Oxidants and antioxidants in tonsillar and adenoidal tissue in chronic adenotonsillitis and adenotonsillar hypertrophy in children

OBJECTIVE: The aim of the study is to determine the possible role of oxidants and antioxidants in the pathogenesis of chronic adenotonsillitis and adenotonsillar hypertrophy in children. PATIENTS AND METHODS: The children were divided into infection and hypertrophy groups, which were comparable according to age and gender distribution. The infection group was consisted of 20 children with the diagnosis of chronic adenotonsillitis and the hypertrophy group was made up of 19 children with adenotonsillar hypertrophy to whom adenotonsillectomy was performed. Preoperative blood levels of erythrocyte MDA, serum MDA, erythrocyte catalase and serum catalase, and adenoidal and tonsillar tissue levels of MDA and catalase were studied. RESULTS: There were significant increase in tonsil MDA, adenoid MDA, tonsil catalase and adenoid catalase levels in infection group (p<0.05). CONCLUSION: Oxidants and antioxidants are found to have an important role in the pathogenesis of adenotonsillar hypertrophy and chronic adenotonsillitis. These findings strengthen the hypothesis that indicates adenotonsillar hypertrophy and chronic adenotonsillitis are different diseases of the same tissues.     

Mismatch negativity in aging and in Alzheimer's and Parkinson's diseases

Mismatch negativity (MMN) is an auditory event-related potential (ERP) that reflects automatic stimulus discrimination in the human auditory system. By varying the interstimulus intervals (ISIs), the MMN can be used as an index of auditory sensory memory. This paper focuses on MMN findings in aging and in Alzheimer's (AD) and Parkinson's diseases (PD). The accumulated data suggest that MMN to duration deviance, unlike MMN to frequency deviance, is reduced in amplitude in aging at short ISIs. The attenuated MMN to frequency deviance observed at long ISIs in elderly subjects seems to be caused by age-related memory trace decay. Existing results suggest that automatic discrimination for the frequency change is not affected in the early phase of AD, whereas the memory trace seems to decay faster in AD patients. The present findings on PD are not as conclusive, although they tentatively suggest deteriorated automatic change detection. The MMN appears to offer an objective tool for studying auditory processing and memory trace decay in different neurological disorders.     

Urokinase-type plasminogen activator expression and proliferation stimulation in head and neck squamous cell carcinoma in vitro and in situ

BACKGROUND: Stimulation of proliferative activity by urokinase-type plasminogen activator (uPA) has been demonstrated in vitro for cultured primary and carcinoma cells. OBJECTIVE: To examine the effect of uPA stimulation on cultured squamous cell carcinoma cell lines of the head and neck in vitro and to compare the results with the situation in tumor tissue specimens. DESIGN: The uPA-mediated growth stimulation of 2 head and neck squamous cell carcinoma cell lines after suppression of endogenous uPA production was monitored by measuring (3)H-thymidine uptake into cellular DNA. Alternatively, applications of antibodies against the uPA-binding domain of the urokinase receptor were used to suppress autostimulation. To analyze the situation in situ we performed Western blot and zymographic studies on tissue homogenates of 25 squamous cell carcinoma specimens. We tested the expression of proliferating cell nuclear antigen (PCNA), a marker for proliferative activity, and uPA in tissue lysates and correlated uPA and PCNA expression by regression analysis. RESULTS: High-molecular-weight urokinase had a proliferation stimulative effect on both cell lines in vitro. The uPA autostimulation was decreased by blocking the uPA-binding domain of urokinase receptor with antibodies. Regression analysis of zymographic and Western blot data of tumor tissue lysates revealed no significant coherency between PCNA and uPA expression. Immunohistochemical stainings frequently showed different sublocalization of uPA and PCNA within tumors. CONCLUSION: In vitro uPA-mediated growth stimulation is not necessarily transferable to the in situ situation.     

ATP induces respiratory ciliostimulation in rat and guinea pig in vitro and in vivo.

Adenosine triphosphate (ATP) has been shown to revitalize the disturbed nasal mucociliary function in man. We investigated the effects of ATP on the ciliary beat frequency (CBF) in animals by immersing tracheal explants from rats in various concentrations of ATP, and by infusing ATP intravenously to guinea pigs. CBF was measured with a photodetector technique from the surface of the explants or from the incised trachea. ATP (from 0.01 to 1 mg/ml) in vitro increased CBF in rat tracheal explants up to 10.5% (p less than 0.05). In vivo ATP (1 mg/kg) increased the CBF by 29% (p less than 0.01) in the guinea pig trachea. As the CBF was increased by ATP, both in vitro and in vivo, it can be suggested that the improvement in mucociliary transport by exogenous ATP as shown in previous studies is caused by the ciliostimulatory effect of ATP.     

