RESUMEN
Modern telecommunications rely on the transmission and manipulation of optical signals. Optical amplification plays a vital part in this technology, as all components in a real telecommunications system produce some loss. The two main issues with present amplifiers, which rely on erbium ions in a glass matrix, are the difficulty in integration onto a single substrate and the need of high pump power densities to produce gain. Here we show a potential organic optical amplifier material that demonstrates population inversion when pumped from above using low-power visible light. This system is integrated into an organic light-emitting diode demonstrating that electrical pumping can be achieved. This opens the possibility of direct electrically driven optical amplifiers and optical circuits. Our results provide an alternative approach to producing low-cost integrated optics that is compatible with existing silicon photonics and a different route to an effective integrated optics technology.
RESUMEN
Benign primary tumors of the facial nerve are frequently misdiagnosed because of the variety of their clinical manifestations. Much attention has been paid to neurilemmomas in the recent otolaryngologic literature, but far less has been focused on intraparotid facial nerve neurilemmomas. In this article, we describe a new case of this truly rare tumor, and we review its diagnosis, pathology, and treatment.
Asunto(s)
Neoplasias de los Nervios Craneales/diagnóstico , Nervio Facial/cirugía , Neurilemoma/diagnóstico , Neurilemoma/cirugía , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Parótida/cirugía , Adulto , Anastomosis Quirúrgica , Neoplasias de los Nervios Craneales/patología , Neoplasias de los Nervios Craneales/cirugía , Diagnóstico Diferencial , Nervio Facial/patología , Enfermedades del Nervio Facial/diagnóstico , Femenino , Humanos , Nervio Hipogloso/cirugía , Neurilemoma/patología , Neoplasias de la Parótida/patologíaRESUMEN
AIM: This study was designed to examine the prognostic significance of the coexpression of three genes (bax, bcl-2 and p53) which play a critical role in the apoptotic mechanisms in patients with squamous cell laryngeal carcinoma. MATERIALS AND METHODS: The immunohistochemical expression of bcl-2, bax and p53 genes was retrospectively examined in 38 patients with squamous cell laryngeal carcinoma and in five controls (necrotomic tissue). Tissue specimens were obtained both during the diagnostic biopsy and at the time of surgery. Clinicopathological and survival data were correlated with the staining results. RESULTS: Bcl-2 protein expression (P=0.0472), stage (P=0.0087) and lymph-node involvement (P=0.0488) were found to be independent prognostic factors. Increased bcl-2 protein expression correlated with a better 5-year survival (P=0.0472). Patients who were bcl-2(-)/p53(-) (n=25) or bax(+)/bcl-2(-) (n=13) had a significantly worse overall survival (P=0.0305 and P=0.0482, respectively). Similarly, patients who were bax(+)/bcl-2(-)/p53(-) (n=11) also had a worse 5-year survival compared with the rest of the group (P=0.0088). Changes that were noticed in bax and p53 protein expression from the time of biopsy until the time of surgery did not correlate with a significant increase in the overall survival. CONCLUSIONS: The expression of bcl-2 gene appears to be an independent prognostic factor for patients with laryngeal carcinoma. The coexpression of the genes studied can be used to determine aggressive clinical phenotypes.
