The Impact of Cytokines on Health-Related Quality of Life in Adolescents with Allergic Rhinitis.

BACKGROUND: Frequent episodes of nasal symptoms are the usual clinical manifestations (CM) of allergic rhinitis (AR) and have a significant negative impact on health-related quality of life (HRQoL) in adolescents. The purpose of this cross-sectional study was to test the hypothesis that cytokines in nasal mucus may be associated with HRQoL in adolescents with AR. METHODS: European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), "The Adolescent Rhinoconjunctivitis Quality of Life Questionnaire" (AdolRQLQ) and the Total 4 Symptom Score (T4SS) scoring system were administered to 113 adolescents with AR, nonallergic rhinitis (NAR) and to healthy control subjects. Nasal secretions were sampled and tested for 13 cytokines using a multiplex flow cytometric bead assay. RESULTS: The AR group had significantly lower EQ-5D-3L (0.661 ± 0.267 vs. 0.943 ± 0.088; p < 0.001) and higher AdolRQLQ total scores (2.76 ± 1.01 vs. 1.02 ± 0.10; p < 0.001) compared to the control group. The AR group had higher concentrations of IL-1ß (p = 0.002), IL-6 (p = 0.031), IL-8 (p < 0.001), IL17-A (p = 0.013) and IL-18 (p = 0.014) compared to the control group, and IL-1ß, IL-6, IL17-A and IL-18 were significantly (p < 0.050) increased with disease progression. Cytokines IL-1ß, IL-6, as well as severe CM, were identified as significant predictors of lower HRQoL in adolescents with AR. CONCLUSIONS: This study identified IL-1ß, IL-6, as well as severe CM, as predictors of lower HRQoL in adolescents with AR. However, these results should only serve as a starting point for additional confirmation research.

Evaluation of Effectiveness of a Novel Multicomponent Mycotoxins Detoxification Agent in the Presence of AFB1 and T-2 Toxin on Broiler Chicks.

This experimental study was conducted to determine the ability of a novel mycotoxins detoxification agent (MR) at a concentration of 0.2% to reduce the toxicity of aflatoxin B1 (AFB1) or T-2 toxin, alone or in combination, and to examine its effect on performance, pathohistological changes (PH) and the residue of these toxins in the tissues of broiler chicks. A total of 96 broiler chicks were divided into eight equal groups: group C, which served as control (without any additives); group MR, which received the novel detoxification agent (supplemented with 0.2%); group E-I (0.1 mg AFB1/kg of diet); group E-II (0.1 mg AFB1/kg of diet + MR 0.2%); group E-III (0.5 mg T-2 toxin/kg of diet); group E-IV (0.5 mg T-2 toxin/kg of diet + 0.2% MR); group E-V (combination of 0.1 mg AFB1/kg, 0.5 mg T-2 toxin/kg of diet); and group E-VI (combination of 0.1 mg AFB1/kg, 0.5 mg T-2 toxin + 0.2% MR). Results indicate that feeds containing AFB1 and T-2 toxin, alone or in combination, adversely affected the health and performance of poultry. However, the addition of MR to diets containing AFB1 and T-2 toxin singly and in combination exerted a positive effect on body weight, feed intake, weight gain, feed efficiency and microscopic lesions in visceral organs. Residual concentration of AFB1 in liver samples was significantly (p < 0.05) decreased when chicks were fed diets supplemented with 0.2% of MR.

Avian tuberculosis in a free-living Eurasian griffon vulture.

Although Mycobacterium spp. often cause disease in domestic birds (chickens and companion birds), there are few data on avian tuberculosis in wild populations, especially in birds of prey. We describe here a case of a young adult female, free-living Eurasian griffon vulture (Gyps fulvus) that was found dead. Granulomas were grossly evident in the lungs at autopsy, and tuberculosis was suspected. Ziehl-Neelsen staining revealed large numbers of intracellular acid-fast-positive bacteria within granulomas. Examination on Löwenstein-Jensen medium was negative, but mycobacteria growth indicator tube medium results were positive. For the molecular detection of Mycobacterium spp., the primer set IS901F and IS901R was used. Positive results were observed on gel electrophoresis, indicating the presence of Mycobacterium avium subsp. avium DNA. Although tuberculosis is not considered to be a common cause of death in wild birds, it undoubtedly deserves special attention because vultures are generally considered to be a species resistant to a large number of pathogens. Determination of the cause of death of griffon vultures is important for future conservation measures for this sensitive wild species.

