Combined treatment for tumours of the base of the skull

AimTumours situated in the region of the base of the skull are at the limits of possibility for radical resection and in patients with malignant tumours it is necessary to use combined methods of treatment. The purpose of this paper is to evaluate the early results of combined treatment tumours of the base of the skull.Materials/MethodsBetween 1994 and 2004 68 patients with malignant tumours of the base of the skull and 10 with benign tumours were treated by an interdisciplinary group. Treatment included surgery, radiotherapy, and chemotherapy.ResultsAfter a period of post operative observation (median length 19 months), 32 patients with malignant tumours were without recurrence of disease, 8 lived with the tumour, 21 died as a result of disease progression and 4 died of other causes. Information was unavailable for 3 patients. Among 10 patients with benign tumours, 5 lived without symptoms of disease and 5 with the tumour.ConclusionsBecause of the limited possibilities regarding radical removal of malignant tumours in the region of the base of the skull, combined treatment using radiotherapy, surgery and, in some cases, chemo therapy is standard. Use of aggressive treatments gave local control in about half the patients though further observation is necessary in order to assess later oncological results

Molecular oncology focus - Is carcinogenesis a 'mitochondriopathy'?

Mitochondria are sub-cellular organelles that produce adenosine triphosphate (ATP) through oxidative phosphorylation (OXPHOS). As suggested over 70 years ago by Otto Warburg and recently confirmed with molecular techniques, alterations in respiratory activity and in mitochondrial DNA (mtDNA) appear to be common features of malignant cells. Somatic mtDNA mutations have been reported in many types of cancer cells, and some reports document the prevalence of inherited mitochondrial DNA polymorphisms in cancer patients. Nevertheless, a careful reanalysis of methodological criteria and methodology applied in those reports has shown that numerous papers can't be used as relevant sources of data for systematic review, meta-analysis, or finally for establishment of clinically applicable markers

Mitochondrial genotype in vulvar carcinoma - cuckoo in the nest

Vulvar squamous cell carcinoma (VSCC) is a rare female genital neoplasm. Although numerous molecular changes have been reported in VSCC, biomarkers of clinical relevance are still lacking. On the other hand, there is emerging evidence on the use of mtDNA as a diagnostic tool in oncology. In order to investigate mtDNA status in VSCC patients, haplogroup distribution analysis and D-loop sequencing were performed. The results were compared with available data for the general Polish population, cancer free-centenarians as well as patients with endometrial and head and neck cancer. The obtained data were also compared with the current status of mitochondrial databases. Significant differences in haplogroup distribution between VSCC cohort, general Polish population and cancer-free centenarians cohort were found. Moreover, a correlation between the VSCC patients haplogroup and HPV status was observed. Finally, a specific pattern of mtDNA polymorphisms was found in VSCC. Our results suggest that the mitochondrial genetic background may influence the risk of VSCC occurrence as well as susceptibility to HPV infection

Laryngeal embryonal rhabdomyosarcoma in an adult - A case presentation in the eyes of geneticists and clinicians

<p>1. Abstract</p> <p>Background</p> <p>Rhabdomyosarcoma is a solid tumor, resulting from dysregulation of the skeletal myogenesis program. For rhabdomyosarcomas (RMS) with a predilection for the head and neck, genitourinary tract, extremities, trunk, retroperitoneum, the larynx is still an unusual site. Till now only several cases of this laryngeal tumor have been described in world literature in the adult population. The entire spectrum of genetic factors underlying RMS development and progression is unclear until today. Multiple signaling pathways seem to be involved in ERMS development and progression.</p> <p>Case presentation</p> <p>In this paper we report an interesting RMS case in which the disease was located within the glottic region. We report an embryonal rhabdomyosarcoma of the larynx in 33 year-old man. After unsuccessful chemotherapy hemilaryngectomy was performed. In follow up CT no signs of recurrence were found. Recently patient is recurrence free for 62 months.</p> <p>Conclusions</p> <p>Considering the histological diagnosis and the highly aggressive nature of the lesion for optimal diagnosis positron electron tomography (PET) and computerized tomography (CT) of the neck and thorax should be performed. At this time surgical treatment with adjuvant radiotherapy seems to be the treatment of choice for this disease. Rhabdomyosarcoma of the larynx has a better prognosis than elsewhere in the body, probably because of its earlier recognition and accessibility to radical surgery.</p

Measurement of the upper respiratory tract aerated space volume using the results of computed tomography

The paper presents the possibilities of quantitative analysis of results obtained from CT examination of organs and anatomical structures of the upper respiratory tract. The presented results of the analysis were obtained using proprietary software developed in the MATLAB 2018b environment (Image Processing toolbox). The software enables to visualize the original results of CT scan and, after evaluating the visible structures, enables to select the area to be subjected to quantitative analysis. After the initial identification of an area of interest requiring detailed diagnostics, its volume and the surface areas of individual cross-sections are calculated in the area separated for examinations. A graphical presentation of the analysis results - the surface areas of selected cross-sections possible to visualize in two- and three-dimensional space - enables quick analysis of changes in the examined region

Anatomical and functional assessment of patency of the upper respiratory tract in selected respiratory disorders - Part 1

