Synthesis of microspheres of triuranium octaoxide by simultaneous water and nitrate extraction from ascorbate-uranyl sols.

A new method for synthesis of uranium oxide microspheres (diameter <100 µm) has been developed. It is a variant of our patented Complex Sol-Gel Process, which has been used to synthesize high-quality powders of a wide variety of complex oxides. Starting uranyl-nitrate-ascorbate sols were prepared by addition of ascorbic acid to uranyl nitrate hexahydrate solution and alkalizing by aqueous ammonium hydroxide and then emulsified in 2-ethylhexanol-1 containing 1v/o SPAN-80. Drops of emulsion were firstly gelled by extraction of water by the solvent. Destruction of the microspheres during thermal treatment, owing to highly reactive components in the gels, requires modification of the gelation step by Double Extraction Process-simultaneously extraction of water and nitrates using Primene JMT, which completely eliminates these problem. Final step was calcination in air of obtained microspheres of gels to triuranium octaoxide.

Ocular vestibular evoked myogenic potentials to air conduction (AC oVEMP): useful in clinical practice?

Cervical vestibular-evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) stimuli can be used to measure otolith function using air (AC) and bone conducted (BC) stimuli. Cervical VEMPs reflect saccular function and can be recorded using air conduction (AC), whereas oVEMPs reflect probably predominantly utricular function. Air- and bone-conducted vibration can be used, because AC oVEMP methodology seems to be fast and simple in clinical practice to measure otolith function. In this study we discuss the advantages and problems of AC oVEMP stimulation. AC oVEMP can be easily and quickly obtained within a few seconds. N10 (first negative peak) and p15 (first positive peak) latencies may be used as parameters for clinical interpretation but amplitude fluctuations are relatively large. For daily clinical use of VEMP visualization in a normogram seems feasible. Especially the AC oVEMP methodology (100 dB nHL, tone burst 500 Hz) is fast and efficient in clinical practice to measure otolith function, predominantly utricular function.

Endoscopic repair of CSF leaks in the postero-superior wall of the frontal sinus - report of 2 cases.

BACKGROUND: Bony defects extending laterally or superiorly within the posterior wall of the frontal sinus are generally deemed too difficult for endoscopic repair in spite of significant progress in surgical endoscopic techniques. PATIENTS AND METHODS: We describe a technique of endoscopic repair of posttraumatic cerebrospinal fluid (CSF) leak from the postero-superior aspect of the frontal sinus in a 40- and a 29-year-old male. In both cases after careful assessment of the surgical anatomy the sinus was widely opened transnasally (Draf IIB and Draf III approach, respectively). Angled (45 and 70°) optics and malleable, individually profiled instruments were used to fit specific anatomic variations encountered during the procedure. RESULTS: Endoscopic manipulation near the dome of the sinus proved to be very limited in spite of a wide surgical opening. In our cases the site of the leak could be identified and successfully sealed with gentle pressure on the dura mater. The bony defects were repaired with a 2-layer reconstruction technique. There were no signs of recurrence during 6 months follow-up. CONCLUSION: With contemporary endoscopic instrumentation, endoscopic closure of CSF leaks in the supero-posterior wall of the frontal sinus is feasible, especially in patients with favourable anatomy of the frontal sinus.

Falls and dizziness in the elderly.

The complaint of dizziness is one of the most common reasons that older adults feel constrained to visit the doctor's office. Because of a growing number of older people in the industrial society the problem grows. Therapeutic process of elderly people with vertigo and dizziness needs more than vestibular diagnostics. In addition to sufficient anamnesis, presence of visual deficits, extrasensory changes and even psychological circumstances are necessary. Frequently the indication and the encouragement of vestibular rehabilitation have significant value. The initiation of fall prevention may also be essential.

Evaluation of tumor microsatellite instability in laryngeal cancer using five quasimonomorphic mononucleotide repeats and pentaplex PCR.

PURPOSE: To determine microsatellite instability (MSI) in squamous cell carcinoma of the larynx. MATERIAL AND METHODS: The study was performed in a group of 30 male patients, aged 42-47 years. All patients underwent total laryngectomy with lymph nodectomy. Histologically all tumors were squamous cell carcinomas. Detection of MSI was based on comparison of allelic profiles generated from amplification of matching normal and tumor DNA. RESULTS: The appearance of novel alleles in the tumor DNA indicated microsatellite instability. MSI analysis showed a microsatellite stable phenotype in 23 cases (77%). CONCLUSIONS: MSI may not contribute to the development of squamous cell carcinoma of the larynx.

Endoscopic trans-nasal approach for biopsy of orbital tumours using image-guided neuro-navigation system.

