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Background: Head and neck carcinomas (HNC) account for a majority of ear, nose and throat tumours. They account for 6.3% of all incident malignancies and 6.2 % of all deaths from cancer in Romania in 2020, the fifth most common cancer in this Eastern Europe country. Aim of the study: The aim of our study was to investigate the association between two MMP-2 and MMP-9 promoter gene polymorphisms and head and neck cancer. Methods. We enrolled 142 subjects, 65 cancer patients, and 77 control subjects and tested them for MMP-2 -735 C/T and MMP-9 -1562 C/T polymorphisms by PCR-RFLP. Results. Comparison between cancer patients and controls demonstrated the presence of MMP-2 -735 C/T and MMP-9 -1562 C/T in head and neck malignant tumours, with OR = 2.206 (95% CI 1.058-4.599, P = 0.03) for MMP-2 and OR = 2.748 (95% C.I. 1.262-5.981, P=0.009) for MMP-9 gene polymorphism. This means that the presence of T allele could be a risk factor for head and neck cancer development. The analysis included a stratification of studied groups by age and gender. Conclusions. Both genotypes were associated with a significant risk for head and neck carcinomas in case of the presence of the T allele. MMP-2 -735 C/T (rs2285053) and MMP-9 -1562 C/T (rs3918242) gene polymorphism could be an important genetic marker for head and neck cancer susceptibility. This finding could be useful for genetic screening in head and neck carcinomas.

Radioiodine (131I) therapy for differentiated thyroid cancer (DTC) involves exposure of the whole body, including the heart, to ionizing radiation. This exposure to the subsequent risk of heart disease is uncertain, especially in patients with DTC associated with type 2 diabetes mellitus (DTC/+T2DM). The current study aimed to assess the relationship between left ventricular ejection fraction (LVEF), high cumulative 131I dose, and peripheral blood parameters in patients with DTC/−T2DM and DTC/+T2DM. The study enrolled 72 female patients with DTC/−T2DM and 24 with DTC/+T2DM who received cumulative 131I doses above 150 mCi (5.55 GBq). LVEF was lower in patients with concomitant T2DM than those without (p < 0.001). The cumulative 131I dosage was inversely correlated with LVEF only in DTC/−T2DM patients (r = −0.57, p < 0.001). In the DTC/+T2DM group, LVEF was negatively associated with absolute platelet count (r = −0.67, p < 0.001) and platelet-to-lymphocyte ratio (r = −0.76, p < 0.001). Our results demonstrate that exposure to high cumulative 131I doses has different cardiovascular effects in DTC/−T2DM and DTC/+T2DM.

Publications investigating the effect of radioactive iodine (131I) therapy on the circulating peripheral blood cells in patients with differentiated thyroid cancer (DTC) are limited to blood samples collected more than 92 h after 131I. Studies conducted on blood samples collected up to 92 h are rare due to the radioactive contamination risk. This research aimed to assess the relationship between the prescribed 131I activity, human whole blood activity, and peripheral blood cells at many time points (6, 22, 46, 69, and 92 h after 131I). The study enrolled 50 female patients with DTC who received a 131I median activity of 90.54 mCi (3.35 GBq). The neutrophil-to-lymphocyte ratio (NLR) was measured as an inflammatory marker. 131I uptake in the residual thyroid tissue peaked after 46 h. Blood activity decreased in the first 46 h and increased 69 h after the 131I intake. Blood activity was associated with the absolute lymphocyte count and the NLR at 69 h (r = −0.49 and r = 0.52, p < 0.001). Our results demonstrate that the time interval between 46 and 69 h should be associated with the release of hematological inflammatory mediators, such as neutrophils and lymphocytes, to eradicate tumor cells in response to 131I therapy.

