Protective effect of lycopene against radiation-induced hepatic toxicity in rats.

The radioprotective effect of lycopene against liver damage was investigated in 80 female Sprague Dawley rats (10 per group). Early-group rats included: controls (group 1), lycopene (group 2), radiotherapy alone (group 3), and lycopene + radiotherapy (group 4). Lycopene (5 mg/kg per day) was administered orally for 7 days; single-fraction 8 Gy abdominopelvic radiotherapy was administered on day 8. Early-group rats were sacrificed on day 10. Late-group rats (groups 5-8) underwent treatment with the same regimens but, in groups 6 and 8, lycopene was administered until all rats were sacrificed, 60 days postradiotherapy. Liver malondialdehyde levels increased significantly and glutathione (GSH) levels, GSH-peroxidase (GSH-Px) and superoxide dismutase (SOD) activity decreased significantly in radiotherapy versus control groups. In lycopene + radiotherapy groups, malondialdehyde levels decreased significantly and GSH levels, GSH-Px and SOD activity increased significantly compared with radiotherapy groups. No significant between-group histo pathological differences were observed in early groups; in late groups, histopathological changes increased significantly in the radiotherapy group versus control group. A significant decrease in histopathological changes occurred in the lycopene + radiotherapy group compared with the radiotherapy group. Lycopene supplementation significantly reduced radiotherapy-induced oxidative liver injury.

Multiple primary malignant neoplasms from the black sea region of Turkey.

Long-term cancer survival is increasing and, as a consequence, so is the prevalence of secondary malignancies. This study evaluated the patient and tumour characteristics of 117 patients with multiple primary malignant neoplasms (MPMN). The incidence of MPMN in children and adults was 0.28% and 1.23%, respectively. The male : female ratio was 1.7 : 1. The mean ± SE age at tumour diagnosis was 60.56 ± 1.18 years. Overall, the top three tumour sites were the larynx, bladder and breast. Among secondary tumours, lung cancer was the most frequent, followed by breast and colon cancer. Among males, the leading primary and secondary tumour sites were the larynx (30.1%) and lung (50.7%), respectively. Among females, the breasts were both the leading primary (32.6%) and secondary (37.2%) cancer site. The mean ± SE overall survival was 97.2 ± 15.0 months. During follow-up, the brain was the most commonly observed site of metastasis. The occurrence and characteristics of MPMN reported in the literature are also reviewed. The present study contributes towards increasing understanding and treatment of MPMN in a different population group.

Balance after stapedotomy: analysis of balance with computerized dynamic posturography.

OBJECTIVES: The aim of this study was to investigate vestibular symptoms and their effect on the balance in otosclerosis patients undergoing stapedotomy operations. DESIGN & SETTING: Prospective study at an academic tertiary referral centre. PARTICIPANTS: Thirty-three patients undergoing stapedotomy were included in the study. MAIN OUTCOME MEASURES: Sensory organisation test (SOT) protocol of computerized dynamic posturography was used to analyse the balance in patients preoperatively, in the first postoperative week and the first postoperative month. Postoperative vestibular symptoms were analysed with a grading system. Audiograms were obtained preoperatively and 1 month after the operation. RESULTS: Preoperatively, all patients were asymptomatic when considering the vestibular system; however, eight of them got low SOT scores on vestibular examination. Postoperatively 82% of the patients had vestibular complaints in variable severity. In the first week, all but one patient become asymptomatic. This patient recovered by the end of postoperative second week. However, a significant drop in SOT scores was encountered at the first week testing (Student's T-test, P = 0.001). One month after the operation, all patients were asymptomatic and SOT scores recovered at least to preoperative level. Neither patient characteristics, nor audiological findings were found to be correlated with vestibular changes. CONCLUSION: Stapedotomy causes a temporary balance loss in a high percentage of patients which then recover to their former levels in the first postoperative month.

Prognostic significance of seizure in patients with glioblastoma multiforme.

