血小板CD62p在突发性聋治疗中的意义

目的 根据血小板细胞黏附分子CD62p的变化，为突发性聋患者的治疗提供有用的指标。方法 156例突发性聋患者血小板CD62p采用流式细胞仪测定，将血小板CD62p≥2％患者分别施以基础治疗（低分子右旋糖甙＋ATP＋CoA＋地塞米松）和基础治疗＋溶栓（巴曲酶），观察2种方案的疗效，同样血小板CD62p＜2％患者亦施以两种治疗方案观察其疗效。结果 在血小板CD62p≥2％组中，基础治疗有效率为60．5％，基础治疗＋溶栓治疗的有效率为84．6％，两者之间差异有显著性。而在血小板CD62p＜2％组中，基础治疗和基础治疗＋溶栓的有效率分别为65．0％、71．8％。差异无显著性。结论 检测突发性聋患者CD62p在临床上确定治疗方案的选择有指导意义。     

巴曲酶与低分子右旋糖酐治疗突发性聋的效果观察

目的 观察巴曲酶注射液与低分子右旋糖酐治疗突发性聋临床疗效.方法 将80例突发性聋患者随机分为两组,治疗组用巴曲酶注射液、对照组用低分子右旋糖酐进行治疗,其他治疗两组相同,观察两组患者听力的改善情况.结果 治疗组听力改善的总有效率76.9%高于对照组(62.5%,P<0.01).结论 巴曲酶注射液治疗突发性聋听力改善疗效较低分子右旋糖酐疗效好.     

鼠神经生长因子治疗全聋型突发性聋的疗效分析

目的观察鼠神经生长因子治疗全聋型突发性聋的临床疗效。方法回以2013年12月至2015年12月期间我科住院治疗的全聋型突发性聋患者为治疗组,应用鼠神经生长因子+巴曲酶+银杏达莫+甲泼尼龙+高压氧方案治疗;以2011年6月至2013年6月收治的全聋型突发性聋45例作为对照组,治疗方案中除无鼠神经生长因子外,余均和治疗组相同;疗程均为2周。采用回顾性研究方法比较分析两组治疗前后的平均听阈差及耳鸣症状分级差以评价疗效。结果治疗组患者听力改善总有效率为81.1%,照组为66.7%,组间差异无统计学意义(χ2=2.068,P=0.102);治疗组耳鸣改善率为86.0%,对照组为75.6%,差异无统计学意义(χ2=1.601,P=0.206)。结论鼠神经生长因子并不能提高全聋型突发性聋的整体效果。     

溶栓治疗突发性聋疗效分析

目的探讨溶栓治疗突发性聋的疗效。方法 128例突发性聋患者随机分为治疗组和对照组,每组64例,两组均给予改善内耳微循环、营养神经、糖皮质激素等常规治疗,治疗组在此基础上加用巴曲酶注射液溶栓治疗,首次给予生理盐水250ml+巴曲酶10BU静脉点滴1小时以上,隔日用巴曲酶5BU,3次为一疗程,共应用2个疗程,2个疗程间隔4天。比较两组疗效。结果治疗组的总有效率为82.81%(53/64),对照组的总有效率为62.50%(40/64),两组比较差异有统计学意义(χ2=8.286,P<0.05)。结论在扩管、营养神经、激素等常规治疗的基础上加用巴曲酶溶栓治疗突发性聋能明显提高疗效。     

溶栓法治疗突发性聋疗效评价

目的探讨溶栓法治疗突发性聋的疗效。方法对1993~2003年间住院治疗的187例(198耳)突发性聋患者的临床资料,根据是否应用溶栓剂治疗分组进行回顾分析。结果①溶栓组总有效率与常规组比较无显著性差异(P>0.05);②病程>3~<15d溶栓组总有效率(56.2%)显著低于常规组(78.4%)(P<0.05);③病程>1~3d溶栓组总有效率(55.9%)显著低于常规组(81.8%)(P<0.05);④病程≤1d溶栓组总有效率(83.3%)高于常规组(66.7%),但无显著性差异(P>0.05)。结论溶栓法治疗突发性聋应慎重,不能作为常规治疗,若有应用指征应在发病1d内进行。     

