Significance of the auditory tube angle and mastoid size in chronic ear disease

The aim of this study was to determine whether a relationship exists between mastoid size and auditory tube angle (ATA) and chronic ear disease. A radiological and clinical study was undertaken of the temporal bones of 36 subjects. There were 24 patients with unilateral chronic otitis media (COM) and 12 healthy controls (HC) the contralateral healthy ears of the COM patients were also used as control (CLHC). From each CT scan the distance between Henle spine and the sigmoid sinus (H-SS) and the ATA was assessed. The angle between a longitudinal line bisecting the transverse length of the external auditory canal and the longitudinal axis of the AT was calculated. A direct correlation between H-SS and ATA, both in COM and HC (p < 0.01), was observed, but not in CLHC (p > 0.05). There was no significant difference in the ATA results between COM and CLHC, or between COM and HC (p > 0.05), however there was a significant difference between CLHC and HC (p = 0.02). H-SS distances were not significantly different between COM and CLHC, or COM and HC, or CLHC and HC (p > 0.05). An association between ATA and mastoid size in both healthy and diseased ears was observed. The anatomical relationships of the AT, mastoid and middle ear, which form a functional unit, are not significantly important in chronic ear disease.     

Analysis of unilateral sclerotic temporal bone: how does the sclerosis change the mastoid pneumatization morphologically in the temporal bone?

Backgrounds Some disorders, such as otitis media and Eustachian tube dysfunction, may cause the temporal bone to become sclerotic. A sclerotic temporal bone has the tendency to shrink. The aim of this study was to evaluate the morphologic changes that result from sclerosis of the temporal bone. Methods We measured 9 variables on 2 axial images, and 8 variables on 2 coronal images in healthy ears and diseased ears in 37 patients with unilateral chronic otitis media. We also measured the volume of mastoid pneumatization. Results The distance from sigmoid sinus to Henle’s spine was correlated to the degree of volume reduction, and it accounted for about 17.7% of the total variation in volume reduction. There was no difference in the sigmoid sinus type in comparisons between sclerotic and pneumatic mastoids. Conclusions The sclerosis of the temporal bone was observed to reduce the volume of the mastoid pneumatization. However, a large portion of the volume reduction may result from the sclerotic change in the air cell system, rather than from shrinkage of the mastoid bone. Therefore, the location of surgically-important structures, in the middle and inner ear, is only rarely changed in sclerotic temporal bone. Presented as a poster titled as “analysis of morphologic changes in the sclerotic temporal bone by spiral high-resolution computed tomography” at XVIII IFOS World Congress (June 25–30, 2006, Rome, Italy).     

The distance of the sigmoid sinus and the middle fossa dura from the external auditory canal in chronic otitis media

Purpose

Mastoid pneumatization is reduced in most patients suffering from chronic otitis media (COM). In most studies, the relationship between the degree of pneumatization and the distance of the sigmoid sinus from the external auditory canal has been examined, yielding different results. This study addresses the relationship between COM and the distance of the sigmoid sinus and also middle fossa dura from the external auditory canal.

Methods

This was a case–control study on 15 adult COM patients, 12 traumatic facial palsy patients, and 15 cadaver temporal bones. After mastoidectomy, the distance between the spine of Henle and both the middle fossa dura and sigmoid sinus were measured, and the findings in each group was analyzed using Tukey’s and ANOVA tests.

Results

The average distance of the external auditory canal and the sigmoid sinus was 15.27 ± 3.3 mm in the COM group, 16.92 ± 3.23 mm in the traumatic facial palsy group, and 14.53 ± 2.92 mm in the cadaver temporal bones. There was no significant difference between the groups (p = 0.115). The average distance of the spine of Henle from the middle fossa dura was 6.73 ± 1.62 mm in the COM group, 11.4 ± 2.05 mm in the traumatic facial palsy group, and 8.93 ± 1.94 in the cadaver temporal bones. There was a significant difference between the groups (p < 0.001).

