分泌性中耳炎豚鼠的咽鼓管表面活性物质变化

目的　观察豚鼠分泌性中耳炎时咽鼓管内表面活性物质的变化 ,探讨表面活性物质在分泌性中耳炎发病中的作用。方法　建立豚鼠分泌性中耳炎动物模型 ,分析咽鼓管内表面活性物质的生化成分和活性变化 ,同时观察给外源性表面活性物质治疗后咽鼓管内表面活性物质的变化。结果　豚鼠分泌性中耳炎模型组表面活性物质主要成分减少 ,磷脂酰胆碱 (phosphatidylcholine ,PC)和磷脂酰乙醇胺 (phosphatidylethanolamine ,PE)分别是 (19 9± 1 7) %和 (36 8± 2 7) % ,而正常组的PC和PE分别是 (2 5 7± 2 1) %和 (43 7± 3 8) % ,P值均 <0 0 0 1。模型组最低表面张力 (minimumsurfacetension ,γmin)为 (18 5± 2 4 )mN/m ,比正常组 (7 6± 0 8)mN/m升高 ,P <0 0 0l。给外源性表面活性物质治疗后 ,PC和PE增高 ,分别为 (2 3 3± 2 2 ) %和 (42 5± 3 6 ) % ,γmin降低 ,为 (11 8± 2 3)mN/m。结论　豚鼠分泌性中耳炎时咽鼓管内表面活性物质的主要生化成分明显减少 ,活性减弱 ,给外源性表面活性物质治疗后明显改善     

表面活性物质在分泌性中耳炎发病中的作用研究

本文就表面活性物质在分泌性中耳炎发病中的作用研究进展进行综述，讨论了表面活性物质的组成，功能及在中耳腔，咽鼓管及鼻咽部的分布特征。纵观表面活性物质研究的历史及新进展，认为内源性表面活性物质缺乏可引起中耳腔及咽鼓管粘膜表面张力改变，使咽鼓管开放压增高而致中耳积液，从而发生分泌性中耳炎，而外源性表面活性物质的运用及激发内源内源性表面活性物质的分泌可分为预防和治疗分泌性中耳炎开辟一条新途径。     

表面活性物质在分泌性中耳发病中的作用研究

本文就表面活性物质在分泌性中耳炎发病中的作用研究进展进行综述,讨论了表面活性物质的组成、功能及在中耳腔、咽鼓管及鼻咽部的分布特征。纵观表面活性物质研究的历史及新进展,认为内源性表面活性物质缺乏可引起中耳腔及咽鼓管粘膜表面张力改变,使咽鼓管开放压增高而致中耳积液,从而发生分泌性中耳炎。而外源性表面活性物质的运用及激发内源性表面活性物质的分泌可为预防和治疗分泌性中耳炎开辟一条新途径。     

肺表面活性物质滴鼻治疗分泌性中耳炎的形态学观察

目的肺表面活性物质滴鼻治疗分泌性中耳炎,观察咽鼓管的组织病理变化。方法鼓室内注射灭活的流感嗜血杆菌,建立豚鼠分泌性中耳炎的动物模型。50只豚鼠随机取10只作为正常组;40只造模,31只造模成功(听力下降,双侧中耳积液),再随机分为3组。造模组10只;生理盐水组10只;肺表面活性物质治疗组(D)11只。观察各组咽鼓管粘膜的组织病理学变化。结果比较各组咽鼓管光镜下的组织病理学变化,发现造模组和生理盐水组咽鼓管粘膜肿胀,杯状细胞增生,纤毛倒伏、排列紊乱、部分脱落;PS治疗组咽鼓管粘膜稍肿胀,纤毛排列整齐、无倒伏,与正常组相似。结论肺表面活性物质滴鼻对分泌性中耳炎咽鼓管粘膜纤毛系统具有抗炎、保护纤毛结构的作用。     

