Local changes in the oral cavity in patients after operation of malignant tumours of the tongue and bottom of the oral cavity

This study is aimed an objective and subjective evaluation of local changes after operations of malignant tumours of the tongue and the bottom of the oral cavity. THE MATERIAL AND METHODS: we have examined 74 patients (70 men and 4 women) treated in Department of Otolaryngology of the University School of Medical Sciences in Poznań with recognized of malignant tumour of the tongue and floor of the mouth. On the base of subjective and objective ultrasound and x-ray examination with use of contrast and stereognostic test it was evaluated movability, alteration of articulation zones, regularity of swallowing acts, sense of taste and efficiency of stereognosion. In all of the patients we found orders in swallowing, speech and taste dependen on the kind of the operation.     

Variables affecting implant performance in children

This study examined the variables that contribute to the large individual differences in the speech perception skills of children with the Nucleus multichannel cochlear implant. Sixty-one children were tested on four measures of speech perception: two tests of closed-set word recognition, one test of open-set recognition of phrases, and one open-set monosyllabic word test, scored on the basis of the percentage of phonemes as well as words identified correctly. The results of a series of multiple regression analyses revealed that the variables of processor type, duration of deafness, communication mode, age at onset of deafness, length of implant use, and age implanted accounted for roughly 35% of the variance on two tests of closed-set word recognition, and 40% of the variance on measures that assessed recognition of words or phomenes in an open set. Length of implant use accounted for the most variance on all of the speech perception measures.     

The Polish physicians's impressions from the First Otolaryngological International Congress in Copenhagen

The problem of meetings and congresses of otologists and laryngologists from 1876 till 1928 is described widely. The First International Congress of Otorhinolaryngologists was performed in 1928 in Copenhagen. It was a unique meeting with numerous magnificent social entertainments with participation of several hundred physicians. The chief of editorial committee was Karl Schmigielow (1856-). The programmatic subject matters: the problems of otitis media, the problems of aural operations, the problems of postinflammatory complications of ear with intracranial complications, the problems of sinusitis, the septic complications of pharyngeal origin, the use of diathermy in treatment of tumors in E.N.T., the problems of malignant neoplasms of larynx, the problems of scleroma of upper respiratory tract, the problems of brain tumors were discussed with full particular. The labyrinthical report of Bronislaw B. Karbowski was well-disposed accepted.     

Applications of distortion-product emissions to an otological practice

OBJECTIVES: The multiple clinical applications of distortion-product emissions (DPEs) to an otological practice are reviewed. Through an examination of studies involving thousands of infants, as well as adult ears, the relationships between measurements of DPEs and PTTs (PTTs) are examined. The cochlear physiology underlying generation of DPEs and the interpretation of these measurements are described in some detail. We study the contribution of phase measurements of DPEs to calculation of delay in cochlear traveling waves. The clinical applications of these measurements are described. The objective of this work is to demonstrate the clinical utility of DPEs through an examination of the correlation of the features of DPEs with PTTs in patients varying in age from newborn to the elderly. STUDY DESIGN: METHODS: Experimental design and methodology involved careful prospective selection of large numbers of subjects in each age group, novel techniques for recording DPEs, and multivariate statistical analysis of the data. Three separate experiments encompass issues surrounding the age groups of adults, neonates, and elderly individuals. RESULTS: The results show that current techniques allow a 90% correct prediction of auditory PTTs for frequencies varying from 1,000 to 6,000 Hz, for patients of all ages. CONCLUSION: Techniques for measurement of DPEs currently represent an integral diagnostic component for an otological practice. The potential future application of measures of DPEs to diagnosis of tinnitus is described. With an extension of the technique for measuring DPEs to the phenomenon of reflectance, there may be promise of application to novel approaches to the treatment of tinnitus and the design of hearing aids.     