Asunto(s)
Carcinoma de Células Escamosas/genética , Genes bcl-2/genética , Genes p53/genética , Pruebas Genéticas , Neoplasias Laríngeas/genética , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Biopsia con Aguja , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Intervalos de Confianza , Femenino , Expresión Génica , Marcadores Genéticos/genética , Humanos , Inmunohistoquímica , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Probabilidad , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Sensibilidad y Especificidad , Análisis de SupervivenciaRESUMEN
OBJECTIVES: Cisplatin chemotherapy is associated with an increased risk of ototoxic changes. The incidence of hearing loss after the 1st cisplatin-infusion session is only scarcely mentioned in the international literature. With increasing survival rates, prevention and/or early detection of ototoxicity are important for providing management options. The predictive value of pure-tone audiometry in early detection of ototoxicity has been questioned, particularly in the higher frequencies. Otoacoustic emissions appear to be more sensitive to cochlear insult than the conventional pure-tone audiometry. The aims of our study was (a) to define the extent of hearing damage in children after the 1st cisplatin-infusion session (50 mg/m(2)); and (b) to compare the efficacy of otoacoustic emissions (transient evoked otoacoustic emissions, distortion-product otoacoustic emissions) with that of pure-tone audiometry as methods of audiological monitoring. METHODS: Baseline audiometric (0.25-8 kHz) and otoacoustic emission testing (transient evoked otoacoustic emissions, distortion-product otoacoustic emissions) was conducted in 19 children, 12 of whom met the criteria for inclusion in the final study. Comparisons were performed between baseline measurements and those recorded after the 1st cisplatin course. Transient evoked otoacoustic emissions were analyzed in terms of emission level and reproducibility as a function of frequency (0.8-4 kHz). Distortion-product otoacoustic emissions were obtained as DP-grams and I/Q functions at 4,6 and 8 kHz. The DP-gram amplitude, the dynamic range and the detection thresholds from the I/Q functions were determined for each child. RESULTS: Threshold changes from baseline were founded to be statistically significant from 4-8 kHz in 50% of the children (P<0.01). Transient evoked otoacoustic emissions revealed a significant decrease in the emission level and in the reproducibility at the highest frequency tested (4 kHz, P<0.01), reflecting the results seen in pure-tone audiometry. Distortion-product otoacoustic emissions demonstrated a significant threshold shift, a reduced dynamic range and a decreased amplitude in the frequencies >3 kHz (P<0.05). Furthermore, DP-gram amplitude also reduced significantly at 3 kHz (P<0.05) without any similar change in pure-tone audiometry. CONCLUSIONS: A significant high-frequency hearing loss is identified in children even after one low-dose cisplatin-infusion session. As ototoxicity screening tools DP-grams were extremely sensitive and superior to pure-tone audiometry and/or transient evoked otoacoustic emissions. Their use is recommended for regular monitoring of cochlear function, aiming in prevention of permanent damage. Some suggestions for reducing the potential for cisplatin ototoxicity (chemoprotective agents, gene therapy, inhibition of apoptosis) are also discussed.
Asunto(s)
Antineoplásicos/efectos adversos , Cisplatino/efectos adversos , Trastornos de la Audición/inducido químicamente , Emisiones Otoacústicas Espontáneas/efectos de los fármacos , Adolescente , Audiometría de Tonos Puros/métodos , Umbral Auditivo/fisiología , Niño , Cóclea/efectos de los fármacos , Cóclea/fisiopatología , Trastornos de la Audición/diagnóstico , Trastornos de la Audición/fisiopatología , Pérdida Auditiva de Alta Frecuencia/inducido químicamente , Pérdida Auditiva de Alta Frecuencia/diagnóstico , Pérdida Auditiva de Alta Frecuencia/fisiopatología , Humanos , Persona de Mediana EdadRESUMEN
Pleomorphic adenoma is the most frequent tumor of the major salivary glands. It is rarely located in the lacrymal glands and is unusual in the nasal cavity. A rare case of a pleomorphic adenoma of the nose is presented along with a review of the literature. The use of nasal endoscopy in removing tumors of the nose and paranasal sinuses is discussed.
