Correlations between selected parameters of nasal cavity in neonates and young infants - computed tomography study

BACKGROUND

Correlations between selected metric parameters of the nasal cavity and nasopharynx in children without atresia may be useful for anticipating probable dimensions of this region in living subjects, in terms of changes with age.

MATERIALS AND METHODS

One hundred and eighty children, age range 0-3 years, were divided into five age groups, and measurements of 18 distances between structures of nasal cavity and nosopharynx were performed on computed tomography scans. Correlation coefficients and relations between parameters have been determined.

RESULTS

Our study confirmed the existence of statistically significant correlations between linear dimensions within nasal cavity in children. The analysis demon-strated that for the values of following indexes: nasal septum length/piriform aperture width, and maximum length of the nasal septum/posterior nares width no statistically significant differences have been noted between age groups of children. All correlations have been positive. No statistically significant differences have been noted between the maximum width of the vomer and osseous parameters measured, both in the anterior and posterior part of the nasal cavity, and nasal septum length.

CONCLUSIONS

The size of posterior nares changed with age in children by a constant value. So far, no such an analysis has been carried out assessing potential correlations between linear dimensions for the entire nasal cavity, nasopharynx, length of the nasal septum in children, as well as proportions of individual linear dimensions of the anatomical structures analysed, in various age groups.

Molecular dynamics studies on the water mixtures of pharmaceutically important ionic liquid lidocaine HCl

In this paper the molecular dynamics of a common local-anesthetic drug, lidocaine hydrochloride (LD-HCl), and its water mixtures were investigated. By means of broadband dielectric spectroscopy and calorimetric measurements it was shown that even a small addition of water causes a significant effect on the relaxation dynamics of analyzed protic ionic liquid. Apart from the two well-resolved relaxations (σ- and γ-processes) and the β-mode, identified as the JG-process, observed for anhydrous LD-HCl, a new relaxation peak (υ) is visible in the dielectric spectra of aqueous mixtures of this drug. Additionally, the significant effect of the water on the glass transition temperature of LD-HCl was found. The sample characterized with mole fraction of water X(w) = 0.44 reveals the glass transition temperature T(g), 42 K lower than that of anhydrous material (307 K). Finally, it was shown that by amorphization of the hydrochloride salt of lidocaine it is possible to obtain its room temperature ionic liquid form.

Gene expression profile analysis in laryngeal cancer by high-density oligonucleotide microarrays

The assessment of gene expression profile in laryngeal cancer shall allow to implement molecular biology methods in diagnostics, as well as in prognosis of the course of disease. Thus, it may influence the choice of the most optimal decisions in regards to the method of treatment, extent of surgical procedure, or the necessity of adding post-operative radiotherapy. The aim of the project was to analyse the gene expression profile of laryngeal cancer using oligonucleotide microarrays, aiming to derive novel molecular markers for that carcinoma. The study comprised a group of 14 patients (12 males and 2 females) with squamous cell laryngeal carcinoma, diagnosed and surgically treated between 2005 - 2007 in the ENT Department of the Silesian Medical University in Katowice, Poland. RNA was isolated from frozen tissue fragments. To assess gene expression profile, high density oligonucleotide microarrays (Affymetrix U 133 Plus 2.0) were applied, with over 54 thousand probesets for over 47 thousand transcripts. Four genes, previously not assesed in diagnostic context in laryngeal carcinoma, seemed to be valuable markers of that neoplasm. These are: metalloproteinase ADAM12, cycline-dependent kinase 2 - CDK2, kinesine 14 - KIF14, suppressor 1 of checkpoint - CHES1.

Toll-like receptors and the tendency of normal mucous membrane to transform to polyp or colorectal cancer

The aim of this study was to identify differences in Toll-like receptor (TLR) expression patterns in normal and diseased tissues of patients with polyps and colorectal cancer. Eight patients were included in the study group (aged 38 to 72 years). Sixteen HG-U133A oligonucleotide microarrays were analysed including four of colonic polyps, four of adenocarcinoma with different degree of histological differentiation (2 poorly and 2 highly differentiated), and eight of macroscopically normal tissue. The levels of selected TLR mRNA transcripts were analysed. An analysis of all per cent variability values with regard to malignancy stage increasing from polyp to stages I to III adenocarcinoma, and normal colon mucosa shows a statistically significant relationship for TLR2 (increasing) and TLR3 (decreasing). In polyps, copy numbers of TLR3, TLR4 and TLR5 mRNA were the highest and TLR7 mRNA the lowest. In normal colon mucosa of polyposis patients the highest mRNA copy numbers were observed for TLR3, and the lowest for TLR7. TLR3 may serve as a marker of colon tissue metaplasia and may indicate the tendency of normal tissue to form polyps transforming to colorectal cancer.

