Malignant inverted papillomas: a review of seven cases and implications for treatment.

Seven cases of inverted papilloma with malignant change, of the nasal cavity and paranasal sinuses, were referred to the department of radiotherapy in Newcastle between 1979 and 1990. All patients received postoperative radiotherapy, which, in three, prevented further recurrence; in the remaining four, locally recurrent disease proved resistant to both radiotherapy and chemotherapy, ultimately becoming fatal. Only one of seven patients developed cervical lymph node metastases. Postoperative radiotherapy is of value in about 40% of patients. It is most useful when only microscopic residual disease is seen. Radiotherapy and chemotherapy, when used for bulky macroscopic disease, were of no value.

Intranasal adhesions which recur despite splinting: an ominous sign?

Intranasal adhesions are a common complication following nasal surgery. They may be prevented by the use of silastic splints, which are also a very effective treatment for established lesions. We report a patient where intranasal adhesions rapidly recurred despite the use of splints, who was found to be suffering from Wegener's granulomatosis.

Nasal tuberculosis--an increasing problem?

Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium tuberculosis: a case is presented together with a review of the literature. The correct management is documented, especially the need to treat the patients as if there was a generalized condition, and the problems concerning drug resistance are also considered. The incidence of this disease is rising and its importance must once again be highlighted.

A study of haemostasis following tonsillectomy comparing ligatures with diathermy.

The use of diathermy to achieve haemostasis after tonsillectomy remains controversial. We have reviewed the English language literature, and found no convicting evidence that diathermy is any more likely to cause post-operative haemorrhage than the use of ligatures. The results of a prospective, randomized study of 1036 consecutive tonsillectomies are presented. No significant difference was found in post-operative haemorrhage rates when either diathermy or ligatures were used. Diathermy was found to reduce operating time compared to ligatures. The possibilities for day-case tonsillectomy are discussed.

Free amino acid determination in whole peanut seeds.

A method which circumvents the lengthy procedural steps for sample preparation in the analysis of free amino acids (FAA) in the peanut is described. Sample preparation consists of extracting a full fat meal with a lithium citrate sample buffer for 15 min. The sample is centrifuged and filtered with two Millipore filters in series. The resulting extract is analyzed "as is" for FAA via a physiological amino acid procedure. The method significantly reduces sample preparation time and eliminates the use of hazardous chemicals. It is well adapted to the analysis of large numbers of samples or samples of limited quantity. It should be applicable to the analysis of FAA in other oilseeds.

Objective measurement of the results of uvulopalatopharyngoplasty.

Thirty-two patients undergoing uvulopalatopharyngoplasty (UPPP) for snoring have been studied prospectively using objective measurement of snoring levels. A significant reduction was found, especially in the supine posture. The quantitative reduction was small and correlations between subjective and objective changes in snoring volume were weak.

Comparison of methods for assessing snoring.

Objective measurements of several sound level indices were made on 32 subjects referred because of snoring and who subsequently underwent uvulopalatopharyngoplasty (UPPP). The measurements were repeated approximately 6 months post-UPPP. The indices were compared with the subjective assessment of snoring by both the subject and his/her bed partner. Correlations between objective and subjective assessments were generally weak and were strongest when the supine posture only was considered. The index which correlated best with subjective assessment was the level which 1% of the sound level samples exceeded.

Objective benefit of laser palatoplasty for non-apnoeic snoring.

Laser palatoplasty (LPP) is widely used for the treatment of non-apnoeic snoring, despite the lack of objective data supporting its use. We report measurements of snoring in a prospective study of LPP, and we compare the results with a previous study of uvulopalatopharyngoplasty (UPPP). Twenty patients with an apnoea/hypopnoea index < 20 h-1 underwent LPP for habitual snoring. Overnight sound recordings were compared before and 6 months after operation using three objective indices; L, (the level exceeded by the loudest 1% of sound), L5 (the level exceeded by the loudest 5% of sound) and P50 (% total sleep time above 50 dBA). The subjective impression of snoring severity (Wilcoxon test, P < 0.001), and objective indices L1 and P50 (t-test, P < 0.001) showed significant reductions after LPP. The mean change in L1 was 4.2 dBA, comparable to that we previously reported for UPPP, while P50 was reduced to less than one-third its preoperative value. No other sleep variables changed significantly following LPP. We conclude that LPP results in reduced snoring volume comparable to that following UPPP.

In vitro assay for predicting protein efficiency ratio as measured by rat bioassay: collaborative study.

Seven laboratories collaborated in testing the calculated protein efficiency ratio (C-PER and DC-PER). The collaborative study required each laboratory to analyze 6 foods and a control protein (ANRC casein) for in vitro apparent protein digestibility, amino acid composition, and PER via rat bioassay. The 6 foods or food ingredients tested were nonfat dry milk, cooked chicken muscle, protein-fortified dry breakfast cereal, textured soy protein, oat-based dry breakfast cereal, and durum wheat flour. Data obtained from the study were analyzed statistically for the intralaboratory variation for each method of analysis (i.e., amino acid analysis, PER, etc.). The ability of the C-PER to rapidly predict rat PER was also measured. The C-PER and DC-PER methods were adopted official first action.