Imre Gerlinger

Mass spectrometry-based salivary proteomics for the discovery of head and neck squamous cell carcinoma

The 5-year survival rates for cases of head and neck squamous cell carcinoma (HNSCC) are only some 60%, mainly because 20%–40% of the patients develop a local relapse in the same or an adjacent anatomic region, even when the surgical margins are histologically tumour-free. Tumours are often discovered in an advanced stage because of the lack of specific symptoms and the diagnostic difficulties. The more advanced the stage of the tumour, the more invasive the diagnostic and treatment interventions needed. An early molecular diagnosis is therefore of vital importance in order to increase the survival rate. The aim of this study was to develop an efficient rapid and sensitive mass spectrometric method for the detection of differentially expressed proteins as tumour-specific biomarkers in saliva from HNSCC patients. Whole saliva samples were collected from patients with HNSCC and from healthy subjects. The proteins were profiled by using SDS PAGE, MALDI TOF/TOF mass spectrometry and the Mascot database search engine. Several potential tumour markers were identified, including annexin A1, beta- and gamma-actin, cytokeratin 4 and 13, zinc finger proteins and P53 pathway proteins. All of these proteins play a proven role in tumour genesis, and have not been detected previously in saliva. Salivary proteomics is a non-invasive specific method for cancer diagnosis and follow-up treatment. It provides facilities for the readily reproducible and reliable detection of tumours in early stages.

Propranolol for infantile haemangioma: Striking effect in the first weeks

OBJECTIVE Discuss effect and dynamics of propranolol (PR) treatment in infantile haemangioma (IH) of head and neck in children during follow-up. METHODS Between 2010 and 2011, 22 children with head and neck infantile haemangioma (IH) treated by PR were recruited into the study. In a retrospective chart review clinical data were analyzed at 5 consecutive, different check-up time from 1 week to 12-14 months. Effectiveness of PR treatment was assessed by a symptom score method. RESULTS In the whole series a significant regression was observed in 13 patients (59%) in the first week of the therapy. Further five patients showed this time a marked, two mild improvements, and two children did not respond initially to the PR therapy. In one of them (case #8) later on a mild improvement could be seen too. At the second check-up (1 month after initiating PR therapy) 50% of children showed definitive improvement compared to the first visit. Difference between first and second check-ups was significant, and between the 4th and 5th visits the improvement showed the lowest rate. Comparison of IH regression between the 2nd and the 5th check-ups resulted in a p value a little larger than 0.05. There was not significant correlation between the initial IH severity and the treatment effectiveness at the follow-ups (p>0.05). No significant differences were found in treatment effectiveness concerning the IH localizations, too. CONCLUSION PR treatment is highly effective in children with IHs. The most striking effect is seen at the first week of treatment; later improvement is much slower, sometimes with periods of stagnations. The cause of this is probably the spectacular early effect of vasoconstriction, though other impacts of PR to the individual molecular markers of IH seemed to be less impressive clinically. However, treatment should be continued for at least 6 months because early cessation can cause a relapse.

Phenotypic Variants of the Deafness-Associated Mitochondrial DNA A7445G Mutation

A number of nuclear and mitochondrial mutations have been implicated in non-syndromic hearing loss. Among them, various mutations of mitochondrial Ser(UCN)-tRNA and 12S rRNA genes have been found to be associated with deafness; the A7445G mitochondrial DNA (mtDNA) in this group is unique, simultaneously affecting two different mitochondrial genes, encoding the Ser(UCN)-tRNA and the first subunit of cytochrome oxidase. Besides the hearing loss, it is mainly associated with palmoplantar keratoderma, though; different phenotypic associations have been reported. The current paper reviews the available PubMed reports on the A7445G mtDNA mutation, with special attention to the phenotypic variations. Further, a Hungarian family with the A7445G mutation is reported, in which analysis of both the affected and the non-affected members revealed the mutation in both homo- and heteroplasmic forms, independently of the hearing status of the subjects, a phenomenon previously not reported in other pedigrees. The female lineage represented a rare variant of the U4b haplogroup.

