Classification of vascular tumors and malformations: basis for classification and clinical purpose

Vascular anomalies are a complex pathological group. They are especially difficult to study because of confusion in the terminology used. The classification developed by the ISSVA (International Society for the Study of Vascular Anomalies) now allows using a common scientific language. The classification is based on clinical, radiological, hemodynamic, and histological arguments. There are two groups of lesions: vascular tumors and vascular malformations. Vascular tumors are associated to vascular proliferation. They are called hemangioma and can be infantile or congenital. Vascular malformations are associated to vessels with morphologic anomalies. They are classified according to the distorted vessel type, capillary, venous, lymphatic, and arteriovenous). Such a classification has many implications. It is a guide for the orientation of radiological exams and treatment of vascular anomalies. The management of these anomalies is still difficult and must involve an interdisciplinary approach.     

Epstein‐Barr virus infectious mononucleosis

The Epstein‐Barr virus (EBV) is the aetiological agent of classical infectious mononucleosis. This review article describes the antigenicity of the virus, the specific antibody response and the stimulated polyclonal heterophile antibody production in the host. The diagnostic tests for EBV infection are discussed, with particular attention drawn to the pitfalls of the Monospot test. Complications are listed and management strategies are outlined. The uses and complications of steroids are discussed. The importance of avoidance of contact sport and the association with splenic rupture is described.     

豚鼠内淋巴管和内淋巴囊的扫描电镜观察

目的 探讨豚鼠内淋巴管和内淋巴囊的表面超微结构特点。方法 用扫描电子显微镜观察正常豚鼠内淋巴管和内淋巴囊的表面超微结构。结果 内淋巴管的管腔面光滑、平整，上皮细胞表面的微绒毛少且短。细胞间隐窝小而少。内淋巴囊近端部上皮细胞表面的微绒毛明显增多、变长，细胞间隐窝明显．偶尔可见细胞顶部的胞饮小泡。内淋巴囊的中间部腔面上皮突起，复合折叠形成褶皱，细胞间隐窝多而大，突向囊腔的细胞多，囊腔内充满细胞和细胞碎片。根据电子密度上皮细胞可分为亮细胞和暗细胞两型，其中暗细胞较多，两型细胞表面均有大量长的微绒毛。细胞顶部可见到较多的胞饮小泡。内淋巴囊远端部的结构与内淋巴管近似，腔面光滑，上皮褶皱小，无细胞间隐窝，上皮细胞以亮细胞为主，表面微绒毛少而短，几乎没有胞饮小泡。结论 内淋巴管及内淋巴囊各部分的结构存在明显的不同，各有特点，这种结构特点可能与其在内淋巴代谢中的不同作用有关。     

蝶窦外侧壁的应用解剖

６３侧尸头解剖测量结果表明，蝶窦外侧壁上颈内动脉骨性隆起可分为①鞍前段，其长度、骨质厚度及至中线距离的均值分别为６．８、１．０、６．２ｍｍ；②鞍下段，其长度、骨质厚度及至中线距离的均值分别为６．６、１．０、５．０ｍｍ；③鞍后段，其长度、骨质厚度及至中线距离的均值分别为６．６、１．８及７．１ｍｍ。视神经管隆起的长度，骨质厚度及至中线距离的均值分别为４．８、１．０、５．５ｍｍ。上颌神经隆起的长度，骨质厚度及至中线距离的均值分别为５．３、１．２、８．５ｍｍ。     

Atypical mycobacterial cervical adenitis: Clinical presentation

A typical mycobacterial cervical adenitis (AMCA) is a disease primarily of childhood and usually presents as a unilateral mass or draining sinus. The pathogens are mycobacteria which are distinct from Mycobacteria tuberculosis, leprae and bovis (the typical mycobacteria). The atypical mycobacteria are readily recovered from the environment and are generally of low virulence. They are increasingly being recognized as pathogens for man though they are probably not transmissible from human contact. Most commonly these organisms are implicated in either pulmonary disease or lymphadenopathy. Fourteen cases of AMCA occurring in childhood are presented. A review of the bacteriology of the atypical mycobacteria is included. The clinical presentation, differential diagnosis, chemotherapeutic management and role of surgical intervention are discussed.     

Action potential suppresion, tuning curves and thresholds: comparison with single fiber data

The collection of compound action potential (AP) threshold curves and their use to define the sensitivity of individual animals are described. Forward masking AP tuning curves (APTC) have also been collected in the chinchilla. Characteristics of APTCs are compared with single fiber frequency-threshold curves (FTC) in the same group of animals. The two sets of data are quite similar when the probe frequency used to collect the APTC is equated with a fiber's characteristic frequency (CF). The major difference is that APTCs are usually broader than FTCs. A paradigm utilizing two maskers in a forward masking situation, developed to study psychophysical unmasking [19,37], has been modified for measuring AP suppression. AP suppression areas are described as similar to single fiber two-tone suppression areas when probe frequency and CF are above 3 kHz. Relationships among single fiber, AP and psychophysical thresholds, tuning curves and suppression areas are discussed.     