喉癌前病变p53过度表达的研究

采用标记链霉菌素－生物素免疫酶技术结合微波炉处理方法，对１５例成人型喉头状瘤，１０例喉部不典型增生，２例喉原位癌，１０例声带息肉以及６例正常喉的组织标本进行了检测，结果发现：在７３．３％喉乳头状瘤，４０％喉不典型增生和５０％喉原位癌中检测到ｐ５３蛋白过度表达，而１０例声带息肉和６例中正常组织无一例出现ｐ５３的过度表达。     

Comparative study between the normally hearing child and the hard of hearing child,by acoustic impedance measurements of the ear

Summary In the first part, the author makes a comparative study of the tympanometric results obtained from the normally hearing child and the hard of hearing child. The frequency of serous otitis media is statistically higher in the deaf child. The author compares such results of tympanometry as obtained from the child, considers the contribution of this technique to the field of pediatric audiology and suggests a classification of tympanograms in terms of the probe-tone frequency of the impedancemeter.The second part concerns the acoustico-facial reflex. This study compares the recording of the stapedius reflex obtained by pure tone and Narrow-Band noise acoustic stimulation, thanks to Madsen electro-acoustic bridge, in two groups of children, the one consisting of normal hearing children and the other of children suffering from severe perception hearing loss. The study of the stapedius reflex threshold makes it possible to analyse the dynamics of the field of perception in both groups. After an analysis of the results, the author outlines the importance attributable to the study of the stapedius reflex in the child as a means of objectively examining the auditive function and a means of differential diagnosis in cases of sensorineural impairment of the hearing function.We wish to thank most sincerely Professor J. Marquet, Messrs. K. J. Van Camp and W. L. Creten of the University of Antwerp as well as Mr. M. Citta of the University of Louvain for their precious collaboration.     

Surgical treatment of loss of substance of the lower lip]

Repair of loss of substance of the lower lip has been the object of numerous studies. Each author has used his own ingenuity to describe a new type of flap aimed at restoring a particular form of loss of substance. The techniques suggested here are capable of solving a majority of problems on the basis of simple and original solutions. These flaps make it possible to resolve the problems posed by most cases of loss of substance of the lower lip. The choice of these plastic procedures permits restoration which is at one and the same time functional and anesthetic.     

Expression of factors inducing apoptosis of peripheral blood lymphocytes in oral cavity cancers

One of possible immunosuppression mechanisms during cancer disease is apoptotic death of immunology system cells. Factor FAS and xi chain of TCR-CD3 complex take part in induction of apoptosis of lymphocyte which infiltrate neoplasm as well as lymphocytes of peripheral blood (PBL). Expression of the two factors was estimated in PBL of patients with cancer of bottom of oral cavity and granuloma fissuratum (control group). During cancer disease higher level of FAS factor in PBL was observed in comparison to control group. Lymphocytes of peripheral blood in cases of cancer disease shown lower expression of TCR-xi.     

前庭代偿过程中前庭传出性和传入性神经系统的相互作用

目的 通过前庭代偿的动物模型，了解在前庭病变的情况下，前庭传出性和传入性神经系统的相互作用。方法 动物模型：A组(16只)为正常大鼠。B组(15只)左侧前庭损毁术后7d。C组(7只)术后3个月。D组(7只)前庭代偿后。检测两侧头长肌静息状态的肌电图。检测传出性前庭神经系统降钙素基因相关肽免疫组化。检测传出性前庭神经系统胆硷乙酰转移酶(choline acetyltransferase，AChT)免疫组化。检测传入性前庭神经系统Na-K-ATP酶活性。结果 损伤同侧肌群肌电活动减弱、对侧肌群增强，前庭代偿期恢复对称性。急性期传出性前庭神经系统降钙素基因相关肽阳性细胞双侧性增多，活性增高。传出性前庭神经系统损伤同侧AChT阳性反应细胞减少，两侧反应程度增加。前庭代偿期对侧反应程度显著增加。急性期同侧Na-K-ATP酶mRNA表达水平低，对侧前庭信号增强，在前庭代偿期，同侧Na-K-ATP酶mRNA表达水平增强，与对侧一致或略强。结论 传出性前庭神经系统可能抑制对侧前庭传入信息，调整同侧前庭中枢兴奋性，在前庭代偿的复杂机制中发挥作用。     

Comparative analysis of approaches to surgical cochlear implantation in adults and children

The aim of a surgical stage of cochlear implantation (CI) is to place the implanted part of the device in the temporal space. Criteria of the decision on the side of the intervention and components of it in CI are outlined. To help selection of an optimal variant of surgical intervention in CI at the initial stage, the techniques of the implanted parts insertion are reviewed. Types of skin cuts, approaches to the cochlea, location of cochleostoma, methods of fixing the stimulator are described. The importance of intraoperative registration of the musculus stapedius reflex and action potential of the acoustic nerve in response to cochlear electrostimulation is emphasized. Basing on the experience of treating 38 deaf patients, the author states that for effective performance of the operation it is desirable to conduct reverse U-cut of the skin, make posterior tympanostoma, cochleostoma in the basic cochlear margin, suturing of the cut with intracutaneous suture.     