Hearing preservation cochlear implantation is an established procedure in patients with low-frequency residual hearing, especially in pediatric cochlear implantation. More delicate, thin electrode arrays can minimize damage in the inner ear and enhance the possibility for residual hearing preservation. The Cochlear® CI532 electrode has been reported as an electrode with the potential for residual hearing preservation. No similar studies pertaining to hearing preservation in pediatric patients have appeared to date. The aim of this study was to investigate whether the Cochlear® CI532 Slim Modiolar electrode allows the preservation of low-frequency residual hearing in children undergoing cochlear implantation. In this multicenter, nonrandomized, prospective clinical cohort study, medical data of 14 pediatric patients implanted with the CI532 were collected. All patients had residual low-frequency hearing (preoperative audiogram or ABR with at least one threshold better than 90 dB HL at 125, 250, 500, or 1000 Hz). Postoperative thresholds were obtained 1, 3, 6, and 12 months after cochlear implantation. Based on the HEARRING classification, 78.6% of children (11/14) had complete hearing preservation at the last follow-up visit (12 months after CI, or if not available, 6 months). A total of 21.4% (3/14) had partial hearing preservation. At the last follow-up visit, neither minimal hearing preservation nor loss of hearing was observed. Functional low-frequency hearing was preserved in 13 out of 14 patients (93%). The residual hearing preservation results in children were superior to the results previously reported in adults.

Hunter syndrome is the type II of mucopolysaccharidose. With impaired glycosaminoglycan catabolism, heparan and dermatan sulfate accumulate in lysosomes. Multiple organ dysfunction is a consequence of this effect. We present the case of a a 9 year-old boy was refered to our department for breathing difficulties, discussing the diagnosis and treatment challenges of the case.

Hairy polyps are tumors that have been described in the literature as congenital masses usually found in the nasopharynx. Clinical symptoms are a consequence of disease dimensions and anatomical positioning. Although rare, this kind of tumors can be mistaken for neurologic impairment of an infant. Histological examination is the base for classification of this malformation. Earlier management of the disease could prevent possible complications (of the airway) and allow a better long-term growth of the patient.

Branchial anomalies are a group of malformations resulting from incomplete closure of the pharyngeal pouches and clefts. They manifest as cysts, fistulae and sinus tracts located in the neck. We present the case of a 3 years-old girl admitted to the Surgery Department of our hospital for reccurent abssceses on the left side of her neck, lateral to the sternocleidomastoid muscle. Management approach should be tailored according to the dimensions of the sinus and its relationships with the carotid artery and reccurent laryngeal nerve

(1) Background: In this paper, we report on three cases of hypoacusis as part of a complex phenotype and some rare gene variants. An extensive review of literature completes the newly reported clinical and genetic information. (2) Methods: The cases range from 2- to 11-year-old boys, all with a complex clinical picture and hearing impairment. In all cases, whole exome sequencing (WES) was performed, in the first case in association with mitochondrial DNA study. (3) Results: The detected variants were: two heterozygous variants in the TWNK gene, one likely pathogenic and another of uncertain clinical significance (autosomal recessive mitochondrial DNA depletion syndrome type 7—hepatocerebral type); heterozygous variants of uncertain significance PACS2 and SYT2 genes (autosomal dominant early infantile epileptic encephalopathy) and a homozygous variant of uncertain significance in SUCLG1 gene (mitochondrial DNA depletion syndrome 9). Some of these genes have never been previously reported as associated with hearing problems. (4) Conclusions: Our cases bring new insights into some rare genetic syndromes. Although the role of TWNK gene in hearing impairment is clear and accordingly reflected in published literature as well as in the present article, for the presented gene variants, a correlation to hearing problems could not yet be established and requires more scientific data. We consider that further studies are necessary for a better understanding of the role of these variants.

Hearing preservation cochlear implantation is an established procedure in patients with low-frequency residual hearing, especially in pediatric cochlear implantation. More delicate, thin electrode arrays can minimize damage in the inner ear and enhance the possibility for residual hearing preservation. The CochlearIn this multicenter, nonrandomized, prospective clinical cohort study, medical data of 14 pediatric patients implanted with the CI532 were collected. All patients had residual low-frequency hearing (preoperative audiogram or ABR with at least one threshold better than 90 dB HL at 125, 250, 500, or 1000 Hz). Postoperative thresholds were obtained 1, 3, 6, and 12 months after cochlear implantation.Based on the HEARRING classification, 78.6% of children (11/14) had complete hearing preservation at the last follow-up visit (12 months after CI, or if not available, 6 months). A total of 21.4% (3/14) had partial hearing preservation. At the last follow-up visit, neither minimal hearing preservation nor loss of hearing was observed. Functional low-frequency hearing was preserved in 13 out of 14 patients (93%).The residual hearing preservation results in children were superior to the results previously reported in adults.

