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1.
Eur Rev Med Pharmacol Sci ; 18(23): 3720-5, 2014.
Article in English | MEDLINE | ID: mdl-25535147

ABSTRACT

OBJECTIVE: The present study aimed to investigate the effects of the bacterial biofilm formation on the tonsil surface exposed N-acetyl-cysteine (NAC) and acetylsalicylic acid (ASA) of patients undergoing tonsillectomy by light and electron microscopy. The general process of biofilm formation comprises adhesion of free-living or planktonic bacteria to a surface, which subsequently develop into microcolonies and form a biofilm. Based on studies that have shown the presence of biofilms in common sites of chronic infections, it has become clear that bacteria may persist on mucosal surfaces through formation of biofilms. PATIENTS AND METHODS: Ten patients between 4 and 39 years of age (mean, 11.9 ± 11.2 years). In all cases, periodic acide Schiff (PAS) staining was found to be an accurate predictor of the presence or absence of biofilm using light microscopy as a control standard. Therapeutic doses of NAC and ASA were identificated as the effective on the tonsil bacterial biofilm using light and electron microscopy. RESULTS: Biofilm formation was detected on all samples. Tonsils removed from patients with ASA-10 had showed higher-grade inhibitory effect at the biofilm formation than the other group (p ≤ 0.0001). The correlation was found between drug dose and decrease at the biofilm formation. CONCLUSIONS: In chronic or recurrent tonsillitis patients, decrease on the tonsils surface biofilm formation may be associated with ASA dose. Whether effect on the tonsils surface biofilm formation of other agent have a role is not known. Key Words: Acetylsalicylic acid, Chronic tonsillitis, In vitro, Mucosal biofilm, N-Acetyl-cysteine.


Subject(s)
Acetylcysteine/pharmacology , Aspirin/pharmacology , Biofilms/drug effects , Palatine Tonsil/drug effects , Palatine Tonsil/pathology , Acetylcysteine/therapeutic use , Adolescent , Adult , Aspirin/therapeutic use , Child , Child, Preschool , Female , Humans , Male , Microscopy, Electron/methods , Microscopy, Polarization/methods , Palatine Tonsil/microbiology , Tonsillitis/diagnosis , Tonsillitis/drug therapy , Young Adult
2.
B-ENT ; 9(1): 17-22, 2013.
Article in English | MEDLINE | ID: mdl-23641586

ABSTRACT

OBJECTIVES: To analyse temporal bone erosion sites (including scutum, labyrinth, facial canal, mastoid tegmen, posterior fossa dural plate and sigmoid sinus plate) in patients with chronic suppurative otitis media (CSOM). METHODOLOGY: Retrospective case review in a tertiary referral centre. Medical records were reviewed from 905 patients (121 complicated; 784 non-complicated) who received a mastoidectomy as a minimum intervention for the treatment of CSOM. RESULTS: All types of temporal bone erosion were found to be more frequent in patients with complicated CSOM. Erosion in the scutum, mastoid tegmen, posterior fossa dural plate and labyrinth was observed significantly more frequently in complicated-CSOM patients with a cholesteatoma. Granulation/polyp tissue invaded the sigmoid sinus and facial canal at a rate similar to cholesteatoma. CONCLUSIONS: Our study demonstrates that bone erosion is more frequent in complicated-CSOM patients. Temporal bone erosion can be seen in both cholesteatomatous and non-cholesteatomatous CSOM patients. Granulation/polyp tissue was as important as cholesteatoma in the erosion of the facial canal and sigmoid sinus plate.


Subject(s)
Cholesteatoma, Middle Ear/diagnostic imaging , Otitis Media, Suppurative/diagnostic imaging , Temporal Bone/diagnostic imaging , Adolescent , Adult , Aged , Child , Child, Preschool , Cholesteatoma, Middle Ear/complications , Chronic Disease , Ear, Inner/diagnostic imaging , Female , Humans , Male , Mastoid/diagnostic imaging , Middle Aged , Otitis Media, Suppurative/complications , Retrospective Studies , Tomography, X-Ray Computed , Young Adult
3.
Eur Arch Otorhinolaryngol ; 270(1): 69-76, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22249835

ABSTRACT

The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach.