Conclusion

The distance of both the sigmoid sinus and the middle fossa dura from the external auditory canal (which indicates mastoid pneumatization) is reduced in COM patients.     

Posterior tympanotomy is a riskier procedure in chronic otitis media than in a normal mastoid: a high-resolution computed tomography study

Purpose

The aim of our study was to compare the difficulty in performing a posterior tympanotomy in chronic otitis media (COM) versus the same procedure in a normal mastoid.

Materials and methods

The study included 122 patients who underwent tympanomastoidectomy for unilateral chronic otitis media with contralateral normal mastoid pneumatization. We evaluated the anatomical relationships between the mastoid segment and neighboring structures by analyzing axial temporal bone computed tomography scans. A vertical line (line A) was drawn tangential to the most lateral end of the posterior semicircular canal (point A). Three distances were measured: the distance (D1) between the point A and the most lateral end of the mastoid segment of the facial nerve (point B), the distance (D2) between the line A and the point B, and the distance (D3) between the point B and the posterior end of the bony annulus of the external auditory canal.

Results

The average measurements of D1 and D3 were 3.79 ± 0.55 and 2.63 ± 0.51 mm, respectively, in the normal mastoid ears and 3.47 ± 0.59 and 2.35 ± 0.44 mm, respectively, in the COM ears. The measurements of D1 and D3 were statistically shorter in the COM ears than in the normal ears.

Conclusions

These findings suggest that the facial recess in COM may be narrower than in a normal mastoid and that performing a posterior tympanotomy may be riskier in COM than in a normal mastoid due to the potential for injury to the neighboring structures and the facial nerve.

     

Körner’s septum (petrosquamosal lamina) and chronic ear disease

To assess the clinical significance of Körners septum (KS) or petrosquamosal (PS) lamina in different chronic ear pathologies, a surgical and anatomic study was carried out, in which the significance of KS was assessed in various otologic diseases. Of 639 patients who underwent ear surgery between 1998 and 2001, 426 were included in the study. The diagnoses were chronic otitis media without cholesteatoma (COM), tympanosclerosis (TS), adhesive otitis media (AOM) and cholesteatoma (COL) in 160, 100, 70 and 96 patients respectively. The operative records of the patients were reviewed for the presence of KS. There was antral blockage by KS in all patients who also had Cog (the middle portion of the PS lamina). KS was mostly seen in cases of TS. The prevalence of KS was not significantly different when the result of the COM group was compared with that of the COL and AOM groups ( p >0.05). The prevalence of KS was significantly higher in patients with TS than in those with COM. Both antral and epitympanic blockages were more prevalent in cases of TS than in those of COM (² =3.9, p =0.04 and ² =6.6, p =0.01 respectively). There is a significant association between the presence of KS and TS. Based on this finding, it is recommended that a mastoidectomy be performed in cases of severe tympanosclerosis in order to remove KS. How the removal of this anatomic impact will affect the natural course of the disease is still a question that needs further investigation.Part of this study was presented at the International Symposium on Morphological Sciences on September11–15, 2002, in Romania     

