After completing this course, the reader will be able to:1. Describe phenotypic and clinical features associated with neurofibromatosis 1. Identify malignant tumors associated with neurofibromatosis 1.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTIntroduction. Neurofibromatosis 1 is a tumor predisposition genetic syndrome with autosomal dominant inheritance and virtually 100% penetrance by the age of 5 years. NF1 results from a loss-of-function mutation in the NF1 gene, resulting in decreased levels of neurofibromin in the cell. Neurofibromin is a negative regulator of various intracellular signaling pathways involved in the cellular proliferation. Although the loss of heterozygosity in the NF1 gene may predispose NF1 patients to certain malignancies, additional genetic alterations are a prerequisite for their development. The precise nature of these additional genetic alterations is not well defined, and genetic testing of all malignancies in NF1 patients becomes an essential component of future research in this subset of patients. In addition to germline NF1 mutations, alteration of the somatic NF1 gene is associated

Elderly patients in the USA account for 26–50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the “Oldest Old” is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student's t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the “Oldest Old” population.

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10a-g) have been synthesized by using Vilsmeier Haack formylation and Hantzsch reaction in high yield.All the synthesized compounds were tested qualitative (Zone of inhibition) and quantitative antimicrobial activities (MIC). Most of the synthesized compounds showed potent antimicrobial activity against gram positive and gram negative bacteria as well as fungi species.

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Styloid process is an apophysis which provides an anchorage for the stylopharyngeus, stylohyoid, styloglossus muscles, stylohyoid ligament and stylomandibular ligament [2]. It lies behind the pharyngeal wall between the internal and external carotid arteries. In close proximity is the glossopharyngeal nerve lying in the posterolateral wall of the tonsillar fossa. The facial nerve emerges from the stylomastoid foramen that is slightly posterolateral to the base of the styloid process. Medially the styloid process is related to the internal carotid artery with the sympathetic chain, internal jugular vein, accessory, hypoglossal, vagus and glossopharyngeal nerves [3,4].Eagle's syndrome or Stylalgia presents with pharyngeal pain, otalgia and irritative sensation in the throat. It is thought to be caused by an elongated styloid process or calcified stylohyoid ligament. The presence of an elongated styloid process is not usually a pathognomonic finding for Eagle's syndrome. There are previous reports showing that the abnormal angulation rather than the Anatomy SectionMorphometric Study of the Styloid Process of Temporal Bone ABSTRACT Objective: Styloid process of temporal bone is clinically important, because variations in length, as well as the angulations of styloid process are associated with the symptoms of stylalgia (Eagle's syndrome) and the surgical excision of the process could alleviate neck and cervicofacial pain in patients. This study was aimed to evaluate the length, angulation and distance between bases and tips of the styloid process. Materials and Methods:We studied 114 dry skull bones with intact styloid processes. The length of styloid process and distance between bases and tips of the styloid process were measured with the help of vernier calipers. The angulation (anterior and medial angles) of the styloid process was measured directly from the digital images by the image analysis using Adobe Photoshop 7.0 and Image Tool 3.0 Program. A styloid process longer than 3 cm was identified as an elongated styloid process.