Subject(s)
Otitis Media, Suppurative/complications , Adolescent , Adult , Aged , Chi-Square Distribution , Child , Child, Preschool , Chronic Disease , Diagnostic Imaging , Female , Humans , Incidence , Male , Middle Aged , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/therapy , Retrospective Studies , Treatment Outcome , Turkey/epidemiology
4.
Cancer ; 92(5): 1092-100, 2001 Sep 01.
Article in English | MEDLINE | ID: mdl-11571720

ABSTRACT

BACKGROUND: Although almost half of all incidents of breast carcinoma occur in women age > or = 65 years, not enough is known about appropriate care for patients in this age group. The objective of the current study was to evaluate the role of breast conservation therapy in the management of breast carcinoma in women age > or = 65 years. METHODS: From 1970 to 1994, 1325 patients with carcinoma of the breast were treated with breast conservation therapy (segmental mastectomy and radiation therapy with or without axillary lymph node dissection) at The University of Texas M. D. Anderson Cancer Center. From this patient group, the authors identified 184 elderly women (> or = 65 years) with Stage 0-III disease at the time of diagnosis. RESULTS: The median patient age was 70 years (range, 65-88 years). The distribution of disease by stage among the women was Stage 0 disease in 12 patients (7%), Stage I disease in 107 patients (58%), Stage II disease in 63 patients (34%), and Stage III disease in 2 patients (1%). Comorbid conditions that may have influenced treatment planning were reported in 91 patients (50%). An axillary lymph node dissection was performed in 135 patients (73%), with positive axillary lymph nodes found in 30 patients (22%). Adjuvant chemotherapy was given to 10 patients (5%), and tamoxifen therapy was given to 63 patients (34%). Complications from treatment were reported in 24 patients (13%). With a median follow-up of 7.3 years (range, 0.25-23.5 years), 9 patients developed locoregional disease recurrence (5%), 10 patients developed contralateral breast carcinoma (5%), and 21 patients developed distant metastasis (11%). At last follow-up, 113 patients (61%) were alive, 15 patients (8%) were dead of disease, and 56 patients (30%) were dead of other causes. The 5-year and 10-year disease specific survival rates were 96% and 91%, respectively. CONCLUSIONS: Breast conservation therapy with segmental mastectomy and postoperative radiation therapy with or without axillary lymph node dissection provides excellent local control and disease free survival in elderly women with breast carcinoma. This treatment should be considered as the standard of care for elderly patients without severe comorbid disease.


Subject(s)
Breast Neoplasms/therapy , Mastectomy, Segmental , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Comorbidity , Female , Humans , Lymph Node Excision , Radiotherapy Dosage , Radiotherapy, Adjuvant , Survival Rate
5.
Ann Surg Oncol ; 8(10): 821-7, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11776497

ABSTRACT

BACKGROUND: In sentinel lymph node (SLN) biopsy for breast cancer, many centers use same-day preoperative injection of technetium 99mTc-labeled sulfur colloid and intraoperative injection of blue dye for localization of SLNs. Same-day sulfur colloid injections can be problematic because of the variability in sulfur colloid migration times, which can lead to ineffective use of operating room time, and low SLN-to-background radioactivity ratios. We examined the utility of day-before-surgery injections of high dose 99mTc-labeled sulfur colloid injections. METHODS: The day before surgery, high-dose 99mTc-labeled sulfur colloid was injected peritumorally, and a lymphoscintigram was obtained. Intraoperatively, after injection of blue dye, a gamma probe was used to localize SLNs. Nodes that were stained blue or were highly radioactive were considered SLNs and were removed. RESULTS: Lymphoscintigraphy demonstrated drainage in 107 patients (91%). Transcutaneous localization of the SLN was possible in 104 patients (89%). In three patients, all of whom had no drainage demonstrated on lymphoscintigraphy, no SLN was identified at surgery (97.5% success rate for SLN identification). A mean of 2.3 SLNs per patient were identified. Twenty-five patients (21%) had at least one histologically positive SLN. In 23 of these patients, the positive SLN was the SLN with the most radioactivity, and in the remaining two patients, the positive SLN was both blue-stained and hot. CONCLUSION: Day-before-surgery injection of high-dose 99mTc-labeled sulfur colloid results in high rates of transcutaneous and intraoperative identification of SLNs. The delay between injection and surgery did not appear to promote significant passage of sulfur colloid to second-echelon nodes.


Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Lymphography/methods , Radiopharmaceuticals , Sentinel Lymph Node Biopsy/methods , Technetium Tc 99m Sulfur Colloid , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Radionuclide Imaging
6.
J Laryngol Otol ; 114(10): 779-80, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11127150

ABSTRACT

Congenital cholesteatoma may arise in the petrous apex, mastoid, middle ear, or external auditory canal. The least common site being the mastoid process. We present one case of primary mastoid cholesteatoma confirmed by clinical examination, surgical findings and radiological evaluation.


Subject(s)
Bone Diseases/congenital , Cholesteatoma/congenital , Mastoid , Aged , Bone Diseases/diagnosis , Bone Diseases/surgery , Cholesteatoma/diagnosis , Cholesteatoma/surgery , Contrast Media , Gadolinium DTPA , Humans , Magnetic Resonance Imaging/methods , Male , Mastoid/surgery , Tomography, X-Ray Computed/methods
7.
Ann Surg Oncol ; 7(9): 656-64, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11034242

ABSTRACT

BACKGROUND: The role of breast-conserving therapy (BCT) in the management of ductal carcinoma-in-situ (DCIS) is controversial because of reported high recurrence rates. We reviewed our experience to determine whether the rate and pattern of locoregional recurrence after BCT were similar in patients with DCIS and patients with early-stage (T1) invasive breast tumors and whether local recurrence affected survival. METHODS: Between 1973 and 1994, 87 patients with DCIS alone, 22 patients with DCIS with microinvasion (DCIS-M), and 646 patients with invasive breast cancer 2 cm or smaller in diameter were treated with BCT (wide local excision with radiotherapy) at The University of Texas M. D. Anderson Cancer Center. Survival was calculated by the Kaplan-Meier method. The median follow-up times were 11 years for patients with DCIS alone, 12 years for patients with DCIS-M, and 8 years for patients with invasive breast cancer. RESULTS: Eleven (13%) of 87 patients with DCIS and 5 (23%) of 22 patients with DCIS-M had developed locoregional recurrences at follow-up. Two patients with DCIS with locoregional recurrence died of breast cancer. Of the 646 patients with invasive breast cancer, 56 (9%) had a locoregional recurrence, and 16 (2%) died of breast cancer. The median time to locoregional recurrence was significantly longer in patients with DCIS or DCIS-M (9-10 years) than patients with invasive tumors (5 years). CONCLUSIONS: DCIS is a favorable disease with an excellent long-term survival. The locoregional recurrence rate in patients with DCIS treated with BCT is similar to that in patients with early-stage invasive breast cancer treated with BCT, but time to locoregional recurrence is significantly longer in patients with DCIS. In patients with DCIS treated with BCT, intense surveillance for locoregional recurrence needs to be maintained for the patient's lifetime.


Subject(s)
Breast Neoplasms/mortality , Breast Neoplasms/therapy , Carcinoma, Intraductal, Noninfiltrating/mortality , Carcinoma, Intraductal, Noninfiltrating/therapy , Mastectomy, Segmental , Adult , Aged , Breast Neoplasms/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Carcinoma, Intraductal, Noninfiltrating/secondary , Chemotherapy, Adjuvant , Female , Humans , Lymphatic Metastasis , Mastectomy, Segmental/mortality , Medical Records , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/prevention & control , Radiotherapy, Adjuvant , Retrospective Studies , Survival Analysis , Texas/epidemiology
8.
J Clin Oncol ; 18(19): 3378-83, 2000 Oct 01.
Article in English | MEDLINE | ID: mdl-11013278