The aim of the paper was to describe the advantages and disadvantages of the surgical adhesives most useful in major cardiovascular surgery.

The AISI H21 steel used for dies in copper hot extrusion softened only after several runs. To improve production parameters a new material was necessary for the die, and, as a first choice, Inconel 718 was preferred. Prior to adopting this material for new extrusion dies an experimental program with temperature exposure cycles was performed so as to study microstructure evolution within AISI H21 and Inconel 718. The samples were studied by optic and scanning electron microscopy (SEM) and were also submitted to X-ray diffraction (XRD) and microhardness tests. The results showed carbide coalescence, which led to softening, followed by a re-precipitation in the steel, while, in Inconel 718, the precipitation (in small amounts) of delta (ä) phase was observed.Using these results and combining them with practical experience with steel, we could predict that the Inconel 718 die performance is such that at least a double quantity of copper could be extruded per die.

The authors present a case with acute coalescent mastoiditis, complicated with facial nerve paralysis and masqueradind as parapharyngeal abscess (with dysphagia, sore throat, trismus, submandibular adenitis). In multiple disease environment, diferential diagnosis can prove difficultand generate therapeutic confusions.

Objective. Presenting a rare case of middle ear cholesteatoma, possible as a result of grommet insertion. The disease occured a few months after tympanostomy tube spontaneous extrusion. The Shepard tube was used to manage suppurative recurrent otitis media persisting after adenoidectomy. Material, method. Otoscopic examination of the eardrum, mastoidectomy, cartilage graft miringoplasty. Results. The patient needed surgery for removal of cholesteatoma from the middle ear and tympanic membrane reconstruction using tragal cartilage with pericondrium. Conclusions. Cholesteatoma can occur after tympanostomy tube insertion. Its incidence is very low but it should be presented as a possible complication to the patient. Precise technique for grommet insertion could prevent the disease.

Vestibular syndrome after cochlear implantation is described in the literature. Its causes are variate but not always amenable to etiologic approach. We describe a patient wich developed cochlear electrode extrusion with persistent vestibular symptoms after a succesful insertion. Material and method. Photos from surgery and CT imaging were used to show this postoperative complication. Results. Revision surgery was necessary to reinsert and properly imobilise the electrode to the osseous walls of the mastoidectomy cavity. Symptoms disappeared completely after this procedure. Conclusions. Persistent vestibular symptoms after cochlear surgery require special and continuous monitoring. Revision surgery is indicated wherever imaging investigations suggest possible and corectable causes.

Higher-noble dental alloys (Au, Ag, and Pd) are the most desirable for dentistry applications, but they are expensive. Low-noble (Ag, Pd, Cu) dental alloys are alternatives to higher-noble ones due to their lower price. In this regard, the paper supports the price lowering of dental alloy by increasing the Cu content, i.e., a new 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn dental alloy. The increasing addition of the Cu leads to a complex structure consisting of a solid solution that engulfs compounds of micrometric and nanometric sizes. The 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn has demonstrated a much better electrochemical corrosion behavior in artificial saliva compared to the Paliag and Unique White dental alloys. The improved corrosion behavior of the new alloy is supported by the diminishing of the Cu selective diffusion into the electrolyte due to its retaining into compounds and into Ag-Pd solid solution. Also, the synergic effects of Cu, Zn, In, Sn may improve the corrosion resistance, but they have strengthened the 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn matrix. The main finding addressed in the paper consists in a new 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn dental alloy with improved corrosion resistance in artificial saliva.

TFacial nerve paralysis is one of the most feared complications of otologic surgery; the surgeon must always be prepared to recognize and solve such lesions if they occur. The authors present 2 clinical cases of intratemporal lesions of the facial nerve; in one of these we performed early neurografting of the facial nerve, in the second one we performed delayed decompression of the nerve. Facial nerve paralysis with early onset after otologic surgery needs timely exploration (via ENoG) and repair – this is always an emergency, the earlier the exploration the better the outcome; there are a variety of surgical methods for facial nerve repair, according to the type of lesion and its duration. Postoperatively the patient should be carefully monitored both clinically and by electromiography. Generally, posttraumatic facial nerve paralysis evolves better in children, compared to adult age.

