Preoperative CT scanning for endoscopic sinus surgery: a rational approach.

Recent research on inflammatory sinus disease has implicated a central role for the ethmoid labyrinth, which may influence changes in the maxillary and frontal sinuses. CT can provide excellent definition of the paranasal sinuses and particularly the ethmoids, which is a prerequisite for endoscopic surgery. We describe a prospective series of 110 coronal CT scans performed on patients with a clinical diagnosis of sinusitis who had undergone diagnostic nasal endoscopies and medical treatment prior to surgery.

The importance of schedule on diethyldithiocarbamate modulation of drug-induced myelosuppression.

Sodium diethyldithiocarbamate (DDTC) has been investigated as a biochemical modulator of the toxicity associated with clinically used cancer chemotherapeutic agents. In the present study, we assessed the ability of DDTC to accelerate recovery of the granulocyte/macrophage progenitor cel (GM-CFC) population following treatment with the myelosuppressive drugs carboplatin (CBDCA), tetrachloro(d,1-trans)1,2-diaminocyclohexane platinum(IV) (tetraplatin), 5-fluorouracil (5-FU), and etoposide (VP-16) in B6D2F1 mice. Myelotoxicity was assessed 24 h after the injection of the anticancer drug using a GM-CFC clonogenic assay.

Composite tragal perichondrial/cartilage autografts vs cartilage or bone paste grafts in tympanoplasty.

Extrusion of plastic or ceramic implants is a significant cause of failure in ossiculoplasty for chronic ear disease. This paper reports the use of a composite tragal cartilage and perichondrial autograft compared to cartilage or bone paste between the graft and tympanic membrane. At 2 years, there were no extrusions in the group with the composite graft (n = 18) and 5 extrusions in the cartilage/bone paste group (n = 18) (P = 0.

Tumor progression of murine epidermal cells after treatment in vitro with 12-O-tetradecanoylphorbol-13-acetate or retinoic acid.

Tumor-promoting or antipromoting agents potentially may act directly on initiated squamous epithelial cells or indirectly through effects on normal keratinocytes or immune cells. The purpose of this study was to examine direct effects by comparing in vitro and in vivo treatment of initiated cell populations with 12-O-tetradecanoylphorbol-13-acetate (TPA) or retinoic acid. Keratinocytes were initiated by treatment in vitro with 7,12-dimethylbenz[alpha]anthracene.

Mastoid obliteration with the temporoparietal fascia flap.

Obliteration of persistently discharging open mastoid cavities is one surgical option to achieve a dry ear. All the currently described techniques involve the use of random pattern local tissue flaps or free grafts. Ten patients have undergone obliteration procedures using the vascularized temporoparietal fascia flap.

Bone-inducing implants in head and neck surgery: an experimental study.

The use of autologous bone for head and neck reconstruction requires a separate harvesting procedure which provides limited quantities of bone that may become infected or undergo resorption after being implanted. In this study, a collagen/ceramic carrier containing osteoinductive factor extract (OFE) was used in a rabbit facial augmentation model. Bone-inducing activity of these implants were evaluated in subcutaneous, intramuscular, and subperiosteal sites.

Osteoinductive biomaterials for medical implantation.

The search for the ideal implant material continues since presently available implants all have significant drawbacks. This paper reviews three studies that we recently completed with bone-inducing implants. Long-term clinical follow-up of 75 allogeneic demineralized bone implants showed an average degree of resorption of 49%.

Intralesional interferon gamma treatment for keloids and hypertrophic scars.

Keloids and hypertrophic scars are characterized by excessive collagen formation. Interferon gamma is a lymphokine that can down-regulate collagen synthesis in vitro and in vivo and, therefore, has potential therapeutic benefit in the management of abnormal scars. Intralesional scar injections of interferon gamma were performed to determine the tolerance toxicity and to obtain preliminary evidence for the efficacy of this treatment in the management of hypertropic and keloid lesions.

Desferrioxamine ototoxicity: evaluation of risk factors in thalassaemic patients and guidelines for safe dosage.

Forty-seven patients with thalassaemia have been studied to define risk factors for development of sensorineural hearing loss, and to establish guidelines for safe chelation. Sensorineural hearing loss was only present in patients who had previously received desferrioxamine (DFO). The two most significant risk factors were the maximum dose of DFO previously received (P less than 0.

Resection of the extra cranial carotid artery in head and neck cancer.

Carotid artery resection and reconstruction by unreversed autogenous saphenous vein grafting was undertaken in six patients undergoing extensive resection for malignancy over a four-year period. There were two deaths within 30 days of operation: one from secondary hemorrhage and one from bronchopneumonia. One patient died at six months and one at three months from recurrence, one died at 12 months from recurrence and one died free of disease at 10 months from aspiration.

Normalization of LDL receptor function by lymphocytes of patients with heterozygous familial hypercholesterolemia after treatment with plasma cholesterol lowering agents.

Low density lipoprotein (LDL)-dependent growth of mitogen-activated lymphocytes, inhibited in their capacity to synthesize cholesterol endogenously, can be used as an assay of functional receptors for LDL. Using this technique, abnormalities can be detected in circulating lymphocytes obtained from patients with familial hypercholesterolemia (FH). Functional lymphocyte LDL receptor activity was decreased in patients with heterozygous FH.

