Aurora B kinase expression in laryngeal squamous cell carcinoma and its prognostic implications.

AIMS: To investigate the clinical and prognostic significance of Aurora B in laryngeal squamous cell carcinomas (LSCC). METHODS AND RESULTS: Aurora B protein expression was analysed in 259 LSCC. The proliferation index (Ki67) and the expression of other cell cycle control proteins, such as Aurora A, survivin and p53 was also determined. Aurora B was highly expressed in 55.4% of LSCC. High Aurora B expression levels were correlated with tumour recurrence (P=0.01), death from disease (P=0.05) and decreased disease-free survival (P=0.013) and overall survival (P=0.04). Survivin expression was neither associated with clinicopathological characteristics nor with survival. However, survivin expression in the nucleus paralleled Aurora B expression (P=0.014). Aurora A expression was associated significantly with increased tumour grade (P=0.008). Multivariate analysis indicated that Aurora B was an independent predictor for LSCC-specific disease-free survival [hazard ratio (HR), 2.10; 95% confidence interval (95% CI), 1.25-3.52 (P=0.005)] and overall survival [HR, 1.91; 95% CI 1.01-3.34 (P=0.023)]. CONCLUSIONS: Aurora B may be a novel prognostic biomarker for LSCC and a potential therapeutic target in this type of tumour.

[Analysis of changes in the spectrogram following endotracheal intubation]. / Análisis de los cambios en el espectrograma tras la intubación endotraqueal.

INTRODUCTION AND OBJECTIVES: Voice alteration is a common event following endotracheal intubation. The objective of this study is to describe strobolaryngoscopic and spectrogram changes after endotracheal intubation, and attempt to identify a relationship between these changes and also with anaesthetic variables. MATERIAL AND METHOD: Thirty-eight patients who underwent endotracheal intubation for otological surgery were studied prospectively. None of these subjects had a history of voice problems or prior cervical surgery, and they did not consume alcohol or tobacco. The patients were studied prior to the operation and 3 hours, 24 hours, and 7 days after surgery. Laryngeal morphology was explored by strobolaryngoscopy. The vocal output was examined by means of the GRABS scale, acoustic analysis and spectrogram. RESULTS: Strobolaryngoscopy was normal 24 hours after surgery in all but 2 subjects, in whom it later returned to normal. Spectrography, acoustic analysis (jitter and shimmer), and GRABS scale all showed an initial worsening of voice production after surgery when compared to pre-operative values, followed by a recovery of normal values 1 week after surgery. No statistical correlation was found between voice output and anaesthetic variables. CONCLUSIONS: Although there are temporary voice changes in subjects undergoing endotracheal intubation during the early post-operative period, these recover to normal parameters within 7 days after surgery. These changes occur even in the absence of strobolaryngoscopic changes.

[Current status of undergraduate teaching of otorhinolaryngology in Spain]. / Estado actual de la enseñanza pregraduada de otorrinolaringología en España.

INTRODUCTION AND OBJECTIVE: Otolaryngology is a branch of medicine of great importance for doctors working in general practice. The goal of this paper is to analyze the otolaryngology syllabuses of the medical schools in Spain. MATERIAL AND METHOD: The data for this article were obtained from 2 sources: a) the web sites of the 27 medical schools with syllabuses available on the Internet, and b) a medline search using the terms undergraduate medical education and otolaryngology/otorhinolaryngology. RESULTS: At all the schools consulted, otolaryngology is a core subject, in most of them a single semester course. In most cases it is taught in the 4th or 5th year (92.6 %). Undergraduate teaching in otolaryngology consists of about 30 lectures. The time available for practical teaching varies greatly between 20 and 60 hours. CONCLUSIONS: Otolaryngology in Spain is a core subject during the specialization stage of the degree, allocated a mean of 7 credits.

Quality of life after surgical treatment of children with obstructive sleep apnea: long-term results.

OBJECTIVES: To measure the long-term impact of tonsillectomy and/or adenoidectomy (T&A) on children with obstructive sleep apnea (OSA). METHODS: A controlled study on 101 OSA children, operated between June 1999 and January 2001. The OSD-6 was used to assess the results. The caregivers of these patients were asked about their subjective impression prior to surgery (first evaluation), 8 days after the procedure (second evaluation), and with a minimum follow-up of 3 years after the operation (third evaluation). RESULTS: Mean of follow-up was 61.9+/-13.1 months (range, 36-75 months). The total mean survey score showed a highly significant improvement when comparing first evaluation versus second evaluation, first evaluation versus third evaluation, and second evaluation versus third evaluation (p<0.001). In the same way, we found a favourable outcome in the six domains when visits were compared. Only sleep disturbance between second and third evaluation did not show a significant improvement (p>0.05). There were not differences in the postsurgical outcome of quality of life (QOL) according to the remaining factors studied (p>0.05). CONCLUSIONS: Children with OSA who undergo surgery show a significant long-term improvement in QOL.

Otolaryngologic surgery in children with von Willebrand disease.

OBJECTIVE: To assess the efficacy, safety, and complications of otolaryngologic surgery in children with von Willebrand disease (vWD) undergoing surgery. DESIGN: A prospective, controlled study of 41 children with vWD who underwent surgery between June 1, 1999, and January 31, 2001. SETTING: A tertiary care, university-based children's hospital. INTERVENTIONS: All children had a preoperative diagnosis of vWD. The patients were treated with either a protocol that includes the use of desmopressin acetate and tranexamic acid (37 children) or factor VIII concentrate in children with a positive history of seizures (4 children). MAIN OUTCOME MEASURES: Immediate and delayed postoperative bleeding, hyponatremia, seizures, and urine output. RESULTS: Two adenotonsillectomy patients (5%) had an immediate postoperative hemorrhage. Delayed postoperative bleeding was not detected in our patients. Severe hyponatremia occurred in 2 patients (1 of them with clinical manifestations). CONCLUSIONS: Our management of children with vWD was efficacious in otolaryngologic surgery. One child had important adverse effects with the use of desmopressin (seizure). Thus, the use of desmopressin should be weighed and closely monitored.