Mecanismele fiziopatologice ale hipertrofiei adenoizilor şi amigdalelor rămân incomplet elucidate, dar numeroasele studii clinice au demonstrat că procesele proliferative din cadrul amigdalitelor hipertrofice obstructive comparativ cu cele din amigdalitele cu recurenţe infecţioase sunt reglate diferit, sugerând procese fiziopatogenice diferite. Studierea aspectelor imunologice ne permite desluşirea etiopatogeniei şi, implicit, abordarea prin intermediul unor căi terapeutice specifice a afecţiunilor acestor organe limfoide cu impact important atât asupra funcţiilor cardiovasculare şi neurologice, cât şi asupra comportamentului copilului.

The mechanisms responsible for adenoids and tonsils hypertrophy still remain a research debate, but lots of published papers show that the proliferative processes in obstructing pharyngeal tonsils are differently regulated versus those in recurrent infectious disease. Studying the immunology of these lymphoid organs allows a better understanding and, eventually, the finding of specific novel targets for the treatment of lymphoid hypertrophy and prevention of complications usually associated with it: cardiovascular, neurological and behavioral.

Cervical lymphadenopathy is a frequent diagnosis in children (encountered in up to 45% of healthy children), as well as a challenging matter for both parents and physician. A complex diagnostic and therapeutical algorithm should be followed step by step in the presence of a neck swelling in a child. The authors review clinical data from the literature, as well as one example of cervical suppuration from their own experience.

The work represents a comparative study of two icon oklads representing St. George killing the dragon: the first of Romanian origin according to the stamp with the silver title “12” - examples of Romanian oklads with this silver title can be found in the works of S.S. Duicu, and the second oklad with stamps that seem to be specific to Russian silverware workshops. The Romanian icon oklad depicting St. George killing the dragon has in the central-lower part two stamps - the first stamp represent the monogram of master controller or craftsman or silver master “KΠ”, and the second represents the silver title “12”. The initials of the master are written in Cyrillic letters, as well as the inscription from the upper part of the oklad “C.ΓEOPΓIE”. The investigations on the two icons oklads were achieved through XRF analysis performed with a portable X-MET 5000 Oxford analyzer (Oxford X-MET 5000 Handheld XRF Analyzer) and SEM-EDX analyzes performed on a Phillips XL-30-ESEM electron microscope using a Quanta Inspect F50, with a field emission gun (FEG) with 1.2 nm resolution and an Energy Dispersive X-ray Spectrometer (EDXS) having 133 eV resolution at MnKa. Following the analyses it was observed that the silver title 84 stamped on the Russian icon oklad does not correspond to reality.

Low life service of steel dies used in copper extrusion brought us to inspect several discarded copper hot extrusion dies in order to identify failures and failure mechanisms. The investigations performed are mainly hardness tests and microscopic investigations. The profiles extruded are circular, rectangular and hexagonal. It was observed that die design is not at fault; rather the die material is to blame for low life service of the tool. Discarded extrusion dies after copper hot extrusions were investigated. The failure of the dies was first observed by naked eye and the observations recorded. From the dies the ones with most plastic deformations and obvious signs of failure were selected. An improvement in die design could expand the service life, but our main concern is the material: a balance between toughness and hot strength is critical, yet this balance is hard to achieve. Other thermal processing of the die is still in question and investigations are currently being performed. At least an increase of tool service life could be achieved by thermal processing of the material to a state prior nanometric carbide precipitation between martensitic plates.

Tumors of the maxillary sinus pose difficult challenges in a young patient. Our paper presents a very rare case of an odontogenic myxoma extended to the maxillary sinus, in a 14-year-old girl. The clinical picture suggested a malignancy or a local infection. The surgical removal was complete and the diagnosis was confirmed by immunohistochemistry. Discussions are made from the perspective of already published cases. A review of the disease is performed. CONCLUSION. Myxoma is a benign but aggressive tumor, needing complete surgical excision for a good long-term outcome.

The failure of a tool steel die used for hot extrusion of copper has been investigated with a view to improving tool life. Hardness measurements and microstructural investigations together with finite element method have been used to map the local softening of the die material resulting in plastic deformation, thus the necessity of the die to be replaced.