Asunto(s)
Adenoma Pleomórfico/diagnóstico , Adenoma Pleomórfico/cirugía , Neoplasias Nasales/diagnóstico , Neoplasias Nasales/cirugía , Adulto , Diagnóstico Diferencial , Endoscopía , Femenino , Humanos , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: We evaluated whether sensorineural loss and vestibular abnormalities are common in patients with primary Sjögren's syndrome (pSS) and whether such abnormalities are clinically significant. METHODS: In an individually matched case-control design, 48 patients with pSS underwent complete audiovestibular evaluation along with 48 age and sex matched individuals without otologic problems. Differences of > 20 dB between patient and control ears at any frequency tested were considered to be significant. RESULTS: Significant differences in hearing loss were seen at 4,000 Hz (6 vs 0 ears; p = 0.03) and at 8,000 Hz (9 vs 0 ears; p = 0.003). Small differences in hearing acuity were also observed in the lower frequencies, but the absolute mean difference was < 3 dB. A decrease of at least 60 dB in hearing acuity at any frequency up to 4,000 Hz was seen only in 3 elderly pSS patients. Abnormal brainstem auditory evoked responses were recorded in 7 patients and 5 controls, but no patient had retrocochlear lesions identified on magnetic resonance imaging. Four patients in each group had abnormalities on electronystagmography. CONCLUSION: pSS is associated with sensorineural hearing loss affecting preferentially the high frequencies, but clinically significant defects are not common. There is no evidence of retrocochlear disease or increased vestibular involvement in pSS.
Asunto(s)
Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Sensorineural/fisiopatología , Síndrome de Sjögren/complicaciones , Anciano , Umbral Auditivo , Estudios de Casos y Controles , Electronistagmografía , Potenciales Evocados Auditivos del Tronco Encefálico , Audición , Humanos , Persona de Mediana Edad , Vestíbulo del Laberinto/fisiopatologíaRESUMEN
Histological specimens from 62 laryngeal and 31 oral carcinomas were immunohistochemically assessed for p53, p21 and p27 proteins; cases with > 10% labelled nuclei were considered as positive. p21 showed higher expression in patients > 65-years-old (P = 0.04), in chemotherapy responders (P = 0.02), and in stage III patients with longer overall survival (P = 0.02), representing the only independent prognostic factor in the multivariate analysis. In addition, stage III patients with p53-/p21+ showed the longest survival whereas those with p53+/p21- tumors showed the shortest overall survival (P = 0.02). A significant influence on the survival of stage III patients was also found for the combinations of p21 and p27 proteins with p21+/p27- imparting the best and p21-/p27+ the worst prognosis (P = 0.04). p27 expression was significantly related to oral cancer specimens (P = 0.04) and to moderate and high tumor grade (P = 0.01). p53 expression was not significantly related to any of the examined clinicopathological characteristics. Our findings indicated that, by functionally promoting apoptosis, p21 seems to play a key role in the successful response to chemotherapy and may be considered as a predictive factor of a better prognosis in stage III patients with head and neck cancers.
Asunto(s)
Carcinoma de Células Escamosas/genética , Proteínas de Ciclo Celular , Ciclinas/biosíntesis , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Neoplasias de Cabeza y Cuello/genética , Proteínas Asociadas a Microtúbulos/biosíntesis , Proteínas de Neoplasias/biosíntesis , Proteína p53 Supresora de Tumor/biosíntesis , Proteínas Supresoras de Tumor , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Inhibidor p21 de las Quinasas Dependientes de la Ciclina , Inhibidor p27 de las Quinasas Dependientes de la Ciclina , Ciclinas/genética , Femenino , Genes p53 , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Humanos , Tablas de Vida , Masculino , Proteínas Asociadas a Microtúbulos/genética , Persona de Mediana Edad , Neoplasias de la Boca/genética , Neoplasias de la Boca/metabolismo , Neoplasias de la Boca/mortalidad , Proteínas de Neoplasias/genética , Estadificación de Neoplasias , Pronóstico , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
In this case report, we present a solitary metastasis of renal cell carcinoma inside the masseter muscle. To our knowledge, it is the very first case ever encountered.