Long term complications of ventilation tube insertion in children with otitis media with effusion.

BACKGROUND/AIM: Otitis media with effusion (OME) is characterized by the prolonged presence of fluid (longer than 12 weeks) of different viscosity in the middle ear, without perforation of the eardrum or signs of acute inflammation. The conservative treatment does not always provide satisfactory recovery, so surgical treatment may be unavoidable. The aim of the study was to determine the incidence, type and frequency of complications caused by ventilation tube insertion as a part of treatment for OME in children, and specifically, to evaluate the evolution of these changes over the extended period of time. METHODS: During a 5-year period (1986-1991), 84 children with chronic bilateral OME, aged from 6 months to 12 years, were enrolled in the study and treated with ventilation tube insertion. All the patients were periodically checked every 6 months over a 3-8 year period following the intervention (otomicroscopic examination, audiometry, tympanometry), and reexamined in 2013 (22-27 years after the primary surgical intervention). RESULTS: The complications observed in this study (51%) were atrophic scarring of the tympanic membrane, myringo- and tympanosclerosis, retraction of the eardrum, persistent perforations, granulation tissue formations, development of chronic otitis and sensorineural hearing loss. CONCLUSION: The incidence of complications after ventilation tube insertion was 51% in this study. Atrophic scars and myringosclerosis were the most prominent complications. Despite high complications rate ventilation tube insertion still remains the treatment of choice in children with otitis media with effusion.

Fusarial toxins: secondary metabolites of Fusarium fungi.

Exposure to mycotoxins occurs worldwide, even though there are geographic and climatic differences in the amounts produced and occurrence of these substances.Mycotoxins are secondary chemical metabolites of different fungi. They are natural contaminants of cereals, so their presence is often inevitable. Among many genera that produce mycotoxins, Fusarium fungi are the most widespread in cereal-growing areas of the planet. Fusarium fungi produce a diversity of mycotoxin types, whose distributions are also diverse. What is produced and where it is produced is influenced primarily by environmental conditions, and crop production and storage methods. The amount of toxin produced depends on physical (viz., moisture, relative humidity, temperature, and mechanical damage), chemical (viz., carbon dioxide,oxygen, composition of substrate, insecticides and fungicides), and biological factors (viz., plant variety, stress, insects, spore load, etc.). Moisture and temperature have a major influence on mold growth rate and mycotoxin production.Among the most toxic and prevalent fusaria) toxins are the following: zearalenone,fumonisins, moniliformin and trichothecenes (T-2/HT-2 toxin, deoxynivalenol,diacetoxyscirpenol, nivalenol). Zearalenone (ZEA; ZON, F-2 toxin) isaphy to estrogenic compound, primarily a field contaminant, which exhibits estrogenic activity and has been implicated in numerous mycotoxicoses of farm animals,especially pigs. Recently, evidence suggests that ZEA has potential to stimulate the growth of human breast cancer cells. Fumonisins are also cancer-promoting metabolites,of which Fumonisin 8 I (FBI) is the most important. Moniliformin (MON) isalso highly toxic to both animals and humans. Trichothecenes are classified as gastrointestinal toxins, dermatotoxins, immunotoxins, hematotoxins, and gene toxins.T-2 and HT-2 toxin, and diacetoxyscirpenol (DAS, anguidine) are the most toxic mycotoxins among the trichothecene group. Deoxynivalenol (DON, vomitoxin) and nivalenol although less toxic are important because they frequently occur at levels high enough to cause adverse effects.The presence of mycotoxins in the animal diet can produce significant production losses. Any considerable presence of mycotoxins, in major dietary components,confirms the need to adopt a continuous prevention and control program. Such programs are usually based on several common approaches to minimize mycotoxin contamination in the food chain. Major strategies include preventing fungal growth and therefore mycotoxin formation, reducing or eliminating mycotoxins from contaminated feedstuffs, or diverting contaminated products to low risk uses. Because of the complexity of their chemical structures, mycotoxins also present a major analytical challenge. They are also found in a vast array of feed matrices. Analysis is essential for determining the extent of mycotoxin contamination, for risk analysis, confirming the diagnosis of a mycotoxicosis and for monitoring mycotoxin mitigation strategies.For the future, adequately controlling the mycotoxin problem in the livestock economy will depend on implementing appropriate agricultural management policies,as well as augmenting production and storage systems and analysis methods.Only such policies offer the opportunity to bring solid and long-lasting economical results to the livestock industry that is afflicted with the mycotoxin problem.