表面活性物质在分泌性中耳炎咽鼓管开放功能中的作用

目的　探讨外源性的表面活性物质在分泌性中耳炎咽鼓管开放功能中的作用。方法　通过鼓室内注入灭活的肺炎链球菌悬液 ,建立分泌性中耳炎动物模型 ,测试咽鼓管的被动开放压。结果　测试了中耳有渗液者 2 7耳和正常者 2 1耳的咽鼓管被动开放压 ,有渗液耳的被动开放压高于正常耳的被动开放压 ,分别注入外源性的表面活性剂后 ,被动开放压均降低 (P <0 .0 1)。结论　外源性的表面活性剂可以降低咽鼓管的表面张力 ,有利于咽鼓管的开放     

咽鼓管表面活性物质的研究进展

本文就咽鼓管表面活性物质研究资料进行综述。咽鼓管表面活性物质的不足可能是导致咽鼓管功能障碍原因之一,并易诱发分泌性中耳炎及中耳气压性损伤。     

肺表面活性物质治疗豚鼠分泌性中耳炎前后咽鼓管的组织形态学变化

目的　研究肺表面活性物质对分泌性中耳炎的治疗作用 ,为分泌性中耳炎的治疗探索新的途径。方法　采用灭活的肺炎链球菌鼓室内注射 ,建立豚鼠分泌性中耳炎的动物模型 ,鼓室内注射肺表面活性物质 1周后检测听性脑干反应 (auditorybrainstemresponse ,ABR)反应阈的变化 ,观察肺表面活性物质治疗前后咽鼓管黏膜光镜和电镜下的组织形态学变化。结果　豚鼠鼓室内注射灭活肺炎链球菌悬浮液 5d后 :鼓室积液 ,鼓膜浑浊 ,光锥消失 ,ABR平均 ( x±s)反应阈由正常对照组的 (14 0± 3 1)dB提高至 (45 0± 5 7)dB ;豚鼠咽鼓管黏膜层增厚 ,黏膜面有无结构的红染物覆盖 ,纤毛排列紊乱。经肺表面活性物质治疗 1周后 :鼓室积液减少或消失 ,ABR平均反应阈由 (45 0± 5 7)dB降低为(2 3 5± 6 3)dB。t检验分析 ,造模组与肺表面活性物质治疗组反应阈差异有极显著性 (P <0 0 0 1) ;豚鼠咽鼓管黏膜层变薄 ,纤毛排列较整齐 ,朝向鼻咽侧。结论　肺表面活性物质对豚鼠分泌性中耳炎有治疗作用。     

头孢克洛和氨溴索治疗分泌性中耳炎的临床观察

分泌性中耳炎 (secretoryotitismedia ,SOM)是耳科的常见病之一 ,也是引起听力损失较常见的原因。引起SOM的原因很多 ,咽鼓管功能不良是SOM发生的重要因素。近年来的研究表明 ,咽鼓管内表面活性物质的缺乏是引起咽鼓管功能不良的重要原因之一 ,外源性表面活性物质已应用于SOM的临床治疗。本文自 2 0 0 2年 1月起对我科门诊确诊的 12 0例分泌性中耳炎患者采用鼓室穿刺抽液后随机分配两种口服药物治疗方案 ,其听力提高及鼓室导抗图由“B”、“C”型图转A型图较明显 ,两组间无统计学差异 ,现将两组治疗方法及结果报告如下。1　资料与方法…     

氨溴索治疗豚鼠分泌性中耳炎实验观察

咽鼓管压力平衡、引流和保护功能的体现与其黏膜表面活性物质有关,咽鼓管黏膜内磷脂堆积形成板层结构,称为板层体即是表面活性物质的前体,咽鼓管表面活性物质的合成、分泌及作用与板层体有关。已有研究表明,氨溴索能够增加肺II型细胞及板层体的数量,提高表面活性物质的作用。由此我们设计本课题,应用氨溴索治疗豚鼠分泌中耳炎,观察其疗效。     

