NOSE AND SINUSES Schibler1collected from the literature reports of 89 cases of melanosarcoma of the upper air and food passages. In 38 of these cases the lesion involved the nose and the paranasal sinuses; in 3, the pharnyx; in 4, the esophagus, and in the remainder, the gingivae and the palate. The larynx, trachea or bronchi were not involved unless there was extension or metastasis from a growth which was situated elsewhere. The most common points of origin in the nose were found to be the septum and the nasal meatus. The results of treatment in these cases confirmed the well known fact that melanosarcoma of these structures is highly virulent. Houser2reported 21 cases in which there was a primary malignant neoplasm of the maxillary sinus. These patients were treated at the University of Pennsylvania Hospital. In 15 cases the tumor was treated surgically, either with
Tetrahydroliponsaure, Metabolit von Liponsaure, kann durch Chelatbildung einen Vitamin-B12-Mangel verursachen. Bei einem 45-jahrigen gesunden Probanden wurde gezeigt, dass die Serumkonzentrationen von Vitamin B12 bei langfristiger Gabe des Pharmakons in den pathologischen Bereich absinken konnen. Bei Patienten mit Polyneuropathie sollten die Vitamin-B12-Serumkonzentrationen daher vor Beginn sowie unter der Therapie mit Liponsaure in 4-6wochentlichen Abstanden kontrolliert werden. Tetrahydrolipoic acid is a metabolite of lipoic acid which may cause vitamin B12 hypovitaminosis by formation of chelates. It was demonstrated in a 45-year old healthy subject that abnormally low serum levels of vitamin B12 may result from long-term treatment with lipoic acid. Therefore serum concentrations of vitamin B12 should be measured in patients with polyneuropathy before and at four to six-week intervals after the initiation of medication with lipoic acid.
During the last twenty-two years, sixty-seven patients presenting chronic, noninflammatory, permanent enlargement of the lips and face have been observed in the Mayo Clinic. This condition has followed repeated swellings and has been associated with facial paralysis in thirteen cases. The condition comes on suddenly in a manner similar to angioneurotic edema, and then, with recurrence of attacks, increasing enlargement is a residue. The condition is apparently a clinical entity, but we have been able to find only slight mention of it in the literature. The results of treatment of the condition have been satisfactory.
LITERATURE
The acute, circumscribed swelling described by Quincke1in 1882 corresponds with the onset of the condition, but Quincke did not mention the residual enlargement. In Quincke's edema, although the swelling has a preference for certain regions, such as the eyelids, cheeks, lips and hands, it does not always recur in the same area.
