RESUMEN
OBJECTIVE: Despite extensive soft tissue reduction, the most common complications associated with bone-anchored hearing aid systems, also known as bone-anchored hearing implants, are related to adverse skin reactions around the abutment. The necessary soft tissue reduction also adds complexity to the surgical procedure. This study aimed to evaluate the surgical and audiological outcomes of a new connective interface of the Cochlear™ Baha® BA400 device implanted using the one-stage surgical technique. METHOD: A multicentre, retrospective case series is presented, including data collected from three tertiary care institutions. RESULTS: In total, 16 patients who had undergone bone-anchored hearing aid surgery over a 10- to 12-month period were assessed for hearing performance, implant stability and surgical complications. CONCLUSION: This case series indicates that new abutments with a hydroxyapatite coating can be implanted percutaneously without soft tissue reduction. Furthermore, device implantation using this surgical technique may have some advantages compared with a conventional device and procedure combination over 12- to 16-months of follow up.
Asunto(s)
Implantación Coclear/instrumentación , Implantación Coclear/métodos , Implantes Cocleares/efectos adversos , Adolescente , Adulto , Anciano , Audiometría , Materiales Biocompatibles/administración & dosificación , Niño , Implantación Coclear/efectos adversos , Durapatita/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/prevención & control , Diseño de Prótesis , Estudios Retrospectivos , Traumatismos de los Tejidos Blandos/etiología , Traumatismos de los Tejidos Blandos/prevención & control , Anclas para Sutura , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: This study aimed to contribute to the literature on the prevention and treatment of ototoxicity due to various drugs and chemicals. MATERIAL AND METHODS: This study compared the histological effects of intratympanic dexamethasone, memantine and piracetam on cellular apoptosis due to cisplatin ototoxicity, in 36 rats. RESULTS: Dexamethasone and memantine had significant effects on the stria vascularis, organ of Corti and spiral ganglion (p < 0.05). Although piracetam decreased the apoptosis rate, this effect was not statistically significant (p > 0.05). CONCLUSION: Dexamethasone and memantine were found superior to piracetam in reducing apoptosis due to cisplatin ototoxicity. Further studies of this subject are needed, incorporating electron microscopy and auditory brainstem response testing.
Asunto(s)
Antineoplásicos/efectos adversos , Cisplatino/efectos adversos , Dexametasona/administración & dosificación , Enfermedades del Laberinto/inducido químicamente , Enfermedades del Laberinto/tratamiento farmacológico , Memantina/administración & dosificación , Piracetam/administración & dosificación , Membrana Timpánica/efectos de los fármacos , Animales , Apoptosis/efectos de los fármacos , Femenino , Ratas , Ratas WistarRESUMEN
OBJECTIVE: To analyse patients with cholesteatoma undergoing canal wall down mastoidectomy together with ossicular reconstruction with a titanium prosthesis, in order to identify factors associated with hearing outcomes. STUDY DESIGN: Retrospective review of 97 cases undergoing single-stage surgical management. METHODS: All patients underwent canal wall down mastoidectomy. Kurz titanium ossicular prostheses were used for ossicular chain reconstruction. Pre-operative and post-operative air conduction and bone conduction hearing thresholds were obtained at 500, 1000, 2000 and 3000 Hz. RESULTS: The mean pure tone average improved from 46.02 ± 14.54 dB pre-operatively to 29.32 ± 14.64 dB post-operatively, for both total and partial ossicular replacement prosthesis groups combined. The mean air-bone gap improved from 30.38 ± 11.12 dB pre-operatively to 15.62 ± 9.65 dB post-operatively, for both groups combined. CONCLUSION: Reconstruction with a titanium prosthesis offers good functional results when performed during canal wall down surgery for advanced cholesteatoma, as a single-stage procedure.
Asunto(s)
Colesteatoma del Oído Medio/cirugía , Apófisis Mastoides/cirugía , Prótesis Osicular , Reemplazo Osicular/métodos , Procedimientos Quirúrgicos Otológicos/métodos , Adolescente , Adulto , Anciano , Audiometría de Tonos Puros , Niño , Pérdida Auditiva Conductiva/cirugía , Humanos , Persona de Mediana Edad , Reemplazo Osicular/instrumentación , Estudios Retrospectivos , Titanio , Resultado del Tratamiento , Adulto JovenRESUMEN
Considerable inter- and intra-individual anatomical differences can be observed during neck dissections. In this case report, we describe an unusual relationship of the accessory nerve to the internal jugular vein.
Asunto(s)
Nervio Accesorio/anomalías , Venas Yugulares/anomalías , Disección del Cuello , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Malignant tumours of the salivary glands in children are extremely rare. We present here a 12-year-old girl initially diagnosed as pleomorphic adenoma on fine needle aspiration biopsy, and adenoid cystic carcinoma (ACC) after the lesion was excised and examined by histopathology. A wide resection of the lesion and bilateral supraomyohyoid neck dissection was performed. To our knowledge this is one of the youngest patients with ACC of the minor salivary glands. Due to its benign histological appearance, the biological agressiveness of ACC is usually underestimated. Although fine needle aspiration cytology (FNAC) is very valuable in diagnosis, cytological variations of pleomorphic adenoma must be considered. ACC of the tongue in a young age group should be treated with wide resection and selective neck dissection if the tumour is localized in places where the risk of metastasis is increased and if there is a clinically palpable lymph node. In such cases the clinician should not avoid radical operations even in a young patient.