Trends and Perspectives in Minimally Invasive Surgery in Otorhinolaryngology-Head and Neck Surgery

The roots of minimally invasive surgery (MIS) in otolaryngology-head and neck surgery (ORL-HNS) can be traced to the 1950s. Today, endonasal sinus surgery and endolaryngeal surgery already fulfill the principles of MIS. To widen its spectrum of indications, however, MIS must be able to offer three advantages that conventional macrosurgery and microsurgery already have: free maneuverability for the instrument, sensory feedback, and three-dimensional imaging. Every anatomical region (e.g., paranasal sinuses, upper aerodigestive tract, cerebellopontine angle) requires specific surgical instrumentation. Here, the authors present recently developed steerable instruments that allow two additional degrees of freedom not attainable with conventional instruments. These instruments may permit access to problem zones(e.g., laterally extending frontal and ethmoidal sinus recesses) in the near future. For better control of the instrument and the operative procedure, tactile feedback can be achieved with appropriate microsensor systems. Three-dimensional vision can be realized by three-dimensional video-endoscopes and sequential image processing.     

Changes in otoacoustic emissions and high-frequency hearing thresholds in children and adolescents

With the aim of characterizing the loss of high frequency hearing sensitivity in children, hearing thresholds and otoacoustic emissions were measured in a group of 126 normal hearing children and adolescents aged from 6 to 25 years. The subjects were divided into four 5-year age groups. Hearing thresholds over a range of 125 Hz-12.5 kHz were similar in all age groups, the average hearing threshold at 16 kHz was significantly elevated in the oldest age group. The response values of transiently evoked otoacoustic emissions (TEOAEs) significantly declined with age; the decline was negatively correlated with the hearing loss at 16 kHz. Significantly larger TEOAE responses and average distortion-product otoacoustic emission (DPOAE) values at 6.3 kHz were present in the youngest group in comparison with the other three older groups. Spontaneous otoacoustic emissions (SOAEs) were present in 70.8% of the children (in either one or both ears) with the greatest prevalence in the 11-20-year-old subjects. In the 21-25-year-old group, the hearing loss at 16 kHz was significantly smaller in ears with SOAEs than in ears without SOAEs. The results demonstrate that the increase in the high frequency hearing threshold at 16 kHz, which starts at ages over 20 years, is correlated with a decrease in the TEOAE responses at middle frequencies.     

Outpatient management in plastic and reconstructive head and neck surgery in France

The present review lays out the main principles governing outpatient management in the French health system in 2018, and more specifically in plastic and reconstructive head and neck surgery. The historical regulatory aspects and the changes of the last few years are explained, along with the trends and health authorities’ expectations for the years to come. The main limitations to implementing outpatient procedures are the common to all surgical specialities, plastic and reconstructive head and neck surgery being no exception. Apart from purely technical aspects concerning surgical procedure and anesthesia, there are issues concerning institutional approval, the organization and continuity of health care, and the patient's environment. The French General Inspectorate of Social Affairs (IGAS), in its 2012 report on the assessment and pricing of hospital care and medical acts, stated that outpatient surgery was becoming standard practice and conventional admission a fall-back, with the aim of meeting the requirement to provide more care without more expenditure. Outpatient plastic and reconstructive head and neck surgery may be available for most patients, but still presupposes certain conditions.     

Ear and hearing in relation to genotype and growth in Turner syndrome

Hearing loss, auricular anomalies and middle ear infections are common findings in many genetic disorders, but the mechanisms have remained unknown. We studied ear and hearing problems in Turner's syndrome (TS) in relation to the degree of X chromosome loss (i.e. degree of mosaicism) and growth. One hundred and nineteen girls and women with TS were studied regarding audiometry, fluorescent in situ hybridisation, serum concentration of insulin-like growth factor-1 (IGF-1) and body height. It was found that sensorineural hearing loss and occurrence of auricular anomalies were significantly increased the greater the proportion of 45,X cells in a particular individual (P<0.05 and P<0.001, respectively). Middle ear infections and sensorineural hearing loss were negatively correlated with IGF-1 (P<0.05 and P<0.001, respectively). Hearing correlated positively with height (P<0.01) and IGF-1 independently of age (P<0.05). Height correlated positively with IGF-1 (P<0.001). Auricular malformations, middle ear infections and hearing impairment in TS were interpreted as due to growth disturbances during development. A new hypothesis on the pathophysiology of external, middle and inner ear disorders due to a delayed cell cycle caused by chromosomal aberrations per se and not only to the specific X chromosome deletion is presented.     

