ABSTRACT
Anterior craniofacial resection and reconstruction surgeries were per formed upon 21 patients [13 females and 8 males] aged 12-72 years, at the period between 1996-2002 at Mansoura University Hospital, Department of ORL Head and Neck surgery. Surgeries were performed for nasal and paranasal sinus malignant tumors with cranial and/or intracranial extention. Various forms of anterior cranial base reconstruction strategies were used in our work, anteriorly pedicled galeal pericranial flap, galeal- pericranial flap+ skin graft, galeal pericranial flap + calvarial bone graft, and galeal-pericranial flap+ temporal is osteo muscular flap. Orbital exenteration was done for two patients with ethmoidal undifferentiated carcinoma and obliteration of the orbit was done using pedicled temporalis muscle flap. Subtotal maxillectomy [18 cases], and total maxillectomy [3 cases] were per- formed. We described the technique of the resection and the reconstruction with evaluation of reconstruction results. Our objective is to evaluate the clinical outcome of our technique in resection and reconstruction of anterior skull base. We concluded that Knowledge's about different methods of reconstruction after craniofacial resection enabled the skull base surgeons to extend their resections in or der to increase the safety margin. Also we found that the pericranial flap is the most ideal and reliable method for reconstruction of skull base after resection. Rigid bony reconstruction can be used in cases where the resection of anterior skull base was extended laterally to involve the orbital roof
ABSTRACT
This study has been conducted to evaluate the diagnostic value of estimating adenosine deaminase [ADA] enzyme activity in the differential diagnosis of RA especially those cases with seronegative RA [those with negative latex test]. The study involved two main groups of patients, 20 osteoarthritis [OA] patients constitute the reference group and 30 rheumatoid arthritis [RA] patients [20 patients were latex positive and 10 patients were latex negative] constitute the test group. ADA activity was studied in sera, peripheral blood lymphocytes and synovial fluids of knee joints of all groups. Serum ADA activity showed significantly higher values in both groups of RA than OA [88.95 +/- 11 .69 IU/L in latex positive and 86.40 + 11.92 lt1/L in latex negative vs 30.2 + 8.05 IU/L, in OA]. In synovial fluids ADA activity showed a similar pattern [183.1 + 14.81 IU/L in latex positive RA and 181.9 +/- 17.31 IU/L in latex negative RA vs 33.9 +/- 5.3 IU/L in OA]. Both latex positive and latex negative RA patients showed significantly higher values of ADA activity in peripheral blood lymphocytes than those with OA [841.55 + 6.1 micromolNH[3] / [10][6] cell/hour in Latex +ve RA and 839 +/- 50.93 /micromolNH[3] / [10][6] cell/hour in Latex negative RA vs 362.6 micromoINH[3] / [10][6] cell/hour in OA. There was no significant difference in ADA activity between both subgroups of RA in all materials studied indicating a reliable sensitivity of ADA in seronegative patients and pointing to the possible use of ADA activity as a diagnostic marker in RA especially seronegative cases