ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01250.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01251.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The cell‐cell‐adhesion molecule E‐cadherin is necessary for the maintenance of the epithelial cellular structure. We were able to show a correlation between decreasing E‐cadherin expression, de‐differentiation and increased invasiveness in a cell line model. We studied 73 squamous cell carcinomas from the upper aerodigestive tract using the immunofluorescent method to demonstrate expression of E‐cadherin. Decreased E‐cadherin expression correlated with a decreased grade of dirrerentiation and an increased lymph node metastatic rate. This confirms the significance of E‐cadherin as a marker for differentiation and invasiveness of squamous cell carcinoma of the pha

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01252.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A prospective study of outcome after treatment for glue ear was performed in a sample of 143 children aged between 1 and 11 years. The resolution or recurrence of effusion following initial surgery was analysed in relation to six potentially relevant factors. Multivariate analysis showed that resolution of effusion was statistically more frequent in ears found to have a dry tap at surgery, children with a history of atopy, those who underwent adenoidectomy and it was related to the age of the child at operation. Older children had a better prognosis. Univariate analysis suggested that girls have a significantly better outcome than boys, but this was not confirmed in multivariate analysis. The results suggest that there should be a longer period of observation in atopic individuals and older children. Furthermore, the study showed that ears with dry taps should not be treated with ventilation tubes.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01253.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This postal questionnaire of British otolaryngologists has shown that most strive to obtain true informed consent when recommending surgery. The consent form is usually signed on the ward or at a pre‐admission clinic and witnessed by a house officer. One‐third of house officers receive no instructions about what to discuss at this time, however, most consultants keep some record of what was discussed. A quarter of surgeons use information sheets, those not using them are more likely to anticipate problems with their use. An assessment of which complications are usually discussed is given. Comparison with a similar study shows increased disclosure of complications, perhaps a more defensive approach in surgical practice is develop

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01254.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Some 497 of 3085 patients with squamous cell carcinoma of the head and neck treated between 1963 and 1990 had a later radical neck dissection at some time after initial treatment. The histological slides were all reviewed, firstly to confirm the presence of squamous cell carcinoma within the neck, and secondly to ascertain whether the metastasis was to soft tissue, to a lymph node or to both. The presence of extracapsular rupture in lymph node deposits was also assessed.Of the 497 patients, 138 had soft tissue deposits only, and 359 had nodal deposits only. Of the patients with nodal deposits 165 had extracapsular rupture and 194 did not. The 5‐year survival of the 138 patients with soft tissue metastases was 27% compared with 33% for patients with extracapsular rupture and 50% for patients with no extracapsular rupture.Weighted logistic regression showed that soft tissue deposits were significantly more common in patients in poor general condition, plus poorly differentiated squamous cell carcinoma plus T4tumours (P<0.005), and in patients with poorly differentiated squamous cell carcinoma plus T4tumours (P<0.025). Cox's multivariate analysis with backward elimination showed that gender, histological differentiation, site of primary tumour and age of patient had no statistically significant effect on survival. The number of nodes (P<0.0001), the presence of extracapsular rupture (P<0.0001) and the presence of soft tissue free metastases (P<0.001) were all highly significant. The N‐status at recurrence also reached statistical significance (P<0.00

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01255.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Oestrogens have been considered to cause nasal congestion during the menstrual cycle and during pregnancy. The aim of the present study was to evaluate the degree of nasal congestion during the menstrual cycle in healthy women. Nasal peak expiratory flow (nPEF) was measured and subjective nasal stuffiness was scored morning and evening by 27 women for 3 months and by 14 women for 6 months. During the menstrual days, when the serum oestrogen level is lowest, the morning nPEFs were significantly lower compared with the rest of the cycle (P= 0.0012). The difference was most pronounced for the second day of the cycle (P= 0.00034). The correlation between nPEFs and the subjective scores was high (R= 0.98), while the coefficient of variation within the series of three nPEF recordings was low (6.4%). It is concluded that the nasal obstruction experienced during menstruation cannot be explained by increased serum levels of oestrogen.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01256.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Matutinal vertigo, characterized by vertiginous attacks occurring in the morning, has been noted in a significant percentage of patients with vestibular disorders and is considered to be precipitated by the patient's movements preparatory to arising from bed. Chronobiological studies of the variations of positional nystagmus in 10 patients with acute vertigo revealed rhythms of circadian periodicities in eight. The acrophases (i. e. computed peak hour), of nearly 40% of the circadian rhythms were found between 02.00 and 07.00 hours. Chronobiological characteristics of the vestibular system are postulated to play a part in the development of this clinical phenomenon.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01257.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A simplein vitronasal mucosal culture model has been developed to measure release of the mast cell specific enzyme tryptase in response to allergen challenge. Patients who were undergoing inferior turbinectomy were skin‐tested for commonly inhaled allergens. The mucosa from the inferior turbinates was kept viable using Minimal Essential Medium. Tryptase release into the medium was measured using the Pharmacia Riact Assay. There was a significant increase in tryptase release in response to allergen challenge from the mucosa harvested from skin‐test positive patients. Mucosa from skin‐test negative patients failed to demonstrate an increase in tryptase release. This could prove to be a useful research model for the study of nasal type I hypersensitivity and drugs that affe

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01258.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In this study the accuracy of a questionnaire filled in by 109 parents of children admitted for routine ENT surgery was compared with the well recognized verbal clerking. A major problem in communication between doctors and parents was highlighted, as just 44% of the parents were able to state the operation their children were admitted for. The study also showed that it is impossible to rely on parents to give the information required in the form of replies to questionnaires as the sensitivity of the questions designed to recognize risk factors was poor.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01259.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY