Hypopharyngeal perforation because of blunt neck trauma

Hypopharyngeal rupture because of blunt neck trauma is an extremely rare clinical entity. Early diagnosis and appropriate management are of great importance, given that an overlooked injury can lead to catastrophic consequences. We herein describe the case of a 21-year-old man who presented with a knee injury after a low-speed motor cycle accident, but was otherwise asymptomatic. A detailed history was taken, whereas thorough clinical examination revealed slight tenderness of the anterior neck. Complete imaging examinations finally revealed characteristic findings of hypopharyngeal perforation. The patient was treated conservatively with success. A high degree of clinical suspicion is therefore the key to an early diagnosis and successful management of this rare injury.     

Lifestyle factors and serum androgens among 636 middle aged men from seven countries in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Objective  To evaluate the association between lifestyle and dietary factors and serum concentrations of androgens in middle-aged healthy men. Methods  We conducted a cross-sectional analysis of the association of lifestyle factors with circulating concentrations of androstenedione (A-dione), 3-α-androstanediol glucuronide (A-diol-g), testosterone (T), SHBG (sex hormone-binding globulin), and free testosterone (FT) among 636 men in the European Prospective Investigation into Cancer and Nutrition. Results  Compared with the youngest age group (40–49 years), the oldest (70–79 years) had a higher mean concentration of SHBG (by 44%) and lower mean concentrations of A-diol-g (by 29%) FT (19%). Men in the highest BMI group (≥29.83 kg/m²) had a higher mean A-diol-g concentration (by 38%) and lower mean concentration of T (by 20%) SHBG (29%) compared with the lowest (<24.16 kg/m²). Current smokers had higher mean concentrations of T (by 13%), SHBG (14%), and A-dione (15%) compared with never smokers. Physical activity and dietary factors were not associated with androgen concentrations, although men in the highest fifth of alcohol intake had higher mean concentrations of A-dione (by 9%), FT (11%) compared with the lowest. Conclusion  Our results suggest that age, body weight, smoking, and alcohol intake are associated with circulating androgen concentrations in men.     

Expression of integrin-linked kinase and its binding partners in chondrosarcoma: association with prognostic significance

Integrin-linked kinase (ILK) and its binding partners alpha-parvin, beta-parvin, Mig-2 and Migfilin are important components of the cell-matrix adhesions implicated in cell motility, growth, survival and ultimately carcinogenesis. Herein, we investigated immunohistochemically the expression of these molecules in cartilaginous neoplasms and explored their involvement in chondrosarcoma pathobiology and behaviour. Our analyses revealed that ILK, alpha-parvin, beta-parvin and Mig-2 are expressed in the majority of chondrosarcomas but in a small proportion of enchondromas, implying that these proteins might have a role in the development and progression of chondrogenic neoplasms. Moreover, our findings highlight the possibilities that ILK might serve as biological marker that could accurately predict a high-grade tumour and that Mig-2 may function as a promising prognostic indicator of high-risk patients.     

Recurrence of brain tumours in patients treated with growth hormone: analysis of KIGS (Pfizer International Growth Database)

Background: Growth hormone (GH) has been used successfully in the treatment of short stature secondary to GH deficiency in survivors of childhood brain tumours. There has been concern that GH might increase the risk of recurrence. Aim: To analyse KIGS (Pfizer International Growth Database) with respect to tumour recurrence in patients with brain tumours. Methods: Data for tumour recurrence were analysed retrospectively in 1038 patients with craniopharyngiomas, 655 with medulloblastomas, 113 with ependymomas, 297 with germinomas, and 400 with astrocytomas or gliomas. All patients had received recombinant human GH (Genotropin®, Pfizer Inc.). Results: Recurrence-free survival rates were 63% at a follow-up of 10.3 y in craniopharyngioma, 69% in 9.1 y in the glial tumours, 71% in 7.4 y in germinomas, 92% in 4.6 y in medulloblastomas and 89% in 2.5 y in ependymomas. Dose of GH and treatment modalities did not differ significantly between patients with and without recurrence.
Conclusion: Tumour recurrence rates in surviving patients with brain tumours receiving GH treatment do not appear to be increased compared with published reports. However, longer follow-up regarding recurrences and secondary neoplasms remains essential.     

Correlation of transiently evoked to distortion-product otoacoustic emission measures in healthy children

OBJECTIVE: Transiently evoked (TEOAEs) and distortion-product otoacoustic emissions at the 2f1-f2 frequency (DPOAEs) are being used as a clinical tool for diagnosis of peripheral auditory pathology. Because both tests are fast and non-invasive, they may be an excellent method for hearing screening in infants and children. The purpose of this study was to compare the TEOAE and DPOAE measures obtained in a group of healthy children. METHODS: Sixty-six school-aged children with normal hearing were included in the study. Subjects with recent otologic disease or abnormal tympanograms were excluded. TEOAEs and DPOAEs were performed using a DP Echoport ILO 292 Otodynamics analyzer connected to a portable personal computer. Correlation between TEOAE amplitudes and DPOAE levels was estimated. RESULTS: Correlation between TEOAE amplitudes and DPOAE levels was highly significant across all measured frequencies. Correlation was more significant at the middle frequencies than at the low and high frequencies. CONCLUSIONS: Although frequency specific information may be obtained by both tests, most reliable results were obtained at the middle frequencies. TEOAE values were more prominent at low frequencies, whereas DPOAEs were more effective at high frequencies. Both methods are reliable, objective, fast and useful tests of the cochlear status and should be included in the standard audiological diagnostic work-up of children.