Facial Baroparesis Caused by Scuba Diving

Middle ear barotrauma is one of the common complications of SCUBA diving representing acute otalgia, hearing loss, and bleeding. But occurrence of facial palsy is rare. Here we report a case of a 30-year-old navy diver suffered middle ear barotrauma with transient facial palsy after SCUBA diving. He felt difficulty in equalizing the pressure in middle ear with Valsalva maneuver during diving, and suffered right facial palsy and aural fullness after diving. Clinical examination showed remarkable bulging of the right tympanic membrane and right facial palsy without other neurological findings. But facial palsy was disappeared immediately after myringotomy. We considered that the etiology of this case was neuropraxia of facial nerve in middle ear caused by over pressure of middle ear

Carbon ion radiotherapy for chondrosarcoma

Purpose: Chondrosarcoma is the second most frequent primary malignant bone tumor. Surgery has been considered as the main form of treatment for chondrosarcoma, and the definitive en bloc resection of tumor is mandatory to obtain long term disease free survival. However, radical surgical intervention has been associated with substantial morbidities. Due to the high linear energy transfer (LET) and the Bragg peak, carbon ion radiotherapy has been expected to be more effective and safe in the treatment for sarcomas than low-LET radiation like photons. We evaluated the effectiveness and safety of carbon ion radiotherapy in patients with chondrosarcoma not suitable for surgical resection.Methods: From 1996 to 2009, 71(male/female:40/31) patients with chondrosarcoma, not suited for resection, received carbon ion radiotherapy. Ages ranged from 17 to 82 (median 56 years). Fifty seven patients had primary disease presentation and 14 patients with recurrent disease after surgery. Histologic grade were as follows: grade 1 in 6, grade 2 in 40, grade 3 in 7, dedifferentiated in 3, mesenchymal in 5 patients, and 10 in not specified their grade. There were 51 pelvic (36 iliac, 13 sacral, and 2 pubic) lesions, 6 thoracic spine, 5 lumber, 5 rib, 4 cervical, 1 scapula, 1 femur, and 1 fibula. Carbon ion radiotherapy was delivered in 16 fractions over 4 weeks. Total doses: 57.6 GyE (3.6 GyE / Fr) in 2, 64.0 GyE (4.0 GyE / Fr) in 7, 70.4 GyE (4.4 GyE / Fr) in 62, and.73.6 GyE (4.6 GyE / Fr) in 3 patients. Clinical target volumes ranged between 25 and 2900 cm3 (median 488 cm3). Results: Median follow up time was 34 (range: 3-117) months for all patients and all living patients were followed more than 6 months. At 5 years, actuarial overall local control rate and overall survival rate were 60% and 60%, respectively. Four patients experienced grade 3 and/or 4 skin/soft tissue late reactions in this series. Conclusions: Carbon ion radiotherapy is suggested to be an effective and safe treatment for chondrosarcoma, especially for whom surgical resection is not a viable option, and it appears to represent a promising alternative to surgery.CTOS 16th Annual Meetin

Bilobed Flap for Reconstruction of Skin Defects after Excision of Parotid Carcinoma: A Case Report

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Carbon Ion Radiotherapy in Bone and Soft Tissue Sarcomas

The Heavy Ion Medical Accelerator in Chiba (HIMAC) is the world\u27s first heavy ion accelerator complex dedicated to medical use in a hospital environment. Heavy ions have superior depth-dose distribution and greater cell-killing capability than other forms of radiation. In June 1996, clinical research for the treatment of bone and soft tissue sarcomas was begun using carbon ions generated by the HIMAC. As of February 2010, a total of 507 patients with bone and soft tissue sarcoma were enrolled in these clinical trials. Most of the patients had locally advanced and/or medically inoperable sarcomas. The clinical trials revealed that carbon ion radiotherapy provided definite local control and offered a survival advantage without unacceptable morbidity for patients with bone and soft tissue sarcomas that were hard to cure using other modalities.The 4th Japanese-European Joint Symposium on Ion Cancer Therapy and KI-NIRS Joint Symposium on Ion-Radiation Science