[The case of a large orbital foreign body evacuated by lateral orbitotomy using the Kronlein-Reese-Berk method]

The authors describe a case of patient with orbital large foreign body (glass) treated using Kronlein lateral orbitotomy.

[Alloplastic valve vocal prosthesis to serve for rehabilitation speech after total laryngectomy]

The authors have presented structure and method of implantation of alloplastical valve vocal prosthesis to serve for rehabilitation speech after total laryngectomy.

[Antioxidant enzymes activity in patients suffering from laryngeal cancer]

The adequate activity of SOD, GPX and GR is a significant factor in oxidoreductation homeostasis maintaining. The attempt was made to estimate SOD, GPX, GR activity in full blood of 14 male patients suffering from laryngeal cancer (T2N0M0-T4N2M0). The studies were made before and in 8 and 16 week after the operation using RANDOX Company tests. The analysis of results proved that there were remarkable disorders of GR activity in comparison to a control group.

[A rare case of multiple neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma]

The authors have presented a very rare case of multiple primary neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma. Primary multiple neoplasms and multifocal neoplasms are a very complex problem and therefore have been a topic of many articles. The authors describe mechanism of origin, frequency of occurrence, possibilities of diagnostics. The main reason of these neoplasms origin are simultaneously exposure of the tissue to damaging factors and special tissue sensitivity.

[A contribution to the etiology of objective tinnitus: the case of arteriovenous fistula between the superficial artery and external jugular vein]

The authors have presented a very rare case of vascular anomaly in 51-years old female with an arteriovenous fistula between the frontal branch and parietal branch of superficial temporal artery and external jugular vein with simultaneously haemangioma cavernosum of temporal region. The clinical manifestation and the diagnosis of this anomaly are discussed with particular stress laid on the role of carotid arteriography which demonstrated the presence of this abnormal arterio-venous communication. Surgical treatment and its results are discussed also. The results of diagnostic and therapeutic procedures were compared with cases described in the literature.

[Histological and clinical analysis of mesenchymal malignant neoplasms (soft tissue sarcomas) of head and neck region in the data of I ENT Department of Silesian Medical Academy]

Between the years 19890-1998 in I ENT Department of Silesian Medical Academy were treated surgically 15 patients suffering from soft tissue sarcomas of head and neck region. Patomorphological examination showed: fibrosarcoma (4 cases), haemangioendothelioma malignum (2 cases), rhabdomyosarcoma (2 cases), schwannoma malignum (2 cases), fibrohistiocytoma malignum (2 cases), tumor mixtus mesenchymalis (1 case), haemangiopericytoma malignum (1 case), extrasceletal osteosarcoma (1 case). Sarcomas were localised in paranasal sinuses (7 cases), orbita (5 cases), parapharyngeal space (1 case), parotid gland (1 case) and bucca (1 case). All those patients were treated surgically and most of them were irradiated postoperatively. The authors have presented the diagnostic and methods of treatment of soft tissue sarcomas. According to our experience and data of the literature the method of choice in treatment soft tissue sarcomas should consist of surgery and radiation therapy postoperatively.

[Air conduction threshold values in expanded range of frequencies (250 Hz-18 kHz) in otologically normal persons as assessment of mobility hearing organ in presbycusis]

High-frequency hearing loss is most significant for the organ of hearing aging. Air conduction threshold measurements were taken in 4 groups (aged 31-40, 41-50, 51-60, 61-70 years) of otologically normal persons in expanded range of frequencies (250-18,000 Hz). The threshold of air conduction increase parallel to age and to pure tone frequency was stated.