ABSTRACT

PURPOSE: The purpose of this study was to test the hypothesis that neoadjuvant chemotherapy (NeoCT) does not increase morbidity in patients undergoing radical surgery for soft tissue sarcomas. PATIENTS AND METHODS: The records of 309 patients who presented to The University of Texas M.D. Anderson Cancer Center for definitive surgical management of primary soft tissue sarcomas were retrospectively reviewed. One hundred five patients who received NeoCT were compared with 204 patients who had surgery first (Surg). Patients had extremity sarcomas (71 NeoCT patients and 130 Surg patients) or retroperitoneal/visceral sarcomas (34 NeoCT and 74 Surg). RESULTS: NeoCT patients had larger tumors (median, 12 v 8 cm), more frequently had high-grade tumors (90% v 64%), and were younger (median age 47 v 55 years). The incidence of surgical complications was not different for NeoCT patients than for Surg patients, both in those with extremity sarcomas (34% v 41%) and in those with retroperitoneal/visceral sarcomas (29% v 34%). The most common complications were wound infections and other wound complications. Preoperative radiation therapy, autologous flap coverage, and extremity tumors were associated with increased wound complications. No significant differences in length of hospital stay, rate of readmission, or rate of reoperation for complications were found between the NeoCT and Surg groups. One of the three postoperative deaths in our series occurred in the NeoCT group. CONCLUSION: In this retrospective review, there was no evidence that NeoCT increased postoperative morbidity in patients with soft tissue sarcomas. Prospective, randomized studies are needed to confirm these results.


Subject(s)
Sarcoma/drug therapy , Sarcoma/surgery , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/surgery , Antibiotics, Antineoplastic/therapeutic use , Antineoplastic Agents, Alkylating/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Female , Humans , Ifosfamide/adverse effects , Ifosfamide/therapeutic use , Male , Middle Aged , Morbidity , Multivariate Analysis , Neoadjuvant Therapy/adverse effects , Postoperative Complications/epidemiology , Retrospective Studies , Sarcoma/epidemiology , Soft Tissue Neoplasms/epidemiology
9.
Clin Cancer Res ; 6(10): 3832-6, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11051226

ABSTRACT

The adenovirus 5 early region 1A (E1A) can function as a tumor suppressor gene and is being used in clinical trials as a therapeutic agent for advanced breast, ovarian, and head and neck cancer. Recently, there has been a dispute regarding whether transfection with the E1A gene can induce expression of the Ewing sarcoma oncogenic fusion transcript EWS-FLI1 (Sanchez-Prieto et al., Nat. Med., 5: 1076-1079, 1999; Melot and Delattre, Nat. Med., 5: 1331, 1999; Kovar et al., Cancer Res., 60: 1557-1560, 2000). In an effort to settle the controversy, we tested several stable E1A transfectants of cell lines MDA-MB-231, MCF-7, MDA-MB-435 (breast cancer), SKOV3-ipl (ovarian cancer), and PC-3 (prostate cancer), as well as parental and vector-transfected controls, HEK 293 cells, and RD-ES (Ewing sarcoma) cells, for the EWS-FLI1 fusion product. The EWS-FLI1 transcript could not be identified with reverse transcription-PCR in any of the 13 E1A-transfected cell lines analyzed. Furthermore, the EWS-FLI1 fusion protein could not be detected by Western blot analysis in E1A-transfected cell lines. These results suggest that E1A transfection does not necessarily lead to expression of the oncogenic EWS-FLI1 fusion transcript. Thus, the potential induction of this gene rearrangement by E1A gene therapy is unlikely to be clinically significant in the treatment of advanced malignant disease.


Subject(s)
Adenovirus E1A Proteins/genetics , Breast Neoplasms/metabolism , Oncogene Proteins, Fusion/biosynthesis , Ovarian Neoplasms/metabolism , Transcription Factors/biosynthesis , Base Sequence , Blotting, Southern , Blotting, Western , Cloning, Molecular , Female , Humans , Molecular Sequence Data , Plasmids/metabolism , Proto-Oncogene Protein c-fli-1 , RNA, Messenger/metabolism , RNA-Binding Protein EWS , Recombinant Fusion Proteins/metabolism , Retroviridae/genetics , Reverse Transcriptase Polymerase Chain Reaction , Sequence Analysis, DNA , Sequence Homology, Nucleic Acid , Transfection , Translocation, Genetic , Tumor Cells, Cultured
10.
Ann Surg Oncol ; 7(7): 490-5, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10947016

