John XXI, the Pope Philosopher and Physician-Scientist of Portuguese Origins Died of Crush Syndrome in 1277.

The aim of this work is to refer on the death due to crush syndrome in 1277 of Pope John XXI, philosopher, logician, anatomist, physician scientist, university professor of medicine at the university of Siena and author of books adopted for nearly 4 centuries in universities in the Middle Ages. The Pope died crushed by the ceiling of his office which had been built in rush to meet his need for a quiet and warm place, his need of light and nature. There he attended to his duties of governing the church, studied fine theological questions, inspected the stars, made experiments and discussed with the renowned ophthalmologists who in those days made Viterbo the center of the study on vision.

[Topical liquid nasal gel, its anatomical distribution and transport].

The objectives of this study are: 1) to assess the anatomical distribution of a topical liquid nasal gel in patients with and without rhinitis using a metered dose nasal pump, and 2) to determine whether the distribution pattern is influenced by dosage and delivery technique. Thirty-nine volunteers were evaluated, 26 without nasal inflammation and 13 with rhinitis. Patients self-administered the nasal spray according to the specifications in one fossa and incorrectly in the other one (sniffing and double doses).

Results of near-total laryngectomy.

The clinical records of 225 patients undergoing primary or salvage near-total laryngectomy (NTL) for laryngeal and pyriform cancer were analyzed for local control and morbidity. If the primary cancer was laryngeal in origin, patients underwent a simple NTL; if it was pyriform, a minor modification called near-total laryngopharyngectomy (NTLP) was used. When NTLP was extended to include necessary portions of the tongue base or posterior pharyngeal wall, pharyngeal reconstructions were added.

A contribution to the history of common salt.

Salt has influenced human nutrition, health, politics, taxation, economy, freight, transport, and commerce throughout the ages. All human activities have been influenced by salt including economy, religious beliefs and practices, art, literature, psychoanalysis, superstitions, and exorcism. Salt is recognized as a symbol for friendship, hospitality, chastity, alliance, table fellowship, fidelity, fertility, blessing, curse and endurance, etc.

Role of the heart surgeon in the emergency treatment of diuretic resistant edema in grades III-IV heart failure.

Acute or chronic valvular diseases, acute myocardial infarction and its complications, dilated cardiomyopathies, all may became the cause of heart failure leading to different degrees of cardiogenic edema. Today cardiac failure is treated from its the early stage by medical and/or surgical therapy. Thereafter, in a small population of patients, heart failure may became unresponsive to any kind of standard medical treatment.

Daily hemofiltration in severe heart failure.

We treated nine patients having severe heart failure (IV NYHA classification) with anuria resistant to diuretics who were on daily hemofiltration, and estimated their survival for a year. The total volume of liquids removed was estimated by means of an echographic determination of the caval collapsability index. Dry weight was obtained from 6 to 22 days.

"Early" cancer of the larynx: the concept as defined by clinicians, pathologists, and biologists.

Since a great deal of confusion surrounds the different uses made by clinicians, pathologists, and biologists of the term, this paper clarifies the concept of "early" cancer of the larynx. Clinically, this is usually a glottic neoplasm in which full cordal mobility is still present; early supraglottic cancer is infrequent, and usually a chance finding. Whatever the site, early laryngeal cancer is a minimally invasive neoplastic lesion that does not invade the muscle or cartilage, but is still capable of metastasis.

Quality of life after surgical treatment of cancer of the larynx.

The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of patients were identified according to surgical treatment: total laryngectomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, familial and spousal relationships, sexuality, and psychologic features such as stress and anxiety.

Are clinical classifications for laryngeal cancer satisfactory?

All clinical classifications for laryngeal cancer are compromises based on clinical and imaging evaluations, with no concern for important elements such as phenotype, host-tumor relationship, and any concomitant nonneoplastic disease. The various staging systems are critically examined along with a report on the outcome of an international survey on the applicability of the TNM system in relation to laryngeal neoplasms, promoted by The Laryngeal Cancer Association.

Primary head and neck cancer. Histopathologic predictors of recurrence after neck dissection in patients with lymph node involvement.

Objective: Retrospectively analyze several histopathologic variables that may predict neck recurrence after neck dissection.

Design: From 1970 through 1980, 284 patients with pathologically confirmed metastatic squamous cell carcinoma underwent neck dissection and received no adjuvant therapy. Kaplan-Meier evaluation estimated a 74% 2-year neck recurrence-free rate.

Recurrences after endoscopic management of early (T1) glottic carcinoma.

From 1976 to 1986, 106 patients with early glottic carcinoma were managed endoscopically at our institution. Twenty-four (23%) patients required retreatment of the larynx for local recurrences or new primary lesions after initial endoscopic management. The probability of remaining free of local recurrence 3 years after primary surgery was estimated to be 0.

Graves ophthalmopathy. Results of transantral orbital decompression performed primarily for cosmetic indications.

Purpose: Transantral orbital decompression is effective treatment for excessive proptosis and optic neuropathy due to Graves ophthalmopathy. In these sight-threatening circumstances, patients willingly accept the side effects of orbital decompression. When transantral orbital decompression is performed for cosmetic indications, patients' acceptance of side effects may be different.

Early glottic carcinoma treated with open laryngeal procedures.

Objective: The purpose of this study was to determine the recurrence rate and long-term survival of patients treated with open cervical procedures.

Design: The study is a retrospective analysis of a cohort of patients who underwent an open laryngeal procedure between 1976 and 1986. The median follow-up was 6.

Carcinoma of the oral cavity in a young woman.

Although tobacco and alcohol abuse are known factors in the genesis of many head and neck cancers, none of the consultants believe that the cause and effect is established in younger patients. No one is willing to make a connection between her carcinoma and her connective tissue disease. With regard to panendoscopy, the consultants would perform a rigid bronchoscopy and an esophagoscopy (Dr.

Results of transantral orbital decompression in 428 patients with severe Graves' ophthalmopathy.

We reviewed records from 428 consecutive patients with severe Graves' ophthalmopathy to determine early and late results after transantral orbital decompression. Optic neuropathy was present in 217 (50.7%) patients.

Base of tongue carcinoma: patterns of failure and predictors of recurrence after surgery alone.

Between January 1971 and December 1986, 55 patients with squamous cell carcinoma of the tongue base underwent complete surgical resection with curative intent. No preoperative or postoperative adjuvant therapy was administered. The study group consisted of 41 men and 14 women (median age 61 years).

Indications and results of cordectomy for early glottic carcinoma.

Select early glottic carcinomas in patients with normal vocal cord mobility can be successfully treated with cordectomy, performed either endoscopically or by means of an open operation (laryngofissure-cordectomy). From 1976 to 1986, 95 patients underwent cordectomy at our institution. There were 88 men and 7 women, with an age range at the time of surgery of 27 to 84 years.

Cervical nodal metastasis of squamous cell carcinoma of unknown origin: indications for withholding radiation therapy.

The records of patients with pathologically confirmed metastatic squamous cell carcinoma involving cervical lymph nodes who were treated at the Mayo Clinic between January 1965 and December 1987 were reviewed. In 117 patients a primary tumor could not be discovered. Of these, 24 patients underwent curative resection of all gross disease by neck dissection or excisional biopsy.

Early supraglottic cancer.

Early supraglottic cancers (T1 and T2) are treated today with several dissimilar programs. Operation or irradiation alone, combined irradiation and operation, and irradiation with operation for salvage are the options. This study analyzed the effectiveness of operation alone in a group of 94 patients with early lesions.

Use of anticytoplasmic autoantibodies in the diagnosis of Wegener's granulomatosis with subglottic stenosis.

Subglottic stenosis is one of the lesser known manifestations of Wegener's granulomatosis and poses great difficulty in confirming the diagnosis. We present the use of the anticytoplasmic autoantibodies (ACPA) blood test, which has been shown to be highly specific for Wegener's granulomatosis, for corroboration of Wegener's granulomatosis in a patient with subglottic stenosis for whom tissue biopsies were nondiagnostic. The ACPA test and the presentation, diagnosis, and management of subglottic stenosis due to Wegener's granulomatosis are discussed.