T cell responses to myelin basic protein in patients with spinal cord injury and multiple sclerosis

Autoimmune inflammation secondary to myelin destruction may play an inhibitory role in restoration of nerve functions in spinal cord injury (SCI). In this study, we demonstrated that T cells recognizing myelin basic protein (MBP) occurred at a high precursor frequency in patients with SCI, which was compatible to that in patients with multiple sclerosis (MS), a disease of presumed autoimmune pathology. The findings suggest of hyperactivity of MBP-reactive T cells in patients with SCI. MBP-reactive T cell lines derived from patients with SCI exhibited a preferential recognition pattern toward the 81-99 and the 151-169 regions of MBP. There were functional differences in the epitope recognition and cytokine profile between two panels of MBP-reactive T cell lines derived from patients with SCI and patients with MS. The study provides new evidence important for further investigation of the role of the inflammatory component in SCI.

[The assessment of lateral orbitotomy by Krönlein-Reese-Berke in surgical treatment of primary non-malignant orbital tumors]

AIM

The assessment of lateral orbitotomy by Krönlein-Reese-Berke was made to evaluate the possibility of radical removal of primary orbital tumors, function of visual system and cosmetic effect after lateral orbitotomy.

MATERIAL AND METHODS

The authors analysed a group of 14 patients treated for primary non-malignant orbital tumors. They were treated in I ENT Clinic of Silesian Medical Academy in Katowice surgically by Krönlein-Reese-Berke lateral orbitotomy. A control examination (after 3 years) performed in all 14 patients did not show recurrence of tumor, the motility of the eye ball and visual function was normal, cosmetic effect was good.

CONCLUSIONS

We suggest that in the cases of primary non-malignant tumors localised in the lateral part of the orbita, orbitotomy by Krönlein-Reese-Berke is the optimal surgical approach.

[Laryngeal carcinoma distant metastasis to the occipital bone: a case report]

The authors present a case of laryngeal carcinoma with rare metastasis to the occipital bone.

Activity of glutathione transferase and reductase in tissues of bird cherry-oat aphid during its host-plant alternation

Changes in activity of detoxifying enzymes, involved in metabolism of glutathione in bird cherry-oat aphid during its host alternation have been investigated. Glutathione transferase (GST) and glutathione reductase (GR) activity was found in homogenates from tissues of the bird cherry-oat aphid, Rhopalosiphum padi (L.). The highest activity of the enzymes was recorded in winged migrants that fly from bird cherry (Prunus padus L.), the winter host onto cereals a summer host. Before the migration an increase in activity of the glutathione transferase and glutathione reductase within tissues of winged migrants was observed. When the migrants started to feed on cereals, GST activity further increased and GR activity decreased. The significance of the R. padi glutathione transferase and reductase in detoxification of plant allelochemicals while the aphid host-plants alternation is discussed.

Increased norepinephrine levels during catheterization in patients with spinal cord injury

The hypothesis for this study was that catecholamine levels increase during urinary catheterization in human patients with spinal cord injury. Catecholamine levels, blood pressure, and pulse were measured prospectively in 40 subjects at baseline and during urinary catheterization. Results showed a significant increase in norepinephrine levels from baseline 245 +/- 240 pg (standard deviation (SD)) to 314 +/- 311 pg (SD) during catheterization (P = 0.018, Wilcoxon's). Results also showed a nonsignificant increase in epinephrine levels from baseline (56 +/- 70 pg, SD) to catheterization (84 +/- 125 pg, SD; P = 0.35, Wilcoxon's). Systolic blood pressure increased from 114 to 124 mm Hg (P = 0.004, paired t test). Diastolic blood pressure increased from 75 to 78 mm Hg (P = 0.11, paired t test). There was no significant change in diastolic blood pressure or pulse (P = 0.11 and P = 0.29, respectively, paired t test). In conclusion, norepinephrine levels increased during catheterization in patients with spinal cord injury. Knowledge of catecholamine levels in this process may assist in determining both pathophysiology and potential pharmacologic treatment options in future studies.

[A case of laryngeal mucoepidermoid carcinoma]

The authors present a very rare case of laryngeal mucoepidermoid cancer. Well separated and encysted tumor was totaly removed with Kleinsasser method.