Sigmoido-rectal junction reflex: Role in the defecation mechanism

The presence of a sphincter at the rectosigmoid junction (RSJ) is debated. This investigation studies the presence or absence of a sphincter and its possible role in sigmoid colon storage and rectal evacuation. Eighteen healthy volunteers (10 males, 8 females) with a mean age of 36.6 ± 14.8 years (range 21–53) were studied. The pressure response of the sigmoid colon, RSJ, and rectum to sigmoid and rectal distension, respectively, was determined before and after anesthetizing either the sigmoid colon or the rectum. The RSJ length was evaluated by the station pull-through technique. Sigmoid distension with balloon volumes of up to 80.6 ± 4.4 ml of H₂O effected no sigmoid, RSJ, or rectal pressure changes (P > 0.05). At a mean sigmoid distension of 88.6 ± 4.1 ml of H₂O, the sigmoid colon showed a significant pressure increase (P < 0.001), a RSJ pressure decrease (P < 0.05), and insignificant pressure changes in the rectum (P > 0.05); the balloon was dispelled into the rectum. Rectal distension of 94.6 ± 5.8 ml of H₂O produced rectal (P < 0.001) and RSJ (P < 0.05) pressure increases. Distension of the anesthetized sigmoid and rectum did not produce pressure changes in the RSJ (P > 0.05). This study demonstrated a high pressure zone at the RSJ of 3.8 ± 0.7 cm in length. This suggests that the RSJ might act as a functional sphincter. It opens reflexly upon sigmoid contraction, by a reflex we call “rectosigmoid inhibitory reflex,” and closes upon rectal contraction, a reflex we call “rectosigmoid excitatory reflex.” The former allows the stored feces in the sigmoid colon to pass to the rectum, and the latter reflex prevents stool reflux to the sigmoid upon rectal contraction. © 1996 Wiley-Liss, Inc.     

Surgical implications of anatomical landmarks on the lateral surface of the mastoid bone

The aim of this study was to examine the relationships of the surgical landmarks on the lateral surface of the mastoid bone with the landmarks in a deeper location. Simple mastoidectomy was carried out without drilling over the linea temporalis inferior (LTI) on 20 adult temporal bones. The suprameatal spine, i.e., Henle spine (HS), variants were noted. Morphometric measurements were performed between these surgical landmarks, and their variations with pneumatization or HS types were evaluated. Three types of HS were identified: triangular, crest, absent. The HS–lateral semicircular canal distance was 15 mm on average and longer in bones with a triangular HS than a crest type HS (16.4 vs. 14.3 mm). The LTI was found to be located on average 4.7 mm inferior to the middle fossa dural plate (MFD). The LTI–MFD distance had a tendency to be longer in bones without an HS than with a crest type of HS (5.9 vs. 3.9 mm). Chorda tympani emerged from the facial nerve at the stylomastoid foramen in five specimens (25%). This anatomical organization was not correlated with the type of HS. Korners septum (KS) was identified in nine bones (45%). It was present in eight of 16 (50%) bones with good pneumatization. No tendency for the existence of KS was found for any specific type of HS. This study confirms that the mastoid antrum is located 15 mm deep to the lateral surface of the mastoid bone. It should be expected to be longer in bones with a triangular HS. In addition, the MFD is located on average 5 mm above the LTI, which could be useful information for beginners or inexperienced surgeons. The ear surgeon should anticipate that the MFD might be longer in bones without an HS.This study was presented at the 25th Turkish National Otorhinolaryngology Congress, Izmir, 18–23 September 1999     

Neural correlates of working memory function in pediatric cancer survivors treated with chemotherapy: an fMRI study

The goal of this study is to investigate the neural correlates of working memory function associated with chemotherapy in pediatric cancer survivors using event‐related functional MRI (fMRI) analysis. Fifteen pediatric cancer survivors treated with chemotherapy and 15 healthy controls were studied. Blood oxygenation level dependent (BOLD) fMRI was acquired. A visual n‐back task was used to test working memory function during the fMRI scan. Responses were recorded via an MRI compatible button box for analysis. fMRI scans were analyzed using statistical parametric mapping software. All statistics were corrected for multiple comparisons by false discovery rate, with p < 0.05 as significance. Patients however gave more incorrect responses (p < 0.05), more no responses (p < 0.05), and longer response times (p < 0.05) compared with healthy controls. Correct responses generated significantly lower BOLD responses in the posterior cingulate for pediatric cancer survivors compared with controls (p < 0.05). Incorrect responses generated significantly greater BOLD responses in the angular gyrus in survivors (p < 0.05), and no response trials generated greater BOLD responses within the superior parietal lobule (p < 0.05) compared with controls. Working memory impairment appears to be due to an inability to manipulate information and to retrieve information from memory. The ability to delineate the affected neural circuits associated with chemotherapy‐induced cognitive impairment could inform treatment strategies, identify patients at high risk of developing cognitive deficits, and pre‐emptively tailor behavioral enrichment to overcome specific cognitive deficits.     