ABSTRACT

BACKGROUND: This retrospective study was performed to assess the outcome among patients who underwent hepatic resection or tumor ablation after hepatic artery infusion (HAI) therapy down-staged previously unresectable hepatocellular carcinoma (HCC) or liver metastases from colorectal cancer (CRC). METHODS: Between 1983 and 1998, 25 patients with HCC and 383 patients with hepatic CRC metastases were treated with HAI therapy for unresectable liver disease. We retrospectively reviewed the records of 26 (6%) of these patients who underwent subsequent surgical exploration for tumor resection or ablation. RESULTS: At a median of 9 months (range 7-12 months) after HAI treatment, four patients (16%) with HCC underwent exploratory surgery; two underwent resection with negative margins, and the other two were given radiofrequency ablation (RFA) because of underlying cirrhosis. At a median postoperative follow-up of 16 months (range 6-48 months), all four patients were alive with no evidence of disease. At a median of 14.5 months (range 8-24 months) after HAI therapy, 22 patients with hepatic CRC metastases underwent exploratory surgery; 10 underwent resection, 6 underwent resection and RFA or cryotherapy, and 2 underwent RFA only. At a median follow-up of 17 months, 15 (83%) of the 18 patients with CRC who had received surgical treatment had developed recurrent disease; the other 3 died of other causes (1 of postoperative complications) within 7 months of the surgery. One patient in whom disease recurred underwent a second resection and was disease-free at 1 year follow-up. CONCLUSIONS: Hepatic resection or ablation after tumor downstaging with HAI therapy is a viable option for patients with unresectable HCC. However, given the high rate of recurrence of metastases from CRC, hepatic resection or ablation after downstaging with HAI should be used with caution.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Hepatocellular/surgery , Colorectal Neoplasms/pathology , Liver Neoplasms/surgery , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/secondary , Combined Modality Therapy , Female , Hepatic Artery , Humans , Infusions, Intra-Arterial , Liver Neoplasms/drug therapy , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Staging , Recurrence , Retrospective Studies , Treatment Outcome
11.
J Pediatr Surg ; 35(7): 1117-9, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10917310

ABSTRACT

Although once considered rare, choledochal cysts now are extensively reported on and have an official anatomic classification. The authors report a case of a 4-year-old girl whom on routine abdominal ultrasound as follow-up for vesicoureteral reflux was found to have a choledochal cyst. Follow-up hepatobiliary scan together with the ultrasound findings was consistent with a rare type II choledochal cyst. On laparoscopy, a type II choledochal cyst was confirmed on dissection and amenable to laparoscopic excision. Intraoperative cholangiogram after excision showed normal remaining biliary anatomy. The patient was discharged the following day without delayed complications on follow-up visits. This report suggests a role for laparoscopic surgery in the definitive management of selected cases of choledochal cystic disease. (Included is relevant radiological documentation, illustration of technique, and review of the literature.)


Subject(s)
Choledochal Cyst/surgery , Laparoscopy , Child, Preschool , Choledochal Cyst/classification , Female , Humans , Laparoscopy/methods
12.
Ann Surg Oncol ; 7(6): 435-40, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10894139

