Hepatic Hypertrophy in Normal and Cirrhotic Livers Following Portal Vein Embolization: Comparative Assessment of 2 Different Embolic Regimens in a Large Animal Model.

PURPOSE: To compare the mechanistic effects and hypertrophy outcomes using 2 different portal vein embolization (PVE) regimens in normal and cirrhotic livers in a large animal model. METHODS AND MATERIALS: The Institutional Animal Care and Use Committee approved all experiments conducted in this study. Fourteen female Yorkshire pigs were separated into a cirrhotic group (CG, n = 7) and non-cirrhotic group (NCG, n = 7) and further subgrouped into those using microspheres and coils (MC, n = 3) or n-butyl cyanoacrylate (nBCA, n = 3) and their corresponding controls (each n = 1). A 3:1 ethiodized oil and ethanol mixture was administered intra-arterially in the CG to induce cirrhosis 4 weeks before PVE. Animals underwent baseline computed tomography (CT), PVE including pre-PVE and post-PVE pressure measurements, and CT imaging at 2 and 4 weeks after PVE. Immunofluorescence stainings for CD3, CD16, Ki-67, and caspase 3 were performed to assess immune cell infiltration, hepatocyte proliferation, and apoptosis. Statistical significance was tested using the Student's t test. RESULTS: Four weeks after PVE, the percentage of future liver remnant (FLR%) increased by 18.8% (standard deviation [SD], 3.6%) vs 10.9% (SD, 0.95%; P < .01) in the NCG vs CG. The baseline percentage of standardized future liver remnant (sFLR%) for the controls were 41.6% for CG vs 43.6% for NCG. Based on the embolic agents used, the sFLR% two weeks after PVE was 58.4% (SD, 3.7%) and 52.2% (SD, 0.9%) (P < .01) for MC and 46.0% (SD, 2.2%) and 47.2% (SD, 0.4%) for nBCA in the NCG and CG, respectively. Meanwhile, the sFLR% 4 weeks after PVE was 60.5% (SD, 3.9%) and 54.9% (SD, 0.8%) (P < .01) and 60.4% (SD, 3.5%) and 54.2% (SD, 0.95%) (P < .01), respectively. Ki-67 signal intensity increased in the embolized lobe in both CG and NCG (P < .01). CONCLUSIONS: This preclinical study demonstrated that MC could be the preferred embolic of choice compared to nBCA when a substantial and rapid FLR increase is needed for resection, in both cirrhotic and non-cirrhotic livers.

[Preoperative MR imaging for hip dysplasia : Assessment of associated deformities and intraarticular pathologies]. / Präoperative MRT-Bildgebung bei Hüftdysplasie : Abklärung assoziierter Deformitäten und intraartikulärer Pathologien.

BACKGROUND: Developmental dysplasia of the hip (DDH) is a known reason for hip pain for adolescents and young adults. Preoperative imaging is increasingly recognized as an important factor due to the recent advances in MR imaging. OBJECTIVES: The aim of this article is to give an overview of preoperative imaging for DDH. The acetabular version and morphology, associated femoral deformities (cam deformity, valgus and femoral antetorsion) and intraarticular pathologies (labrum and cartilage damage) and cartilage mapping are described. METHODS: After an initial evaluation with AP radiographs, CT or MRI represent the methods of choice for the preoperative evaluation of the acetabular morphology and cam deformity, and for the measurement of femoral torsion. Different measurement techniques and normal values should be considered, especially for patients with increased femoral antetorsion because this could lead to misinterpretation and misdiagnosis. MRI allows analysis of labrum hypertrophy and subtle signs for hip instability. 3D MRI for cartilage mapping allows quantification of biochemical cartilage degeneration and yields great potential for surgical decision-making. 3D-CT and, increasingly, 3D MRI of the hip to generate 3D pelvic bone models and subsequent 3D impingement simulation can help to detect posterior extraarticular ischiofemoral impingement. RESULTS AND DISCUSSION: Acetabular morphology can be divided in anterior, lateral and posterior hip dysplasia. Combined osseous deformities are common, such as hip dysplasia combined with cam deformity (86%). Valgus deformities were reported in 44%. Combined hip dysplasia and increased femoral antetorsion can occur in 52%. Posterior extraarticular ischiofemoral impingement between the lesser trochanter and the ischial tuberosity can occur in patients with increased femoral antetorsion. Typically, labrum damage and hypertrophy, cartilage damage, subchondral cysts can occur in hip dysplasia. Hypertrophy of the muscle iliocapsularis is a sign for hip instability. Acetabular morphology and femoral deformities (cam deformity and femoral anteversion) should be evaluated before surgical therapy for patients with hip dysplasia, considering the different measurement techniques and normal values of femoral antetorsion.