Serum thyroid hormones and trace element concentrations in crossbred holstein cattle naturally infected with Theileria annulata

This research was carried out to study thyroid function in view of serum trace element and possible serum cortisol concentration changes in crossbred Holstein cattle naturally infected with Theileria annulata. Twenty cattle of different age and sex which had been naturally infected with T. annulata were examined. A control group were selected among the clinically healthy crossbred Holstein cattle with the same age, sex, and production stage similar to the naturally infected group. Serum T3, T4 concentrations were significantly lower in cattle suffering from theileriosis than in the healthy controls (p < 0.05). The cattle suffering from theileriosis had significantly lower concentrations of zinc and selenium in their sera as compared with the healthy control subjects (p < 0.05). Lower packed cell volume (PCV) theileriosis-affected cattle had a lower serum selenium concentration than higher PCV-affected group (p < 0.05). Significant differences were also found in PCV, total protein, albumin and total bilirubin concentrations and alkaline phosphatase and gama-gluthamyl transferase activities between theileriosis-affected and healthy cattle (p < 0.05). Total protein and albumin concentrations were statistically different in age (less and more than two years) and PCV (lower and higher) groups of theileriosis-affected cattle (p < 0.05). No significant changes were found in free T3, free T4, cortisol, copper, cobalt, and manganese levels of theileriosis-affected cattle.     

单侧慢性化脓性中耳炎颞骨CT解剖学研究

目的 研究单侧慢性化脓性中耳炎颞骨CT解剖学特征及其临床意义。 方法 回顾性分析35例单侧非胆脂瘤型慢性化脓性中耳炎患侧颞骨（病例组）与健侧颞骨（对照组）CT影像资料，比较两组咽鼓管外耳道角、岩枕角、乳突窦入口直径、咽鼓管骨部直径、咽鼓管骨部长度、咽鼓管骨部最大径与咽鼓管骨部长度之比，及乳突气化程度（良好、差）等解剖参数。 结果 患侧咽鼓管外耳道角、岩枕角分别是（137.4 ± 8.1）°、（52.5 ± 3.8）°，乳突窦入口直径、咽鼓管骨部最大径分别是（0.29±0.08）cm、（0.18±0.07）cm，咽鼓管骨部长度为（1.07±0.15）cm，咽鼓管骨部最大径与骨部长度之比为（17.1±5.4）%；健侧咽鼓管外耳道角、岩枕角分别是（138.3±7.7）°、（53.1±4.3）°，乳突窦入口直径、咽鼓管骨部最大径分别是（0.35±0.07）cm、（0.21±0.07）cm，咽鼓管骨部长度为（1.17±0.17）cm，骨部最大径与骨部长度之比为（20.9±14.3）%。患侧乳突窦入口直径、咽鼓管骨部最大径、咽鼓管骨部长度较健侧小，差异具有统计学意义（t = 4.37、3.09、－3.17，P<0.05）。患侧乳突气化较健侧差，差异具有统计学意义（χ2 = 6.34，P<0.05）。患侧与健侧咽鼓管外耳道角、岩枕角及咽鼓管骨部最大径与咽鼓管骨部长度之比差异无统计学意义（P>0.05）。 结论 单侧慢性化脓性中耳炎患侧颞骨存在解剖变异。咽鼓管骨部小、乳突气化差及乳突窦入口狭窄与单侧慢性化脓性中耳炎相关。     

Downregulated parafibromin expression is a promising marker for pathogenesis, invasion, metastasis and prognosis of gastric carcinomas