Evidence for selective proliferation and histological localisation of B lymphocytes in the human tonsil.

Tonsil lymphocytes are labeled in vitro by 14C-thymidine and, respectively, 14C-uridine. The cells are separated by E-rosetting technique, and the fractions are characterised as B and T lymphocytes. Specific radioactivity was highest in the B lymphocytes, and large Lymphocytes are enriched in this fraction. The B lymphocytes are located in the germinal centres, the perinodular tissue contains T lymphocytes. The results indicate a selective proliferation of B lymphocytes in the germinal centres.     

The historical review of the adenotomy

The opinions of famous foreign and also such Polish physicians as Jan Sedziak, W?adys?aw Wr6blewski, Zdzis?aw Dmochowski on problem of removal of hypertrophic pharyngeal tonsil are presented first of all. An unsuccessful trials of conservative treatment are pointed out. Adenotomy was preformed in general anaesthesia, especially by chloroform, in "half-anaesthization", in local anaesthesia. The problems of anaesthesia are presented widely. The various method of removal of hypertrophic pharyngeal tonsils by forceps, by curettes, by loops, by nail are depicted with full particulars. The Loewenberg's forceps in various modifications, the Gottstein's curette and later the Beckmann's and La Force's adenotoms were best. The problem of rinsing of nose after the operation and influence of this rinsing on complications in auditory organ, the problem of postoperative relapses are discussed. The postoperative complications after adenotomy, bleeding and haemmorhage early and late, running of bits of tonsil into larynx, the inflammations of upper respiratory tract are also presented. The Jan Miodoński's and Jan Danielewicz's modern opinions at a performance of problem of adenotomy are depicted finally.     

Emergency Otorhinolaryngolocal cases in Medical College, Kolkata—A statistical analysis

At the round the clock entergency of the Deparment of Otorhinolaryngology, Medical College, Kolkata, different types of cases are managed everyday. The various emergency conditions encountered by us in last four years are gathered and analyzed in this study. The different problems and their modes of management are discussed here.     

耳源性再发性脑膜炎5例报告

为探讨耳源性发性脑膜炎的临床特征，报告５例病患者的临床资料。５例均经手术治疗，降低脑脊液压力后，用颞筋膜及砧骨嵌入前庭窗，封闭瘘口均一次成功。认为本病多因内耳先天解剖异常引起，易发生误诊。     

French ENT Society (SFORL) guidelines for the management of immunodeficient patients with head and neck cancer of cutaneous origin

ObjectivesThe French ENT Society (SFORL) created a workgroup to draw up guidelines for the management of immunodeficient patients with head and neck cancer of cutaneous origin. The present guidelines cover diagnostic and therapeutic management and prevention of head and neck cancer of cutaneous origin in immunodeficient patients, and in particular in transplant patients and those with HIV infection.Materials and methodsThe present guidelines were based on a critical multidisciplinary reading of the literature. Immunosuppression and its varieties are defined. The usual risk factors for skin cancer and those specific to immunodeficiency are presented. The prevention, assessment and management of cutaneous carcinoma, melanoma, Kaposi's sarcoma and lymphoma are dealt with. The level of evidence of the source studies was assessed so as to grade the various guidelines. When need be, expert opinions are put forward.ResultsImmunodeficient patients are at higher risk of head and neck skin tumors. The level of risk depends on the type of deficiency; there is an especially high risk of squamous cell carcinoma in transplant patients and of Kaposi's sarcoma in HIV-positive subjects. Various viruses are associated with skin cancers. Skin tumors are often evolutive in case of immunodeficiency, requiring rapid treatment. Management is generally the same as in immunocompetent subjects and should be discussed in a multidisciplinary team meeting. Immunosuppression may need to be modulated. In organ transplant patients, the only class of immunosuppressants with proven antitumoral efficacy are mTOR inhibitors, particularly in cutaneous squamous cell carcinoma. The rhythm of clinical surveillance should be adapted according to the risk of recurrence. Preventive measures should be undertaken.ConclusionSkin cancers in immunodeficiency are highly evolutive, requiring the earliest possible treatment. Immunosuppression may need modulating. As the risk of recurrence may be elevated, careful surveillance should be implemented. Preventive measures should also be undertaken.     

