Posterior cervical arthrodesis for subacute odontoid fracture in a patient with osteopetrosis: case report.

Study Design: A case of subacute odontoid fracture in a patient with osteopetrosis treated with posterior cervical arthrodesis using transarticular screws and interspinous wiring.

Objectives: To report the first successful cervical arthrodesis in a patient with osteopetrosis and to highlight the potential perioperative pitfalls in this rare surgical population.

Summary Of Background Data: Osteopetrosis is a group of skeletal dysplasias characterized by osteoclast dysfunction, impaired bone resorption, and poor bone remodeling.

Competitiveness among Japanese, Chinese, and American undergraduate students.

Although research indicates that competitiveness, defined as the desire to win in interpersonal situations, is an important individual difference that influences a range of social interactions, little research has focused on competitiveness in cultures outside the United States. This study investigated competitiveness in three cultures by comparing Chinese (n=61), Japanese (n=232), and American (n=161) undergraduate college students. Nationality and sex were compared on two scales of the revised Competitiveness Index.

Delayed sodium thiosulfate as an otoprotectant against carboplatin-induced hearing loss in patients with malignant brain tumors.

Carboplatin is effective in the treatment of malignant brain tumors. However, when administered in conjunction with osmotic opening of the blood-brain barrier (BBB), carboplatin is ototoxic. The purpose of this study was to determine whether delayed administration of sodium thiosulfate (STS), given after BBB closure, provided protection against carboplatin ototoxicity.

Delayed administration of sodium thiosulfate in animal models reduces platinum ototoxicity without reduction of antitumor activity.

Platinum-based chemotherapeutic agents, such as carboplatin and cisplatin, are effective against many human tumors, but their use may be limited by a high incidence of ototoxicity. Delayed administration of the chemoprotective agent sodium thiosulfate (STS) reduces the ototoxicity of carboplatin in a guinea-pig model, when given up to 8 h after the chemotherapy, and also reduces hearing loss in patients given carboplatin with osmotic blood-brain barrier opening for treatment of brain tumors. We tested whether STS, given at times that achieved otoprotection, could impact the chemotherapeutic efficacy of carboplatin.

Cruciate injury patterns in knee hyperextension: a cadaveric model.

We created an experimental model to evaluate the effects of strain rate on the mechanism of combined cruciate ligament injuries in knee hyperextension. Using straight knee hyperextension to rupture the anterior and posterior cruciates, two strain rates (approximately 100% per second and 5400% per second) were applied to reproduce two clinical injury patterns of the knee: low energy (sporting) and high energy (pedestrian-motor vehicle accident). Ten pairs of fresh-frozen cadaveric knees were injured to 45 degrees of hyperextension.

First evidence of otoprotection against carboplatin-induced hearing loss with a two-compartment system in patients with central nervous system malignancy using sodium thiosulfate.

Sodium thiosulfate (STS) provides protection against carboplatin-induced ototoxicity in an animal model. The purpose of this study was to determine the STS dose required for otoprotection, in patients with malignant brain tumors treated with carboplatin in conjunction with osmotic blood-brain barrier disruption. Twenty-nine patients received STS intravenously 2 hr after carboplatin.

Ototoxicity resulting from combined administration of cisplatin and gentamicin.

The hypothesis that cisplatin can augment the ototoxicity of gentamicin was tested. Seven groups of 11 guinea pigs each were given a single dose of cisplatin either alone or 14 days before, at the beginning, midway through, or at the end of a course of gentamicin administered daily for 14 days. Blood and perilymph gentamicin and cisplatin concentrations were determined in three of the animals from each group.

In vitro and animal studies of sodium thiosulfate as a potential chemoprotectant against carboplatin-induced ototoxicity.

When carboplatin (cis-diammine-1,1-cyclobutane-dicarboxylato-platinum) delivery to brain tumors is optimized with osmotic blood-brain barrier disruption (BBBD), high frequency hearing loss can result. Treatment with sodium thiosulfate (STS) blocked carboplatin cytotoxicity against the LX-1 human small cell lung carcinoma cell line in vitro. STS decreased carboplatin-induced ototoxicity in a guinea pig model, as determined by electrophysiological measurements and analysis of inner ear outer hair cell numbers.

Safety of silver oxide-impregnated silastic tympanostomy tubes.

Otorrhea occurs after the insertion of tympanostomy tubes in as many as 50% of ears. Although topical antibiotic solutions minimize otorrhea in the immediate postoperative period, recurrent otorrhea is sometimes a clinical problem. The antimicrobial effects of silver oxide when impregnated into a tympanostomy tube may decrease the incidence of recurrent otorrhea.

Toxicity and efficacy of carboplatin and etoposide in conjunction with disruption of the blood-brain tumor barrier in the treatment of intracranial neoplasms.

CARBOPLATIN AND ETOPOSIDE have been investigated in preclinical studies and a limited toxicity study in 13 patients; these studies have established carboplatin and etoposide as a tolerable combination when administered with blood-brain barrier disruption. The studies also found a predictable dose-limiting toxicity of myelosuppression. Subsequently, a broad efficacy trial of this regimen was carried out.

