Brachial Plexus Schwannoma - Case Report and Literature Review.

Schwannoma as an extracranial nerve sheath tumor rarely affects brachial plexus. Due to the fact that brachial plexus schwannomas are a rare entity and due to the brachial plexus anatomic complexity, schwannomas in this region present a challenge for surgeons. We present a case of a 49-year-old female patient with a slow growing painless mass in the right supraclavicular region that was diagnosed as schwannoma and operated at our department.

Fine needle aspiration cytology of metastatic Merkel cell carcinoma.

Merkel cell carcinoma (MCC) is uncommon cutaneous malignant neuroendocrine tumour of the elderly people with rapidly growing skin nodules found frequently on sun-exposed areas of the body. MCC is often an aggressive tumour with high tendency for local recurrence, lymph node involvement and distant metastases. This paper reports a case of metastatic MCC diagnosed by fine needle aspiration cytology (FNAC), flow cytometric deoxiribonucleated acid (DNA) analysis, pathohistology and electron microscopy.

Life threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy in multi-trauma patient with cervical spine injury.

Percutaneous tracheostomy (PCT) is a safe method under proper patient selection, increased technical experience and bronchoscopy- or ultrasound-guided procedure. Trauma patients with cervical spine fractures and spinal cord injury are at a high risk for respiratory failure and require a definitive airway followed by prolonged mechanical ventilation. We would like to present multiple, life- threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy (GWDF) in one trauma patient with a cervical spine injury.

Investigation of auditory brainstem function in elderly diabetic patients with presbycusis.

We performed brainstem auditory evoked potential (BAEP) examinations in 100 patients older than 60 years and having type I diabetes mellitus and presbycusis. The aim of our investigation was to compare the BAEP results of this group with those of healthy controls with presbycusis and to look for possible correlations between alteration of the auditory brainstem function and the aging of elderly diabetic patients. Absolute and interpeak latencies of all waves were prolonged significantly in the study group of diabetic patients.

The optimal pediatric induction dose of propofol in combination with reduced-dose rocuronium and alfentanil for day-case tonsillectomy in children.

Objective: Tonsillectomy in children may be performed on a day-case basis. To achieve quality anesthesia and successful, fast recovery with minimal morbidity without the use of volatile anesthetic, the choice of drug combination has to be centered on one rapid- and short-acting hypnotic, opioid and non-depolarizing muscle relaxant. The aim of our study was to determine the optimal pediatric induction dose of propofol that by means of alfentanil and reduced-dose rocuronium allows the highest percentage of excellent intubating conditions.

[Prevention of thromboembolism and survival after trauma].

Aim: Thromboembolism (TE) is a well-known and potentially fatal complication after injury and orthopedic surgery. Thromboembolic prophylaxis is generally recognized as a factor of significant interest concerning posttraumatic comorbidity and mortality. In this context, the aim of the study was to analyze hospital mortality 24 hours after injury, and to assess the proportion of fatal pulmonary embolism in overall hospital mortality.

"Warning card" as a prevention of prolonged apnea in children.

Human butyrylcholinesterase (EC 3.1.1.

Osteoma of the internal auditory canal.

Osteomas of the internal auditory canal, inaccesible to clinical examination, are rare lesions. There are only 14 cases of osteomas and exostoses of the internal auditory canal reported in the international medical literature. A patient with an osteoma of the internal auditory canal is presented, along with differential diagnosis and possible etiologic factors for the lesion.

Diagnostic accuracy of transesophageal echocardiography for detection of atrial masses.

The aim of this study was to assess the diagnostic accuracy of transthoracic (TTE) and transesophageal echocardiography (TEE) for the detection of atrial masses. The authors' own experiences with the use of TTE and TEE images in the assessment of atrial masses are reported. These masses included tumors, thrombi, and valvular vegetations.

A comparison of surgery and radiotherapy in the management of advanced pyriform fossa carcinoma.

This retrospective study analyses the outcome of treatment of 61 patients with advanced carcinoma of the pyriform fossa. Thirty-two patients (group 1) underwent surgery and postoperative radiotherapy and 29 patients (group 2) had induction chemotherapy followed by radiotherapy. The local recurrence-free survival at 5 years from the completion of therapy for group 1 was 54%, compared to 61% for group 2.

Recruitment in the diagnosis of small PCA tumors.

Acoustic brainstem response (ABR) waveforms were preoperatively analyzed in 86 cases of pontocerebellar angle (PCA) tumors. Absolute (APL) and interpeak latencies (IPL) ipsilateral to the tumor and interaural absolute latency differences of wave V (IAAPLD V) were normal in two patients with small intracanalicular tumors. However, results of latency-intensity studies were abnormal.

Pilocarpine in the prevention of postirradiation xerostomia.

During radiation therapy to the head and neck region, salivary gland hypofunction commonly develops. The aim of our study was to evaluate whether the sialogogue pilocarpine given during radiation therapy may reduce the severity of xerostomia and salivary dysfunction. Our results showed the pilocarpine-treated group to have a lower frequency of oral symptoms during the treatment than the placebo-treated group.

