Proangiogenic signature in advanced laryngeal carcinoma after microRNA expression profiling.

The aim of this study is to evaluate which dysregulated angiomiRs compose the specific proangiogenic microRNA signature of advanced laryngeal cancer and review the literature. Thirty-six samples from twelve patients with advanced laryngeal carcinoma were collected. Total RNA was extracted and microRNA global profiling was performed using Agilent Technologies Microarray Kit. Fifty-nine microRNAs were found to have significantly different expression levels. Eleven microRNAs from the whole group were sorted as regulators of tumor angiogenesis (angiomiRs): seven were up-regulated-miR-1246, miR-181b 5p, miR-18a 5p, miR-21 3p, miR-210 3p, miR-503 5p, miR-93 5p and four were down-regulated-miR148a 5p, miR-145 5p, miR-204 5p, miR-125b 5p. For none of those microRNAs we found heterogeneity in tumor tissue. We are the first to report the specific proangiogenic microRNA signature in advanced laryngeal carcinoma and we confirm and amplify findings from previous studies that expand our perception of a specific "molecular state" of angiogenesis that is distinctive only for laryngeal cancer.

Higher doses of fentanyl during bronchoscopy in infants significantly reduces perioperative complication rates.

OBJECTIVES: The specific aim of this study was to assess the effect of higher fentanyl doses on reducing perioperative complication rates among infants undergoing rigid bronchoscopy. METHODS: Sixty children who underwent rigid bronchoscopy for foreign body removal were enlisted in our 2-year prospective cohort study at the Department of ENT and Head & Neck Surgery, Medical University - Sofia. Infants were randomly distributed into two groups according to fentanyl dose (group 1 - 1-2 µg/kg vs group 2 - 6-7 µg/kg). Hemodynamic parameters and perioperative complications were recorded. RESULTS: The mean age of the whole study group was 1.94 years. Five minutes prior to anesthesia both groups presented with similar parameter levels and no statistically significant difference was found. In contrast, at 5th and 10th minutes after intubation the heart rate, systolic and diastolic blood pressure levels were recorded at significantly higher levels in group 1 compared to group 2 (p = .000). Same results were obtained five minutes after extubation. Additionally, after performing the Pearson chi-Square test we found that bronchospasm and laryngospasm were significantly more frequent among patients from group 1 infused with lower dosage of fentanyl in comparison to the infants that were administered with a higher dose of this medication (p = .020). Phi and Cramer's V tests both display moderate strength of this association (V = 0.302). CONCLUSION: In the current study we propose refinement of current anesthetic protocols by using higher doses of fentanyl during rigid bronchoscopy in infants. This significantly reduces perioperative complication rates and improves intraoperative hemodynamics without presenting any newly formed risks.

[Evaluation of the immunogenic and reactogenic properties of vaccine "Euvax B" in persons aged 16-18 years in different geographical zones of Russia].

The comparative evaluation of the reactogenic and immunogenic properties of vaccine "Euvax B" in adolescents aged 16-18 years was carried out in factory housing estate Lvovsky, the Podolsk district, the Moscow region, and in the Yamalo-Nenets Autonomous District (AD): in towns Salekhard, Noyabrsk, Muravlenko, in housing estate Tarko-Sale. The evaluation demonstrated that the use of this vaccine in a dose of 20 mg/ml produced no postvaccinal complications and the frequency of postvaccinal reactions was insignificant. Postvaccinal anti-HBs were detected, on the average, in protective concentrations in 98.4 +/- 1.8% of the vaccines (99.0 +/- 1.9% in the Moscow region, 97.7 +/- 3.2% in the Yamalo-Nenets AD). In most of the vaccinated adolescents high concentrations of postvacinal anti-HBs were detected: in 51.4 +/- 9.7% of the vaccinees in the Moscow region and in 89.7 +/- 6.4% in the Yamalo-Nenets AD they exceeded 1,000 I.U./lit. The conclusion was made that in the territories located in subarctic latitudes vaccinal prophylaxis against hepatitis B was safe and highly effective and have no limitations connected with the conditions of the Far North.

Macrophageal infiltration and microvessel density in laryngeal carcinoma: study of 52 cases.

Angiogenesis is one of the six originally constituted hallmarks of cancer that has been extensively studied in the last two decades. The aim of our study is to assess the microvessel and macrophageal density in laryngeal carcinoma and its clinicopathological correlations. We immunohistochemically assessed microvessel density (CD34) and macrophage count (CD68) using microarray techniques and then looked for clinicopathological correlations. The mean micro-vessel density in the study group was 14.27 ± 12.92 vessels in a ×200 field with a mean macrophageal infiltration density of 5.19 ± 4.32. Median microvessel density was significantly higher in patients with metastasis than in patients without metastasis. Additionally, linear regression established that macrophageal infiltration density could predict microvessel density in laryngeal carcinoma. We found no association between either factor and recurrence rate or other clinical characteristics. Our study adds additional data to a problem that has been widely studied during the last two decades, even if controversies in this area still remain.

Comparison between myringotomy and tympanostomy tubes in combination with adenoidectomy in 3-7-year-old children with otitis media with effusion.

The specific aim of this study was to compare, by means of a randomized clinical trial, the efficacy between the two surgical combinations - adenoidectomy with myringotomy and tympanostomy (A+T) and adenoidectomy with myringotomy (A+M) - in reducing middle ear disease in children with otitis media with effusion (OME). Seventy-eight 3-7-year-old patients (156 ears) with a history of bilateral middle ear effusion for at least 3 months were randomly assigned to either A+T or A+M. Hearing threshold levels, recurrence rate of the effusion and episodes of acute otitis media (AOM) and otorrhea were evaluated for a follow-up period of 1 year. Audiometry testing showed that there was no statistically significant difference in the hearing loss levels of both groups during the whole follow-up period. Free of AOM episodes were 72% of the patients in the A+T group and 75% of those in the A+M group. None of the patients with A+M had episodes with otorrhea which contrasted with the 40% occurrence rate in the A+T group. During the follow-up period we documented a 10% recurrence rate of OME in the A+T group and 14% recurrence rate in the A+M group. Overall our data suggests that the insertion of tympanostomy tubes in association with adenoidectomy provides no additional benefit to adenoidectomy in association with myringotomy alone in terms of hearing loss or AOM episode occurrences in patients with bilateral otitis media with effusion. Furthermore no relationship was found between the choice of operative intervention and the recurrence rate of OME despite the slightly greater relative risk in the A+M group.

Cochlear implantation in a pediatric patient with thalassemia major.

We report the first known cochlear implantation in a pediatric patient with thalassemia major. After bilateral profound hearing loss was diagnosed a cochlear implantation was performed in the right ear when he was 24 months old. No complications occurred during the surgery and the postoperative period. Free-field audiometry and evaluation of auditory responses to speech (EARS) battery tests were used to evaluate perceptual auditory abilities, speech recognition and language growth. The patient demonstrated encouraging improvement in threshold levels that reached similar values to those of his peers. In contrast his level of language growth and recognition stayed at low levels. Results are discussed in the light of the specificity of this hereditary disease and its complications as we share our experience for better management of those type of patients in future.