Extracorporal septal reconstruction with polydioxanone foil

•  Conventional septoplasty cannot be the answer to all types of septal deviation. •  Indications of extracorporal septal reconstruction with polydioxanone (PDS) foil: (i) selected cases of very high septal deviations, (ii) post‐traumatic and (iii) extremely pronounced congenital septal deviations and/or aesthetic deformities. •  Polydioxanone foil facilitates the incorporation of a newly implanted septal graft without significant postoperative complications and is absorbed within 25 weeks. •  The surgical technique is described in detail, and the early postoperative functional and aesthetic results (mean follow‐up: 11 months) on 16 patients (mean age: 42 years) are reported. Overall, 88% of the patients responded positively to the question of whether they would choose to undergo the same procedure again, knowing the postoperative result. •  The procedure is easy to learn and has already proved to be an excellent combination of modern functional and aesthetic nasal surgery.

Recurrent laryngeal papillomatosis with oesophageal involvement in a 2 year old boy: successful treatment with the quadrivalent human papillomatosis vaccine.

Authors present a case report of a 2-year-old boy with recurrent laryngeal papillomatosis with oesophageal involvement due to human papilloma virus types 6 and 11, who needed surgical treatment every 4-6 weeks, altogether 11 times. After detailed immunological evaluation of basic immunological parameters, and in vitro detection of good responses to routine childhood immunization, a therapeutic vaccination has been decided with a 4-valent HPV vaccine. Following the third vaccine dose both laryngeal and oesophageal lesions disappeared completely, and for 2 years follow-up no papillomas could be detected. Vaccination could be a promising method in the treatment of RRP in children.

KTP-laser stapedotomy with a self-crimping, thermal shape memory Nitinol SMart piston: 1 year follow-up results: how we do it.

• We evaluate the long-term speech perception results in 12 children with bilateral large vestibular aqueduct syndrome, who received cochlear implantation as the treatment. The mean duration of implant usage was 4.8 years. The performance of cochlear implantation in the originally poorer hearing ear is compared to that of the contralateral better hearing ear using a hearing aid after at least 3 years of follow-up. • Speech perception measures included a Mandarin closed-set consonant discrimination test, a closed-set tone identification test, two open-set sentence recognition tests and an open-set word identification test. These tests were carried out with live voice in a sound-proofed room. • The median scores of the five speech perception tests were 80%, 75%, 97%, 91.5% and 86% respectively for the implanted ears. For the opposite ear with hearing aids, the median scores were 35%, 40%, 11%, 8% and 10% respectively. In all five tests, the results were statistically significantly higher in the implanted ear. • Our results confirmed that cochlear implantation is an effective treatment for subjects with large vestibular aqueduct syndrome once their hearing deteriorated to the profound level. Moreover, we have shown that the long-term speech perception results are significantly better in ears with cochlear implantation than the contralateral ear using hearing aids. Conflict of interest

Ionomer cement for reconstruction of the long process of the incus: the Pécs experience

•  Experience gained with the repair of the defects of the long process of the incus with ionomer cement in 35 patients is reported. •  The integrity of the reconstructed tympanic membrane and the four‐frequency average of the air‐bone gaps of the postoperative audiograms (best, most recent and at around 1 year) were evaluated. •  This ‘physiological’ reconstruction of the ossicular chain fulfilled our expectations in 40% of the patients (air‐bone gap ≤ 10 dB). •  The background of the unsuccessful cases was investigated.

Tracheal Ceramic Rings for Tracheomalacia: A Review After 17 Years

Background: Despite different support techniques, the surgical management of tracheomalacia is still a challenging problem. Satisfactory results after internal stenting are above 80%, whereas, when performing external stenting using biocompatible ceramic rings, results are reported at over 90%.

Optimization of bioassay method for the quantitative microbiological determination of amphotericin B.

The aim of this study was to find the optimal bioassay parameters for the quantitative analysis of an amphotericin B nasal spray solution as the bioassay conditions recommended by the Ph. Eur. 6. were less sensitive and were only applicable for the measurement of a narrow concentration range, which makes the method unsuitable in case of a stability test. We evaluated five commonly used assay media with Candida albicans and Saccharomyces cerevisiae as test organisms. Our results showed that Mueller Hinton Agar supplemented with 2% glucose and 0.5 μg ml−1 methylene blue inoculated with C. albicans gave the best bioassay circumstance as a wide concentration range (1.54–60.0 μg ml−1 amphotericin B) could be measured and the inhibition zone borders were distinct and easy to read.

Radiosurgical Excision of Rhinophyma

&NA; The authors have indicated no significant interest with commercial supporters.