Parafibromin is a protein encoded by the hyperparathyroidism 2 oncosuppressor gene and its downregulated expression is involved in pathogenesis of parathyroid carcinomas. To clarify the roles of parafibromin expression in tumourigenesis and progression of gastric carcinomas, it was examined by immunohistochemistry (IHC) on tissue microarray containing gastric carcinomas (n = 508), adenomas (n = 45) and gastritis (n = 49) with a comparison of its expression with clinicopathological parametres of carcinomas. Gastric carcinoma cell lines (MKN28, AGS, MKN45, KATO-III and HGC-27) were studied for parafibromin expression by IHC and western blot. Parafibromin expression was localised in the nucleus of gastric epithelial cells, adenoma, carcinoma cells and cell lines. Its expression was gradually decreased from gastritis to gastric carcinoma, through gastric adenomas (p < 0.05) and inversely correlated with tumour size, depth of invasion, lymphatic invasion, lymph node metastasis and Union Internationale Contre le Cancer (UICC) staging (p < 0.05) but not with sex or venous invasion (p > 0.05). Parafibromin was strongly expressed in older carcinoma patients compared with younger ones (p < 0.05). There was stronger positivity of parafibromin in intestinal-type than diffuse-type carcinomas (p < 0.05). Univariate analysis indicated cumulative survival rate of patients with positive parafibromin expression to be higher than without its expression (p < 0.05). Multivariate analysis showed that age, tumour size, depth of invasion, lymphatic invasion, lymph node metastasis, UICC staging and Lauren’s classification but not sex, venous invasion or parafibromin expression were independent prognostic factors for carcinomas(p < 0.05). Downregulated parafibromin expression possibly contributed to pathogenesis, growth, invasion and metastasis of gastric carcinomas. It was considered as a promising marker to indicate the aggressive behaviours and prognosis of gastric carcinomas.     

Evaluation of skeletal muscle DTI in patients with duchenne muscular dystrophy

Diffusion tensor imaging (DTI) is a popular method to assess differences in fiber organization in diseased and healthy muscle tissue. Previous work has shown that muscle DTI measurements depend on signal‐to‐noise ratio (SNR), %fat, and tissue T₂. The goal of this study was to evaluate the potential biasing effects of these factors on skeletal muscle DTI data in patients with Duchenne Muscular Dystrophy (DMD). MR images were obtained of the right lower leg of 21 DMD patients and 12 healthy controls on a Philips 3T system. DTI measurements were combined with quantitative in‐vivo measures of mean water T₂, %fat and SNR to evaluate their effect on DTI parameter estimation. All outcome measures were determined within ROIs drawn for six lower leg muscles. Between group analysis, using all ROIs, revealed a significantly elevated FA in the GCL, SOL and PER muscles (p<0.05) and an increased mean diffusivity (p<0.05) and λ₃ (p<0.05) in the TA muscle of DMD patients. In‐vivo evaluation of the individual confounders showed behaviour in line with predictions from previous simulation work. To account for these confounders, subsequent analysis used only ROIs with SNR greater than 20. With this criterion we found significantly greater MD in the TA muscle of DMD patient (p<0.009) and λ₃ in the TA and GCL muscles (p<0.001) of DMD patients, but no differences in FA. As both increased %fat and lower SNR are expected to reduce the apparent MD and λ₃, these between‐group differences are likely due to pathophysiology. However, the increased FA, observed when using all ROIs, likely reflects the effect of low SNR and %fat on the DTI parameter estimation. These findings suggest that measuring mean water T₂, %fat and SNR is essential to ascribe changes in DTI measures to intrinsic diffusion changes or to confounding influences. Copyright © 2015 John Wiley & Sons, Ltd.     

Gastric acid and histamine secretion in patients on continuous ambulatory peritoneal dialysis (CAPD)

Gastric secretion was measured in patients with chronic renal failure (CRF) on continuous ambulatory peritoneal dialysis (CAPD), non-uraemic patients with a duodenal ulcer (DU), and healthy volunteers (HV). Basal acid outputs were not significantly different in the three groups. Under pentagastrin stimulation, acid secretion was lower in CAPD patients than in DU patients (p<0.02) but not different from HV controls. Between CAPD and DU, basal histamine secretion measured in the gastric juice was not different, but the concentration in blood plasma was significantly lowr in the CAPD group (p<0.05). Under pentagastrin stimulation, gastric histamine output and plasma histamine concentration were significantly lower in CAPD patients (p<0.05, respectively). Both basal and pentagastrin-stimulated gastric acid and histamine outputs were directly related. These results suggest that CAPD patients do not have an increased risk of developing DU, but may need acid blockade if they are treated for hyperphosphataemia with aluminium containing drugs.