The rapidly developing measurement techniques and emerging new physical methods are frequently used in otolaryngological diagnostics. A wide range of applied diagnostic methods constituted the basis for the review study aimed at presenting selected modern diagnostic methods and achieved diagnostic results to a wider group of users. In this part, the methods based on measuring the respiratory parameters of patients were analysed. Respiration is the most important and necessary action to support life and its effective duration. It is an actual gas exchange in the respiratory system consisting of removing CO2 and supplying O2. Gas exchange occurs in the alveoli, and an efficient respiratory tract allows for effective ventilation. The disruption in the work of the respiratory system leads to measurable disturbances in blood saturation and, consequently, hypoxia. Frequent, even short-term, recurrent hypoxia in any part of the body leads to multiple complications. This process is largely related to its duration and the processes that accompany it. The causes of hypoxia resulting from impaired patency of the respiratory tract and/or the absence of neuronal respiratory drive can be divided into the following groups depending on the cause: peripheral, central and/or of mixed origin. Causes of the peripheral form of these disorders are largely due to the impaired patency of the upper and/or lower respiratory tract. Therefore, early diagnosis and location of these disorders can be considered reversible and not a cause of complications. Slow, gradually increasing obstruction of the upper respiratory tract (URT) is not noticeable and becomes a slow killer. Hypoxic individuals in a large percentage of cases have a shorter life expectancy and, above all, deal with the consequences of hypoxia much sooner

HINTS na ostro – opis przypadku

Vertigo is a false sense of motion of either the environment or self and is diagnosed in approximately half of the patients with dizziness. Acute spontaneous onset of vertigo is called acute vestibular neuritis (AVN). It is caused by peripheral lesion and requires symptomatic treatment. The symptoms of AVN can mimic a central pathology like cerebellar or brainstem infarction with no concomitant red-flag manifestation. Magnetic Resonance Neuroimaging with Diffusion-weighted imaging (MRI-DWI) as well as Computed Tomography (CT) scan delivers false negatives results what significantly delays stroke treatment. HINTS is an acronym for the battery of three bedside tests of ocular motor physiology. The method is more sensitive in diagnosing posterior circulation infarct than MRI-DWI with specificity -96 %. We present a case of a patient with vertigo who underwent two cranial CT scans and neurological examination. HINTS was worrisome. The brainstem infarct diagnosis was confirmed by MRI-DWI.Vertigo to fałszywe poczucie ruchu otoczenia lub własnej osoby. Jest to objaw rozpoznawany u około połowy pacjentów z zawrotami głowy. Nagły, samoistny napad vertigo nazywany jest ostrym zespołem przedsionkowym (OZP). Jest to schorzenie spowodowane uszkodzeniem obwodowego układu nerwowego wymagające leczenia objawowego. Objawy OZP mogą imitować patologię ośrodkową, m.in. zawał móżdżku lub pnia mózgu. Co więcej, zawrotom głowy, zaburzeniom równowagi zwykle nie towarzyszą objawy alarmowe takie jak ból głowy, porażenie połowy ciała, utrata przytomności i niewyraźna mowa. Dodatkowo, badanie rezonansu magnetycznego z opcją DWI oraz tomografia komputerowa używane w diagnostyce udaru, często dają wyniki fałszywie ujemne. Powyższe problemy diagnostyczne znacznie opóźniają leczenie udaru niedokrwiennego omawianej okolicy. HINTS to akronim, pochodzący od pierwszych liter trzech testów przyłóżkowych, mających na celu obserwację ruchów gałek ocznych. Metoda jest bardziej czuła niż MRI-DWI w diagnozowaniu zawału tylnego krążenia mózgu ze swoistością -96%. Przedstawiamy przypadek pacjenta z zawrotami głowy, któremu wykonano dwa tomografie komputerowe i badanie neurologiczne. Wynik baterii testów HINTS był niepokojący. Rozpoznanie zawału pnia mózgu zostało potwierdzone po wykonaniu MRI-DWI

Association of breathing patterns and quality of life in patients with nasal obstruction

Introduction: In the general population, nasal obstruction is a common complaint. However, an objective evaluation of nasal obstruction is difficult. Nose examination, computed tomography (CT), acoustic rhinometry, and anterior rhinomanometry do not accurately reflect the discomfort reported by patients with nasal obstruction. In patients with nasal obstruction, this study evaluated nasal breathing with a unique device for continuous nasal-oral spirometry – a nasal-oral flow analyzer (NOFA); moreover, quality of life was compared between patients with normal nasal breathing on NOFA and of those with impaired nasal breathing on NOFA.Methods: Of 181 adult patients admitted to an ENT department due to nasal obstruction that were enrolled in the study, 97 (53.6%) completed all per-protocol assessments, including the SF-36 questionnaire and 3-hour, continuous nasal-oral spirometry with NOFA. Based on the presence of normal nasal breathing defined as ≥95% of nasal flow, the 97 patients were divided into those with normal nasal breathing (n=31) and impaired nasal breathing (n=66).Results: Patients with normal nasal breathing differed from those with impaired nasal breathing with respect to all SF-36 subscales (physical functioning, p=0.004; role-physical, p=0.009; bodily pain, p<0.001; general health, p=0.007; vitality, p=0.002; social functioning, p=0.008; mental health, p=0.009; physical component summary, p<0.001; mental component summary, p=0.02), except for the role-emotional subscale (p=0.1).Conclusions: Among patients with symptoms of nasal obstruction, compared to patients with normal nasal breathing, those with impaired nasal breathing had significantly lower quality of life in the physical and mental domains. Further research needs to determine whether NOFA can be used to diagnose nasal obstruction