Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2.

BACKGROUND: Necrotic laryngitis, caused by Fusobacterium necrophorum, frequently requires surgical intervention (laryngostomy) in the chronic stage. HYPOTHESIS/OBJECTIVES: To determine survival until slaughter of cattle surgically treated for necrotic laryngitis and to identify predictors of mortality. ANIMALS: A total of 221 cattle diagnosed with necrotic laryngitis by laryngoscopy and surgically treated METHODS: Retrospective cohort study. Clinical records were matched with the national cattle identification, registration, and movement database. Information on possible predictors including clinical examination, biochemistry, and surgery was collected. A multivariable Cox proportional hazard model was used to identify predictors of mortality. RESULTS: The overall survival rate was 65.2% and 58.6% of the animals with a completed life cycle could be slaughtered. Animals <6 months old experienced significantly higher mortality risk (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1-3.5). The venous partial pressure of carbon dioxide (pCO2 ; HR, 2.4; 95% CI, 1.4-4.2) at a 64.5 mm Hg cut-off was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2 were 49.1 and 86.4%, respectively. Instead of pCO2 , total carbon dioxide (TCO2 ) could also be used, with similar diagnostic accuracy. CONCLUSIONS AND CLINICAL RELEVANCE: The lifetime prognosis for chronic necrotic laryngitis in cattle with surgical intervention appears fair. Age, venous pCO2 and TCO2 are easily accessible predictors of survival to support owners and veterinarians in their decision process of whether or not to operate and to identify high risk animals that require more intensive follow-up.

[SOME CLINICAL AND CYTOKINE FEATURES OF THE CLINICAL COURSE OF RECURRENT RESPIRATORY SYSTEM DISEASES IN CHILDREN WITH THE TOXOCARIASIS INVASION].

The aim of the present study was to analyze clinical and cytokine features of recurrent respiratory system diseases in children with toxocariasis. 50 children aged 1 to 17 years (mean age - 10±5 years) with recurrent current of respiratory system disorders were studied. During the survey such clinical manifestations of the respiratory system disorders as obstructive bronchitis (50%), bronchial asthma (30%), pneumonia (10%) and laryngotracheitis (10%) have been revealed. Statistical analysis of the results was performed using the software package STATISTICA 6.1 (SNANSOFT). We have shown that the disorders of respiratory system in case of toxocariasis invasion often occur with severe intoxication and bronchial obstruction syndromes, temperature reaction, respiratory insufficiency and hepatomegaly. A prolonged course of the disease has been noted. "Inflammatory" indicators of general blood analysis, such as leukocytosis and increased of ESR have been recorded in patients with respiratory system disorders in children with T.canis infection significantly more often, significant "allergic" laboratory changes were in the form of eosinophilia. High average levels of pro-inflammatory IL-6, as well as low levels of IL 5 have been determined in children suffering from the respiratory system disorders and with toxocariasis invasion in the anamnesis. The obtained findings require further study.

Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions.

BACKGROUND: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. MATERIALS AND METHODS: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. RESULTS: The mean NLRs of the BLL, PLL and the LSCC groups were 2.12 ± 0.86, 2.32 ± 0.68 and 3.46 ± 1.51, respectively, and the difference was statistically significant (p = 0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p = 0.031 and p = 0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p > 0.05). CONCLUSIONS: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.

[Determination of serum fucosidase activities].

A method has been developed for simultaneous determination of the activity of alpha-L-fucosidase (EC 3.2.1.51) and the beta-D-fucosidase activity induced by beta-D-galactosidase (IV, EC 3.2.1.23) in the serum. The paper presents data on changes in these enzymatic activities in the serum in an experiment, in acute hematogenous osteomyelitis and recurrent laryngotracheitis in children in pregnant females with gestosis and placental insufficiency.

Low adrenal androgen output in patients with abnormal laryngeal epithelium.

We present 16 new patients who had abnormal vocal cord biopsies. Each had a serum sex hormone profile performed on the morning of the procedure. The striking abnormality was that 12 (75%) had low dehydroepiandrosterone sulphate (DHEAS), the main adrenal androgen, and four of these had prepubertal levels.

[Serum dihydrotestosterone versus total testosterone values of patients with laryngeal carcinomas and chronic laryngitis]. / Dihydrotestosteron- versus Gesamttestosteronwerte im Serum von Patienten mit Larynxkarzinomen und chronischer Laryngitis.

BACKGROUND: Paradoxically, the highest incidence of laryngeal carcinomas occurs in the presence of reduced gonadal androgen levels associated with ageing, while the stimulating effects of androgens on the laryngeal mucosa and their tumors have been reported in the literature. The decrease of testosterone values and nearly unchanged values of dihydrotestosterone in serum and tissues of elderly men have been documented in recent endocrinological literature. This trial was performed in an effort to resolve this apparent contradiction. METHODS: Twenty-two male laryngeal cancer patients and ten patients with chronic laryngitis were examined, and their dihydrotestosterone and total testosterone values in serum recorded. Blood sampling was performed for each patient between 7 and 10 a.m. before commencement of tumor therapy. An enzyme immunoassay (Serono automat SR 1) was used to determine the values of total testosterone, whereas a 5 alpha dihydrotestosterone (H 3)- radio-immuno-assay was carried out after serum extraction. RESULTS: The total testosterone values of the laryngeal cancer patients were found to be significantly lower than the values in the laryngitis group, but the mean levels of dihydrotestosterone were found to be comparable within both groups. However, the scattering of dihydrotestosterone values was much higher in the group of laryngeal cancer patients than in the laryngitis group. CONCLUSIONS: The average age of the cancer patients examined was 10 years higher than in the laryngitis group. The present results partially correspond to the reports in the endocrinological literature. Together with experimental results regarding the effects of pure substances of testosterone and dihydrotestosterone on permanent laryngeal cancer cell lines, the current results confirm the importance of the imbalance between testosterone and dihydrotestosterone as a cofactor in the development of squamous cell carcinomas of the larynx. Testosterone substitution as well as blocking of 5 alpha-reductase, the enzyme which facilitates formation of dihydrotestosterone from testosterone, are regarded as promising therapeutic opportunities for the future, especially for patients with laryngeal preneoplasias or as recurrence prophylaxis after primary tumor therapy.

The measurement of thoraco-abdominal asynchrony in infants with severe laryngotracheobronchitis.

Retractions of the lower ribcage (chest wall distortion [CWD]) during inspiration are frequently observed with moderate to severe respiratory disease in the infant. Laryngotracheobronchitis (LTB) results in a reversible partial airway obstruction with severe CWD. We wished to measure the motion of the chest wall during distortion to determine the changes in minute ventilation (VE) and to evaluate this clinical sign as a means of assessing disease severity. The respiratory inductance plethysmograph was used to determine the distortion of the lower chest wall, and distortion was correlated with VE, measured at the mouth, in six infants with severe LTB and ventilatory failure. As the conditions of these infants improved, the CWD decreased with decreasing transcutaneous carbon dioxide tension (tcPCO2), VE increased from 0.27 +/- 0.12 L.min-1 x kg-1 at a tcPCO2 of 64 mm Hg to 0.64 +/- 0.06 L.min-1 x kg-1 when the tcPCO2 had fallen to 28 mm Hg. Over the same change in tcPCO2, the tidal volume (VT) increased from 4.8 +/- 0.5 ml.kg-1 to 15.7 +/- 1.4 ml.kg-1. In the most severe disease state, the excursion of the chest wall (as an inductance) was -14 +/- 3 mV in severe obstruction, but increased to 75 mV +/- 4 mV with resolution of the illness. The timing and vector of movement of the abdomen and chest wall were expressed as a Lissajous figure, which is measured as a phase angle. The severity of the disease process, as determined by tcPCO2 was directly related to the phase relationship, and thus reflected both VE and VT. The severity of the CWD may be assessed rapidly by the use of Lissajous figures.

[Role of the tumor marker TAG-72 in head and neck neoplasms]. / Zur Rolle des Tumormarkers TAG-72 in den Neoplasien des Kopf-Hals-Bereiches.

The serum glycoprotein TAG-72 level was determined in 34 patients with chronic laryngitis or ENT malignancy. This marker is in widespread use in cases of gynaecological and gastrointestinal malignancy. TAG-72 levels did not differ significantly either from the levels of healthy subjects or in the post-operative follow-up, so that this indicator appears to be of no clinical value in head and neck oncology.

[Monitoring respiratory and circulatory parameters in comparing various jet ventilation procedures]. / Monitoring von Atem- und Kreislaufparametern zum Vergleich verschiedener Jet-Beatmungsverfahren.

Reported is a system of apparatures to control characteristic changes of cardiorespiratory function during different methods of endoscopic ventilation. The aim of the study is to measure and record simultaneously and continuously ECG, thoracic movement, tracheal pressure, pulmonary artery pressure and arterial oxygen pressure using transcutaneous technique. Measurements of arterial blood pressure and blood gas analysis (PaO2, PaCO2, BE, HCO3-, pH) are carried out in intervals. Four different methods of injector-ventilation are compared with the conventional laryngoscopic ventilation on the basis of a test program. Laryngoscopic ventilation as well as injectorventilation by CARDEN-Tubus make it possible to achieve a hyperoxaemic situation by normofrequent ventilation. Despite of hyperventilation it is not possible in every case to achieve an increased capillary oxygen pressure of 200 to 300 mm Hg by injector-ventilation with Venturi effect because of a smaller oxygen proportion. In jet-ventilation with N2O/O2-mixture (3:1) there is no appreciable hyperoxia, but a small reduction of systemic arterial blood pressure. With all techniques of mechanical respiration usual middle intratracheal pressure of respiration was not exceeded. Traumatic pressure of jets was only indirectly shown in steep rises of pressure by the applied technique of measurement.

[Immunoglobulins A, M, G, and E in children with acute viral respiratory diseases and the croup syndrome]. / Immunoglobuliny A, M, G i E u detei pri ostrykh virusnykh respiratornykh zabolevaniiakh s sindromom krupa.

Children with croup appearing in the presence of acute viral respiratory diseases (AVRD) show an increase in the IgM content in their blood sera during the first days of the disease followed by a decrease, and an increase in the IgG and IgE levels during the convalescence period. No essential shifts in the content of IgA have been observed. The total content of the immunoglobulins in children with croup, was lowered as compared to that in AVPD patients having no croup which is, probably, of a certain pathogenic importance. The increased content of IgE revealed in the blood sera of children with croup indicates the presence of an allergic component in this disease.