ABSTRACT

BACKGROUND: Although preoperative chemotherapy has become the standard of care for inoperable locally advanced breast cancer, its role for downstaging resectable primary tumors is still evolving. The purpose of this study was to determine whether the prognostic information from an axillary node dissection in patients with clinical T3N0 breast cancer was altered by preoperative chemotherapy compared with surgery de novo. METHODS: Between 1976 and 1994, 91 patients with clinically node-negative operable T3 breast cancer received doxorubicin-based combination chemotherapy on protocol at one institution. Fifty-three patients received both preoperative and postoperative chemotherapy (PreopCT), and 38 received postoperative chemotherapy only (PostopCT). All patients underwent axillary lymph node dissection as part of their definitive surgical treatment. There were no differences between the PreopCT and PostopCT groups in median age (51 vs. 49 years), median tumor size at presentation (6 cm vs. 6 cm), tumor grade, or estrogen receptor status (estrogen receptor negative 38% vs. 32%). The median follow-up time was 7 years. RESULTS: Patients in the PreopCT group had fewer histologically positive lymph nodes (median, 0 vs. 3, P < .01), and a lower incidence of extranodal extension (19% vs. 42%, P = .02). By univariate analysis, the number of pathologically positive lymph nodes (P < .01) and extranodal extension (P < .01) were predictors of disease-specific survival in PreopCT patients. Multivariate analysis showed that extranodal extension was the only independent prognostic factor in PreopCT patients (P < .01). Overall, PreopCT and PostopCT patients had similar 5-year disease-free survival rates (66% vs. 57%); however, PreopCT patients had worse disease-free (P = .01) and disease-specific survival (P = .04) when survival was compared after adjustment for the number of positive lymph nodes. Furthermore, PreopCT patients with 4-9 positive lymph nodes had a lower 5-year disease-free survival rate than PostopCT patients with 4-9 positive nodes (17 vs. 48%, P = .04). CONCLUSIONS: Axillary lymph node status remains prognostic after chemotherapy. Pathologically positive lymph nodes after preoperative chemotherapy are associated with a worse prognosis than the same nodal status before chemotherapy.


Subject(s)
Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Lymph Nodes/pathology , Adult , Aged , Biopsy , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Disease-Free Survival , Female , Humans , Lymphatic Metastasis/diagnosis , Middle Aged , Multivariate Analysis , Neoplasm Staging/methods , Preoperative Care , Prognosis , Risk Factors , Survival Analysis
13.
Rhinology ; 38(1): 45-7, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10780048

ABSTRACT

Chondrosarcoma of the nasal septum is a rather uncommon tumour. Therefore, only limited numbers of cases have been described in the literature. This paper reveals one more case observed at the ORL department of Dicle University. In the present case, by using a transnasal and transpalatal approach, total resection of the tumour was performed in conjunction with postoperative radiotherapy.


Subject(s)
Chondrosarcoma/epidemiology , Nasal Septum , Nose Neoplasms/epidemiology , Adult , Chondrosarcoma/diagnosis , Chondrosarcoma/therapy , Humans , Male , Nose Neoplasms/diagnosis , Nose Neoplasms/therapy
14.
Am J Surg ; 180(6): 523-6; discussion 526-7, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11182411

ABSTRACT

BACKGROUND: We investigated the role of observation or insertion of a small French pigtail catheter with Heimlich valve as alternative management to a tube thoracostomy for iatrogenic pneumothorax complicating central venous catheter (CVC) insertion. METHODS: A retrospective review of 9,637 consecutive patients who had had subclavian CVCs inserted on an outpatient basis identified 100 patients with pneumothoraces. Treatment consisted of (1) observation, (2) outpatient insertion of a Heimlich valve, or (3) inpatient tube thoracostomy. RESULTS: The median pneumothorax size was 10% (range 1% to 100%). Fifty-eight patients had observation as initial treatment, and this strategy was successful in 35 (60%). Thirty-four patients were treated initially with Heimlich valves, and this strategy was successful in 29 (85%). Tube thoracostomy as initial therapy was successful in 7 (88%) of 8 patients. Patients in who initial treatment failed were treated with insertion of a Heimlich valve or tube thoracostomy. CONCLUSION: In appropriately selected patients, pneumothorax after insertion of a subclavian CVC can be successfully managed in the outpatient setting with observation. Patients in whom observation fails can be treated with insertion of a Heimlich valve. Tube thoracostomy can be reserved for refractory PTX or emergent situations.


Subject(s)
Catheterization, Central Venous/adverse effects , Pneumothorax/etiology , Pneumothorax/therapy , Ambulatory Care , Catheterization , Humans , Retrospective Studies , Subclavian Vein , Thoracostomy
15.
Eur Arch Otorhinolaryngol ; 257(10): 555-7, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11195036

ABSTRACT

Neurogenous tumours of the larynx are extremely uncommon. We present a rare case of schwannoma of the larynx. Clinical findings are presented together with computed tomography (CT) and magnetic resonance images. The tumour was located in the right aryepiglottic fold of the larynx. CT showed a well defined and hypodense mass extending from the right aryepiglottic fold to the right vocal cord. The patient underwent an excision of the mass through a lateral thyrotomy and the tumour was completely removed. The diagnosis and treatment of this tumour are discussed.