突发性聋合并眩晕的临床观察

目的：探讨突发性聋合并眩晕的治疗方案。方法：对确诊的26例伴有眩晕突发性聋患者,应用扩血管、溶栓、神经营养药物、中医中药及高压氧治疗,并对治疗前后纯音测听结果进行比较。结果：26例病人眩晕症状全部消失,根据突发性聋疗效分级标准,痊愈6例（23．1％）,显效12例（46．2％）,有效4例（15．4％）,总有效率84．6％。结论：突发性聋合并眩晕患者,其病因可能以内耳微循环障碍为主,采用以扩管、扩容、溶栓及中医中药、高压氧等为主的综合治疗措施,是目前较为可靠治疗方法。     

启聋汤治疗突发性聋疗效观察

目的观察西药配合启聋汤治疗突发性聋的临床疗效。方法将60例(65耳)确诊的突发性聋患者随机分为对照组(30例,31耳)和治疗组(30例,34耳),对照组采用低分子右旋糖酐、三磷酸腺苷、辅酶A及地塞米松治疗,治疗组在使用相同西药治疗基础上加用启聋汤,比较两组的临床疗效。结果治疗组痊愈5耳,显效8耳,有效13耳,无效8耳,有效率76.47%;对照组痊愈2耳,显效6耳,有效11耳,无效12耳,有效率61.29%,两组疗效经卡方检验差异有统计学意义(χ2=4.866,P<0.05)。结论西药配合启聋汤治疗突聋的临床效果优于单纯西药治疗。     

血浆纤维蛋白原水平对溶栓治疗突发性聋疗效的影响

目的探讨血浆纤维蛋白原水平与突发性聋患者发病之间的关系及溶栓治疗的效果。方法选择56例诊断明确、发病在3 d以内的突发性聋患者,根据血浆纤维蛋白原水平分为2组:血浆蛋白原升高组(纤维蛋白原>3.5 g/L,36耳)和血浆蛋白原正常组(纤维蛋白原≤3.5 g/L,20耳),比较两组应用巴曲酶溶栓治疗后的效果。结果血浆纤维蛋白原水平升高组患者急诊溶栓后有效率为80.56%(29/36),纤维蛋白原水平正常组患者急诊溶栓治疗有效率为25.00%(4/16),纤维蛋白原升高组疗效明显高于纤维蛋白原正常组(P<0.05)。结论伴血浆纤维蛋白原水平升高的突发性聋患者在发病3天内可采用降纤溶栓治疗,且效果较好。     

鼓室内联合全身应用糖皮质激素治疗全聋型突发性聋

目的探讨早期鼓室内联合全身应用糖皮质激素治疗全聋型突发性聋的疗效情况。方法选取我院自2011年3月至2015年3月间收治的130例全聋型突发性聋患者,按照治疗方案分不同为治疗组与对照组,对照组给予糖皮质激素全身给药、营养神经及改善微循环类药物治疗,而治疗组在对照组用药基础之上加用糖皮质激素鼓室内注射治疗,观察和分析各组疗效情况。结果糖皮质激素联合治疗组听力改善的总有效率达到88.7%,而糖皮质激素全身治疗组听力改善的总有效率为70.6%,治疗组与对照组差异比较有统计学意义(P<0.05)。糖皮质激素联合治疗组耳鸣改善的总有效率达到82.5%,而糖皮质激素全身治疗组耳鸣改善的总有效率为77.2%,但是两组之间的差异没有统计学意义(P>0.05)。两组患者眩晕改善的总有效率均为100%。结论鼓室内联合全身应用糖皮质激素治疗全聋型突发性聋能够取得较好的疗效。     

糖皮质激素口服联合鼓室内注射治疗重度和极重度突发性聋

目的　观察糖皮质激素全身应用和鼓室内注射联合治疗重度和极重度突发性聋的临床疗效,以探索糖皮质激素治疗突发性聋的方法。方法　对54例重度和极重度突发性聋患者的临床资料进行回顾性分析,所有患者均给予口服激素、改善微循环、溶栓抗凝等治疗,同意加用鼓室内注射激素的患者为治疗组,其余患者为对照组,治疗2周后复查纯音测听。结果　治疗组和对照组患者平均听阈改善均具有显著统计学意义,但两组之间疗效无差异（P =0.194）。治疗组与对照组中重度突发性聋患者间疗效无差异（P =0.251）,两组中极重度突发性聋患者间疗效也无差异（P =0.380）。结论　糖皮质激素全身应用联合鼓室内注射治疗重度和极重度突发性聋有效,但并不能得到较单独全身用药更好的疗效。     

One‐stop neck lump clinic: phase 2 of audit. How are we doing?