BACKGROUND: Several prognostic factors have been described but there are few studies evaluating the prognostic importance of seizure in patients with glioblastoma multiforme (GBM). AIMS: To evaluate the prognostic importance of seizure at the time of the diagnosis of glioblastoma multiforme (GBM) and compare it with other known prognostic factors. SETTINGS AND DESIGN: Between January 1994 and December 2000, 81 patients underwent irradiation for intracranial GBM at our institution. The criteria for inclusion in this study were biopsy-proven GBM, being treated for primary disease. Seventy-six patients were retrospectively evaluated and the remaining five patients could not be enrolled due to lack of details. MATERIAL AND METHODS: The prognostic importance of age, sex, performance status, a history of seizure at diagnosis, extent of surgery, radiotherapy field and dose were studied. STATISTICAL ANALYSIS: The Kaplan-Meier method, the Log rank test, the Cox proportional hazard model and the Mann-Whitney U test were used for statistical analysis. RESULTS: Survival at first and second years was 19.74% and 4.81%, respectively. Univariate analysis revealed age, performance status, history of seizure, and radiotherapy dose as significant prognostic factors and with multivariate analysis age, history of seizure and radiotherapy dose were positive prognostic factors. CONCLUSION: This study concluded that in GBM, history of seizure prior to diagnosis of GBM was a positive prognostic factor.

Intratympanic dexamethasone, intratympanic gentamicin, and endolymphatic sac surgery for intractable vertigo in Meniere's disease.

OBJECTIVE: To compare the efficacy of intratympanic dexamethasone (ID), intratympanic gentamicin (IG), and decompression of the endolymphatic sac (ESD) for intractable vertigo in Meniere's disease. STUDY DESIGN AND SETTING: This prospective study was conducted at Hacettepe University Medical Faculty, a tertiary care center. Dexamethasone was applied through a ventilation tube in 24 patients, intratympanic gentamicin (also through a ventilation tube) to 16 patients, and 25 patients underwent ESD. RESULTS: Satisfactory control of vertigo was 72%, 75%, and 52%, respectively for the ID, IG, and ESD. Two patients in the gentamicine group had total hearing loss. In the dexamethasone group, hearing level remained the same in 46% of the patients with 16% increase and 38% decrease (30% 10dB and 8% 20 dB). CONCLUSION: If the vertiginous symptoms still persist after 6 months of medical treatment, ID can be started. If there is no further improvement after 3 months with ID, patients with profound sensorineural hearing loss undergo treatment with IG, ESD is reserved for patients with good hearing. If ESD also fails, patients with good hearing may undergo vestibular nerve section; patients with nonservicable hearing become candidates for labyrinthectomy.

Relationship of vestibular aqueduct and inner ear pressure in Ménière's disease and the normal population.

OBJECTIVE: Etiopathogenesis of Ménière's disease has not been resolved. The principal histopathologic finding in this disease is endolymphatic hydrops. The majority of radiologic and histopathologic studies demonstrated a narrow vestibular aqueduct in Ménière's disease. There is no study in the literature investigating the relationship between inner ear pressure and vestibular aqueduct dimensions. Static acoustic compliance is a noninvasive procedure that is thought to measure perilymphatic pressure at the footplate. An increase in mechanical fluid pressure in the inner ear is transmitted to the footplate of the stapes. This causes a reduction in the compliance at the drum. The aim of this study is to investigate the relationship between vestibular aqueduct dimensions and static acoustic compliance in Ménière's disease and the normal population. STUDY DESIGN: Prospective study. METHODS: Forty patients with Ménière's disease and 40 healthy individuals with no otolaryngologic disorders were the subjects of this study. Each group was further divided into two according to static compliance value (normal and low static compliance). In these four groups dimensions of vestibular aqueduct were determined radiologically by high-resolution computerized tomography and correlated with normal and low static acoustic compliance values (normal and high perilymphatic pressure). RESULTS: The results demonstrated that vestibular aqueduct is narrower in patients with Ménière's disease than the normal population. However, there is no relationship between vestibular aqueduct dimensions and inner ear pressure obtained by static acoustic compliance measurements.

Positive surgical margins in cancer of the larynx.

In order to determine what should be done for laryngeal cancer patients when surgical margins are positive, and to evaluate their prognosis, a retrospective review of 21 laryngeal cancer patients with positive surgical margins out of 714 surgically treated cases (2.9%) was carried out. Nineteen patients were treated with postoperative radiation therapy. Two patients who had had endolaryngeal partial laryngectomy were treated with vertical partial laryngectomy. Two patients were lost to follow-up. Ten patients (10/19; 53%) were recurrence-free. Four patients had local, two had regional, and two had locoregional recurrences. Only one patient with a local recurrence could be salvaged with total laryngectomy and is disease-free. One patient developed liver metastasis. Nineteen patients had a mean and median disease-free survival of 48 and 36 months, respectively. Nine out of fourteen patients (64%) treated curatively were recurrence-free. The patients with positive margins developed significantly more locoregional recurrences than those with free margins (P < 0.05). We conclude that surgical margins must be checked peroperatively with frozen sections to make sure that they are free. The margins of every laryngectomy specimen must be diligently examined. If positive, re-excision, postoperative radiotherapy and chemotherapy are treatment alternatives. They should not just be managed with close follow-up. However, whatever treatment is applied, the prognosis for patients with positive margins is significantly worse than for those with free margins.