缺血性脑血管病致眩晕的经颅多普勒检查

目的：应用经颅多普勒（ＴＣＤ０检测对一些缺血性脑血管病所致訾晕进行鉴别诊断。方法：对椎基底动脉短暂缺血性眩晕（Ａ组）、偏头痛（Ｂ组）、过度换气综合征（Ｃ组）和高血压病（Ｄ组）等病例,进行经颅多普勒常规检查（ＴＣＤ－Ｒ）、过度换气１ｍｉｎ（ＴＣＤ－ＨＶ）和自主屏气１ｍｉｎ（ＴＣＤ－Ｂ）检查,测定椎基基底动脉的收缩期峰流速和张期末峰流速。结果：Ａ组、Ｂ组和Ｄ组和三项测试中Ｖｓ和Ｖｄ皆降低,以Ｄ组最为明     

The fine structure of the cochlear plexus

Summary Ultrathin sections and freeze-fracture replicas of the guinea pig cochlear plexus were studied under the electron microscope. Generally, the capillaries possess a continuous endothelial cell layer. The endothelial cells are connected by tight junctions. Occasionally, fenestrated capillaries can be found. Nonmyelinated nerves are intimately related to smooth muscle cells of arterioles as well as pericytes and endothelial cells of capillaries. The axonal varicosities contain clear synaptic-type vesicles. The cochlear plexus cells are connected by desmosomes, gap junctions, and tight junctions. The latter are thought to be part of the blood-perilymph-barrier in this region. There is evidence that the cochlear plexus derives from the meninges.Supported by grants of the Deutsche Forschungsgemeinschaft, Ja 205/6     

Penetrating injuries involving the anterior cranial fossa

Summary Penetrating injuries of the anterior cranial fossa may result in permanent neurologic changes or even death if injuries are unrecognized and remain untreated. The diverse etiologies of such injuries are reviewed, as well as their diagnosis, treatment and prognosis.The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U. S. Department of Defense or any of its branches     

Cochlear nerve topography and fiber spectrum in the pigmented mouse

The topographical and cytological features of the pigmented mouse (CBA/CBA) cochlear nerve were analyzed. The cochlear nerve is very short and is approximately 0.2-0.3 mm in its length. The entire cochlear nerve and a portion of the ventral cochlear nucleus are located within the internal acoustic meatus, and are closely surrounded by bone. Approximately 10,000 nerve fibers are present, of which only about 3% are unmyelinated. The distribution of the axon diameters in the myelinated nerves is close to unimodal.     

Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management

This review describes the microbiology, and medical management of orbital and intracranial complications of sinusitis in children. The most common complications are orbital cellulitis, subperiosteal abscess, orbital abscess, brain abscess, subdural empyema and meningitis. The predominate organisms recovered from these infection are anaerobic, aerobic, and microaerophilic bacteria of oral flora origin. Establishing the microbiology by obtaining appropriate cultures for both aerobic and anaerobic bacteria are essential for proper antimicrobial selection. Early recognition and appropriate surgical and medical therapy are essential to ensure recovery.     

La discrimination auditive d'intensité et ses applications audiologiques et cliniques

Studies on this type of discrimination are very interesting, as they can be made at suprathreshold levels. The nature of auditory intensity discriminations and the most useful methods for measuring the auditory intensity difference limens are briefly described. The most important results obtained with normal subjects are then presented; the monaural intensity difference limens, the intensity difference limens measured on one ear while stimulating the other ear by an unvarying tone or a noise, are treated successively. The most important clinical applications of the intensity auditory difference limens are presented (especially, the monaural intensity difference limens, and the difference limens on one ear in presence of an unvarying tone on the other ear). New explanations of the results obtained in the monaural intensity difference limen tests used are proposed, based on the localization areas in the cochlea, along the auditory nervous system and in the higher auditory centers.

New suggestions for the use of the difference limens in audiometry are made.     

Oronasal fistula in sequels of labialalveolarvelopalatine clefts

Labial and palatine maxillary clefts are treated by surgery, as for oronasal fistula. One of the most important parts of management is the timing of primary surgery in order to avoid growth disturbance. The authors describe the various possibilities to close secondary oronasal fistula. The timing and choice of surgical techniques are still debated and being improved. Various surgical techniques are available, from mucoperiosteal palatal flap to a free flap. Nevertheless, the mucoperiosteal palatal flap is the most commonly used. In some cases mucoperiosteal flaps are impossible to perform, so other options for extreme cases are discussed.     

Keratocysts of the maxilla and zygoma. Case report and review of the literature

Keratocysts are a special entity of jaw cysts. The horizontal and distal regions of the mandible and the ascending ramus of the mandible are the most common locations of these cysts. Keratocysts of the os zygomaticum and orbital floor are extremely rare. In case of infection radiologic and histologic diagnosis are difficult and these cysts are often misdiagnosed as radicular and follicular cysts. The case of a 49-year old man is reported, who was admitted to hospital suffering from recurrent episodes of maxillary sinusitis with orbital involvement. He had previous sinus surgery six times. The clinical, histologic and radiologic characteristics are reported. In a literature review the present case is discussed. Because the recurrent-rate of keratocysts is rather high, complete removal and careful post-operative follow-up are mandatory.     

5 years of clinical experience with Ceravital prostheses in the middle ear

The characteristics and properties of the bioactive glass ceramic Ceravital are reported. The histological findings of this material in animals and humans are presented. The operative techniques, otoscopic postoperative findings and audiological results are described.