Subject(s)
Laryngeal Neoplasms/diagnosis , Neurilemmoma/diagnosis , Female , Humans , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/surgery , Laryngoscopy , Larynx/pathology , Magnetic Resonance Imaging , Middle Aged , Neurilemmoma/pathology , Neurilemmoma/surgery , Tomography, X-Ray Computed
16.
Mol Cell Biol ; 19(6): 3958-68, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10330136

ABSTRACT

The Polycomb group (Pc-G) genes encode proteins that assemble into complexes implicated in the epigenetic maintenance of heritable patterns of expression of developmental genes, a function largely conserved from Drosophila to mammals and plants. The Pc-G is thought to act at the chromatin level to silence expression of target genes; however, little is known about the molecular basis of this repression. In keeping with the evidence that Pc-G homologs in higher vertebrates exist in related pairs, we report here the isolation of XPc1, a second Polycomb homolog in Xenopus laevis. We show that XPc1 message is maternally deposited in a translationally masked form in Xenopus oocytes, with XPc1 protein first appearing in embryonic nuclei shortly after the blastula stage. XPc1 acts as a transcriptional repressor in vivo when tethered to a promoter in Xenopus embryos. We find that XPc1-mediated repression can be only partially alleviated by an increase in transcription factor dosage and that inhibition of deacetylase activity by trichostatin A treatment has no effect on XPc1 repression, suggesting that histone deacetylation does not form the basis for Pc-G-mediated repression in our assay.


Subject(s)
Gene Expression Regulation, Developmental , Histone Deacetylases/physiology , Repressor Proteins/genetics , Transcription Factors , Transcription, Genetic , Xenopus Proteins , Xenopus laevis/embryology , Amino Acid Sequence , Animals , Blotting, Northern , Blotting, Western , Cell Nucleus/metabolism , Centrifugation, Density Gradient , Enzyme Inhibitors/pharmacology , Genes, Reporter , Hydroxamic Acids/pharmacology , Molecular Sequence Data , Phosphorylation , Sequence Homology, Amino Acid , Time Factors , Tissue Distribution
17.
J Laryngol Otol ; 113(9): 823-4, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10664685

ABSTRACT

Nasal septal perforation may present with various symptoms. Perforations may be surgically closed or managed by obturation, inserting a prosthesis. We used a silicon septal button in the management of nasal septal perforation. In the follow-up period, although the insertion of the nasal septal button alleviated epistaxis, whistling during inspiration, and nasal obstruction, it could not control the production of crusting around the margin of the button.


Subject(s)
Nasal Septum/injuries , Nasal Septum/surgery , Nose Diseases/surgery , Prostheses and Implants , Adolescent , Adult , Child , Female , Humans , Male , Treatment Outcome
18.
J Pediatr Surg ; 33(7): 1108-11; discussion 1111-2, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9694104

ABSTRACT

BACKGROUND/PURPOSE: Latex sensitization is a well-documented occurrence in children with myelodysplastic and urologic anomalies. The incidence of latex allergy in general pediatric surgical patients, however, has not been previously addressed. The purpose of this study was to examine the risk of perioperative latex reactions in a general pediatric surgical practice over a 1-year period. METHODS: This study examined the occurrence of latex sensitization using two methods. First, the preoperative anesthesia records of patients that have undergone surgery from October 1995 through September 1996 at Mott Children's Hospital were reviewed retrospectively. Second, all patients who had intraoperative anaphylaxis attributable to latex sensitization, including those from three additional hospitals, were evaluated. RESULTS: During a 12-month period, 1,523 pediatric general surgical operations were performed at the C.S. Mott Children's Hospital. Of these, only 11 operations on five patients were performed under latex precautions. All of these patients had a preoperative diagnosis of latex sensitivity. During the same period, intraoperative anaphylactic reactions caused by latex allergy occurred in two of the general surgical patients (0.13%) at the C.S. Mott Hospital. Four additional cases are also reported from other study hospitals. None of these patients were suspected, based on current screening methods, of having a latex allergy before their surgery. CONCLUSIONS: Latex allergy is a potentially life-threatening condition in the pediatric general surgical population. Further study is needed to develop criteria to preoperatively identify patients at risk for latex sensitization.