Asunto(s)
Carcinoma de Células Renales/secundario , Neoplasias Renales , Músculo Masetero , Neoplasias de los Músculos/secundario , Carcinoma de Células Renales/cirugía , Carcinoma de Células Renales/terapia , Terapia Combinada , Humanos , Interferón beta/uso terapéutico , Interleucina-2/uso terapéutico , Neoplasias Renales/cirugía , Neoplasias Renales/terapia , Masculino , Persona de Mediana Edad , Neoplasias de los Músculos/cirugía , Neoplasias de los Músculos/terapiaRESUMEN
The treatment of patients with vocal fold paralysis presents a challenge to the otolaryngologist-head and neck surgeon. Many techniques have been proposed to manage individuals with unilateral or bilateral vocal fold paralysis. We herein describe the experience of our department in dealing with bilateral vocal fold paralysis. At the University of Athens, patients presenting with symptomatic bilateral paralysis are treated with a posterior cordectomy by using the CO2 or KTP-532 laser. During the last 5 years, we have treated 20 patients (8 men and 12 women) presenting with symptomatic bilateral vocal fold paralysis. For augmentation of the glottic airway, a modification of Kashima's cordotomy was used, completing a partial posterior cordectomy of one or both true and false vocal folds with the CO2 laser (15 patients) and the KTP-532 laser (5 patients). An elective tracheotomy was done before the cordotomy. Complications, such as infection, stridor, or dyspnea, were minimal. Although no objective voice analysis was performed, all patients were able to communicate without any phonation device and were satisfied with the result of the surgery. When compared with other techniques, the advantages offered by the posterior cordectomy included rapidity and simplicity in concept, reliability of outcome, short hospitalization, low risk of complications, and the possibility for revision when necessary (posterior cordectomy). From the successful postsurgical results of this study, it can be concluded that the posterior cordectomy is a reliable treatment option for the management of patients with bilateral vocal fold paralysis.
Asunto(s)
Terapia por Láser/métodos , Parálisis de los Pliegues Vocales/cirugía , Centros Médicos Académicos , Adulto , Anciano , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Grecia , Humanos , Laringoscopía/métodos , Masculino , Persona de Mediana Edad , Traqueotomía/métodos , Resultado del Tratamiento , Universidades , Pliegues Vocales/cirugíaRESUMEN
Inverted papilloma is a rare benign sinonasal tumour, characterized by a potentially invasive nature. The lateral nasal wall represents the most common site of origin, whereas paranasal sinuses are quite frequently found to be involved by extension. In contrast, primary sinus inverted papillomas have rarely been reported. The present study describes an extremely rare case of inverted papilloma, isolated to the left sphenoid sinus, that was treated by a transnasal endoscopic procedure. The therapeutic approach chosen is discussed and the results of a two-year follow-up are also presented.
Asunto(s)
Endoscopía/métodos , Papiloma Invertido/cirugía , Neoplasias de los Senos Paranasales/cirugía , Seno Esfenoidal , Humanos , Masculino , Persona de Mediana Edad , Papiloma Invertido/diagnóstico por imagen , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
The Arnold-Chiari malformation type I is a rare congenital condition characterized by herniation of the cerebellar tonsils into the upper cervical spinal tract. Various otoneurological manifestations occur in patients with the disease, which has usually been associated with a downbeat type of nystagmus. In this paper a case with this condition is reported presenting with periodic alternating nystagmus (PAN), which is a rare type of nystagmus observed in diseases of the central nervous system of different pathologies. The patient had a complete otoneurological examination and vestibular function testing. Diagnosis was established by using magnetic resonance imaging (MRI).
Asunto(s)
Malformación de Arnold-Chiari/complicaciones , Nistagmo Patológico/etiología , Adulto , Malformación de Arnold-Chiari/diagnóstico , Malformación de Arnold-Chiari/fisiopatología , Audiometría de Respuesta Evocada , Humanos , Imagen por Resonancia Magnética , Masculino , Nistagmo Optoquinético/fisiología , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/fisiopatología , Seguimiento Ocular Uniforme/fisiología , Movimientos Sacádicos/fisiologíaRESUMEN
Various recognized prognostic factors in squamous cell carcinoma (SCC) of the larynx influence the therapeutic options offered to an individual patient in order to extend the survival expectancy. Additional prognostic indicators are required in specific patient subgroups. The present study used a standard immunohistochemical technique in order to retrospectively evaluate the accumulation of p53 gene product and the immunoreactivity of bcl-2 protein and cathepsin-D as possible prognostic markers of laryngeal SCC. Formalin-fixed, paraffin-embedded tumor materials were obtained from a series of 64 patients with cancer of the larynx. Immunostaining was evaluated by computerized image analysis. The accumulation of p53 protein was found in 57.8% (37/64) of the patients and was associated with large tumor size. The percentage of p53-positive neoplastic cells increased in high-grade carcinomas, particularly when they simultaneously demonstrated cathepsin-D immunoreaction in stromal cells (P = 0.049); bcl-2 immunoexpression was found to be generally limited. Cathepsin-D immunostaining was observed in tumor parenchymal and stromal cells (31.25% and 37.5% of all cases, respectively); it was found to be useful in defining patient subgroups with differences in relapse-free survival. Among patients with posi-tive lymph nodes, those with cathepsin-D immunopositive tumor cells were at higher risk for relapsing (P = 0.0395). Although the classical prognostic factors of laryngeal carcinoma retain their predominance, cathepsin-D immunoreactivity may serve as an additional prognosticator in specific patient subgroups.