[Primary orbital tumors treated surgically in ENT department of Silesian Medical Academy in Katowice]

Primary tumours of orbital cavity are a difficult diagnostic and therapeutic problem from a borderline of ophthalmology, laryngology and neurosurgery. Particular anatomical relations of orbital cavity surrounded by paranasal sinuses, cranial cavity cause that it has become an interdisciplinary region and the best method of therapy is multispecialistic surgical treatment ("team approach"). In this article the classification and general symptomatology of orbital cavity primary tumours were presented. 37 patients suffering from primary orbital tumours were treated surgically in the ENT Department of Silesian Medical Academy in Katowice. The patients were aged from 23 (woman with neurosarcoma) to 73 (man with melanoma). All patients were treated surgically: 15 of them by orbital exenteration, 10 by lateral orbitotomy m. Kronlein-Reese-Berk, and 12 by canthotomy. Special attention was paid to possible postoperative complications.

[Plastic tracheostomy tube of Luer's type]

The authors describe a plastic tracheostomy tube which has been accepted as the registered model No: PL 54620 Y1. The presented tube is applied in patients in I ENT Department of the Silesian Medical Academy in Katowice. The authors presented advantages of plastic tracheostomy tube.

[A rare case of multiple primary malignant neoplasms of parotid gland: fibrosarcoma and squamous cell carcinoma]

Primary multiple malignant neoplasms and multifocal neoplasms are a very complex problem and therefore have been a topic of many articles. The mechanism of origin, frequency of occurrence, co-existence of neoplasms in functionally similar organs (uterus, mammary gland), heredity, a possibility of diagnostic and therapy are the most interesting aspects. Frequency of multiple primary malignant neoplasms occurrence is about 2-8% and still increases. Pathogenesis of multifocal and multiple neoplasms has rarely been a subject of articles. A simultaneous exposure of a tissue to damaging factors and special tissue sensitivity are the main reasons for neoplasms origin in this group. The authors present a rare case of parotid gland multiple neoplasm: fibrosarcoma and squamous cell carcinoma, as well as discuss the diagnostics, therapy, and prognosis of multiple neoplasms.

[Rare primary malignant orbital neoplasms treated surgically in the I Clinic of Otolaryngology of the Silesian Medical Academy in Katowice in the years 1992-1995]

14 patients suffering from primary orbital tumours were treated surgically in the Otolaryngological Department in Silesian Medical Academy in Katowice in the years 1992-1995. The patients were aged from 23 (woman with neurosarcoma) to 67 (woman with haemangioma). All patients were treated surgically: 8 of them by lateral orbitotomy m. Krönlein-Reese-Berk, 3 of them by orbital exenteration, and 3 of them by canthotomy. The author analysed 3 very rare cases of primary orbital malignant neoplasms: neurosarcoma, rhabdomyosarcoma and additionally I case with fibrosarcoma, osteosarcoma and chondrosarcoma simultaneously.

Clinical assessment of spasticity in spinal cord injury: a multidimensional problem

OBJECTIVE

To determine the relation between various components of spasticity evaluated clinically in persons with spinal cord injury (SCI).

DESIGN

Case series evaluating spasticity using clinical scales commonly referenced in contemporary literature, including the Penn Spasm Frequency Scale, the Ashworth Scale, and standard scales of tendon taps, clonus, and plantar stimulation. SETTING. A Veterans Affairs Medical Center Spinal Cord Injury Center. PATIENTS. Eighty-five spinal cord injured individuals with varying degrees of spasticity.

RESULTS

Correlations demonstrated weak relationships between Spasm Frequency Scale and self-report scales of interference with function (.407) and painful spasms (.312). No clinical examination score correlated with self-report scores greater than 0.4. Three clinical examination scores correlated modestly (> 0.5)-Ashworth score with patellar tendon taps (.553), ankle clonus with Achilles tendon tap (.663), and patellar tendon tap with adductor tendon tap (.512). Two other clinical scales correlated weakly (> 0.4)-Achilles tendon tap with patellar tendon tap (.417) and plantar reflex with adductor tendon taps (.423).

CONCLUSIONS

Clinical scales currently used to evaluate spasticity in SCI correlate poorly with each other, suggesting that they each assess different aspects of spasticity. The use of any single scale is likely to underrepresent the magnitude and severity of spasticity in the SCI population. In the absence of agreement among these various scales and with the absence of an appropriate criterion standard for evaluation of spasticity, assessments of spasticity, whether clinical or neurophysiological in nature, should be comprehensive in scope.