Combined assessment of pulmonary arterial enlargement and coronary calcification predicts the prognosis of patients with chronic obstructive pulmonary disease.

INTRODUCTION: In chronic obstructive pulmonary disease (COPD), chest computed tomography (CT) provides clinically important cardiovascular findings, which include diameter of pulmonary artery (PA), its ratio to the diameter of the aorta (PA:A ratio), and coronary artery calcium score (CACS). The clinical importance of these cardiovascular findings has not been fully assessed in Japan, where cardiovascular morbidity and/or mortality is reported to be much less compared with Western counterparts. METHODS: PA diameter and PA:A ratio were measured in 172 and 130 patients with COPD who enrolled in the Hokkaido COPD cohort study and the Kyoto University cohort, respectively. CACS was measured in 131 and 128 patients in each cohort. RESULTS: While the highest quartile group in PA diameter was associated with higher all-cause mortality compared to the lowest quartile group in both cohorts, individual assessments of PA:A ratio and CACS were not associated with the long-term clinical outcomes. When PA diameter and CACS were combined, patients with PA enlargement (diameter >29.5 mm) and/or coronary calcification (score >440.8) were associated with higher all-cause mortality in both cohorts. CONCLUSION: Combined assessment of PA enlargement and CACS was associated with poor prognosis, which provides a clinical advantage in management of patients with COPD even in geographical regions with lower risk of cardiovascular diseases.

Dietary-challenged mice with Alzheimer-like pathology show increased energy expenditure and reduced adipocyte hypertrophy and steatosis.

Alzheimer's disease (AD) is frequently accompanied by progressing weight loss, correlating with mortality. Counter-intuitively, weight loss in old age might predict AD onset but obesity in midlife increases AD risk. Furthermore, AD is associated with diabetes-like alterations in glucose metabolism. Here, we investigated metabolic features of amyloid precursor protein overexpressing APP23 female mice modeling AD upon long-term challenge with high-sucrose (HSD) or high-fat diet (HFD). Compared to wild type littermates (WT), APP23 females were less prone to mild HSD-induced and considerable HFD-induced glucose tolerance deterioration, despite unaltered glucose tolerance during normal-control diet. Indirect calorimetry revealed increased energy expenditure and hyperactivity in APP23 females. Dietary interventions, especially HFD, had weaker effects on lean and fat mass gain, steatosis and adipocyte hypertrophy of APP23 than WT mice, as shown by 1H-magnetic-resonance-spectroscopy, histological and biochemical analyses. Proteome analysis revealed differentially regulated expression of mitochondrial proteins in APP23 livers and brains. In conclusion, hyperactivity, increased metabolic rate, and global mitochondrial dysfunction potentially add up to the development of AD-related body weight changes in APP23 females, becoming especially evident during diet-induced metabolic challenge. These findings emphasize the importance of translating this metabolic phenotyping into human research to decode the metabolic component in AD pathogenesis.

Explicit interaction information from WikiPathways in RDF facilitates drug discovery in the Open PHACTS Discovery Platform.

