Use of the laryngeal mask airway for laser treatment of the subglottis.

A technique for treating subglottic lesions with the intubating laryngeal mask airway is described. It provides unhampered exposure of the subglottis and upper trachea, excellent airway control, and a means of access for ablation with flexible laser bronchoscopy.

Gentamicin disposition in young and elderly patients with various degrees of renal function.

The effect of aging on the total body clearance, volume of distribution, and half-life of gentamicin was examined in 99 febrile patients with various degrees of renal function. In the 50 patients who were 18 to 64 years old, clearance of gentamicin was 79.0 +/- 27.0 mL/min (mean +/- standard deviation), creatinine clearance was 98.6 +/- 33.3 mL/min, volume of distribution was 0.242 +/- 0.077 L/kg, and half-life was 2.63 +/- 0.90 hours. In the 49 patients who were 65 to 90 years old, these values were 36.9 +/- 16.3 mL/min, 51.2 +/- 21.2 mL/min, 0.244 +/- 0.102 L/kg, and 5.80 +/- 4.13 hours. Significant differences were observed between the two groups for all parameters except volume of distribution. Linear regression revealed good correlations between the disposition characteristics (clearance and elimination-rate constant) of gentamicin and age as well as creatinine clearance. However, there was no apparent relationship between the ratio of gentamicin clearance to creatinine clearance and age (r = .0731). These findings suggest that the disposition of gentamicin is independent of age but dependent on renal function.

Growth inhibition of laryngeal UM-SCC cell lines by tamoxifen. Comparison with effects on the MCF-7 breast cancer cell line.

Six laryngeal squamous cell carcinoma (SCC) cell lines and the MCF-7 breast cancer line, all of which contain estrogen and progesterone receptors, were tested for in vitro growth inhibition by the antiestrogen tamoxifen citrate. Cell line MCF-7 was more sensitive to growth retardation at 1 mumol/L of tamoxifen citrate, but SCC lines showed higher sensitivity than MCF-7 to cytotoxic effects at higher drug concentrations (7 to 10 mumol/L). A cytostatic level of growth inhibition was produced by 5 mumol/L tamoxifen citrate for both types of cell lines. When tamoxifen and estradiol were added to cultures simultaneously, partial reversal of growth inhibition was observed with MCF-7 but not with UM-SCC-5. All of the cell lines recovered from inhibition when tamoxifen was replaced with 0.1 mumol/L estradiol, but laryngeal SCC lines recovered equally well in estradiol-free medium, whereas MCF-7 recovered only partially in the absence of estradiol. These findings indicate that there are at least two tamoxifen receptor sites--one for which estradiol is a competitor and one for which it is not--and that tamoxifen reversibly blocks growth and may synchronize SCC cells.