One‐stop neck lump clinic: phase 2 of audit. How are we doing? Regular monitoring and audit of a service are integral to ensuring maintenance of efficiency and standards. This is particularly important where the quality of the service is operator dependent, as is the case in the clinical diagnosis of neck lumps and fine needle aspiration cytology. The one‐stop neck lump clinic has now been running in the department for more than 20 months. A previous article described the results of the first phase audit carried out at 6 months and had identified a waiting time to be seen that was longer than that recommended by the British Association of Otorhinolaryngologists, Head and Neck Surgeons. Measures were implemented to reduce this waiting time and a second audit was carried out after another 10 months with the aims of assessing if modification of the means of referral reduces waiting time and if the outcomes of clinical performance in phase 1 could be maintained or improved. We discuss the results of phase 2 in the audit spiral.     

A Decrease in Maxillary Sinus Pressure,as Seen in Upper Airway Allergy or Infection,Results in an Increase in Upper Airway Nitric Oxide Levels

The paranasal sinuses are connected to the nasal cavity via small osties. Ostial occlusion, caused by mucosal swelling, will result in a slowly increasing negative pressure inside the sinus cavity. In parallel, the oxygen content in the sinus will decrease, resulting in the development of relative hypoxia. Hypoxia is a powerful inducer of nitric oxide (NO) synthase, and inducible NO synthase has been shown to be present in considerable amounts in the upper airways, including the sinuses. The present study was designed to investigate whether a reduction in sinus pressure would affect upper airway NO production. Thirteen healthy volunteers were investigated. A pressure chamber was used to lower the ambient pressure to-4.9 kPa. NO was sampled from one nostril or via a drainage tube inserted into the maxillary sinus before, during and after the hypobaric exposure. When the pressure was decreased, NO levels increased from 256 &#45 15 to 316 &#45 19 ppb ( n =13, p <0.001). The NO levels remained elevated (282 &#45 21 ppb; p <0.05) when measurements were repeated 20 min after leaving the chamber. The nasal airway resistance (V2 tot ) also increased as a result of the chamber session (from 16 &#45 2° before to 21 &#45 3° after; p <0.05). An increase in NO levels was also found when the experiments were repeated with NO sampled directly from the maxillary sinus (225 &#45 6 before and 265 &#45 9 ppb after; n =6, p <0.001). For control purposes the nasal analyses were repeated again, this time under hyperbaric conditions (+4.9 kPa). This resulted in a slight decrease in the NO levels (from 273 &#45 22 to 241 &#45 17 ppb; n =10, p <0.001), but there was no change in the nasal airway resistance. We conclude that a reduction in sinus pressure, as seen in upper airway allergy or infection, may result in an increase in upper airway NO production.     