Open PHACTS is a pre-competitive project to answer scientific questions developed recently by the pharmaceutical industry. Having high quality biological interaction information in the Open PHACTS Discovery Platform is needed to answer multiple pathway related questions. To address this, updated WikiPathways data has been added to the platform. This data includes information about biological interactions, such as stimulation and inhibition. The platform's Application Programming Interface (API) was extended with appropriate calls to reference these interactions. These new methods of the Open PHACTS API are available now.

Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease.

PURPOSE: To investigate the association of renal elasticity to microscopic findings of nephron hypertrophy and nephrosclerosis. METHODS: Patients who underwent renal biopsy were enrolled. Renal elasticity was measured by acoustic radiation force impulse, and nephron size (glomerular volume, non-sclerotic glomerular density, and mean profile tubular area) and nephrosclerosis (globally sclerotic glomeruli and interstitial fibrosis) were estimated. Nephron hypertrophy was indicated by larger glomerular volume, larger tubular area, and lower non-sclerotic glomerular density. Nephrosclerosis was indicated by a higher percentage of globally sclerotic glomeruli and higher severity of fibrosis. RESULTS: Renal elasticity was negatively correlated with glomerular volume (r = - 0.480, P = 0.024) and mean tubular area (r = - 0.469, P = 0.028), but it was not correlated with non-sclerotic glomerular density (r = 0.205, P = 0.359), percentage of globally sclerotic glomeruli (r = 0.057, P = 0.800), and severity of fibrosis (r = 0.014, P = 0.950). In a multiple linear regression analysis, glomerular volume and mean tubular area were independently associated with renal elasticity (std ß = - 0.454, P = 0.015 and std ß = - 0.577, P = 0.007, respectively). CONCLUSION: Renal elasticity was correlated with microstructural findings of nephron hypertrophy. Measuring renal elasticity could help in detecting kidney disease.

Assessment of inferior turbinate radiofrequency treatment: Monopolar versus bipolar.

OBJECTIVE: The aim of this study is to compare the early results of monopolar (MP) and bipolar (BP) radiofrequency (RF) used in inferior turbinate hypertrophy treatment concerning aspects of patient and surgeon comfort. STUDY DESIGN: Prospective randomized single-blind study. MATERIALS AND METHODS: The study included 71 patients with inferior turbinate hypertrophy resistant to medical treatment. BP RF was applied to 36 patients. MP RF was applied to 35 patients. Patients received no other treatment during their 6 months of follow-up examinations. They were evaluated by their symptoms (nasal obstruction severity, nasal obstruction frequency, postnasal drip, nasal crusting, hyposmia, patient satisfaction, and preoperative pain) with a visual analogue scale (VAS) done preoperatively on the 1st and 7th days and then in the 1st, 3rd, and 6th months postoperatively. RESULTS: No significant difference was observed comparing the symptoms of patients after BP and MP inferior turbinate RF in long-term follow-up, whereas patients treated with MP RF showed early improvement in their symptoms on the 1st and 7th days postoperatively when compared to the BP group. The application time of MP RF was longer than that of the BP group. Pain during the operation was reported more frequently in the BP group. CONCLUSION: MP and BP RF treatment showed no difference in long-term efficacy. However, MP RF therapy showed early improvement in symptoms and less pain in patients than in the BP RF group.

Comparative assessment of monopolar and bipolar radiofrequency surgery of inferior turbinate.