Implication of mitochondrial apoptosis in neural degeneration of cochlea in a murine model for presbycusis

HYPOTHESIS: Pathologies of senescence, in particular those of neurosensory organs represent an important health problem. The improvement of the life expectation entails the fast increase of the frequency of the presbyacusis in the population. The biological and molecular causes of this degenerative pathology of the inner ear are linked to the disappearance of the sensory cells (inner and outer hair cells) and are associated to nervous damages of the spiral ganglion in the cochlea. We were interested in mechanisms causing the cochlear degeneration in a model of mouse CD 1 presenting prematurely auditive losses. MATERIALS AND METHODS: We tried to correlate the evolution of the hearing and the appearance of apoptotic phenomena by marking with specific antibody, activated anti-caspase-3, in the cochlea during time. We studied the role and the involvement of proteins controlling the apoptosis as the P53 protein and from an energy point of view at the level of the mitochondria such as proteins of the Bcl-2 family and the cytochrome c in the various structures of the cochlea. RESULTS: After implantation of electrodes for auditory nerve acoustic thresholds measurements, the audition of mice CD 1 presented a characteristic profile of hearing losses which begins in the high frequencies from the age of 1 month and which quickly evolves towards the low frequencies. The observation (between the 1st and 3rd month of age) of spiral ganglion cells revealed an unchanged number of cellular bodies of type 1 neurons, on the other hand a characteristic morphology of apoptosis of glial cells with the formation of apoptotic body was noted. Indeed, glial cells expressed activated caspase-3. Furthermore, this phenomenon seems to be under the control of the pro-apoptotic protein Bax by its overexpression and a increased release of the cytochrome c. This phenomenon was followed at 3 and 6 months by the disappearance of the outer hair cells by 9 and 48% respectively. CONCLUSION: The apparition of the deafness in the murin model CD 1 allowed us to demonstrate that the degeneration of cochlear structure begins at the level of glial cells of the spiral ganglion from 3 months, followed thereafter by the deterioration of the nervous conduction between the spiral ganglion and the sensory cells. As a consequence, because of the impoverishment in nervous signals, the outer hair cells would begin to disappear during the 6th month. In conclusion, the understanding of the sequence and the cause of these mechanisms responsible for the neural degeneration and the loss of hearing could eventually, allow us to optimize the various treatments of the presbyacusis.     

The impact of radiotherapy on quality of life -- a survey of 1411 patients with oral cancer]

PURPOSE: The therapy of patients with oral cancer often requires a combination of surgery and radiotherapy. This leads to trauma of healthy tissue. The impact of this side effect on quality of life was investigated. Additionally the impairment of 19 factors was determined (comprehension of speech for unknown others, comprehension of speech for familiar others, eating/swallowing, mobility of the tongue, opening range of the mouth, mobility of lower jaw, mobility of neck, mobility of arms and shoulders, sense of taste, sense of smell, appearance, strength, appetite, respiration, pain, swelling, xerostomia, halitosis). METHODS: This retrospective multicenter study was conducted under the auspices of DOESAK (a German, Austrian and Swiss cooperative group on tumors of the maxillofacial region). The Bochum Questionnaire on Rehabilitation was used to determine 147 items. 3894 questionnaires where sent to 43 clinics in Germany, Austria and Switzerland. 1761 questionnaires where returned, while 1411 of them included all of the answers necessary for this study. RESULTS: 686 of 1411 patients where irradiated. Before the beginning of therapy the impairment of the 19 factors was not significantly higher in the group that later received radiotherapy. After therapy there is a significantly higher impairment of the irradiated patients. The factors that are especially worse are xerostomia, swallowing and understanding of speech. The quality of life was not significantly lower. CONCLUSIONS: Although radiotherapy leads to trauma of healthy tissue this method is indicated as it has no significant impact on quality of life. During the rehabilitation physiotherapists should relieve the impairment of speech, eating and swallowing.     