Asunto(s)
Carcinoma de Células Escamosas/metabolismo , Catepsina D/metabolismo , Neoplasias Laríngeas/metabolismo , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/análisis , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Recuento de Células , Supervivencia sin Enfermedad , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Técnicas para Inmunoenzimas , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Células del Estroma/metabolismo , Células del Estroma/patologíaRESUMEN
Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by osseous fragility, blue sclerae and hearing loss. In order to assess the impact of stapedotomy on improving hearing on OI, a retrospective, one-group, pre-test-post-test design was used to compare the pre-operative and post-operative audiograms of nine OI patients, treated with stapedotomy for their mixed hearing loss. Operative findings included fixation or thickening of the stapes footplate with normal superstructure configuration and hypervascularization of the promontory mucosa. Immediate post-operative results showed a significant improvement (p < 0.05) from 250-4000 Hz in air conduction and from 250-2000 Hz in bone conduction. A significant closure of the air-bone gap between 250-2000 Hz was also achieved (p < 0.05). The long-term results remained satisfactory with a mean threshold shift of 8 dB HL and an almost unchanged air-bone gap. These satisfactory results and the lack of complications make stapedotomy an appealing method for the management of OI-associated hearing loss.
Asunto(s)
Pérdida Auditiva Conductiva/cirugía , Pérdida Auditiva Sensorineural/cirugía , Osteogénesis Imperfecta/cirugía , Cirugía del Estribo/métodos , Adulto , Audiometría/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Aiming to improve voice quality and to facilitate swallowing rehabilitation, we modified the supracricoid partial laryngectomy with cricohyoidopexy by preserving the posterior segment of the true vocal cord on the less involved side of the larynx. Between 1983 and 1994, 13 patients with supraglottic cancer were treated with this modified procedure. The possibility of incomplete tumor excision was eliminated by careful patient selection and intraoperative reconfirmation of tumor extent with frozen sections. Our results have been promising, with a 76.9% 3-year survival rate and a 69.2% laryngeal preservation rate. There were 7 recurrences, 3 local (2 at the superior border of the cricoid and 1 at the cricoarytenoid region) and 4 nodal, in 5 patients. Distant metastases developed in another patient. Three patients, 2 with local and nodal recurrence and 1 with distant metastases, died of disease. Functional outcomes were also good, with all patients achieving normal swallowing by the end of the first year, although 5 patients required temporary gastrostomy for transient swallowing impairment. Early decannulation and satisfactory voice quality were achieved in all cases. We believe that with proper patient selection this modified procedure is effective both for tumor control and for preserving a more functional larynx.
Asunto(s)
Cartílago Cricoides/cirugía , Glotis , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Humanos , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Resultado del TratamientoRESUMEN
We studied 29 patients in the final stage of head or neck cancer who were suffering pain that was not relieved by oral morphine. Cervical or thoracic epidural morphine was administered to relieve the pain. The quality of analgesia was equally good for both techniques. However, cervical epidural administration appeared to be superior, because much smaller doses of morphine were required in order to induce more rapid and longer analgesia.