     

Impairment in recognition of emotional facial expressions in Alzheimer's disease is represented by EEG theta and alpha responses

Behavioral studies have shown that the recognition of facial expressions may be impaired in patients with Alzheimer's disease (AD). The identification and recognition of a facial expression might be represented by event‐related brain oscillations. The present study aims to analyze EEG event‐related oscillations and determine the electrophysiological indicators of impaired facial expression recognition in AD patients. EEGs of 30 healthy controls and 30 AD patients were recorded during their perception of three different facial expressions (angry, happy, neutral). Event‐related power spectrum and phase locking were analyzed in the theta (4?7) and alpha (8?13 Hz) frequency bands with the EEGLAB open toolbox. There was a significant facial Expression × Group interaction (p < 0.05) for the theta power spectrum; the healthy control group had higher theta power than the AD group during the perception of angry facial expressions (p < 0.05). There was a significant hemisphere difference between the two groups (p < 0.05). There was a right hemisphere alpha power dominance in healthy subjects. However, AD patients did not have this alpha power asymmetry. The present study, for the first time in the literature, presents the electrophysiological indicators of impaired recognition of facial expression in AD patients. The current study could be a basis for future studies that will analyze emotional processing in different kinds of dementia patients, and this study may have provided indicators of electrophysiological correlates of behavioral problems observed in clinical practice.     

Three‐Dimensional Study of the Facial Canal Using Microcomputed Tomography for Improved Anatomical Comprehension

The aims of this study were to determine the various dimensions of the normal facial canal and to identify the spatial relationships between the facial canal and its adjacent structures using microcomputed tomography (micro‐CT) imaging and three‐dimensional (3D) reconstruction. The petrous parts of 54 temporal bones were scanned using micro‐CT with a slice thickness of 35 μm. The serial micro‐CT images were used to reconstruct 3D volumes of the facial canal and the bony labyrinth with the aid of computer software. These volumes were used to measure 31 dimensions of the facial canal and its spatial relationships with adjacent structures. The length of the meatal segment, the tympanic segment, and the mastoid segment were significantly larger in males than in females (p < 0.05). The narrowest portions of the facial canal were immediately lateral to the meatal foramen in the labyrinthine segment and the midpoint of the tympanic segment. The distance between the origin of the canal for the chorda tympani nerve and midpoint of the stylomastoid foramen was 35.3% of the length of the mastoid segment, and the angle between the tympanic segment and the lateral semicircular canal was 16.3°. The angle between the mastoid segment and the canal for the chorda tympani nerve could be classified into two groups: <180° and >180°. These findings represent supplemental data for improving the detailed understanding of the facial canal anatomy. Anat Rec, 297:1808–1816, 2014. © 2014 Wiley Periodicals, Inc.     

Endostatin,Placental Growth Factor,and Fibroblast Growth Factors-1 and -2 in the Sera of Patients with Primary Osteosarcomas

Serum levels of endostatin, placental growth factor (PlGF), and fibroblast growth factors-1 and -2 (FGF-1 and FGF-2) were measured in 58 patients with primary osteosarcomas before therapy and in 21 healthy subjects. The incidence of serum FGF-1 in bone tumors was 2.5 times higher than in healthy individuals (p=0.004); significant levels of FGF-2, PlGF, and endostatin were detected in all examined subjects. The mean serum level of endostatin in healthy individuals was significantly lower than in the total group of patients with bone tumors (p=0.005). The level of FGF-1 in osteosarcomas was significantly higher than in chondrosarcomas (p<0.05). No appreciable differences in FGF-2 levels were detected in patients with tumors of different histological structure. The mean serum content of PlGF was virtually the same in healthy individuals and patients with bone tumors. A significant relationship between serum PlGF level and maximum tumor size (p=0.008) was detected in osteosarcoma. No relationships between the levels of FGF-1, FGF-2, PlGF, and endostatin were detected in healthy subjects and patients with primary tumors of the bones. Differences in 3-year overall survival values of patients with bone sarcomas with different initial serum levels of FGF-1 and endostatin were detected.     