Antibiotic prophylaxis for urodynamic testing in patients with spinal cord injury: a preliminary study

This study was performed in order to: (i) determine the incidence of symptomatic urinary tract infection (UTI) in patients with spinal cord injury after urodynamic testing; (ii) evaluate the role of antibiotic prophylaxis for such a procedure; and (iii) investigate whether pre-existing bacteriuria predisposes to the development of symptomatic UTI after urodynamic testing. Forty patients were prospectively randomized in a double-blind fashion to receive a 3-day oral course of either ciprofloxacin (18 patients) or placebo (22 patients), beginning 2 days prior to the urodynamic procedure. None of 18 (0%) patients who received ciprofloxacin developed symptomatic UTI within 5 days after the procedure compared with three of 22 (14%) subjects randomized to the placebo group; the protective efficacy of antibiotic prophylaxis, however, did not attain statistical significance (P = 0.24). None of the three bacterial isolates that were responsible for symptomatic infection were grown in corresponding urine cultures prior to the procedure. These findings may serve as a pilot for a larger study.

Osteomyelitis associated with pressure sores

BACKGROUND

Pressure sores may be associated with underlying osteomyelitis that is difficult to differentiate clinically from infection or colonization of adjacent soft tissue. Cultures of bone specimens are frequently contaminated with organisms residing in adjacent soft tissue. The three objectives of this cohort study were to (1) determine the accuracy of clinical evaluation for osteomyelitis; (2) evaluate the potential role of quantitative cultures of bone in differentiating osteomyelitis from soft-tissue infection or colonization; and (3) assess the impact of treating osteomyelitis on the outcome of pressure sores.

METHODS

Thirty-six patients with pressure sores related to spinal cord injury or cerebrovascular accident underwent clinical evaluation for osteomyelitis, followed by percutaneous needle biopsy of bone. Routine semiquantitative and quantitative, aerobic and anaerobic cultures of bone specimens were performed. Pathologic examination of bone tissue was used as the standard criterion for diagnosing osteomyelitis.

RESULTS

Six (17%) of 36 patients were diagnosed by pathologic examination as having osteomyelitis. The sensitivity and specificity of clinical evaluation were 33% and 60%, respectively. When positive, quantitative bone cultures yielded a similar number of bacterial isolates and a comparable range of bacterial concentration in patients with osteomyelitis vs those without osteomyelitis. Pressure sores healed in all six patients with osteomyelitis after appropriate therapy.

CONCLUSIONS

Clinical evaluation for osteomyelitis is often inaccurate. Pathologic examination of bone tissue is required for definitive diagnosis of osteomyelitis. Quantitative bone cultures do not help differentiate osteomyelitis from infection or colonization of adjacent soft tissue. It is possible that treatment of osteomyelitis may improve the outcome of associated pressure sores.

Progression from asymptomatic to symptomatic urinary tract infection in patients with SCI: a preliminary study

The purpose of this prospective pilot study was to (1) evaluate the role of pyuria in predicting the progression from asymptomatic to symptomatic urinary tract infection (UTI) in spinal cord-injured patients who undergo sterile intermittent bladder catheterization and (2) evaluate the impact of treating asymptomatic UTI on this progression. Twenty hospitalized patients were randomized to either the treatment group (10 subjects) or the control group (10 subjects). Weekly urine samples were obtained for quantitation of bacterial growth and pyuria. Neither the level nor the trend of pyuria helped predict the imminent progression to symptomatic UTI. Thirty percent of patients in the treatment group developed symptomatic UTI vs 70 percent of patients in the control group; it took a significantly longer time for patients in the treatment vs control group to develop symptomatic UTI (median number of days: 72 vs 7, respectively; p < 0.003). Further analysis of the long-term impact of antibiotic treatment of asymptomatic UTI is warranted.