颌下径路阻塞咽鼓管创建大鼠分泌性中耳炎模型

目的 探讨建立大鼠分泌性中耳炎模型的纯物理学方法 ,为建立无化学因素影响的分泌性中耳炎动物模型提供一种造模参考方法 .方法 24只清洁级SD大鼠右侧耳为模型组,左侧为对照组.模型组用木塞经右侧颌下径路阻塞咽鼓管创建分泌性中耳炎大鼠模型,对照组不做任何处理,用ABR和鼓室导抗图检测动物听功能和中耳功能的变化,并用光学显微镜观察中耳黏膜的病理改变.结果模型组24耳中有20耳ABR反应阈从造模前的34.25±5.45 dB升高到57.63±5.46 dB,造模前后ABR反应阈差异有统计学意义(P<0.05).对照组鼓室导抗图为A型或As型,模型组中20耳为B型.光镜下可见模型组病变主要在中耳腔及咽鼓管,有浆细胞大量渗出,咽鼓管腔狭窄,纤维增生,毛细血管扩张.结论 通过颌下径路用木塞阻塞大鼠咽鼓管的方法 可以影响其咽鼓管的功能,成功建立分泌性中耳炎动物模型.     

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF‐C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty‐two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow‐up was 2 years after radiotherapy. Expression of VEGF and VEGF‐C was evaluated by immunohistochemistry of formalin‐fixed, paraffin‐embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF‐C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF‐C (P < 0.001). In addition, the expression of VEGF‐C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF‐C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF‐C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.     

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.     

Cervical Reflex Induced by Click Stimuli in Cats

We studied click-evoked potentials in the anterior horn of the spinal cord in 17 cats. A concentric needle electrode was inserted into the anterior horn of the spinal cord at levels C3-C6. Potentials evoked with 105 dB SPL clicks were recorded with a peak latency of 4.89-5.10 ms only at the C3 level. These responses were observed 45-60 dB SPL above the auditory brainstem response (ABR) threshold, and no potentials were evoked by stimulation of the contralateral ear. Average was performed 100 times with changes in stimulation frequency of 1-20 Hz. The amplitude of the potentials decreased with increasing stimulus frequency, but there were no changes in ABRs. The responses disappeared after destruction of the medial vestibulospinal tract at the obex level, but ABRs were still recorded. The spinal nucleus of the accessory nerves was located in the anterior horn of the spinal cord at levels C1-C6, and the sternocleidomastoid muscle motoneurons were found at levels C1-C3. The click-evoked potentials recorded in this study reflect responses of the spinal nucleus of accessory nerves through the vestibulospinal tract to click stimulation. The responses have the same characteristics as vestibular-evoked myogenic potentials that can be recorded using surface electrodes over the sternocleidomastoid muscles of humans.     

Lack of significant estrogen and progesterone receptor expression in nasal telangiectasias in hereditary hemorrhagic telangiectasia: an immunohistochemical analysis

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change - 39, SD 57.3, p <0.001), recall (mean change - 24.3, SD 39.3, p <0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change-9.1, SD 15.7, p <0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p <0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p <0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.     

Measurement of chemosensory function

Although hundreds of thousands of patients seek medical help annually for disorders of taste and smell, relatively few medical practitioners quantitatively test their patients' chemosensory function, taking their complaints at face value. This is clearly not the approach paid to patients complaining of visual, hearing, or balance problems. Accurate chemosensory testing is essential to establish the nature, degree, and veracity of a patient's complaint, as well as to aid in counseling and in monitoring the effectiveness of treatment strategies and decisions. In many cases, patients perseverate on chemosensory loss that objective assessment demonstrates has resolved. In other cases, patients are malingering. Olfactory testing is critical for not only establishing the validity and degree of the chemosensory dysfunction, but for helping patients place their dysfunction into perspective relative to the function of their peer group. It is well established, for example, that olfactory dysfunction is the rule, rather than the exception, in members of the older population. Moreover, it is now apparent that such dysfunction can be an early sign of neurodegenerative diseases such as Alzheimer's and Parkinson's. Importantly, older anosmics are three times more likely to die over the course of an ensuring five-year period than their normosmic peers, a situation that may be averted in some cases by appropriate nutritional and safety counseling. This review provides the clinician, as well as the academic and industrial researcher, with an overview of the available means for accurately assessing smell and taste function, including up-to-date information and normative data for advances in this field.