Mismatch negativity and late discriminative negativity in investigating speech perception and learning in children and infants

For decades, behavioral methods, such as the head-turning or sucking paradigms, have been the primary tools to investigate speech perception and learning of a language in infancy. Recently, however, new methods provided by event-related potentials have emerged. These are called mismatch negativity (MMN) and late discriminative negativity (LDN). MMN, the brain's automatic change-detection response in audition, has been intensively used in adults in both basic and clinical studies for longer than 20 years. LDN, on the other hand, was only recently discovered. There seem to be many differences between these two responses. MMN is developmentally quite stable and can be obtained even from preterm infants. LDN, however, can be obtained most reliably from young children, and its amplitude decreases as a function of age. New data suggest that both of these responses have a special role in language processing, although both of them can also be elicited by nonspeech stimuli.     

Otorhinolaryngological findings and hearing in HIV-positive and HIV-negative children in a developing country

The otorhinolaryngological (ORL) manifestations of Human Immunodeficiency virus (HIV) are common, but remain poorly characterized among children of Sub-Saharan Africa, where 90% of new pediatric infections occur. Our objective was to compare ORL findings and hearing in HIV-positive and -negative children of Luanda, Angola, using a comparative study of 78 outpatients from the HIV polyclinic and of 78 age- and sex-matched controls in a pediatric hospital with interview, general and ORL examination, brainstem auditory evoked potentials, and at age >5 years pure tone open-air audiometry. ORL pathology emerged in 92% of HIV-positive and 78% (p = 0.02) of control children. HIV-associated ORL findings comprised dental caries (56 vs. 32%; p = 0.0009), cervical lymphadenopathy >1 cm (45 vs. 10%; p < 0.0001), facial skin lesions (32 vs. 5.1%; p < 0.0001), chronic suppurative otitis media (26 vs. 3.8%; p = 0.0002), dry tympanic membrane perforations (9 vs. 1%; p = 0.03), tonsils of Mallampati score 0–1 (87 vs. 64%; p = 0.0009), and bilateral hearing loss of >25 dB (13 vs. 1%; p = 0.009). Other HIV-associated characteristics included ear pain (44 vs. 27%; p = 0.006), earlier otorrhea episodes (34 vs. 17%; p = 0.004), tuberculosis (29 vs. 2.6%; p < 0.0001), and pneumonia (22 vs. 2.6%; p = 0.0003). ORL pathology appeared usual in both HIV-positive and -negative children. However, the overall high frequency and severity of the findings among the HIV-positive children require regular inclusion of the ORL area in these children’s clinical evaluation.     

头颈肿瘤转移与淋巴管生成的研究进展

淋巴管是头颈部肿瘤最常见的转移途径。近年来随着一些淋巴管内皮分子标记物及与淋巴管形成关系密切的一些调节因子的发现，对肿瘤淋巴管形成及作用机制研究有了较大进展。本文就近年来头颈部肿瘤与淋巴管的生成研究进展予以综述。     

Frequency selectivity and comodulation masking release in adults and in 6-year-old children

Frequency selectivity and comodulation masking release (CMR) for a 1000-Hz signal frequency were examined in 6-year-old children and adults. An abbreviated measure of frequency selectivity was also conducted for a 500-Hz signal. Frequency selectivity was measured using a notched-noise masking method, and CMR was measured using narrow bands of noise whose amplitude envelopes were either uncorrelated or correlated. There were 6 listeners in each age group. No differences were observed between the adults and children for either auditory measure. Similarly, no differences were observed in the ability to detect a pure-tone signal in a relatively wideband noise masker. When the masking noise was narrowband, however, the masked thresholds of the children were higher than those of the adults. Two characteristics that distinguish narrowband noise from wideband noise are: (1) narrowband noise has a pitch quality corresponding to its center frequency, whereas wideband noise does not have definite pitch; (2) the intensity fluctuations are relatively greater in narrowband noise than in wideband noise. This may suggest that 6-year-old children have a reduced ability to detect signals in noise backgrounds where the signal has perceptual qualities similar to the noise, or in noise backgrounds having a high degree of fluctuation.     