Physiologische Grundlagen einer Hörprothese

Zusammenfassung Im Bemühen, eine Hörprothese zu entwickeln, die ein Sprachverständnis erlaubt, erscheint es zumindest fürs erste am zweckmäßigsten, durch künstliche elektrische Reizung des Hörnerven die natürlichen Verhältnissen so gut als möglich zu imitieren. Der normale Hörnerv enthält etwa 30000 Nervenfasern, die sich qualitativ gleich, quantitativ jedoch unterschiedlich verhalten, wobei über die Eigenschaften der von den ÄHZ kommenden Spiralfasern im Augenblick sichere Aussagen nicht möglich sind (siehe 2.3). Die quantitativen Unterschiede zwischen den einzelnen Hörnervenfasern beziehen sich auf deren Frequenzabstimmung, Frequenzselektivität, Schwellen, Intensitätsfunktionen und — wichtig insbesondere für das Vorhaben einer künstlichen elektrischen Reizung — in Zeitunterschieden in den Aktivitätsmustern, die durch Laufzeitunterschiede auf der Basilarmembran bedingt sind (2.3). Diese Zeitunterschiede in der Aktivität einzelner Fasern liegen im Bereich mehrerer ms (2.3.6; 2.3.7). Die durch Schallreize im normalen Hörnerven ausgelösten Aktionspotentiale haben überdies einen probabilistischen Charakter, d. h. ihr Auftreten ist keineswegs streng determiniert. Es versteht sich von selbst, daß man bei künstlicher, elektrischer Reizung nicht alle verbliebenen Nervenfasern selektiv reizen kann. Somit wird eine Reizelektrode immer eine Gruppe von Nervenfasern erregen müssen. Bei jeder denkbaren elektrischen Reizung wären alle Fasern im Reizbereich einer Elektrode synchron und streng deterministisch aktiviert, was einen außerordentlich ernstzunehmenden Unterschied zu natürlichen Verhältnissen darstellt (3.2).Um die Zahl der zum Sprachverständnis mindestens notwendigen Reizkanäle abzuschätzen, wird man, in Ermangelung anderer experimenteller Daten, von psychoakustischen Untersuchungen an Normalhörenden auszugehen haben. Diese haben gezeigt, daß das Gehör neben einer außerordentlichen Fähigkeit verschiedene Tonhöhen zu unterscheiden, andererseits die Fähigkeit besitzt, bestimmte Frequenzgebiete zu sogenannten Frequenzgruppen zu integrieren. Die in eine solche Frequenzgruppe fallende Schallenergie wird zu einem einheitlichen Höreindruck verarbeitet. Es scheint also sinnvoll, die für einen Prothesenbau notwendige Zusammenfassung von Gruppen von Fasern des Hörnerven in verschiedene Reizkanäle entsprechend diesen Frequenzgruppen vorzunehmen (3.1). Demnach müßte der Sprachbereich in 15 Reizkanäle aufgeteilt werden, was wiederum, wenn man in der Cochlea reizen will, 1,2 mm Abstand von Kanal zu Kanal erlauben würde. Dabei müßte der Reizerfolg sauber auf die einzelnen Kanäle beschränkt bleiben, d.h. eine optimale Kanaltrennung erreicht werden. In Anbetracht der groben Abweichungen der neuronalen Aktivität vom normalen Verhalten, die bei künstlicher, elektrischer Reizung unvermeidlich sind, ist freilich unsicher, ob die angegebene Zahl ausreichen würde. Andererseits ist es in Anbetracht der zu erwartenden Stromverteilung im Sprachbereich kaum vorstellbar, mehr als die angegebene Zahl von Kanälen realisieren zu können.Was die Kodierung der Schallparameter innerhalb eines Elektrodenkanals betrifft, wird vorgeschlagen, die Frequenzkodierung nach dem Ortsprinzip optimal auszunutzen, und im Hinblick auf die Periodizitätsanalyse und die Lautheitskodierung sich soweit als möglich den natürlichen Verhältnissen anzunähern (3.3). Dabei wären Laufzeitunterschiede zwischen den Kanälen und der probabilistische Charakter der neuronalen Entladungen soweit als möglich einzuführen, um die Dominanz eines periodicity pitch zu vermeiden.Eine für Sprachverständnis ausreichende Prothese ist auch nur denkbar, wenn eine Prothese die zur Sprachübertragung notwendige Übertragungskapazität besitzt. Ergebnisse der Kanal-Vocoder-Technik zeigen, daß Sprache noch mit 1500 bit/s befriedigend übertragen werden kann. Eine Abschätzung der möglichen Leistungsfähigkeit einer 15-kanaligen Prothese (3.4), basierend auf der Zahl der möglichen unterscheidbaren Unterschiedsstufen der Hörempfindung, ergibt, daß diese Übertragungskapazität knapp erreicht werden könnte. Allerdings ist damit noch nicht gesagt, daß das Zentralnervensystem die angebotene Information auch im Sinne einer Phonemanalyse auswertet und damit für ein Sprachverständnis maximal ausschöpft. Nur für diesen Fall wäre ein Sprachverständnis zu erwarten.Als Reizort erscheint in erster Linie die Cochlea (5.1) geeignet. Für den Fall einer Degeneration der primären afferenten Fasern des Hörnerven ist aufgrund physiologischer Überlegungen auch der Nucleus cochlearis ventralis (5.5) interessant, allerdings würde so nur der ventrale Anteil der Hörbahn stimuliert. Doch besitzen auch andere Reizorte spezifische Vorteile (5.2–5.4).Theoretische Überlegungen (6.1) und experimentelle Messungen an implantierten Elektrodensätzen (6.3) zeigen, daß die Forderung der Kanaltrennung nur schwer zu erreichen sein wird. Deswegen wird der dynamische Bereich (im Hinblick auf Veränderung des Reizstromes) eines nach den obigen Kriterien konstruierten Reizkanals auf maximal 3 dB zu beschränken sein, so daß Erregungsausbreitung auf weitere Bereiche der Cochlea durch Ansteuerung von mehreren Reizkanälen zu imitieren wäre.Die Chancen, eine Prothese zu verwirklichen, die befriedigendes Sprachverständnis auf der Basis einer quasinatürlichen Reizung des Hörnerven erlaubt, wird von uns in Anbetracht der geschilderten mannigfaltigen Schwierigkeiten als sehr niedrig angesehen. In Anbetracht des großen Nutzens, der andererseits eventuell resultieren könnte, halten wir die Erforschung des Problems jedoch für angebracht.Es wird von uns vorgeschlagen, auch zu untersuchen, ob sich für eine prothetische Versorgung vorverarbeitete Sprache besser eignet (7.). Für Prothesen, die ein Sprachverständnis nicht anstreben, halten wir eine Implantation in die Cochlea für überflüssig. Hier erscheint uns die Implantation von Reizelektroden am runden Fenster (Douek et al., 1977; Fourcin et al., 1978; s. a. 1. und 7.) wegen des geringeren Risikos der überlegenere Weg.Die zitierten eigenen Arbeiten der Autoren wurden mit Unterstützung der DFG durchgeführt (DFG-K1 219).     

