Lateral skull base surgery: the otology group experience

Lateral skull base surgery has remained the surgical frontier of new developments in the treatment of lesions heretofore difficult to access. Examination of surgical results stimulates technical innovation and provides an intervention risk-benefit ratio assessment for particular lesions useful in management planning. With this in mind, we report the updated collective experience with lateral skull base surgery at the Otology Group over the past 20 years. Two hundred ninety-eight patients underwent surgical intervention for lateral skull base lesions. In 81 patients these lesions were malignant; in 217, benign. Of the benign lesions, 165 were glomus tumors: 139 glomus jugulare, 19 glomus vagale, and 7 glomus tympanicum. The remainder comprised 21 menigniomas, 14 neuromas, two neurofibromas, and a small group of much rarer entities. The philosophy of surgical approach, results, and follow-up are discussed.     

Hepatitis C virus-infected, HCV-RNA-negative patients with bleeding disorders--relationship to age, HIV and treatment

All 155 anti-hepatitis C-virus (HCV) positive patients with haemostatic disorders at our unit were tested for HCV-RNA in order to determine the prevalence of a negative result. The patients were also characterized in order to find predictors for a negative HCV-RNA test. The prevalence of a negative HCV-RNA test was 15.5% (24 of 155) and this was similar among anti-HIV positive and negative patients. A common denominator for the 4 HIV-infected, HCV-RNA negative haemophiliacs was treatment with azidothymidin prior to the first test. Among the anti-HIV negative patients, those < 40 y of age had a significantly greater chance of being HCV-RNA-negative than the older ones (27.3 vs 3.6%). They also had a lower consumption of plasma products than age-matched HCV-RNA positive cases. Absence of co-infection with hepatitis B was not correlated with a negative HCV-RNA test. Young age and a low requirement for factor concentrates thus seem to be predictors for a negative HCV-RNA test in patients with bleeding disorders.     

Differentiated storage mechanisms for noradrenaline and dopamine in the rabbit heart

Uptake and binding of dopamine and noradrenaline were studied in rabbit heart and brain after partial depletion of the amine stores with decaborane and inhibition of β-hydroxylation with disulfiram. Intravenous or intramuscular injection of noradrenaline and dopamine increased the noradrenaline content in partially noradrenaline-depleted hearts. After decaborane + disulfiram, 50 μg/kg noradrenaline intravenously still increased the noradrenaline content from 0.28 to 0.77 μg/g in 1 hr (P = < 0.001) whereas 100 μg/kg dopamine intravenously only increased the dopamine content from 0.016 to 0.105 μg/g in the same time. It is concluded that dopamine cannot effectively utilize the noradrenaline-binding sites made available after partial depletion by decaborane and inhibition of β-hydroxylation.     

Standard and variant CD44 isoforms are commonly expressed in lung cancer of the non-small cell type but not of the small cell type

Cluster of differentiation 44 (CD44) encompasses a polymorphic family of cell membrane glycoproteins involved in the mechanism of tumour invasion and metastasis. Since non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) display very different rates of progression, a significant discrepancy in their CD44 expression profiles is to be expected. An immunohistochemical study was undertaken on the expression of standard CD44 (CD44s) and the variant isoforms containing the domains encoded by variant exon 3 (CD44v3) or variant exon 6 (CD44v6) in paraffin-embedded bronchial biopsy specimens from 32 NSCLC cases and 11 SCLC cases. An absolute lack of immunoreactivity for CD44s, CD44v3, and CD44v6 was obtained in every case of SCLC, whereas 28 of the 32 NSCLC cases showed a positive immunoreaction for at least one of the three epitopes investigated. In conclusion, the occurrence of standard and variant CD44 isoforms in NSCLC and their absence in SCLC suggest the possibility that CD44 is in some way instrumental in conditioning the biological behaviour of NSCLC, but not of SCLC, whose metastatic cascade would be set in motion by the activation of hitherto unidentified, CD44-independent pathways.     

Über die struktur der aus maleinsäureanhydrid in gegenwart organischer basen erhaltenen polymeren

The structure of the dark polymers of maleic anhydride obtained in the presence of triethylamine and pyridine was investigated. A cis-polyvinyleneketoanhydride structure is suggested for the polymer obtained with triethylamine. The polymer obtained with pyridine is a cis-polyvinyleneketoanhydride but other structural units are also present in its chain (cyclopentanone, maleic anhydride). The polymers display the characteristic properties of polyconjugated polymers: dark colour, signal of electron paramagnetic resonance and solubility only in polar solvents.     

Über oligomere siliciumverbindungen mit funktionellen gruppen. 18. Mitt. Herstellung und polyadditionsreaktionen des 1,1′-bis-(dimethylhydrosilylmethyl)-ferrocens

Cyclopentadienyl sodium reacts in polar solvents with chloromethyldimethylhydrosilane and chloromethyldimethyl-n-butoxysilane to the corresponding cyclopentadienylmethylsilanes. These can be converted to silylmethyl substituted ferrocene derivatives having either two H? Si- (a) or two n? C₄H₉? O? Si- (b) groups by treatment with isopropylmagnesiumchloride and FeCl₂. Reduction of (b) with LiAlH₄ leads to (a). 1,1′-Bis-(dimethylhydrosilymethyl)-ferrocene (a) adds to acetylene in the presence of H₂PtCl₆ as catalyst to form 1,1′-bis-(dimethylvinylsilymethyl)-ferrocene (c). The polyaddition of (a) to (c) or of (a) to 1,3-divinyldisiloxane yields polymers with ferrocene in the main chain whose thermal properties are examined.     

Sorptions- und diffusionsuntersuchungen an polypropylenfasern

The equilibrium swelling and sorption, and the diffusion coefficient of methylmethacrylat vapour in unstretched and to various degrees stretched polypropylene fibres were determined. The crystallinity of the fibres increased by heat treatment. The equilibrium swelling and sorption alter inversely with the change of orientation and cristallinity. The alteration of the specific gravity respectively the crystallinity as a consequence of heat treatment is appreciated by the sorption and swelling results, especially at less oriented specimens. The diffusion coefficient is influenced first of all by the change of orientation, which is demonstrated by the difference of activation energies of stretched and unstretched specimens too.     

Interaction of the terminal complement components C5b-9 with synovial fibroblasts: binding to the membrane surface leads to increased levels in collagenase-specific mRNA.

The late complement components, apart from their lytic function, are known to trigger the release of various proinflammatory substances from different types of nucleated cells. In the present study, the interaction of C5b-9 with synovial fibroblast cells (SFC) was examined. It was found that incubation of SFC with activated complement components resulted in binding of C5b-9 to the cell membrane; subsequently an increase in abundance of collagenase-specific mRNA was seen, as assessed by Northern blotting. When C8-deficient serum was used as source of complement neither binding of C5b-9 nor an increase in collagenase-specific mRNA could be detected. These findings suggest that C5b-9, which might be generated during rheumatoid inflammation, may contribute to chronic joint destruction by triggering collagenolytic activity.     

Über polystyrol-phenyl-disulfimid. Umsetzungen an hochpolymeren in einer dreiphasenreaktion

In a “three-phase-reaction” polystyrenesulfonamide reacts with benzenesulfonylchloride to polystyrenephenyldisulfimide. From this polymer 11 salts were obtained by ion-exchange chromatography and their thermostability was studied.