Asunto(s)
Analgesia Epidural/métodos , Analgésicos Opioides/administración & dosificación , Neoplasias de Cabeza y Cuello/complicaciones , Morfina/administración & dosificación , Dolor/tratamiento farmacológico , Anciano , Analgesia Epidural/efectos adversos , Analgésicos Opioides/efectos adversos , Femenino , Humanos , Masculino , Morfina/efectos adversos , Dolor/etiología , Dimensión del DolorRESUMEN
The incidence of nonvisualization of the vestibular aqueduct and the endolymphatic duct-endolymphatic sac (ED-ES) complex as well as the type of periaqueductal pneumatization were evaluated in 23 patients with definite Meniere's disease (MD) by high-resolution CT and by MRI. Fifty subjects with no previous history of any ear disease were used as a control group. High-resolution CT results disclosed that in the control group the percentage of nonvisualized vestibular aqueduct (3.4%) was statistically significantly lower than in the MD group, when either the diseased ear (27.8%) or the nondiseased ear of the same group (22.2%) was examined. In addition, no differences were observed between the diseased and nondiseased ears of the patients with MD. The periaqueductal pneumatization was also found to be statistically significantly lower in the MD group. As regards the MRI examination, the results of the analysis showed that the ED-ES complex was visualized more frequently in the ears of the control subjects (64.1%) than in the diseased ears of the patients with Meniere's disease (39.1%). This difference had a marginal statistical significance (P approximately 0.05). We discussed the results in relation to possible underlying pathophysiologic mechanisms involving the flow of endolymph toward the ES during the different stages of the disease.
Asunto(s)
Aumento de la Imagen , Imagen por Resonancia Magnética , Enfermedad de Meniere/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Anciano , Endolinfa/fisiología , Conducto Endolinfático/patología , Saco Endolinfático/patología , Femenino , Humanos , Masculino , Enfermedad de Meniere/cirugía , Persona de Mediana Edad , Valores de Referencia , Sensibilidad y Especificidad , Hueso Temporal/patología , Acueducto Vestibular/patologíaRESUMEN
The aim of the present study was to examine topoisomerase II alpha (topo II alpha) expression in cancers of the head and neck and to establish a correlation with clinicopathological parameters and survival. Paraffin embedded tissue specimens (studied by immunohistochemistry), from 103 consecutive patients with squamous cell carcinoma of the head and neck regions, were examined on the primary tumor (96 patients) and on recurrence (7 patients). Immunostaining evaluation was quantified by examining at least 1,000 neoplastic cells and counting the percentage of positively stained nuclei. Topoisomerase II alpha expression was correlated with age, gender, stage, site of the disease, tumor differentiation, response to chemotherapy, disease-free survival and overall survival. More than half of the specimens had a high expression of topoisomerase II alpha (> or = 15% positive neoplastic cells). Topoisomerase II alpha expression was significantly higher in tumors of low and moderate differentiation versus tumors of high differentiation (P = 0.00001). There was also a significant difference in topo II alpha in specimens of responders to chemotherapy versus non-responders (P = 0.02), although the cytotoxic drugs used do not belong to topoisomerase II alpha antagonists. The correlation of high topoisomerase II alpha expression and stage of disease, age, gender, primary site, recurrence, disease-free survival and overall survival was not statistically significant. In conclusion, topoisomerase II alpha is highly expressed in histological specimens of the majority of patients with head and neck cancers; mainly, it is related to a significant degree to low and moderately differentiated tumors versus highly differentiated ones. High expression of topoisomerase II alpha is also significantly related to response to chemotherapy.