Limited Surgery for Cancer of the Larynx and Hypopharynx: Options and Consequences

We reviewed surgical options for laryngeal preservation (limited surgery) in laryngeal and hypopharyngeal cancers and the consequences of the options. Of 44 patients with laryngeal cancer, 11 (25%) received limited surgery and 33 (75%) received total laryngectomy. The survival rates were 91% for the limited surgery group and 73% for the total (radical) surgery group. Of 31 patients with hypopharyngeal cancer, 7 (23%) received limited surgery and 24 (77%) received total laryngopharyngectomy. The survival rates were 53% for the limited surgery group and 40% for the total (radical) surgery group. The survival rates associated with limited surgery were thus better than those for total (radical) surgery for cancers of both the larynx and hypopharynx. This was attributed to the limited surgery group comprising well-selected patients with confined lesions. Organ preservation surgery should be technically simple, reliable in terms of its functional impact and, above all, should not jeopardize the patient's survival. Supracricoid subtotal laryngectomy with cricohyoidoepiglottopexy or cricohyoido-pexy has great potential for laryngeal preservation and will become the major limited surgery modality for treating cancer of the larynx. Limited surgery, however, needs to be performed with great care and is indicated only for very well-selected patients with cancer of the hypopharynx.     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.     

Cochlear Function in Ears with Immunomediated Inner Ear Disorder

The aim of the present study was to evaluate the performance of ears with inner ear disorder, responsive to immunosuppressive drugs, in advanced tests designed to assess primary cochlear functions (temporal integration, frequency selectivity, cochlear mechanics). The results of this study suggest that immunomediated inner ear disease results, in the acute clinical stage, in the development of endolymphatic hydrops, which increases the stiffness of the vibrating structures within the inner ear and causes dysfunctions of the outer hair cells. Our patients presented with upsloping or flat sensorineural hearing loss, absence of evoked otoacoustic emissions and distortion-product otoacoustic evoked emissions and abnormal temporal integration, frequency selectivity and cochlear mechanics. Following immunosuppressive treatment, hydrops recovered, hearing subsequently returned to normal, the audiometric curve became flat at low-to-middle frequencies and primary cochlear function tended to normalize. This study seems to support the usefulness of testing primary cochlear functions in order to monitor the clinical course of immunomediated inner ear disorders.     