[Anesthetic dose correction in hospital pharmacology using bispectral index monitoring technology].

INTRODUCTION: Modern hospital pharmacology insists on assessing each patient's individual characteristics because of their influence on drug pharmacokinetics and pharmacodynamic effect. The study was aimed at evaluating anesthetic doses in patients with benign larynx tumors treated by general endotracheal anesthesia during endoscopic surgery procedures. MATERIAL AND METHODS: The study is a part of a prospective, phase IV, academic study carried out at the Clinical Center of Serbia. The evaluation included 30 patients, who were divided into two groups: Group A - 10 patients, anesthetized with standard recommended anesthetic doses. The insight into the obtained bispectral index values was possible only after completion of the surgery. Group B consisted of 20 patients, anesthetized with anesthetic doses corrected according to bispectral index monitoring values. RESULTS: The average duration of waking up in group A and B was 120.0 +/- 10.0 sec and B 70.0 +/- 9.0 sec, respectively, (p<0.01). When compared with group A the corrected induction anesthetic doses, corrected maintenance doses and anesthetic total consumption were lower in group B by 25% (p<0.01), 15% (p<0.01) and 25% (p<0.01), respectively. CONCLUSION: It is possible to overdose anesthetic drug during surgery without using bispectral index technology monitoring during general anesthesia in otorhinolaryngology maxillofacial surgery. Bispectral index monitoring should be the clinical standard in general anesthesia.

[T lymphocyte function in laryngectomized patients].

AIM: Malignant tumors of the larynx account for 2.3% of all malignancies, while their frequency among tumors of the head and neck ranges between 12% and 20%. Research on the general immune competence in patients with malignant diseases has provided useful insight in the relationship between immune disorders on one side and the clinical course on the other. Unfortunately, only few complete studies have been published so far with this regard in patients with malignant tumors of the larynx, and therefore our study was essentially aimed at establishing of general immunocompetence, presence and levels of the possible immune disorders and their association with the malignant tumors. MATERIAL AND METHOD: The study included forty two patients with primary squamocellular laryngeal cancer. All the patients underwent surgery, out of whom fifteen were treated postoperatively with radiotherapy. We tested the immune competence prior to the operation and in the postoperative period nine months later. In the venous blood we examined T lymphocyte function, monocyte levels and mononuclear phagocyte function. RESULTS: Preoperative evaluation of the presence and levels of general immune competence in patients with laryngeal cancer, showed a distinct decrease in the proliferative response to the PHA mitogen in vitro, with a tendency to normalize in patients who do not develop a relapse of the disease or distant metastasis during the follow-up period. During the whole study period, the number of monocytes and mononuclear phagocyte activity was above the normal level. CONCLUSION: The patients with operable laryngeal carcinoma had considerable immune disorders at various levels, primarily at the level of T lymphocytes. Of all the disorders, reduced mitotic activity of T lymphocytes in response to mitogens showed the highest dependance on the presence of malignant tissue in the organism.

Temporalis fascia graft perforation and retraction after tympanoplasty for chronic tubotympanic otitis and attic retraction pockets: factors associated with recurrence.

OBJECTIVES: To correlate the recurrence of temporalis fascia graft perforation and retraction in adults and children after tympanoplasty for chronic tubotympanic otitis and deep attic retraction pockets with age, pathologic process, mucosal lesions, mucociliary transport time, chronic sinusitis, and lateral attic wall reconstruction. DESIGN: Retrospective study. SETTING: Tertiary referral center. PATIENTS: Two hundred seventy-four adult ears and 41 child ears were operated on for chronic tubotympanic otitis, 50 adult ears were operated on for traumatic tympanic membrane rupture, and 56 adult ears were operated on for attic retraction pockets. INTERVENTIONS: Underlay tympanoplasty with or without mastoidectomy and lateral attic wall reconstruction for attic retraction pockets. Mucociliary transport time was investigated using saccharin testing. MAIN OUTCOME MEASURES: Recurrent perforation, recurrent attic retraction, and temporalis fascia graft retraction were evaluated. RESULTS: Higher incidences of recurrent perforation were found in adults operated on for tubotympanic otitis vs traumatic tympanic membrane rupture (P = .02) and in children (P = .004), especially those 9 years and younger (P = .02). A risk factor in adults was chronic sinusitis (risk ratio, 35.0; 95% confidence interval, 32.1-38.2; P = .004). Temporalis fascia graft retraction correlated with slower mucociliary transport time in adults (P < .001). A lower incidence of recurrent attic retraction was associated with lateral attic wall reconstruction (P < .001). CONCLUSIONS: Recurrent temporalis fascia graft perforation after tympanoplasty for tubotympanic otitis may be related to age and coexisting chronic sinusitis. Temporalis fascia graft retraction correlates with slower mucociliary transport time in the eustachian tube. Lateral attic wall reconstruction minimizes recurrent attic retraction in adults.