Subject(s)
Hypersensitivity/prevention & control , Latex/adverse effects , Adolescent , Anaphylaxis/epidemiology , Anaphylaxis/etiology , Anaphylaxis/prevention & control , Child , Child, Preschool , Humans , Hypersensitivity/epidemiology , Hypersensitivity/etiology , Incidence , Infant , Infant, Newborn , Mass Screening , Preoperative Care , Retrospective Studies , Risk Factors
19.
Environ Health Prev Med ; 3(1): 55-8, 1998 Apr.
Article in English | MEDLINE | ID: mdl-21432509

ABSTRACT

The present study intended to investigate whether radiofrequency (RF) affects auditory system of people who are occupationally exposed to RF in terms of noise-induced hearing loss (NIHL) or not. The study was carried out on 31 men from 26 to 53 years of age. All of them have been working in the Diyarbakir Radio Broadcasting Station. On the other hand, the control group was based on 30 unexposed voluntary and healthy men. The range of age for control group was the same as in the exposed group (experimental group). The results of the present study showed that the incidence of NIHL in the exposed group is more and more than that of the unexposed (control) group. The incidence of NIHL was approximately found 70 % for exposed group and 6% for unexposed group. The difference of the incidence of NIHL between exposed and unexposed groups were statistically found significant for right and left ears at "4 kHz notch" (p < 0.001). Hearing loss was not observed below 1 kHz. The percentage difference in the incidence of hearing loss (decibel) between control and experimental group was found insignificant for frequency below 1 kHz (p > 0.05). The experimental group was also divided to three subgroups of technicians, officers and men staying in the quarters of radio broadcasting station. Three subgroups were compared with one another statistically. The incidence of NIHL for the right ears of technicians was found higher than the officer (p < 0.05). The incidence of NIHL for the left ears of men staying in quarters was found higher than officers (p < 0.05). The other results of comparison were found insignificant (p > 0.05). In conclusion, the incidence of NIHL at "4 kHz Notch" in the experimental group was found more common than the control group.

20.
J Biol Chem ; 272(19): 12840-6, 1997 May 09.
Article in English | MEDLINE | ID: mdl-9139745

ABSTRACT

We examine the translational regulation of histone H4 mRNA when Xenopus laevis oocytes are induced to mature with progesterone. Histone H4 mRNA synthesized from plasmid templates microinjected into oocyte nuclei is translationally silenced (masked). This masked mRNA becomes translationally active only after oocyte maturation. In contrast, histone H4 mRNA injected into the oocyte cytoplasm is translationally active both before and after oocyte maturation. Thus, transcription in vivo is required to mask histone H4 mRNA and to allow subsequent translational regulation. Protein association with histone H4 mRNA synthesized in vivo was determined before and after oocyte maturation. UV cross-linking of radiolabeled RNA to protein and immunoprecipitation of cross-linked proteins reveals an increased association of the chaperone nucleoplasmin with ribonucleoprotein particles dependent on the oocyte maturation process. The Y-box protein FRGY2 inhibits translation of histone H4 mRNA in vitro. Nucleoplasmin is able to partially relieve this repression. We discuss the potential role of nuleoplasmin in the remodeling of repressive ribonucleoprotein particles containing maternal mRNA to facilitate translational activation.


Subject(s)
Nuclear Proteins/metabolism , Oocytes/cytology , Phosphoproteins , RNA, Messenger/biosynthesis , Amino Acid Sequence , Animals , Female , Histones/genetics , Models, Chemical , Molecular Sequence Data , Nucleoplasmins , Oocytes/metabolism , Protein Biosynthesis , Transcription, Genetic , Ultraviolet Rays , Xenopus laevis
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