Bacterial Interference Between Pathogens in Otitis Media and Alpha-Haemolytic Streptococci Analysed in an In Vitro Model

Bacterial interference studied by means of agar methods has shown a decreased number of inhibitory alpha-haemolytic Streptococci among otitis-prone children. Additional information was gained regarding the interplay between alphahaemolytic Streptococci (AHS) and otitis media (OM) pathogens by comparing the bacterial interference in broth with the interference activity studied using agar overlay methods. We found that non-typeable Haemophilus influenzae (NTHI) and Moraxella catarrhalis are readily inhibited by AHS in broth. Streptococcus pneumoniae was more bacteriostatically inhibited. If two OM pathogens were inoculated simultaneously, an isolate of AHS with poor inhibitory activity was not able to inhibit the growth, in contrast to an isolate of AHS with good inhibitory activity. The initial amount of AHS inoculated with M. catarrhalis seemed to play a decisive role with respect to the inhibitory activity. M. catarrhalis developed reduced susceptibility against AHS both in vivo and in vitro . In vivo studies showed that children with secretory otitis media had fewer isolates of AHS in their nasopharynx with the ability to inhibit all the test pathogens than healthy children ( p < 0.001). Although the factor(s) responsible for the inhibitory activity have thus far not been defined, we could exclude low pH and nutrition depletion as the inhibitory mechanism of AHS with good inhibitory activity.     

Compound Action Potential and Cochlear Microphonic Extracted from Electrocochleographic Responses to Condensation or Rarefaction Clicks

In electrocochleography (ECochG) compound action potential (CAP) and summation potential (SP) are usually separated from the cochlear microphonic (CM) by the CM cancellation technique consisting in averaging the responses evoked by rarefaction and condensation clicks. With the aim of analysing the ECochG responses evoked by monophasic clicks, we developed a numerical method based on the theory of optimal filtering, which makes no assumptions about the unknown potentials. The application of the filtering technique to the ECochG recordings obtained from 6 normally hearing children and 10 children with cochlear hearing loss allowed us to perform CAP extraction in cases where CM was not cancelled by the conventional method. Differences in SP amplitude and polarity were found between rarefaction and condensation click-evoked responses in cochlear hearing losses.     

A simple objective evaluation and grading for facial paralysis outcomes

Matrix metalloproteinase (MMP)-2 and -9 degrade type IV collagen, which is one of the major components of the basement membrane in normal tissue and expressed in the surroundings of the cancer nest in squamous cell carinoma. The degeneration of type IV collagen is an essential step in the metastasis to lymph nodes and distant organs. In this study, we examined MMP-2 and -9 levels of cancer tissue and serum obtained from patients with head and neck squamous cell carcinoma (HNSCC) in order to evaluate the relationship between the clinicopathologic features and MMPs. We examined the production of MMP-2 and -9 in cancer tissue homogenates of 73 patients who had HNSCC and the serum MMP levels of 16 patients with HNSCC and 8 healthy volunteers. We also studied the localization of MMP-2 in the carcinoma using an immunohistochemical approach. The concentrations of MMP-2 and -9 in the tissue homogenates and serum were measured by means of a sandwich enzyme immunoassay using a monoclonal antibody. Immunohistochemical analyses were performed with monoclonal antibody to MMP-2. The concentration of MMP-2 in the tumor tissue homogenates was unrelated to tumor size, but that in patients with lymph node metastases was significantly higher than in those without lymph node metastases. The concentration of MMP-9 was unrelated to lymph node metastasis and tumor size. The levels of both MMP-2 and -9 in serum were unrelated to lymph node metastasis. Immunohistochemistry indicated that MMP-2 was mainly expressed in cancer cells. Because MMP-2 degrades type IV collagen, the level of MMP-2 in carcinomas may be a useful indicator of the degree of invasion and metastasis.