OBJECTIVE: The aim of this study was to compare early outcomes of monopolar (MP) and bipolar (BP) radiofrequency (RF) treatment of inferior turbinate hypertrophy from the perspective of both the patient and the surgeon. STUDY DESIGN: Prospective, randomized, single-blind study. MATERIALS AND METHODS: Seventy-one patients with inferior turbinate hypertrophy resistant to medical treatment. BP RF was used in 36 patients and MP RF in 35 patients, respectively. Patients received no other treatment during a 6-month follow-up. They were evaluated for symptoms such as nasal obstruction severity, nasal obstruction frequency, postnasal drip, nasal crusting, hyposmia, patient satisfaction, and preoperative pain with the use of a visual analogue scale (VAS) before surgery and then 1 and 7 days as well as 1, 3, and 6 months after surgery. RESULTS: No significant difference was observed regarding symptoms of patients after BP and MP inferior turbinate RF surgery in a long-term follow-up. Patients treated with MP RF showed early symptom improvement on days 1 and 7 days after surgery compared to the BP group. Procedure duration of MP RF was longer than that of BP RF. Pain during surgery was reported more frequently in the BP group. CONCLUSION: MP and BP RF treatment showed no difference in long-term efficacy. However, MP RF therapy was associated with early symptom improvement and less pain reported by patients in comparison to the BP RF group.

Assessment of the correlation between nasal septal deviation and compensatory hypertrophy of the middle turbinate.

The aim of the study was to investigate the relationship between nasal septal deviation and the middle turbinate hypertrophy using computed tomography. In this retrospective analysis, we examined 77 patients with nasal septal deviation. The mucosal and bone structures of the middle turbinate and the angle of the septum were measured using radiological analysis. Measurements of the middle turbinate on the convex side were compared to those on the concave side. Measurements of the bony and mucosal structure area of the middle turbinate were significantly greater than those on the concave side. The dimensions of medial mucosa thickness and bone thickness were not significantly different between the convex and concave sides. No significant correlation was found between the angle of deviation and other parameters. The present findings suggest that compensatory middle turbinate hypertrophy was caused both by conchal bone growth and mucosal hypertrophy in patients with nasal septal deviation.

Quantitative MRI and strength measurements in the assessment of muscle quality in Duchenne muscular dystrophy.

The purpose of this study was to assess leg muscle quality and give a detailed description of leg muscle involvement in a series of Duchenne muscular dystrophy patients using quantitative MRI and strength measurements. Fatty infiltration, as well as total and contractile (not fatty infiltrated) cross sectional areas of various leg muscles were determined in 16 Duchenne patients and 11 controls (aged 8-15). To determine specific muscle strength, four leg muscle groups (quadriceps femoris, hamstrings, anterior tibialis and triceps surae) were measured and related to the amount of contractile tissue. In patients, the quadriceps femoris showed decreased total and contractile cross sectional area, attributable to muscle atrophy. The total, but not the contractile, cross sectional area of the triceps surae was increased in patients, corresponding to hypertrophy. Specific strength decreased in all four muscle groups of Duchenne patients, indicating reduced muscle quality. This suggests that muscle hypertrophy and fatty infiltration are two distinct pathological processes, differing between muscle groups. Additionally, the quality of remaining muscle fibers is severely reduced in the legs of Duchenne patients. The combination of quantitative MRI and quantitative muscle testing could be a valuable outcome parameter in longitudinal studies and in the follow-up of therapeutic effects.

Inferior turbinate hypertrophy: review and graduated approach to surgical management.

BACKGROUND: Surgical techniques for managing inferior turbinate hypertrophy (ITH) vary widely and have evolved substantially in the past four decades as new technologies have emerged. METHODS: Literature review. RESULTS: Inferior turbinate (IT) procedures can be categorized as: simple turbinate outfracture; turbinoplasty techniques such as extramucosal destruction, and submucosal tissue removal; and extramural turbinate resection (partial or complete). Each of these approaches has advantages and drawbacks. Considerations for technique selection include clinical setting (in-office versus operating room), cost of the devices used, efficacy of the procedure to relieve nasal obstruction, and minimizing postoperative complications such as nuisance bleeding, adhesion formation, and crusting. CONCLUSION: There are a variety of contemporary surgical techniques used for IT reduction. This article highlights the available literature and gaps in current knowledge. A graduated approach to the management of ITH will be presented.