Oral squamous cell carcinoma detection by salivary biomarkers in a Serbian population.

Early detection of oral squamous cell cancer (OSCC) is the key to improve the low 5-year survival rate. Using proteomic and genomic technologies we have previously discovered and validated salivary OSCC markers in American patients. The question arises whether these biomarkers are discriminatory in cohorts of different ethnic background. Six transcriptome (DUSP1, IL8, IL1B, OAZ1, SAT1, and S100P) and three proteome (IL1B, IL8, and M2BP) biomarkers were tested on 18 early and 17 late stage OSCC patients and 51 healthy controls with quantitative PCR and ELISA. Four transcriptome (IL8, IL1B, SAT1, and S100P) and all proteome biomarkers were significantly elevated (p<0.05) in OSCC patients. The combination of markers yielded an AUC of 0.86, 0.85 and 0.88 for OSCC total, T1-T2, and T3-T4, respectively. The sensitivity/specificity for OSCC total was 0.89/0.78, for T1-T2 0.67/0.96, and for T3-T4 0.82/0.84. In conclusion, seven of the nine salivary biomarkers (three proteins and four mRNAs) were validated and performed strongest in late stage cancer. Patient-based salivary diagnostics is a highly promising approach for OSCC detection. This study shows that previously discovered and validated salivary OSCC biomarkers are discriminatory and reproducible in a different ethnic cohort. These findings support the feasibility to implement multi-center, multi-ethnicity clinical trials towards the pivotal validation of salivary biomarkers for OSCC detection.

Risk factors for the occurrence of undifferentiated carcinoma of nasopharyngeal type: a case-control study.

INTRODUCTION: The incidence rate of nasopharyngeal carcinoma in Serbia is less than one per 100,000 citizens, which classifies it as a region with low incidence for this disease. OBJECTIVE: The aim of this study was to test some hypotheses of the risk factors for undifferentiated carcinoma of nasopharyngeal type (UCNT) in the low incidence population. METHODS: A case-control study was used for the research. The study included 45 cases with histopathological diagnosis of UCNT and 90 controls. Cases and the controls were individually matched by sex, age (+/- 3 years), and place of residence (city-village). Data were gathered about sociodemographic characteristics, occupational exposure to harmful agents, habits, diet, personal history, and family history. In the analysis of the data, conditional univariate and multivariate logistic regression analyses were applied. RESULTS: According to the results of multivariate logistic regression analysis UCNT was significantly positively associated with "passive smoking" of tobacco in the family during childhood, frequent consumption of industrially manufactured food additives for enhancing flavour and frequent consumption of white bread. UCNT was significantly negatively associated with frequent consumption of margarine, olive oil and cornbread. CONCLUSION: In our low incidence population, an independent risk factor for the occurrence of UCNT was "passive smoking" of tobacco in the family during childhood, use of industrially manufactured food with additives for enhancing flavour and consumption of white bread. Multicentric study enrolling a greater number of cases would be desirable.

Enzymatic study of tonsil tissue alkaline and acid phosphatase in children with recurrent tonsillitis and tonsil hypertrophy.