BACKGROUND: Histopathological diagnosis of intraorbital tumours is of crucial value for planning further therapy. The aim of the study was to explore clinical utility of image-guided endoscopy for biopsy of orbital tumours. METHOD: Trans-nasal endoscopic biopsy of intraorbital mass lesions was performed in 6 patients using a neuro-navigation system (Medtronic Stealth Station Treon plus). The CT and MRI 1 mm slice images were fused by the system in order to visualise both bony and soft tissue structures. The anatomic fiducial registration protocol was used during the procedure. RESULTS: All lesions were precisely localised and the biopsies could be taken from the representative part of the pathological mass. None of the patients developed aggravation of ocular symptoms after the procedure. The operative corridor as well as the size of orbital wall fenestration could be limited to a minimum. The accuracy of neuro-navigation remained high and stable during the entire procedure. CONCLUSIONS: The image-guided neuro-navigation system facilitated endoscopic localisation and biopsy of intraorbital tumours and contributed to the reduction of surgical trauma during the procedure. The technique was particularly useful in small, medially located, retrobulbar tumours and in unclear situations when the structure of the lesion resembled surrounding intraorbital tissue.

Human red blood cells' physiological water exchange with the plasma.

In the present paper, fundamental issues related to the mechanisms of human red blood cells' physiological water exchange with the plasma (for the stationary conditions) have been discussed. It has been demonstrated, on the basis of mechanistic transport equations for membrane transport that red blood cells are capable of exchanging considerable amounts of water with the plasma. Water absorption is osmosis-driven, and its removal occurs according to the hydromechanics principle, i.e. is driven by the turgor pressure of red blood cells. This newly-acquired knowledge of these issues may appear highly useful for clinical diagnosis of blood diseases and blood circulation failures.

Loss of heterozygosity in laryngeal cancer.

PURPOSE: Head and neck cancers account for about 6% of all human cancers. Molecular changes leading to the disease development and progression still remain not fully explained. Examination of loss of heterozygosity (allelic loss, LOH) using the specific microsatellite markers is a method of choice in assessing tumour suppressor genes (TSGs) localisation in human genome. MATERIAL AND METHODS: The study was performed in a group of 46 male patients, aged 42-77 years. Forty three patients underwent total laryngectomy with lymph nodectomy, two patients--chordectomy and one patient--partial laryngectomy. Tumour tissue specimens and reference peripheral blood samples were obtained during surgical resections. Standard methods were used for DNA isolation. Fluorescent multiplex PCR was used to amplify microsatellite loci included in commercially available human identification kits. RESULTS: LOH was found at the following loci: BAT26, D3S1358, FGA, CSF1PO, D5S818, D8S1179, VWA, D13S317, D18S51. The highest LOH frequency was found in the tumor samples where the neighbouring cervical lymph nodes were affected but the incidence of LOH at BAT26 was statistically insignificant (p = 0.07). CONCLUSIONS: High incidence of LOH is considered an unfavourable prognostic factor accompanying an aggressive nature of the tumour and indicating an involvement of certain genome regions in cancerogenesis. In head and neck cancers LOH was found on the following chromosomes: 3p, 5q, 8p, 9p, 9q, 11q, 17p, 17q, 18p, 18q.

The evaluation of voice in elderly patients.

Results of voice analysis in 96 elderly patients are presented. The objective of the study was to evaluate dysphonia and its morphologic conditions. Videolaryngostroboscopic (VLSS) examination distinguished between oedematic and atrophic form of senile dysphonia. Morphologic evaluation of the vocal fold mucosa with the use of light microscopy (LM) and transmission electron microscopy (TEM) confirmed the clinical diagnosis. Evaluation of aerodynamic factors of the larynx function, particularly MPT and VVI, suggested hyperfunctional and hypofunctional modes of the voice formation in patients with the larynx oedema and in patients with atrophic changes, respectively.

Using a CFD model to understand the fluid dynamics promoting E. coli breakage in a high-pressure homogenizer.

A Computational Fluid Dynamic (CFD) model of flow in a high-pressure homogenizing valve (APV Gaulin model 30CD) was developed with the Fluent software. The 2D model consists of an unstructured hexagonal mesh, dense in the regions of high gradients. The flow (single-phase) was modeled as laminar upstream of and in the channel (gap) and turbulent downstream of the channel exit. Applying a realizable kappa-epsilon turbulence model, the CFD model accurately predicted the effect of gap space on fluid dynamic conditions upstream (inlet pressure and pressure gradient) and downstream (impact pressure) of the channel for a valve with a standard (CD-0) impact distance (0.25 mm) and a 1 cP fluid. This CFD model was then used to estimate the magnitude of the fluid dynamic parameters (except cavitation effects) presumed to be responsible for cell breakage, as a function of gap space, impact distance and fluid viscosity. The CFD models predicted that for a given volumetric flowrate the upstream fluid conditions (inlet pressure gradient, maximum channel strain rate) and the maximum energy dissipation rate in the post-gap jet depend only on the gap space and the fluid viscosity and not on the impact distance. The impact pressure however depends on the gap spacing, the fluid viscosity and especially the impact distance. Experimental results indicate that higher inlet pressures are required to break cells, if the impact distance is increased. By conducting experiments to isolate individual cell breakage mechanisms for a single pass, threshold values were identified for breaking Escherichia coli cells: pressure gradient, 1.2 x 10(12) Pa/m; energy dissipation rate, 1.0 x 10(10) m(3)/s(2); and impact pressure, 160 psig. By isolating the wall impact as the sole mechanism responsible for breaking the E. coli cells between 3000 and 6000 psig inlet pressure, a relationship between E. coli cell breakage rate and maximum wall impact pressure was established (eq 5).