Quantitative histological assessment of xenobiotic-induced liver enzyme induction and pituitary-thyroid axis stimulation in rats using whole-slide automated image analysis.

Preclinical evaluation of a new compound, RO2910, identified a hypertrophic response in liver, thyroid gland, and pituitary gland (pars distalis). We aimed to develop and validate automated image analysis methods to quantify and refine the interpretation of semi-quantitative histology. Wistar-Han rats were administered RO2910 for 14 days. Liver, thyroid, and pituitary gland tissues were processed for routine histology and immunolabeled with anti-thyroid stimulating hormone (TSH) antibody (pituitary) and anti-topoisomerase II antibody (thyroid). Glass slides were scanned, image analysis methods were developed and applied to whole-slide images, and numerical results were compared with histopathology, circulating hormone levels, and liver enzyme mRNA expression for validation. Quantitative analysis of slides had strong individual correlation with semi-quantitative histological evaluation of all tissues studied. Hepatocellular hypertrophy quantification also correlated strongly with liver enzyme mRNA expression. In the pars distalis, measurement of TSH weak-staining areas correlated with both hypertrophy scores and circulating TSH levels. Whole-slide image analysis enabled automated quantification of semi-quantitative histopathology findings and a more refined interpretation of these data. The analysis also enabled a direct correlation with non-histological parameters using straightforward statistical analysis to provide a more refined dose- and sex-response relationship and integration among affected parameters. These findings demonstrate the utility of our image analysis to support preclinical safety evaluations.

Assessment of intramural blood flow and neurogenic control in intact and hypertrophic urinary bladder with harmonic analysis of bioimpedance in rats.

High-resolution impedancometry and harmonic (Fourier) analysis of variable component of bioimpedance revealed rhythmic oscillations of urinary bladder bioimpedance at the Mayer wave, respiration, and heartbeat frequencies. The power values of the corresponding Mayer, respiratory, and cardiac peaks were calculated to assess circulation in the urinary bladder wall and its autonomic nervous control at various stages of infusion cystometry in intact rats and in the rats with preliminary formed infravesical obstruction (IVO). In intact rats, filling of the bladder with physiological saline diminished the power of the first (fundamental) cardiac peak attesting to a decrease of the blood flow in the bladder wall. Simultaneously, the power of low-frequency Mayer peak reflecting sympathetic activity increased, while the power of respiratory peak decreased supposedly reflecting abatement of the parasympathetic influences. Bladder voiding was accompanied by a decrease of Mayer peak and increase of the respiratory one. Prior to infusion cystometry, the intravesical pressure in IVO rats was elevated while the power of fundamental cardiac peak was below the control value. Filling the bladder in these rats was accompanied by further decrease of the cardiac peak reflecting still greater drop in blood supply. In control rats, voiding the bladder normalized the vesical circulation assessed by the cardiac peak, while in IVO rats this peak remained decreased. The reciprocal changes of Mayer and respiratory peaks observed during infusion cystometry in the norm were replaced by unidirectional decrease in the power of both peaks in IVO rats, which probably attest to disturbance of autonomic nervous control in the hypertrophic urinary bladder in these rats.

Accuracy of non-ECG-gated computed tomography angiography of the chest in assessment of left-sided cardiac chamber enlargement.

