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Aim To determine the prognostic value of cell cycle regulators cyclin D1 and p27 for papillary thyroid carcinomas.Methods Analysis included 180 patients with papillary thyroid carcinoma who underwent surgery at Split University Hospital Center between 1999 and 2001. Clinical data were obtained from clinical charts and histopathology reports. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue by antibody p27 and cyclin D1. Quantification was based on the intensity and distribution of nuclear staining.Results Univariate analysis showed that sex (P = 0.019) and capsular invasion (P = 0.010) were significant predictors of lymph node metastases, whereas age (P = 0.96), histopathological variant (P = 0.075), size (P = 0.556) and multifocality (P = 0.131) were not. Univariate analysis also showed that overexpression of cyclin D1 (P < 0.001) and underexpression of p27 (P < 0.001) predicted lymph node metastases in papillary thyroid carcinomas. There was a significant correlation between cyclin D1 (P = 0.024) and p27 (P = 0.029) expression in two prognostic groups of low and high risk. Low risk group was cyclin D1 negative and p27 positive, whereas high risk group was cyclin D1 positive and p27 negative. Multivariate analysis confirmed that sex (P = 0.041), capsular invasion (P = 0.027), and p27 (P < 0.001) were strong independent predictors of lymph node metastases in the high-risk group.Conclusions Immunohistochemical analysis of p27 expression may be a valuable tool for identifying risk of lymph node metastases and more aggressive behavior of papillary thyroid carcinoma.

OBJECTIVE:To measure the effect of hyperbaric oxygen (HBO) therapy as salvage therapy after the failure of steroid therapy for sudden sensorineural hearing loss (SSNHL). MATERIALS and METHODS:Ninety-three patients with SSNHL were unsuccessfully treated with systemic steroid therapy. Following steroid therapy, 43 patients received additional HBO therapy while 50 did not. Hearing levels at 0.25, 0.5, 1, 2, 4, and 8 kHz before and after therapy were measured. RESULTS:A significant difference in hearing thresholds after HBO therapy was found at all frequencies in patients with a hearing loss of >61 dB. The group of patients with a hearing threshold of ≤60 dB had a significant improvement only at 250 and 500 Hz, while group of patients without additional therapy control group showed no hearing improvement. CONCLUSION:Hyperbaric oxygen therapy therapy as salvage therapy for SSNHL showed some benefits in hearing improvement. Better results could be expected in patients with severe hearing loss, while in patients with mild-or-moderate hearing loss, recovery should be expected only at low frequencies.

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