Oral surgery during Byzantine times.

The Byzantine World covers the eleven-century period between 323-1453 AD and was characterized by a comprehensive system of medicine based on the fundamental principles of Ancient Greek medicine. Several clinical entities, such as epulis, parulis, constrictions of the tongue (short frenum), sublingual ranula, jaws fractures and disclocations, oral fistulae were well-known and treated during the Byzantine period with primarily surgical, but also non-surgical, interventions. Tooth extractions and operations on the uvula were also popular. The variety of these operations, for which special dental instruments were used, demonstrates the high level of surgical knowledge among physicians in Byzantine times.

Cyclin D1 protein tissue detection in laryngeal cancer.

Cyclin D1 (CCND1) is a set of periodic regulatory proteins that is believed to govern cell cycle transit from G1 into S phase. Overexpression of CCND1 leads to abnormal cellular proliferation which underlies processes of tumorigenesis; CCND1 can thus function as a cooperative oncogene in cell transformation. In the present study we investigate the immunohistochemical expression of CCND1 in a well-documented series of 58 laryngeal squamous cell carcinomas (LSCC) and search for statistical associations between CCND1 index and various clinicopathological parameters including several immunomarkers' expression as well as patients' disease-free survival. Tissue sections from archival paraffin blocks were stained using the avidin-biotin-peroxidase complex method; the H-295 rabbit polyclonal antibody was applied at dilution of 1:150. The percentage of CCND1 immunoreactive tumor cells for each tumor was counted by an image analysis system. CCND1 staining was confined to cell nuclei and, in the examined samples, ranged from undetectable (i.e. 0% of tumor cells, n = 6) to the majority of tumor cells (i.e. 89% of tumor cells) with mean value: 15.73%. In tumor adjacent, non invasive lesions, strong CCND1 staining was noticed in areas with cellular atypia. In cases with nodal metastases, no change in CCND1 expression in the nodal metastases compared with the primary tumors was observed. p53 protein accumulation in malignant cells was positively linked with CCND1 index (Mann-Whitney U: 205.5, p = 0.034). CCND1 expression appears to be an early event in processes of tumorigenesis and tumor progression in some LSCC. Apart from p53 protein accumulation, CCND1 immunohistochemical expression does not seem to correlate with nodal metastasis, disease recurrence or any other clinicopathological prognostic indicator.

Chondrotympanoplasty: a modified technique of cartilage graft tympanoplasty.

BACKGROUND: Although the temporalis fascia has been widely used since 1957as a graft in tympanoplasty, it can eventually become thin and atrophic. In addition, due to the lack of elasticity and resistance to pressure changes in the external ear canal, secondary perforations may also develop. Therefore, several authors have suggested that temporalis fascia should be strengthened by periosteum or replaced by cartilage. MATERIAL/METHODS: In the present paper the term chondrotympanoplasty is introduced to describe modified techniques of cartilage graft tympanoplasty and intratympanal chondroplasties. These techniques were used in 76 patients who were prospectively followed up for two years post-operatively. RESULTS: In type I chondrotympanoplasty, the mean pre-operative air-bone gap was reduced from 20 dB to 8 dB at 2000 Hz. In 93% of these cases the cartilage graft was taken without problems and there was no perforation in the new eardrum. In two cases of type I chondrotympanoplasty who experienced acute post-operative otitis media, the cartilage graft was found to be relatively resistant to infection, as only a pinhole perforation was noted. Type III chondrotympanoplasty with endotympanic chondroplasty (intratympanal tubal chondroplasty and intratympanal stapes chondroplasty) was found to give good aeration in the cavity, an intact new eardrum, and remarkable hearing results, reducing the mean pre-operative air-bone gap from 25 dB to 10 dB at 2000 Hz. CONCLUSIONS: Cartilage was found to be an excellent graft material and the described chondrotympanoplasties gave very promising results. Cartilage should be used more widely in tympanoplasty (chondrotympanoplasty).