Changes in nasal cavity dimensions in children and adults by gender and age

OBJECTIVE: The aim of the study was to establish the dynamics of changes in the intranasal spaces of children and adults by gender and age. MATERIALS AND METHODS: Each side of the nasal cavity was evaluated separately in 366 healthy subjects 9 to 74 years old. The following acoustic rhinometry parameters were analyzed: 1) I-C, distance between the isthmus nasi (I) and the head of the inferior turbinate (C); 2) CA-I, cross-sectional area at the isthmus nasi; 3) CA-C, at the head of the inferior turbinate; and 4) CA-F, the highest point on the rhinometric curve between points I and C. RESULTS: Before age 11 years, the intranasal spaces were slightly larger in girls than in boys. After age 11 years the nasal parameters were larger in boys than in girls. The growth rates before age 17 years were as follows: I-C: 0.073 cm/yr, 0.135 cm/yr, CA-F: 0.055 cm2/yr, 0.133 cm2/yr (P < .00001), and CA-C: 0.010 cm2/yr, 0.034 cm2/yr (P < .02) in girls and boys, respectively. In subjects older than 16 years, the mean values of I-C were 1.707 cm, 1.934 cm (P < .0001), and of CA-C, 0.493 cm2, 0.611 cm2 (P < .0001) in women and men, respectively, and changed slightly over the year. CONCLUSIONS: The parameters of intranasal spaces depend on age and gender. The dynamics of the changes is greater in boys than in girls and usually the growth is completed by the age of 16. After this age, nasal cavities are bigger in men than in women.     

c-Maf基因在小鼠耳蜗内外毛细胞中的表达及意义

目的研究c-Maf基因在小鼠耳蜗内、外毛细胞中的表达、分布特点及意义。方法 1)根据形态上的差异分离收集成年小鼠内、外毛细胞,利用Microarray基因芯片技术分别检测内、外毛细胞c-Maf基因RNA水平的表达;2)全耳蜗基底膜铺片,免疫组织化学染色后激光共聚焦显微镜观察c-Maf蛋白在不同发育阶段小鼠耳蜗内、外毛细胞中的分布特点及表达,并使用软件Image Pro Plus进行c-Maf蛋白定量分析。结果 1)耳蜗内、外毛细胞c-Maf基因RNA水平相近;2)c-Maf蛋白主要表达于成年小鼠的耳蜗内外毛细胞胞质,在内毛细胞的核下区表达强于核上区,且在内、外毛细胞的表达强度相近;3)c-Maf蛋白在小鼠出生后0天、7天、12天及成年小鼠耳蜗内、外毛细胞稳定表达。结论 c-Maf蛋白从出生开始在小鼠耳蜗内、外毛细胞上稳定表达,且在成年小鼠内毛细胞的核下区表达较强,表明其可能在毛细胞生长发育以及功能维持中发挥重要的作用。     

Racial differences in stage and survival in head and neck squamous cell carcinoma

OBJECTIVES: The goal of this study was to characterize differences in survival between black patients and white patients with squamous cell carcinoma of the head and neck (HNSCCA). DESIGN: Cases of oral tongue and glottic SCCA in black patients or white patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (years 1988-2002). For each primary site, TNM staging was imputed, and staging distributions were compared between races. For each black patient, a randomly selected white control was matched for age at diagnosis, sex, stage, surgical treatment, and radiation. Kaplan-Meier survival comparisons for both overall and disease-specific survival were then conducted for the matched pairs. RESULTS: From 1,919 cases of carcinoma of the oral tongue, those of 151 black and 1,768 white patients were extracted. Black patients had a significantly elevated T stage (P = .001) and N stage (P = .002) at primary presentation. Of glottic carcinoma, 4,578 cases (625 black and 3,953 white patients) were extracted. Black patients again presented with significantly elevated T stage (P < .001) and N stage (P < .001) compared with white patients. For 43 matched pairs with tongue carcinoma, mean overall survival for black patients was 66.1 months versus 74.8 months for matched white controls (P = .502, log-rank test). Disease-specific survival was 91.1 months for black patients versus 109.6 months for white patients (P = .168). For 401 matched pairs with glottic carcinoma, mean overall survival for black patients was 96.6 months versus 114.5 months for white controls (P < .001). Similarly, the mean disease-specific survival was 149.4 months for black patients versus 167.1 months for white patients (P < .001) CONCLUSION: Controlling for stage and treatment, black patients demonstrate poorer overall and disease-specific survival with SCCA, implying other intrinsic or extrinsic factors influencing survival.