Effect of teflon piston diameter on hearing result after stapedotomy.

This study compares hearing results after stapedotomy by 0.6 mm and 0.8 mm teflon pistons. Retrospective analysis studied 100 patients randomly selected who underwent stapedotomy for otosclerosis with insertion of 0.8 mm teflon piston prosthesis and 100 patients with 0.6 mm teflon piston prosthesis. Air-conduction hearing level in both groups were measured before and after the procedure and the gain of the air conduction between the 2 groups at different frequencies were compared statistically. The group with the 0.8 mm prosthesis had better results that were statistically significant and more pronounced at lower frequencies.

The value of elective neck dissection in treatment of cancer of the tongue.

PURPOSE: The "adequate" therapy of tongue cancer has not yet been determined. The authors report their experience with 58 N(0) patients to elucidate the role of elective neck dissection in surgical treatment of cancer of the tongue. MATERIALS AND METHODS: The files of 58 N(0) patients with tongue cancer were evaluated retrospectively. In every patient, partial glossectomy continuous with neck dissection was the mainstay of the treatment. TNM staging, intraoperative N staging, pathologically confirmed cervical lymph node metastases and their levels, and clinical outcomes (local and regional recurrences) were recorded. The sensitivity and specificity of intraoperative staging was determined. RESULTS: Fifty-four percent (31/58) of the patients presented as T(1), and 26% (15/58) as T(2). The overall occult metastasis rate was 29.3% (17/58). The occult metastasis rate for T(1) and T(2) lesions was 19.4% (6/31) and 26.7% (4/15), respectively. The sensitivity of intraoperative staging was 76.5%, and the specificity was 51.2%. CONCLUSIONS: The rate of occult metastasis to the neck is too high in all tongue cancer cases to take the risk of regional recurrence, and the surgeon can not solely depend on neck palpation for determination of neck metastasis. Radiologic investigations and fine-needle aspiration decrease, but never reduce to zero the rate of false-negative examination. There is an obvious indication for neck dissection, even in early cases.

Transtympanic dexamethasone application in Ménière's disease: an alternative treatment for intractable vertigo.

The aetiology of Ménière's disease still remains unknown and its therapy is therefore empirical. As a result of immunological abnormalities demonstrated, steroids are commonly used in Ménière's disease. The place of topical steroids is still controversial. In this investigation topical dexamethasone is applied for three months through a ventilation tube in patients with intractable vertigo. The results showed that this treatment controls vertigo in 72 per cent of cases. No patient was worse than before treatment. Only in 17 per cent of the patients was there an increase in hearing level. When compared to the reports which used only tympanostomy tubes, this procedure seems to have a placebo effect with minimal harmful effects. It appears that transtympanic dexamethasone application is a good alternative to vestibular nerve section. Topical treatment may be sufficient in most patients. Systemic treatment may be used in patients where topical treatment fails.

Prognostic significance of vascular and perineural invasion in cancer of the larynx.

PURPOSE: Perineural and vascular invasion are generally recognized as poor prognostic factors in cancer. The authors report the prognostic significance of perineural and vascular invasion in cancer of the larynx. MATERIALS AND METHODS: The laryngectomy specimens of 94 patients with squamous cell carcinoma of the larynx were analyzed histopathologically for vascular and perineural invasion. Prognostic significance of vascular and perineural invasion was evaluated related to the cervical lymph node metastasis, recurrence, and disease-free survival. RESULTS: Vascular invasion significantly influences cervical lymph node metastasis for supraglottic tumors, yet not for glottic and transglottic tumors. Perineural invasion has marginal significance in cases of cervical lymph node metastasis of supraglottic tumors; it has no significance in cases of cervical lymph node metastasis of glottic and transglottic tumors. Vascular invasion significantly increases local and regional recurrence rate, but not distant metastasis rate. Perineural invasion significantly increases local recurrence rate, but not regional recurrence and distant metastasis rate. The disease-free survival is significantly shortened by the presence of vascular and perineural invasion. According to multivariant analysis, neither vascular nor perineural invasion significantly effects the disease-free survival independently (P> .15). The presence of vascular invasion significantly affects the recurrence independently (P=.045). The presence of vascular invasion significantly reduces the interval between surgery and the development of recurrence (P=.013). CONCLUSION: The presence of vascular and perineural invasion should be checked in every laryngectomy specimen because both have a significant prognostic value; both influence the disease-free survival and recurrence significantly. Vascular invasion significantly increase cervical lymph node metastasis of supraglottic tumors; perineural invasion has only marginally significant effect on cervical lymph node metastasis of supraglottic cancers. Vascular invasion plays an independent role in determining the recurrence.

nm23 Protein expression in larynx cancer and the relationship with metastasis.

