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The progression of normal squamous epithelium to a malignant metastatic phenotype may depend on cellular genetic events and the failure of host mechanisms. Intermediate biomarkers are needed to more effectively identify and quantify malignant progression and develop the potential for specific treatments and prevention strategies. The nuclear matrix is the RNA-protein scaffold of the nucleus, which controls in part nuclear shape, DNA organization, and DNA function. Nuclear matrix proteins in all previously studied cell types show a common set of nuclear matrix proteins and a subset of tissue- and cell type-specific proteins. In every system studied to date, the nuclear matrix has been demonstrated to undergo quantifiable alterations in its protein composition with transformation to the malignant phenotype. The loss and gain of nuclear matrix proteins are being investigated as biomarkers for malignant transformation in breast, colon, and prostate carcinoma. We have investigated nuclear matrix protein composition in laryngeal and oral cavity primary squamous cell tumors and metastatic cervical lymph nodes. Laryngeal carcinoma demonstrated the gain of two specific nuclear matrix proteins in comparison with noncancerous squamous epithelium. Squamous cell carcinoma matrixes demonstrate greater heterogeneity than do previously studied adenocarcinoma matrixes, and yet they display specific matrix proteins that may represent important potential biomarkers.

Objective: We sought to test whether the use of the harmonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery. Design and Setting: In a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate- and mid-term pain, pain medications required, time to eating, morbidities and charges. Results: There were no differences between the groups on an intention-to-treat basis except for costs, which were higher in the harmonic scalpel group. When rescue use of electrocautery was required to control bleeding in the in the harmonic scalpel patients, more pain and longer times to taking food were noted. Conclusions: Used with discretion the harmonic scalpel is equivalent to electrocautery for tonsillectomy. Significance: The harmonic scalpel does not provide a major benefit over more conventional methods of tonsillectomy. (Otolaryngol Head Neck Surg 2002;127:333-8.)

To construct, propose, and evaluate the usefulness of a new clinical facial fracture classification scheme to accurately denote, communicate, and compare facial fractures.A retrospective, consecutive sample study with application of the proposed classification scheme to denote maxillary and zygomatic fractures with computed tomography.Metropolitan tertiary care trauma center.A total of 213 consecutive adult patients with facial fractures evaluated by means of 2-dimensional computed tomography.The classification scheme is defined according to fractures of vertical buttresses and horizontal beams. The scheme uses 3 primary descriptors of laterality and support sites to denote the clinical pattern of the fractures. This scheme was accurately applied and sufficient to describe 87 midfacial fracture patterns in this study. In addition, 118 (98%) of 120 mock fracture patterns were correctly transcribed and reproducibly communicated among 12 participating physicians.This newly proposed facial fracture classification scheme provides a convenient, specific, descriptive, and reproducible method of denoting fracture patterns. This scheme may be used to accurately communicate and compare, in greater detail than permitted using current independent classification schemes, the essential site and degree-of-severity characteristics of facial fractures critical to their surgical reduction and reconstruction. The usefulness of this classification scheme in determining optimal methods and subsequent outcomes in midfacial fracture reduction requires further investigation.