Asunto(s)
Adenoma Pleomórfico/diagnóstico , Carcinoma Adenoide Quístico/diagnóstico , Neoplasias de las Glándulas Salivales/diagnóstico , Glándulas Salivales Menores , Biopsia con Aguja/métodos , Carcinoma Adenoide Quístico/cirugía , Niño , Diagnóstico Diferencial , Errores Diagnósticos , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Neoplasias de las Glándulas Salivales/cirugíaRESUMEN
Both laryngocele and laryngeal amyloidosis are uncommon, and simultaneous occurrences of these entities are extremely rare. A case of laryngeal amyloidosis with laryngocele in which the computed tomography (CT) and magnetic resonance (MR) imaging of the larynx, clearly demonstrating both disease processes, is discussed. Diagnosis is confirmed by histopathologic specimens. Only two cases have been reported in the world literature, and this is the third case of laryngeal amyloidosis associated with laryngocele.
Asunto(s)
Amiloidosis/complicaciones , Enfermedades de la Laringe/complicaciones , Laringe/patología , Amiloidosis/diagnóstico , Dilatación Patológica , Hernia/complicaciones , Hernia/diagnóstico , Humanos , Enfermedades de la Laringe/diagnóstico , Laringe/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
In order to improve the biological characteristics of DA-3934 (5), a novel gastrin/cholecystokinin (CCK)-B receptor antagonist, phenoxyacetic acid derivatives replacing the N-methyl-N-phenylcarbamoylmethyl moiety of 5 with various alkyl chains have been synthesized and their biological activity evaluated. The relationship between the structure of these compounds and their human gastrin receptor binding affinity showed that there should be the optimal size among the various N-alkyl chains. Also a significant increase in the receptor binding affinity was achieved by several compounds. Among those compounds, 2-[3-[3- [N-cyclohexylmethyl-N-[2-(N-methyl- N-phenylcarbamoylmethoxy)phenyl]carbamoylmethyl]ureido]pheny l]acetic acid (22c) and (+/-)-2-[3-[3-[N-[2-(N-methyl-N- phenylcarbamoylmethoxy)phenyl]-N-(3-methylpentyl)carbamoy lmethyl]ureido] phenyl]acetic acid (22h) exhibited high affinity for human gastrin receptors and were also more potent inhibitors in a pentagastrin-induced gastric acid secretion model than the parent compound, 5. The ED50 values of these compounds when administered intraduodenally to rats were 0.12 and 0.63 mg/kg, respectively.
Asunto(s)
Acetatos/farmacología , Fenoxiacetatos/síntesis química , Fenoxiacetatos/farmacología , Compuestos de Fenilurea/farmacología , Receptores de Colecistoquinina/antagonistas & inhibidores , Acetatos/química , Alquilación , Animales , Células CHO , Fenómenos Químicos , Química Física , Cricetinae , Mucosa Gástrica/efectos de los fármacos , Mucosa Gástrica/metabolismo , Gastrinas/metabolismo , Humanos , Masculino , Pentagastrina/antagonistas & inhibidores , Pentagastrina/farmacología , Compuestos de Fenilurea/química , Ratas , Ratas Sprague-Dawley , Receptor de Colecistoquinina B , Relación Estructura-ActividadRESUMEN
We compared the main pharmacological effect of DQ-2511 (3-[[[2-(3,4-dimethoxyphenyl)- ethyl]carbamoyl]methyl]amino-N-methylbenzamide), a novel gastroprokinetic agent, with that of cisapride. Single oral administration of DQ-2511 (3-10 mg kg-1) caused similar significant improvements to delays in gastric emptying of semi-solid meals evoked by cholecystokinin-octapeptide (CCK8: 5 micrograms kg-1, i.v.) in monkeys, to that with cisapride (3 mg kg-1). A 2-week oral treatment of unilaterally vagotomized rats with DQ-2511 (1-10 mg kg-1) lessened delays in gastric emptying, whereas cisapride (0.3-10 mg kg-1) had no effect under the same experimental protocols. In anesthetized rats, bolus intravenous injection of either compound (60 micrograms kg-1) enhanced gastric motility determined by means of strain gauge force transducers. Electrophysiological investigations revealed that bolus injection of DQ-2511 (6-60 micrograms kg-1) depressed the afferent discharge rate of the ventral gastric branch of the vagus nerve, while cisapride showed no effect. These results suggest that the mechanism of ameliorative action of DQ-2511 on delayed gastric emptying may differ from that of cisapride.
Asunto(s)
Antiulcerosos/farmacología , Benzamidas/farmacología , Vaciamiento Gástrico/efectos de los fármacos , Motilidad Gastrointestinal/efectos de los fármacos , Fibras Nerviosas/fisiología , Piperidinas/farmacología , Sincalida/farmacología , Nervio Vago/fisiología , Vías Aferentes/efectos de los fármacos , Vías Aferentes/fisiología , Análisis de Varianza , Animales , Cisaprida , Femenino , Vaciamiento Gástrico/fisiología , Motilidad Gastrointestinal/fisiología , Masculino , Músculo Liso/efectos de los fármacos , Músculo Liso/inervación , Músculo Liso/fisiología , Fibras Nerviosas/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Saimiri , Estómago/efectos de los fármacos , Estómago/inervación , Estómago/fisiología , Vagotomía , Nervio Vago/efectos de los fármacosRESUMEN
The pharmacological characteristics of DQ-2511, a substituted benzamide (3-[[[2-(3,4-dimethoxyphenyl)ethyl]carbamoyl]methyl] amino-N-methylbenzamide), as a prokinetic agent were studied. Cholecystokinin-octapeptide, dopamine, and alpha-calcitonin gene-related peptide, all suppressed gastric emptying in mice. Reversal of the depressed emptying occurred when DQ-2511 was administered by the oral or intraperitoneal route. When the action of eight proposed metabolites of DQ-2511 on the mouse cholecystokinin-octapeptide model was investigated, the main metabolite in plasma, MA-2, showed no effect, although two minor metabolites ameliorated or aggravated the delayed gastric emptying. This finding implies that DQ-2511, as the parent compound itself, exerts the ameliorative action. In dogs treated with cisplatin or copper sulfate, DQ-2511 had no antiemetic activity, as assessed by the number of vomiting episodes. The concern that the mechanism of action of DQ-2511 was blockade of receptors for cholecystokinin-octapeptide, dopamine, serotonin, alpha-calcitonin gene-related peptide, nicotine or muscarine, was resolved by results of radioligand binding studies showing the absence of a DQ-2511 binding to any of these receptor types. Evidence is accumulating that the mechanism of the prokinetic action of DQ-2511 involves the intrinsic and extrinsic autonomic innervation.
Asunto(s)
Antiulcerosos/farmacología , Benzamidas/farmacología , Vaciamiento Gástrico/efectos de los fármacos , Piperidinas/farmacología , Administración Oral , Análisis de Varianza , Animales , Antiulcerosos/sangre , Benzamidas/administración & dosificación , Benzamidas/sangre , Benzamidas/uso terapéutico , Péptido Relacionado con Gen de Calcitonina/metabolismo , Péptido Relacionado con Gen de Calcitonina/toxicidad , Cisaprida , Cisplatino/toxicidad , Sulfato de Cobre/toxicidad , Perros , Dopamina/metabolismo , Dopamina/toxicidad , Femenino , Inyecciones Intraperitoneales , Masculino , Ratones , Muscarina/metabolismo , Muscarina/toxicidad , Nicotina/metabolismo , Nicotina/toxicidad , Piperidinas/administración & dosificación , Piperidinas/uso terapéutico , Ensayo de Unión Radioligante , Sincalida/metabolismo , Sincalida/toxicidad , Relación Estructura-Actividad , Vómitos/tratamiento farmacológicoRESUMEN
The present study was designed to clarify the potential of DQ-2511 (3-[[[2-(3,4-dimethoxyphenyl)ethyl]carbamoyl]carbamoyl]methyl] amino-N-methylbenzamide: ecabapide) as a gastroprokinetic agent in spontaneously hypertensive rats (SHR). The gastric emptying of SHR was clearly retarded relative to that of weight-matched normotensive Wistar-Kyoto (WKY) rats when evaluated by the acetaminophen (APAP) method with the semi-solid test meal. There was, however, no significant difference between both strains in gastric mucosal blood flow (GMBF) determined by means of a laser doppler flowmetry. A 2-week treatment of SHR with DQ-2511 (1 mg/kg, oral) stimulated gastric emptying without affecting body weight gain or indirect systolic blood pressure (SBP), whereas cisapride (3 and 10 mg/kg, oral) had no effect under the same conditions. The pharmacological characteristics of DQ-2511 as a gastroprokinetic agent are discussed on the basis of these results.
Asunto(s)
Antiulcerosos/farmacología , Benzamidas/farmacología , Vaciamiento Gástrico/efectos de los fármacos , Hipertensión/fisiopatología , Animales , Masculino , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Vasopresinas/sangreRESUMEN
A description of the development of educational objectives for urologic residency training is presented. The purpose of these objectives is to define the knowledge and skills expected of urology residents at the completion of their training. Twenty-six urologists from residency programs throughout the country, one resident, and one medical educator formed a task force for the Society of University Urologists to write these objectives. During a one-year period, fifty-five sets of objectives were drafted, reviewed, and revised into the present form. Discussion of the methodological problems and implications for residents and program directors are included.