PURPOSE: To determine whether measurement of left ventricular (LV) and left atrial (LA) diameters on nongated computed tomography angiography (CTA) can detect left atrial and left ventricular enlargement (LAE and LVE) with high specificity. MATERIALS AND METHODS: Ninety-nine patients who had undergone both nongated CTA of the chest and echocardiography within 1 week constituted the pilot group. On CTA, LA and LV diameters were measured in the axial plane and on a 3-chamber-view multiplanar reconstruction. These measurements were compared with echocardiography results. Receiver operating characteristic (ROC) curves were then generated to determine optimal cutoff values for diagnosis of LAE and LVE. These thresholds were applied to a validation group (n = 203), and sensitivities and specificities for cutoff values were determined. Simple κ-coefficients were calculated for interobserver agreement. RESULTS: In the pilot group, axial measurements of the LA and LV diameters were superior to multiplanar reconstruction measurements based on areas under the ROC (LV: 0.82 vs. 0.76, LA: 0.87 vs. 0.82). Using the ROC results, cutoff values of 5.5 and 4.5 cm were chosen for LVE and LAE, respectively. These thresholds were applied to the validation group, achieving an average sensitivity and specificity for LAE of 53% [confidence interval (CI): 37%-71% and 94% (89%-97%)], respectively. Average sensitivity and specificity for LVE were 41% (CI: 23%-59%) and 99% (CI: 96%-100%), respectively. Kappa coefficients for diagnosis of LAE and LVE were 0.70 and 0.81, respectively. CONCLUSION: Thresholds for LA and LV diameter on nongated CTA can be chosen to provide specific, but not sensitive, detection of LAE and LVE.

Racial and socioeconomic disparities in reduction mammoplasty: an analysis of nationwide inpatient sample database.

The American Society of Plastic Surgery recently recorded a decline in numbers of breast reductions, one of the most common procedures performed by plastic surgeons. The purpose of this study is to characterize the reduction mammoplasty patient population which would further assist in planning the future workforce needs. Using the Nationwide Inpatient Sample database for 2007, a χ analysis of female in-patients treated with reduction mammoplasty for breast hypertrophy was performed to identify significant differences in race and payer mix. Of 8394 female in-patients with breast hypertrophy, 61% were treated with reduction mammoplasty. Black and Hispanic patients (P < 0.0001) and patients with private insurance (P < 0.0001) were more likely to undergo reduction mammoplasty. This study demonstrates racial and socioeconomic disparities in breast reduction in the United States in 2007. With the pending institution of universal healthcare, it is predicted that disparities revealed may worsen due to cost containment pressures.

Diagnostic efficacy of different methods in the assessment of adenoid hypertrophy.

OBJECTIVE: This study was designed for better understanding of the role of different methods of nasal endoscopy in the assessment of adenoid hypertrophy and comparing them with lateral neck radiography and patients' symptoms. SUBJECTS AND METHOD: From August 2007 until January 2009, in the otolaryngology ward of a tertiary referral center, 89 patients who had symptoms related to chronic mouth breathing participated in this study. History of the symptoms related to adenoid hypertrophy was obtained from them. In addition, all patients underwent nasal endoscopy and lateral nasopharynx x-ray. The clinician who did nasal endoscopy was blinded to information about clinical data and x-ray and vice versa. Afterward, the relationship between symptoms and each diagnostic procedure was evaluated. RESULTS: Patients had a mean age of 9.47 ± 4.68 years. In the evaluation of the relationship between symptoms grading and grading in lateral neck radiography, this relationship was significant about snoring. Furthermore, there was a significant relationship between the endoscopic size of adenoid and number of the episodes of acute otitis media. The sum of symptoms grading had a significant relationship with the size of adenoid in lateral neck x-ray, but not in nasal endoscopy. CONCLUSION: The results of the present study indicated that both radiography and nasal endoscopy could define the relationship between adenoid hypertrophy and associated symptoms and therefore are complementary. Between them, despite the popularity of nasal endoscopy, radiography can serve as a better planning tool.

Assessment of the consensus about tonsillectomy and/or adenoidectomy among pediatricians and otolaryngologists.