The nm23 gene, which encodes nucleoside diphosphate (NDP) kinase, is proposed as a metastatic suppressor gene and has been demonstrated to correlate inversely with metastatic potential in several tumours. To elucidate the role of nm23 in larynx carcinomas, we examined using immunohistochemistry the expression of the nm23 protein in matched sets of primary tumours and metastatic lymph nodes. nm23 Protein was expressed in all the carcinomas as well as in non-neoplastic larynx mucosa. Overexpression of nm23 protein was found in the majority of primary tumours compared with corresponding normal mucosa, while decreased expression was associated with poor differentiation and distant metastasis and/or recurrence. No significant difference in age, sex and stage was found between primary tumours with high and low nm23 protein expression. These results suggest that decreased nm23 protein expression may play a role in metastasis and/or recurrence in larynx cancer and therefore could be used as a prognostic factor.

Effects of gamma irradiation on the survival of Listeria monocytogenes and on its growth at refrigeration temperature in poultry and red meat.

Gamma irradiation sensitivity of a strain of Listeria monocytogenes was determined in trypticase soy broth supplemented with yeast extract (TSB-YE), in a slurry of chicken breast meat and in raw ground beef. D10 values in these different media were 0.364, 0.599, and 0.699 kGy, respectively. This organism appeared most sensitive in TSB-YE, more resistant in minced fresh chicken breast meat, and most resistant in fresh minced beef. It was found that irradiation at 2.5 kGy prior to refrigeration is an efficient way for the preservation of meat products contaminated at 10(3) to 10(4) per gram initial load of L. monocytogenes for about 7 d. However, with this initial load, the injured cells might repair themselves and cause a health hazard during storage at 4 C in the presence of air after 7 d.

Role of MRI in the diagnosis of otitic hydrocephalus.

The pathogenesis of otitic hydrocephalus still remains doubtful. Magnetic resonance imaging (MRI) demonstrated sigmoid and transverse sinus thrombosis in two consecutive patients. The role of MRI in the diagnosis and pathogenesis of this complication, together with literature findings, is discussed. Until now, lumbar puncture, which is a minimally invasive technique, was the only diagnostic measure. MRI, however, can be used to establish the diagnosis of otitic hydrocephalus by showing the thrombosis in the sigmoid and transverse sinus.

[Primary cholesteatoma of the petrous bone apex]. / Das primäre Cholesteatom der Felsenbeinspitze.

BACKGROUND: Primary cholesteatoma of the temporal bone is a very rare disease. Initially, the tympanic membrane is intact, and often facial palsy may be the presenting symptom. The authors present a case of primary cholesteatoma which was surgically treated using a transmastoid-translabyrinthine approach. Other surgical approaches to the petrous apex are discussed.

MRI of the facial nerve in idiopathic facial palsy.

The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell's palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to as equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment.

Wegener's granulomatosis: case report and review of the literature.

The clinical manifestations of Wegener's granulomatosis (WG) may be varied and easily overlooked. Awareness of distinguishing signs and symptoms allows early recognition and appropriate management. The body of literature dealing with the various facets of this disorder has grown in the past few years. Development of new diagnostic markers and successful therapies has rekindled interest in this disease. To assure early diagnosis and optimal prognosis the physician must maintain a high index of suspicion for WG. Although introduction of immunosuppressive therapy has dramatically improved the course of this disorder, treatment-related morbidity is often profound.

The effect of lymphocytic infiltration on clinical survival in cancer of the tongue.

Many factors have been claimed to influence the clinical prognosis of cancer of the tongue, one of them being the inflammatory response at the advancing tumor border. In a retrospective study of 60 patients with squamous cell carcinoma of the oral tongue, lymphocytic peritumoral inflammation was not found to be an objective prognostic marker.

Giant osteoma of the frontal sinus.

Osteoma is the most common benign tumour of the nose and paranasal sinuses, and the frontal sinus is its most frequent location. This tumour may be discovered incidentally on radiographs, or may enlarge to produce symptoms and, rarely, complications referable to its location near the orbit and anterior cranial vault. A 61-year-old man presented with right proptosis was found to have a giant osteoma involving frontal sinus. The aetiology, presenting features, and treatment of this tumour are reviewed.