Experiences in the treatment of patients with tinnitus and/or hyperacusis using the habituation method.

The purpose of this study was to summarize the results achieved by patients with tinnitus and/or hyperacusis during the Tinnitus Retraining Therapy. One hundred cases, out of 516 patients registered until January 1999 at the Tinnitus and Hyperacusis Management Clinic, Warsaw, Poland, were examined. The patients have been treated for at least 10 months but not longer than 1 year. A questionnaire specially prepared for this program was used to assess the results. In the group of 100 cases, the results after a minimum of 10 months' therapy are different in each category but they show a significant improvement in about 70% of cases.

Effects of tinnitus retraining therapy (TRT) for patients with tinnitus and subjective hearing loss versus tinnitus only.

The patients with tinnitus and/or hyperacusis undergoing an 18-24 month period of TRT are divided into five categories of treatment. Different types of counselling and sound therapy are used in each category. Selection of patients into a specific category depends on such factors as: hyperacusis, subjective hearing loss and long-lasting effect of noise on tinnitus. The 108 cases were evaluated After 1 year of treatment. The results of therapy of 40 patients with tinnitus and subjective hearing loss (category II) were compared with the results of therapy of patients with tinnitus only (categories 0 and I). A special questionnaire, answered before and during the treatment, was used to assess the results. Our data indicate significant improvement in about 70% of patients with tinnitus only and in about 90% of patients with tinnitus and subjective hearing loss after one year of therapy.

Assessment of the ability of mononuclear blood cells to produce IFN-gamma in patients with laryngeal cancer.

The ability of mononuclear blood cells (PBMC), derived from patients with cancer of the larynx, to produce IFN-gamma in vitro was assessed in this paper. Thirty patients (27 male, 3 female) were qualified to the study. Their mean age was 65 (range: 41 to 78 years), tumour sizes found in the group were from T2 to T4, levels of pathologic malignancy G2 or G3. The percentage rates different blood cells phenotypes (CD3+, CD3+ HLADR+, CD4+, CD8+, CD14+ HLADR+, CD19+, CD56+) were evaluated by means of flow cytometry (Coulter EPICS XL). The control group consisted of 20 healthy blood donors. PBMC were derived by centrifugation of heparinized venous blood on Lymphoprep gradient according to Boyum method. Double cell cultures were performed for 24 hours with antibody anti-CD3 or recombinant interleukins 12 (rhIL-12) or 18 (rhIL-18). The statistic analysis was based on Student t and Mann-Whitney's test with significancy at p<0.05. A significant decrease in the production of IFN-gamma by PBMC in patients with laryngeal cancer after stimulation with antiCD3 (p=0.018), rhIL-12 (p=0.027), rhIL-18 (p=0.016) was found in comparison with the controls. The results suggest a decreased production of IFN-gamma in patients with cancer of the larynx.

Voice creating aspect after horizontal laryngectomy and chordectomy in patients with carcinoma of the larynx.

Voice quality was assessed in 55 patients with the laryngeal carcinoma. A quality of voice was examined in 18 patients before and after chordectomy and in 37 patients before and after supraglottic surgery. Subjective and objective spectrography methods were applied to evaluate dysphony. The larynx was examined by indirect larngoscopy and videolaryngostroboscopy (VLSS). Significant voice pathology was found in patients before surgery when compared with the normal group. A change of voice colour was found, which was manifested in spectrography by decreased in formant levels, especially F3 and F4 in patients after supraglottic surgery. Dysphagia and longer tracheostomy were temporary complications after the surgery and resulted in further phoniatric rehabilitation. Early phoniatric rehabilitation after chordectomy helped to achieve subjective and objective improvement of voice quality in patients after surgery. Good voice quality in patients after chordectomy is due to preserved structure and increased levels F1, F2, F3, and F4 formants in spectrography.

Voice analysis after the partial laryngectomy in patients with the larynx carcinoma.