Effect of otologic drill noise on ABR thresholds in a guinea pig model.

The noise generated by the otologic drill has been implicated as a cause of sensorineural hearing loss after ear surgery. However, clinical studies on this subject are contradictory and difficult to interpret. Therefore a guinea pig model was used to study whether the level of noise generated by the otologic drill can cause threshold shifts in the auditory brainstem response (ABR).

Ototoxicity of vancomycin and analogues.

This article details clinical reports and animal studies of ototoxicity associated with vancomycin and its analogues. From these studies, the ototoxicity of these agents is still not clear. In the author's opinion, vancomycin must affect the auditory system in a manner that results in augmentation of the usual ototoxicity of aminoglycoside antibiotics.

Ototoxic liability of erythromycin and analogues.

This article details clinical reports and studies of ototoxicity associated with the administration of erythromycin and its analogues. Suspected mechanisms of ototoxicity also are discussed. Ototoxicity due to erythromycin appears to be clearly dose related.

Use of alprazolam for relief of tinnitus. A double-blind study.

Objective: To systematically test the effectiveness of alprazolam as a pharmacological agent for patients with tinnitus.

Design: Prospective, placebo-controlled, double-blind study.

Patients: Forty adult patients with constant tinnitus who had experienced their tinnitus for a minimum of 1 year and who resided in the Portland, Ore, metropolitan area.

Quantitative relationships of the interaction between sound and kanamycin.

It is well known that the ototoxicity resulting from the use of aminoglycoside antibiotics in experimental animals can be augmented by intense sound. However, the dose-effect relationship of this interaction is not known. This study was designed to determine the shape of this dose-effect relationship in guinea pigs at sound intensities approaching those that would be experienced by patients receiving aminoglycoside antibiotics.

Steroids and rhinoplasty. A double-blind study.

Many facial plastic surgeons use perioperative steroids to reduce postoperative edema and morbidity. This use of steroids is based more on theory and anecdotal experience than on controlled studies. We studied 49 patients undergoing rhinoplasty in a randomized, double-blind fashion to evaluate the effects of perioperative and postoperative steroid use.

The effect of tobramycin on the renal handling of vancomycin.

Studies in experimental animals and humans have suggested that enhanced renal and auditory toxicity occur with concurrent vancomycin and aminoglycoside treatment. In volunteers, systemic vancomycin clearance at steady-state was measured simultaneously with renal clearances of vancomycin, creatinine, inulin, and para-aminohippurate. Group 1 (n = 9) received vancomycin 5 mg/kg IV for 1 hour, then 1.

Incendiary potential of the flash-lamp pumped 585-nm tunable dye laser.

The recently introduced pulsed flash-lamp pumped tunable dye laser is used to treat cutaneous port-wine stains. In our practice, infants and children receive general anesthesia for these brief, yet painful, treatments. Because the flammability of this laser has not been reported and because we administer supplemental oxygen and nitrous oxide, we analyzed the incendiary potential of this laser by measuring the flammability of gauze and Telfa strips, hair, clear plastic face masks and tracheal tubes, and green nasal cannulae in 21%-100% oxygen and in nitrous oxide at laser energies between 6.

The incidence of aminoglycoside antibiotic-induced hearing loss.

The definition of ototoxicity in most clinical studies of aminoglycoside antibiotics is an increase in pure-tone threshold from a baseline audiogram greater than or equal to 15 dB at two or more frequencies, or greater than or equal to 20 dB at one or more frequencies. In this study, test-retest auditory threshold differences of this magnitude were found in a group of 20 normal volunteers who were not taking any known ototoxic drugs. Depending on which of the two criteria for ototoxicity are used, these data represent a 20% or 33% incidence of ototoxicity.

Augmented gentamicin ototoxicity induced by vancomycin in guinea pigs.

Vancomycin has been reported to be an ototoxic drug in the clinical literature. At best, this literature is confusing. There are no reports of ototoxicity of vancomycin in experimental animals, even when it is administered concurrently with ethacrynic acid, a drug known to augment the ototoxic effect of most other ototoxic drugs.

Potential hearing loss resulting from MR imaging.

To determine if the loud noise generated by magnetic resonance (MR) imaging equipment is capable of inducing hearing loss, the hearing of 24 patients was tested before and after MR imaging. Fourteen patients were imaged without ear protection, and six (43%) suffered a temporary, mild loss of hearing (less than or equal to 15 dB at at least one frequency). Ten patients were imaged with ear protection, and only one experienced any hearing loss.

The influence of tobramycin dosage regimens on nephrotoxicity, ototoxicity, and antibacterial efficacy in a rat model of subcutaneous abscess.

The influence of dosage regimen on the nephrotoxicity, ototoxicity, and antibacterial efficacy of tobramycin was assessed in Fisher rats with Pseudomonas aeruginosa subcutaneous abscesses. A subcutaneous tobramycin dose of 10 mg/kg every 4 h resulted in peak and trough serum concentrations that approximated those currently recommended for patients. Subsequently, the influence of this subcutaneous dosage regimen was compared with three other regimens that administered the same total daily dose: 20 mg every 8 h, 30 mg every 12 h, and 60 mg every 24 h.