Eradication of colonization by methicillin-resistant Staphylococcus aureus by using oral minocycline-rifampin and topical mupirocin

In an attempt to control the spread of methicillin-resistant Staphylococcus aureus (MRSA) within a spinal cord injury unit, we investigated the mode of transmission and implemented a multidisciplinary approach for control that consisted of grouping of patients into cohorts, contact isolation, and antibiotics. Surveillance cultures of patients and nose and hand cultures of medical personnel were performed. Of 11 colonized patients, 6 had MRSA isolates that shared a similar plasmid profile and antibiogram, raising the possibility of interpatient spread of the organism. Medical personnel had no evident role in transmitting MRSA. All patients' pretherapy MRSA isolates were susceptible to minocycline and, except for one, to rifampin. Time-kill studies showed an indifferent interaction of these two antibiotics. Ten colonized patients received a 2-week oral course of 100 mg of minocycline twice daily and 600 mg of rifampin once daily, while the 11th patient was treated for only 1 week. Patients with colonization of the nares also had twice daily nasal application of 2% mupirocin for 5 days. Colonization with MRSA cleared in 10 of 11 patients (91%) and 20 of 21 sites (95%). When the individual circumstances of a medical facility justify eradication of MRSA colonization, a multidisciplinary approach that includes antibiotic therapy with oral minocycline and rifampin, along with topical mupirocin for those with nasal carriage, may be successful.

Galvanic couples of 316L steel with Ti and ion plated Ti and TiN coatings in Ringer's solutions

Steel 316L was coated with titanium or titanium nitride by ion plating. The tightness of the coatings was examined electro-chemically. The galvanic effects for the galvanic couples steel-titanium, steel-titanium-coated steel and steel-titanium nitride-coated steel were studied. It was found that both titanium and titanium nitride coatings were non-porous in Ringer's solution; titanium served as an anode in the couple steel-titanium; it was oxidized according to the logarithmic law. For the other two couples, the coatings were the cathodes. The rate of dissolution of steel in these couples, was however, smaller than expected, owing to a strong polarization of the coatings. The potential of the couple was similar to that of steel.

Differences between trunk heat patterns shown by complete and incomplete spinal cord injured veterans

Thermograms showing heat patterns in the trunk of the body were taken of ten intact subjects, seven subjects with incomplete spinal cord injuries (SCI), and fifteen subjects diagnosed as having complete SCIs. Fourteen of the subjects with complete SCIs had a thermal demarcation line across the trunk. This line represented a temperature gradient of one to 2.5 degrees Celsius between a relatively warm upper level where sensations were normal and a relatively cool lower level in which sensations were either absent or different from pre-injury sensations. The transition zone was narrow and sharp for ten of the complete SCI subjects but was wide and gradual for the other five complete SCI subjects. The shape and width of the thermal transition zone corresponded to the location and degree of abruptness with which sensations changed from normal to abnormal. One of the subjects diagnosed as having a complete SCI failed to show a significant transition zone. The temperature difference between the upper and lower portions of his trunk was less than one degree Celsius. None of the intact or incomplete SCI subjects produced the transition zone. Only one incomplete SCI subject showed even a minimal difference in temperature between the normal sensation and abnormal sensation levels. A panel blind to the subjects' conditions was unable to differentiate between intact and incomplete SCI subjects but was able to sort complete from incomplete SCI subjects in all but the case with an indistinct transition zone.

Relationships between near surface blood flow and altered sensations among spinal cord injured veterans

Ten patients with clinical diagnoses of complete transverse spinal cord tissue destruction were interviewed about any sensations they felt below the level at which normal feelings were evident. All ten reported experiencing various feelings most of the time and nine reported that some of those feelings were usually quite painful. Videothermographs showing differences in skin temperature of 0.1 degrees celsius were taken to evaluate blood flow patterns to a depth of 1.5 cm. Changes in blood flow patterns were found to correlate highly with the level at which sensations changed from normal to abnormal and to correlate virtually exactly with the locations of pain reported from supposedly desenate areas.

Lymphedema incidence after specific postmastectomy therapy

In a retrospective study the incidence of lymphedema was analyzed in 58 women, ages 35 to 81 years, who had received a specific treatment program after radical or modified radical mastectomy for breast carcinoma in a county hospital. Thirty-nine percent (23 patients) had cobalt treatment and 48% (28 patients) had delayed wound healing. Circumferential measurements of both upper limbs were obtained at specific corresponding sites. At the end of the 12 months, 69% of the patients had no lymphedema, 22.4% had slight lymphedema, 5.2% had moderate lymphedema and 3.4% had severe lymphedema. The benefits of close follow-up and specific treatment of mastectomized patients are evidenced in this study by the relatively large group of patients which was free of lymphedema over an extended period of time in spite of wound healing complications.