Head shaking nystagmus]

The method of head shaking test and the clinical significance of head shaking nystagmus were studied. A series of 300 patients suffering from dizziness and disturbance of equilibrium and a group of 60 normal persons were investigated. There was no head shaking nystagmus in normal persons. The incidences of head shaking nystagmus were exceedingly higher than those of other methods of nystagmus provocation. The elicited nystagmus was considered as a form of pathologic sign of central lesions if it was of vertical and oblique type. The head shaking test for detection of latent imbalance of vestibular function as well as for the examination of the patients with dizziness and disturbance of equilibrium was stressed.     

正常人群鼻黏膜中组胺受体亚型的表达

目的 通过观察健康志愿者鼻黏膜中4种组胺受体(histamine receptor,HR)亚型的表达及分布差异,初步阐明4种HR亚型在正常人群鼻黏膜中的表达,为了解组胺(histame,HA)及其受体HR在鼻腔病理生理学中的作用提供理论基础.方法 选择健康志愿者10人,表面麻醉下取下鼻甲黏膜,分别行HR免疫组化检测及半...     

Evaluation of oxygen free radical generation and antioxidative enzymatic activity in blood of patients with carcinoma of the larynx (preliminary report)

The aim of the study were the evaluation of generation of oxygen free radical and antioxidative enzymatic activity in blood of patients with carcinoma of larynx (7 persons, aged 48-68) in comparison with healthy persons (15, aged 21-28). The superoxide anion generation of blood granulocytes described by the rate of the reducted cytochrom C at rest and after stimulation with opsonized zymosan according to Bellavite et al. were measured. The enzymatic activity of superoxide dismutase in blood (method of Misra and Fridovich), catalase (method of Beers and Sizer) and malonyl dialdehyde (method of Placer et al.). The obtained data pointed at the growth of generation of oxygen free radical in blood (at rest and after stimulation with opsonized zymosan) of patients with carcinoma of larynx in comparison with the healthy ones. At the same patients with carcinoma of larynx observed at significant reduction of antioxidative enzymatic activity against the oxygen species generation in blood and significant growth of peroxidation lipids and disturbances of function of cells the human body.     

Video-roentgen cinematographic evaluation of pharyngeal phase disorders during swallowing in patients after partial laryngectomy due to localized supraglottic cancer

Videorentgenocinematographic examinations of swallowing were conducted on 81 patients after partial laryngectomy and on 35 subjects being a control group. Resection of piriform recess, a part of base of the tongue, the hyoid bone or its part is the factor that causes intensified difficulty during swallowing and increase in the frequency of the occurrence of aspiration. The results of videorentgenocinematographic examinations indicate that the shape and mobility of the tongue and the mobility of remaining after the surgery parts of the larynx have the greatest influence on the efficient swallowing in patients who have undergone partial laryngectomy due to cancer initially located in the supraglottic area. The larynx mobility is closely related to the remaining of the hyoid bone. The importance of remaining the possibly non-deformed structure and mobility of the tongue during partial laryngectomy involves the issue of reconstruction of defects occurred during the surgery. Videorentgenocinematographic examinations confirm the effectiveness of the method involving reconstruction of defects in a part of the base of the tongue with a vascular pedicle flap of the submandibular gland.     

Computed tomography of the temporal bone in diagnosis of otitis media chronica purulenta

Computed tomography (CT) of the temporal bone has been used to study thirty-eight 5-72-year-old patients with otitis media chronica purulenta (OMCP), in 14 of them the process was bilateral. A scheme of CT assessment of the temporal bone is proposed. The analysis of 52 CTs of the temporal bone with consideration of otoscopic and operative findings helped to distinguish CT signs of non-cholesteatomic OMCP. These signs include sclerotic alterations of the bone tissue of the mastoid process (82.7%), defective pneumaticity of the middle ear cavities (tympanic cavity - 80.7%) due to pathological substrate, destructive changes of the auditory bones (50%), carious alterations of the walls of the middle ear cavities (21%). The study of the temporal bone by the proposed scheme detected such anomalies and structural features as presentation of the sigmoid sinus (36.5%), elevation of the bulb of the jugular vein (3.8%), diverticulum of the jugular vein (3.8%), low fundus of the middle cranial fossa (7.7%).     

