RESUMEN
Influenza A(H1N1)pdm09 pandemic virus causing the 2009 global outbreak moved into the post-pandemic period, but its variants continued to be the prevailing subtype in the 2015-2016 influenza season in Europe and Asia. To determine the molecular characteristics of influenza A(H1N1)pdm09 isolates circulating during the 2015-2016 season in Turkey, we identified mutations in the hemagglutinin (HA) genes and investigated the presence of H275Y alteration in the neuraminidase genes in the randomly selected isolates. The comparison of the HA nucleotide sequences revealed a very high homology (>99.5%) among the studied influenza A(H1N1)pdm09 isolates, while a relatively low homology (96.6%-97.2%), was observed between Turkish isolates and the A/California/07/2009 vaccine virus. Overall 14 common mutations were detected in HA sequences of all 2015-2016 influenza A(H1N1)pdm09 isolates with respect to the A/California/07/2009 virus, four of which located in three different antigenic sites. Eleven rare mutations in 12 HA sequences were also detected. Phylogenetic analysis revealed that all characterized influenza A(H1N1)pdm09 isolates formed a single genetic cluster, belonging to the genetic subclade 6B.1, defined by HA amino acid substitutions S84N, S162N, and I216T. Furthermore, all isolates showed an oseltamivir-sensitive genotype, suggesting that Tamiflu (Oseltamivir) could still be the drug of choice in Turkey.
Asunto(s)
Glicoproteínas Hemaglutininas del Virus de la Influenza/genética , Subtipo H1N1 del Virus de la Influenza A/genética , Gripe Humana/virología , Mutación , Sustitución de Aminoácidos , Antivirales/farmacología , Farmacorresistencia Viral/genética , Variación Genética , Genotipo , Humanos , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Gripe Humana/epidemiología , Oseltamivir/farmacología , Filogenia , Turquía/epidemiologíaRESUMEN
OBJECTIVE: To compare a novel functional neck dissection technique that offers wider exposure and reduced morbidity compared to classic functional neck dissection, which is the gold standard for neck treatment of squamous cell carcinoma of the head and neck. STUDY DESIGN: A prospective, double-blind, controlled clinical study. SETTING: Fifty surgical neck dissections were performed on 25 patients diagnosed with laryngeal cancer. SUBJECTS AND METHODS (MAIN OUTCOME MEASURES): The open neck dissection technique was used on the primary tumour side (study group) and functional neck dissection was used on the other side (control group). Electromyographic measurements of the trapezius and sternocleidomastoid muscles and neurologic evaluations were performed preoperatively and at 1 and 6 months postoperatively. Also, the number and tumour stages of lymph nodes excised during neck dissection were evaluated by histopathologic examination as a measure of surgical efficacy. RESULTS: The electromyographic measurements of the study group at 1 and 6 months postoperatively were found to be superior to those of the control group, although the difference between the groups was not significant. The mean number of dissected lymph nodes was significantly higher in the study group than in the control group. CONCLUSION: The open functional neck dissection procedure described in this study allows wider exposure, reduces the acute morbidity associated with the spinal accessory nerve compared to classic modified neck dissection, and offers improved surgical efficacy with respect to lymphadenectomy.
Asunto(s)
Nervio Accesorio/fisiopatología , Carcinoma de Células Escamosas/cirugía , Neoplasias Laríngeas/cirugía , Disección del Cuello/métodos , Enfermedades del Nervio Accesorio/etiología , Enfermedades del Nervio Accesorio/fisiopatología , Enfermedades del Nervio Accesorio/prevención & control , Adulto , Anciano , Carcinoma de Células Escamosas/secundario , Método Doble Ciego , Electromiografía , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Laríngeas/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVES: The purpose of this study was to assess the patency of the internal jugular vein after functional neck dissection. PATIENTS AND METHODS: Twenty-five patients (6 females, 19 males; mean age 53.9 years; range 30 to 71 years) who were operated on because of larynx, hypopharynx and intraoral cavity tumors in the Ear, Nose and Throat Clinic of Haseki Training and Research Hospital between January 2001 and March 2003 were included in the study. Internal jugular veins were evaluated after 42 functional neck dissections. By means of power duplex Doppler ultrasonography, the jugular blood flow, presence or absence of a thrombus, diameter of the vein, velocity of the blood flow were evaluated. RESULTS: In our study the internal jugular vein patency rate was found to be 95.2%, and thrombosis was detected only in two patients. Blood flow velocity in patients with thrombus was found to be significantly lower than that observed in patients without thrombus (p<0.05). CONCLUSION: It was observed that blood flow of the internal jugular vein was ensured in most patients after functional neck dissection.