Asunto(s)
Carcinoma de Células Escamosas/enzimología , ADN-Topoisomerasas de Tipo II , ADN-Topoisomerasas de Tipo II/análisis , Neoplasias de Cabeza y Cuello/enzimología , Isoenzimas/análisis , Proteínas de Neoplasias/análisis , Adulto , Anciano , Anciano de 80 o más Años , Antígenos de Neoplasias , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bleomicina/administración & dosificación , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Diferenciación Celular , Núcleo Celular/enzimología , Cisplatino/administración & dosificación , ADN-Topoisomerasas de Tipo II/biosíntesis , ADN-Topoisomerasas de Tipo II/genética , Proteínas de Unión al ADN , Supervivencia sin Enfermedad , Inducción Enzimática , Femenino , Fluorouracilo/administración & dosificación , Regulación Neoplásica de la Expresión Génica , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/terapia , Humanos , Técnicas para Inmunoenzimas , Isoenzimas/biosíntesis , Isoenzimas/genética , Laringectomía , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Proteínas de Neoplasias/biosíntesis , Proteínas de Neoplasias/genética , Recurrencia Local de Neoplasia , Adhesión en Parafina , Pronóstico , Radioterapia , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
This study examined the effect of the number of accepted responses in transient evoked otoacoustic emissions on the results of neonatal hearing screening programmes. The ILO88 Otodynamics Analyzer Quickscreen programme was used for all testing, and a three-stage procedure was adopted by averaging 20, 30, and 260 low-noise samples in total. The results were recorded after each stage of the testing in those cases in which, after the first 20 accepted responses, the "pass" criteria were met. Under these circumstances, 117 ears were included in the study from a total number of 334 screened ears. It was concluded that 20 averaged quiet responses are adequate for screened newborn babies to pass the test if the conditions of the "pass" criteria are fulfilled at this stage. In the rest of the newborn babies, testing should be continued using a larger number of clicks. For diagnostic and clinical purposes, the full 260 quiet samples must be used since the results indicated statistically better scores in response and reproducibility measures after the 260 averaged responses.
Asunto(s)
Trastornos de la Audición/diagnóstico , Trastornos de la Audición/epidemiología , Tamizaje Neonatal , Emisiones Otoacústicas Espontáneas/fisiología , Cóclea/fisiología , Femenino , Humanos , Recién Nacido , Masculino , Proyectos Piloto , Factores de RiesgoRESUMEN
Laryngeal obstruction due to bilateral vocal fold paralysis has been treated in many different ways. The CO2 laser or KTP-532 laser endoscopic cordectomy described in this report is a slight modification of the posterior partial cordectomy proposed by Dennis and Kashima. This technique was used in 18 patients (14 with the CO2 and four with the KTP-532 laser). Prophylactic tracheostomy was performed pre-operatively. Post-operative results were excellent in nine cases, good in seven cases and poor in two cases who had to remain with a permanent tracheostomy tube with a speaking valve. The main complications noted were the formation of a granuloma (seven cases) and arytenoid oedema (six cases). Revision surgery was performed in the seven cases with granuloma formation and in the two with persistent oedema. The results and the post-operative findings from the use of the two lasers were similar.
Asunto(s)
Terapia por Láser , Parálisis de los Pliegues Vocales/cirugía , Pliegues Vocales/cirugía , Adulto , Anciano , Cartílago Aritenoides , Dióxido de Carbono , Femenino , Granuloma Laríngeo/etiología , Granuloma Laríngeo/cirugía , Humanos , Edema Laríngeo/etiología , Masculino , Persona de Mediana Edad , Fosfatos , Complicaciones Posoperatorias , Reoperación , Estudios Retrospectivos , Titanio , Traqueostomía , Resultado del Tratamiento , Calidad de la VozRESUMEN
Multiple-frequency tympanometry (MFT) is a sweep-frequency method of acoustic immittance measurement, recently introduced in clinical practice. It provides values for the resonant frequency of the middle ear system. The purpose of this study was to use MFT to collect information about the mechanoacoustical changes occurring to the middle ear system after acute otitis media and to compare it with the results of conventional, low probe-tone tympanometry. Children with acute otitis media were followed up with both methods for 1 month after an episode of acute infection. Also, children with normal hearing were studied to establish normative data. Resonant frequency of the middle ear was found to be lower than normal even 1 month past the initial episode, for all types of 226-Hz tympanograms. MFT seemed to record changes in the middle ear after acute otitis media that 226-Hz tympanometry was unable to detect, implying persistence of pathology. More extended research will illuminate the clinical value of this method in the follow-up of acute otitis media.