with the rapidly increasing, rapidly changing information base of medicine. The definition, goals, practice, strength, and problems of PBL in medical education are discussed. The curriculum and educational philosophy of McMaster Medical School, where PBL in small group tutorials predominates the programme, are also introduced. Hinderences from implementing PBL in our medical education are discussed.
Curriculum ; Education, Medical ; Humans ; Learning ; Philosophy ; Problem-Based Learning* ; Schools, Medical ; Thinking

No abstract available.
Neck*

No abstract available.
Aspergillus* ; Sinusitis*

The authors, after inducing acute sinusitis in rabbits, compared cases where we opened the natural ostium and a general dose of administered antibiotics and cases where we opened the natural ostium and locally administered dose of antibiotics using polymer, and found that the application of local antibiotics using polymer is the superior of the two in treating sinusitis. To be able to develop a treatment for sinusitis using antibiotics incorporating polymer, we first need to examine the toxicity of polymer. The purpose of this study was to examine the toxicity of polymer through a general toxicity test as well as a special toxicity test in experiments using animals. As a result of this study, we discovered that poly-L-lactic acid (PLA) polymer works as an intraperitoneal foreign body and causes adhesion of viscera, but nethier acute nor subacute toxicity of PLA polymer was detected, and no negative effect on reproductive function was observed. It was also observed to induce neither immune reaction such as hypersensitivity nor local toxicity to the maxillary sinus mucosa of rabbit. We conclude that the results of this study can provide basic information for developing antibiotics-incorporating PLA polymer for the treatment of sinusitis and for clinical experiments involving such antibiotics.
Animals ; Anti-Bacterial Agents ; Foreign Bodies ; Hypersensitivity ; Maxillary Sinus ; Mucous Membrane ; Polymers* ; Rabbits ; Sinusitis* ; Toxicity Tests ; Viscera

No abstract available.
Neck*

BACKGROUND AND OBJECTIVES: It has been suggested that the combination of a leukotriene receptor antagonist with an antihistamine may have beneficial effects in the treatment of allergic rhinitis. The aim of this study were to evaluate the effects of combining a leukotriene receptor antagonist, pranlukast, and an antihistamine, cetirizine, to treat nasal symptoms of allergic rhinitis and the quality of life of the patients. SUBJECTS AND METHOD: Thirty-three patients with allergic rhinitis were enrolled in this study. The control group (n=12) received 5 mg cetirizine plus 120 mg pseudoephedrine twice a day while the study group (n=21) received 5 mg cetirizine plus 225 mg pranlukast twice a day. Patients completed a daily symptom-score list for nasal obstruction, rhinorrhea, sneezing, nasal itching during the 7-day treatment period. They also answered the quality of life questionnaire before and after the completion of 7-day treatment. RESULTS: There were significant improvements in the nasal symptoms after the treatment in the control and the study group. However, there was no significant difference between the control and the study group on the improvement of nasal symptom-scores except for the rhinorrhea symptom-score. There were significant improvements in the quality of life domain after the treatment in the control group and the study group. However, there was no significant difference between the control and the study group on the improvement in quality of life domain except for activity limitations. CONCLUSION: A combination of pranlukast and cetirizine is as effective as a combination of pseudoephedrine and cetirizine in treating allergic rhinitis. Therefore, a combination of pranlukast and cetirizine may be another therapeutic alternative for allergic rhinitis patients who are not tolerable of pseudoephedrine.
Cetirizine* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Leukotrienes ; Nasal Obstruction ; Pruritus ; Pseudoephedrine ; Quality of Life ; Surveys and Questionnaires ; Receptors, Leukotriene ; Rhinitis* ; Sneezing

Actinomycosis is a disease caused by an anaerobic bacteria called Actinomyces species (predominantly Actinomyces israelii), which is a common and normally nonpathogenic organism found in the nose and throat. The four major clinical presentations of actinomycosis include the cervicofacial, thoracic, abdominal, and pelvic region. Actinomycosis is difficult to diagnose because of variable presentation and fastidious nature of the organism in culture. A high index of suspicion and biopsy are often necessary to make the diagnosis, because the disease can mimic neoplasm or a chronic granulomatous infection. We present, with the appropriate review, a case of actinomycosis in the mandibular angle area which was mistaken for a parotid abscess.
Abscess* ; Actinomyces ; Actinomycosis ; Actinomycosis, Cervicofacial ; Bacteria, Anaerobic ; Biopsy ; Diagnosis ; Nose ; Pelvis ; Pharynx

The intranasal endoscopic prelacrimal recess approach (PLRA) is a novel technique that was recently introduced for the management of maxillary sinus lesions. We utilized this approach for the surgical resection of a medial maxillary bony lesion; gross total resection was achieved without significant complications. The PLRA appears to be an effective and safe technique for the treatment of bony lesions of the maxilla as well as the maxillary sinus, particularly those confined to the medial maxillary wall.
Hemangioma* ; Maxilla ; Maxillary Sinus

No abstract available.
Neck*

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) production in the respiratory epithelium and the demonstration of inducible nitric oxide synthase in ciliated epithelium of the upper airway have recently been reported. The aim of this study was to investigate the expression of inducible nitric oxide synthase in the nasal epithelium after capsaicin treatment, which stimulates the substance P innervation. MATERIALS AND METHODS: In vivo treatment -Capsaicin (112 nM) was applied to the nasal cavities of the rat and guinea pig, and 30 nl of normal saline was applied for the control groups. After 2 hours, animals were sacrificed with cardiac perfusion of 4% paraformaldehyde and septal mucosa were removed. The 8 nm serial frozen tissue sections were made, and the expression of inducible nitric oxide synthase was determined using nicotinamide adenine diphosphate-diaphorase histochemistry. In vitro treatment- The nasal septum of the rats and the trachea of the guinea pigs were incubated in DMEM culture media with or without 112 nM capsaicin for experimental or control groups. After 0, 30 or 120 minutes of incubation, the tissues were fixed and processed for nicotinamide adenine diphosphate-diaphorase histochemistry. RESULTS: Both in vivo and in vitro studies demonstrated that the strong positive histochemical reactivity were observed in the respiratory epithelium of the rats and guinea pigs after capsaicin treatment compared to control groups. CONCLUSION: These data imply that capsaicin induces the expression of inducible nitric oxide synthase and that the substance P innervation of the nasal mucosa may have a protective role in the airway defense mechanism through nitric oxide production.
Adenine ; Animals ; Capsaicin* ; Culture Media ; Epithelium* ; Guinea Pigs ; Guinea* ; Mucous Membrane ; Nasal Cavity ; Nasal Mucosa ; Nasal Septum ; Niacinamide ; Nitric Oxide ; Nitric Oxide Synthase Type II* ; Perfusion ; Rats* ; Respiratory Mucosa ; Substance P ; Trachea