OBJECTIVE: Indications for tonsillectomy in recurrent tonsillitis are defined according to the number of episodes of acute bacterial infections in a year. However, little is known about the tonsil immune competence status in patients presenting with recurrent tonsillitis with either hypertrophied or atrophied tonsils, or in patients presenting with obstructive sleep apnoea. In this study we examined the tonsil immune status in children with 3-5 acute recurrent infections a year and in children with obstructive sleep apnoea by comparing the activity of tonsil and adenoid tissue nonspecific alkaline and acid phosphatase. METHODS: Specific activity of tonsil and adenoid tissue nonspecific alkaline and acid phosphatase was investigated in children who underwent tonsillectomy and adenoidectomy for recurrent infection (72 children) and for obstructive sleep apnoea (10 children). Tissue enzyme activities were measured using p-nitrophenylphosphate as a substrate. Tissue samples were examined by the haematoxylin-eosin histological technique. Statistical analyses were performed using SPSS v. 16 software. RESULTS: The tissue nonspecific alkaline phosphatase activity was similar in hypertrophied tonsils in the recurrent infection group and in the obstructive sleep apnoea group (3.437+/-1.226 and 3.978+/-0.762 U/mg of protein, respectively). The enzyme activity in both hypertrophied tonsil groups was significantly higher as compared to atrophied tonsils in the recurrent tonsillitis group, p=0.021 and p=0.006, respectively. The enzyme activity was significantly higher in the adenoids compared to the tonsils from all three groups. Contrary to this, no significant differences were noticed for tonsil and adenoid acid phosphatase activities among the groups. CONCLUSION: Similar acid phosphatase activity in all three groups implies that all three groups have preserved antigen presenting cell activity. In patients with hypertrophied tonsils similar tissue nonspecific alkaline phosphatase activity suggests preserved B cell tonsil immune activity, regardless of the pathology. Patients with atrophied tonsils had significantly lower alkaline phosphatase activity, indicating relative tonsil B cell immune deficiency. Thus, different immunological status in patients presenting with hypertrophied vs. atrophied tonsils could point to a different underlying pathophysiologic mechanism of the disease.

Middle ear tuberculosis: diagnostic criteria.

INTRODUCTION: Tuberculous otitis is a diagnostic problem due to the difficulty to obtain microbiological, histomorphological and cytological confirmation of the disease. OBJECTIVE: Our objective was to compare clinical and radiological characteristic and development of otogenic complications in patients with tuberculous otitis and otitis with cholesteatoma as the most destructive form of chronic nonspecific otitis in the purpose of establishing the diagnostic criteria for tuberculous otitis. METHODS: Medical records of 12 patients with tuberculous otitis and 163 patients with cholesteatoma treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery in Belgrade during the eight-year period were analyzed. All of the patients underwent otomicroscopic, audiological and radiological examination of the thorax and temporal bone, microbiological examination of the secretion and histomorphological examination of the tissue taken during middle ear surgery. Statistical analysis was done using chi2 test with Yates correction. RESULTS: Otogenic complication as facial palsy and sensorineural hearing loss were more frequent in tuberculous otitis patients, than in cholesteatoma. Also, fistulas of the labyrinth and facial canal bone destruction were also more frequent in tuberculous otitis than in cholesteatoma. A larger extent of temporal bone destruction was noticed on CT scans of the temporal bone in half of the patents with tuberculous otitis. Coexistence with miliary pulmonary tuberculosis was detected in one third of the patients. There were no microbiological or histomorphological confirmations of the disease, except in one case with positive ZiehI-Neelsen staining. CONCLUSION: Tuberculous otitis media should be considered in patients with serious otogenic complications and with shorter duration of ear discharge, and in association with diagnosed miliary pulmonary tuberculosis and extensive temporal bone destruction. Polymerase chain reaction still is not reliable for diagnosis.

Incidence of nasopharyngeal carcinoma in Belgrade during the period 1991-2005.

BACKGROUND/AIM: Nasopharyngeal carcinoma (NPC) is a relatively rare malignant disease, of which 80,000 individuals become ill around the world annually, which amounts to 0.7% of all carcinomas. The aim of this descriptive study was to analyze NPC incidence in Belgrade (the capital city of Serbia, with about 1.6 milion inhabitants) during the period 1991-2005. METHODS: In data analysis, crude rates age and sex specific rates, and standardized incidence rates were used. Standardization was performed by a direct method, using world population as the standard. RESULTS: In Belgrade, during the observed 15-year-period, the number of new NPC patients totaled 118, of which 86 (72.9%) were male and 32 (27.1%) were female. The average standardized incidence rate for men was 0.52 per 100,000 and for women 0.16 per 100,000. In both sexes the incidence was very low before 40 years of age. In men, the greatest incidence rate of NPC was in the 50-59 years age group, and in women in those 60 and more years old. Furthermore, undifferentiated carcinoma of nasopharyngeal type was 3.6 times more often in comparison to squamous cell carcinoma. CONCLUSION: Belgrade belongs to a region with a low incidence rate of NPC. Further investigations are needed to explain higher frequency of undifferentiated carcinoma of nasopharyngeal type than squamous cell carcinoma.

Surgical treatment of the supraglottic laryngeal carcinoma.

This is a retrospective analysis of 439 patients with supraglottic laryngeal cancer primary surgically treated in the period 1976-1999. The objectives of our study were to analyze the localizations as well as local and regional tumor spread, frequency of occult and palpable cervical metastases, the incidence of local and regional recurrences, five-year survival rate and functional results of supraglottic partial horizontal laryngectomies. A retrospective analysis of operated patients was carried out. T1 tumor was prevalent in 184 (42%) patients, T2 in 228 (52%) patients, and T3 tumor in 27 (6%) of cases. Clinically negative finding of the neck was found in 369 (84%) patients, and metastasis N1 was established in 70 (16%) patients. The patients with clinically negative cervical finding underwent selective neck dissection, while N1 metastasis patients were subjected to a selective or modified radical neck dissection. Five-year disease-free survival rate was 76% (334/439).

Alteration of adenoid tissue alkaline and acid phosphatase in children with secretory otitis media.

OBJECTIVE: The role of pharyngeal lymphoid tissue in etiopathogenesis of secretory otitis is not yet defined. The influence of tonsillar and adenoid mass, weight, obstruction of naspharyngeal orrifitium, bacterial reservoire or some immunological events are of scientific interest. Tissue nonspecific alkaline phosphatase (TNAP) and acid phosphatase (ACP) are enzymes detected in lymphoid tissue, TNAP as characteristic of B cells, ACP as a characteristic of macrophages and folucullardentritic cells. These enzymes interfere in cell metabolism by removing 5' phosphate group from nucleotides and proteins. Specific activity and kinetic properties were studied in palatinal tonsils and adenoids of children with secretory otitis (OME) and compared with children with recurrent tonsillitis without ear involvement. METHOD: Adenoid and tonsillar tissue of l7 children with OME and 30 children with recurrent tonsillitis were subjected to biochemical investigation using method of releasing of p-nitrophenol from p-nitrophenylphosphate (pNPP). Kinetic parameters as Michaelis-Menten constant were calculated by non-linear regression estimation method. RESULTS: Specific activity of adenoid alkaline phosphatase was lower in children with OME in relation to children with recurrent tonsillitis (t=5.733507, p<0.01). Specific activity of adenoid acid phosphatase was also lower in children with OME (t=3.655456, p<0.01). pH optimum for both enzymes was the same in these two groups of children. Michaelis-Menten constant for both enzymes was significantly higher in adenoid of children with OME than in children with recurrent tonsillitis suggesting lower enzyme affinity for the substrate. CONCLUSION: Differences in specific activities and kinetic properties of adenoid alkaline and acid phosphatases between children with OME and children with recurrent tonsillitis without OME were verified in this study. The results of the study are not able to explain the alteration of alkaline and acid phosphatase characteristics but could point to some possible and specific role of nasopharyngeal lymphoid tissue in pathogenesis of secretary otitis.

[Possibility of the use of serological method for the determination of immunoglobuline A antibody against early antigene of Epstein-Barr virus as a marker in the diagnosis of nasopharyngeal tumors].

BACKGROUND/AIM: According to the data from immunological, biological and molecular researches, there is a close association between the undifferentiated carcinoma of nasopharyngeal type (UCNT) and Epstein-Barr virus (EBV). To use IgA EA antibody as a serological marker in our patients with nasopharyngeal carcinoma from a clinical viewpoint. METHODS: 91 patients were followed in the period from 1989-1998. In 11 of the patients the antibody titre serum for the early antigen of EBV virus were determinated before the treatement, and in 24 of the patients 3 years after the treatement. There were three control groups of patients: 20 voluntary blood donors, 26 patients with squamocellular laryngeal carcinoma, and 10 patients with squamocellular nasopharyngeal carcinoma. RESULTS: In the group of 11 patients with UCNT before the treatment, the value of anti-EA IgA titre was 31.09, and in the patients after the treatement anti-EA IgA antiody titre was 14.56. In the control groups of patients the results were: in the blood donors 5.00; in the group with the diagnosis of squamocellular laryngeal carcinoma, the titre was 5.00; in the patients with squamocellular nosopharyngeal carcinoma, the titre anti-EA IgA was 5.36. CONCLUSION: These results were statisticly highly significant (p < 0.01). Our research clearly showed that anti-EA IgA EBV marker could be useful in diagnosing, differential diagnosing and prognosing as well.