BACKGROUND: Several recent publications have shown that the current indications for tonsillectomy and/or adenoidectomy (T&A) in children vary considerably between and even within countries. The objective of our study is to present statistically valid information to surgeons and pediatricians, primary care physicians, and family physicians as key referral channels to the operation, whether there is consensus between pediatricians and otolaryngologists regarding the appropriateness of T&A. METHODS: Six academic pediatricians and six otolaryngologists participated in the study. After otolaryngologists visited 200 patients, the cases were referred to a pediatrician who also visited the patients independently on the same day pre-operatively. They ranked the appropriateness of T&A on a numerical Likert scale from 0 (never indicated) to 9 (always indicated) in a questionnaire. RESULTS: Overall, 200 (102 boys and 98 girls) children with a mean age of 6.1+/-5.6 were enrolled in this study. Otolaryngologists and Pediatricians had agreed about the history of tonsillitis attacks in the previous 6 months and previous year. The patients provided them with the same history. The agreement between otolaryngologists and pediatrician's views about T&A was poor. CONCLUSIONS: This study can serve as an initial warning in developing a national community-based working group to prepare a transparent local guideline regarding T&A indications. More attention should focused the role of pediatricians, primary care physicians, and family physicians for more follow up and determining which patients will eventually need T&A.

[The use of acoustic rhinometry for the assessment of adenoid hypertrophy: a clinical study]. / Rinometría acústica en la valoración de la hipertrofia adenoidea. Estudio clínico.

OBJECTIVE: In our study, we employed the method of acoustic rhinometry for preoperative and postoperative (after adenoidectomy) evaluation of 25 children between 3-12 years of age who suffered from adenoid hypertrophy. MATERIAL AND METHOD: This method showed with accuracy the changes of the dimensions of the nasal cavity following the operation. The parameters which were evaluated prior and subsequent to the operation were the diameter of the nasal cavity in the area of the adenoids and the total volume of the nasal passage. RESULTS: As shown by acoustic rhinometry, the change of the cross-sectional area of the nasopharynx was 59.43% on average. Similarly, the augmentation of the volume of the nasal cavity was 46.39 % on average. The change of the dimensions of the nasal cavity paralleled the alteration of clinical symptoms. CONCLUSIONS: In conclusion, we can assume that acoustic rhinometry can show with accuracy the dimensions of the nasal cavity, especially at the front part. It is also very useful in the assessment of the efficiency of the treatment in cases of nasal obstruction and especially of adenoid hypertrophy.

Assessment of pulmonary function and nasal flow in children with adenoid hypertrophy.

OBJECTIVE: Adenotonsillar hypertrophy is the most common cause of upper airways obstruction in children. The consequences of this disorder were analyzed by many researchers. The aim of the study was the assessment of pulmonary function and nasal flow in children with adenoid hypertrophy. METHODS: The study group covered 30 children treated surgically due to adenoid hypertrophy. Nasometric and spirometric tests were performed before and after surgery. RESULTS: The results revealed statistically significant differences between pre- and post-operative values of nasometric flows and the following spirometric parameters: VC, FVC, PEF, FEV1/PEF and FEV1/FVC. CONCLUSION: The influence of adenoid hypertrophy on pulmonary function in children has been confirmed on the basis of the conducted research.

Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy.

OBJECTIVE: To determine whether the current practice and incurred cost of histologic examination of tonsillectomy and adenoidectomy specimens is warranted. STUDY DESIGN: Review article based on medical literature. SUBJECTS AND METHODS: A retrospective PubMed review of all pertinent literature regarding tonsillectomy, adenoidectomy, and related surgical pathology was conducted. References of the articles obtained were reviewed for additional sources. RESULTS: Twenty studies report 54,901 patients and found 54 malignancies (0.087% prevalence). Of these, 48 (88% of the patients) had suspicious features such as tonsillar asymmetry, cervical lymphadenopathy, or abnormal tonsil appearance, preoperatively. The remaining six patients without any suspicious features (better representing true occult malignancy) were 0.011% of the total cases. CONCLUSION: Submission of tonsillectomy, adenoidectomy, or both specimens is warranted only when patients demonstrate findings associated with malignancy: tonsillar asymmetry, history of cancer, neck mass, tonsil firmness or lesion, weight loss, and constitutional symptoms.