The paper presents 170 cases of patients with the larynx carcinoma after the partial laryngectomy. According to the procedure which we used, vertical, horizontal and subtotal supraglottis laryngectomies were distinguished. Voice pattern was analysed with the use of subjective and objective spectrography. The lowest degree of dysphonia was found in patients after the horizontal laryngectomy, while the highest degree dysphonia in those after subtotal supraglottis laryngectomy.

Evaluation of the voice function after the supraglottis subtotal laryngectomy.

Voice quality was analysed in 39 patients with the larynx carcinoma after the supraglottis subtotal laryngectomy. Voice pattern was analysed with the use of subjective and objective spectrography before and after the surgery. A deteriorated voice quality was found after the surgery. The spectrographic examination revealed decreased frequency levels of the formants F3 and F4 and the presence of a noise component generated in the glottis area.

[Preliminary assessment of the role of IL-5 in the pathogenesis of nasal polyps]. / Próba oceny roli IL-5 w patogenezie polipów nosa--doniesienie wstepne.

Preliminary results of IL-5 levels in homogenates derived from nasal polyps tissue are presented. The IL-5 concentration was assessed by immunoenzymatic method (ELISA, R&D, Systems Minneapolis). 26 patients at age 21-60 years were examined. IL-5 cevels were higher in polips with allergic and were examined. IL-5 levels were higher in polips with allergic and aspirin idiocracy background compared with inflammatory polips. In addition, IL-5 levels were increased in recurrent polips.

[The importance of brain stem evoked potentials in the diagnosis of neurosurgical patients]. / Znaczenie sluchowych potencjalów wywolanych z pnia mózgu w diagnostyce chorych neurochirurgicznych.

The technique of Brainstem Electric Response Audiometry (BERA) is a non-invasive electrophysiologic method used in comatose patients for localization of areas of neuronal and synaptic dysfunction not evident in clinical evaluation. This test has a diagnostic and prognostic value in detection of abnormalities and evaluation of comatose head-injured patients at a reversible clinical stage. In contrast to most clinical signs, brainstem auditory evoked potentials are independent of levels of consciousness, analgesics, sedatives. This test is aetiologically non-specific and must be carefully integrated into the clinical situation. Generators of brainstem auditory evoked potentials are located in the auditory nerve (waves I and II) and brainstem (waves III-V). Patients in acute posttraumatic coma are assessed by means of Glasgow Coma Score (GCS), which is reliable in forecasting a favourable outcome. Patients with a score 8 points have an unfavourable outcome in 16%. Brainstem auditory evoked potentials are reliable predictors of unfavourable outcome. Subsequent brainstem auditory evoked potential testing provides relevant prognostic information, since improvement of graded brainstem auditory evoked potentials indicates a favourable outcome. Progressive deterioration of brainstem auditory evoked potentials indicates irreversible damage and is associated with unfavourable outcome, whereas singular abnormal evoked potentials may result from reversible neuronal dysfunction. The absence of waves III-V associated with the end EEG activity is the proof of brain death. Serial BERA monitoring has been used to evaluate progressive clinical syndromes, such as "uncal herniation" and evolving brain death. The use of serial BERA recordings appeared to improve the outcome predictions in comparison with single BERA tests. A combination of brainstem auditory evoked potentials, somatosensory and visual evoked potentials (multimodality evoked potentials-MEP) provides more information for management of a patient than a single evoked potential modality. The main goal to use BERA is early detection of secondary deterioration in comatose patients suffering from intracranial lesions. The results of brainstem auditory evoked potentials and clinical examination of patients obtained within the acute phase after head injury may indicate increased intracranial pressure (ICP) and incipient transtentorial herniation but do not always predict outcome (GOS). The outcome can be better evaluated later, 3-6 days after head injury. In summary, BERA is a non-invasive, safe and objective method of evaluating patients after severe head injury and adds valuable information for assessment of their outcome.

[Transient evoked otoacoustic emissions (TEOAE) in tinnitus patients treated with xylocaine]. / Przejsciowo wywolane emisje otoakustyczne (TEOAE) u pacjentów leczonych ksylokaina z powodu szumów usznych.

The group of patients suffering from tinnitus was treated with intravenous Xylocaine. Ten consecutive doses of Xylocaine (2 mg/kg b.m.) were administered during a period of ten days. Changes of amplitudes of TEOAE in relation to tinnitus suppression was assessed. In 91.5% of cases we observed correlation between amplitude changes and complaint abatement. Both amplitude changes and the time of tinnitus suppression increased after ten days of treatment in comparison with single dose of Xylocaine. The differences of amplitude variations between tinnitus and non tinnitus ear group was statistically significant (Wilcoxon test p < 0.05). The treatment with Xylocaine was considered to be the beginning of long-term procedure aimed at causing habituation of tinnitus in patients conscience (TRT).