The evaluation of functional deglutition in patients after partial supraglottic laryngectomy by CO 2 laser was performed by videoflouroscopy of the swallowing act. We studied 20 patients in PA and LL projections, and the swallowing act, at 25 frames per s, was captured on videotape. Aspiration was found in six patients, four of whom had manifest clinical symptoms of aspiration. Four patients had post-deglutitive, one intra-deglutitive and one both intra-and post-deglutitive aspiration. Other swallowing disturbances or structural deformities were not detected. Dynamic radiological studies of swallowing, such as videoflouroscopy of the swallowing act, can provide valuable information regarding functional results after surgical procedures in the upper aerodigestive tract. Our encouraging results prove the validity of partial supraglottic laryngectomy by CO 2 laser as a method of treatment for carcinoma of the larynx.
Kaposi sarcoma (KS) is a locally aggressive endothelial tumor, commonly diagnosed among individuals with acquired immunodeficiency syndrome (AIDS). The most typical site of involvement by KS is the skin, but in some cases, it can also affect other tissues and organs. Most patients with gastrointestinal involvement of Kaposi's sarcoma remain asymptomatic and they are often diagnosed on endoscopy or autopsy. However, there are cases of KS mimicking ulcerative colitis (UC), whereby clinical manifestations can confuse physicians. We report a 31 y old homosexual man who presented with rectal pain and bleeding. Patient was diagnosed eight years ago with HIV/ AIDS, and despite highly active retroviral therapy, he developed extensive skin lesions. Because of expressive rectal pain and bleeding, he underwent rectoscopy, which revealed ulcerous and hemorrhagic lesions. The rectoscopic and clinical presentation mimicked acute flare of UC, which was patient initial diagnosis. Tissue samples were collected for microscopical examination. After histological, histochemical and immunhistochemical examination of the sampled tissue, KS diagnosis was confirmed. The clinical manifestations of Kaposi sarcoma can be confused with acute exacerbation of ulcerative colitis often delaying the diagnosis. Therefore, early endoscopic evaluation with adequate biopsies could help in timely diagnosis and management of gastrointestinal KS (GI-KS) in patients with HIV/AIDS, even if they do not have skin lesions.
The obtained results imply, according to the overall percentage of labeled nuclei, that high-grade dysplasia is very close to carcinoma, while there is the difference in the percentage of moderately stained nuclei. We showed that Ki-67 positivity have a different internal distribution which could be useful in analysing these lesions. These findings also, indicate the important biological differences between low-grade dysplasia and carcinoma in UC, and a low proliferative potential of the former. Automated image analysis permits an objective [corrected] estimation of Ki-67 immunohistochemical staining in UC-associated dysplasia and carcinoma.
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