Clinical interpretation of brainstem evoked response audiometry abnormalities in cochlear pathology.

This investigation involved 45 patients with sensorineural hearing loss (SNHL): 24 with Meniere's disease, 18 with acoustic trauma, and 3 with SNHL due to ototoxic drugs. They all underwent pure tone audiometry and standard brainstem evoked response audiometry (BERA). In patients without wave I in auditory brainstem response, electrocochelography (ECochG) was performed.

Bilateral Bell's palsy in a pregnant woman.

Bell's palsy is a peripheral facial palsy of unknown etiology. During pregnancy, there is an increased incidence of idiopathic facial paralysis (Bell's palsy). Nevertheless, bilateral facial paralysis in pregnant woman is a rare phenomenon with only a few case reports in medical literature.

Vertigo as a prognostic factor in sudden hearing loss.

A group of 87 patients suffering from unilateral sudden hearing loss were investigated. They were divided into two groups with and without vertigo, and were evaluated according to the severity of initial hearing loss and shape of tonal audiogram. Twenty-five percent of the patients had accompanying vertigo.

Serum total, LDL, HDL cholesterol and triglycerides related to age, gender and cigarette smoking in patients with first acute myocardial infarction.

The aim of this study was to examine relationships between total cholesterol, LDL, HDL cholesterol, triglycerides and age, gender, and cigarette smoking in 190 patients (132 men and 58 women) aged 34-87 years with first AMI. The control group included 103 patients (57 men and 46 women) aged 29-90 years without a history of angina pectoris or AMI. High total cholesterol (over 5.

Syncope caused by carotid body tumor.

A 71-year-old woman with a syncope and carotid body tumor is described. On palpation of the tumor on the left side of the neck, the patient felt vertiginous and has a syncope, while ECG showed an asystolic pause of 7.6 s.

Prognostic value of Glasgow Coma Scale for tracheotomy in head injured patients.

The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify the head injured patients who will eventually undergo tracheotomy. Authors' present retrospective study reveals that the likelihood of tracheotomy is significantly greater in patients with a GCS rating < 7 than in those with a GCS rating > 7 (p < 0.01).

[Complications after prolonged intubation in patients with head trauma].

In this study, 72 patients with head injury, hospitalized in the Intensive Care Unit (ICU) were analyzed. All of them required prolonged intubation. Every patient was initially intubated.

[Bilateral glomus caroticum tumors].

Paragangliomas of the head and neck are tumors which are believed to function as chemosensory reflex receptors that respond to changes in their chemical environment. They may occur in the carotid body, on the vagus nerve, along the jugular vein, in the middle ear, in the orbit, in the larynx and nasopharynx. The incidence of multiple paragangliomas is about 3% of all the patients with this tumor and 26% of the patients with positive family history.

[Auditory evoked potentials: monaural and binaural stimulation in cochlear hearing loss].

We have evaluated the auditory brain stem responses of 37 patients with bilateral, symmetrical, cochlear hearing loss, by mono and binaural stimulation. These patients were divided into several groups according to the shape of the pure-tone audiometry curve. It was found that binaural stimulation is better with regard to monoaural, since it results in a significant increase of wave amplitudes (45%) what allows the answers at lower levels of stimulation.

Oxalosis associated with aluminum bone disease: a new type of mixed renal osteodystrophy.

An 18-year-old man suffering from uremia was hospitalized because of severe skeletal pain and multiple exostoses. The patient had been treated for 5 years by regular hemodialysis; primary oxalosis was the suspected cause of uremia. Transiliac bone biopsy and subsequent histomorphometric analysis of undecalcified bone specimen as well as specific aluminum staining revealed a picture of oxalosis combined with osteomalacia and a marked accumulation of aluminum at the front of mineralization.

Laryngeal cancer and blood selenium levels.

Blood selenium concentrations in 43 patients with laryngeal cancer and 47 normal subjects were determined by atomic absorption spectrophotometry. No significant differences in selenium values were observed in sera from the cancer patients when compared with controls, but there were significant differences between patients with advanced (T4) supraglottic cancers and the normal controls. These results suggest that lower blood selenium levels in this latter group of laryngeal cancer patients may be a consequence of their disease rather than its cause.

Nasopharyngeal cancer and blood selenium level.

A case-control study of nasopharyngeal carcinoma was performed in Zagreb from 1989 until 1993. Blood selenium concentrations were determined in 34 patients with nasopharyngeal cancer and 47 normal subjects by means of the atomic absorption spectrophotometric method. The sera of nasopharyngeal cancer patients showed no significant differences in selenium values from the sera of normal individuals, but there were significant differences between patients with enlarged cancer (T4 stage) and normal individuals.

[Summating potentials in the differential diagnosis of cochlear pathology].

Three groups of patients with Ménière's disease, sensorineural hearing loss caused by acoustic trauma, and healthy controls were examined by electrocochleography in order to establish the value of absolute summating potential (SP) amplitudes in the differential diagnosis of these entities. A statistically significant increase in absolute SP amplitudes was found in patients with Ménière's disease in comparison to patients with sensorineural hearing loss caused by acoustic trauma (p < 0.01).