[Mucociliary transport in Eustachian tubes in chronic suppurative otitis media]. / Mukocilijarni transport u eustahijevoj tubi kod hronicnog gnojnog zapaljenja srednjeg uva.

Eustachian tube dysfunction is one of the well-known factors leading to development of chronic suppurative otitis media. Tube mucociliary transport is important for elimination of the inflammation products from the middle ear enabling recovery of the affected mucosa of the middle ear, local circulation and restoration of normal air pressure in the middle ear. The study was aimed at determining: 1. whether perforation site on the tympanic membrane influences tube mucociliary transport time in individuals with traumatic rupture of the eardrum; 2. possible time difference of tube mucociliary transport between group of patients with chronic suppurative otitis media and group of patients with traumatic rupture of the tympanic membrane; 3. possible time difference of tube mucociliary transport between chronic tubotympanic type of suppurative otitis media, so called tubotympanic otitis media and atticoantral type of chronic suppurative otitis media, the so called atticoantral otitis; 4. the association between the degree of defect of the tympanic membrane mucosa and time of tube mucociliary transport in each individual type of chronic suppurative inflammation of the middle ear. Eustachian tube mucociliary transport was studied in 16 patients with tubotympanic otitis, in 13 patients with atticoantral otitis and in 9 patients with traumatic rupture of the eardrum (control group of patients). All patients were treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia in Belgrade during 2002. Tube mucociliary transport was studied upon instillation of 10 microl 5% sterile saccharine solution through the existing eardrum perforation in the course of preoperative preparation of the patient for surgical intervention. The time interval from the moment of sterile saccharine solution application till perception of the sweet taste in the mouth and pharynx was measured in studied patients. The obtained results were analyzed using the methods of descriptive and analytical statistics (t-test for small independent samples). The mean time of tube mucociliary transport in patients with traumatic rupture of the tympanic membrane was 7.6 minutes. The mean time of tube mucociliary transport in tubotympanic otitis with normal mucosa of the tympanic cavity promontorium was 15 minutes, while mean time of tube mucociliary transport in tubotympanic otitis with polypoid changes of the promontory mucosa was 24 minutes (t = 5.218; p < 0.01). Mean time of tube mucociliary transport in atticoantral otitis with normal promontory mucosa of the tympanic cavity was 35.5 minutes, while mean time of mucociliary tube transport in atticoantral otitis with polypold changes of promontory mucosa was 48 minutes (t = 6.99; p < 0.01). In the irreversibly changed tympanic cavity mucosa, tube clearance saccharine test was negative even after one hour. The results of our study indicate the possibility that prolonged mucociliary tube transport has greater influence to development of atticoantral otitis rather than to development of tubotympanic otitis. The association between the degree of mucosal defect and time of mucocillary transport was evidenced in both types of chronic suppurative inflammation of the middle ear.

[Clinical characteristics of the tympanic membrane retraction pocket]. / Klinicke odlike retrakcionog dzepa bubne opne.