Progress in genetic testing and prevention of hereditary hearing disorders

The article reviews the latest achievements of molecular-genetic technologies in diagnosis of hereditary hypoacusis, statistics on hereditary hypoacusis morbidity in different countries. Arguments for genetic testing, diagnostic algorithm of congenital hypoacusis and trends in prophylaxis are considered. Presently 65 genes are identified which are related with syndromes and non-syndrome forms of neurosensory hypoacusis. In foreign countries about 200 mutations in 8 genes are diagnosed now. Pathological changes of the majority of genes lead to peripheral neurosensory hypoacusis as all these genes code proteins of the internal ear. In view of this, genetic testing makes topic diagnosis of the disease of the organ of hearing. Most of genetically confirmed hearing problems are indication for cochlear implantation. Prophylactic activity should be focused on explanation of the role and possibilities of genetic counseling and DNA diagnostic tests, promotion of knowledge of etiological structure of congenital hearing disorders. Active measures are necessary for early detection of genetic alterations among risk groups, early diagnosis of mutation carriers among couples of reproductive age with normal hearing.     

A study of the tactual and visual reception of fingerspelling

A method of communication in frequent use among members of the deaf-blind community is the tactual reception of fingerspelling. In this method, the hand of the deaf-blind individual is placed on the hand of the sender to monitor the handshapes and movements associated with the letters of the manual alphabet. The purpose of the current study was to examine the ability of experienced deaf-blind subjects to receive fingerspelled materials, including sentences and connected text, through the tactual sense. A parallel study of the reception of fingerspelling through the visual sense was also conducted using sighted deaf subjects. For both visual and tactual reception of fingerspelled sentences, accuracy of reception was examined as a function of rate of presentation. In the tactual study, where rates were limited to those that could be produced naturally by an experienced interpreter, highly accurate reception of conversational sentence materials was observed throughout the range of naturally produced rates (i.e., 2 to 6 letters/s). In the visual study, rates in excess of those that can be produced naturally were achieved through variable-speed playback of videotapes of fingerspelled sentences. The results of this study indicate that performance varies systematically as a function of rate of presentation, with scores of 50% correct on conversational sentences obtained at rates of 12 to 16 letters/s (i.e., rates roughly double to triple normal speed). These results suggest that normal communication rates for the visual reception of fingerspelling are restricted by limitations on the rate of manual production. Although maximal rates of natural manual production of fingerspelling correspond to the presentation of a new handshape on the order of once every 150-20 ms, the data from the sped-up visual study suggest that experienced receivers of visual fingerspelling are able to receive sentences at substantially higher rates of fingerspelling (which are, in fact, comparable to communication rates for spoken English).     

Models of otolithic membrane-hair cell bundle interaction

Transformation of the mechanical input in the chain: acceleration of otolithic membrane (OM)-displacement of the OM gel layer-deflection of hair cell bundle (HCB)-formation of the temporal pattern of polarization was studied using simplified analytical models of these stages of conversion of mechanical stimulus into the HCB electrical response. The dynamic behavior of an OM was modeled by a homogeneous viscoelastic (Kelvin-Voight body) model of the OM. Two alternative models of an 'HCB-surrounding gel' interaction corresponding to different types of the HCB were considered: (1) a model of stereocilia tip-link deformation in the case when the HCBs passively follow the gel deformation and (2) a model in which the tip-link dynamics is determined by an 'HCB-viscous fluid' interaction. It was shown that in the first model the 'HCB-OM gel' system functions as an accelerometer while in the second model it measures the time derivative of external acceleration. A simplified model of the temporal formation of cell depolarization is proposed and analyzed. Results of the modeling suggest that formation of a temporal response of the HCB to external acceleration occurs mainly due to two mutually correlated factors: the spatial dependence of gel displacement on the distance from a macular plane and the spatial distribution of stereocilia heights in the HCB.