A clinical analysis for sudden sensorineural hearing loss with acoustic neurinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Retrospectively analyzed the clinical data of sudden sensorineural hearing loss with acoustic neuroma.</p><p><b>METHODS</b>The clinical data of 467 cases with sudden sensorineural hearing loss were collected between Jan, 2008 and Aug, 2012. Discussed the clinical data which were diagnosed as acoustic neuroma.</p><p><b>RESULTS</b>In 467 cases of sudden sensorineural hearing loss, nine cases were diagnosed as acoustic neuromas (9 ears, 1.93%), two males and seven females, with a age range of 28 to 57 years. Among them, seven cases accompanied with tinnitus, seven cases with vertigo. The hearing results in nine cases, two cases were found to be mild, two were moderate, four were severe, and one was profound hearling loss respectively. Hearing was classified into five types according to audiogram shape (1 of up-sloping, 1 of down-sloping, 2 of mid-frequency, 1 of profound loss, 4 of flat audiogram). Eight cases had abnormal ABR, nine cases with ear ipsilateral stapedius reflex were completely not elicited, seven cases with health ear contralateral stapedius reflex were completely not elicited. Tumors were graded by Koos Grades according to size (7 of grade I, 1 of grade II, 1 of grade IV). Seven small acoustic neuroma was taken waiting strategies. Meanwhile, we use glucocorticoid and improve the microcirculation of the inner ear medication short-termly for these patients. Four patients' hearing were improved.</p><p><b>CONCLUSIONS</b>The initial symptoms of some acoustic neuroma are sudden hearing loss, especially the small tumors in internal auditory canal. In order to prevent misdiagnosis, MRI and ABR should be performed as a routine test for sudden sensorineural hearing loss. It is necessary to give appropriate treatment to protecting hearing for the small acoustic neuroma patients whose first symptoms are diagnosed as sudden sensorineural hearing loss.</p>

Pathological features and clinical managements of nasopharyngeal angiofibroma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the pathological features of nasopharyngeal angiofibroma (NA) and the principles for clinical managements.</p><p><b>METHODS</b>Thirty-five patients with NAs were treated in First Affiliated Hospital of Fujian Medical University from Oct. 1981 to May 2007. The pathological changes, sites of origin, causes of intraoperative bleeding and the experiences of managements were retrospectively analysed. Using Fish stage: 6 cases were in stage I, 8 cases were in stage II, 17 cases were in stage III, 4 cases were stage IV. Two cases via endoscopic surgery, 2 cases via palatal approach, 19 cases via midfacial degloving approach, 9 cases via lateral rhinotomy approach, 3 cases via craniofacial combined approach.</p><p><b>RESULTS</b>In nasal cavity and paranasal sinus, the tumor was covered by squamous or columnar epithelium. The tumor extensions such as in pterygopalatine fossa and infratemporal fossa were covered by fibrous pseudocapsule. All cases of this series originated in the lateral wall of posterior portion of the nasal cavity. Fifteen of thirty-five cases confidentially originated near sphenopalatine foramen. Large and thick vessels in the pedicle region were the exact sites of serious intraoperative bleeding. Thirty-one cases were totally removed. Four cases were subtotal resected. Visual loss revealed in 6 cases, 4 cases visual acuity improved postoperatively. Three cases revealed postoperative dry eye due to surgical involvement of the sphenopalatine ganglion.</p><p><b>CONCLUSIONS</b>nasopharyngeal angiofibroma is covered by epithelium or pseudo-capsule, it does not infiltrate the surrounding tissue. Dissecting along the surface of tumor might decrease bleeding and facilitate removal of tumor. An ideal surgical management should be done according to actually size and image examination, to the greatest extent keeping normal facial appearance. Attention should be paid to the complications such as visual loss and dry eye.</p>

Proceeding of Xenotransplantation / 中国生物工程杂志

Xenotransplantation is a feasibility way of solving the shortage of human organs for transplantation. Although it is urgently needed to satisfy the demand of people and sustain the function of human organs, there are multiple hurdles existed to clinical application, such as the immune rejection between human body and the xenografts, the infection of pathogens and a series of ethic, morality and social issues. A historical retrospect of xenotransplantation was given, and then probe into the strategies according to the main problems and the actualities. Finally, the prospect in the field of xenotransplantation was showed.

Mitochondrial 12S rRNA gene A827G in two pedigrees with nonsyndromic deafness / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of associating mitochondrial DNA 12S rRNA gene mutations with non-syndromic and aminoglycoside-induced hearing loss happening to Chinese families.</p><p><b>METHODS</b>The diagnosis was validated by hearing tests. Blood samples were collected from 20 family members (13 subjects from pedigree A and 7 from pedigree B) and 32 sporadic deafness cases. DNA was extracted from the leukocytes in blood samples. The gene fragments of mitochondrial DNA 12S rRNA, tRNA(Ser(UCN)) and GJB(2) were amplified by polymerase chain reaction (PCR). PCR products were analyzed by sequencing.</p><p><b>RESULTS</b>The target gene fragments of all individuals were successfully amplified by PCR. The mitochondrial DNA 12S rRNA 827 A to G transition was detected from all maternal members including 12 patients with hearing loss, which was the homoplasmic mutation. Non-maternal members in two pedigrees did not carry this mutation. However, the tRNA(Ser(UCN)) A7445G, 12SrRNA A1555G and GJB2 gene mutations were not found from both the family members of two pedigrees and sporadic patients. One sporadic individual (1/32) who was diagnosed as aminoglycoside-induced hearing impairment carried A827G mutation too.</p><p><b>CONCLUSION</b>It is confirmed that the mitochondrial DNA 12S rRNA gene is a hot spot for mutations associated with non-syndromic inherited hearing loss. The 12S rRNA nt827 A to G mutation may play a pivotal role in the pathogenesis of hearing impairment in two Chinese pedigrees.</p>