Development of the eardrum retraction pocket, as pathologic finding, depends on Eustachian tube dysfunction, onset of the middle ear infection and site of development of retraction on the eardrum. The study is aimed at: 1. Determining the incidence of eardrum retraction pocket and cholesteatoma within it, as well as at the degree of eardrum retraction; 2. Determining of association between eardrum retraction pocket and changes of the eardrum mucosa and pars tensa of the tympanic membrane; 3. Determining of onset and intensity of the bone destruction in eardrum retraction pocket; 4. Examining of Eustachian tube function based on time of mucocilliary transport according to the type of the eardrum retraction pocket. The study is based on the retrospective analysis of the results obtained from the patients treated at the Institute of Oto-Rhino-Laryngology and Maxillofacial Surgery, Clinical Centre of Serbia in Belgrade for the diagnosis of the chronic suppurative otitis who underwent otosurgical procedures during the six-year period, from 1996-2001. In our series of 540 patients subjected to otosurgical treatment, the incidence of the retraction pocket of the eardrum was 11.23%. Onset of more severe degree of eardrum retraction was most frequent in the attic. Cholesteatoma was detected in 82.2% of patients of the group with the attic-retraction pocket of the eardrum, as well as in 25% of patients of the group of tensa-sinus retraction pocket of the eardrum. Atrophic changes of the tympanic membrane pars tensa were detected in almost all tensa-sinus retraction pockets of the eardrum. Approximately one half of the attic-retraction pockets of the eardrum were accompanied by eardrum atrophy. Bone destruction of the auditory ossicles was limited to the long process of incus and superior structures of stapes. Time of the mucocilliary transport was significantly longer (p < 0.01) in attic-retraction pocket of the eardrum than in tensa-sinus retraction pocket of the eardrum, indicating significance of tube in development of attic-retraction pocket of the tympanic membrane. Reversible changes of the middle ear mucosa were evidenced in three quarters of the tensa-sinus retraction pockets of the eardrum indicating that inflammation is the major factor influencing onset of tensa-sinus retraction pocket of the eardrum.

Formant structure of the voice during the intensive acute hypoxia.

The influence of intensive acute hypoxia on the frequency-amplitude formant vocal O characteristics was investigated in this study. Examinees were exposed to the simulated altitudes of 5,500 m and 6,700 m in climabaro chamber and resolved Lotig's test in the conditions of normoxia, i.e. pronounced the three-digit numbers beginning from 900, but in reversed order. Frequency and intensity values of vocal O (F1, F2, F3 and F4), extracted from the context of the pronunciation of the word eight (osam in Serbian), were measured by spectral speech signal analysis. Changes in frequency values and the intensity of the formants were examined. The obtained results showed that there were no significant changes of the formant frequencies in hypoxia condition compared to normoxia. Though, significant changes of formant's intensities were found compared to normoxia on the cited altitudes. The rise of formants intensities was found at the altitude of 5,500 m. Hypoxia at the altitude of 6,700 m caused the significant fall of the intensities in the initial period, compared to normoxia. The prolonged hypoxia exposure caused the rise of the formant intensities compared to the altitude of 5,500 m. In may be concluded that, due to different altitudes, hypoxia causes different effects on the formants structure changes, compared to normoxia.

[Brain abscesses of otogenic origin]. / Apscesi mozga otogenog porekla.

Chronic inflammation of the middle ear is the most frequent cause of otogenic complications. Meningitis is the most frequent otogenic intracranial complication, followed by otogenic brain abscesses, while other complications are significantly less frequent. The study is aimed at presenting clinical causitry of otogenic brain abscesses consequential to chronic suppurative otitis in order to evaluate modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia diagnosed with otogenic brain abscess during a five-year period (1996-2000). A total of 9 patients (male to female ratio 8:1), aged 16-68 years, were assessed. The following parameters were analyzed: sex, age groups, place of living, occupation, number of hospitalizations, diagnostic procedures, symptoms and clinical signs of otogenic complications, other otogenic complications associated with brain abscess, endocranial localization of otogenic abscess, therapeutic procedures (oto-surgical treatment) and intraoperative otological findings. In our group of patients, otogenic brain abscesses were significantly more frequent in male patients in their forties, with median age of 33.5 years. As for the place of living, the patients from the provinces were more frequent, while with respect to their level of education, those with elementary or high school degrees were predominant. The inflammatory process most frequently spread into the endocranium through direct destruction of the bone walls of the middle ear. Diagnostic procedures included history, clinical otorhinolaryngological examination, audiological and vestibulological assessment, neurological ophthalmologic and radiographic examinations (CT, MRI). CT is the most reliable diagnostic tool enabling localization of the change, timing of surgical treatment and monitoring of surgical success. Presence of other otogenic complications associated with brain abscess was evidenced in six of our patients. Cerebral localization of abscess was more frequent (7). Four patients underwent previous oto-surgical treatment. The treatment included primary neurosurgical approach (radical extirpation or abscess drainage), followed by radical oto-surgical treatment after improvement of the patient's general condition.