Serum sFas, Leptin, and VEGF in Patients with Ovarian Cancer and Benign Tumors

The initial levels of soluble Fas antigen (sFas), leptin, and vascular endothelium growth factor (VEGF) were measured in the sera of 100 patients with ovarian cancer and benign tumors and in 60 healthy women aged 28–65 years. Serum levels of sFas and VEGF were elevated in the total group of patients with ovarian tumors, while leptin levels were the same as in healthy women. The studied parameters did not depend on the age of patients and healthy women. The levels of sFas and leptin were virtually the same in benign and malignant ovarian tumors, while VEGF concentration was higher in patients with ovarian cancer. The mean serum levels of sFas, VEGF, and leptin in patients with poorly and moderately differentiated serous ovarian cancer were 2-fold higher than in well-differentiated tumors (p<0.05), while serum concentrations of sFas and leptin increased with the disease stage progress in patients with ovarian cancer (p<0.05). According to the data of unifactorial analysis, the increase in serum levels of sFas and VEGF in ovarian cancer patients correlated with short duration of the relapse-free period. Multifactorial analysis showed that the disease stage (p=0.006), presence of ascites (p=0.03), VEGF concentration (p=0.02), and the sFas/leptin coeffi cient (p=0.045) are highly signifi cant independent factors for predicting the relapse-free survival of patients with serous ovarian cancer.     

The effectiveness of minimally invasive total knee arthroplasty to preserve quadriceps strength: A randomized controlled trial

We performed a single-center, randomized, double-blind study to compare muscle strength in patients who had undergone primary total knee arthroplasty (TKA), performed using either a minimally invasive or a conventional surgical technique. We evaluated 30 knees in healthy age-matched subjects, 22 knees after conventional TKA (conventional group), and 23 knees after minimally invasive surgery TKA (MIS group). The Hospital for Special Surgery (HSS) score, Oxford knee score (OKS), and isokinetic (60º/s) muscle strength were evaluated the day before surgery and 3, 6, and 12 months after surgery. HSS and OKS improved significantly over time during follow-up (p < 0.001), but there was no significant difference between the groups (p > 0.05). The extensor peak torque (EPT) and flexor peak torque (FPT) improved significantly over time (p < 0.001) and EPT was greater in the MIS group than in the conventional group during the follow-up period (p < 0.05). There was no difference in FPT and the hamstring-to-quadriceps ratio between the groups. Although MIS patients had a significant deficit in extensor strength following TKA, compared with healthy controls, this approach offers a significant improvement in extensor muscle strength over conventional surgery. These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.     

Normal cellular morphology of the blood of Japanese quail (<Emphasis Type="Italic">Coturnix coturnix japonica</Emphasis>)

Blood samples were collected from the wing vein of 75 clinically healthy quails (Coturnix coturnix japonica) according to their age (<1 week, 3, 5 and >5 weeks) and sex. The blood smears were stained using the Giemsa, Wright and new methylene blue methods. The result indicated that blood cell morphology in quails is similar to that in chickens and other birds. Age had a significant effect on lymphocyte size (p=<0.05), whereas sex had a significant effect on the width of reticulocytes and small lymphocytes (p =<0.05).     

Facial nerve paralysis due to chronic otitis media: prognosis in restoration of facial function after surgical intervention

Purpose

Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment.

Materials and Methods

A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes.

Results

Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis.

Conclusion

COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.