Carbon Ion Radiotherapy in Bone and Soft Tssue Sarcomas

The Heavy Ion Medical Accelerator in Chiba (HIMAC) is the world first heavy ion accelerator complex dedicated to medical use in a hospital environment. Carbon ion therapy offers the potential advantages of improved dose localization and enhanced biological effects. It has been suggested that carbon ion therapy is effective against radioresistant pancreatic cancer. In April 2000, clinical studies examining the treatment of pancreatic cancer with carbon ions were begun at the HIMAC. As of February 2010, 48 patients treated with preoperative carbon ion radiotherapy and 89 patients treated for locally advanced pancreatic cancer were enrolled into the clinical trials. Both protocols are still ongoing. The interim results of these clinical trials suggest that carbon ion radiotherapy provides good local control and offers a survival advantage for patients with otherwise hard to cure pancreatic cancer, without unacceptable morbidity

Case Report Facial Baroparesis Caused by Scuba Diving

Middle ear barotrauma is one of the common complications of SCUBA diving representing acute otalgia, hearing loss, and bleeding. But occurrence of facial palsy is rare. Here we report a case of a 30-year-old navy diver suffered middle ear barotrauma with transient facial palsy after SCUBA diving. He felt difficulty in equalizing the pressure in middle ear with Valsalva maneuver during diving, and suffered right facial palsy and aural fullness after diving. Clinical examination showed remarkable bulging of the right tympanic membrane and right facial palsy without other neurological findings. But facial palsy was disappeared immediately after myringotomy. We considered that the etiology of this case was neuropraxia of facial nerve in middle ear caused by over pressure of middle ear

Impact of carbon ion radiotherapy for unresectable osteosarcoma of the trunk.

BACKGROUND: The authors summarized the outcomes of patients with unresectable osteosarcoma of the trunk who received carbon ion radiotherapy (CIRT).\nMETHODS: The authors performed a retrospective analysis of 78 patients who had medically inoperable osteosarcoma of the trunk and received treatment with CIRT between 1996 and 2009. Tumor sites included the pelvis in 61 patients, the spine and paraspinal region in 15 patients, and other sites in 2 patients. The median applied CIRT dose was 70.4 Gray equivalent (GyE) in a total of 16 fixed fractions over 4 weeks.\nRESULTS: The minimum duration of follow-up for survivors was 14 months. Forty-eight patients remained alive. The 5-year overall survival rate was 33%, and the local control rate was 62%. Thirty-eight patients who had a clinical target volume 5 years, 8 were able to walk with or without the help of a cane, and 6 were free from pain killers.\nCONCLUSIONS: CIRT appeared to be a safe and effective modality for the management of unresectable osteosarcoma of the trunk, providing good local control and offering a survival advantage and good long-term functional results without unacceptable morbidity

Protein transduction therapy into cochleae via the round window niche in guinea pigs

Cell-penetrating peptides (CPPs) are short sequences of amino acids that facilitate the penetration of conjugated cargoes across mammalian cell membranes, and as such, they may provide a safe and effective method for drug delivery to the inner ear. Simple polyarginine peptides have been shown to induce significantly higher cell penetration rates among CPPs. Herein, we show that a peptide consisting of nine arginines (“9R”) effectively delivered enhanced green fluorescent protein (EGFP) into guinea pig cochleae via the round window niche without causing any deterioration in auditory function. A second application, 24 hours after the first, prolonged the presence of EGFP. To assess the feasibility of protein transduction using 9R-CPPs via the round window, we used “X-linked inhibitor of apoptosis protein” (XIAP) bonded to a 9R peptide (XIAP-9R). XIAP-9R treatment prior to acoustic trauma significantly reduced putative hearing loss and the number of apoptotic hair cells loss in the cochleae. Thus, the topical application of molecules fused to 9R-CPPs may be a simple and promising strategy for treating inner ear diseases