Biomedical subjects
Publications and source records attributed to C Morera.
Melanomas are rare tumors that are usually lethal. Melanomas of the head and neck represent 15-20% of all malignant melanomas and mucosal melanomas 1-2%. We reviewed every case of melanoma of the head and neck diagnosed in our department in 15 years and analyzed presentation, clinical evolution, diagnosis and treatment. We emphasized early diagnosis.
We studied 40 members of 12 families with FSHD, 23 symptomatic and 17 healthy. Tonal audiometry was done at a 4-year interval. Brainstem evoked potentials were recorded. The auditory function of healthy subjects was normal. Ten patients (25%) had sensorineural deafness, all bilateral; 2 were from one family and 3 from another. The significant incidence of deafness in this series of FSHD (p < 0.05) shows that deafness is an important feature of FSHD. Deafness did not seem to be related with the intensity of muscular symptoms. The pathogenesis of the disorder is unknown, but it is thought to be related to a mechanism of neural degeneration or of immunologic abnormality (Coat's syndrome).
There are many causes of tympanic perforation but usually only one treatment, surgical. However, many patients cannot or will not undergo surgery. In such cases, treatment with sodium hyaluronidate may be satisfactory. In our group of 20 patients with 21 tympanic perforations who underwent this treatment, 15 evolved favorably. The drawbacks and patient selection are discussed.
Anorectal manometry is a non invasive, safe and useful procedure for exploring anorectal function in several disease. The anorectal studies made in our service the last five years in children, were reviewed. There were made 234 procedures in patients 21 year old or less 93.25% of the studies could be finished and 72.64% of the patients were from other hospitals or centers. The age average was 5.62 +/- 4.72 years and the main indication was constipation (78.20%). We didn't find any statistical difference in the manometrical findings of the internal anal sphincter between the patients with only constipation, only encopresis, constipation plus encopresis and normal values. The main manometrical diagnostic in the constipated patient without Hirschsprung disease was "Normal Study" even though between 30 and 55% of the studies showed "inspecific motor dysfunction". The patients with anorectal malformations had a main internal and pressure statistically lower (Z = 3.29 p = 0.03) and "Non concluyent Study" percentage higher (Z03.44 p = 0.02) than the constipated ones. The main external anal pressure was not different between groups. In 43 patients the manometrical study showed "Suggestive of Hirschsprung Disease". We recovered the histological reports in 55.88% with aganglionosis in the 91.66%. There were no statistical differences in the other manometrical parameters. Our finding agree with the ones reported in the specialized literature and support the anorectal manometry as an useful tool for exploring the anal sphincter integrity in anorectal malformations.
Pleomorphic adenomas with atypical facial presentation, specifically, in the nasal sinus region, were studied. A patient who presented with malignant tumor of the nasal sinus was diagnosed as pleomorphic adenoma after histologic misdiagnosis. The surgical technique and outcome at one year are described.