Parapharyngeal masses. Report de 4 cases.

The reduced incidence of inflammatory pathology in the head and neck over the last 20 years has diminished the clinical importance of the potential fascial spaces in this region. However, the parapharyngeal space, because of its contents, is still important. Lesions in this region have variable presentations and their management often requires a multidisciplinary approach.

Effects of combined therapy with lovastatin and colestipol in heterozygous familial hypercholesterolemia. Effects on kinetics of apolipoprotein B.

This investigation was carried out in 10 male patients with heterozygous familial hypercholesterolemia to determine the effects of combined drug therapy with lovastatin and colestipol on the kinetics of apolipoprotein B (apo B) in low density lipoproteins (LDL) and very low density lipoproteins (VLDL). Drug treatment produced reductions in plasma total cholesterol and LDL cholesterol averaging 41% and 48%, respectively. Levels of LDL apo B declined by only 34%, which resulted in a reduction in LDL cholesterol/apo B ratios.

UCH/RNID single channel cochlear implant: surgical technique.

In a series of thirty patients who received single-channel cochlear implants a simple standard operative procedure has been developed. No life-threatening complication and no wound breakdown occurred. The only problems encountered during surgery were related to the position or obliteration of the round window niche.

Reduced C27-steroid 26-hydroxylase activity in heterozygotes for cerebrotendinous xanthomatosis.

C27-steroid 26-hydroxylase activity in fibroblasts from two heterozygotes for CTX was determined, using an optimized enzyme assay. With 5 beta-cholestane-3 alpha,7 alpha,12 alpha-triol, 5 beta-cholestane-3 alpha,7 alpha-diol, 7 alpha-hydroxy-4-cholestane-3-one or 7 alpha-hydroxycholesterol as substrates, the activities were about 50% of those of control cells. The Km for the substrates was not increased in the CTX heterozygotes.

Combination drug therapy for familial combined hyperlipidemia.

Study Objective: To compare the efficacy of gemfibrozil and colestipol with gemfibrozil and lovastatin in patients with familial combined hyperlipidemia.

Design: A prospective, randomized trial.

Setting: An outpatient clinical research center in a tertiary care center.

Dermal, subcutaneous, and tendon xanthomas: diagnostic markers for specific lipoprotein disorders.

Many patients with lipoprotein disorders are at increased risk for the development of premature atherosclerosis and, less commonly, other disorders that cause systemic morbidity. In some of these patients, xanthomas also develop and provide cutaneous markers for the lipoprotein disorder. As advances in molecular biology refine our understanding of lipoprotein metabolism, it has become increasingly clear that several types of xanthomas are associated with specific disease states.

Uptake of cholesterol-rich remnant lipoproteins by human monocyte-derived macrophages is mediated by low density lipoprotein receptors.

The uptake and degradation of cholesterol-rich remnant lipoproteins, referred to as beta-VLDL, are shown in the present study to be mediated by LDL receptors (apoB,E(LDL) receptors), not by unique beta-VLDL receptors. Human blood monocytes cultured for 5-7 d bound apoB- and/or apoE-containing lipoproteins from different species with affinities equivalent to those demonstrated for the receptors on cultured human fibroblasts. Low density lipoproteins competed effectively and completely with 125I-beta-VLDL for binding to and degradation by monocyte-derived macrophages.

Tracheostomal reconstruction using a fenestrated deltopectoral skin flap.

Tracheostomal stenosis following laryngectomy can prevent satisfactory rehabilitation of a patient, and may be difficult to correct. A reconstructive technique using a flap within a deltopectoral flap to treat this condition is described.

Lovastatin therapy in familial dysbetalipoproteinemia: effects on kinetics of apolipoprotein B.

Familial dysbetalipoproteinemia is characterized by hyperlipidemia, increases in beta-migrating, very low density lipoproteins (beta-VLDL), and homozygosity for apolipoprotein E2 (apo E2). In this study, 3 patients with familial dysbetalipoproteinemia were treated with lovastatin, and kinetics for apolipoprotein B (apo B) were determined in control and drug treatment periods. Multicompartmental analyses of apo B kinetics in VLDL and in low density lipoproteins (LDL) were carried out.

Benign and malignant tumor stages in a mouse keratinocyte line treated with 7,12-dimethylbenz[a]anthracene in vitro.

Stable pre-tumorigenic, benign tumor and squamous cell carcinoma stages have been isolated after treatment of a cloned mouse keratinocyte line with 7,12-dimethylbenz[a]anthracene. Intraperitoneal injection and skin grafting of athymic nude mice were suitable for growth of these well-differentiated tumor cells, whereas subcutaneous injection was not.

The suppression of palatal (or intra-tympanic) myoclonus by tinnitus masking devices. A preliminary report.

Twelve cases of well established palatal myoclonus with objective clicking tinnitus were treated with tinnitus masking techniques. After a few months, three patients became completely symptom free, one for five years now. A further four patients continued to get periods of relief from their clicking sounds with continuous masking, and four patients found the distracting effects of the white noise helped them.